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Cognitive Performance in Operational Environments

Optimal cognition during complex and sustained operations is a critical component for success in current and future military operations. "Cognitive Performance, Judgment, and Decision-making" (CPJD) is a newly organized U.S. Army Medical Research and Materiel Command research program focused on sustaining operational effectiveness of Future Force Warriors by developing paradigms through which militarily-relevant, higher-order cognitive performance, judgment, and decision-making can be assessed and sustained in individuals, small teams, and leaders of network-centric fighting units. CPJD evaluates the impact of stressors intrinsic to military operational environments (e.g., sleep deprivation, workload, fatigue, temperature extremes, altitude, environmental/physiological disruption) on military performance, evaluates noninvasive automated methods for monitoring and predicting cognitive performance, and investigates pharmaceutical strategies (e.g., stimulant countermeasures, hypnotics) to mitigate performance decrements. This manuscript describes the CPJD program, discusses the metrics utilized to relate militarily applied research findings to academic research, and discusses how the simulated combat capabilities of a synthetic battle laboratory may facilitate future cognitive performance research.

Russo, Michael↗

Converging Indicators for Assessing Individual Differences in Adaptation to Extreme Environments: Preliminary Report

This paper describes the development and validation of a new methodology for assessing the deleterious effects of spaceflight on crew health and performance. It is well known that microgravity results in various physiological alterations, e.g., headward fluid shifts which can impede physiological adaptation. Other factors that may affect crew operational efficiency include disruption of sleep-wake cycles, high workload, isolation, confinement, stress and fatigue. From an operational perspective, it is difficult to predict which individuals will be most or least affected in this unique environment given that most astronauts are first-time flyers. During future lunar and Mars missions space crews will include both men and women of multi-national origins, different professional backgrounds, and various states of physical condition. Therefore, new methods or technologies are needed to monitor and predict astronaut performance and health, and to evaluate the effects of various countermeasures on crew during long duration missions. This paper reviews several studies conducted in both laboratory and operational environments with men and women ranging in age between 18 to 50 years. The studies included the following: soldiers performing command and control functions during mobile operations in enclosed armored vehicles; subjects participating in laboratory tests of an anti-motion sickness medication; subjects exposed to chronic hypergravity aboard a centrifuge, and subject responses to 36-hours of sleep deprivation. Physiological measurements, performance metrics, and subjective self-reports were collected in each study. The results demonstrate that multivariate converging indicators provide a significantly more reliable method for assessing environmental effects on performance and health than any single indicator.

Cowings, Patricia S.↗

Subclinical Shed of Infectious Varicella zoster Virus in Astronauts

Aerosol borne varicella zoster virus (VZV) enters the nasopharynx and replicates in tonsillar T-cells, resulting in viremia and varicella (chickenpox). Virus then becomes latent in cranial nerve, dorsal root and autonomic nervous system ganglia along the entire neuraxis (1). Decades later, as cell-mediated immunity to VZV declines (4), latent VZV can reactivate to produce zoster (shingles). Infectious VZV is present in patients with varicella or zoster, but shed of infectious virus in the absence of disease has not been shown. We previously detected VZV DNA in saliva of astronauts during and shortly after spaceflight, suggesting stress induced subclinical virus reactivation (3). We show here that VZV DNA as well as infectious virus in present in astronaut saliva. VZV DNA was detected in saliva during and after a 13-day spaceflight in 2 of 3 astronauts (Fig. panel A). Ten days before liftoff, there was a rise in serum anti-VZV antibody in subjects 1 and 2, consistent with virus reactivation. In subject 3, VZV DNA was not detected in saliva, and there was no rise in anti-VZV antibody titer. Subject 3 may have been protected from virus reactivation by having zoster <10 years ago, which provides a boost in cell-medicated immunity to VZV (2). No VZV DNA was detected in astronaut saliva months before spaceflight, or in saliva of 10 age/sex-matched healthy control subjects sampled on alternate days for 3 weeks (88 saliva samples). Saliva taken 2-6 days after landing from all 3 subjects was cultured on human fetal lung cells (Fig. panel B). Infectious VZV was recovered from saliva of subjects 1 and 2 on the second day after landing. Virus specificity was confirmed by antibody staining and DNA analysis which showed it to be VZV of European descent, common in the US (5). Further, both antibody staining and DNA PCR demonstrated that no HSV-1 was detected in any infected culture. This is the first report of infectious VZV shedding in the absence of clinical disease. Spaceflight presents a uniquely stressful environment which includes physical isolation and confinement, anxiety, sleep deprivation, as well as exposure to increased radiation and microgravity. It is interesting that in our study, VZV and not HSV-1 reactivation was detected, since stress-induced HSV-1 reactivation has been reported (6). Future studies are needed to determine the specific inducer of VZV reactivation.

