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A Pilot Project for Quantifying the Effect of Medical Provider Knowledge, Skills, and Abilities on Outcomes for Spaceflight Using a Probabilistic Risk Assessment Tool

In order to enable the future of long-duration deep space exploration we must confront the uncertainty in medical risk. Limitations of communication, resupply, and evacuation in deep space will require a high degree of crew autonomy and accurate risk assessment will be critical to ensure adequate crew training and medical system design. To address this, NASA’s Human Research Program Exploration Medical Capability Element has developed the Informing Mission Planning via Analysis of Complex Tradespaces Tool (IMPACT). IMPACT is a suite of tools that can provide evidence-based, data-driven trade space assessments between available medical resources in the mass- and volume-constrained environment of a deep space exploration vehicle. In the current model, medical conditions either can or cannot be treated based on the availability of medical system resources and equipment. However, medical outcomes often depend just as much on the knowledge, skills, and abilities (KSA) of the provider operating the system. This paper presents a method for modeling and quantifying the effect of medical officer KSA on medically relevant mission risk outcomes during spaceflight.

capabilities

Assessing Long-Term Health (LTH) Outcomes in Astronauts

NASA has linked potential Long-Term Health (LTH) risks of astronauts to their spaceflight experience, including the effects of space radiation, microgravity, and stressors such as isolation, sleep deprivation, and stress. Therefore, assessing the LTH outcomes for astronauts exposed to these hazards becomes a critical investigation in ensuring any deleterious effects are minimal. Prior research conducted into LTH outcomes of astronauts has not revealed increases in non-accidental mortality rates when compared to the U.S. general population, analog healthy cohorts, and professional athletes. One study did report an increased incidence of non-fatal cardiovascular disease events (Hazard Ratio=2.41, 95% Confidence Interval 1.26 to 4.63). Additional evidence indicates that astronauts may have increases in incidences of melanoma, prostate, and hematologic cancers, though the former is consistent with rates observed among aircraft pilots and the latter two are likely caused by detection bias due to increased screening on former astronauts.

long term health

NASA’s Student Airborne Science Activation for Minority Serving Institutions: Inaugural Program, Educational Outcomes, and Lessons Learned

The NASA Student Airborne Science Activation (SaSa) for Minority Serving Institutions (MSIs) held its inaugural summer research program for early career undergraduates interested in the Geosciences. SaSa is a NASA Science Activation funded 8-week summer internship program. Twenty-four first- and second-year undergraduates from MSIs across the U.S. participated in the summer program - June 6 to July 29, 2022. Students had the opportunity to gain hands-on research experience in all components of an airborne science campaign including flying on-board a NASA research aircraft to collect atmospheric measurements. Students conducted independent research projects related to the atmosphere, ocean, and geosciences that feed into NASA’s broader Earth Science Division’s and Decadal Survey goals using air quality, meteorological, and oceanic measurements from surface, airborne, and satellite-based observations. The program split its time between partner institution, University of Maryland Baltimore County and NASA’s Wallops Flight Facility in Wallops Island, Virginia. Students also made site visits at partner institutions, including: Hampton University, University of Maryland Eastern Shore, Morgan State University, Howard University, and Coppin State University and attended lectures from visiting faculty and NASA Subject Matter Experts. Students were guided on their research projects by near-peer graduate mentors, SaSa program leadership, co-Is at partner institutions, and NASA scientists to address two major research themes: 1) how human-caused air pollution has human and environmental implications, and 2) how large-scale meteorological factors influence local weather conditions. Students sorted into research groups, based on sub-discipline areas in the Geosciences, including: “Clouds, Aerosols and Radiation”, “Meteorology and Planetary Boundary Layer”, “Air Quality: Particle Pollution and Trace Gases”, and “Air-Water-Land Interface”. Their research was presented as 3-minute lightning talks and in-person poster presentations at a close-out event at NASA Goddard Space Flight Center in Greenbelt, Maryland. The students’ inter- and trans-disciplinary research experiences centered in the use of multiple ground, airborne, and satellite remote sensing NASA Earth Science Division assets. Providing a unique experience aligned to recognize the societal benefits that NASA contributes in the areas of resource management, air quality monitoring and policy decisions, energy and weather predictions, and research on the Earth’s climate. The SaSa program aims to increase the number of students from MSIs that identify as underrepresented or underserved individuals in the Geosciences discipline, Earth System Science graduate programs, and the NASA workforce. A summary of the summer research program, educational, scientific, and programmatic outcomes, as well as lessons learned will be presented.

