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NASA NTRS2008

Assessment of Evidence Base from Medical Debriefs Data on Space Motion Sickness Incidence and Treatment

An objective of this data compilation and analysis project is to examine incidence and treatment efficacy of common patho-physiological disturbances during spaceflight. Analysis of medical debriefs data indicated that astronauts used medications to alleviate symptoms of four major ailments for which astronauts received treatment for sleep disturbances, space motion sickness (SMS), pain (headache, back pain) and sinus congestion. In the present data compilation and analysis project on SMS treatment during space missions, subject demographics (gender, age, first-time or repeat flyer), incidence and severity of SMS symptoms and subjective treatment efficacy from 317 crewmember debrief records were examined from STS-1 through STS-89. Preliminary analysis of data revealed that 50% of crew members reported SMS symptoms on at least one flight and 22% never experienced it. In addition, there were 387 medication dosing episodes reported, and promethazine was the most commonly used medication. Results of analysis of symptom check lists, medication use/efficacy and gender and flight record differences in incidence and treatment efficacy will be presented. Evidence gaps for treatment efficacy along with medication use trend analysis will be identified.

Younker, D.R.↗
NASA NTRS2009

Antarctica Meta-Analysis: Psychosocial Factors Related to Long Duration Isolation and Confinement

This meta-analysis is examining the psychological effects of wintering-over in Antarctica. As an isolated, confined, and extreme (ICE) environment, Antarctica provides invaluable opportunities to experience stressors more common to spaceflight than to the average person s everyday life. Increased prevalence of psychological symptoms, syndromes, and psychiatric disorders, as well as positive effects, are expected to be associated with various demographic and environmental factors. Implications for spaceflight are discussed. Findings from statistical review of the Antarctic articles will be shared.

Leveton, Lauren↗
NASA NTRS2009

Metabolic and Subjective Results Review of the Integrated Suit Test Series

Crewmembers will perform a variety of exploration and construction activities on the lunar surface. These activities will be performed while inside an extravehicular activity (EVA) spacesuit. In most cases, human performance is compromised while inside an EVA suit as compared to a crewmember s unsuited performance baseline. Subjects completed different EVA type tasks, ranging from ambulation to geology and construction activities, in different lunar analog environments including overhead suspension, underwater and 1-g lunar-like terrain, in both suited and unsuited conditions. In the suited condition, the Mark III (MKIII) EVA technology demonstrator suit was used and suit pressure and suit weight were parameters tested. In the unsuited conditions, weight, mass, center of gravity (CG), terrain type and navigation were the parameters. To the extent possible, one parameter was varied while all others were held constant. Tests were not fully crossed, but rather one parameter was varied while all others were left in the most nominal setting. Oxygen consumption (VO2), modified Cooper-Harper (CH) ratings of operator compensation and ratings of perceived exertion (RPE) were measured for each trial. For each variable, a lower value correlates to more efficient task performance. Due to a low sample size, statistical significance was not attainable. Initial findings indicate that suit weight, CG and the operational environment can have a large impact on human performance during EVA. Systematic, prospective testing series such as those performed to date will enable a better understanding of the crucial interactions of the human and the EVA suit system and their environment. However, work remains to be done to confirm these findings. These data have been collected using only unsuited subjects and one EVA suit prototype that is known to fit poorly on a large demographic of the astronaut population. Key findings need to be retested using an EVA suit prototype better suited to a larger anthropometric portion of the astronaut population, and elements tested only in the unsuited condition need to be evaluated with an EVA suit and appropriate analog environment.

Norcross, J.R.↗
NASA NTRS2007

GRB070610: A Curious Galactic Transient

GRB 070610 is a typical high-energy event with a duration of 5s.Yet within the burst localization we detect a highly unusual X-ray and optical transient, SwiftJ195509.6+261406. We see high amplitude X-ray and optical variability on very short time scares even at late times. Using near-infrared imaging assisted by a laser guide star and adaptive optics, we identified the counterpart of SwiftJl95509.6+261406. Late-time optical and near-infrared imaging constrain the spectral type of the counterpart to be fainter than a K-dwarf assuming it is of Galactic origin. It is possible that GRB 070610 and Swift J195509.6+261406 are unrelated sources. However, the absence of a typical X-ray afterglow from GRB 070610 in conjunction with the spatial and temporal coincidence of the two motivate us to suggest that the sources are related. The closest (imperfect) analog to Swift J195509.6+261406 is V4641 Sgr, an unusual black hole binary. We suggest that Swift J195509.6+261406 along with V4641 Sgr define a sub-class of stellar black hole binaries -- the fast X-ray novae. We further suggest that fast X-ray novae are associated with bursts of gamma-rays. If so, GRB 070610 defines a new class of celestial gamma-ray bursts and these bursts dominate the long-duration GRB demographics

Kasliwal, M. M.↗
NASA NTRS2009

Participatory Exploration: The Role of the User Contribution System

This viewgraph presentation explores how NASA can apply the global shift in demographics, the popularity of collaborative technology and the desire for participation to the future of space exploration. Included in this is a review of the evolution of work, the engagement gap, user contribution systems and a case study concerning the "digital astronaut".