Cohrs, Randall J.↗

Plasma Cytokine Levels in Astronauts Before and after Spaceflight

Space flight is a unique experience and results in adverse effects on human physiology. Changes have been reported in various physiological systems, including musculoskeletal, neurovestibular, cardiovascular, endocrine, immunity and increased latent viral reactivation as well as others. The potential mechanisms behind these changes are not fully understood. Various cytokines such as IL-1, IL-6, TNF and chemokines have been linked to several of these changes, like muscle loss, bone loss, fatigue, sleep deprivation and viral reactivation. Eighteen astronauts (15 M and 3 F) from 8 spaceflights and 10 healthy age-matched adults (6 M, 4 F) were included in the present study. A panel of 21 plasma cytokines was analyzed with the Luminex 100 to measure the cytokines in these subjects 10 days before the flight (L-10), 2-3 hour after landing (R+0), 3 days after landing (R+3), and at their annual medical exam (AME). IL-10, IL-1, IFN-alpha, MCP-1 and IP-10 increased significantly at L-10 as compared with AME levels. IL-6 and IFN-alpha showed significant increases at R + 0 (P less than .05) over their baseline levels (AME). Cytokine levels at R+3 were not significantly different from R+0. IL-10 and IL-6 have been reported to increase in during viral reactivation. These data show that there was a shift from TH1 to TH2 cytokines L-10 and R+0. We also studied viral reactivation in 10 of the 18 subjects included in the present study before, during, and after space flight. Increased salivary varicella zoster virus (VZV) shedding in these subjects was found either during or after the mission. VZV shedding correlated with the increased levels of cytokines especially IL-10 and IL-6. Overall, our data suggests that cytokines may play an important role in regulating adverse changes in astronauts, and further studies are needed to fully understand the mechanism.

Mehta, Satish K.↗

Latent Herpes Viruses Reactivation in Astronauts

Space flight has many adverse effects on human physiology. Changes in multiple systems, including the cardiovascular, musculoskeletal, neurovestibular, endocrine, and immune systems have occurred (12, 32, 38, 39). Alterations in drug pharmacokinetics and pharmacodynamics (12), nutritional needs (31), renal stone formation (40), and microbial flora (2) have also been reported. Evidence suggests that the magnitude of some changes may increase with time in space. A variety of changes in immunity have been reported during both short (.16 days) and long (>30 days) space missions. However, it is difficult to determine the medical significance of these immunological changes in astronauts. Astronauts are in excellent health and in superb physical condition. Illnesses in astronauts during space flight are not common, are generally mild, and rarely affect mission objectives. In an attempt to clarify this issue, we identified the latent herpes viruses as medically important indicators of the effects of space flight on immunity. This chapter demonstrates that space flight leads to asymptomatic reactivation of latent herpes viruses, and proposes that this results from marked changes in neuroendocrine function and immunity caused by the inherent stressfullness of human space flight. Astronauts experience uniquely stressful environments during space flight. Potential stressors include confinement in an unfamiliar, crowded environment, isolation, separation from family, anxiety, fear, sleep deprivation, psychosocial issues, physical exertion, noise, variable acceleration forces, increased radiation, and others. Many of these are intermittent and variable in duration and intensity, but variable gravity forces (including transitions from launch acceleration to microgravity and from microgravity to planetary gravity) and variable radiation levels are part of each mission and contribute to a stressful environment that cannot be duplicated on Earth. Radiation outside the Earth's magnetosphere is particularly worrisome because it includes ionizing radiation from cosmic galactic radiation. Increased stress levels appear even before flight, presumably from the rigors of preflight training and the anticipation of the mission (12, 32, 38, 39). Space flight causes significant changes in human immune function (32), but the means by which these changes come about have been difficult to discern. Consistent indicators of stress associated with space flight include increased production of stress hormones, and changes in cells of the immune system. These changes include elevated white blood cell (WBC) and neutrophil counts at landing (15, 16, 35, 37). Activation of generalized stress responses before, during, and after space flight probably affects the function of the immune system. Space flight has been shown to decrease many aspects of immune function, including natural killer (NK) cell activity, interferon production, the blastogenic response of leukocytes to mitogens, cell-mediated immunity, neutrophil function and monocyte function (5, 16, 18, 21, 35-37).

