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NASA NTRS2023

Exploration Medical Capability Clinical Decision Support Use Cases for CDSS Test Bed

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. Each of these challenges necessitates greater degrees of crew autonomy as our distance from Earth increases. Specifically, as communication delays intensify - and evacuation capability diminishes the further we explore space - the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will become key to mission continuation and success. This need will be especially true should a crewmember become ill or injured wherein treatment and disposition “in-situ” ultimately falls to the crew itself to determine. To augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained exploration mission crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution. A CDSS would facilitate, guide, and inform Earth-independent medical operations while assisting crewmembers through various clinical presentations. The CDSS would allow crewmembers to take advantage of pre-mission training tied to the in-flight/in-mission use of pre-planned protocols that offer both a range of diagnostic options and “just-in-time” (refamiliarization) training and assistance. CDSS will expand such capabilities by improving the utility and effectiveness of various available diagnostic, treatment, and health maintenance tools, techniques, and measures.

ExMC↗

NASA NTRSDate not supplied

Oxidative Stress and Neuroconsequences of the Spaceflight Environment –A 5-ion GCRsim Dose-response Study

The overall scope of this project is to test the hypothesis that Ionizing Radiation (IR), microgravity and social isolation combine synergistically to trigger an oxidative stress response that alters immune homeostasis, brain structure/function, and neurobehavioral/cognitive performance. Specific Aims for this project are to: (1) Determine dose-response curves for acute ‘Five-Ion GCR Simulation’ exposure for immune, brain and performance responses in crew age-matched adult male and female mice; (2) Determine effects of acute ‘Five-Ion GCR Simulation’ exposure singly and in combination with simulated microgravity and social isolation, on immune, brain and performance responses in crew age-matched male and female mice mimicking deep space missions; and (3) Determine efficacy of the dietary antioxidant, Nicotinamide Mononucleotide (NMN), a key intermediate in nicotinamide adenine dinucleotide (NAD+) biosynthesis. Here we exposed mature (23-24-week-old) male and female mice to simulated 5-Ion GCR (either 0, 5, 15, or 50cGy) at the NASA Space Radiation Laboratory (NSRL). Across ‘Acute’ (IR+72hrs and IR+14 days) and ‘Delayed’ (IR+28 to IR+124 days) phases of the 6-month-long study, we assessed immune, neural, and functional (sensorimotor/behavioral/cognitive) responses anticipated during a transit to Mars. This presentation will report on dose-response curves for 5-ion GCRsim related to potential biomarkers; structural/functional changes in the immune and nervous systems; and behavioral/cognitive performance deficits. This project addresses NASA’s efforts to characterize risks and identify appropriate countermeasures in anticipation of future deep space missions. Ensuring crew health and performance during extended transits necessitates that sensorimotor and cognitive abilities remain strong to avoid potentially catastrophic health and safety outcomes.

deep space↗

NASA NTRS2020

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Pre-, In-, and Post-Spaceflight

