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NASA NTRSDate not supplied

NASA's Identified Risk of Adverse Outcomes due to Inadequate Human Systems Integration Architecture

The NASA Human System Risk Board (HSRB) is responsible for tracking the evolution of the top ~30 human system risks identified to be associated with human spaceflight. As part of this process, the Board is charged with maintaining a consistent, integrated process to evaluate those risks and developing evidence-based risk posture recommendations. Risks are ranked by likelihood and consequence. Intermediate causal relationships between risk contributing factors and countermeasures that link hazards to outcomes are described using Directed Acyclic Graphs (DAGs). The DAGs are also useful for identifying common factors and countermeasures across the top 30 risks as well as communicating how astronaut exposure to spaceflight hazards leads to meaningful mission-level health and performance outcomes. One of the top risks tracked by the HSRB is The Risk of Adverse Outcomes Due to Inadequate Human-Systems Integration Architecture (HSIA). This risk captures the possibility that due to decreasing real-time ground support during missions beyond LEO, crew will be unable to adequately respond to unanticipated critical malfunctions or detect safety-critical procedural errors. The HSIA risk is ranked red (high) for Lunar surface and Mars missions due to the probability of Loss of Crew and Loss of Mission consequences. This paper describes the evidence that supports the HSIA risk ranking and presents the central narrative of the HSIA risk DAG-- i.e., anomaly detection, diagnosis, intervention, and task performance. Characterizations of the current state of practice for each of the DAG’s central nodes and the future tools needed for successful anomaly response are provided.

human-systems integration architecture↗

NASA NTRSDate not supplied

NASA’s Identified Risks of Adverse Outcomes Due to Inadequate Human Systems Integration Architecture in Human Spaceflight

The NASA Human System Risk Board (HSRB) has the overall responsibility for tracking the evolution of the top ~30 human system risks that it has identified to be associated with human spaceflight. As part of this process, the Board is charged with maintaining a consistent, integrated process to mitigate those risks, and developing evidence-based risk posture recommendations. One of the identified risks is due to inadequate human systems integration architecture (HSIA) and a driving factor of this risk is that given decreasing real-time ground support for execution of complex operations during future exploration missions, there is a possibility of adverse performance outcomes including that crew are unable to adequately respond to unanticipated critical malfunctions or detect safety critical procedural errors. The HSRB uses Directed Acyclic Graphs (DAGs) as a communication tool for describing how astronaut exposure to spaceflight hazards leads to meaningful mission-level health and performance outcomes and as the basis for understanding intermediate causal relationships between risk contributing factors and countermeasures that link hazards to outcomes. The HSIA risk DAG will be presented and described. Historically, critical malfunctions requiring Crew/MCC management occurred at a rate of 1.7 times per year for ISS averaged over the lifetime and 3-4 times per year in the burn in phase for the vehicle. These averages do not include EVA data, which greatly increases the incident rate. Prior experience from the Apollo program showed 10/11 crewed missions experienced significant anomalies where crew relied heavily on MCC expertise in real-time. These failure patterns are in line with those observed in other complex engineered systems (e.g., oil rigs, launch systems, commercial aviation, etc.) It is likely that general malfunction and error rates are > 10% for short duration missions (<30 days), based on past and current spaceflight operations data. Likelihood of adverse outcomes has the potential to increase as crew conduct work with new, complex systems and with less ground support. For Low Earth Orbit missions and Lunar missions less than 30 days, assuming minimal comm delays, disruptions and bandwidth limitations, malfunctions and errors can affect mission objectives and crew health but may be mitigated by ground support. For Lunar missions greater than 30 days and any potential Mars mission malfunctions and errors can have Loss of Crew and Loss of Mission consequences due to reduced ground support (communication delays, constraints and blackouts) for more complex operations, as well as reduced resupply and evacuation options.

Daniel M Buckland↗

NASA NTRSDate not supplied

IMPACT-ing Exploration Spaceflight Risk Prediction and Medical System Design

Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 120 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. IMPACT provides evidence-based, mission-specific PRA estimates of in-flight medical risk and an initial list of clinical capabilities and medical resources/hardware to be considered. In addition, sophisticated trade space capabilities estimate how human system risk varies with changes to the mission architecture or medical capability set (e.g., if the system mass constraint decreases by 10% or ultrasound is removed). This panel will provide an overview of IMPACT, its intended use cases, and future development plans. The panel will be the first public presentation of IMPACT results, including medical risk estimates for extended duration Artemis missions, the medical conditions most influencing medical risk metrics, and the clinical capabilities that have the largest effect on medical risk.

