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NASA NTRS2004

Space Biology and Medicine: Health, Performance, and Safety of Space Crews - Volume 4

Volume IV is devoted to examining the medical and associated organizational measures used to maintain the health of space crews and to support their performance before, during, and after space flight. These measures, collectively known as the medical flight support system, are important contributors to the safety and success of space flight. The contributions of space hardware and the spacecraft environment to flight safety and mission success are covered in previous volumes of the Space Biology and Medicine series. In Volume IV, we address means of improving the reliability of people who are required to function in the unfamiliar environment of space flight as well as the importance of those who support the crew. Please note that the extensive collaboration between Russian and American teams for this volume of work resulted in a timeframe of publication longer than originally anticipated. Therefore, new research or insights may have emerged since the authors composed their chapters and references. This volume includes a list of authors' names and addresses should readers seek specifics on new information. At least three groups of factors act to perturb human physiological homeostasis during space flight. All have significant influence on health, psychological, and emotional status, tolerance, and work capacity. The first and most important of these factors is weightlessness, the most specific and radical change in the ambient environment; it causes a variety of functional and structural changes in human physiology. The second group of factors precludes the constraints associated with living in the sealed, confined environment of spacecraft. Although these factors are not unique to space flight, the limitations they entail in terms of an uncomfortable environment can diminish the well-being and performance of crewmembers in space. The third group of factors includes the occupational and social factors associated with the difficult, critical nature of the crewmembers' work: the risks involved in space flight, changes in circadian rhythms, and intragroup interactions. The physical and emotional stress and fatigue that develop under these conditions also can disturb human health and performance. In addition to these factors, the risk also exists that crewmembers will develop various illnesses during flight. The risk of illness is no less during space flight than on Earth, and may actually be greater for some classes of diseases.

Dietlein, Lawrence F.↗

NASA NTRS2017

Wearable Biosensor Monitor to Support Autonomous Crew Health and Readiness to Perform

For future human exploration missions, NASA needs a health monitoring system composed of hardware that is compact, fully interoperable with an integrated data management system, and requires minimal consumables. Such a system will be achieved through the integration of small, easy to use biomedical sensors that will have the ability to measure, store and transmit physiological parameters during operational and ambulatory activity. Since 2012, the Canadian Space Agency (CSA) has been active in funding the development of wearable biomonitoring sensors. The Astroskin is the first prototype and consists of a shirt-based garment and headband with embedded sensors, and associated software and technology that measure vital signs, sleep quality and activity level of the wearer. NASA and CSA have been collaborating since 2014 to test and validate this system in a lab environment at Ames Research Center and more recently in the Human Exploration Research Analog (HERA) located at Johnson Spaceflight Center. Specific objectives of the HERA study were: 1) to assess the performance of the Astroskin biosensor system for long-term health monitoring (24-hours) capabilities and during exercise as a measure of crew fitness; 2) to obtain crew feedback on comfort and usability of the Astroskin system; 3) to demonstrate performance of Bluetooth communication during real-time transmission and for verification of data in this environment; and 4) to obtain baseline data for further development of algorithms and tools that facilitate decision support for diagnosing and monitoring of a sick or injured crewmember. HERA Campaign 3 included four missions (each 30-days in duration) with four crewmembers assigned to each mission. A total of 9 men and 7 women participated in the Astroskin evaluation that included continuous physiological monitoring (24-hours) on mission days MD-11, MD1 (high workload), MD15 (low workload), MD19, MD29, and MD+7. Mission days 19 and 29 also included 30 minutes of sub-maximal exercise on a cycle ergometer. Following each 24-hour monitoring session crew physiological data were downloaded to laptops and each crewmember completed a 28 question survey on their experiences with the Astroskin hardware and software. This presentation will focus on lessons learned from the HERA missions. Specifically it will address Astroskin system performance in terms of data loss and data quality (no comparison to lab standard devices), wireless communication with the onboard mobile device, crew usability and comfort, and future development of a next generation biomonitoring system.

crew fitness↗

NASA NTRS2022

Evidence Report: Risk of Injury and Compromised Performance due to EVA Operations