Mehta, Satish K.↗

Latent Virus Reactivation in Astronauts and Shingles Patients

Spaceflight is a uniquely stressful environment with astronauts experiencing a variety of stressors including: isolation and confinement, psychosocial, noise, sleep deprivation, anxiety, variable gravitational forces, and increased radiation. These stressors are manifested through the HPA and SAM axes resulting in increased stress hormones. Diminished T-lymphocyte functions lead to reactivation of latent herpesviruses in astronauts during spaceflight. Herpes simplex virus reactivated with symptoms during spaceflight whereas Epstein-Barr virus (EBV), cytomegalovirus (CMV), and varicella zoster virus (VZV) reactivate and are shed without symptoms. EBV and VZV are shed in saliva and CMV in the urine. The levels of EBV shed in astronauts increased 10-fold during the flight; CMV and VZV are not typically shed in low stressed individuals, but both were shed in astronauts during spaceflight. All herpes viruses were detected by polymerase chain reaction (PCR) assay. Culturing revealed that VZV shed in saliva was infectious virus. The PCR technology was extended to test saliva of 54 shingles patients. All shingles patients shed VZV in their saliva, and the levels followed the course of the disease. Viremia was also found to be common during shingles. The technology may be used before zoster lesions appear allowing for prevention of disease. The technology may be used for rapid detection of VZV in doctors offices. These studies demonstrated the value of applying technologies designed for astronauts to people on Earth.

Mehta, Satish K.↗

Salivary Varicella Zoster Virus in Astronauts and in Patients of Herpes Zoster

Spaceflight is a uniquely stressful environment with astronauts experiencing a variety of stressors including: isolation and confinement, psychosocial, noise, sleep deprivation, anxiety, variable gravitational forces, and increased radiation. These stressors are manifested through the HPA and SAM axes resulting in increased stress hormones. Diminished T-lymphocyte functions lead to reactivation of latent herpes viruses in astronauts during spaceflight. Herpes simplex virus reactivated with symptoms during spaceflight whereas Epstein-Barr virus (EBV), cytomegalovirus (CMV), and varicella zoster virus (VZV) reactivate and are shed without symptoms. EBV and VZV are shed in saliva and CMV in the urine. The levels of EBV shed in astronauts increased 10-fold during the flight; CMV and VZV are not typically shed in low stressed individuals, but both were shed in astronauts during spaceflight. All herpesviruses were detected by polymerase chain reaction (PCR) assay. Culturing revealed that VZV shed in saliva was infectious virus. The PCR technology was extended to test saliva of 54 shingles patients. All shingles patients shed VZV in their saliva, and the levels followed the course of the disease. Viremia was also found to be common during shingles. The technology may be used before zoster lesions appear allowing for prevention of disease. The technology may be used for rapid detection of VZV in doctors? offices. These studies demonstrated the value of applying technologies designed for astronauts to people on Earth.

