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At least 145 records · Page 8

Evidence Report: Risk of Adverse Health Effects Due to Host-Microorganism Interactions

While preventive measures limit the presence of many medically significant microorganisms during spaceflight missions, microbial infection of crewmembers cannot be completely prevented. Spaceflight experiments over the past 50 years have demonstrated a unique microbial response to spaceflight culture, although the mechanisms behind those responses and their operational relevance were unclear. In 2007, the operational importance of these microbial responses was emphasized as the results of an experiment aboard STS-115 demonstrated that the enteric pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium) increased in virulence in a murine model of infection. The experiment was reproduced in 2008 aboard STS-123 confirming this finding. In response to these findings, the Institute of Medicine of the National Academies recommended that NASA investigate this risk and its potential impact on the health of the crew during spaceflight. NASA assigned this risk to the Human Research Program. To better understand this risk, evidence has been collected and reported from both spaceflight analog systems and actual spaceflight including Mir, Space Shuttle, and ISS missions. Although the performance of virulence studies during spaceflight are challenging and often impractical, additional information has been and continues to be collected to better understand the risk to crew health. Still, the uncertainty concerning the extent and severity of these alterations in host-microorganism interactions is very large and requires more investigation as the focus of human spaceflight shifts to longer-duration exploration class missions.

Ott, C. Mark↗

Risk Assessment of Physiological Effects of Atmospheric Composition and Pressure in Constellation Vehicles

To limit the risk of fire and reduce denitrogenation time to prevent decompression sickness to support frequent extravehicular activities on the Moon, a hypobaric (PB = 414 mmHg) and mildly hypoxic (ppO2 = 132 mmHg, 32% O2 - 68% N2) living environment is considered for the Crew Exploration Vehicle (CEV) and Lunar Surface Access Module (LSAM). With acute change in ppO2 from 145-178 mmHg at standard vehicular operating pressure to less than 125 mmHg at desired lunar surface vehicular operating pressures, there is the possibility that some crewmembers may develop symptoms of Acute Mountain Sickness (AMS). The signs and symptoms of AMS (headache plus nausea, dizziness, fatigue, or sleeplessness), could impact crew health and performance on lunar surface missions. An exhaustive literature review on the topic of the physiological effects of reduced ppO2 and absolute pressure as may contribute to the development of altitude symptoms or AMS was performed. The results of the nine most rigorous studies were collated, analyzed and contents on AMS and hypoxia symptoms summarized. There is evidence for an absolute pressure effect per se on AMS, so the higher the altitude for a given hypoxic alveolar O2 partial pressure (PAO2), the greater the AMS response. About 25% of adults are likely to experience mild AMS near 2,000 m altitude following a rapid ascent from sea level while breathing air (6,500 feet, acute PAO2 = 75 mmHg). The operational experience with the Shuttle staged denitrogenation protocol at 528 mmHg (3,048 m) while breathing 26.5% O2 (acute PAO2 = 85 mmHg) in astronauts adapting to microgravity suggests a similar likely experience in the proposed CEV environment. We believe the risk of mild AMS is greater given a PAO2 of 77 mmHg at 4,876 m altitude while breathing 32% O2 than at 1,828 m altitude while breathing 21% O2. Only susceptible astronauts would develop mild and transient AMS with prolonged exposure to 414 mmHg (4,876 m) while breathing 32% O2 (acute PAO2 = 77 mmHg). So the following may be employed for operational risk reduction: 1) develop procedures to increase PB as needed in the CEV, and use a gradual or staged reduction in cabin pressure during lunar outbound; 2) train crews for symptoms of hypoxia, to allow early recognition and consider pre-adaptation of crews to a hypoxic environment prior to launch, 3) consider prophylactic acetazolamide for acute pressure changes and be prepared to treat any AMS associated symptoms early with both carbonic anhydrase inhibitors and supplemental oxygen.

