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NASA NTRS1996

A Cross-Industry Analysis of LOFT Debriefings

Line Oriented Simulation (LOS) iss widely used to provide crews opportunities to practice Cockpit Resource Management (CRM) concepts in realistic, challenging simulated flight situations. LOS includes both Line Oriented Flight Training (LOFT), the original "non-jeopardy" form in which the crews are not graded on their performance, and Line Oriented Evaluation (LOE). In LOE, crews are graded, which is required in those airlines that participate in the FAA's Advanced Qualification Program (ALP). How much crews learn in LOS arid take back to the line hinges on the effectiveness of the debriefing that follows the LOS. The simulation itself is a busy, intense experience, and thoughtful discussion afterwards is necessary for the crew to sort out and interpret what happened and why. Instructors are expected to lead briefings in a way that encourages crew members to analyze for themselves their performance in the LOS. Rather than lecturing the crew in the traditional manner on what they did right and wrong, the instructor is expected to facilitate self-discovery and self-critique by the crew. We have recently completed a study in which we observed 36 LOFT briefings at 5 major U.S. airlines. We audiotape recorded the briefings, transcribed the recordings, and coded for more than 70 variables. Our analysis addresses four broad questions: To what extent do instructors attempt to facilitate crew self-analysis? What techniques do instructors use to facilitate and how effective are these techniques? What is the character of crew participation? To what extent do briefings emphasize CRM and crew performance? We discuss the implications of our findings for ALP and LOE.

Dismukes, Key↗

NASA NTRSDate not supplied

Conclusions of A Mini Technical Interchange Meeting on New Cross Risk Integration Projects Managed By the NASA Space Radiation Element

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. Recently, the Space Radiation Element was tasked with supporting multiple HRP Elements with innovative and enabling projects to inform risk characterization, facilitate mitigation activities, and support crew health and performance. These projects, such as precision health initiative, NASA Omics Archive (NOA) and human sample repositories, are agnostic to any HRP Element, hence the name, Cross Risk Integration Projects (CRIP). CRIP serves three broad purposes: Services: Generate samples/data or manage the receipt, inventory, archive and ultimate redistribution of biospecimens created in HRP-funded spaceflight and analog research activities – includes NASA Omics Archive (NOA) project and various human and animal sample repositories. Method Development: Identify and evaluate, new-to-NASA research or analysis methods or techniques – includes TRRaC (Translational Radiation Research and Countermeasures) Project. Enabling Capabilities: Demonstrate real world application by adapting, adopting and/or developing capabilities to benefit crew health & performance and improve risk – includes Precision Health Initiative (Pharmacogenomics) and advanced biological systems and engineered tissue microsystems initiative (tissue chips, organ-on-a-chip). To identify new technologies, 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, limitations of current approaches, and incorporation of novel experimental strategies and other innovative techniques. Here a summary and lessons learned from the SRE-sponsored mini-TIM titled “Space Radiation Cross Risk Integrations Projects” at HRP IWS 2024 will be communicated. The 90-min TIM had 6 speakers who presented impressive novel ideas and work This poster presents the outcomes of the session along with proposed future workshops and other SRE initiatives.

Janapriya Saha↗

NASA NTRSDate not supplied

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to facilitate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1)an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of selected bilateral lower extremity muscles (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. HARDWARE AND PROTOCOL DEVELOPMENT Proprioceptive countermeasure design enhancements continued as part of the Mars Campaign Office (MCO) Crew Health and Performance (CHP) Crew Health Countermeasures (CHC). The primary goals of this work were to assemble a portable version of the countermeasure system that can be used at the :envihab facility, expand the software feedback system’s capabilities, and develop an actuator loading system that mimics what could be used on the International Space Station. In addition, one major piece of exercise hardware used in previous HDBR studies, the Horizontal Squat Device, was reassembled and restored to full functionality. Human-in-the-loop pilot testing is ongoing, prior to shipping both devices to the :envihab HDBR facility. Evaluations are also underway for the best EMS device technologies and specific methods. Finally, assessment techniques are being translated for administration in the horizontal position (e.g., leg dexterity and foot sole skin sensitivity). Our current goals are to refine the countermeasure training and assessment techniques and integrate protocols across multiple modalities. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If one or more countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element and by the Canadian Space Agency (L. Bent).

