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At least 109 records · Page 6

Human behavioral research in space: quandaries for research subjects and researchers

With the advent of long-duration spaceflight on board the International Space Station (ISS) and possible future missions beyond low Earth orbit (LEO) such as Mars, it is critical that those at NASA have a realistic assessment of the challenges that will face individuals on long-duration missions so that they can develop preventive and real-time countermeasures to behavioral health issues. While space travellers are very interested in having countermeasures to the deleterious effects of space missions, they have a powerful disincentive to participate in this research if they feel it could in any way negatively affect their flight status. The behavioral issues of isolation and confinement for extended-duration space missions are reviewed. Areas of basic and clinical behavioral research are listed. And the classical clinical model for research is not considered appropriate for the current configuration of the space program. The use of analogue environments and advanced statistical analysis are suggested as ways to address the limited spaceflight research opportunities. The challenge of research subject or patient confidentiality vs. mission safety and issues of personal flight status are addressed.

Review, Tutorial↗

Circadian rhythms, sleep, and performance in space

Maintaining optimal alertness and neurobehavioral functioning during space operations is critical to enable the National Aeronautics and Space Administration's (NASA's) vision "to extend humanity's reach to the Moon, Mars and beyond" to become a reality. Field data have demonstrated that sleep times and performance of crewmembers can be compromised by extended duty days, irregular work schedules, high workload, and varying environmental factors. This paper documents evidence of significant sleep loss and disruption of circadian rhythms in astronauts and associated performance decrements during several space missions, which demonstrates the need to develop effective countermeasures. Both sleep and circadian disruptions have been identified in the Behavioral Health and Performance (BH&P) area and the Advanced Human Support Technology (AHST) area of NASA's Bioastronautics Critical Path Roadmap. Such disruptions could have serious consequences on the effectiveness, health, and safety of astronaut crews, thus reducing the safety margin and increasing the chances of an accident or incident. These decrements oftentimes can be difficult to detect and counter effectively in restrictive operational environments. NASA is focusing research on the development of optimal sleep/wake schedules and countermeasure timing and application to help mitigate the cumulative effects of sleep and circadian disruption and enhance operational performance. Investing research in humans is one of NASA's building blocks that will allow for both short- and long-duration space missions and help NASA in developing approaches to manage and overcome the human limitations of space travel. In addition to reviewing the current state of knowledge concerning sleep and circadian disruptions during space operations, this paper provides an overview of NASA's broad research goals. Also, NASA-funded research, designed to evaluate the relationships between sleep quality, circadian rhythm stability, and performance proficiency in both ground-based simulations and space mission studies, as described in the 2003 NASA Task Book, will be reviewed.

Review↗

Operational behavioral health and performance resources for international space station crews and families

The Behavioral Health and Performance Section (BHP) at NASA Johnson Space Center provides direct and indirect psychological services to the International Space Station (ISS) astronauts and their families. Beginning with the NASA-Mir Program, services available to the crews and families have gradually expanded as experience is gained in long-duration flight. Enhancements to the overall BHP program have been shaped by crewmembers' personal preferences, family requests, specific events during the missions, programmatic requirements, and other lessons learned. The BHP program focuses its work on four areas: operational psychology, behavioral medicine, human-to-system interface, and sleep and circadian. Within these areas of focus are psychological and psychiatric screening for astronaut selection as well as many resources that are available to the crewmembers, families, and other groups such as crew surgeon and various levels of management within NASA. Services include: preflight, in flight, and postflight preparation; training and support; resources from a Family Support Office; in-flight monitoring; clinical care for astronauts and their families; and expertise in the workload and work/rest scheduling of crews on the ISS. Each of the four operational areas is summarized, as are future directions for the BHP program.

Space Flight↗

Brain ageing in schizophrenia: evidence from 26 international cohorts via the ENIGMA Schizophrenia consortium

Schizophrenia (SZ) is associated with an increased risk of life-long cognitive impairments, age-related chronic disease, and premature mortality. We investigated evidence for advanced brain ageing in adult SZ patients, and whether this was associated with clinical characteristics in a prospective meta-analytic study conducted by the ENIGMA Schizophrenia Working Group. The study included data from 26 cohorts worldwide, with a total of 2803 SZ patients (mean age 34.2 years; range 18–72 years; 67% male) and 2598 healthy controls (mean age 33.8 years, range 18–73 years, 55% male). Brain-predicted age was individually estimated using a model trained on independent data based on 68 measures of cortical thickness and surface area, 7 subcortical volumes, lateral ventricular volumes and total intracranial volume, all derived from T1-weighted brain magnetic resonance imaging (MRI) scans. Deviations from a healthy brain ageing trajectory were assessed by the difference between brain-predicted age and chronological age (brain-predicted age difference [brain-PAD]). On average, SZ patients showed a higher brain-PAD of +3.55 years (95% CI: 2.91, 4.19; I 2 = 57.53%) compared to controls, after adjusting for age, sex and site (Cohen’s d = 0.48). Among SZ patients, brain-PAD was not associated with specific clinical characteristics (age of onset, duration of illness, symptom severity, or antipsychotic use and dose). This large-scale collaborative study suggests advanced structural brain ageing in SZ. Longitudinal studies of SZ and a range of mental and somatic health outcomes will help to further evaluate the clinical implications of increased brain-PAD and its ability to be influenced by interventions.