NASA

Cognitive aging outcomes are related to both tau pathology and maintenance of cingulate cortex structure

Abstract INTRODUCTION Successful cognitive aging is related to both maintaining brain structure and avoiding Alzheimer's disease (AD) pathology, but how these factors interplay is unclear. METHODS A total of 109 cognitively normal older adults (70+ years old) underwent amyloid beta (Aβ) and tau positron emission tomography (PET) imaging, structural magnetic resonance imaging (MRI), and cognitive testing. Cognitive aging was quantified using the cognitive age gap (CAG), subtracting chronological age from predicted cognitive age. RESULTS Lower CAG (younger cognitive age) was related to slower decline in episodic memory, multi‐domain cognition, and atrophy of the midcingulate cortex (MCC). Lower entorhinal cortical tau was linked to slower decline in episodic memory, multi‐domain cognition, and hippocampal atrophy. DISCUSSION These results suggest that aging outcomes may be influenced by two independent pathways: one associated with tau accumulation, affecting primarily memory and hippocampal atrophy, and another involving tau‐independent structural preservation of the MCC, benefiting multi‐domain cognition over time. Highlights Younger cognitive age (lower cognitive age gap [CAG]) is related to slower cognitive decline. Lower CAG is linked to slower midcingulate cortex (MCC) atrophy. Reduced tau in the entorhinal cortex is related to less hippocampal atrophy and cognitive decline. Structural preservation of the MCC benefits multi‐domain cognition over time. Two independent pathways influence cognitive aging: tau accumulation and MCC preservation.

Neurosciences & Neurology

A Million Person Study Innovation: Evaluating Cognitive Impairment and other Morbidity Outcomes from Chronic Radiation Exposure Through Linkages with the Centers for Medicaid and Medicare Services Assessment and Claims Data

Here, the study of One Million U.S. Radiation Workers and Veterans, the Million Person Study (MPS), examines the health consequences, both cancer and non-cancer, of exposure to ionizing radiation received gradually over time. Recently the MPS has focused on mortality patterns from neurological and behavioral conditions, e.g., Parkinson's disease, Alzheimer's disease, dementia, and motor neuron disease such as amyotrophic lateral sclerosis. A fuller picture of radiation-related late effects comes from studying both mortality and the occurrence (incidence) of conditions not leading to death. Accordingly, the MPS is identifying neurocognitive diagnoses from fee-for-service insurance claims from the Centers for Medicare and Medicaid Services (CMS), among Medicare beneficiaries beginning in 1999 (the earliest date claims data are available). Linkages to date have identified ∼540,000 workers with available health information. Such linkages provide individual information on important co-factor and confounding variables such as smoking, alcohol consumption, blood pressure, obesity, diabetes and many other health and demographic characteristics. The total person-level set of time-dependent variables, outcomes, organ-specific dose measures, co-factors, and demographics will be massive and much too large to be evaluated with standard software. Thus, development of specialized open-source software designed for large datasets (Colossus) is nearly complete. The wealth of information available from CMS claims data, coupled with individual dose reconstructions, will thus greatly enhance the quality and precision of health evaluations for this new field of low-dose radiation and neurocognitive effects.

Dauer, Lawrence T.

Anatomy of a Turtle Confiscation: What to Expect When You're Not Expecting and Recommendations for Improving Outcomes

Turtles are being subjected to unprecedented collection for the illegal wildlife trade, but only a portion of the trade is detected. When confiscations do happen, wildlife agencies must decide what to do with those animals—euthanize them, place them in permanent captivity, or release them back into the wild. Here, we present a case study of a confiscation of .200 eastern box turtles (Terrapene carolina carolina) and our efforts to repatriate them back to the wild. Twentyfive percent of turtles died in captivity, and at least another 33% died during the soft-release phase. Approximately half of the confiscated turtles survived until they were released from their soft-release pen 9 months post-confiscation. For each phase, from the time turtles were seized until released, we describe our objectives, the challenges we encountered, and our recommendations for improving future turtle confiscations. Given the extended stressful conditions that confiscated turtles often experience before being seized, it is important to recalibrate our expectations regarding future confiscation outcomes.