T R Macaulay↗

NASA NTRS1977

Crew efficiency on first exposure to zero-gravity

Activation task performance of Skylab crews showed improved efficiency as experience was gained in weightlessness living. During three activation intervals, less than 12 man-hours were lost due to reduced efficiency (including the effects of motion sensitivity) while almost 200 man-hours of productive work were delivered. Work rate improved for tasks in which simulation and training time were extensive and for tasks which allowed zero-gravity operations to be optimized.

Garriott, O. K.↗

NASA NTRSDate not supplied

CLINICAL DECISION SUPPORT: PATH TO FUNCTIONAL REQUIREMENTS

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. To augment the requisite knowledge, skills and abilities (KSAs) of a time-constrained crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance this decade and beyond. Hence, data, software and computational resources will play an essential and synergistic role in maintaining crew health, wellness and performance in deep space missions. The focus of the CDS project is to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance and medical care during exploration missions. The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/databases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.

clinical decision support↗

NASA NTRSDate not supplied

Overview of Crew Operations for Transit to Mars

Crewed Mars missions are estimated to be 700-1,200 days in length which is two to three times longer than any continuous human spaceflight mission to date. When architecting a Mars mission there are numerous resources that must be considered, evaluated, and planned for, including—but not limited to—mass, cost, performance, and risk. Crew time is a limited resource that will need to be appropriately allocated during future Mars missions. NASA’s “Moon to Mars Objectives” specifically recognizes as Recurring Tenets the need to return crews safely to Earth while mitigating adverse impacts to crew health and maximizing crew time available for science and engineering activities within planned mission durations. Crew operations and the crew time allocation for a Mars missions will likely be different than current operational planning aboard the ISS due to communication delays, crew health and performance needs, transportation system needs, potential vehicle dormancy, and mass ejection. Crew will need to operate much more Earth independently and potentially be responsible for more operations since traditional Earth ground support will be delayed. Incidents requiring immediate crew action will therefore either be the responsibility of the crew or an automated feature of the transit vehicle. This paper discusses the operational challenges of a Mars transit mission and the associated activities that will need to take place during each operational phase of transit to and from Mars.

Crew Time↗

NASA NTRSDate not supplied

Overview of Crew Operations for Transit to Mars

Crew Time↗

NASA NTRSDate not supplied

Early Assessments of Crew Timelines for the Lunar Surface Habitat

As NASA progresses towards sustained crewed space missions, crew timelines will become increasingly important to achieving mission goals. While it is desirable to spend as much time as possible during crewed space missions on science activities and experiments, there are a large number of activities that crew members must perform each day in order to maintain both crew and vehicle health and safety. The time available for science activities in space is highly dependent on mandatory tasks required for crew and vehicle health and safety. The different crewed activities need to be planned accordingly long before the start of a mission in order to optimize crew time for science. To begin assessing the potential crew time for available for science, an understanding of the requirements to maintain crew and vehicle health and safety is needed. These additional activities may include sleep, exercise, vehicle maintenance, logistics handling, crew personal time, as well as many other tasks. The remaining time outside of these required tasks, within a reasonable crew work schedule, can be dedicated to science operations. This paper will detail a collaborative effort to analyzing crew times for sustained spaceflight missions and how the results of that analysis are applied to the crew timeline for the proposed Lunar Surface Habitat (SH).To determine the crew time for all of these required activities, an analysis was conducted utilizing defined agency requirements and historical crewed mission data. Predicted crew activity times were integrated into a daily schedule in order to optimize the crew’s time during the mission. This methodology was utilized to produce expected crew timelines for NASA’s proposed Artemis Base Camp (ABC) missions. The current plans for the ABC contain two different sustained habitats, the Pressurized Rover (PR) and the Surface Habitat (SH). While the crew are separated between the two habitats, the timelines for each element are dependent on the other element’s operations, so the two element timelines are formed in conjunction with one another. The results described in this paper, however, will focus solely on the crew timeline in the SH. This paper will explain the methodology behind predicting the required crew time spent in the SH for each activity, and the process of incorporating these predicted crew times into a coherent schedule.