Ben Easter↗

NASA NTRSDate not supplied

Strategy for Risk Quantification of Spaceflight Crew Health and Performance Using Dynamic Probabilistic Risk Assessment

At NASA, the Crew Health and Performance (CHP) system represents the span of countermeasures, capabilities, interventions, and tested processes and procedures that in combination work to mitigate the human component of spaceflight mission risk. Across the varying NASA mental models of the CHP system, the different functionalities needed to meet human flight systems standards can be broken down into specific categories (i.e. medical capability, environmental health, behavioral health). These categories can be further broken down into specific subgroups generally associated with the CHP functionalities meant to mitigate or buy down individual human system risks. Taking a similar development approach we seek to leverage dynamic probabilistic risk assessment as a means to quantify and relatively assess the human risk state within the crew health and performance domain. By utilizing existing tools as integrators, we propose a rapid development strategy for incorporating research and operational data that represent the influence of the CHP system functionalities, in order to provide order of magnitudes estimates of the influence on most human system risks outcomes. The model system utilizes a modest cumulative risk approach and that limits the scope to primary paths of influence between the CHP functionalities and human system risks, thus enabling quick prototypes of the integrative effects of CHP functional combinations to solicit valuable feedback from stakeholders and customers on the data, relationship, and structure of the integration.

Drayton Munster↗

NASA NTRS2022

Directed Acyclic Graph Guidance Documentation

For over a decade, the National Aeronautics and Space Administration (NASA) has tracked and configuration-managed approximately 30 risks to astronaut health and performance that occur before, during and after spaceflight. The Human System Risk Board (HSRB), a Health and Medical Technical Authority (HMTA) Board at NASA Johnson Space Center, is the entity responsible for identifying, assessing, analyzing, and monitoring the official understanding of the risk or risk posture for each of the Human System Risks and determining – based on evaluation of the available evidence – when that risk posture changes. The ultimate purpose of tracking and researching these risks is to find ways to reduce the risk that astronaut crews face during spaceflight. Historically, research, development and operations relevant to one risk have been conducted in isolation from other risks; these individual risk ‘silos’ enabled initial characterization of each specific risk. In spaceflight however, the impact of exposure to risk for astronaut crews is cumulative, and not independent of exposures or other risks, as all the adverse effects of the spaceflight environment begin at launch, continue throughout the duration of the mission and in some cases across the lifetime of the crews. In January of 2020, the HSRB at NASA embarked on a pilot project designed to assess the potential value of causal diagramming as a tool to facilitate understanding these cumulative and interdependent effects as applied within Human System Risk management. This process uses directed acyclic graphs as a means of formalizing a shared mental model of the causal flow of risk among Risk Board stakeholders. Initially this model was to improve communication among those stakeholders, but the potential value exceeds communication alone. Formalization of the process for creating these causal diagrams will enable the creation of a composite risk network that is vetted by members of the NASA community and configuration managed. The causal diagrams are formulated as directed acyclic graphs (DAGs) to function as a type of knowledge graph for reference for the board and its stakeholders. This document outlines the pilot process, the standardized approaches, and guidance for risk custodian teams when creating and updating DAGs as a part of the NASA Human System Risk Management process.

Risk↗

NASA NTRSDate not supplied

Incorporation of Human Risk Directed Acyclic Graphs (DAG) With Mishap Investigations to Un-Silo Knowledge

