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The Lifetime Surveillance of Astronaut Health Newsletter

The June 2010 LSAH newsletter introduced the change from the Longitudinal Study of Astronaut Health research study to the new Lifetime Surveillance of Astronaut Health program (An Overview of the New Occupational Surveillance Program for the Astronaut Corps). Instead of performing research-focused retrospective analyses of astronaut medical data compared to a JSC civil servant control population, the new program is focused on prevention of disease and prospective identification and mitigation of health risks in each astronaut due to individual exposure history and the unique occupational exposures experienced by the astronaut corps. The new LSAH program has 5 primary goals: (1) Provide a comprehensive medical exam for each LSAH participant; (2) Conduct occupational surveillance; (3) Improve communication, data accessibility, integrity and storage; (4) Support operational and healthcare analyses; and (5) Support NASA research objectives. This article will focus primarily on the first goal, the comprehensive medical exam. Future newsletters will outline in detail the plans and processes for addressing the remaining program goals.

Lee, Lesley↗

The Biomolecule Sequencer Project: Nanopore Sequencing as a Dual-Use Tool for Crew Health and Astrobiology Investigations

Human missions to Mars will fundamentally transform how the planet is explored, enabling new scientific discoveries through more sophisticated sample acquisition and processing than can currently be implemented in robotic exploration. The presence of humans also poses new challenges, including ensuring astronaut safety and health and monitoring contamination. Because the capability to transfer materials to Earth will be extremely limited, there is a strong need for in situ diagnostic capabilities. Nucleotide sequencing is a particularly powerful tool because it can be used to: (1) mitigate microbial risks to crew by allowing identification of microbes in water, in air, and on surfaces; (2) identify optimal treatment strategies for infections that arise in crew members; and (3) track how crew members, microbes, and mission-relevant organisms (e.g., farmed plants) respond to conditions on Mars through transcriptomic and genomic changes. Sequencing would also offer benefits for science investigations occurring on the surface of Mars by permitting identification of Earth-derived contamination in samples. If Mars contains indigenous life, and that life is based on nucleic acids or other closely related molecules, sequencing would serve as a critical tool for the characterization of those molecules. Therefore, spaceflight-compatible nucleic acid sequencing would be an important capability for both crew health and astrobiology exploration. Advances in sequencing technology on Earth have been driven largely by needs for higher throughput and read accuracy. Although some reduction in size has been achieved, nearly all commercially available sequencers are not compatible with spaceflight due to size, power, and operational requirements. Exceptions are nanopore-based sequencers that measure changes in current caused by DNA passing through pores; these devices are inherently much smaller and require significantly less power than sequencers using other detection methods. Consequently, nanopore-based sequencers could be made flight-ready with only minimal modifications.

John, K. K.↗

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

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

directed acyclic graphs↗

Long-Term Health Risk Quantification

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

Beth Lewandowski↗

Spaceflight Medical Evacuation Risk Assessment Principles - A Qualitative Investigation

BACKGROUND Future human space exploration beyond Low Earth Orbit (LEO) will require innovative solutions in many areas, primarily those that provide direct medical support to crew on long-duration missions and optimize their health and performance. The associated challenges therein will be numerous, including but not necessarily limited to extended one-way or "asynchronous" communication delays, minimal to non-existent resupply, and a prolonged transit time to "definitive care" ranging from 3-days to 9-months. At the same time, long-duration exploration spacecraft and crew will face restrictions on mass, power, volume, and data far more significant than that seen in current LEO settings. Given these limitations, medical risk assessment is of primary importance, especially evaluating the implications of a medical evacuation of an ill or injured crewmember. Such evacuations are complicated, potentially dangerous, and well may be impossible in certain phases of the mission. Regardless, such issues must be weighed against the risks of the injured crew remaining aboard a spacecraft with limited medical resources. OBJECTIVE This qualitative study drew from the experiences of subject matter experts (SMEs) in spaceflight and appropriate analog environments (i.e., military, disaster, and extreme environment fields) to identify unique principles common amongst medical evacuation considerations helpful in informing future risk assessment tools. Appropriate analog environments included austere operational settings where multiple factors (weather, logistics/limited resupply, denied/extreme environments, and patient condition) resulted in a limited ability to provide definitive local medical care. The fundamental principles in question revolved around scenarios where evacuation became a complicating yet necessary consideration and where life-threatening medical concerns had to be weighed against critical mission objective(s). The primary authors collected semi-structured data gathered through in-depth interviews with 16 subject matter experts (SMEs). Interview questions investigated how these SMEs consider and weigh the attendant risks present in medical evacuation scenarios. Among the critical questions posed were those that sought to understand how the SME balanced the challenges and requirements of medical evacuation (or keeping an injured patient "on-site" aka: "prolonged field care") against the evacuation operation's risks on impacting overarching mission success. The team analyzed interview transcripts for common themes and principles using the qualitative methods of thematic analysis based on consensus, co-occurrence, and comparison. As a result, nine primary risk consideration themes and nine contributing factor themes emerged, all of which will ideally inform future medical evacuation decision-making tools and operational decision-making for exploration class missions. Specific aims for this study included: 1. Identification of common principles used to assess risks and benefits of medical evacuations in extreme environments 2. Identification of common points of friction or complication and challenges in extreme environment evacuations