Scheuring, Richard A.↗

Traditional Cardiovascular Risk Factors as Predictors of Cardiovascular Events in the U.S. Astronaut Corps

Risk prediction equations from the Framingham Heart Study are commonly used to predict the absolute risk of myocardial infarction (MI) and coronary heart disease (CHD) related death. Predicting CHD-related events in the U.S. astronaut corps presents a monumental challenge, both because astronauts tend to live healthier lifestyles and because of the unique cardiovascular stressors associated with being trained for and participating in space flight. Traditional risk factors may not hold enough predictive power to provide a useful indicator of CHD risk in this unique population. It is important to be able to identify individuals who are at higher risk for CHD-related events so that appropriate preventive care can be provided. This is of special importance when planning long duration missions since the ability to provide advanced cardiac care and perform medical evacuation is limited. The medical regimen of the astronauts follows a strict set of clinical practice guidelines in an effort to ensure the best care. The purpose of this study was to evaluate the utility of the Framingham risk score (FRS), low-density lipoprotein (LDL) and high-density lipoprotein levels, blood pressure, and resting pulse as predictors of CHD-related death and MI in the astronaut corps, using Cox regression. Of these factors, only two, LDL and pulse at selection, were predictive of CHD events (HR(95% CI)=1.12 (1.00-1.25) and HR(95% CI)=1.70 (1.05-2.75) for every 5-unit increase in LDL and pulse, respectively). Since traditional CHD risk factors may lack the specificity to predict such outcomes in astronauts, the development of a new predictive model, using additional measures such as electron-beam computed tomography and carotid intima-media thickness ultrasound, is planned for the future.

Halm, M. K.↗

Institutionalizing Lessons Learned

The NASA Integrated Action Team (NIAT) was formed by the NASA Administrator in March 2000. The purpose of this team was to identify the actions that NASA must take to address systemic findings reported in 4 different anomaly investigations. Team membership represented senior managers from all the field centers and NASA Headquarters. NIAT report addressed 165 findings and developed 17 action plans that are described in five themes: people and teams, technology, risk, formulation rigor, and communications. The NIAT actions present a systems solution for strengthening formulation and implementation of programs and improving the environment for their support. NIAT results included: enhancing success by avoiding failures that could have been prevented through good planning and sound practice; ensuring that prudent risks do not compromise safety; and ensuring that mission risks are objectively assessed, appropriately mitigated and consciously accepted by the program team and customers. Definitions of Faster, Better, Cheaper and Success Criteria were also developed and included as part of the NIAT report. As a result of the NIAT report, program and project management process changes were incorporated into NASA's quality system documentation, including NPG 7120.513, "NASA Program and Project Management Processes and Requirements. This paper describes the NIAT results and the resulting updates to NPG 7120.5 that keep this program and project management description a living process.

McBrayer, Robert O.↗

Programmed Multiphasic Health Testing

Multiphase health screening procedures are advocated for detection and prevention of disease at an early stage through risk factor analysis. The use of an automated medical history questionnaire together with scheduled physical examination data provides a scanning input for computer printout. This system makes it possible to process laboratory results from 1,000 to 2,000 patients for biochemical determinations on an economically feasible base.

Hershberg, P. I.↗

Proceedings from the 2001 NASA Occupational Health Conference: Risk Assessment and Management in 2001

This Conference convened approximately 86 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Two days' Professional Development Courses on Exposure Assessment Strategies and Statistics and on Advanced Cardiac Life Support training and recertification preceded the Conference. With the theme, 'Risk Assessment and Management in 2001,' conferees were first provided updates from the Program Principal Center Office and the Headquarters Office. Plenary sessions elaborated on several topics: biological terrorism, OSHA recordability, Workers' Compensation issues, Federal ergonomic standards, bridging aerospace medicine and occupational health-especially in management of risk in spaceflight, and EAP operations with mission failures. A keynote address dealt with resiliency skills for 21st century workers and two NASA astronaut speakers highlighted a tour of the Johnson Space Center. During discipline specific breakout sessions, current issues in occupational health management and policy, credentialing and privileging, health risk assessment, measurement and standardization, audits, database development, prevention and rehabilitation, international travel and infection control, employee assistance, nursing process, and environmental health were presented.