NASA’s Human System Risk Board (HSRB) has been a central driver in efforts to understand, mitigate, and communicate the 29 human systems risks monitored by the board. As a result of the collaboration between research, operations, and technical authorities, large bodies of knowledge have been collected and digested to represent the current understanding of the risks. As a part of these bodies of knowledge, directed acyclic graphs (DAGs) have been developed to communicate the current understanding of the causal relationship of the hazards, contributing factors, countermeasures, other risks, and outcomes that contribute to the overall risk. This risk knowledge is applied in a theoretical sense for potential incidents during exploration even while informed by surveillance data. However, there have been mishaps and close calls during past space exploration that intersect with one or more of the Human System Risks DAGs and knowledge bases. The purpose of this exercise was to un-silo this risk knowledge and connect it to the close call of EVA 23 through the development of a DAG representing the intersection of the HSRB Risks and the events of the close call. The development of the DAG occurred through an iterative process, with each iteration expanding and/or refining the nodes and connections described by the source materials. In addition to the risk documentation developed by the HSRB, lessons learned and other mishap investigation documents were utilized to understand the events that led to water entering the helmet of a crewmember on the EVA. New nodes specific to the events of EVA 23 were interconnected with existing HSRB DAG nodes and edges. Nodes within the DAG were defined within a “DAG-tionary” with any updates to a definition that may have previously existed from the HSRB DAGs, and edges were recorded in a matrix. Both the DAG-tionary and matrix describe where nodes and edges are present across the Risk and Mishap DAG. This DAG will then be reviewed by experts outside of HSRB and HRP to confirm that interpretations of the non-health related events (such as the engineering nodes) are represented accurately. DISCUSSION This process highlighted a method by which the knowledge generated among the contributing members of the HSRB Risks can be effectively adapted and utilized through the tools employed by the Risk Custodian teams. By leveraging these tools, new context and insights to the information at hand can be brought forward to address current spaceflight challenges. Moreover, un-siloing this knowledge through future DAGs and other efforts can drive interprofessional collaboration and foster communication. This will enable teams to work together more effectively, leveraging their diverse expertise to tackle the complex challenges of space exploration and human research. Ultimately, this collaboration will bring NASA closer to achieve agency goals and contribute to the overall shared mission and vision.

Samuel Jacobs↗

NASA NTRSDate not supplied

Machine Learning for the Validation of Expert-Elicited Causal Risk Diagrams

Exposure to spaceflight poses risk to human health in complex ways. To help manage this risk, the Human Systems Risk Board (HSRB) at the National Aeronautics and Space Administration (NASA) maintains a set of causal diagrams that attempt to explain how spaceflight hazards generate health risks and lead to adverse outcomes both in-mission, immediately post-mission, and over the long term. These causal risk diagrams are formulated as directed acyclic graphs (DAGs) and can function as knowledge graphs of connected risks and outcomes. These DAGs have proven useful for communication, and, through network analysis, have allowed for the identification of structurally important factors in the risk network. However, the utility these DAGs provide is directly proportional to their verisimilitude, making assessment of this trait using empirical data – whether from actual human spaceflight or various spaceflight analogue exposures and model organisms – a high priority. In this research we explore the use of machine learning algorithms to learn DAG structure from empirical data as a means of evaluating human-elicited DAG structures. To do so, we test several different graph structure-learning algorithms on data concerning changes in the bones of rats and mice after exposure to either spaceflight or a spaceflight analogue. We explore potential methods for indexing the similarity between each algorithm’s output DAG with all the others and with that of the expert-elicited DAG. We discuss next steps in this ongoing line of research and open science initiatives underway to complete them.

directed acyclic graphs↗

NASA NTRSDate not supplied

Development of A Crew Health and Performance System Probabilistic Risk Assessment Tool: Proof-of-Concept Approach

The crew health and performance (CHP) system represents the span of technological interventions and tested processes and procedures that in combination address the human risk to space flight. The Human Research Program (HRP) mental model of the CHP system breaks the capabilities needed to meet NASA human flight systems standards into specific categories (i.e., countermeasures, behavioral health, medical intervention). These categories are further broken down into specific sub-groups generally associated with the human system risks that these capabilities seek to mitigate. Like the approach used to develop the Integrated Medical Model (IMM) and the Medical Extensible Dynamic Probabilistic Risk Analysis Tool (MEDPRAT), HRP tasked NASA GRC’s Cross-Cutting Computational Modeling Project with developing a CHP probabilistic risk assessment tool, the CHP-PRA. The CHP-PRA model seeks to quantify and relatively assess the human risk state within the crew health and performance domain, using a combination of knowledge about human system risks and technology and practices likely to be applied during space flight missions. This modeling system will incorporate customer and stakeholder feedback and be flexible enough to address multiple different questions about important low-level mission-specific parameters. This presentation will introduce the initial concept and development timeline for this tool and demonstrate proof-of-concept through an application addressing a specific human risk question posed within the Artemis program.