Crew Time↗

NASA NTRS1998

Crew Alertness Management on the Flight Deck: Cognitive and Vigilance Performance

This project had three broad goals: (1) to identify environmental and organismic risks to performance of long-haul cockpit crews; (2) to assess how cognitive and psychomotor vigilance performance, and subjective measures of alertness, were affected by work-rest schedules typical of long-haul cockpit crews; and (3) to determine the alertness-promoting effectiveness of behavioral and technological countermeasures to fatigue on the flight deck. During the course of the research, a number of studies were completed in cooperation with the NASA Ames Fatigue Countermeasures Program. The publications emerging from this project are listed in a bibliography in the appendix. Progress toward these goals will be summarized below according to the period in which it was accomplished.

Dinges, David F.↗

NASA NTRS1989

Communication indices of crew coordination

The relationship between communication patterns and performance in 10 two-person flightcrews is explored with the aim of identifying speech variations which differentiate low- and high-error full mission simulator flights. Verbal data, transcribed from the videotaped performances, are treated as interactive sequences of speech events in which statements spoken by one crewmember are considered within the context of the other crewmember's prior and subsequent speech. Specific speech patterns characterized each crew, but the overriding findings included: a) marked homogeneity of patterns characterizing low-error crews, interpreted as the adoption of a standard form of communicating, and b) heterogeneity of patterns characterizing high-error crews, interpreted as the relative absence of a conventionalized form. Because conventions are regularities which confirm the expectations of those involved, predictability of crewmember behavior should be greater when standard conventions are followed. We conclude that such a practice can facilitate the coordination process and enhance crew performance.

Aerospace Medicine↗

NASA NTRS2012

NASA - easyJet Collaboration on the Human Factors Monitoring Program (HFMP) Study

This is the first annual report jointly prepared by NASA and easyJet on the work performed under the agreement to collaborate on a study of the many factors entailed in flight - and cabin-crew fatigue and documenting the decreases in performance associated with fatigue. The objective of this Agreement is to generate reliable, automated procedures that improve understanding of the levels and characteristics of flight - and cabin-crew fatigue factors, both latent and proximate, whose confluence will likely result in unacceptable flight crew performance. This study entails the analyses of numerical and textual data collected during operational flights. NASA and easyJet are both interested in assessing and testing NASA s automated capabilities for extracting operationally significant information from very large, diverse (textual and numerical) databases, much larger than can be handled practically by human experts.

Srivistava, Ashok N.↗

NASA NTRS2012

Human Research Program: 2012 Fiscal Year Annual Report

Crew health and performance are critical to successful human exploration beyond low Earth orbit. Risks to health and performance include physiologic effects from radiation, hypogravity, and planetary environments, as well as unique challenges in medical treatment, human factors, and support of behavioral health. The scientists and engineers of the Human Research Program (HRP) investigate and reduce the greatest risks to human health and performance, and provide essential countermeasures and technologies for human space exploration. In its seventh year of operation, the HRP continued to refine its management architecture of evidence, risks, gaps, tasks, and deliverables. Experiments continued on the International Space Station (ISS), on the ground in analog environments that have features similar to those of spaceflight, and in laboratory environments. Data from these experiments furthered the understanding of how the space environment affects the human system. These research results contributed to scientific knowledge and technology developments that address the human health and performance risks. As shown in this report, HRP has made significant progress toward developing medical care and countermeasure systems for space exploration missions which will ultimately reduce risks to crew health and performance.

Effenhauser, Laura↗

NASA NTRS2023

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

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

K A Shair↗

NASA NTRSDate not supplied

IMPACTing Medical System Design with a Risk Analysis Tool

K A Shair↗

NASA NTRS2018

Extension of Space Food Shelf Life Through Hurdle Approach

The processed and prepackaged space food system is the main source of crew nutrition, and hence central to astronaut health and performance. Unfortunately, space food quality and nutrition degrade to unacceptable levels in two to three years with current food stabilization technologies. Future exploration missions will require a food system that remains safe, acceptable and nutritious through five years of storage within vehicle resource constraints. The potential of stabilization technologies (alternative storage temperatures, processing, formulation, ingredient source, packaging, and preparation procedures), when combined in hurdle approach, to mitigate quality and nutritional degradation is being assessed. Sixteen representative foods from the International Space Station food system were chosen for production and analysis and will be evaluated initially and at one, three, and five years with potential for analysis at seven years if necessary. Analysis includes changes in color, texture, nutrition, sensory quality, and rehydration ratio when applicable. The food samples will be stored at -20 C, 4 C, and 21 C. Select food samples will also be evaluated at -80 C to determine the impacts of ultra-cold storage after one and five years. Packaging film barrier properties and mechanical integrity will be assessed before and after processing and storage. At the study conclusion, if tested hurdles are adequate, formulation, processing, and storage combinations will be uniquely identified for processed food matrices to achieve a five-year shelf life. This study will provide one of the most comprehensive investigations of long duration food stability ever completed, and the achievement of extended food system stability will have profound impacts to health and performance for spaceflight crews and for relief efforts and military applications on Earth.

