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NASA NTRSDate not supplied

NASA’s NextGen Remote Sensing Instruments Have Arrived: Data Products For Studying Disease Vectors

Remote sensing can be used to measure, evaluate or estimate both the environment (state functions) and interfaces (processfunctions) defining vector habitats. The products of remote sensing can be integrated directly into the epidemiological equationsto significantly enhance our understanding of disease vector’s life cycles and habitats. The next generation of NASA’s remotesensing instruments which have become recently operational will provide a significant enhancement in our ability to studydisease vector’s life cycles and habitats. These instruments are on the International Space Station (ISS) and includeECOSTRESS, DESIS, and GEDI. ECOSTRESS is a 5 channel, thermal IR instrument with 70 m resolution and approximately1-5 day repeat cycle of day/night pairs. DESIS jointly developed by German Aerospace Center and Teledyne Brown Engineeringis a hyperspectral sensor system of 235 channels and 30 m resolution. DESIS data is only being acquired on demand. GEDI is ahigh-resolution laser ranger used for observing Earth’s forests and topography. NASA’s current ISS instrument configuration provides measurements of the critical environmental measures of environmentalstate functions important to vector & disease life cycles. Remote sensing data provide a spatial context and time series oflandscape scale process functions represented by land use mapping and measurements of ecological functions. Global publichealth is entering a new information age through the use of spatial models of disease vector/host ecologies driven by the use ofremotely sensed data to measure environmental and structural factors critical in determining disease vector habitats. In 2018, NASA initiated a new study for the Surface Biology and Geology (SBG) Designated Observable, identified in the 2018National Academies’ Decadal Survey entitled, “Thriving on Our Changing Planet: A Decadal Strategy for Earth Observationfrom Space.” (https://www.nap.edu/catalog/24938/thriving-on-our-changing-planet-a-decadal-strategy-for-earth) . The SBG isplanned to collect global remote sensing measurements using a hyperspectral spectrometer and multispectral thermal data. Thesedata sets will provide a significant enhancement in our ability to study disease vector’s life cycles and habitats globally. The 3sensors on the ISS provide precursor data to prepare the community for the application of future SBG data toward diseasestudies.

Disease Vectors↗
NASA NTRSDate not supplied

Space Radiation and Central Nervous System Impacts: NASA Standards and Evidence

It is well understood that large radiation localized doses to the brain cause clinically significant impacts to the central nervous system in human populations. However, the effects in adults exposed to lower doses remain unclear due to lack of data in relevant human cohorts. The impact of exposure to high-energy particles is even less understood. NASA’s Human Research Program relies heavily on model systems to characterize the impacts of the space radiation environment on the human brain and how potential changes may effect mission success and long term health and well-being. Animal, cellular, and molecular experiments implicate multiple – and possibly related – mechanisms that mediate impacts to the central nervous system in model systems including, but not limited to inflammation, immune responses, oxidative stress, metabolism, myelination, molecule transport, electrophysiology, and a variety of “omic” changes. While animal studies demonstrate potential changes across a number of cognitive and behavioral domains the direct applicability to the astronaut population remains unclear. Furthermore data access experiments and model systems can be inconsistent and dependent on multiple experimental variables indicating a clear need for robust validation. To minimize potential impacts to astronauts NASA limits dose to the CNS based on a combination of terrestrial epidemiology informed by experimental evidence in model systems. To date no recommendations have been provided by the National Committee on Radiation Protection and Measurements. This presentation will provide an overview of NASA’s current dose limits for CNS exposure to space radiation as well as highlights of the current state of evidence and ongoing research.

S Robin Elgart↗
NASA NTRSDate not supplied

Overview of the Translational Radiation Research and Countermeasures (TRRaC) Project in Space Radiation

The Translational Radiation Research and Countermeasures (TRRaC) Project was initiated by the Space Radiation (SR) Element within NASA’s Human Research Program (HRP) to support the SR mission to understand and characterize the space radiation environment, understand and quantify radiation-associated risks, and mitigate the impacts of radiation-induced adverse health outcomes to enable human space exploration. TRRaC’s mission is to translate radiation research results from experimental studies and epidemiological data to humans and astronauts using bioinformatics and computational modeling. TRRaC will leverage existing datasets such as those available from NASA’s GeneLab repository and human medical radiation exposure registries, along with relevant data generated from ground-based research at molecular, cellular, tissue, and system levels, to: (1) refine the radiation dose rate effectiveness factor, (2) characterize radiation quality effects to improve estimates of the risk of exposure-induced death (REID) from space-relevant radiation exposures, and (3) identify pathways and biomarkers for cancer, cardiovascular disease, and central nervous system changes that are impacted by space radiation exposure.