During future missions to the Moon and Mars, each crewmember will most likely perform up to 24 hours a week of extravehicular activity (EVA) in support of exploration, science, construction, and maintenance tasks. Achieving mission objectives will require EVA systems and operations concepts that maximize human performance and efficiency while minimizing health and safety risks for crewmembers. Currently, over 450 EVAs have been performed in microgravity using the Extravehicular Mobility Unit (EMU). The EMU space suit has enabled the successful assembly and maintenance of the International Space Station (ISS) for over 20 years, as well as deployment of payload experiments, solar arrays, satellite launches and repairs. This EVA work was accomplished at a slower cadence than is expected for Moon and Mars, with ISS crewmembers performing no more than 7 EVAs during a single mission and without any back-to-back EVAs. Despite their success, ISS EVAs have resulted in more injury to EVA crewmembers than may be acceptable for long-duration exploration missions. The Apollo astronauts completed EVA tasks in suits that were designed for their short-duration lunar missions, although suit mobility problems were evident. The more frequent EVAs and more varied EVA tasks that are anticipated during the future longer-duration exploration missions will require EVA suits and systems that are better oriented to human health and performance than those used during the Apollo Program. Many of the problems that were encountered with the Apollo EVA suits (e.g., limited mobility and dexterity, high and aft center of gravity, and other features requiring significant crew compensation) will need to be corrected or mitigated to optimize EVA objectives of exploration missions. It is critical that we understand how EVA system design variables such as suit pressure, weight/mass, center-of-gravity location, joint ranges of motion, and biomedical monitoring, affects the ability of astronauts to perform safe, efficient, and effective EVAs. To achieve this understanding, EVA researchers will need to develop and execute an integrated human testing program across multiple environments. The research will provide objective data that will enable informed design decisions and crewmember standards, thereby ensuring EVA systems that optimize crewmember health, safety, efficiency, and performance. This report describes the risks to crew health, safety, performance, and efficiency caused by EVA operations, and it provides the evidence base to substantiate the importance of the risk.

EVA↗

NASA NTRSDate not supplied

Evaluation of Aerobic Standards for Lunar Surface Extravehicular Activities

Introduction: As NASA prepares to return to the Moon, astronauts will need to be physically primed to successfully execute Extravehicular Activities (EVA) on the Lunar surface. Compared to past Apollo missions, Artemis missions will include EVAs of increased physical demand, frequency, intensity, and duration, thus requiring adequate fitness to successfully and safely complete mission objectives. The physical demand associated with partial gravity (g) EVAs on the Moon is expected to be greater compared to microgravity EVAs based on initial workload estimation. Currently, aerobic fitness standards for partial g EVAs are not well supported by high-fidelity data and require further research for establishing standards to protect crew health and performance during Lunar surface missions. Therefore, the aim of this investigation is to characterize metabolic data from Lunar analog simulations and in-flight crew population aerobic capacity data to validate the current NASA 3001 standard for celestial partial g aerobic fitness (aerobic capacity (VO_2pk) ≥36.5ml/kg/min). Methods: In order to evaluate aerobic fitness requirements for Lunar EVAs, the following were performed: 1) preliminary analysis of long-duration (6 hr) EVA analog simulations in the Neutral Buoyancy Laboratory (NBL) and the Active Response Gravity Offload System (ARGOS) to evaluate expected metabolic rates for 1/6 g EVAs (NBL: n=1 female; ARGOS: n=1 male) and 2) assessment of the current NASA 3001 celestial surface EVA aerobic standard (aerobic capacity (VO_2pk) ≥36.5ml/kg/min) with data from an ISS astronaut population (n=30 male + 13 female) captured before and during space flight (flight day 15). Preliminary Results: Average fractional aerobic capacity during simulated EVAs were 33%±7% VO_2pk and 23.3±7% VO_2pk in the NBL and ARGOS, respectively. This was within a previously predicted 30–40% sustainable work rate. Average metabolic rates for some tasks performed in the NBL, such as traverse (40.4% VO_2pk) and ingress (47.1% VO_2pk) were higher than the predicted sustainable work range. In ARGOS, the tasks with the greatest metabolic rates were object relocation (34.2% VO_2pk) and incapacitated crew rescue (27.0% VO_2pk). Characterization of ISS crewmember aerobic capacity determined that the average preflight VO_2pk was 42.1±5.4 ml/kg/min for females and 37.5±5.4 ml/kg/min for males. At preflight, 21.5% of crewmembers were below the 36.5 ml/kg/min in-mission aerobic standard for celestial surface EVA as outlined in NASA-STD-3001. In-flight, both female and male crewmembers experienced reductions in VO_2pk (11.7% and 10.9%, respectively), such that, during the mission, 62% of crewmembers were below the standard aerobic capacity level for celestial surface EVAs. Conclusions: Our preliminary data suggest that while average metabolic rates for simulated Lunar EVA fall within the 30–40% sustainable work range, task specific metabolic rates exceed this range and may indicate that greater fitness is necessary for more strenuous tasks expected to be performed on the Lunar surface. Additionally, deconditioning due to space flight results in most crewmembers falling below the current celestial partial g EVA standard, which may increase risk to crew health and performance and completing mission objectives for surface missions. Further research is necessary in Artemis-specific analog environments to validate the current NASA-3001 aerobic standard for celestial EVAs. Additionally, work is ongoing to validate the current NASA-3001 strength standard for celestial EVAs.

