Apollo to Artemis: Mining 50-Year Old Records to Inform Future Human Lunar Landing Systems

Under the Artemis lunar exploration program, NASA is committed to landing American astronauts on the moon by 2024. While NASAs new Space Launch System rocket and Orion capsule will carry astronauts from Earth to the Gateway, the human lunar landing system has not yet been fully defined. As in the Apollo program, there are concerns for vehicle weight and internal volume such that seats may not be desirable, and standing during lunar descent and ascent may be a preferred engineering solution. With such a design, astronauts will experience +GZ (head-to-foot) accelerations during capsule accelerations, and it is unclear whether spaceflight deconditioned astronauts can tolerate these. Apollo astronauts stood during lunar descent and ascent, and the data contained in the early program records for those missions represent a unique resource that may provide insights to the cardiovascular stress associated with this human landing system design

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

INTRODUCTION Back pain during spaceflight has often been attributed to the lengthening of the spinal column due to the absence of gravity during both short and long-duration missions. Upon landing and re-adaptation to gravity, the spinal column reverts back to its original length thereby causing some individuals to experience pain and muscular spasms, while others experience no ill effects. With International Space Station (ISS) missions, cases of back pain and injury are more common post-flight, but little is known about the potential risk factors. Thus, the purpose of this project was to perform an initial evaluation of reported post-flight back pain and injury cases to relevant spaceflight risk factors in United States astronauts that have completed an ISS mission. METHODS All US astronauts who completed an ISS mission between Expeditions (EXP) 1 and 41 (2000-2015) were included in this evaluation. Forty-five astronauts (36 males and 9 females) completed 50 ISS missions during the study time period, as 5 astronauts completed 2 ISS missions. Researchers queried medical records of the 45 astronauts for occurrences of back pain and injury. A case was defined as any reported event of back pain or injury to the cervical, thoracic, lumbar, sacral, or coccyx spine regions. Data sources for the cases included the Flight Medicine Clinic's electronic medical record; Astronaut Strength, Conditioning and Rehabilitation electronic documentation; the Private Medical Conference tool; and the Space Medicine Operations Team records. Post-flight cases were classified as an early case if reported within 45 days of landing (R + 45) or a late case if reported from R + 46 to R + 365 days after landing (R + 1y). Risk factors in the astronaut population for back pain include age, sex, prior military service, and prior history of back pain. Additionally, spaceflight specific risk factors such as type of landing vehicle and onboard exercise countermeasures were included to evaluate their contribution to post-flight cases. Prior history of back pain included back pain recorded in the medical record within 3 years prior to launch. Landing vehicle was included in the model to discern if more astronauts experienced back pain or injury following a Shuttle or Soyuz landing. Onboard exercise countermeasures were noted for those astronauts who had a mission following 2009 deployment of the Advanced Resistive Exercise Device (aRED) (EXP 19 to 41). T-test and chi-squared tests were performed to evaluate the association between each individual risk factor and post-flight case. Logistic regression was used to evaluate the combined contribution of all the risk factors on post-flight cases. Separate models were calculated for cases reported by R + 45 and R + 1y. RESULTS During the study time period, there were 13 post-flight cases reported by R + 45 and an additional 5 reported by R + 1y. Most of these cases have been reported since EXP 19 with 10 cases by R + 45 and 4 by R + 1y. Individual risk factors of age, sex, landing vehicle, and prior military service were not significantly associated with post-flight cases identified at R + 45 or R + 1y (p greater than 0.05). Having back pain or injury within 3 years prior to launch significantly increased the likelihood of becoming a case by R + 1y (p = 0.041), but not at R+45 (p=0.204). Additionally, astronauts who experienced onboard exercise countermeasures that included aRED had a significantly increased risk of becoming a case at R + 45 (p = 0.024) and R + 1y (p=0.003). Multiple logistic regression evaluating all the risk factors for cases identified no significant risk factors at either the R + 45 or R + 1y time period (p greater than 0.05). Overall model fit was poor for both the R + 45 (R(exp 2) = 0.132) and R + 1y (R(exp 2) = 0.186) cases showing that there are risk factors not represented in our model. CONCLUSIONS Regardless of cause, post-flight cases are reported more often since aRED was deployed in 2009. This may reflect improved documentation or unidentified risk factors. No spaceflight risk factor explains the data fully. Post-flight cases are probably due to multi-faceted factors that are not easily elucidated in the medical data

Cluster approximations for infection dynamics on random networks

In this paper, we consider a simple stochastic epidemic model on large regular random graphs and the stochastic process that corresponds to this dynamics in the standard pair approximation. Using the fact that the nodes of a pair are unlikely to share neighbors, we derive the master equation for this process and obtain from the system size expansion the power spectrum of the fluctuations in the quasi-stationary state. We show that whenever the pair approximation deterministic equations give an accurate description of the behavior of the system in the thermodynamic limit, the power spectrum of the fluctuations measured in long simulations is well approximated by the analytical power spectrum. If this assumption breaks down, then the cluster approximation must be carried out beyond the level of pairs. We construct an uncorrelated triplet approximation that captures the behavior of the system in a region of parameter space where the pair approximation fails to give a good quantitative or even qualitative agreement. For these parameter values, the power spectrum of the fluctuations in finite systems can be computed analytically from the master equation of the corresponding stochastic process.Comment: the notation has been changed; Ref. [26] and a new paragraph in Section IV have been adde