Roberson, Sheri↗

Predicting sudden cardiac death from T wave alternans of the surface electrocardiogram: promise and pitfalls

Sudden cardiac death remains a preeminent public health problem. Despite advances in preventative treatment for patients known to be at risk, to date we have been able to identify, and thus treat, only a small minority of these patients. Therefore, there is a major need to develop noninvasive diagnostic technologies to identify patients at risk. Recent studies have demonstrated that measurement of microvolt-level T wave alternans is a promising technique for the accurate identification of patients at risk for ventricular arrhythmias and sudden cardiac death. In this article, we review the clinical data establishing the relationship between microvolt T wave alternans and susceptibility to ventricular arrhythmias. We also review the methods and technology that have been developed to measure microvolt levels of T wave alternans noninvasively in broad populations of ambulatory patients. In particular, we examine techniques that permit the accurate measurement of T wave alternans during exercise stress testing.

Review, Tutorial↗

Dividing the Concentrator Target From the Genesis Mission

The Genesis spacecraft, launched in 2001, traveled to a Lagrangian point between the Earth and Sun to collect particles from the solar wind and return them to Earth. However, during the return of the spacecraft in 2004, the parachute failed to open during descent, and the Genesis spacecraft crashed into the Utah desert. Many of the solar wind collectors were broken into smaller pieces, and the field team rapidly collected the capsule and collector pieces for later assessment. On each of the next few days, the team discovered that various collectors had survived intact, including three of four concentrator targets. Within a month, the team had imaged more than 10,000 fragments and packed them for transport to the Astromaterials Acquisition and Curation Office within the ARES Directorate at JSC. Currently, the Genesis samples are curated along with the other extraterrestrial sample collections within ARES. Although they were broken and dirty, the Genesis solar wind collectors still offered the science community the opportunity to better understand our Sun and the solar system as a whole. One of the more highly prized concentrator collectors survived the crash almost completely intact. The Genesis Concentrator was designed to concentrate the solar wind by a factor of at least 20 so that solar oxygen and nitrogen isotopes could be measured. One of these materials was the Diamond-on-Silicon (DoS) concentrator target. Unfortunately, the DoS concentrator broke on impact. Nevertheless, the scientific value of the DoS concentrator target was high. The Genesis Allocation Committee received a request for approximately 1 cm(sup 2) of the DoS specimen taken near the focal point of the concentrator for the analysis of solar wind nitrogen isotopes. The largest fragment, Genesis sample 60000, was designated for this allocation and needed to be precisely cut. The requirement was to subdivide the designated sample in a manner that prevented contamination of the sample and minimized the risk of losing or breaking the precious requested sample fragment. The Genesis curator determined that the use of laser scribing techniques to "cut" a precise line and subsequently cleave the sample (in a controlled break of the sample along that line) was the best method for accomplishing the sample subdivision. However, there were risks, including excess heating of the sample, that could cause some of the implanted solar wind to be lost via thermal diffusion. Accidentally breaking the sample during the handling and cleaving process was an additional risk. Early in fiscal year 2013, to address this delicate, complicated task, the ARES Directorate assembled its top scientists to develop a cutting plan that would ensure success when applied to the actual concentrator target wafer; i.e., to produce an approximately 1 cm(sup 2) piece from the requested area of the wafer. The team, subsequently referred to as the JSC Genesis Tiger Team, spent months researching and testing parameters and techniques related to scribing, cleaving, transporting, handling, and holding (i.e., mounting) the specimen. The investigation required considerable "thinking outside the box," and many, many trials using nonflight wafer analogs. After all preliminary testing, the following method was adopted as the final cutting plan. It was used in two final end-to-end practice runs before being used on the actual flight target wafer. The wafer was oriented on the laser cutting stage with the 100 and 010 directions of the wafer parallel to the corresponding X and Y directions of the cutting stage. The laser was programed to scribe 31 lines of the appropriate length along the Y stage direction. The programed scribe lines were separated by 5 micron in the X direction. The laser parameters were set as follows: (1) The laser power was 0.5 watts; (2) each line consisted of 50 passes, with the Z position being advanced 5 micron per pass; and (3) 30 s would elapse before the next line was scribed to allow for wafer cool down from any possible heating via the laser. The ablated material that "stuck" in the "scribe-cut" was removed from the "cut" using an ultrasonic micro-tool. After all the ablated silicon was removed from the wafer, the wafer was repositioned in exactly the same orientation on the laser stage. The laser was focused using the bottom of the wafer channel, and the 31-line scribing pattern described above was reprogrammed using the Z position of the groove bottom as the starting Z value instead of the top wafer surface, which was used previously. Upon completion of the second set of scribes, the ultrasonic micro-tool was again used to clean out the cut. The wafer was remounted on the stage in exactly the same orientation as before. The laser was again focused on the bottom of the groove. This time, however, the laser was.programed to scribe only one line down the exact center of the channel. The final scribe line consisted of 100 passes with a Z advance of 5 micron per pass and with the laser power set at 0.5 watts. As mentioned above, the final cutting plan was practiced in two end-to-end trials using non-flight, triangular-shaped silicon wafers similar in size and orientation to the actual DOS 60000 target sample. The actual scribing of the triangular-shaped wafers required scribing two lines and cleaving (i.e. scribe-cleave, then scribe-cleave) to obtain the piece requested for allocation. Early in December 2012, after many months of experiments and practicing and perfecting the techniques and procedures, the team successfully subdivided the Genesis DoS 60000 target sample, one of the most scientifically important samples from the Genesis mission (figure 2). On December 17, 2012, the allocated piece of concentrator target sample was delivered to the requesting principal investigator.The cutting plan developed for the subdivision of this sample will be used as the model for subdividing future requested Genesis flight wafers (appropriately modified for different wafer types).