60 APPLIED LIFE SCIENCES

Mapping the Outcomes of Stellar Evolution in the Disks of Active Galactic Nuclei

The disks of active galactic nuclei (AGNs) are expected to be populated by numerous stars, either formed in the outer regions of the disk via gravitational instability or captured from the nearby nuclear star cluster. Regardless of their formation mechanism, these stars experience altered evolutionary paths, mostly shaped by the accretion of dense disk material. In this study, through the comparison of different timescales, we chart the evolutionary outcomes of these AGN stars as a function of disk radius and across a range of supermassive black hole masses, spanning from 10 6 to 10 9 M ⊙ , for two popular AGN disk models. We find that in the outer regions of the disk, stars evolve similarly to those in the interstellar medium, but in the inner and denser regions, accretion quickly turns low-mass stars into massive stars, and their fate depends on just how quickly they accrete. If accretion occurs at a faster rate than nuclear burning, they can reach a quasi-steady "immortal" state. If stars accrete faster than they can thermally adjust, runaway accretion occurs, potentially preventing a quasi-steady state and altering the disk structure. During the AGN lifetime, in the regions of the disk that produce massive stars, supernovae (SNe) and gamma-ray bursts (GRBs) may occur within the disk over a wide range of optical depths and ambient densities. Subsequently, in the final phase of the AGN, as the disk becomes depleted, formerly immortal stars will be unable to replenish their fuel, leading to additional SNe and GRBs.

79 ASTRONOMY AND ASTROPHYSICS

Evaluating SWAT + model uncertainties for human and natural outcomes: Application in a Great Lakes agricultural watershed

Nutrient exports from agricultural lands in the Great Lakes Region pose significant threats to water quality and ecological health through eutrophication, hypoxia, and harmful algal blooms. Climate change and agricultural adaptation practices complicate future nutrient loading due to intensified hydrologic cycles and land use decisions. Our research focuses on evaluating the Soil and Water Assessment Tool (SWAT) plus model parametric uncertainties for human and natural outcomes across different scales. These factors are integral to ensuring a balance between productive agricultural practices and maintaining the health of watershed hydrology. However, uncertainties in modeling such complex interactions pose significant challenges, limiting our ability to precisely determine critical factors that influence crop yield and soil moisture. Our analysis employs Sobol global sensitivity analysis to evaluate first-order, second order, and total-order indices for SWAT crop growth parameter, ensuring comprehensive assessment of individual and interactive effects on model outputs. The objective is to identify the parameters that significantly affect model outputs for crop yield and soil moisture and improve our understanding of their interactions at the basin and hydrological response unit (HRU) scale. Our case study, the Portage River Watershed, which drains into Lake Erie, is chosen to better capture finer scale interactions crucial for predicting nutrient loading under future climate scenarios. This foundational work is aimed at setting the stage for the future development of an agent-based model (ABM). The ABM model would incorporate SWAT outputs to dynamically simulate decision-making processes.

Bunyon, Enock

The effects of outcome and process feedback

A study was conducted to examine the effects of process and outcome feedback on performance during a skill acquisition phase and a transfer test phase. The research also examined the role of two moderators: self-efficacy and intrinsic motivation. Subjects were college students participating for course credit. The task involved using a computerized simulation of the Space Shuttle's Remote Manipulation System (RMS). Results provided evidence of the beneficial effects of process feedback during skill acquisition. Results also provided evidence that self-efficacy and intrinsic motivation moderate the effects of feedback type on performance.

Johnson, Debra Steele

Hydrocode predictions of collisional outcomes: Effects of target size

Traditionally, laboratory impact experiments, designed to simulate asteroid collisions, attempted to establish a predictive capability for collisional outcomes given a particular set of initial conditions. Unfortunately, laboratory experiments are restricted to using targets considerably smaller than the modelled objects. It is therefore necessary to develop some methodology for extrapolating the extensive experimental results to the size regime of interest. Results are reported obtained through the use of two dimensional hydrocode based on 2-D SALE and modified to include strength effects and the fragmentation equations. The hydrocode was tested by comparing its predictions for post-impact fragment size distributions to those observed in laboratory impact experiments.

Ryan, Eileen V.

Effects of 2.0-g 1.75-g and 1.5-g Hypergravity on Pregnancy Outcome in Rats (Rattus norvegicus)