59 BASIC BIOLOGICAL SCIENCES↗

The history of aeronautical medicine in Venezuela

The Aerial Medical Service of the Ministry of Transportation and Communications of Venezuela was created on June 1949, and later became the Department of Aeronautical Medicine. Its functions include the medical examinations of future pilots, navigators and flight engineers. The importance of good mental and physical health in all flight and ground personnel to ensure the safety of air travel is discussed.

Iriarte, D. R.↗

The Exploration Crew Health and Performance System of the Future - A Shared Mental Model

The challenges involved in vehicle/habitat design and operation for long-duration deep space missions are complex, and the needs of a human crew must be considered in the context of all the system trades required to enable such missions. An exploration Crew Health and Performance (CHP) system complements all the other vehicle/habitat systems to achieve one specific and critical endpoint – ensuring that the astronauts can perform the job that they were sent into space to do. This includes accounting for all aspects of the physiological, psychological, medical, and environmental realities that the human crew must face in deep space. Along with this system complexity comes the additional need for increased autonomy of the crew due to the immense distance from Earth. The design of future systems must respect the real human capabilities and limitations within the context of a mission to the Moon or Mars. The NASA Moon to Mars Objectives document outlines the need for advanced CHP system designs: • Develop systems that monitor and maintain crew health and performance throughout all mission phases, including during communication delays to Earth, and in an environment that does not allow emergency evacuation or terrestrial medical assistance. • Evaluate and validate progressively Earth-independent crew health & performance systems and operations with mission durations representative of Mars-class missions. • Validate readiness of systems and operations to support crew health and performance for the initial human Mars exploration campaign. This presentation will outline the initial work that Exploration Medical Capability is leading on the development of a prototype design for an exploration Crew Health and Performance (CHP) system for future NASA human deep space long-duration missions. This effort will require commitment from all stakeholders to a shared mental model of what a future exploration CHP system should look like, one that will address the needs, goals, and objectives of the Agency and help to ensure mission success in deep space.

K R Lehnhardt↗

Lead Adsorption and Desorption at the Barite (001) Surface in the Presence of EDTA

Scaling minerals, such as barite, can cause detrimental consequences for oil/gas pipelines and water systems, but their formation can be inhibited by organic chelators such as ethylenediaminetetraacetic acid (EDTA). Here, we resolve how EDTA affects sorption and desorption of Pb at the barite (001) surface using a combination of X-ray scattering and microscopy measurements. In the presence of EDTA, Pb incorporated in the topmost part of the barite surface and adsorbed as inner-sphere complexes on the surface. In barite saturated solutions containing [Pb] ≥ 100 μM, overgrowth films grew along step edges. These films were exclusively monolayer thick, indicating that their growth was a self-limiting process. Approximately half of the Pb was removed after 14.5 h reaction with a Pb-free EDTA solution where most of the desorption occurred to adsorbed Pb rather than incorporated Pb. Dissolution proceeded primarily via step retreat and etch pit formation in EDTA, but in deionized water, the secondary phase was quickly removed within 3 min. Together these results suggest EDTA binds to both the surface and Pb in solution, which limits Pb sorption. However, EDTA binding to the surface also inhibits removal of the secondary phase that formed at higher Pb concentrations.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Quantum Computing for Biomedical Computational and Data Sciences: A Joint DOE-NIH Roundtable

The overlap of quantum computing and biomedical research, while less explored, presents significant near-term opportunities. The Department of Energy (DOE) and the National Institutes of Health (NIH) are interested in exploiting the DOE community’s capabilities and expertise in quantum computing to potentially advance biomedical research, targeting fundamental studies of biological and molecular structures, understanding of human health as well as mental and physical disorders and diseases, and deriving insights from clinical data. NIH’s approach to quantum computing is guided by its Strategic Plan for Data Science, emphasizing the importance of findable, accessible, interoperable, and reusable (FAIR) data assets, security and privacy of data, and efficient computing and storage. DOE’s Office of Science (SC), and more specifically the Advanced Scientific Computing Research (ASCR) program, supports quantum information science (QIS) research, contributing to a unique portfolio of quantum computing and communications expertise. This roundtable was assembled to consider the opportunities and challenges in the near-, medium-, and long-term at the intersection of quantum computing, data science, and biomedical research and how these could be addressed through inter-agency collaboration and multi-disciplinary partnerships.