Parastou Eslami↗
NASA NTRSDate not supplied

Crowd Sourcing Medical Data Collection Using Medical Students

OBJECTIVE We undertook an upgrade of the Evidence Library database of NASA HRP’s Integrated Medical Model, assessing 120 medical conditions which integrate with a novel probabilistic risk assessment (IMPACT) tool of medical risk and resource utilization for long duration exploration human spaceflight. This data collection process included a selection of these conditions crowd sourced over one year via three 4-week medical student electives at the University of Colorado School of Medicine (IDPT 8059 Space Medicine: Human Spaceflight Factors & Medical Risk Assessment). Students undertook a rapid systematic review of each medical condition, under close preceptors with backgrounds in clinical medicine, library science, epidemiology, biostatistics, and evidence-based medicine. As part of the elective, students also received instruction in core space medicine concepts, evidence based medicine and problem based learning sessions as a flight surgeon supporting a simulated Mars mission. METHODS The list of 120 medical conditions includes both common, terrestrial illness/injury (epistaxis, diverticulitis) as well as spaceflight-specific ones (space adaptation conditions, EVA-related injuries). A rapid systematic review process was developed that would allow students to find the data for determining disease incidence/prevalence, return to definitive care (often a surrogate such as hospitalization rates), loss of crew life, and treatment duration. Each data point required a tailored, specialized search process using different databases and corresponding specialized search filters. Databases were selected on their ability to provide high quality literature in an efficient manner and prioritized by their ability to provide graded evidence via a set rubrics specific to human spaceflight. Students were responsible for performing all literature searches and identifying the highest quality available evidence for each data point. Completed student data sheets underwent initial review by faculty preceptors followed by a secondary editing review by the ExMC Clinical Science Team. RESULTS Over the course of three electives, approximately 105 medical conditions were researched by students using spreadsheets with pre-crafted search strategies. Overall, this process was successful in allowing students to perform the preponderance of work to update incidence, treatment duration, return to definitive care, and loss of crew life data points. Students were successful in running searches, identifying the necessary data points within the literature, and determining the types of terrestrial data that most aligns with the astronaut population for successful completion of their tasks. Limitations included variable student experience with search methodologies [PubMed], differing values of evidence grading [best practice evidence based medicine vs. relevant to spaceflight], and students’ unfamiliarity with spaceflight specific conditions. CONCLUSION Finding the relevant literature for medical conditions in spaceflight within terrestrial databases in a systematic method is time consuming and not intuitive. However, the stepwise process that balanced sensitivity with specificity allowed for students to be highly successful in a short amount of time. Additionally, as the process was refined over the course of three electives, preceptors were better able to anticipate where students were likely to encounter barriers, which allowed the course to be adjusted to account for certain data points needing more time for completion. This replicable process may be an efficient way to accomplish rapid systematic reviews for a large volume of data in a short amount of time.

J Lemery↗
NASA NTRSDate not supplied

Human System Risk Changes in 2021

The Human System Risk Board (HSRB) has the overall responsibility for tracking the evolution of the top ~30 human system risks that it has identified to be associated with human spaceflight. As part of this process, the Board is charged with maintaining a consistent, integrated process to mitigate those risks, and developing evidence-based risk posture recommendations. Risks are re-evaluated in a Continuous Risk Management (CRM) process. This session will summarize the risk posture changes that have occurred in the last year and what high level research, performance, and epidemiologic data have informed those changes. Human System Risks updated in 2021 include: Dynamic Loads, Sensorimotor, EVA, Crew Egress, Behavioral Medicine, Electrical Shock, Human System Integration Architecture (HSIA), Toxic Exposure, Bone Fracture, Cardiovascular, Medical Conditions, Renal Stone, CO2 Exposure, and Pharmacology.