Skytland, Nicholas G.↗
NASA NTRS2009

Collaborative Systems Thinking: A Response to the Problems Faced by Systems Engineering's 'Middle Tier'

Experienced systems engineers are adept at more than implementing systems engineering processes: they utilize systems thinking to solve complex engineering problems. Within the space industry demographics and economic pressures are reducing the number of experienced systems engineers that will be available in the future. Collaborative systems thinking within systems engineering teams is proposed as a way to integrate systems engineers of various experience levels to handle complex systems engineering challenges. This paper uses the GOES-R Program Systems Engineering team to illustrate the enablers and barriers to team level systems thinking and to identify ways in which performance could be improved. Ways NASA could expand its engineering training to promote team-level systems thinking are proposed.

Phfarr, Barbara B.↗
NASA NTRS2009

Heart Rhythm Monitoring in the Constellation Lunar and Launch/Landing EVA Suit: Recommendations from an Expert Panel

There are currently several physiological monitoring requirements for EVA in the Human-Systems Interface Requirements (HSIR) document. There are questions as to whether the capability to monitor heart rhythm in the lunar surface space suit is a necessary capability for lunar surface operations. Similarly, there are questions as to whether the capability to monitor heart rhythm during a cabin depressurization scenario in the launch/landing space suit is necessary. This presentation seeks to inform space medicine personnel of recommendations made by an expert panel of cardiovascular medicine specialists regarding in-suit ECG heart rhythm monitoring requirements during lunar surface operations. After a review of demographic information and clinical cases and panel discussion, the panel recommended that ECG monitoring capability as a clinical tool was not essential in the lunar space suit; ECG monitoring was not essential in the launch/landing space suit for contingency scenarios; the current hear rate monitoring capability requirement for both launch/landing and lunar space suits should be maintained; lunar vehicles should be required to have ECG monitoring capability with a minimum of 5-lead ECG for IVA medical assessments; and, exercise stress testing for astronaut selection and retention should be changed from the current 85% maximum heart rate limit to maximal, exhaustive 'symptom-limited' testing to maximize diagnostic utility as a screening tool for evaluating the functional capacity of astronauts and their cardiovascular health.

Scheuring, Richard A.↗
NASA NTRS2009

Using Satellite Data to Evaluate Linkages Between Land Cover/Land Use and Hypertension in a National Cohort

Coincident with global expansion of urban areas has been an increase in hypertension. It is unclear how much the urban environment contributes as a risk factor for blood pressure differences, and how much is due to a variety of environmental, lifestyle, and demographic correlates of urbanization. Objectives/Purpose: The purpose of this study is to examine the relationship between living environment (defined as urban, suburban, or rural) and hypertension in selected regions from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Methods: REGARDS is a national cohort of 30,228 participants from the 48 contiguous United States. We used data from 4 metropolitan regions (Philadelphia, Atlanta, Minneapolis and Chicago) for this study (n=3928). We used Land Cover/Land Use (LCLU) information from the 30-meter National Land Cover Data. Results: Overall, 1996 (61%) of the participants were hypertensive. We characterized participants into urban, suburban or rural living environments using the LCLU data. In univariate models, we found that living environment is associated with hypertension, but that after adjustment for known hypertension risk factors, the relationship was no longer present at the 95% confidence level. Conclusions: LCLU data can be utilized to characterize the living environment, which in turn can be applied to studies of public health outcomes. Further study regarding the relationship between hypertension and living environment should focus on additional characteristics of the associated environment.