A T Almand↗

Incorporating biologically based models into assessments of risk from chemical contaminants

The general approach to assessment of risk from chemical contaminants in drinking water involves three steps: hazard identification, exposure assessment, and dose-response assessment. Traditionally, the risks to humans associated with different levels of a chemical have been derived from the toxic responses observed in animals. It is becoming increasingly clear, however, that further information is needed if risks to humans are to be assessed accurately. Biologically based models help clarify the dose-response relationship and reduce uncertainty.

Review, Tutorial↗

Surveillance and Control of Malaria Transmission in Thailand using Remotely Sensed Meteorological and Environmental Parameters

These slides address the use of remote sensing in a public health application. Specifically, this discussion focuses on the of remote sensing to detect larval habitats to predict current and future endemicity and identify key factors that sustain or promote transmission of malaria in a targeted geographic area (Thailand). In the Malaria Modeling and Surveillance Project, which is part of the NASA Applied Sciences Public Health Applications Program, we have been developing techniques to enhance public health's decision capability for malaria risk assessments and controls. The main objectives are: 1) identification of the potential breeding sites for major vector species; 2) implementation of a risk algorithm to predict the occurrence of malaria and its transmission intensity; 3) implementation of a dynamic transmission model to identify the key factors that sustain or intensify malaria transmission. The potential benefits are: 1) increased warning time for public health organizations to respond to malaria outbreaks; 2) optimized utilization of pesticide and chemoprophylaxis; 3) reduced likelihood of pesticide and drug resistance; and 4) reduced damage to environment. !> Environmental parameters important to malaria transmission include temperature, relative humidity, precipitation, and vegetation conditions. The NASA Earth science data sets that have been used for malaria surveillance and risk assessment include AVHRR Pathfinder, TRMM, MODIS, NSIPP, and SIESIP. Textural-contextual classifications are used to identify small larval habitats. Neural network methods are used to model malaria cases as a function of the remotely sensed parameters. Hindcastings based on these environmental parameters have shown good agreement to epidemiological records. Discrete event simulations are used for modeling the detailed interactions among the vector life cycle, sporogonic cycle and human infection cycle, under the explicit influences of selected extrinsic and intrinsic factors. The output of the model includes the individual infection status and the quantities normally observed in field studies, such as mosquito biting rates, sporozoite infection rates, gametocyte prevalence and incidence. Results are in good agreement with mosquito vector and human malaria data acquired by Coleman et al. over 4.5 years in Kong Mong Tha, a remote village in western Thailand. Application of our models is not restricted to the Greater Mekong Subregion. Our models have been applied to malaria in Indonesia, Korea, and other regions in the world with similar success.