Cooper, M. R.↗

NASA NTRSDate not supplied

Human Capabilities Assessments for Autonomous Missions: A Multi-Team Research Effort to Reduce Risk in the Human-System Integration Architecture for Future Deep-Space Missions

In future exploration missions beyond low earth-orbit, crew will have to execute complex operations and respond to off-nominal events, without real-time support from Mission Control. It is anticipated that increased reliance on automated systems, including human-centric vehicle and information architecture, will need to be designed to support the crew; increased risk to performance, health, and safety may occur if these are not implemented appropriately. The Human Factors and Behavioral Performance Element (HFBP) in the NASA Human Research Program supports research to characterize and mitigate such human health and performance risks, including the Risk of Adverse Outcome Due to Inadequate Human Systems Integration Architecture (HSIA). The HSIA risk addresses the integration of onboard capability and the crew roles and responsibilities necessary to enable the crew to respond effectively and efficiently in the increasingly autonomous mission operations environment. In 2017, HFBP released the “Human Capabilities Assessments for Autonomous Missions” (HCAAM) research topic to address HSIA related questions. HCAAM is a major NASA research effort that has assembled a multidisciplinary team from seven institutions to work closely with design and engineering efforts on research towards developing and refining human performance standards, guidelines and automation tools. The scientific focus is on quantitative assessment of human capabilities relevant to future deep-space missions during which earth/spacecraft communication is so delayed and intermittent that the crew must be able to function autonomously. The integrated strategy of the HCAAM project characterizes human capabilities and limitations related to potential performance decrements during long duration exploration mission spaceflight as relevant to both routine and complex task performance; defines system characteristics that reduce the likelihood or impact of potential decrements in human performance capabilities; performs integrated assessment of intelligent system responses within the context of an operational environment with relevant NASA tools, systems, and data structures in order to determine positive or negative interactions and validate recommended approaches; and proposes specific updates to existing standards and guidelines for inclusion in NASA handbooks for the design of future spacecraft intelligent systems that provide crew performance assessment/feedback, and to also serve as decision-support aids for the onboard crew (i.e., NASA-STD-3001, and NASA/SP-Human Integration Design Handbook (HIDH)). The scientific research vectors being addressed by the seven HCAAM teams include: - crew task performance (accuracy, efficiency) (crew + automation) - crew performance (accuracy, efficiency) - crew Situation Awareness - procedure design and multi-modal enhancement - concurrent tasking (mixed manual + some level of autonomy) - task handover - crew self-planning and time-lining - task design - trust in automation, real-time calibration - human multi-sensory feedback and guidance - human trust in on-board software-based intelligent assistants - virtual assistants The presentation will highlight plans and progress made in each of these research areas as well as the methods by which surrogate astronaut crews in the NASA JSC HERA spaceflight analog facility will function as human test subjects for all of the HCAAM research projects.

HCAAM VNSCOR↗

NASA NTRS1981

Group 3: Performance evaluation and assessment

Line-oriented flight training provides a unique learning experience and an opportunity to look at aspects of performance other types of training did not provide. Areas such as crew coordination, resource management, leadership, and so forth, can be readily evaluated in such a format. While individual performance is of the utmost importance, crew performance deserves equal emphasis, therefore, these areas should be carefully observed by the instructors as an rea for discussion in the same way that individual performane is observed. To be effective, it must be accepted by the crew members, and administered by the instructors as pure training-learning through experience. To keep open minds, to benefit most from the experience, both in the doing and in the follow-on discussion, it is essential that it be entered into with a feeling of freedom, openness, and enthusiasm. Reserve or defensiveness because of concern for failure must be inhibit participation.

Frink, A.↗

NASA NTRSDate not supplied

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH 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 outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