McClure, Leslie↗
NASA NTRS2010

TEACH (Train to Enable/Achieve Culturally Sensitive Healthcare)

Personnel from diverse ethnic and demographic backgrounds come together in both civilian and military healthcare systems, facing diagnoses that at one level are equalizers: coronary disease is coronary disease, breast cancer is breast cancer. Yet the expression of disease in individuals from different backgrounds, individual patient experience of disease as a particular illness, and interactions between patients and providers occurring in any given disease scenario, all vary enormously depending on the fortuity of the equation of "which patient happens to arrive in whose exam room." Previously, providers' absorption of lessons-learned depended on learning as an apprentice would when exposed over time to multiple populations. As a result, and because providers are often thrown into situations where communications falter through inadequate direct patient experience, diversity in medicine remains a training challenge. The questions then become: Can simulation and virtual training environments (VTEs) be deployed to short-track and standardize this sort of random-walk problem? Can we overcome the unevenness of training caused by some providers obtaining the valuable exposure to diverse populations, whereas others are left to "sink or swim"? This paper summarizes developing a computer-based VTE called TEACH (Training to Enable/Achieve Culturally Sensitive Healthcare). TEACH was developed to enhance healthcare providers' skills in delivering culturally sensitive care to African-American women with breast cancer. With an authoring system under development to ensure extensibility, TEACH allows users to role-play in clinical oncology settings with virtual characters who interact on the basis of different combinations of African American sub-cultural beliefs regarding breast cancer. The paper reports on the roll-out and evaluation of the degree to which these interactions allow providers to acquire, practice, and refine culturally appropriate communication skills and to achieve cultural and individual personalization of healthcare in their clinical practices.

Maulitz, Russell↗
NASA NTRS2010

Filovirus Research: The Need for an Integrated Approach in Time and Space

The episodic appearance of Ebola virus (EBOV) and Marburg virus (MARV) across central Africa over the last 15 years not only underscores the importance of filoviruses as uniquely virulent agents to both human and wildlife communities but also implies a very complex transmission scenario that must be understood if we are to prevent or mitigate filovirus outbreaks in the future. Efforts of a global network of scientists and healthcare workers have expanded our knowledge of filoviruses to meet the growing threat of Ebola and Marburg hemorrhagic fevers in Africa. In recent decades, several newly emerging diseases have resulted in major threats to both affected communities and global public health. Viruses from wildlife hosts in particular, have exhibited a capability for cross-species transmission (CST), and have caused high-impact diseases in humans Such as Ebola and Marburg hemorrhagic fevers, Nipah and severe acute respiratory syndrome (SAILS). It has been estimated that about 60.3% (Jones et al. 2008) of human infectious diseases are of animal origin (zoonoses) and even some important viral diseases that are traditionally considered of human origin, for example measles and smallpox, may very well have their prehistoric origins in wildlife (Wolfe et al 2007). It maybe logical and prudent therefore, to anticipate that there are other, new filoviruses out there that will cross into humans at some point in time. If we anticipate that these will happen and wish to be prepared for and mitigate this potential, then an understanding of filoviruses as a biologic system in the environment will be essential to that process. We will need to know how the ecological dynamic of CST interacts with a 'new' viruse's evolutionary factors to overcome environmental, demographic and host-specific barriers to transmission and infectivity to humans.

Pinzon, Jorge E.↗
NASA NTRS2011

Use of Inverse Reinforcement Learning for Identity Prediction

We adopt Markov Decision Processes (MDP) to model sequential decision problems, which have the characteristic that the current decision made by a human decision maker has an uncertain impact on future opportunity. We hypothesize that the individuality of decision makers can be modeled as differences in the reward function under a common MDP model. A machine learning technique, Inverse Reinforcement Learning (IRL), was used to learn an individual's reward function based on limited observation of his or her decision choices. This work serves as an initial investigation for using IRL to analyze decision making, conducted through a human experiment in a cyber shopping environment. Specifically, the ability to determine the demographic identity of users is conducted through prediction analysis and supervised learning. The results show that IRL can be used to correctly identify participants, at a rate of 68% for gender and 66% for one of three college major categories.

Hayes, Roy↗
NASA NTRS2011

Characterizing Vegetation Cover in Global Savannas with an Annual Foliage Clumping Index Derived from the MODIS BRDF Product

The global savanna biome is characterized by enormous diversity in the physiognomy and spatial structure of the vegetation. The foliage clumping index can be calculated from bidirectional reflectance distribution function (BRDF) data. It measures the response of the darkspot reflectance to increased shadow associated with clumped vegetation and is related to leaf area index. Clumping index theoretically declines with increasing woody cover until the tree canopy begins to become uniform. In this study, clumping index is calculated for Moderate Resolution Imaging Spectroradiometer BRDF data for the Australian tropical savanna, the tropical savannas of South America, and the tropical savannas of east, west and southern Africa and compared with site-based measurements of tree canopy cover, and with area-based classifications of land cover. There were differences in sensitivity of clumping index between red and near-infrared reflectance channels, and between savanna systems with markedly different woody vegetation physiognomy. Clumping index was broadly related to foliage cover from historical site data in Australia and in West Africa and Kenya, but not in Southern Africa nor with detailed site-based demographic data in the cerrado of Brazil. However, clumping index decreased with proportion of woody cover in land cover datasets for east Africa, Australia and the Colombian Llanos. There was overlap in the range of clumping index values for forest, cerrado and campo land covers in Brazil. Clumping index was generally negatively correlated with percentage tree cover from the MODIS Vegetation Continuous Fields product, but regional differences in the relationship were evident. There were large differences in the frequency distributions of clumping index from savanna, woody savanna and grassland land cover classes between global ecoregions. The clumping index shows differing sensitivity to savanna woody cover for red and NIR reflectance, and requires regional calibration for application as a universal indicator.