N.C. Strock↗

NASA NTRSDate not supplied

Performance Risk Model Validation with Operationally Relevant Tasks

Human Research Program aims to develop methods to support astronauts’ health and productivity during spaceflight. The Crew Health and Performance Probabilistic Risk Assessment (CHP-PRA) team uses powerful computational methods to predict mission risk in both domains: medical and performance. Here, we show how CHP-PRA uses the Performance Risk Model (PRisM) to quantify the performance risk and show an application of the model on operationally relevant tasks. There are various metrics adopted across performance researchers that PRisM can accommodate. For data analysis, interpretation, and integration, we use a method of unifying data from multiple sources by converting each to a single metric. We consult subject matter experts prior to integrating the converted data into PRisM. The method we use is inspired by the Cooper-Harper rating scale [1]. Using this unified metric, we can easily combine data from various tests and lab groups. We explain our conversion method in detail and show how it pertains to the process of testing and validation of PRisM on operational tasks. We conducted an initial validation in collaboration with the Behavioral Health and Performance (BHP) lab. We test PRisM using data on their operationally relevant task ROBoT-r, a track-and-capture task for grappling incoming resupply vehicles [2]. Several other labs at NASA Johnson Space Center worked together to design 7 Functional Task Tests (FTTs) in pursuit of simulating the tasks required after landing on a planetary surface and after return to Earth [3]. Here we use the results from both ROBoT-r and the 7 FTTs and compare their experiment data to PRisM’s computational output to demonstrate how PRisM can support operations by predicting crew performance on future missions.

performance modeling↗

NASA NTRS2012

Human Research Program: 2012 Fiscal Year Annual Report

Crew health and performance are critical to successful human exploration beyond low Earth orbit. Risks to health and performance include physiologic effects from radiation, hypogravity, and planetary environments, as well as unique challenges in medical treatment, human factors, and support of behavioral health. The scientists and engineers of the Human Research Program (HRP) investigate and reduce the greatest risks to human health and performance, and provide essential countermeasures and technologies for human space exploration. In its seventh year of operation, the HRP continued to refine its management architecture of evidence, risks, gaps, tasks, and deliverables. Experiments continued on the International Space Station (ISS), on the ground in analog environments that have features similar to those of spaceflight, and in laboratory environments. Data from these experiments furthered the understanding of how the space environment affects the human system. These research results contributed to scientific knowledge and technology developments that address the human health and performance risks. As shown in this report, HRP has made significant progress toward developing medical care and countermeasure systems for space exploration missions which will ultimately reduce risks to crew health and performance.

Effenhauser, Laura↗

NASA NTRS2006

Converging Indicators for Assessing Individual Differences in Adaptation to Extreme Environments: Preliminary Report

This paper describes the development and validation of a new methodology for assessing the deleterious effects of spaceflight on crew health and performance. It is well known that microgravity results in various physiological alterations, e.g., headward fluid shifts which can impede physiological adaptation. Other factors that may affect crew operational efficiency include disruption of sleep-wake cycles, high workload, isolation, confinement, stress and fatigue. From an operational perspective, it is difficult to predict which individuals will be most or least affected in this unique environment given that most astronauts are first-time flyers. During future lunar and Mars missions space crews will include both men and women of multi-national origins, different professional backgrounds, and various states of physical condition. Therefore, new methods or technologies are needed to monitor and predict astronaut performance and health, and to evaluate the effects of various countermeasures on crew during long duration missions. This paper reviews several studies conducted in both laboratory and operational environments with men and women ranging in age between 18 to 50 years. The studies included the following: soldiers performing command and control functions during mobile operations in enclosed armored vehicles; subjects participating in laboratory tests of an anti-motion sickness medication; subjects exposed to chronic hypergravity aboard a centrifuge, and subject responses to 36-hours of sleep deprivation. Physiological measurements, performance metrics, and subjective self-reports were collected in each study. The results demonstrate that multivariate converging indicators provide a significantly more reliable method for assessing environmental effects on performance and health than any single indicator.