59 BASIC BIOLOGICAL SCIENCES↗

Occupational Medical Trends in the 70's from Industrial View

Industrial health measures to ensure worker productivity constitute physical examinations as well as environmental control systems. Considered are automatic record keeping facilities for case histories, preventive medical and mental counselling, development of safety standards, and health insurance and disability benefit plans. Cooperation of industry health programs with community health aspects is required to eliminate the loss of manpower capability through alcoholism or mental disease.

Williamson, S. M.↗

2023 Artemis Crew Health and Performance System Model Development

While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper

Systems engineering↗

2023 Artemis Crew Health and Performance (CHP) System Model Development

While the NASA Human Research Program (HRP) utilizes a Crew Health and Performance (CHP) System to represent all the Agency’s efforts to ensure the health and performance of NASA astronauts, there is no shared mental model of a CHP system at NASA. Some groups may consider a CHP system to be only a medical kit, while others may not be using the concept at all. To facilitate the integration of functions and capabilities to ensure astronaut health and performance during vehicle development, HRP has proposed a CHP Shared Mental Model derived from the NASA Human Health, Medical, and Performance Spaceflight Standards (NASA-STD-3001 Vol.1/Vol.2). [1] Even though many vehicle, ground, and communication systems as well as mission operations are modeled for the Artemis Campaigns, no mission level CHP system model was created to achieve the intent of the HRP CHP Shared Mental Model. The lack of this model renders it difficult to visualize and understand how the many programs work together to provide the necessary cross program functions and capabilities to ensure the health and performance of the crew throughout an Artemis mission. For this purpose, the Exploration Medical Capability (ExMC) element of HRP developed a CHP system model for the Artemis III and IV missions to provide a view of how each program contributes to and interacts with the overall CHP system. To develop the 2023 Artemis CHP system model, ExMC leveraged existing data and models from the Moon to Mars Program Office, the Office of the Chief Health and Medical Officer (OCHMO) and the Orion, Gateway, Extravehicular Activity and Human Surface Mobility (EHP) and Human Landing System (HLS) programs. By using a Model-Based Systems Engineering (MBSE) approach, existing requirements, functions, and concepts of operations were combined to create a single system model focused on representing CHP from the launch to the return to Earth segments of the Artemis III and IV missions. Additionally, by incorporating the HRP Systems Platform for Aggregating and Relating Capabilities, or SPARC tool, the data from the programs was also related back to the 2nd volume of the NASA Human Health, Medical, and Performance Spaceflight Standard (NASA-STD-3001, Vol.2) and the human system risks identified by the Human System Risk Board (HSRB). The first version of the 2023 Artemis CHP system model was baselined in Fall of 2023 after the model was demonstrated to be a potentially useful tool for systems engineers integrating CHP capabilities in vehicle development as well as members of the Health and Medical Technical Authority providing oversight of those programs. The model may also be useful to any stakeholder of astronaut health and performance by providing insights on how an Artemis mission satisfies the NASA Human Health, Medical, and Performance Spaceflight Standards as well as how they mitigate the HSRB Human System Risks. This presentation highlights how the model was developed and the possible benefits of the model. [1] NASA HRP (2022), Crew Health and Performance System Whitepaper

Systems engineering↗

Individualized Behavioral Health Monitoring Tool

Behavioral health risks during long-duration space exploration missions are among the most difficult to predict, detect, and mitigate. Given the anticipated extended duration of future missions and their isolated, extreme, and confined environments, there is the possibility that behavior conditions and mental disorders will develop among astronaut crew. Pulsar Informatics, Inc., has developed a health monitoring tool that provides a means to detect and address behavioral disorders and mental conditions at an early stage. The tool integrates all available behavioral measures collected during a mission to identify possible health indicator warning signs within the context of quantitatively tracked mission stressors. It is unobtrusive and requires minimal crew time and effort to train and utilize. The monitoring tool can be deployed in space analog environments for validation testing and ultimate deployment in long-duration space exploration missions.