Mehta, Satish↗

Astronaut Biography Project for Countermeasures of Human Behavior and Performance Risks in Long Duration Space Flights

This final report will summarize research that relates to human behavioral health and performance of astronauts and flight controllers. Literature reviews, data archival analyses, and ground-based analog studies that center around the risk of human space flight are being used to help mitigate human behavior and performance risks from long duration space flights. A qualitative analysis of an astronaut autobiography was completed. An analysis was also conducted on exercise countermeasure publications to show the positive affects of exercise on the risks targeted in this study. The three main risks targeted in this study are risks of behavioral and psychiatric disorders, risks of performance errors due to poor team performance, cohesion, and composition, and risks of performance errors due to sleep deprivation, circadian rhythm. These three risks focus on psychological and physiological aspects of astronauts who venture out into space on long duration space missions. The purpose of this research is to target these risks in order to help quantify, identify, and mature countermeasures and technologies required in preventing or mitigating adverse outcomes from exposure to the spaceflight environment

Banks, Akeem↗

Review of Human Cognitive Performance in Spaceflight

Human space exploration is inherently hazardous, particularly for lon g duration (LD) missions (22 days or longer). Maintenance of cognitive functioning is essential, but flight environments pose numerous pote ntial risks to the brain and cognitive performance (eg, radiation, to xins, chronic stress, sleep deprivation, hypercarbia, fluid shifts, h ormone imbalances, and injury). There have been persistent anecdotal reports of cognitive deficits during missions, but an up?-to-date rev iew of the evidence for such changes has remained unavailable. Method s: We identified and reviewed English language publications found via electronic searches in PubMed, PsycInfo, Inspec, the NASA Technical Report Server, and the Defense Technical Information Center, plus rec ursive searches of publication bibliographies. Search terms included the word cognition, cognitive, or performance along with spaceflight, flight, mission, or closely related terms. Results: Inter?-study variability precluded meta?-analysis. Some 32 published studies involving cognitive assessment during spaceflight were identified, involving a total of 110 participants (mean: 3.4 participants per study). The lo ngest?-duration study spanned 438 days, with six additional studies i nvolving flight durations of 90 days, and 11 more studies involved fl ight durations exceeding 21 days. The available evidence failed to st rongly support or refute the existence of cognitive deficits in LD sp aceflight, in part due to inadequate power or control conditions. Evi dence of increased variability in cognitive performance during spacef light, both within and between individuals, was common. Discussion: T hese results represent a negative finding based on small numbers of s ubjects for any given cognitive function. The increased variability within and (particularly) between individuals highlights the potential danger of generalizing from case studies. A mismatch therefore remain s between anecdotal reports describing generalized cognitive slowing, attention and memory problems during missions and the experimental e vidence supporting such deficits. Since a major justification for man ned spaceflight rests with the cognitive flexibility of humans, addit ional studies and further analysis of existing operational data appea rs warranted.

Strangman, Gary↗

Protecting Neural Structures and Cognitive Function During Prolonged Space Flight by Targeting the Brain Derived Neurotrophic Factor Molecular Network

Brain derived neurotrophic factor (BDNF) is the main activity-dependent neurotrophin in the human nervous system. BDNF is implicated in production of new neurons from dentate gyrus stem cells (hippocampal neurogenesis), synapse formation, sprouting of new axons, growth of new axons, sprouting of new dendrites, and neuron survival. Alterations in the amount or activity of BDNF can produce significant detrimental changes to cortical function and synaptic transmission in the human brain. This can result in glial and neuronal dysfunction, which may contribute to a range of clinical conditions, spanning a number of learning, behavioral, and neurological disorders. There is an extensive body of work surrounding the BDNF molecular network, including BDNF gene polymorphisms, methylated BDNF gene promoters, multiple gene transcripts, varied BDNF functional proteins, and different BDNF receptors (whose activation differentially drive the neuron to neurogenesis or apoptosis). BDNF is also closely linked to mitochondrial biogenesis through PGC-1alpha, which can influence brain and muscle metabolic efficiency. BDNF AS A HUMAN SPACE FLIGHT COUNTERMEASURE TARGET Earth-based studies reveal that BDNF is negatively impacted by many of the conditions encountered in the space environment, including oxidative stress, radiation, psychological stressors, sleep deprivation, and many others. A growing body of work suggests that the BDNF network is responsive to a range of diet, nutrition, exercise, drug, and other types of influences. This section explores the BDNF network in the context of 1) protecting the brain and nervous system in the space environment, 2) optimizing neurobehavioral performance in space, and 3) reducing the residual effects of space flight on the nervous system on return to Earth