Risk analysis↗

NASA NTRS2010

Harnessing the Risk-Related Data Supply Chain: An Information Architecture Approach to Enriching Human System Research and Operations Knowledge

NASA's Human Research Program (HRP) and Space Life Sciences Directorate (SLSD), not unlike many NASA organizations today, struggle with the inherent inefficiencies caused by dependencies on heterogeneous data systems and silos of data and information spread across decentralized discipline domains. The capture of operational and research-based data/information (both in-flight and ground-based) in disparate IT systems impedes the extent to which that data/information can be efficiently and securely shared, analyzed, and enriched into knowledge that directly and more rapidly supports HRP's research-focused human system risk mitigation efforts and SLSD s operationally oriented risk management efforts. As a result, an integrated effort is underway to more fully understand and document how specific sets of risk-related data/information are generated and used and in what IT systems that data/information currently resides. By mapping the risk-related data flow from raw data to useable information and knowledge (think of it as the data supply chain), HRP and SLSD are building an information architecture plan to leverage their existing, shared IT infrastructure. In addition, it is important to create a centralized structured tool to represent risks including attributes such as likelihood, consequence, contributing factors, and the evidence supporting the information in all these fields. Representing the risks in this way enables reasoning about the risks, e.g. revisiting a risk assessment when a mitigation strategy is unavailable, updating a risk assessment when new information becomes available, etc. Such a system also provides a concise way to communicate the risks both within the organization as well as with collaborators. Understanding and, hence, harnessing the human system risk-related data supply chain enhances both organizations' abilities to securely collect, integrate, and share data assets that improve human system research and operations.

Buquo, Lynn↗

NASA NTRS2023

Identifying and Closing Medical Capability Gaps for Human Spaceflight Missions Beyond Low Earth Orbit

BACKGROUND: Features of human space missions beyond low Earth orbit such as increasing distance from Earth, lack of real-time communication, and limited or no evacuation or resupply capability are expected to drive an increase in medical risk and require crews to operate in an increasingly autonomous fashion. A diverse set of stakeholders at NASA are seeking to fund the development of concepts of operations, medical requirements, and medical capabilities for such missions. However, a systematic approach to identification of current medical capability gaps and a strategic framework to gap closure is needed. OVERVIEW: The Exploration Medical Integrated Product Team (XMIPT) has developed a list of nine high-level medical capability gaps and associated activities required for gap closure. The list was derived based on inputs from subject matter experts at NASA including flight surgeons, other clinical providers, as well as operational and research communities regarding medical capabilities required to support human missions to the Moon and the Mars surface. Responses were reviewed and distilled to identify common themes across capabilities. To ensure alignment with established human system risks, the gap list was further refined based on inputs from NASA’s Human System Risk Board. Relevant medical gap closure activities outside of those funded by the XMIPT were identified through solicitation of inputs from Elements of NASA’s Human Research Program (particularly Exploration Medical Capability), the broader medical operations community, and other stakeholders. This medical capability gap list is reviewed and updated regularly as new information becomes available or new stakeholders are identified. DISCUSSION: The medical capability gap list has matured to include a large group of NASA stakeholders and development activities. This has enabled articulation of priorities to funding entities and programmatic stakeholders, while serving as an accessible resource summarizing gap closure activities, relevant programmatic infusion points, and opportunities for collaboration between stakeholders. This presentation will provide an overview of the nine NASA medical capability gaps and their associated gap closure activities.