NASA’s vision for future exploration missions depends on the ability to protect astronauts’ health and safety for performance of Extravehicular Activity (EVA), and to allow astronauts to safely egress from vehicles in a variety of landing scenarios (e.g. water landing upon return to Earth and undefined planetary/lunar landings). Prolonged exposure to spaceflight results in diminished tolerance to prolonged physical activity, decreased cardiac and sensorimotor function, and loss of bone mineral density, muscle mass, and muscle strength. For over 50 years exercise has been the primary countermeasure against these physiologic decrements during spaceflight, and while the resulting protection is adequate for ISS missions (i.e., Soyuz landing, microgravity EVAs), there is little information regarding time-course changes in muscle and aerobic performance. As spaceflight progresses towards longer exploration missions and vehicles with less robust exercise capabilities compared to ISS, countermeasures will need to be combined and optimized to protect crew health and performance across all organ systems over the course of exploration missions up to 3 years in duration. This will require a more detailed understanding of the dynamic effects of spaceflight on human performance. Thus, the focus of this study is quantifying decrements in physical performance over different mission durations, and to provide detailed information on the physiological rational for “why” and “when” observed changes in performance occur. The research proposed will temporally profile changes in astronauts’ cardiorespiratory fitness, muscle mass, strength, and endurance over spaceflight missions of 2 months, 6 months, and up to 1 year in duration. Additionally, an extrapolation model will provide predictions for changes associated with exploration missions 2-3 years in duration. To accomplish these objectives astronauts will be asked to participate in pre, in, post-flight measurement of muscle performance, muscle size, cardiorespiratory fitness and submaximal performance capabilities, as well as non-invasive assessment of cerebral and muscle oxygenation and perfusion (Table 1). Additionally, ambulatory and in-flight exercise, nutrition, and sleep will be monitored using a variety of commercial technologies and in-flight assessment tools. Significance: Our detailed testing protocol will provide valuable information for describing how and when spaceflight-induced muscle and aerobic based adaptations occur over the course of spaceflight missions up to and beyond 1 year. This information will be vital in the assessment as to whether humans can be physically ready for deep space exploration such as Mars missions with current technology, or if additional mitigation strategies are necessary.

Downs, M. E.↗

NASA NTRSDate not supplied

Monitoring Human Performance on Future Deep Space Missions Abstract

NASA and the commercial spacecraft community are working diligently to put the first woman on the moon in the 2024 timeframe. At the same time, NASA researchers are thinking about how to solve the even larger challenges that future deep space missions will bring. Space travel itself is difficult, but astronauts on deep space missions will face obstacles and unknowns never before experienced. In addition to the altered gravity and hostile/closed environment of a spacecraft, deep space crews will face increased radiation, isolation, and distance from Earth. During Extravehicular Activity (EVA, or “spacewalk”) operations, crew will experience increased physical and cognitive workload due to extended types, frequencies and durations of tasks performed on exploration missions in partial gravity environments. All of these stressors will impact crew physical and mental health and performance in difficult-to-anticipate ways. Crew autonomy may be one of the biggest challenges faced. Communication delays and blackouts will occur, and in those situations, the crew may not have access to the Mission Control Center (MCC). They may be forced to be solely dependent on each other and the available information onboard to stay alive, healthy, and achieve the mission. The only conceivable way to meet the challenges of Earth independence is to enable the crew to monitor their own health and performance -- preferably unobtrusively as they perform their duties. Technologies and techniques must be developed to aid the crew in these assessments. A deep space mission is expected to have relatively short periods of high cognitive demand, stress, and fatigue, alongside potentially long periods of cognitive underload during the transit, where boredom, loneliness, and depression can set in. Both ends of this spectrum are dangerous. Crew must be made aware when their task performance drops significantly, when their cognitive workload is too high, when they have lost situation awareness, or when they are too stressed or too fatigued to perform well. They must be able to identify these risks, and then mitigate them with countermeasures available onboard. A number of self-monitoring technologies are presently being explored by NASA to advance crew state determination capabilities. These range from real-time, physiological workload and situation awareness assessments, to crew health measurements determining physical and mental fitness for duty, to task performance metrics such as suit resource expenditures. For EVA tasks during surface exploration missions, biomedical information such as metabolic rate may be provided to crewmembers for situational awareness related to task performance efficiency. In addition, translation distances, hydration, nutrition, inspired CO2 exposure and other consumables usage rates may be useful input metrics for modeling individualized performance during tasks to inform crew or provide estimates of work efficiency. Oculomotor metrics such as gaze dwell time, pupilometry, and eye tracking collected in advanced helmet mounted displays could potentially be used to characterize crew situation awareness. This paper highlights some of these projects, and provides broader discussion about the need for advanced monitoring and smart technologies, as NASA takes the leap into the next generation of space exploration.

Kritina Holden↗

NASA NTRSDate not supplied

Evaluation of Aerobic Standards for Lunar Surface Extravehicular Activities

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).