Schmidt, M. A.↗

Effects of Acute Exposures to Carbon Dioxide Upon Cognitive Functions

Large quantities of carbon dioxide (CO2) originate from human metabolism and typically, within spacecraft, remain about 10-fold higher in concentration than at the earth's surface. There have been recurring complaints by crew members of episodes of "mental viscosity" adversely affecting their performance, and there is evidence from the International Space Station (ISS) that associates CO2 levels with reports of headaches by crewmembers. Additionally, there is concern that CO2 may contribute to vision impairment and intracranial pressure that has been observed in some crewmembers. Consequently, flight rules have been employed to control the level of CO2 below 4 mm Hg, which is well below the existing Spacecraft Maximum Allowable Concentration (SMAC) of 10 mm Hg for 24-hour exposures, and 5.3 mm Hg for exposures of 7 to 180 days. However, the flight rule imposed limit, which places additional demands upon resources and current technology, still exceeds the lower bound of the threshold range for reportable headaches (2 - 5 mm Hg). Headaches, while sometime debilitating themselves, are also symptoms that can provide evidence that physiological defense mechanisms have been breached. The causes of the headaches may elicit other subtle adverse effects that occur at CO2 levels well below that for headaches. The concern that CO2 may have effects at levels below the threshold for headaches appears to be substantiated in unexpected findings that CO2 at concentrations below 2 mm Hg substantially reduced some cognitive functions that are associated with the ability to make complex decisions in conditions that are characterized by volatility, uncertainty, complexity, ambiguity, and delayed feedback. These are conditions that could be encountered by crews in off-nominal situations or during the first missions beyond low earth orbit. If findings of the earlier study are confirmed in crew-like subjects, our findings would provide additional evidence that CO2 may need to be controlled at levels that are well below current spacecraft limits. Our study will extend the earlier study to determine if crew-like subjects are similarly effected by CO2. In addition to employing the Strategic Management Simulation tool, we will use the Cognition battery of psychometric measures that are being utilized aboard the ISS. It will be important to learn, by using Cognition, if additional cognitive domains are sensitive to concentrations of CO2 at or below limits currently controlled by flight rules. While spaceflight Cognition data will greatly enhance the knowledge base related to inflight behavioral health and performance, some of the measures may be influenced by fatigue (related to sleep deprivation and or workload) and changes in circadian rhythms. Therefore our use of this battery of tests in a well-controlled, ground-based study that is free of these potential confounding influences will establish a baseline terrestrial data set against which Cognition data collected in flight may be assessed. The findings from this study will be useful to the NASA Toxicology Office and the National Research Council Committee on Toxicology, which assists NASA in setting environmental standards, for revision of the SMAC for CO2, and for designing further studies on effects of CO2 upon cognitive functions.

Scully, R. R.↗

NASA HRP Plans for Collaboration at the IBMP Ground-Based Experimental Facility (NEK)

NASA and IBMP are planning research collaborations using the IBMP Ground-based Experimental Facility (NEK). The NEK offers unique capabilities to study the effects of isolation on behavioral health and performance as it relates to spaceflight. The NEK is comprised of multiple interconnected modules that range in size from 50-250m(sup3). Modules can be included or excluded in a given mission allowing for flexibility of platform design. The NEK complex includes a Mission Control Center for communications and monitoring of crew members. In an effort to begin these collaborations, a 2-week mission is planned for 2017. In this mission, scientific studies will be conducted to assess facility capabilities in preparation for longer duration missions. A second follow-on 2-week mission may be planned for early in 2018. In future years, long duration missions of 4, 8 and 12 months are being considered. Missions will include scenarios that simulate for example, transit to and from asteroids, the moon, or other interplanetary travel. Mission operations will be structured to include stressors such as, high workloads, communication delays, and sleep deprivation. Studies completed at the NEK will support International Space Station expeditions, and future exploration missions. Topics studied will include communication, crew autonomy, cultural diversity, human factors, and medical capabilities.