Mary Van Baalen↗
NASA NTRSDate not supplied

Watching Without Seeing a Tool to Surveil Astronaut Health Outcomes While Maintaining Astronaut Medical Privacy

BACKGROUND The Privacy Act of 1974 regulates the use a nd disclosure of personally identifiable information by US Federal agencies. The Act applies to biographical, financial, a nd other identity-linked information, a s well a s personal health information (PHI). As such, the use of astronaut PHI is limited to authorized personnel for preapproved uses, with data reporting often limited to aggregated information about groups. These limitations on the use a nd reporting of astronaut PHI complicates surveillance efforts, wherein epidemiologists a t the National Aeronautics and Space Administration (NASA)monitor the incidence of targeted health conditions in the astronaut population, or to discover emerging trends of aging and disease. Stratification on one or more covariates –particularly time-period, sex, a nd mission participation –can lead to extremely small datasets such that the reporting of results is potentially attributable to individuals. An additional challenge is the small size of the astronaut population, both in terms of numbers of individuals a s well a s in terms of density of exposure time. Such small datasets yield volatile rate estimates that are difficult to interpret. To a id the epidemiological surveillance efforts, a surveillance tool is required that can (a) satisfy the need for rapid computation of condition-specific incidence and mortality rates; (b) improve the statistical estimates of these estimated rates; and (c) maintain astronaut privacy. Here we describe a nd demonstrate such a tool. METHODS We devised a system that models incidence a nd mortality rates rather than calculating them directly. This ha s the advantage of using all the available data to derive the estimates, lea ding to rates that a re not attributable to any one individual, a nd a re a s numerically stable a s they can be given the extremely limited data. The system models disease endpoints using a Poisson regression model with exposure density (measured in person-years) a s a n offset term. By doing so the model is estimating event counts per person-year, equivalent to modeling the rates directly. It uses a standard (pre-specified)set of covariates; the system does not engage in “model-building” as model parsimony is not the goa l. Instead, it is explicitly recognized that if a covariate is not statistically significant a nd not a confounder then it will likely have very little effect on the estimate of the incidence a nd mortality rates. Users are able to specify the disease endpoint of interest and the covariates over which they would like to stratify. The system then uses the resulting model to compute the estimated rates for the user-chosen configuration of variables as visualizes those either over an age range within a specified time-period, or over time for astronauts with a specified age range. RESULTS The first iteration of the tool computes incidence a nd mortality rates for cardiovascular conditions and cancers. Code ha s been developed to retrieve the appropriate data from the IMPALA analysis platform, compute the models for incidence a nd mortality, a nd then use those models to generate the corresponding rate curves. A companion graphical user interface allows the user to specify the curves and visualize the results. CONCLUSIONS It is important to note that the rapid surveillance tool described here is neither meant to be a definitive assessment of the incidence or mortality of any particular disease or condition in the astronaut population, nor is it meant to be used for research purposes. Rather, it is meant as an early indicator that in-depth investigation may be warranted. By automating a repetitive process and leveraging carefully curated astronaut health outcomes, the tool makes possible a rapid “first look” into known areas of concern, and, if used judiciously, may surface new areas of concern for long-term astronaut health. This work is supported in part by the Translational Research Institute for Space Health (TRISH) through NASA Cooperative Agreement NNX16AO69A.

R J Reynolds↗
NASA NTRS2021

Acute health effects associated with satellite-determined cyanobacterial blooms in a drinking water source in Massachusetts

The occurrence of cyanobacterial blooms in freshwater presents a threat to human health. However, epidemiological studies on the association between cyanobacterial blooms in drinking water sources and human health outcomes are scarce. The objective of this study was to evaluate if cyanobacterial blooms were associated with increased emergency room visits for gastrointestinal (GI), respiratory and dermal illnesses.

Remote sensing↗
NASA NTRSDate not supplied

Cardiovascular Disease Spaceflight Equivalent Stressor Risk Modeling Project

The risk of cardiovascular disease (CVD) may be exacerbated by spaceflight hazards including radiation, isolation, distance from the Earth, gravity fields, and closed or confined environments. This project aims to use epidemiologic, scientific research evidence of surrogate spaceflight stressors on analog populations in terrestrial cohorts to model CVD risk for spaceflight conditions. To date, Dr. Butler and the multi-disciplinary CVD Spaceflight Equivalent Stressors (SES) team have conducted a formal systematic literature review on the risk of sleep loss as it relates to cardiovascular disease outcomes and are currently working on a meta-analysis for the data gathered from nearly 100 studies and their various CVD outcomes. The research will continue to examine other surrogate stressors in depth, such as altered gravity, radiation exposure, noise, etc. with cardiovascular outcomes to determine an overall combined spaceflight risk for long term future missions such as Artemis Lunar and Mars missions.