The role of clustering and gridlike ordering in epidemic spreading

The spreading of an epidemic is determined by the connectiviy patterns which underlie the population. While it has been noted that a virus spreads more easily on a network in which global distances are small, it remains a great challenge to find approaches that unravel the precise role of local interconnectedness. Such topological properties enter very naturally in the framework of our two-timestep description, also providing a novel approach to tract a probabilistic system. The method is elaborated for SIS-type epidemic processes, leading to a quantitative interpretation of the role of loops up to length 4 in the onset of an epidemic.Comment: Submitted to Phys. Rev. E; 15 pages, 11 figures, 5 table

Compiling a Comprehensive EVA Training Dataset for NASA Astronauts

Training for a spacewalk or extravehicular activity (EVA) is considered a hazardous duty for NASA astronauts. This places astronauts at risk for decompression sickness as well as various musculoskeletal disorders from working in the spacesuit. As a result, the operational and research communities over the years have requested access to EVA training data to supplement their studies. The purpose of this paper is to document the comprehensive EVA training data set that was compiled from multiple sources by the Lifetime Surveillance of Astronaut Health (LSAH) epidemiologists to investigate musculoskeletal injuries. The EVA training dataset does not contain any medical data, rather it only documents when EVA training was performed, by whom and other details about the session. The first activities practicing EVA maneuvers in water were performed at the Neutral Buoyancy Simulator (NBS) at the Marshall Spaceflight Center in Huntsville, Alabama. This facility opened in 1967 and was used for EVA training until the early Space Shuttle program days. Although several photographs show astronauts performing EVA training in the NBS, records detailing who performed the training and the frequency of training are unavailable. Paper training records were stored within the NBS after it was designated as a National Historic Landmark in 1985 and closed in 1997, but significant resources would be needed to identify and secure these records, and at this time LSAH has not pursued acquisition of these early training records. Training in the NBS decreased when the Johnson Space Center in Houston, Texas, opened the Weightless Environment Training Facility (WETF) in 1980. Early training records from the WETF consist of 11 hand-written dive logbooks compiled by individual workers that were digitized at the request of LSAH. The WETF was integral in the training for Space Shuttle EVAs until its closure in 1998. The Neutral Buoyancy Laboratory (NBL) at the Sonny Carter Training Facility near JSC opened in March 1997 and is the current site for US EVA training. Other space agencies also have used water to simulate weightlessness and train for EVAs. Russia has a training facility similar to the NBL named the Hydro Lab. The Hydro Lab began operations at the Gagarin Cosmonaut Training Center (GCTC) in 1980 and has been used extensively to the present. Although a majority of training in the Hydro Lab uses the Russian Orlan suit, a small number of sessions have been conducted using a NASA suit. The Japanese Weightlessness Environment Test System (WETS) went into service at the Tsukuba Space Center in 1997 but was closed in 2011 due to extensive earthquake damage. Several sessions were performed using a NASA suit, but these sessions were short and considered "development" runs. LSAH has assembled records from the WETF, NBL and Hydro Lab. Recording of the EVA training data has changed considerably from 1967 to present. The goal of early record keeping was to track use of hardware components, and the person involved was treated as a suited operator, not as a focus of interest. Records from the past two decades are fairly precise with the person, date, suit type and size noted. On occasion the length of the session was listed, but this data is not included on all records. Records were merged from data sources and extensive cleaning of the records was required since the multiple sources frequently overlapped and duplicated records. To date the LSAH EVA training dataset includes over 12,500 EVA training sessions performed by NASA astronauts since 1981. The following variables are included for most records: Name, Sex, Event date, Event name, HUT type, HUT size, Facility, and Estimated run time. For a smaller subset of records, the following variables are available: Actual run time, Time inverted, and the suit components Waist bearing type, Shoulder harness, Shoulder pads, and Teflon inserts. The LSAH dataset is currently the most complete resource for data regarding EVA training sessions performed by NASA astronauts. However, it is not 100 percent complete since the WETS (Japan) and NBS (Marshall) training facility data were not included. This dataset has been compiled by LSAH to study the relationship of EVA training to musculoskeletal injuries but has many other non-medical applications. This dataset can be provided to other groups in order to respond to program and research questions with appropriate board approvals