Mollicone, Daniel↗

A framework for inferring and analyzing pharmacotherapy treatment patterns

Background: To discover pharmacotherapy prescription patterns and their statistical associations with outcomes through a clinical pathway inference framework applied to real-world data. Methods: We apply machine learning steps in our framework using a 2006 to 2020 cohort of veterans with major depressive disorder (MDD). Outpatient antidepressant pharmacy fills, dispensed inpatient antidepressant medications, emergency department visits, self-harm, and all-cause mortality data were extracted from the Department of Veterans Affairs Corporate Data Warehouse. Results: Our MDD cohort consisted of 252,179 individuals. During the study period there were 98,417 emergency department visits, 1,016 cases of self-harm, and 1,507 deaths from all causes. The top ten prescription patterns accounted for 69.3% of the data for individuals starting antidepressants at the fluoxetine equivalent of 20-39 mg. Additionally, we found associations between outcomes and dosage change. Conclusions: For 252,179 Veterans who served in Iraq and Afghanistan with subsequent MDD noted in their electronic medical records, we documented and described the major pharmacotherapy prescription patterns implemented by Veterans Health Administration providers. Ten patterns accounted for almost 70% of the data. Associations between antidepressant usage and outcomes in observational data may be confounded. The low numbers of adverse events, especially those associated with all-cause mortality, make our calculations imprecise. Furthermore, our outcomes are also indications for both disease and treatment. Despite these limitations, we demonstrate the usefulness of our framework in providing operational insight into clinical practice, and our results underscore the need for increased monitoring during critical points of treatment.

60 APPLIED LIFE SCIENCES↗

Psychiatric Components of a Health Maintenance Facility (HMF) on Space Station

The operational psychiatric requirements for a comprehensive Health Maintenance Facility (HMF) on a permanently manned Space Station are examined. Consideration is given to the psychological health maintenance program designed for the diagnosis of mental distress in astronauts during flight and for prevention of mental breakdown. The types of mental disorders that can possibly affect the astronauts in flight are discussed, including various organic, psychotic, and affective mental disorders, as well as anxiety, adjustment, and somatoform/dissociative disorders. Special attention is given to therapeutic considerations for psychiatric operations on Space Station, such as restraints, psychopharmacology, psychotherapy, and psychosocial support.

Patricia A Santy↗

Information needs, approaches, and case studies in human health risk communication

This article uses ten case studies to illustrate the information needs, various communication approaches, and the communicator's role in explaining environmental health risks from a variety of hazards, to a variety of audiences, over time frames from days to years, using in person consultation, lectures, zooms, and email formats. Events often had a long history before the communication began and may have had a long tail afterward. Audiences may be public officials, companies, workers, communities, or individuals. Each individual may have their own understanding or mental model regarding the hazard, exposure, and risk. The communicator's role or intention may be to reassure an audience that has unrealistic exaggerated concerns or fears or to protect a client if the fears are realistic. Or it may be altruistic to inform a complacent audience to take the risks it faces more seriously. Although risk assessment research has advanced the techniques for communicating abstruse probabilities to audiences with low numeracy, in my experience, audiences are unimpressed by precise–sounding probability numbers, and are more interested in whether exposure is occurring or may occur and how to stop it. Often audiences have reason to be outraged and may be more concerned about punishing wrong doers than about the hazard itself, particularly when the exposure is past and cannot be undone. Thus, there is a difference between discussing the riskiness of a situation (risk communication) and what you are going to do about the situation (risk management). Risk communication is successful when the audience responds as intended, calming down or taking action. These case studies are drawn from a large number of risk communication experiences that I and my Rutgers colleagues have engaged in over the past four decades. Through the 20th century, New Jersey was the most densely industrialized State in United States. New Jersey experienced growth of the chemical and petrochemical industries and the unfortunately profligate disposal of toxic wastes. Having the most Superfund sites of any state is a dubious distinction, but New Jersey also has the most experience in evaluating and responding to these hazards.

60 APPLIED LIFE SCIENCES↗

Exploration Medical Capability System Engineering Introduction and Vision

Human exploration missions to beyond low Earth orbit destinations such as Mars will require more autonomous capability compared to current low Earth orbit operations. For the medical system, lack of consumable resupply, evacuation opportunities, and real-time ground support are key drivers toward greater autonomy. Recognition of the limited mission and vehicle resources available to carry out exploration missions motivates the Exploration Medical Capability (ExMC) Element's approach to enabling the necessary autonomy. The Element's work must integrate with the overall exploration mission and vehicle design efforts to successfully provide exploration medical capabilities. ExMC is applying systems engineering principles and practices to accomplish its integrative goals. This talk will briefly introduce the discipline of systems engineering and key points in its application to exploration medical capability development. It will elucidate technical medical system needs to be met by the systems engineering work, and the structured and integrative science and engineering approach to satisfying those needs, including the development of shared mental and qualitative models within and external to the human health and performance community. These efforts are underway to ensure relevancy to exploration system maturation and to establish medical system development that is collaborative with vehicle and mission design and engineering efforts.

Mindock, J.↗