Nicole Strock↗

NASA NTRSDate not supplied

Developing Natural Language Processing and Supervised Learning Techniques to Classify Mars Tasks

As NASA's Human Research Program (HRP) prepares for long-duration Mars missions, understanding astronaut tasks is crucial. This study, conducted at NASA Glenn Research Center (GRC), employed Natural Language Processing (NLP) and machine learning techniques to analyze and classify Mars tasks. A list of 1,058 Mars tasks was provided by HRP experts including binary labeling of 18 Human System Task Categories (HSTCs). We developed an NLP model using Google's BERT language model to capture the semantic and syntactic nuances of these tasks. Supervised training was initially applied to a subset of the NLP-analyzed tasks to assess the model's effectiveness in classifying the remaining tasks. Incorporating HSTC descriptions significantly enhanced the classification accuracy for 9 out of the 18 HSTCs and reduced training time. To address the issue of severe class imbalance in the HSTC data, we introduced innovative weighting and sampling techniques for data augmentation. We then fine-tune BERT to implement a pairwise relatedness scoring method, allowing us to cluster tasks based on their relatedness and similarity, getting a step closer to labeling the tasks without supervision. In this presentation we guide you through data preprocessing, deciphering key syntax components using BERT, and performing supervised classification of the Mars tasks. This work showcases the potential use of advanced NLP techniques to analyze Mars missions to be incorporated into various crew health and performance analyses.

GenAI↗

NASA NTRS1992

Strategic considerations for support of humans in space and Moon/Mars exploration missions. Life sciences research and technology programs, volume 1

During the next several decades, our nation will embark on human exploration in space. In the microgravity environment we will learn how human physiology responds to the absence of gravity and what procedures and systems are required to maintain health and performance. As the human experience is extended for longer periods in low Earth orbit, we will also be exploring space robotically. Robotic precursor missions, to learn more about the lunar and Martian environments will be conducted so that we can send crews to these planetary surfaces to further explore and conduct scientific investigations that include examining the very processes of life itself. Human exploration in space requires the ability to maintain crew health and performance in spacecraft, during extravehicular activities, on planetary surfaces, and upon return to Earth. This goal can only be achieved through focused research and technological developments. This report provides the basis for setting research priorities and making decisions to enable human exploration missions.

Source record↗

NASA NTRSDate not supplied

Improving Efficacy and Safety of Pharmacological Treatment Through Precision Medicine and Pharmacogenomics for Human Deep Space Exploration