In 1995, ten pregnant female rats were launched on the Space Shuttle (STS-70) on Gestational day(G) 11 of their 22-day pregnancy as part of the NASA/NIH.Rodent (R)2 Experiment. Following landing on G20, fetuses were harvested from half of the dams, while the remaining five dams underwent birth. Spaceflight did not interrupt pregnancy, alter litter sizes, or affect body weights or gender ratios of the fetuses or neonates. In the present study we used the NASA/NIH.R2 experimental paradigm to analyze the effects of hypergravity on pregnancy outcome. On G10, time-bred Sprague-Dawley rat dams were assigned to either G20 or Birth conditions, then further assigned to Hypergravity (HG) 2.0-g, HG 1.75-g, HG 1.5-g, Rotational Control (RC, 1.03), or Stationary Control (SC, 1.0-g) treatments. Dams were exposed to continuous centrifugation from G11 through G20, with brief daily stops for animal health checks and maintenance. For both the G20 and Birth dams, comparable litter sizes and litter gender ratios were observed across gravity conditions. However, centrifugation-exposed (HG and RC) fetuses and neonates showed significantly lower body masses (p less than 0.05) relative to SC offspring. HG 2.0-g offspring weighed significantly less than those in all other gravity conditions (p less than 0.05). The observed reductions in offspring body mass at 1.5-g and 1.75-g, can be attributed to the rotational component of centrifugation, rather than to increased gravitational load, whereas 2.0-g hypergravity exposure further exacerbated the gravity centrifugation effect on offspring body mass. Pregnant dams exposed to centrifugation weighed significantly less than SC dams (p less than 0.05), suggesting that centrifugation effects on maternal body mass may contribute to reduced size of the developing offspring. These findings are consistent with previous reports of non-pregnant adult animals suggesting that, whereas spaceflight has virtually no effect on body mass, centrifugation is associated with changes in body weight regulation.

Mills, Nicole A.

Swift Multi-wavelength Observing Campaigns: Strategies and Outcomes

The Swift gamma-ray burst explorer has been operating since December 2004 as both a gamma-ray burst (GRB) monitor and telescope and a multi-wavelength observatory, covering the energy range from V band and near UV to hard X rays above 150 keV. It is designed to rapidly repoint to observe newly discovered GRBs, and this maneuverability, combined with an easily changed observing program, allows Swift to also be an effective multiwavelength observatory for non-GRB targets, both as targets of opportunity and pre-planned multi-wavelength observing campaigns. Blazars are particularly attractive targets for coordinated campaigns with TeV experiments since many blazars are bright in both the hard X-ray and TeV energy ranges. Successful coordinated campaigns have included observations of 3C454.3 during its 2005 outburst. The latest Swift funding cycles allow for non- GRB related observations to be proposed. The Burst Alert Telescope on Swift also serves as a hard X-ray monitor with a public web page that includes light curves for over 400 X-ray sources and is used to alert the astronomical community about increased activity from both known and newly discovered sources. This presentation mill include Swift capabilities, strategies and policies for coordinated multi-wavelength observations as well as discussion of the potential outcomes of such campaigns.

Krimm, Hans A.

Characterizing the Joint Effect of Diverse Test-Statistic Correlation Structures and Effect Size on False Discovery Rates in a Multiple-Comparison Study of Many Outcome Measures

In their 2009 Annals of Statistics paper, Gavrilov, Benjamini, and Sarkar report the results of a simulation assessing the robustness of their adaptive step-down procedure (GBS) for controlling the false discovery rate (FDR) when normally distributed test statistics are serially correlated. In this study we extend the investigation to the case of multiple comparisons involving correlated non-central t-statistics, in particular when several treatments or time periods are being compared to a control in a repeated-measures design with many dependent outcome measures. In addition, we consider several dependence structures other than serial correlation and illustrate how the FDR depends on the interaction between effect size and the type of correlation structure as indexed by Foerstner s distance metric from an identity. The relationship between the correlation matrix R of the original dependent variables and R~, the correlation matrix of associated t-statistics is also studied. In general R~ depends not only on R, but also on sample size and the signed effect sizes for the multiple comparisons.

Feiveson, Alan H.

Flight-Deck Strategies and Outcomes When Flying Schedule-Matching Descents

Recent studies at NASA Ames Research Center have investigated the development and use of ground-based (air traffic controller) tools to manage and schedule air traffic in future terminal airspace. An exploratory study was undertaken to investigate the impacts that such tools (and concepts) could have on the flight-deck. Ten Boeing 747-400 crews flew eight optimized profile descents in the Los Angeles terminal airspace, while receiving scripted current day and futuristic speed clearances, to ascertain their ability to fly schedulematching descents without prior training. Although the study was exploratory in nature, four variables were manipulated: route constraints, winds, speed changes, and clearance phraseology. Despite flying the same scenarios with the same events and timing, there were significant differences in the time it took crews to fly the approaches. This variation is the product of a number of factors but highlights potential difficulties for scheduling tools that would have to accommodate this amount of natural variation in descent times. The focus of this paper is the examination of the crews' aircraft management strategies and outcomes. This includes potentially problematic human-automation interaction issues that may negatively impact arrival times, speed and altitude constraint compliance, and energy management efficiency.

Flight Management System

Clinical Outcome Metrics for Optimization of Robust Training

The objective of this research is to develop and use clinical outcome metrics and training tools to quantify the differences in performance of a physician vs non‐physician crew medical officer (CMO) analogues during simulations.

Ebert, Doug

Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk.

Evans-Flynn, Erin