Jennifer Butler↗
NASA NTRSDate not supplied

An Approach to Quantitative Risk Assessment for Combined Spaceflight Hazards: Evaluating the Impact of Short Sleep Durations on Space Crew Cardiovascular Health

Astronauts embarking on long-duration missions will be exposed to multiple spaceflight hazards including radiation, isolation and confinement, distance from Earth, hostile closed environments, and altered gravity. These hazards pose health risks to the crew in-mission and postflight, including risks to cardiovascular health. For radiation, quantitative risk models have been developed that are based on large-scale epidemiological evidence from exposed terrestrial populations, which are extrapolated to account for the difference in radiological effectiveness between ground-based and in-flight exposures. •Cardiovascular diseases (CVD) are multifactorial, therefore multiple risk factors can influence disease risk estimates. •Astronauts with spaceflight experience is a very small population. •To overcome limitations of cohort, population data from presumed equivalent stressors on Earth can be used to quantitatively assess possible risks. •Sleep disruption and short sleep duration are known consequences of spaceflight and are also established risk factors for cardiovascular disease on earth (Pateletal.,2020). •Coronary Heart Disease (CHD), Myocardial Infarction (MI), and stroke are negative health effects due to short sleep durations and sleep disruptions (Yinetal.,2017); (Cappuccio et al., 2010). •A combined CVD risk model including spaceflight stressor such as sleep, stress, radiation, etc.) will provide more precise estimate of risks.

Spaceflight Hazards↗
NASA NTRS2021

Satellite Monitoring for Air Quality and Health

Data from satellite instruments provide estimates of gas and particle levels relevant to human health, even pollutants invisible to the human eye. However, the successful interpretation of satellite data requires an understanding of how satellites relate to other data sources, as well as factors affecting their application to health challenges. Drawing from the expertise and experience of the 2016–2020 NASA HAQAST (Health and Air Quality Applied Sciences Team), we present a review of satellite data for air quality and health applications. We include a discussion of satellite data for epidemiological studies and health impact assessments, as well as the use of satellite data to evaluate air quality trends, support air quality regulation, characterize smoke from wildfires, and quantify emission sources. The primary advantage of satellite data compared to in situ measurements, e.g., from air quality monitoring stations, is their spatial coverage. Satellite data can reveal where pollution levels are highest around the world, how levels have changed over daily to decadal periods, and where pollutants are transported from urban to global scales. To date, air quality and health applications have primarily utilized satellite observations and satellite-derived products relevant to near-surface particulate matter <2.5 μm in diameter (PM(sub 2.5)) and nitrogen dioxide (NO2). Health and air quality communities have grown increasingly engaged in the use of satellite data, and this trend is expected to continue. From health researchers to air quality managers, and from global applications to community impacts, satellite data are transforming the way air pollution exposure is evaluated.

Satellites↗
NASA NTRSDate not supplied

Conclusions of a Mini Technical Interchange Meeting on Mechanisms and Pathways Common Between Adverse Health Outcomes from Exposures to Space Radiation

To enable deep space exploration and sustained human presence in space, the NASA Human Research Program’s (HRP) Space Radiation Element (SRE) funds research to characterize and mitigate adverse health outcomes from exposure to space radiation that include risks of carcinogenesis, cardiovascular disease (CVD) and central nervous system (CNS) decrements. Over the past decade, a growing body of compelling experimental evidence suggests shared mechanisms and pathophysiological processes for CVD, neurodegenerative effects, and cancer development and progression, which are traditionally managed as separate disease processes. Additionally, epidemiological studies have identified cross-sectional and longitudinal associations between some specific types of cancer and CVD, and accumulating evidence indicates that the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease may overlap with CVD and cancer pathogenesis. Identifying the mechanisms and pathways common to these important health decrements will not only accelerate development of effective countermeasures and improve management of spaceflight-induced risk, it will also help to develop new treatment strategies for patients on Earth. To identify common pathways and mechanisms of disease induction and progression from current SR-funded studies and to inform future work and solicitations, the SRE organizes themed sessions at annual HRP Investigators’ Workshops (IWS). These technical interchange meetings (TIMs) provide a venue for the scientific community to present ongoing work and engage in open discussion on results, limitations of current approaches, and incorporation of novel experimental strategies, model systems, and other innovative techniques. Here a summary and lessons learned from the SRE-sponsored mini-TIM titled “mechanisms and pathways common between adverse health outcomes” held at HRP IWS 2023 will be communicated. The 90-min TIM had 30-min dedicated to discussing and developing potential collaboration and tissue sharing opportunities among investigators. The SRE facilitated the discussion using a set of pressing questions and gaps in knowledge that need to be addressed by the scientific community. This poster presents the outcomes of the session along with proposed future workshops and other SRE initiatives.