Hill, Michael J.↗
NASA NTRS2011

Climate Change Impacts and Responses: Societal Indicators for the National Climate Assessment

The Climate Change Impacts and Responses: Societal Indicators for the National Climate Assessment workshop, sponsored by the National Aeronautics and Space Administration (NASA) for the National Climate Assessment (NCA), was held on April 28-29, 2011 at The Madison Hotel in Washington, DC. A group of 56 experts (see list in Appendix B) convened to share their experiences. Participants brought to bear a wide range of disciplinary expertise in the social and natural sciences, sector experience, and knowledge about developing and implementing indicators for a range of purposes. Participants included representatives from federal and state government, non-governmental organizations, tribes, universities, and communities. The purpose of the workshop was to assist the NCA in developing a strategic framework for climate-related physical, ecological, and socioeconomic indicators that can be easily communicated with the U.S. population and that will support monitoring, assessment, prediction, evaluation, and decision-making. The NCA indicators are envisioned as a relatively small number of policy-relevant integrated indicators designed to provide a consistent, objective, and transparent overview of major variations in climate impacts, vulnerabilities, adaptation, and mitigation activities across sectors, regions, and timeframes. The workshop participants were asked to provide input on a number of topics, including: (1) categories of societal indicators for the NCA; (2) alternative approaches to constructing indicators and the better approaches for NCA to consider; (3) specific requirements and criteria for implementing the indicators; and (4) sources of data for and creators of such indicators. Socioeconomic indicators could include demographic, cultural, behavioral, economic, public health, and policy components relevant to impacts, vulnerabilities, and adaptation to climate change as well as both proactive and reactive responses to climate change. Participants provided inputs through in-depth discussion in breakout sessions, plenary sessions on break-out results, and several panels that provided key insights about indicators, lessons learned through experience with developing and implementing indicators, and thoughts on how the NCA could proceed to develop indicators for the NCA.

Kenney, Melissa A.↗
NASA NTRS2011

Sensitivity Analysis of Median Lifetime on Radiation Risks Estimates for Cancer and Circulatory Disease amongst Never-Smokers

Radiation risks are estimated in a competing risk formalism where age or time after exposure estimates of increased risks for cancer and circulatory diseases are folded with a probability to survive to a given age. The survival function, also called the life-table, changes with calendar year, gender, smoking status and other demographic variables. An outstanding problem in risk estimation is the method of risk transfer between exposed populations and a second population where risks are to be estimated. Approaches used to transfer risks are based on: 1) Multiplicative risk transfer models -proportional to background disease rates. 2) Additive risk transfer model -risks independent of background rates. In addition, a Mixture model is often considered where the multiplicative and additive transfer assumptions are given weighted contributions. We studied the influence of the survival probability on the risk of exposure induced cancer and circulatory disease morbidity and mortality in the Multiplicative transfer model and the Mixture model. Risks for never-smokers (NS) compared to the average U.S. population are estimated to be reduced between 30% and 60% dependent on model assumptions. Lung cancer is the major contributor to the reduction for NS, with additional contributions from circulatory diseases and cancers of the stomach, liver, bladder, oral cavity, esophagus, colon, a portion of the solid cancer remainder, and leukemia. Greater improvements in risk estimates for NS s are possible, and would be dependent on improved understanding of risk transfer models, and elucidating the role of space radiation on the various stages of disease formation (e.g. initiation, promotion, and progression).