Lauer, H. V., Jr.↗

Epidemiologic and Environmental Risk Factors of Rift Valley Fever in Southern Africa from 2008 to 2011

Background: Rift Valley fever (RVF) outbreaks have been associated with periods of widespread and above normal rainfall over several months. Knowledge on the environmental factors influencing disease transmission dynamics has provided the basis for developing models to predict RVF outbreaks in Africa. From 2008 to 2011, South Africa experienced the worst wave of RVF outbreaks in almost 40 years. We investigated rainfall associated environmental factors in southern Africa preceding these outbreaks. Methods: RVF epizootic records obtained from the World Animal Health Information Database (WAHID), documenting livestock species affected, location, and time, were analyzed. Environmental variables including rainfall and satellite-derived normalized difference vegetation index (NDVI) data were collected and assessed in outbreak regions to understand the underlying drivers of the outbreaks. Results: The predominant domestic vertebrate species affected in 2008 and 2009 were cattle, when outbreaks were concentrated in the eastern provinces of South Africa. In 2010 and 2011, outbreaks occurred in the interior and southern provinces affecting over 16,000 sheep. The highest number of cases occurred between January and April but epidemics occurred in different regions every year, moving from the northeast of South Africa toward the southwest with each progressing year. The outbreaks showed a pattern of increased rainfall preceding epizootics ranging from 9 to 152 days; however, NDVI and rainfall were less correlated with the start of the outbreaks than has been observed in eastern Africa. Conclusions: Analyses of the multiyear RVF outbreaks of 2008 to 2011 in South Africa indicated that rainfall, NDVI, and other environmental and geographical factors, such as land use, drainage, and topography, play a role in disease emergence. Current and future investigations into these factors will be able to contribute to improving spatial accuracy of models to map risk areas, allowing adequate time for preparation and prevention before an outbreak occurs.