Janapriya Saha↗
NASA NTRSDate not supplied

Conclusions of a Mini Technical Interchange Meeting on Mechanisms and Pathways Common Between Adverse Health Outcomes from Exposures to Space Radiation

To enable deep space exploration and sustained human presence in space, the NASA Human Research Program’s (HRP) Space Radiation Element (SRE) funds research to characterize and mitigate adverse health outcomes from exposure to space radiation that include risks of carcinogenesis, cardiovascular disease (CVD) and central nervous system (CNS) decrements. Over the past decade, a growing body of compelling experimental evidence suggests shared mechanisms and pathophysiological processes for CVD, neurodegenerative effects, and cancer development and progression, which are traditionally managed as separate disease processes. Additionally, epidemiological studies have identified cross-sectional and longitudinal associations between some specific types of cancer and CVD, and accumulating evidence indicates that the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease may overlap with CVD and cancer pathogenesis. Identifying the mechanisms and pathways common to these important health decrements will not only accelerate development of effective countermeasures and improve management of spaceflight-induced risk, it will also help to develop new treatment strategies for patients on Earth. To identify common pathways and mechanisms of disease induction and progression from current SR-funded studies and to inform future work and solicitations, the SRE organizes themed sessions at annual HRP Investigators’ Workshops (IWS). These technical interchange meetings (TIMs) provide a venue for the scientific community to present ongoing work and engage in open discussion on results, limitations of current approaches, and incorporation of novel experimental strategies, model systems, and other innovative techniques. Here a summary and lessons learned from the SRE-sponsored mini-TIM titled “mechanisms and pathways common between adverse health outcomes” held at HRP IWS 2023 will be communicated. The 90-min TIM had 30-min dedicated to discussing and developing potential collaboration and tissue sharing opportunities among investigators. The SRE facilitated the discussion using a set of pressing questions and gaps in knowledge that need to be addressed by the scientific community. This poster presents the outcomes of the session along with proposed future workshops and other SRE initiatives.

Janapriya Saha↗
NASA NTRSDate not supplied

Evaluating the Feasibility of Data Simulation for Radiation Research: Estimating RBE Values for HZE Radiation

As the drive for deep space exploration intensifies, a comprehensive understanding of the health effects of radiation exposure becomes paramount to the future of human space flight. However, epidemiological data for radiation exposure, particularly to high-energy (HZE) ions, is limited, partially due to the financial and logistical costs of radiation studies. As an alternative, this study aims to assess the viability of data simulation strategies to accurately model potential study parameters prior to utilizing laboratory conditions. This study estimates a relative biological effectiveness (RBE) factor based on the solid tumor data for outbred mice provided by Edmundson et al. 2020. Excess relative risk (ERR) models for HZE-Fe ions and gamma radiation were estimated using Poisson regression with Weibull models to represent the background solid tumor hazard without radiation. RBE values were calculated from the ratio of the heavy ion linear slope to the gamma linear slope. The parameters from these models were then applied to simulate iterations of 300 datasets across HZE-Fe doses of 0.05, 0.2, 0.4, and 0.75 Gy; gamma radiation doses of 0.75, 2, and 3 Gy, as well as an unirradiated control group. Sample size per dose varied from 100-500 mice across simulations (800-4000 mice total per dataset). 1500 datasets were generated total (300 each for sample sizes 800, 1600, 3200, and 4000). For each dataset, ERR per radiation type and RBE for HZE-Fe were calculated. The RBE from the Edmondson data was calculated to be 5.55. The RBEs from the simulated data converged around this value across the increasing sample sizes. For n = 4000, the mean RBE across the 300 datasets was 5.71 (95% CI: 5.47-5.95). These results suggest that RBEs calculated from simulated data are credible. Based on this exploration, data simulation is a viable method of testing radiation studies. It provides a method of testing study assumptions and refining research questions prior to embarking on costly laboratory experiments.