Chappell, Lori J.↗
NASA NTRS2011

The SEDs and Host Galaxies of the Dustiest GRB Afterglows

The afterglows and host galaxies of long gamma-ray bursts (GRBs) offer unique opportunities to study star-forming galaxies in the high-z Universe, Until recently, however. the information inferred from GRB follow-up observations was mostly limited to optically bright afterglows. biasing all demographic studies against sight-lines that contain large amounts of dust. Aims. Here we present afterglow and host observations for a sample of bursts that are exemplary of previously missed ones because of high visual extinction (A(sub v) (Sup GRB) approx > 1 mag) along the sight-line. This facilitates an investigation of the properties, geometry and location of the absorbing dust of these poorly-explored host galaxies. and a comparison to hosts from optically-selected samples. Methods. This work is based on GROND optical/NIR and Swift/XRT X-ray observations of the afterglows, and multi-color imaging for eight GRB hosts. The afterglow and galaxy spectral energy distributions yield detailed insight into physical properties such as the dust and metal content along the GRB sight-line as well as galaxy-integrated characteristics like the host's stellar mass, luminosity. color-excess and star-formation rate. Results. For the eight afterglows considered in this study we report for the first time the redshift of GRBs 081109 (z = 0.97S7 +/- 0.0005). and the visual extinction towards GRBs 0801109 (A(sub v) (Sup GRB) = 3.4(sup +0.4) (sub -0.3) mag) and l00621A (A(sub v) (Sup GRB) = 3.8 +/- 0.2 mag), which are among the largest ever derived for GRB afterglows. Combined with non-extinguished GRBs. there is a strong anti-correlation between the afterglow's metals-to-dust ratio and visual extinction. The hosts of the dustiest afterglows are diverse in their properties, but on average redder(((R - K)(sub AB)) approximates 1.6 mag), more luminous ( approximates 0.9 L (sup *)) and massive ((log M(sup *) [M(solar]) approximates 9.8) than the hosts of optically-bright events. We hence probe a different galaxy population. suggesting that previous host samples miss most of the massive. chemically-evolved and metal-rich members. This also indicates that the dust along the sight-line is often related to host properties, and thus probably located in the diffuse ISM or interstellar clouds and not in the immediate GRB environment. Some of the hosts in our sample. are blue, young or of small stellar mass illustrating that even apparently non-extinguished galaxies possess very dusty sight-lines due to a patchy dust distribution. Conclusions. The afterglows and host galaxies of the dustiest GRBs provide evidence for a complex dust geometry in star-forming galaxies. In addition, they establish a population of luminous. massive and correspondingly chemically-evolved GRB hosts. This suggests that GRBs trace the global star-formation rate better than studies based on optically-selected host samples indicate, and the previously-claimed deficiency of high-mass host galaxies was at least partially a selection effect.

Kruhler, T.↗
NASA NTRS2012

Assessing the Association Between Asthma and Air Quality in the Presence of Wildfires

Asthma hospital/emergency room (patient) data are used as the foundation for creating a health outcome indicator of human response to environmental air quality. Daily U.S. Environmental Protection Agency (EPA) Air Quality System (AQS) fine particulates (PM2.5) ground data and the U.S. National Aeronautical Space Administration (NASA) MODIS aerosol optical depth (AOD) data were acquired and processed for years of 2007 and 2008. Figure 1 shows the PM2.5 annual mean composite of all the 2007 B-spline daily surfaces. Initial models for predicting the number of weekly asthma cases within a Florida county has focused on environmental variables. Weekly maximums of PM2.5, relative humidity, and the proportions of the county with smoke and fire were the environmental variables included in the model. Cosine and sine functions of time were used to account for seasonality in asthma cases. Counties were considered to be random effects, thereby adjusting for differences in socio ]demographics and other factors. The 2007 predictions for Miami ]Dade county when using B ]splines PM2.5 are displayed in Figures 2.

Young, L. J.↗
NASA NTRS2013

The Lifetime Surveillance of Astronaut Health (LSAH) Project

From 1989-2010 NASA conducted a research study, the Longitudinal Study of Astronaut Health, to investigate the incidence of acute and chronic morbidity and mortality in astronauts and to determine whether their occupational exposures were associated with increased risk of death or disability. In 2004, the Institute of Medicine recommended that NASA convert the longitudinal study into an occupational health surveillance program and in 2010, NASA initiated the Lifetime Surveillance of Astronaut Health project. The new program collects data on astronaut workplace exposures, especially those occurring in the training and space flight environments, and conducts operational and health care analyses to look for trends in exposure and health outcomes. Astronaut selection and retention medical standards are rigorous, requiring an extensive clinical testing regimen. As a result, this employee population has contributed to a large set of health data available for analyses. Astronauts represent a special population with occupational exposures not typically experienced by other employee populations. Additionally, astronauts are different from the general population in terms of demographic and physiologic characteristics. The challenges and benefits of conducting health surveillance for an employee population with unique occupational exposures will be discussed. Several occupational surveillance projects currently underway to examine associations between astronaut workplace exposures and medical outcomes will be described.

Bopp, Eugenia↗