Kiang, Richard K.↗

Flood Analysis of the Thomas Flood in California Using NASA Data in a GIS

In December 2017, the Thomas Fire burned areas in Ventura and Santa Barbara Counties in California, consuming 281,893 acres (440 square miles), and becoming the largest wildfire in California history. On January 8, 2018, a winter storm made landfall in Santa Barbara County, releasing more than 5 inches of rain onto the same scarred area, causing San Ysidro and Montecito Creeks to overflow and leading to devastating flash flooding and debris flows by January 9, 2018. Several areas that were not typically prone to flooding were at risk due to the higher than usual flows in the nearby streams and creeks. The unprecedented flooding killed at least 20 people and left several others missing. NASA's Earth Observing System Data Information System (EOSDIS) manages Earth Observation satellites and the Distributed Active Archive Centers (DAACs), where the data is stored and processed. This poster presents the use of satellite data from NASA's inventory that have the potential for use in identification and analysis of forest fire risk and subsequent after-effects within a geographic information system (GIS).

science↗

Reducing the risks of using Ada onboard the Space Station

In 1986, the Ada programming language was chosen by NASA as the primary computer programming language for the development of new software for the Space Station. Ada was selected based on the results of investigations coordinated through Johnson Space Center (JSC). These investigations resulted in the identification of a set of problems and risks associated with using software developed in Ada onboard the Space Station. But the risks associated with these problems were found to be of insufficient severity to outweigh the significant benefits and suitability of Ada for the project. However, since the selection of Ada for the Space Station Project, detailed investigations have continued at Johnson Space Center into the most important problems identified in using Ada. This paper discusses some of the specific solutions to problems which have been identified through these investigations and which are reducing the risks of using Ada onboard the Space Station.

Humphrey, Terry D.↗

Development of Computational Environmental Microbiome Workflows for the Laboratory and the International Space Station

Identification of microorganisms in the spaceflight environment is critical for crew health risk assessment on the International Space Station (ISS). Since 2017, nanopore sequencing technology has been used to support thein situ identification of microbial species during spaceflight. Beginning in 2018, a culture-independent, swab-to-sequencer method was implemented onboard the ISS to provide a more thorough insight of the ISS microbiome. Eliminating microbial culture enables identification of difficult-to-culture organisms, reduces risks associated with potentially pathogenic cultures, and could significantly reduce the time from sample-to-answer. However, this molecular-based approach generates large metagenomic datasets that require substantial computational resources for analysis. To process nanopore-generated sequencing data, the JSC Microbiology Laboratory established a bioinformatics workflow on Amazon EC2 under the security guidance of the NASA Science Managed Cloud Environment (SMCE).This resource allows for the development, testing, and accessing of computational tools for processing large and complex datasets. The work described here will address the downlinking of data from the ISS, the automated pipeline developed to identify targeted bacterial and fungal organisms, and the time from sampling onboard to microbial identification. The pipelines have been enhanced to address high and low biomass samples using optimization based on sample source (air, water, or surface) and type of collection (filter, colony, or swab).The resulting microbiome data can be assessed beyond microbial identifications to gain understanding toward population changes over time, potential selective environmental pressures, and evaluating correlations with a wide range of additional data sets. Metagenome analysis pipelines in development could allow for simultaneous identification of microbial species, gene function, and gene pathways present in the environment. Beyond the ground processing, the developed analysis pipeline is currently deployed onboard the ISS to allow for near real-time assessments of the ISS microbiome. This study serves as a critical foundation for exploration missions, where rapid microbiome analyses will be required.

G. Marie Sharp↗

A guide for performing system safety analysis

A general guide is presented for performing system safety analyses of hardware, software, operations and human elements of an aerospace program. The guide describes a progression of activities that can be effectively applied to identify hazards to personnel and equipment during all periods of system development. The general process of performing safety analyses is described; setting forth in a logical order the information and data requirements, the analytical steps, and the results. These analyses are the technical basis of a system safety program. Although the guidance established by this document cannot replace human experience and judgement, it does provide a methodical approach to the identification of hazards and evaluation of risks to the system.

Brush, J. M.↗

System safety in manned spaceflight

System safety in manned spaceflight is discussed with attention to the organization of the NASA safety effort, hazard identification and resolution, safety program integration, risk management visibility, and space transportation system payload safety. Key ingredients of the safety program, including concepts such as a distinct and appropriate level of responsibility for safety, and comprehensive and appropriate safety requirements from the policy level to the system level, are summarized. Program safety interrelationships are indicated.