Sneha Mehta↗
NASA NTRS2023

Using Regionalized Air Quality Model Performance and Bayesian Maximum Entropy Data Fusion to Map Global Surface Ozone Concentration and Associated Uncertainty

Estimates of ground-level ozone concentrations have been improved through data fusion of observations and atmospheric chemistry models. Our previous global ozone estimates for the Global Burden of Disease study corrected for bias uniformly across continents and then corrected near monitoring stations using the Bayesian Maximum Entropy (BME) framework for data fusion. Here, we use the Regionalized Air Quality Model Performance (RAMP) framework to correct model bias over a much larger spatial range than BME can, accounting for the spatial inhomogeneity of bias and nonlinearity as a function of modeled ozone. RAMP bias correction is applied to a composite of 9 global chemistry-climate models, based on the nearest set of monitors. These estimates are then fused with observations using BME, which matches observations at measurement stations, with the influence of observations declining with distance in space and time. We create global ozone maps for each year from 1990 to 2017 at fine spatial resolution. RAMP is shown to create unrealistic discontinuities due to the spatial clustering of ozone monitors, which we overcome by applying a weighting for RAMP based on the number of monitors nearby. Incorporating RAMP before BME has little effect on model performance near stations, but strongly increases R 2 by 0.15 at locations farther from stations, shown through a checkerboard cross-validation. Corrections to estimates differ based on location in space and time, confirming heterogeneity. We quantify the likelihood of exceeding selected ozone levels, finding that parts of the Middle East, India, and China are most likely to exceed 55 parts per billion (ppb) in 2017. About 96% of the global population was exposed to ozone levels above the World Health Organization guideline of 60 µg m −3 (30 ppb) in 2017. Our annual fine-resolution ozone estimates may be useful for several applications including epidemiology and assessments of impacts on health, agriculture, and ecosystems.

Ozone↗
NASA NTRS2024

Exposure Limits for Hydrogen Sulfide in Spaceflight

Hydrogen sulfide (H 2 S) has not historically been detected in spacecraft, but the possible evolution of volatile components from polar ice on the lunar surface is a potential concern for NASA’s planned Artemis missions. Numerous case reports and occupational epidemiological studies document that exposure to H 2 S at high concentrations has effects on the respiratory system, potentially leading to unconsciousness followed by debilitating neurological effects. Studies in rodents demonstrate sensitivity of the respiratory system to lower concentrations of H 2 S. Adverse respiratory effects have also been indicated in workers chronically exposed to H 2 S. The objective of the present publication is to develop Spacecraft Maximum Allowable Concentrations (SMACs) for H 2 S for all current standard durations of exposure for spaceflight (1-hour, 24-hours, 7-days, 30-days, 180-days, and 1000-days). Summary sources and literature review were used to identify relevant studies to inform SMAC development. Space flight mission specific activities and most probable exposure scenarios were used to determine the relevant toxicity endpoints and supporting studies. SMACs were established for hydrogen sulfide of 5 ppm for 1-hour, 1.3 ppm for 24-hours, 1.3 ppm for 7-days, 1.3 ppm for 30-days, and 0.3 ppm for 180-days. Data are not sufficient currently to establish a 1000-day SMAC value. SMACs for H 2 S will support development of handling protocols and proper containment for lunar sample collection.

hydrogen sulfide↗
NASA NTRSDate not supplied

Plausible Biological Mechanisms Underlying Sex Differences in Radiation-Induced Lung Cancer Risk

Some epidemiological studies suggest that women are at greater risk for radiation-induced lung cancer than men, but this observation is not consistent across all studies. A scientific committee formed by the National Council on Radiation Protection and Measurement evaluated evidence for a sex difference in lung cancer risk from radiation exposuresby reviewing animal studies and assessing the biological plausibility that such a difference might exist. The committee identified four mechanisms that could potentially result in greater radiogenic lung cancer risks for women. The first of these is that radiation exposure increases the relative risk for a molecular subtype of spontaneous lung cancer that occurs predominantly in women. The second is that is that sex chromosome or gene expression differences between men and women places women at greater risk. The third is that hormonal differences between men and women, particularly for estrogen levels, puts women at greater risk. The fourth mechanism is that sex differences in immune system function underlie a sex difference in radiation associated lung cancer risk.None of these mechanisms hasyet been proven to play a role in radiogenic lung cancer risk.

radiation↗
NASA NTRSDate not supplied

Artificial Intelligence (AI) Methods for Augmenting the IMPACT Tool Evidence Library