INTRODUCTION: Future spaceflight will require increased crew medical autonomy as exploration class missions expanding duration and distance from Earth, especially for Mars missions. As mission duration increases, it will be even more essential to have appropriate amounts of effective medication to ensure the maintenance of crew health and performance. Conversely, mass and volume constraints will become more severe as future spaceflight expands beyond low Earth orbit, where resupply is difficult or becomes impossible. These constraints thus convey an urgency to further tailor medications included in the spacecraft formulary and increased examination of appropriate dosing regimens. BACKGROUND: Precision Health is an exciting area of cutting-edge research and medicine focused on maintaining an individual’s health and performance through in-depth understanding of an individual’s unique factors and molecular profiles. This approach can be adapted to better predict, monitor, and address physiological responses to the spaceflight environment. One example is the field of pharmacogenomics (PGX),the study of how the expressed genome impacts drug responses with the goal of prescribing the right dose of the right drug at the right time. Specifically, PGX testing provides valuable information on an individual’s precise allelic variations to guide physicians in making informed decisions on pharmaceutical choice and dosing to avoid adverse drug events and maximize pharmacological efficacy. The goal of this study was to evaluate which drugs in the current space pharmacy could be evaluated using PGX testing and to understand the potential impact on the health and wellness of the astronaut population. Additionally, we sought to evaluate clinically available FDA-approved PGX testing solutions to better understand its applicability. METHODS: A complete list of drugs onboard the International Space Station (ISS) was analyzed for risk and likelihood of drug failure and PGX actionability. This analysis encompassed both personal astronaut medications, including supplements and over the counter drugs (n=151) and ISS MedKit formulary medications (n=95). Duplicate medications and different formulations were removed, which resulted in 157 total drugs used in the subsequent analysis. A 5x5 risk assessment table was produced by examining the likelihood of drug failure compared to the consequence of drug failure. Likelihood of individual drug failure was defined by whether existing processes are sufficient to prevent adverse events, as ranked from 1 (very low, can easily be prevented) to 5 (very high, cannot be prevented) during a Mars mission. In contrast, the consequence of drug failure was defined by impact to safety, schedule, cost or technical and ranked from 1 (very low) to 5 (very high).A comprehensive assessment of commercially available PGX solutions is currently underway to evaluate specimen requirements, cost/benefit analysis (cost vs. number of alleles assessed), utility of variant analysis, relevance to inflight medication usage, quality of reporting in enabling clinical application, and ease of integration into electronic medical records. RESULTS: Risk assessments(LxC 5x5 table) indicated29medicationswere in the yellow or red zone driven predominantly by drug failure or safety concerns, with the remainder(n=128)of the medications in the green zone where risk is acceptable. We found that current PGX testing results could impact 21% of the total medications in the ISS MedKit and IMAK; of these, 9 medications currently have direct clinically actionable guidance available. Results of the clinical PGX solution evaluations as related to these medications will be presented. CONCLUSION: PGX testing has demonstrated clear benefits in terrestrial medicine and clinical environments for the selection of proper medications, avoiding adverse drug reactions, and maximizing drug efficacy. We propose that similar benefits would be bestowed on the astronaut and commercial spaceflight passenger population by performing preemptive pre-flight PGX testing to reduce risk of mission failure due to ineffective or toxic medications, improve targeting drug efficacy and safety, and further open the door to countermeasure research exploring PGX-related allelic variants. For example, PGX results could allow tailoring of specific medications at optimal doses more precisely to each individual astronaut, particularly in areas of space motion sickness, sleep aids, and analgesics. An additional benefit is that PGX results could provide information for better planning of the components of a space pharmacy for deep space missions to be more cost effective and more efficient in the utilization of limited pharmaceutical resources. Finally, while PGX testing of the astronaut corps is not currently conducted, this approach could provide immediate impact in support of mission success by reducing risks, optimizing astronaut performance, and providing valuable insights into long-term astronaut health. Such advancements in clinical decision making are important next steps in building dynamic individual risk profiles for astronauts, increasing crew autonomy and providing tailored countermeasures

Alice R W Tang↗

NASA NTRS2023

IMPACTing Medical System Design with a Risk Analysis Tool [“IMPACT” sur la Conception du Système Médical avec un Outil d'Analyse des Risques]

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair↗

NASA NTRSDate not supplied

IMPACTing Medical System Design with a Risk Analysis Tool

K A Shair↗

NASA NTRSDate not supplied

Oxidative Stress and the Neuroconsequences of Spaceflight Environment - Immune Dysregulation and Antioxidant Dietary Countermeasure Efficacy