Hammack, J. B.↗

Millimeter wave satellite concepts. Volume 1: Executive summary

The objectives of the program were: (1) development of methodology based on the technical requirements of potential services that might be assigned to millimeter wave bands for identifying the viable and appropriate technologies for future NASA millimeter research and development programs, and (2) testing of this methodology with user applications and services. The scope of the program included the entire communications network, both ground and space subsystems. The reports include: (1) cost, weight, and performance models for the subsystems, (2) conceptual design for point-to-point and broadcast communications satellites, (3) analytic relationships between subsystem parameters and an overall link performance, (4) baseline conceptual systems, (5) sensitivity studies, (6) model adjustment analyses, (7) identification of critical technologies and their risks, (8) brief R&D program scenarios for the technologies judged to be moderate or extensive risks.

Hilsen, N. B.↗

Program Models Propagation Of Failures

FIRM is software tool for identification of failure and management of risk based on directed-graph ("digraph") approach. Three core algorithms optimized for processing singletons and doubletons and also handle tripletons. FIRM identifies loops in digraphs and displays direct failure paths between any two nodes. Solves for reachability for given node without computing reachability for entire digraph. Represents hybrid between schematic-diagram and fault-tree approaches. Written in C.

Hackler, Donald B.↗

Fire Analysis of the Thomas Fire in California Using NASA Data in a GIS

NASA's Earth Observing System Data Information System (EOSDIS) manages Earth Observation satellites and the Distributed Active Archive Centers (DAACs), where the data is stored and processed. This poster presents the use of satellite data from NASA's inventory that have the potential for use in identification and analysis of forest fire risk and subsequent after-effects within a geographic information system (GIS). The challenge is that Earth Observation data is complicated. There is plenty of data available, however, the science teams have had a "top-down" approach: define what it is you are trying to study -select a set of satellite(s) and sensor(s), and drill down for the data.

Worldview↗

NASA Systems Engineering and Safety Culture: Aerospace Project Design and Implementation Challenges

Using Systems Engineering principles and the NASA Glenn Safety procedures and protocols, a rigorous method was developed to ensure safe testing and operation of a small, commercial off the shelf turbofan engine at the Aero-Acoustic Propulsion Laboratory (AAPL). The DGEN380 is a small, ~500-lbf thrust class, high-bypass, geared- turbofan engine with a separate flow nozzle. It is a modular, compact, lightweight turbofan with Full-Authority Digital Engine Control. It’s general characteristics make it an ideal candidate for utilization as a testbed for engine aero-acoustic technology maturation in a relevant performance environment. The DGEN380 is the core component of the DGEN Aero-propulsion Research Turbofan (DART) mobile test rig. The full presentation will describe the risk assessment and mitigation process applied to the DART by the project team. The identification and analysis of failure modes led to the development of risk mitigation plans, which include administrative, engineering, and physical controls for the safe operation of the DART test rig at the AAPL facility.

Systems Engineering, Aeronautics, safety↗

The 7 Year Evolution of EOS CA Support for Planning & Executing Risk Mitigation Maneuvers

This presentation will discuss the evolution of Collision Avoidance (CA) support for planning and executing Risk Mitigation Maneuvers (RMMs) for the Earth Observing System (EOS) Aqua, Aura, and Terra satellites within the seven-year period of January 2015 through December 2021. Several enhancements were implemented by the EOS team to expedite and improve the RMM planning and execution process, including updates to High Interest Event (HIE) analysis, maneuver preparation, maneuver ephemeris generation, conjunction event data screening, and maneuver commanding. As of 2022, these advancements allow the EOS team to plan and execute an RMM within 5 hours of identification with an accurate and low-risk solution. This represents a vast improvement from the 30 hours required to turn around an RMM back in 2015. In addition, the current process is substantially less error prone. Details of this progression and the specific aspects of each supporting component are explicated in the content of the presentation.

Syed Hasan↗

Space Station Freedom/lunar transfer vehicle propellant operation hazard analysis

Space Station Freedom (SSF), as a transportation node for Space Exploration Initiative missions, would involve the assembly and refurbishing of lunar and Mars transfer vehicles. This includes operations involving cryogenic propellants (LH2 7 LO2) such as storing and handling of loaded propellant tanks, assembly onto the vehicle, and propellant transfer. Cryogenic propellants dictate rigorous safety precautions and impose unique requirements to ensure flight safety to both personnel and SSF elements. The objective of this study is to identify potential hazards and risks associated with cryogenic propellants. This involves identification of pertinent system design features and operational procedures. Criticality of identified risks/hazards shall be assessed and those that fall in the catastrophic and critical categories shall include mitigating solutions.

Dominick, Sam↗