Development of the Evidence Library for use with the IMPACT probability risk assessment tool took several years and involved a staggering amount of effort from a multi-disciplinary team. A very significant amount of the labor effort to collect, assess and finalize the Clinical Finding Form (CliFF) for each of the 119 medical conditions was provided by physician subject matter experts from the Exploration Medical Capability (ExMC) Element Clinical and Science Team. Many AI tools such as ChatGPT are excellent at summarizing large amounts of information and the current project was initiated to determine how such tools might streamline laborious processes, e.g., review and summarization of many scientific research publications, to execute key steps more efficiently in the process of developing CliFFs. The process for collecting the evidence which is found in the CliFFs is well documented in the Evidence Library Methods document (ELM; HRP-48036*). Using ELM and the CliFF development instructions as a guideline, a team of developers is leveraging Microsoft Azure AI tools and services along with open-source frameworks, to construct an AI-assisted automated pipeline. This pipeline is designed to search, retrieve, and process the necessary data sources, and ultimately help generate the final version of a CliFF. Currently, the large language model evaluates the relevance of each source material to spaceflights, either as direct evidence or as an analog. Additionally, the model assists in extracting keywords and generating brief summaries to enhance augmented retrieval and search processes in later stages of CliFF development. Once the data is ready, the model can perform semantic search and retrieval, generating and extracting valuable information for the CliFF. For instance, it can handle epidemiological statistical data, such as incidence rates and the likelihood of best or worst-case scenarios. The steps that required reading and summarizing articles were viewed as providing the greatest return on investment since large language models are very efficient and accurate in summarizing large amounts of text. Since labor effort to complete the original CliFF was not recorded with sufficient granularity, comparisons with an AI tool-generated CliFF will provide merely an approximation of time saved. Upon completion of the process, the CliFF for the medical condition “appendicitis” generated with the support of AI-based methods will serve as a proof-of-concept and will be compared to the original appendicitis CliFF to determine if use of the tools resulted in content and conclusory similarity. Based upon the results from face validation of the two CliFFs, modifications to the process will be made if necessary and additional condition CliFFs will be evaluated. Ultimately, CliFFs for the entire set of medical conditions will be created with the assistance of AI tools. Depending on the cost savings realized, CliFFs for additional medical conditions can be created to expand the Evidence Library. Future direction includes specifying the characteristics of the reviewer (prompting the AI tools to generate output assuming the reviewer is a sub-specialist physician, or nurse or EMT/medic) to determine if the effects on AI-generated output are different based on knowledge, skills and abilities. *Exploration Medical Capability Evidence Library Methods, HRP-48036 Rev A, July 2022.

Ali Al↗
NASA NTRSDate not supplied

Artificial Intelligence (AI) Methods for Automating the Impact Tool Evidence Library

INTRODUCTION: The development of the Evidence Library for use with the IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) probability risk assessment tool involved a multilayered, time intensive process of data collection and analysis by subject matter experts from the Exploration Medical Capability (ExMC) Element Clinical and Science Team to produce clinical findings forms (CliFFs) for 120 medical conditions. Artificial Intelligence Large Language Models (LLMs) can be leveraged to facilitate this process, thus reducing labor and time. TOPIC: CliFFs contain information about medical conditions as they pertain to spaceflight. This includes condition definitions, incidence data, crew task impairment estimates caused by conditions, treatment protocols and references to literature used for gathering condition evidence. Guided by the Evidence Library Methods document and the CliFF development instructions, a team has leveraged Microsoft Azure AI services and open-source documentation to construct an AI-assisted automated pipeline for CliFF development. This process is designed to search, retrieve, and evaluate the applicable data, and ultimately generate a completed CliFF. The LLM evaluates the relevance of each of the source materials to spaceflight, either as direct evidence or as an analog. The model extracts keywords and generates brief summaries to enhance search and retrieval in later stages of CliFF development. For instance, it can calculate epidemiological statistical data, such as incidence rates and the likelihood of best or worst-case scenarios. APPLICATION: Large Language Models (LLMs) can efficiently summarize large amounts of text. Leveraging this technology will automate data retrieval and evidence gathering for medical databases, like the IMPACT tool, by aiding in the labor-intensive process of analyzing large bodies of literature and organizing it into a formatted document like a CliFF. This added efficiency will enable expeditious expansion of the Evidence Library with additional medical conditions and update previous CLiFFs as new technology becomes available.

Ali Al↗