Rift Valley Fever (RVF)↗

Achieving Equilibrium for Dense, Integrated, Vehicle Navigation

Drone usage has proliferated in recent years with many applications that have market-changing potential. Applications that include parcel delivery, wildlife protection, precision farming, law enforcement, and industrial inspection, just to name a few. In this paper, the term drone is used to mean both Unmanned Aerial Vehicle and small Unmanned Aircraft System vehicles. Flight infrastructure can currently only support a few thousand aircraft flying over the United States National Airspace System (NAS) at any given time. A delay atone airport sends ripple effects through the system, causing more delays and missed connections. Once regulations and safety policies are put in place to allow for the widespread use of unmanned drones, the number of aircraft in the NAS is expected to skyrocket to millions, potentially congesting the airspace resulting in possible separation violations. In air traffic control, separation is the concept of keeping an “ownship” aircraft outside a minimum distance from “intruder” aircraft to reduce the risk of the aircraft colliding, as well as preventing accidents due to secondary factors, such as wake turbulence. Maintaining proper separation is a safety critical property for drones in the airspace. This paper addresses separation in time and in distance for high volume corridors (en-route) and lanes(on ground). The requirements and necessary conditions for maintaining proper separation and reaching maximum throughput for a given corridor/lane are addressed assuming unidirectional corridors/lanes where an aircraft arrives from one side and departs from the opposite side. Simulation results are presented that show the presented solution guarantees a set of drones to reach the equilibrium state by adjusting their speed based on their distance to the aircraft in front of them. The equilibrium state is defined as a state when a set of n aircraft moving at a relatively constant speed and uniform spacing from each other in a congested system. A congested system is defined as a state when the aircraft cannot move at their maximum allowed speed. Unlike existing centralized and pre-planned approaches, the proposed solution is fully distributed and enables autonomous aircraft to decide to adjust their speed and distance with respect to the preceding aircraft, dynamically. Simulation results are presented that assess the feasibility of the approach using a large number of drones and evaluate the scalability of the proposed solution.

Mahyar R. Malekpour↗

Defect Detection and Prevention

As NASA continues to impement its Faster, Better, Cheaper philosophy, new approaches for implementing Mission Assurance activities are being developed.

faster↗

A Strategic Approach for Dense, Integrated, Vehicle Navigation

Drone usage has been on the rise in recent years with applications that include parcel delivery, wildlife protection, precision farming, law enforcement, and industrial inspection, just to name a few. Once regulations and safety policies are put in place to allow for the widespread use of unmanned drones, the number of aircraft in the National Airspace System (NAS) is expected to skyrocket to millions, potentially congesting the airspace which increases the likelihood of separation violations and possibly incidents. Currently, flight infrastructure can only support a few thousand aircraft flying over the United States National Airspace System (NAS) at any given time. A delay at one airport can send ripple effects throughout the system, causing more delays and missed connections. In air traffic control, separation is the concept of keeping an “ownship” aircraft outside a minimum distance from “intruder” aircraft to reduce the risk of the aircraft colliding, as well as preventing accidents due to secondary factors, such as wake turbulence. Maintaining proper separation is often a safety critical property for fixed-wing drones in the airspace. This paper addresses drone separation in time and distance for high volume corridors (en route) and lanes (on ground), merging as well as crossing intersections of multiple corridors/lanes. In this paper, the term drone is applied to both Unmanned Aerial Vehicle (UAV) and small Unmanned Aircraft System (UAS) vehicles operating autonomously. There exists a gamut of approaches to the merging and crossing problems. At one end of the extreme are the conservative yet low cost and verifiable solutions of today that deal with two drones at a time. At the other end are complex Machine Learning-based solutions with high computing requirements for fully autonomous drones of the future that are expected to handle all contentions. This paper presents a feasible and verifiable strategic approach to these problems that is based on distributed cooperation between the drones and the infrastructure. Three phases of the strategic approach (Prepare, Adjust, Commit) are presented. Simulation results are presented that show the proposed approach is stable and resilient to induced perturbations and guarantees a set of fixed-wing drones to merge and cross intersections by adjusting their speed based on their distance to the aircraft in front of them while remaining in the equilibrium state. The equilibrium state is defined as the state when a set of n aircraft move at a relatively constant speed and uniform spacing from each other in a congested system. A congested system is defined as the state when at least one aircraft cannot move at its maximum allowed speed. Unlike existing centralized and pre-planned approaches, the proposed solution is fully distributed and enables autonomous aircraft to decide to adjust their speed and distance with respect to the preceding aircraft, dynamically. Simulation results are presented that assess the feasibility of the approach.