In this project, we will test the hypothesis that Ionizing Radiation (IR), microgravity and social isolation combine synergistically to trigger an oxidative stress response that alters immune homeostasis, brain structure and function, and neurobehavioral and cognitive performance. Specific Aims for this project are: (1) Determine dose-response curves for acute ‘Five-Ion GCR Simulation’ exposure for immune, brain and performance responses in crew age-matched adult male and female mice; (2) Determine effects of acute ‘Five-Ion GCR Simulation’ exposure singly and in combination with simulated microgravity and social isolation, on immune, brain and performance responses in crew age-matched male and female mice mimicking deep space missions; and (3) Determine efficacy of the dietary antioxidant, Nicotinamide Mononucleotide (NMN), a key intermediate in nicotinamide adenine dinucleotide (NAD+) biosynthesis. The project relies on established and highly translatable ground-based mouse models and assays with IR exposures to be performed at the NASA Space Radiation Laboratory (NSRL). The experimental approach will provide definitive data on the timing and mechanisms involved in the oxidative stress response, immune and brain changes, and ensuing functional (behavioral/cognitive) impairments expected during human transit to Mars. This project will identify potential biomarkers for, and mechanisms underlying, structural and functional changes in the immune and nervous systems leading to behavioral/cognitive performance deficits, and its potential application to develop effective countermeasures to mitigate negative health effects of long duration space habitation. The project will address NASA’s efforts to rapidly advance the characterization of risks and identify appropriate countermeasures in anticipation of future deep space missions. Ensuring crew health and performance during extended transits necessitates that sensorimotor and cognitive abilities remain strong to avoid potentially catastrophic health and safety outcomes. Further, despite historically low numbers of female astronauts, the two most recent NASA Astronaut Corps class selections, comprised of ~50% women as compared to men, signal the need to understand how sex differences affect physiological adaptation and health in the space environment. Here, we will determine how key features of the deep space environment may interact to increase risk to crewmembers by negatively impacting health and performance, and identify and develop strategies to characterize and mitigate the potential risks via countermeasures. Supported by the NASA Human Research Program (HRP) Human Factors Behavioral Performance Element Grant 18-18FLAG_2-0028.

radiation↗

NASA NTRSDate not supplied

Veggie on Ice: The Effects of Plant Production on Human Behavioral Health Long-Duration Antarctic Overwintering Missions

Exploration class missions pose an increased risk of adverse crew behavioral health and psychiatric conditions. Identifying and developing effective and efficient countermeasure strategies are necessary to maintain crew health and performance. Previous studies (VEG-04A and VEG-04B) in the Veggie vegetable-production system on the International Space Station have evaluated the behavioral health effects of caring for plants as a potential countermeasure for crew stresses in spaceflight. The presence of plants can augment sensory stimulation (visual, tactile, and olfactory), provide a psychological link to Earth, reduce stress, and increase happiness. However, further research is needed to understand this strategy for longer-duration missions in isolated, confined, extreme (ICE) environments. The Neumayer III Station in Antarctica is one such environment that hosts a small crew for fourteen-month missions, of which eight to nine months are the remote overwintering phase. Neumayer III also features EDEN ISS, a greenhouse facility with 12.5 m2 plant cultivation space that, like Veggie, currently supplements the crew diet with a variety of fresh produce. Up to nine crew members of the 2021 overwintering mission will complete behavioral health surveys that are designed to capture enjoyment and time spent conducting various plant-related activities, sensory stimulation, and active and passive psychological effects of having live plants and available fresh food in an ICE environment. Data will be collected once pre-mission, up to ten times in-mission at monthly increments, and once post-mission. This study aims to quantify the impact of plant care as a countermeasure strategy for human spaceflight and Antarctic exploration missions.

J M Bunchek↗

NASA NTRSDate not supplied

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery↗

NASA NTRS2009

NASA Exercise Physiology and Countermeasures Project Overview

Efficient exercise countermeasures are necessary to offset or minimize spaceflight-induced deconditioning and to maximize crew performance of mission tasks. These countermeasure protocols should use the fewest crew and vehicle resources. NASA s Exercise Physiology and Countermeasures (ExPC) Project works to identify, collect, interpret, and summarize evidence that results in effective exercise countermeasure protocols which protect crew health and performance during International Space Station (ISS) and future exploration-class missions. The ExPC and NASA s Human Research Program are sponsoring multiple studies to evaluate and improve the efficacy of spaceflight exercise countermeasures. First, the Project will measure maximal aerobic capacity (VO2max) during cycle ergometry before, during, and after ISS missions. Second, the Project is sponsoring an evaluation of a new prototype harness that offers improved comfort and increased loading during treadmill operations. Third, the Functional Tasks Test protocol will map performance of anticipated lunar mission tasks with physiologic systems before and after short and long-duration spaceflight, to target system contributions and the tailoring of exercise protocols to maximize performance. In addition to these studies that are actively enrolling crewmember participants, the ExPC is planning new studies that include an evaluation of a higher-intensity/lower-volume exercise countermeasure protocol aboard the ISS using the Advanced Resistive Exercise Device and second-generation treadmill, studies that evaluate bone loading during spaceflight exercise, and ground-based studies that focus on fitness for duty standards required to complete lunar mission tasks and for which exercise protocols need to protect. Summaries of these current and future studies and strategies will be provided to international colleagues for knowledge sharing and possible collaboration.