Moriah Thompson↗

NASA NTRSDate not supplied

Long-Term Health Risk Quantification

Astronauts face hazards during spaceflight, including space radiation exposure, isolation and confinement, traveling far distances from Earth, reduced gravity levels, and closed and hostile environments. These hazards drive the definition of human health and performance risks associated with spaceflight. NASA’s Human System Risk Board maintains the human spaceflight risk posture for in-mission risks, as well as post-flight, Long-Term Health (LTH)risks potentially occurring later in the astronaut’s life. LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. Possible LTH risk outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH risk outcomes can also include a reduction in life expectancy due to spaceflight exposures. There have been 144 medical conditions identified by NASA’s Lifetime Surveillance of Astronaut Health team to be associated with LTH risk. Epidemiological studies have been performed for some of these conditions to determine if astronauts suffer from an increased prevalence or severity of the condition due to their spaceflight experience compared to a comparable cohort .Differences in astronaut mortality or morbidity due to spaceflight experience were not detected in several of these studies. There were two cases where a modest increase in the incidence rate of astronaut LTH outcomes was detected. The first suggested an increase in the incidence of melanoma cases in astronauts, where the number of cases in astronauts were similar to the elevated number of cases observed in airplane pilots. The second provided some evidence of elevated numbers of cardiovascular disease events in astronauts compared to an appropriate healthy comparator cohort, which may warrant additional investigation. The lack of detection of LTH risk outcomes should not ease concerns about astronaut LTH. The studies highlighted here constitute only a small portion of the potential LTH conditions that could occur. Once epidemiological studies are performed on all conditions, significant findings may be detected. The analysis of astronaut LTH also suffers from limited numbers of data points because of the limited numbers of astronauts overall and the even fewer who have reached an age where LTH outcomes may begin to manifest. As shuttle and ISS astronauts begin to age and increase the feasibility of analysis, LTH outcomes may be detected. An application of risk quantification is the use of risk metrics within trade studies for resource prioritization and decision making. Trade studies regarding countermeasures to LTH risk outcomes would benefit from a quantification of LTH risk. NASA has ground-based processes in place such as astronaut screening and access to continuous medical monitoring and care during and after their astronaut career which are the main methods for mitigating LTH risk. In-mission countermeasures, such as acceptable levels of medical care and available countermeasures to counter spaceflight related physiological decrements, can mitigate a poor health and performance status immediately post-flight. Identifying appropriate risk metrics, obtaining valid quantities for them, and tying them to LTH countermeasures are necessary steps for realizing their use in trade studies. This presentation will highlight the challenges associated with the identification, quantification, and utilization of LTH risk metrics

Beth Lewandowski↗

NASA NTRSDate not supplied

CHP-PRA Proof-of-Concept [Simulation] Sensitivity Assessment

An effort is underway to establish a Crew Health and Performance system (CHP) tradespace tool using a Probabilistic Risk Assessment (PRA) modeling and simulation system. The goal of the CHP-PRA effort is to provide a means of quantifying the integrated influence of CHP functions and capabilities on risk outcome metrics associated with health, performance, and long-term health. These metrics can then be used to establish potential risk-based trades on CHP system designed functionality and capabilities. Previously, our team demonstrated a proof-of-concept PRA approach that estimated the integrated influence of exercise countermeasures on 8 human system risks (Figure 1a) with outcomes associated with health and medical risk metrics. We reported that the change in the integrated relative health risk was small (Figure 1b) and that the small change in overall risk resulted from compounding and competing contribution levels of the individual risks. This interesting observation illustrates the emergent complexity of even straightforward representations of the human health and performance risk space and the ability of PRA models to capture this balance of global risk concerns. A key question that is not addressed in the initial analysis is “even though the global risk is relatively nominal, do any of the local risks become unacceptable?” In essence, we seek to determine what relative change in the human system risks are contributing to the relatively muted sensitivity of the proof-of-concept model combined risk assessments. Evaluations at the component risk level should elucidate if any individual risk reaches a high level that is subsequentially balanced by reductions in other areas. To further understand the relative changes in the component risks in the proof-of-concept model, and to elucidate how future refinements can be targeted, a means of establishing the contributions of the robustness of the proof-of-concept approach will be demonstrated.

astronaut health↗

NASA NTRSDate not supplied

Brace For Impact – It’s Coming, Do You Know What to Do With It?

Long-duration human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for providing in-mission medical care. Compared with the International Space Station, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to define and quantitatively estimate human system risk attributable to medical conditions. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and medical trade space analysis tool being developed by NASA to advance medical system design for exploration missions. IMPACT has made a number of enhancements on the Integrated Medical Model, the PRA tool currently used by NASA. These updates include a novel medical evidence base baselined to a long duration, deep space exploration environment; an expanded medical condition list; and a trade space analysis capability (e.g. comparing risk profiles and mass/volume constraints for medical capabilities and resources). IMPACT core functionality includes quantification of a medical capability set and assisting with identification of specific medical resources/hardware for exploration missions. In addition, IMPACT provides sophisticated trade space capabilities to estimate how human system risk varies with changes to the mission architecture or medical capability set. This presentation will provide a brief overview of the IMPACT tool, discuss representative use cases, and show example results.