Cowings, Patricia S.↗

NASA NTRSDate not supplied

Clinical Decision Support: Path to Functional Requirements

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. To augment the requisite knowledge, skills and abilities (KSAs) of a time-constrained crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance this decade and beyond. Hence, data, software and computational resources will play an essential and synergistic role in maintaining crew health, wellness and performance in deep space missions. The focus of the CDS project is to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance and medical care during exploration missions. The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/databases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.

Clinical decision support↗

NASA NTRS2020

Preparing for Human Missions to Mars: The role of ISS and Artemis as Analogs for Research and Technology Testing

The hazards of spaceflight to the human system are present in in varying degrees on different spaceflight platforms: altered gravity, isolation and confinement, distance from Earth, radiation, and hostile closed environments. A strategic view of the fidelity of hazards experienced on different platforms can shape the testing plans for human research and technology demonstration related to crew health and performance. Working across the international partnership, the International Space Station (ISS) is planning periods of modified operations to improve the fidelity of Mars simulations. To understand transit durations as an independent variable, a series of 1-year, 6-month and 30-45 day missions are being planned on ISS. Standard measurements across ISS missions of different durations, lunar missions and ground analogs offers the opportunity to distinguish different hazards and their effects in the context of the relevance to future mission concepts. The ISS partnership is planning for additional test cases that are aligned with Mars mission plans. (1) Evaluating crew performance capabilities when transitioning to gravity after long durations in microgravity representative of a Mars transit. (2) Simulating crew medical care under Mars-like autonomous operations. (3) Identification and testing of operations under communications delay and autonomy expected for Mars missions and the linked effects on behavioral health and performance of the crew. Artemis missions serve as a valuable analogs for Mars surface operations, with partial gravity and deep space radiation hazards, but with crewmembers that are probably more physically capable than their counterparts would be after a Mars transit. Getting unobtrusive data from early Artemis missions, and knowledge gained from operational experience as Artemis operations develop can improve engineering design, medical requirements and countermeasures, and ultimately ensure mission success on Mars. Linking Mars architectures with the plans and capabilities for ISS and Artemis allows us to plan to most operationally relevant tests of crew health and performance on current spaceflight missions to inform planning for future missions to Mars. By using human spaceflight platforms as well as ground simulation in an integrated way, the international community can improve exploration readiness, develop countermeasures and reduce risks of future human space missions.

International Space Station↗

NASA NTRS2017

Meal Replacement Mass Reduction and Integration Acceptability Study

NASA, in planning for long-duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore the team is challenged to reduce the mass of the food system by 10% while maintaining product safety, nutrition, and acceptability. Commercially available products do not meet the nutritional requirements for a full meal replacement in the spaceflight food system, and it is currently unknown if daily meal replacements will impact crew food intake and psychosocial health over time. The purpose of this study was to develop a variety of nutritionally balanced breakfast replacement bars that meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% savings in food mass. To date, six nutrient-dense meal replacement bars (approximately 700 calories per bar) have been developed, using traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). The four highest rated bars were evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact of bars on mood, satiety, digestive discomfort, and satisfaction with food. These factors are currently being analyzed to inform successful implementation strategies where crew maintain adequate food intake. In addition, these bars are currently undergoing shelf-life testing to determine long-term sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that this work will enable a successful meal replacement strategy to be implemented that will maintain crew food consumption and health, while informing exploration missions with appropriate mass savings expectations.

Sirmons, T.↗

NASA NTRS2021

Exploration Medical Capability Clinical Decision Support System Concept of Operations

The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.