Loerch, Linda↗

NASA NTRSDate not supplied

Determining the Importance of In-Flight Treadmill Running Capabilities for Maintaining Astronaut Health and Performance

BACKGROUND: Physical deconditioning induced via spaceflight is most effectively attenuated through in-flight exercise training. Throughout its evolution, NASA has implemented advancements to in-flight exercise countermeasures, culminating in the triad of devices currently used aboard the International Space Station (ISS): a treadmill (T2), cycle ergometer (CEVIS), and resistance exercise device (ARED). Despite high-quality exercise devices and prescriptions, many crewmembers experience reductions in both aerobic capacity (VO2peak pre-post mean change: -10%) and strength (knee isokinetic pre-post mean change: -15%). As NASA moves towards exploration missions, which will impose greater size, power, and time constraints on exercise systems in addition to physically demanding surface extravehicular activities (EVAs), providing robust capabilities to protect crew health and performance should be prioritized. OVERVIEW: Future missions to the Lunar and Martian surfaces will include EVAs requiring ambulation and greater physical exertion than those in Apollo missions. While the exercise device concepts planned for exploration missions include resistive and aerobic capabilities, they do not allow for ambulation. Specifically, the countermeasure planned for Artemis Lunar transit is a flywheel device, which provides both exercise modalities through a single resistive cable. While more robust than the flywheel, the devices planned for the Lunar orbital space station, and subsequent Mars habitats, will provide distinct aerobic and resistance modalities capable of achieving high intensities. However, these modalities do not include a treadmill. Recent research suggests that greater in-flight running intensity and volume attenuate decrements in aerobic capacity and strength; however, this has not been experimentally confirmed. The Exploration Exercise Treadmill Requirements study is currently underway, aiming to determine the effects of exercising without a treadmill on aerobic capacity, strength, bone density, and sensorimotor function during long-duration spaceflight. DISCUSSION: Providing running capabilities on future exploration missions may help to maintain astronaut physical ability, reduce injury, and promote health. Studies quantifying the effects of using exploration exercise devices are in progress, which will help provide critical recommendations on whether a treadmill is a necessary component of the in-flight training regime. This presentation will discuss the capabilities of exploration exercise devices and the potential implications of not having running capabilities during long-duration spaceflight.

Alyssa N Varanoske↗

NASA NTRSDate not supplied

Human Systems Risk Network - A Ranking Analysis of Risks

INTRODUCTION The Human Systems Risk Board (HSRB) is responsible for understanding, managing, and mitigating the risks associated with spaceflight. For a particular mission, the HSRB assigns each human system risk a rating on a 5x5 grid assessing its likelihood and consequence, which is ultimately used to compare and rank the risks. The HSRB approaches risk management by primarily establishing the context of each human system risk individually with the understanding that mitigating one risk might affect the likelihood, consequence, and mitigation approaches of another. To support this effort the HSRB, subject matter experts, and risk custodian teams created directed acyclic graphs (DAG), often called a causal graph, for the twenty-nine risks. In this presentation, we propose a new ranking algorithm for the risks which includes the downstream influence of each risk according to the information in the DAGs and provide an application of graph theoretic tools. METHODS In 2014, Mindock and Klaus proposed a taxonomy for human system risk influences which we have adopted to categorize the nodes in each DAG. Analyzing the nodes that correspond to the risks in this taxonomy allows us to analyze and understand how each risk influences the others. We construct an auxiliary network, which we call the Primary Risk Network (PRN), where the nodes are the twenty-nine space flight risks and, a directed edge connects Risk A to Risk B if Risk A has some influence on the likelihood or consequence of Risk B as described in the DAGS. We perform a variety of graph theoretic ranking methods on the nodes (or risks) in the PRN, including Katz centrality. RESULTS We rank the nodes in the PRN using the Katz centrality score. The ten risks with the highest score are pictured in Figure 1, colored (light to dark) according to their score. We analyze other centrality measures like betweenness centrality, eigenvector centrality, and the Estrada index, and provide the meaning of the corresponding rankings in terms of the risks. Future work includes analyzing the other categories in the taxonomy defined by Mindock and Klaus [1]. For example, we are interested in analyzing the nodes that are labeled as countermeasures or capabilities and perform similar analysis to measure their effect on certain medical conditions.