Benjamin Easter↗

NASA NTRS2014

Managing Research in a Risk World

The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.

Anton, W.↗

NASA NTRS2016

Capability for Integrated Systems Risk-Reduction Analysis

NASA's Human Research Program (HRP) is working to increase the likelihoods of human health and performance success during long-duration missions, and subsequent crew long-term health. To achieve these goals, there is a need to develop an integrated understanding of how the complex human physiological-socio-technical mission system behaves in spaceflight. This understanding will allow HRP to provide cross-disciplinary spaceflight countermeasures while minimizing resources such as mass, power, and volume. This understanding will also allow development of tools to assess the state of and enhance the resilience of individual crewmembers, teams, and the integrated mission system. We will discuss a set of risk-reduction questions that has been identified to guide the systems approach necessary to meet these needs. In addition, a framework of factors influencing human health and performance in space, called the Contributing Factor Map (CFM), is being applied as the backbone for incorporating information addressing these questions from sources throughout HRP. Using the common language of the CFM, information from sources such as the Human System Risk Board summaries, Integrated Research Plan, and HRP-funded publications has been combined and visualized in ways that allow insight into cross-disciplinary interconnections in a systematic, standardized fashion. We will show examples of these visualizations. We will also discuss applications of the resulting analysis capability that can inform science portfolio decisions, such as areas in which cross-disciplinary solicitations or countermeasure development will potentially be fruitful.

Mindock, J.↗

NASA NTRS2010

Risk as a Driver for Innovation

The Space Life Sciences directorate (SLSD) and Human Research Program (HRP) at NASA Johnson Space Center has implemented a system for managing human systems risks. These risks are defined as the health and performance risks posed to crew during and after spaceflight. Identification and evaluation of these risks has led to the identification of gaps in knowledge about the risks as well as gaps in technology needed to mitigate them. Traditional routes of closing technology gaps have, in some cases, proven to be too slow when a solution was required quickly. Therefore, certain gaps were used to drive the development of "challenges" for the scientific community. Partnering with open innovation service providers such as InnoCentive and Yet2.com, SLSD and HRP have decreased the amount of time from identification of a need to the evaluation of a solution. Although not all proposed solutions will result in a risk mitigation strategy or tool, the process has allowed faster evaluation of proposed solutions providing the researcher the ability to move to another possible solution if the first does not sufficiently address the problem. Moreover, this process engages the community outside of NASA and broadens the population from which to draw solutions. In the traditional grant funding structure, only those in the specific field will apply for the grant. However, using open innovation, solutions can come from individuals in many different fields. This can expand the general view of a field (way of thinking within a field) and the application of solutions form new fields while providing a pathway for the acquisition of novel solutions or refinements of current mitigations. Identification of the human systems risks has helped drive the development and evaluation of innovative solutions as well as engaging a broader scientific audience in working with NASA.

Davis, Jeff↗

NASA NTRS2023

Risk of Impaired Performance Due to Reduced Muscle Mass, Strength &, Endurance (Short Title: Muscle) and Risk of Reduced Physical Performance Capabilities Due to Reduced Aerobic Capacity (Short Title: Aerobic)