Cromwell, Ronita L.↗

General Nobile and the Airship Italia: No Second-In-Command

The airship Italia, commanded by General Umberto Nobile, crashed during its return flight from the North Pole in 1928. Prior work has demonstrated the possibility that this crash was fatigue-related, due to significant sleep-deprivation on the part of its Commander, and to resulting errors in cognition and judgment. However, the underlying cause of the fatigue was likely due to the fact that the Commander did not have a Second-In-Command on board to take over duties while the Commander was allowed to rest. At that time the Second-In-Command was a formally designated position, and according to Nobiles previous writings was considered to be a necessary crew member on an airship.

Second-In-Command↗

Human Factors and Behavioral Performance Exploration Measures Harmonized Across HERA, NEK, and ISS: Teams Risk

BACKGROUNDThe Human Factors and Behavioral Performance Exploration Measures (HFBP-EM) suite is a set of standardized measures to assess behavioral health and performance risk related to future exploration class missions, and to support reduction of the Human Research Program’s (HRP) Behavioral Medicine (BMed), Team, Sleep, and Human Systems Integration Architecture risks. HFBP-EM were collected during Human Exploration Research Analogs (HERA) campaigns 4 (C4) and 5 (C5), and during SIRIUS 17 and 19 missions in the Russian Ground Based Experiment Complex, NEK, to document the feasibility, flexibility, and acceptability of these measures in analogsof the spaceflight environment. A subset of the HFBP-EM suite was collected during spaceflight as part HRP’s Standard Measures in Spaceflight Project. Whenever possible, the HFBP-EM protocol and measures are kept the same across studies, however, differences across research settings (e.g., experimental manipulations, mission scenarios, mission length) and implementation of the measures require the data are harmonized to ensure comparable views across missions. The purpose of our project is to develop a harmonized database of HFBP-EM data from different settings, and to summarize the trajectory of behavioral health and performance within and between research settings. In this presentation, we will summarize the harmonized dataset and the trajectory of measures related to the Team Risk, including team performance, team cohesion, team processes, and psychological safety, over time and between and within settings.METHODSWe followed best practices for data harmonization. Characteristics of each research setting were assessed for harmonization potential, and we deemed NEK-SIRIUS 17 as inappropriate due to study aims, length, and data quality. Common variables of interest were identified. Study characteristics and key variables with which datafiles could be merged were defined as “meta-data.” HFBP-EM data from all settings were processed under a common format. We then created a harmonized team-level database designed to facilitate analyses that address HRP research gaps related to HRP’s Team risk. In this database, team cohesion, processes, performance, psychological safety, and group living were operationalized as the team mean of the crew responses for each data collection (e.g., on mission day 7). Data collected on the International Space Station (ISS) included a subset of scale items administered to participants. Data collected from ISS team members within +/- 7 days of the first data collection and every following 30 +/-4 days were aggregated to the team level. We generated figures that display the mean and variability of team constructs across research settings. We also generated plots of changes in team constructs with mission day and with percentage of the mission completed. Where possible, we compared data from spaceflight analogs with data from astronauts aboard the ISS. RESULTS AND DISCUSSIONThe team-level harmonized database was structured such that each row represents data for a team on a specific mission day. Team constructs (e.g., team cohesion) were included as columns (i.e., wide format) with repeated measures across mission days given in rows (i.e., long format). The database included data from 18 crews: five, 4-person American crews in HERA C4, four 4-person American crews in HERA C5, one 6-person multinational crew in NEK-SIRIUS 19, and eight, 2–11-person multinational crews aboard the ISS. Results provide insights into mission and campaign differences in team functioning and performance. For example, between campaign differences were observed for team processes—the interdependent team actions that orchestrate taskwork in pursuit of the team’s goals [1]. Greater between-team variability on team processes was detected during HERA C4 than during C5, and a downward trend was observed over the duration of C4, but not C5 or SIRIUS 19. This may be due to the campaign-level differences such as the sleep deprivation implemented during C4. Responses on the subset of team process items administered on the ISS indicate between-crew variability more like those observed in C4 than C5 and NEK, with some, but not all ISS crews demonstrating a downward trend over time. Additional findings will be presented. REFERENCESMarks, M. A., et al (2001) Academy of Management Review, 26(3), 356-376.