Distributed↗

A Strategic Approach for Dense, Integrated, Vehicle Navigation

Drone usage has been on the rise in recent years with applications that include parcel delivery, wildlife protection, precision farming, law enforcement, and industrial inspection, just to name a few. Once regulations and safety policies are put in place to allow for the widespread use of unmanned drones, the number of aircraft in the National Airspace System (NAS) is expected to skyrocket to millions, potentially congesting the airspace which increases the likelihood of separation violations and possibly incidents. Currently, flight infrastructure can only support a few thousand aircraft flying over the United States National Airspace System (NAS) at any given time. A delay at one airport can send ripple effects throughout the system, causing more delays and missed connections. In air traffic control, separation is the concept of keeping an “ownship” aircraft outside a minimum distance from “intruder” aircraft to reduce the risk of the aircraft colliding, as well as preventing accidents due to secondary factors, such as wake turbulence. Maintaining proper separation is often a safety critical property for fixed-wing drones in the airspace. This paper addresses drone separation in time and distance for high volume corridors (en route) and lanes (on ground), merging as well as crossing intersections of multiple corridors/lanes. In this paper, the term drone is applied to both Unmanned Aerial Vehicle (UAV) and small Unmanned Aircraft System (UAS) vehicles operating autonomously. There exists a gamut of approaches to the merging and crossing problems. At one end of the extreme are the conservative yet low cost and verifiable solutions of today that deal with two drones at a time. At the other end are complex Machine Learning-based solutions with high computing requirements for fully autonomous drones of the future that are expected to handle all contentions. This paper presents a feasible and verifiable strategic approach to these problems that is based on distributed cooperation between the drones and the infrastructure. Three phases of the strategic approach (Prepare, Adjust, Commit) are presented. Simulation results are presented that show the proposed approach is stable and resilient to induced perturbations and guarantees a set of fixed-wing drones to merge and cross intersections by adjusting their speed based on their distance to the aircraft in front of them while remaining in the equilibrium state. The equilibrium state is defined as the state when a set of n aircraft move at a relatively constant speed and uniform spacing from each other in a congested system. A congested system is defined as the state when at least one aircraft cannot move at its maximum allowed speed. Unlike existing centralized and pre-planned approaches, the proposed solution is fully distributed and enables autonomous aircraft to decide to adjust their speed and distance with respect to the preceding aircraft, dynamically. Simulation results are presented that assess the feasibility of the approach.

Distributed↗

Mitigating Microbial Contamination Risks in CO 2 Removal Systems for Long-Duration Space Missions

Crewed missions to Mars and beyond pose new challenges for the crew and the technological solutions they depend upon. Crucial considerations in designing the next generation of Environmental Control and Life Support Systems (ECLSS) include enhanced reliability and autonomy, given the challenges of resupply and resource recovery in remote missions. One significant challenge faced in various sectors of the International Space Station and ECLSS is the phenomena of microbial growth, particularly biofilm formation. As such, microbial growth is a critical consideration in the design phase of new ECLSS systems. Two novel CO2 removal systems—Liquid-Amines CO2 Removal (LACR) and Cold-Surface CO2 Deposition (CDep)—are currently under development at the NASA Ames Research Center to meet the needs of extended space travel. In this presentation, the authors aim to make a risk assessment of microbial growth in LACR and CDep through: 1) a comprehensive literature review to identify LACR and CDep components most vulnerable to microbial contamination and 2) wet lab testing commencing with a subscale test of the most susceptible component of CDep. The literature review revealed that the hollow-fiber Liqui-Cel membrane employed in CDep exhibits the highest susceptibility to microbial growth. Our wet lab tests corroborated these findings, as airborne microbes introduced into the membrane led to considerable biomass accumulation. These results indicate a significant risk of microbial invasion into the membranes. To prevent microbial growth in CDep or other CO2 removal systems, proper ECLSS arrangement is essential—a CO2 removal system should remain behind the charcoal-HEPA filters, condensing heat exchanger, and Trace Contaminant Control System. In summary, anticipating potential microbial interactions within ECLSS for remote crewed missions is vital to mission success. It should, therefore, be included as one of the many factors when designing future ECLSS systems to perform reliably and consistently to support astronaut life.