This report reviews the scientific literature regarding the human system risks to the microgravity environment of space flight in relation to human performance. The primary human performance-related risks involve deconditioning of the cardiovascular and skeletal muscles systems due to prolonged exposure to the reduced gravitational input. The chronological history of U.S. space flight is reviewed as a starting point to inform and understand the gaps in the knowledge to these risks. Maintenance of physical performance capabilities involves understanding the health of many organ systems (peripheral [vascular, heart, blood volume, skeletal muscle] and central [brain]) that ultimately contribute to the submaximal and maximal capacity of the aerobic (VO2peak), skeletal muscle (strength and endurance) systems. Maintaining astronaut VO2peak, muscle mass, strength, and endurance before, during, and after space flight is a significant priority to NASA for the current International Space Station (ISS) era, as well as for future exploration missions. A growing research database from both space flight and ground-based analog studies finds that the cardiorespiratory system is compromised and skeletal muscles (predominantly postural muscles of the lower limbs) undergo atrophy. These structural and metabolic responses to living in microgravity conditions contribute to physiological deconditioning during space flight that potentially increase the risks to astronauts returning to surface operations (i.e., Moon, Mars, or Earth). The time course changes from short to long-duration space flight and the relationships between in-flight performance deconditioning levels are not well characterized. Moreover, there are large interindividual variabilities that may be dependent on genetics, age, sex, preflight fitness levels, and individual exercise prescriptions that need further careful evaluations. Efforts should be made to understand the current status of preflight, in-flight, and postflight exercise performance capability and to define the operational goals and target areas for protection with the in-flight exercise program. There is a bi-directional relationship between exercise prescription and hardware countermeasures that need further understanding in-flight. For example, hardware with limited capabilities/modalities may be counterbalanced by changes in exercise prescription (i.e., frequency, time, intensity, volume) for providing effective responses to maintain fitness. Importantly, the minimal requirements for exercise prescription on ISS hardware may not translate to lower capability hardware on exploration missions. Due to limited volume on exploration vehicles, future Artemis missions to the Lunar surface will not have similar exercise hardware capabilities as ISS. This may alter the effectiveness of hardware to provide adequate physiological stress on bodily systems allowing for adaptations to maintain aerobic capacity, strength, and bone density. Thus, it will be important to understand the exercise responses of current ISS countermeasures to develop individualized exercise prescriptions that minimize aerobic and muscular risks, accounting for the large variability of responses among crewmembers. Newer exploration exercise hardware is currently being evaluated that is more compact (i.e., E4D and Orion Flywheel) and will require careful evaluation of the hardware on the stressor (i.e., metabolic rate, oxygen uptake, and heart rate work relationships, and force plate load profiles) needed the human body to protect and maintain crew health and performance. Moreover, exercise responses on the hardware need careful evaluation on the chronic adaptations. Lastly, in-flight evaluation of hardware exercise response may differ in 0-g or partial-g compared to 1-g. Therefore, it cannot be assumed that the stress on the body will be the same in each environment. Understanding this has a direct impact on exercise prescriptions. This document provides an overview of key scientific investigations that have been conducted before, during, and after human space flight missions, as well as from human ground-based analog studies that contribute to the evidence base on changes in aerobic capacity and muscle mass, strength, and endurance. Additional data from rodent and nonhuman primate experiments of skeletal muscle unloading completed during space flight or ground-based flight-simulations provide supportive information about this risk topic. Most importantly, a recent, large dataset from long-duration ISS crew has been added to give improved insight into the variability of exercise response of crew, demonstrating that a large portion of the crew population return to Earth with greater than 10-20% loss of aerobic capacity and muscle strength and endurance. Data from human space flight and ground-based studies are narrowing in on the required exercise paradigms but thus far still provide an incomplete answer to an effective approach for maintaining skeletal muscle function and aerobic fitness of all human space travelers. Finally, the relationship of this risk topic to various space flight operational scenarios is examined and discussed.

Eric Rivas↗

NASA NTRS2023

Human Systems Integration: Managing Risk in Anesthesia

The practice of anesthesia relies on clinicians’ ability to safely manage increasingly complex equipment. Devices such as ventilators, drug infusion pumps, and physiologic monitors use sophisticated algorithms to deliver care, but most clinicians are only trained to manage automated systems during normal operation. Few if any receive training on how to manage system failures. Although manufacturers are required to consult with human factors engineers as part of the equipment design process, most pieces of equipment are ultimately brought to market without extensive input from clinicians. Systems in the operating room can be as simple as an oxygen tank, or as complex as a multi-institutional healthcare organization. Humans are also a complex system, and play a critical role in the domains of operations, design, fabrication, maintenance, repair, and ultimately, dismantling and closeout. HSI seeks to provide a means for advocating the human side of the system. Human Systems Integration (HSI) is the cross disciplinary process used as part of the Systems Engineering process to reduce risk in systems. HSI professionals consider the human, hardware, and software elements of system design to optimize system performance and improve safety. HSI professionals work in domains of study that include training, management, human factors engineering, safety, and occupational health, among others. This article discusses the role of systems in the practice of anesthesia, and how consideration of the human during all phases of the system life cycle helps manage risks and promote a better patient outcome.

Human Factors↗