HRP↗

NASA NTRSDate not supplied

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH 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 outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗

NASA NTRS2016

Meal Replacement Mass Reduction and Integration Acceptability Study

NASA, in planning for long duration missions, has an imperative to provide a food system with the necessary nutrition, acceptability, and safety to ensure sustainment of crew health and performance. The Orion Multi-Purpose Crew Vehicle (MPCV) and future exploration missions are mass constrained; therefore we are challenged to reduce the mass of the food system by 10% while maintaining safety, nutrition, and acceptability for exploration missions. Food bars have previously been used to supplement meals in the Skylab food system, indicating that regular consumption of bars will be acceptable. However, commercially available products do not meet the requirements for a full meal replacement in the spaceflight food system. The purpose of this task is to develop a variety of nutritionally balanced breakfast replacement bars, which meet spaceflight nutritional, microbiological, sensorial, and shelf-life requirements, while enabling a 10% food mass savings. To date, six nutrient-dense meal replacement bars have been developed, using both traditional methods of compression as well as novel ultrasonic compression technologies developed by Creative Resonance Inc. (Phoenix, AZ). All bars will be prioritized based on acceptability and the four top candidates will be evaluated in the Human Exploration Research Analog (HERA) to assess the frequency with which actual meal replacement options may be implemented. Specifically, overall impact to mood, satiety, dietary discomfort, and satisfaction with food will be analyzed to inform successful implementation strategies. In addition, these bars will be evaluated based on final product sensory acceptability, nutritional stability, qualitative stability of analytical measurements (i.e. water activity and texture), and microbiological compliance over two years of storage at room temperature and potential temperature abuse conditions to predict long-term acceptability. It is expected that this work will enable a successful meal replacement strategy to be implemented that maintains crew food consumption and health, while informing exploration missions with appropriate mass savings expectations.

Sirmons, T.↗

NASA NTRSDate not supplied

CLINICAL DECISION SUPPORT: PATH TO FUNCTIONAL REQUIREMENTS

clinical decision support↗

NASA NTRSDate not supplied

Exploration Medical Capability - Advancing Medical System Design and Risk-Informed Decision Making for Deep Space Exploration

BACKGROUND: Within NASA’s Human Research Program, the Exploration Medical Capability (ExMC) Element has three primary focus areas: clinical and scientific research, systems engineering and trade space analysis, and technology development and demonstrations. These focus areas feed into the overarching goal of enabling progressively Earth-Independent Medical Operations (EIMO), a new paradigm that will be necessary for future Artemis and Mars medical and vehicle systems. This EIMO end state aligns with NASA’s Moon to Mars Objectives, which clearly outline the need for NASA deep space exploration missions to reduce their reliance upon Earth and become increasingly autonomous, in preparation for the first human Mars mission. OVERVIEW: To advance exploration medical systems and ultimately, integrated crew health and performance systems, ExMC’s portfolio includes: funding ground development & testing of novel medical capabilities; creation of new approaches for the development of medical protocols and procedures; deployment of innovative technologies into analog environments; technology demonstrations in spaceflight; and eventual transition to operations of new capabilities for deep space exploration missions. The portfolio also includes: pharmaceutical research targeting stability, pharmacokinetics, and pharmacodynamics; integrated data architectures and clinical decision support tools; and systems engineering and trade space analysis tools to assist NASA in the development of future medical system models as well as the medical system requirements that can serve as a foundation for deep space exploration missions. All of these investments are done in a collaborative and coordinated fashion with other NASA stakeholders, such as the Environmental Control and Life Support Systems – Crew Health and Performance System Capability Leadership Team and the Health and Medical Technical Authority. DISCUSSION: In this presentation, ExMC will provide an overview of our work from across our portfolio, all of which will inform future EIMO efforts at NASA. ExMC’s research and development investments are targeted to reduce the human system risks associated with deep space exploration to the Moon and Mars.

Kris Lehnhardt↗

NASA NTRS2024

Conclusions of a Mini Technical Interchange Meeting on New Cross Risk Integration Projects Managed by the NASA Space Radiation Element

