Towards Crew-Centered, Mission-Oriented Space Flight Training

This poster describes a training approach that applies empirically derived principles of training to reimagining the overall design of NASA's space flight training program. The poster is focused specifically on the design of astronaut training for NASA's future deep space, exploration missions to Mars. We briefly describe NASA's space flight training practices during the Apollo and Space Shuttle eras as well as NASA's current practices for training astronauts for their missions to the International Space Station. We provide an overview of NASA's current concepts for a mission to Mars to scope our training approach. We envision a new space flight training approach which we term crew-centered, mission oriented training, inspired by the design approach offered in the context of airline pilot training by Barshi. We apply research-based training principles reviewed by Kole and his colleagues, as well as by other researchers in training science, into real-world, practical guidelines for the particular context of training astronauts for a mission to Mars

Applying Research-Based Training Principles: Towards Crew-Centered, Mission-Oriented Space Flight Training

This chapter describes a training approach that applies empirically derived principles of training to re-imagining the overall design of NASAs space flight training program. The chapter is focused specifically on the design of astronaut training for NASAs future deep space, exploration missions to Mars. We briefly describe NASAs space flight training practices during the Apollo and Space Shuttle eras as well as NASAs current practices for training astronauts for their missions to the International Space Station. We provide an overview of NASAs current concepts for a mission to Mars to scope our training approach. We envision a new space flight training approach which we term crew-centered, mission oriented training, inspired by the design approach offered in the context of airline pilot training by Barshi (2015). We apply some of the training principles reviewed by Kole and his colleagues in the companion volume (Kole, Healy, Schneider & Barshi, 2019), as well as by other researchers in training science (e.g., Ericsson, Krampe, & Tesch-Rmer, 1993; Healy & Bourne, 2012; Salas, Wilson, Priest and Guthrie, 2006), into real-world, practical guidelines for the particular context of training astronauts for a mission to Mars.processes over very long retention intervals

ISS Training Best Practices and Lessons Learned

Training our crew members for long-duration Deep Space Transport (DST) missions will have to be qualitatively and quantitatively different from current training practices. However, there is much to be learned from the extensive experience NASA has gained in training crew members for missions on board the International Space Station (ISS). Furthermore, the operational experience on board the ISS provides valuable feedback concerning training effectiveness. Keeping in mind the vast differences between current ISS crew training and training for DST missions, the needs of future crew members, and the demands of future missions, this ongoing study seeks to document current training practices and lessons learned. The goal of the study is to provide input to the design of future crew training that takes as much advantage as possible of what has already been learned and avoids as much as possible past inefficiencies. Results from this study will be presented upon its completion. By researching established training principles, examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs

Human Research Program: Long Duration, Exploration-Class Mission Training Design

This is a presentation to the International Training Control Board that oversees astronaut training for ISS. The presentation explains the structure of HRP, the training-related work happening under the different program elements, and discusses in detail the research plan for the Training Risk under SHFHSHFE. The group includes the crew training leads for all the space agencies involved in ISS: Japan, Europe, Russia, Canada, and the US

The Effects of Long-Duration Spaceflight on Training Retention and Transfer

Training our crew members for long duration, exploration-class missions will have to maximize long-term retention and transfer of the trained skills. The expected duration of the missions, our inability to predict all the possible tasks the crew will be called upon to perform, and the low training-to-mission time ratio require that the training be maximally effective such that the skills acquired during training will be retained and will be transferrable across a wide range of specific tasks that are different from the particular tasks used during training. However, to be able to design training that can achieve these ambitious goals, we must first understand the ways in which long-duration spaceflight affects training retention and transfer. Current theories of training retention and transfer are largely based on experimental studies conducted at university laboratories using undergraduate students as participants. Furthermore, all such studies have been conducted on Earth. We do not know how well the results of these studies predict the performance of crew members. More specifically, we do not know how well the results of these studies predict the performance of crew members in space and especially during long-duration missions. To address this gap in our knowledge, the current on-going study seeks to test the null hypothesis that performance of university undergraduate students on Earth on training retention and transfer tests do in fact predict accurately the performance of crew members during long-duration spaceflights. To test this hypothesis, the study employs a single 16-month long experimental protocol with 3 different participant groups: undergraduate university students, crew members on the ground, and crew members in space. Results from this study will be presented upon its completion. This poster presents results of study trials of the two tasks used in this study: a data entry task and a mapping task. By researching established training principles, by examining future needs, and by using current practices in spaceflight training as test beds, this research project is mitigating program risks and generating templates and requirements to meet future training needs

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

A missense variant in human perilipin 2 (PLIN2 Ser251Pro) reduces hepatic steatosis in mice

Background & Aims: Non-alcoholic fatty liver disease (NAFLD) is characterised by the accumulation of lipid droplets (LDs) within hepatocytes. Perilipin 2 (PLIN2) is the most abundant protein in hepatic LDs and its expression correlates with intracellular lipid accumulation. A recently discovered PLIN2 coding variant, Ser251Pro (rs35568725), was found to promote the accumulation of small LDs in embryonic kidney cells. In this study, we investigate the role of PLIN2-Ser251Pro (PLIN2-Pro251) on hepatic LD metabolism in vivo and research the metabolic phenotypes associated with this variant in humans. Methods: For our animal model, we used Plin2 knockout mice in which we expressed either human PLIN2-Pro251 (Pro251 mice) or wild-type human PLIN2-Ser251 (Ser251 mice) in a hepatocyte-specific manner. We fed both cohorts a lipogenic high-fat, high-cholesterol, high-fructose diet for 12 weeks. Results: Pro251 mice were associated with reduced liver triglycerides (TGs) and had lower mRNA expression of fatty acid synthase and diacylglycerol O-acyltransferase-2 compared with Ser251 mice. Moreover, Pro251 mice had a reduction of polyunsaturated fatty acids-TGs and reduced expression of epoxygenase genes. For our human study, we analysed the Penn Medicine BioBank, the Million Veteran Program, and UK Biobank. Across these databases, the minor allele frequency of PLIN2-Pro251 was approximately 5%. There was no association with the clinical diagnosis of NAFLD, however, there was a trend toward reduced liver fat in PLIN2-Pro251 carriers by MRI-spectroscopy in UK Biobank subjects. Conclusions: In mice lacking endogenous Plin2, expression of human PLIN2-Pro251 attenuated high-fat, high-fructose, high-cholesterol, diet-induced hepatic steatosis compared with human wild-type PLIN2-Ser251. Moreover, Pro251 mice had lower polyunsaturated fatty acids-TGs and epoxygenase genes expression, suggesting less liver oxidative stress. In humans, PLIN2-Pro251 is not associated with NAFLD. Impact and Implications: Lipid droplet accumulation in hepatocytes is the distinctive characteristic of non-alcoholic fatty liver disease. Perilipin 2 (PLIN2) is the most abundant protein in hepatic lipid droplets; however, little is known on the role of a specific polymorphism PLIN2-Pro251 on hepatic lipid droplet metabolism. PLIN2-Pro251 attenuates liver triglycerides accumulation after a high-fat-high-glucose-diet. PLIN2-Pro251 may be a novel lipid droplet protein target for the treatment of liver steatosis