A. Nicolas Whitlock↗

The Role of Space Medicine in Management of Risk in Spaceflight

The purpose of Space Medicine is to ensure mission success by providing quality and comprehensive health care throughout all mission phases to optimize crew health and performance and to prevent negative long-term health consequences. Space flight presents additional hazards and associated risks to crew health, performance, and safety. With an extended human presence in space it is expected that illness and injury will occur on orbit, which may present a significant threat to crew health and performance and to mission success. Maintaining crew health, safety and performance and preventing illness and injury are high priorities necessary for mission success and agency goals. Space flight health care should meet the standards of practice of evidence based clinical medicine. The function of Space Medicine is expected to meet the agency goals as stated in the 1998 NASA Strategic Plan and the priorities established by the Critical Path Roadmap Project. The Critical Path Roadmap Project is an integrated NASA cross-disciplinary strategy to assess, understand, mitigate, and manage the risks associated with long-term exposure to the space flight environment. The evidence based approach to space medicine should be standardized, objective process yielding expected results and establishing clinical practice standards while balancing individual risk with mission (programmatic) risk. The ability to methodically apply available knowledge and expertise to individual and mission health issues will ensure appropriate priorities are assigned and resources are allocated. NASA Space Medicine risk management process is a combined clinical and engineering approach. Competition for weight, power, volume, cost, and crew time must be balanced in making decisions about the care of individual crew with competing agency resources.

Clark, Jonathan B.↗

The Critical Path Roadmap Project: Biomedical Risk Reduction for Extended Spaceflight

Human exploration of space requires an understanding of the risks to which crews will be exposed during such missions, and the mitigation of those risks to the fullest extent practical. This becomes a greater imperative as we prepare for interplanetary expeditions involving long periods in weightlessness in transit to and then from the destination (a planet, such as Mars, or perhaps a point in space, such as the Lagrangian point L2), and exposure to the unique environment of the destination itself. We need to know, more definitively, what the risks are to human health, safety, and performance, and how to prevent or counteract them throughout all phases of a long duration mission. The Johnson Space Center's Space and Life Sciences Directorate and the National Space Biomedical Research Institute (NSBRI) have implemented an effort to identify the most critical risks confronting humans on such mission and the types of research and technology efforts required to mitigate and otherwise reduce the probability and severity of those risks. This paper describes the "Critical Path Roadmap Project" to define, assess and prioritize the risks and present the results of the assessment with an emphasis on the research and technology priorities to meet the challenge of long duration human spaceflight mission.

Charles, John B.↗

Standard measures in Analogs of Spaceflight

Standard measures are defined as research measures (physiological, performance, or otherwise) that quantify the subject’s health and performance before, during, and after a spaceflight or a spaceflight analog mission. The Standard Measures Cross-Cutting Project (SMCCP) collects and analyzes standard measures that support assessment and quantification of health risks and efficacy of countermeasures and technologies required to prevent or mitigate adverse outcomes from exposure to the spaceflight environment. SMCCP uses the following spaceflight analogs: - Human Exploration Research Analog (HERA) in Houston, TX: 4-person isolation/confinement; nominal mission duration of 45 days; run by the Human Research Program (HRP). SMCCP uses weekly questionnaires to gather data on the crewmembers’ emotional and mental state and collects blood samples biweekly to measure crewmembers’ serum cortisol levels at the start, middle, and end of the mission. - Institute for Biomedical Problems (IBMP) Ground-Based Experimental Complex, called NEK, in Moscow, Russia: 6-person isolation/confinement; duration of 8 months; run by IBMP. Standard measures data collected during NEK are the same as for HERA above. - :envihab in Cologne, Germany: 12-person bed rest facility; closed environment; 30 to 60-day campaigns; run by the German Aerospace Center (DLR). For bedrest studies, SMCCP uses the international standard measures as documented in the International Academy of Astronautics publication titled Guidelines for Standardization of Bed Rest Studies in the Spaceflight Context (June 2014). These international standard measures evaluate potential changes in bone, muscle, cardiovascular, and visual systems, as well as changes in psychology and nutrition. The international standard measures complement those collected during studies by individual investigators and allow comparison of responses across different bed rest and countermeasures durations. In this presentation, we will review available SMCCP data collected during the recent isolation studies in HERA (C6) and NEK (SIRIUS-21), and during the SANS (SM1, SM2) bed rest studies in :envihab. These standard measures datasets are made available to concurrent investigators in the given mission or campaign via data sharing agreements and/or data sharing plans and to other investigators that have been granted retrospective access to the data (researchers with IRB approved protocols, risk custodians) to advance understanding of physiological and behavioral risks associated with these spaceflight analogs.

Standard Measures↗