S T Bell↗

Dynamic Ensemble Prediction of Cognitive Performance in Space

Astronauts are exposed to a unique set of stressors in spaceflight. Microgravity, isolation, confinement, and environmental and operational hazards: all of these can impact sleep, vigilant attention, and alertness, which are critical to mission success. In this paper, we seek to understand the most important predictors of alertness over the course of a space mission, using self-reported, cognitive, and environmental data collected from 24 astronauts on 6-month missions to the International Space Station (ISS). Alertness was repeatedly and objectively assessed on the ISS with a brief 3-minute Psychomotor Vigilance Test (PVT) that is highly sensitive to sleep deprivation. To relate PVT performance to time-varying and sparsely-measured environmental, operational, and psychological covariates, we propose a n ensemble prediction model comprising of linear mixed effects regression, random forest, and functional concurrent regression models. An extensive cross-validation procedure reveals that this ensemble outperforms any one of its components alone. We also discover that a participant’s past performance, reported fatigue and stress, and temperature and radiation exposure were among the most important variables associated with alertness. This method is broadly applicable to environmental studies where the main goal is accurate, individualized prediction involving a mixture of person-level traits and irregularly measured time series.

Danni Tu↗

Assessing Long-Term Health (LTH) Outcomes in Astronauts

NASA has linked potential Long-Term Health (LTH) risks of astronauts to their spaceflight experience, including the effects of space radiation, microgravity, and stressors such as isolation, sleep deprivation, and stress. Therefore, assessing the LTH outcomes for astronauts exposed to these hazards becomes a critical investigation in ensuring any deleterious effects are minimal. Prior research conducted into LTH outcomes of astronauts has not revealed increases in non-accidental mortality rates when compared to the U.S. general population, analog healthy cohorts, and professional athletes. One study did report an increased incidence of non-fatal cardiovascular disease events (Hazard Ratio=2.41, 95% Confidence Interval 1.26 to 4.63). Additional evidence indicates that astronauts may have increases in incidences of melanoma, prostate, and hematologic cancers, though the former is consistent with rates observed among aircraft pilots and the latter two are likely caused by detection bias due to increased screening on former astronauts.

long term health↗

Microgravity reduces sleep-disordered breathing in humans

To understand the factors that alter sleep quality in space, we studied the effect of spaceflight on sleep-disordered breathing. We analyzed 77 8-h, full polysomnographic recordings (PSGs) from five healthy subjects before spaceflight, on four occasions per subject during either a 16- or 9-d space shuttle mission and shortly after return to earth. Microgravity was associated with a 55% reduction in the apnea-hypopnea index (AHI), which decreased from a preflight value of 8.3 +/- 1.6 to 3.4 +/- 0.8 events/h inflight. This reduction in AHI was accompanied by a virtual elimination of snoring, which fell from 16.5 +/- 3.0% of total sleep time preflight to 0.7 +/- 0.5% inflight. Electroencephalogram (EEG) arousals also decreased in microgravity (by 19%), and this decrease was almost entirely a consequence of the reduction in respiratory-related arousals, which fell from 5.5 +/- 1.2 arousals/h preflight to 1.8 +/- 0.6 inflight. Postflight there was a return to near or slightly above preflight levels in these variables. We conclude that sleep quality during spaceflight is not degraded by sleep-disordered breathing. This is the first direct demonstration that gravity plays a dominant role in the generation of apneas, hypopneas, and snoring in healthy subjects.

short duration↗