To enable deep space exploration and sustained human presence in space, the NASA Human Research Program’s (HRP) Space Radiation Element (SRE) funds research to characterize and mitigate adverse health outcomes from exposure to space radiation that include risks of carcinogenesis, cardiovascular disease, and central nervous system decrements. Recently, the SRE was tasked with supporting multiple HRP Elements with innovative and enabling projects to inform risk characterization, facilitate mitigation activities, and support crew health and performance. These projects, such as precision health initiative, NASA Omics Archive (NOA) and human sample repositories, are agnostic to any HRP Element, hence the name, Cross-Risk Integration Projects (CRIP). CRIP serves 3 broad purposes: - Services: Generate samples and data and manage the receipt, inventory, archive, and ultimate redistribution of biospecimens created in HRP-funded spaceflight and analog research activities—includes NASA Omics Archive project and various human and animal sample repositories. - Method Development: Identify and evaluate new-to-NASA research or analysis methods or techniques that could fundamentally improve existing or planned research efforts—includes the Translational Radiation Research and Countermeasures Project. - Enabling Capabilities: Demonstrate real-world application by adapting, adopting, and/or developing capabilities to benefit crew health and performance and improve risk mitigation—includes Precision Health Initiative (Pharmacogenomics) and advanced biological systems and engineered tissue microsystems initiative (tissue chips, organ-on-a-chip). To identify new technologies, future work, and solicitations, the SRE organizes themed sessions at annual HRP Investigators’ Workshops (IWS). These technical interchange meetings (TIMs) provide a venue for the scientific community to present ongoing work and engage in open discussion of results, limitations of current approaches, and incorporation of novel experimental strategies, model systems, and other innovative techniques. Here, a summary of the studies presented at the SRE-sponsored mini-TIM at the HRP IWS along with the goals and objectives of the CRIP projects is communicated. The 90-min TIM had 6 speakers who presented impressive novel ideas and work, some of which are funded under CRIP by the Space Radiation Element.

Janapriya Saha↗

NASA NTRSDate not supplied

A Strategy for Advancing Earth Independent Medical Operations

Exploration medical operations to the Moon and Mars present unprecedented challenges for providing in-mission medical care. The greater distance from Earth is the primary hazard that drives the need for a medical operations paradigm shift from low earth orbit mission. Increasingly complex long duration and long distance missions will have resource constraints (ex: mass, power, volume, data), a paucity of resupply or evacuation opportunities, and disruptions in real-time communications. In order to advance a more autonomous medical approach, a multi-faceted strategy will need to optimize all aspects of human health and performance in space. This strategy will include: increasing onboard medical autonomy through the development of novel crew health and performance systems; decision support capabilities to augment astronauts’ abilities in preventing, diagnosing, and treating medical conditions; creating new procedures and training tools for skill maintenance and just-in-time training; and enabling rapid crew access to data from all on-board systems, leading to better-informed, real-time, autonomous decisions. Collectively, this approach can be referred to as “Earth Independent Medical Operations” (EIMO). The Exploration Medical Capability Element of NASA’s Human Research Program has undertaken a longitudinal planning process to consensus around EIMO. Technical interchange meetings will occur with key constituents in late 2022 and again in early 2023 to define EIMO in practical terms and identify key elements of an EIMO system, with greater conceptual articulation and dissemination planned for the second half of 2023. We will share insights into the strategy for internal and external consensus building around EIMO, with a particular focus on the approach to partner stakeholders within NASA as well as commercial agencies.

Jay Lemery↗

NASA NTRS2005

Microbial Air and Surface Monitoring Results from International Space Station Samples

Over the course of long-duration spaceflight, spacecraft develop a microbial ecology that directly interacts with the crew of the vehicle. While most microorganisms are harmless or beneficial to the inhabitants of the vehicle, the presence of medically significant organisms appearing in this semi-closed environment could adversely affect crew health and performance. The risk of exposure of the crew to medically significant organisms during a mission is estimated using information gathered during nominal and contingency environmental monitoring. Analysis of the air and surface microbiota in the habitable compartments of the International Space Station (ISS) over the last four years indicate a high presence of Staphylococcus species reflecting the human inhabitants of the vehicle. Generally, air and surface microbial concentrations are below system design specifications, suggesting a lower risk of contact infection or biodegradation. An evaluation of sample frequency indicates a decrease in the identification of new species, suggesting a lower potential for unknown microorganisms to be identified. However, the opportunistic pathogen, Staphylococcus aureus, has been identified in 3 of the last 5 air samples and 5 of the last 9 surface samples. In addition, 47% of the coagulase negative Staphylococcus species that were isolated from the crew, ISS, and its hardware were found to be methicillin resistance. In combination, these observations suggest the potential of methicillin resistant infectious agents over time.

Ott, C. Mark↗