Shoulder Injury Incidence Rates in NASA Astronauts

Evaluation of the astronaut shoulder injury rates began with an operational concern at the Neutral Buoyancy Laboratory (NBL) during Extravehicular Activity (EVA) training. An astronaut suffered a shoulder injury during an NBL training run and commented that it was possibly due to a hardware issue. During the subsequent investigation, questions arose regarding the rate of shoulder injuries in recent years and over the entire history of the astronaut corps

Characterization of Evidence for Human System Risk Assessment

Understanding the kinds of evidence available and using the best evidence to answer a question is critical to evidenced-based decision-making, and it requires synthesis of evidence from a variety of sources. Categorization of human system risks in spaceflight, in particular, focuses on how well the integration and interpretation of all available evidence informs the risk statement that describes the relationship between spaceflight hazards and an outcome of interest. A mature understanding and categorization of these risks requires: 1) sufficient characterization of risk, 2) sufficient knowledge to determine an acceptable level of risk (i.e., a standard), 3) development of mitigations to meet the acceptable level of risk, and 4) identification of factors affecting generalizability of the evidence to different design reference missions. In the medical research community, evidence is often ranked by increasing confidence in findings gleaned from observational and experimental research (e.g., "levels of evidence"). However, an approach based solely on aspects of experimental design is problematic in assessing human system risks for spaceflight. For spaceflight, the unique challenges and opportunities include: (1) The independent variables in most evidence are the hazards of spaceflight, such as space radiation or low gravity, which cannot be entirely duplicated in terrestrial (Earth-based) analogs, (2) Evidence is drawn from multiple sources including medical and mission operations, Lifetime Surveillance of Astronaut Health (LSAH), spaceflight research (LSDA), and relevant environmental & terrestrial databases, (3) Risk metrics based primarily on LSAH data are typically derived from available prevalence or incidence data, which may limit rigorous interpretation, (4) The timeframe for obtaining adequate spaceflight sample size (n) is very long, given the small population, (5) Randomized controlled trials are unattainable in spaceflight, (6) Collection of personal and environmental data on the astronaut population may create opportunities for advanced analytics and human-environment modeling that goes beyond that achieved in isolated experimental designs; and (7) Translation of relevant research to operations is a complex, transdisciplinary enterprise in which the approach must apply across the physical, biological, behavioral, and social sciences. The approach to synthesizing evidence must address both source and fidelity of data, and reflect the most general attributes of quality of evidence in science and engineering: reliability and validity. The authors are developing a two-factor approach which includes the various kinds of evidence required to understand risks and for the integrated interpretation of all evidence that is essential to develop standards and countermeasures. A unified framework for aggregating and assessing different kinds of evidence provides a consistent, traceable, evidence-based decision-making process to translate research to operations in an environment where engineers, scientists, physicians, and managers all engage in analyzing the trade space of vehicle design, standards, requirements and solutions for spaceflight

Compiling a Comprehensive EVA Training Dataset for NASA Astronauts

Training for a spacewalk or extravehicular activity (EVA) is considered hazardous duty for NASA astronauts. This activity places astronauts at risk for decompression sickness as well as various musculoskeletal disorders from working in the spacesuit. As a result, the operational and research communities over the years have requested access to EVA training data to supplement their studies

Email-Based Informed Consent: Innovative Method for Reaching Large Numbers of Subjects for Data Mining Research

Since the 2010 NASA authorization to make the Life Sciences Data Archive (LSDA) and Lifetime Surveillance of Astronaut Health (LSAH) data archives more accessible by the research and operational communities, demand for data has greatly increased. Correspondingly, both the number and scope of requests have increased, from 142 requests fulfilled in 2011 to 224 in 2014, and with some datasets comprising up to 1 million data points. To meet the demand, the LSAH and LSDA Repositories project was launched, which allows active and retired astronauts to authorize full, partial, or no access to their data for research without individual, study-specific informed consent. A one-on-one personal informed consent briefing is required to fully communicate the implications of the several tiers of consent. Due to the need for personal contact to conduct Repositories consent meetings, the rate of consenting has not kept up with demand for individualized, possibly attributable data. As a result, other methods had to be implemented to allow the release of large datasets, such as release of only de-identified data. However the compilation of large, de-identified data sets places a significant resource burden on LSAH and LSDA and may result in diminished scientific usefulness of the dataset. As a result, LSAH and LSDA worked with the JSC Institutional Review Board Chair, Astronaut Office physicians, and NASA Office of General Counsel personnel to develop a "Remote Consenting" process for retrospective data mining studies. This is particularly useful since the majority of the astronaut cohort is retired from the agency and living outside the Houston area. Originally planned as a method to send informed consent briefing slides and consent forms only by mail, Remote Consenting has evolved into a means to accept crewmember decisions on individual studies via their method of choice: email or paper copy by mail. To date, 100 emails have been sent to request participation in eight HRP-funded studies. The development of the Remote Consent process, the laws allowing transmission of consent via electronic means, total metrics to date, and remaining challenges (e.g., response issues, use of International Partner data, biospecimens/genetic data) for the research use of LSAH/LSDA data will be described