dag↗

NASA NTRS2017

Understanding the International Space Station Crew Perspective following Long-Duration Missions through Data Analytics & Visualization of Crew Feedback

The International Space Station (ISS) first became a home and research laboratory for NASA and International Partner crewmembers over 16 years ago. Each ISS mission lasts approximately 6 months and consists of three to six crewmembers. After returning to Earth, most crewmembers participate in an extensive series of 30+ debriefs intended to further understand life onboard ISS and allow crews to reflect on their experiences. Examples of debrief data collected include ISS crew feedback about sleep, dining, payload science, scheduling and time planning, health & safety, and maintenance. The Flight Crew Integration (FCI) Operational Habitability (OpsHab) team, based at Johnson Space Center (JSC), is a small group of Human Factors engineers and one stenographer that has worked collaboratively with the NASA Astronaut office and ISS Program to collect, maintain, disseminate and analyze this data. The database provides an exceptional and unique resource for understanding the "crew perspective" on long duration space missions. Data is formatted and categorized to allow for ease of search, reporting, and ultimately trending, in order to understand lessons learned, recurring issues and efficiencies gained over time. Recently, the FCI OpsHab team began collaborating with the NASA JSC Knowledge Management team to provide analytical analysis and visualization of these over 75,000 crew comments in order to better ascertain the crew's perspective on long duration spaceflight and gain insight on changes over time. In this initial phase of study, a text mining framework was used to cluster similar comments and develop measures of similarity useful for identifying relevant topics affecting crew health or performance, locating similar comments when a particular issue or item of operational interest is identified, and providing search capabilities to identify information pertinent to future spaceflight systems and processes for things like procedure development and training. In addition, the comments were scored for sentiment using a polarity scoring algorithm to identify both positive and negative comments for particular groups and clusters, allowing the team to make analytically informed decisions regarding future hardware and operating procedures. The use of polarity scoring with time series analysis was used to provide insight into how crew health and habitability is changing throughout various spaceflight increments or the station lifecycle as a whole. Finally, a visualization framework was developed to address the needs of the end users to search for and analyze comments by user, category or mission. This paper will discuss how the use of an analytical framework in conjunction with the current human interface, improved the understanding of crew perspective and shortened the time for analysis allowing for more informed decisions and rapid development of improvements. These methods are significantly optimizing the way that this valuable data can be assessed and applied to current and future spaceflight design and development. This collaboration allows the FCI OpsHab team to effectively analyze and share data in a more automated and timely fashion. Trends are no longer derived manually and can be illustrated effectively and accurately with these evolving techniques to an ever growing group of human spaceflight end users.

Bryant, Cody↗

NASA NTRS1992

Psychological training of NASA astronauts for extended missions

The success of operational teams working in remote and hostile environments rests in large part on adequate preparation of those teams prior to emplacement in field settings. Psychological training, directed at the maintenance of crew health and performance becomes increasingly important as space missions grow in duration and complexity. Methods: Topics to be discussed include: the conceptual framework of psychological training; needs analysis; content and delivery options; methods of assessing training efficacy; use of testbeds and analogies and the relationship of training to crew selection and real-time support activities. Results and Conclusions: This paper will discuss the psychological training approach being developed at the NASA/JSC Behavior and Performance Laboratory. This approach will be compared and contrasted with those underway in the U.S. Department of Defense and in other space agencies.

Holland, A. W.↗