If you’re fascinated by the idea of humans traveling through space and curious about how that all works, you’ve come to the right place.

“Houston We Have a Podcast” is the official podcast of the NASA Johnson Space Center from Houston, Texas, home for NASA’s astronauts and Mission Control Center. Listen to the brightest minds of America’s space agency – astronauts, engineers, scientists and program leaders – discuss exciting topics in engineering, science and technology, sharing their personal stories and expertise on every aspect of human spaceflight. Learn more about how the work being done will help send humans forward to the Moon and on to Mars in the Artemis program.

For Episode 143, Dr. Dorit Donoviel and Dr. Kristin Fabre, Director of TRISH and Senior Innovation Scientist, respectively, help NASA solve challenges and prepare for deep space travel at the Translational Research Institute for Space Health (TRISH) by connecting with the most innovative technology, companies and researchers all over the world. This episode was recorded on January 22, 2020.

Transcript

Gary Jordan (Host): Houston, we have a podcast. Welcome to the official podcast of the NASA Johnson Space Center, Episode 143, “Space Health Technologies,” I’m Gary Jordan and I’ll be your host today. On this podcast we bring in the experts, scientists, engineers, astronauts, all to let you know what’s going on in the world of human spaceflight. I hope you tuned in to our recent series on NASA’s Human Research Program. We dove into the work being done at NASA to help understand what happens to the human body in areas such as human performance, human health, radiation, medicine and a whole lot more. We gave many examples through this series on different ways that the Human Research Program does research in these areas to get the best science possible. The latest science possible, using the latest technologies. Helping the Human Research Program solve challenges for human space exploration and preparing for deep space travel is the Translational Research Institute for Space Health. In this episode we’ll just call it TRISH. TRISH is helping NASA conduct research on some of the latest and greatest technologies and procedures both to find out if it can be integrated in NASA’s future missions and also to help these technologies develop for Earth benefits. Here to tell us about this organization, and some of the disruptive technologies and ideas are Dorit Donoviel, Ph.D., and Dr. Kristin Fabre. Dorit is the Director of TRISH. And Kristin is a Senior Innovation Scientist. And both have extensive and impressive backgrounds in science and technology, so here we go. Space Health Technologies and the work being done at TRISH to help NASA test the latest medical technologies and advances with Dorit Donoviel and Kristin Fabre. I hope you enjoy.

[ Music]

Host: Dorit and Kristin, thanks so much for coming on the podcast today.

Kristin Fabre: Thank you, my pleasure to be here.

Dorit Donoviel: It’s a pleasure.

Host: So, TRISH, I like saying TRISH because it sounds like another person. But it is an organization. Dorit why don’t you tell me what TRISH is and what you do?

Dorit Donoviel: Yeah, I know, it sounds like a Texas soccer mom, right? [Laughter] Driving in a minivan. Yeah, it’s hard to take us seriously. But that’s OK because where are all about having fun with the work that we do. So, it’s the Translational Research Institute. That was the original name. But it’s so generic and there’s so many out there, and it doesn’t really tell you what the institute does. So, when I became director I changed the name to Translational Research Institute for Space Health, which is unfortunately — it was very close to being TRASH, but it’s actually TRISH now. [Laughter]

Host: I’m glad you stayed away from TRASH. [Laughter]

Dorit Donoviel: Yeah me too. We are just so happy and — to be a partner with NASA. We are a standalone research institute that essentially functions through a cooperative agreement with NASA. We work very closely with the Human Research Program and we’re entrusted to basically go out there and find what NASA is not already doing, in terms of reducing the risks to human health and performance in deep space. So, we’re very Mars forward. We’re very focused on the future, those missions that haven’t yet been scoped out. Our job is to connect with the most innovative technologies, companies, researchers all over the world. But really funding things on U.S. soil and bring them forward to NASA to take a look at, to see whether they can integrate them into their current research portfolio.

Host: Yeah, because sometimes you can sort of get caught in the regular routine of research. You’re not really looking out for some of those latest and greatest technologies that might fit the needs, which we’re looking for all the time.

Dorit Donoviel: Yeah in science people tend to get siloed. They tend to have a favorite hypothesis or a certain way of thinking about things. And they do work that takes decades to come to fruition and sometimes you’re blind to what else is going on in the outside world. And so that’s precisely why NASA needed an external organization. To go out there and look at things from a new perspective and to help them sort of realize if there’s a better way of doing things.

Host: So, how is TRISH integrated? Because I see — Baylor College of Medicine is sort of intertwined with all of this. What’s that relationship like?

Dorit Donoviel: Yeah so, the cooperative agreement was given to Baylor College of Medicine, which is the lead institution, so it’s a grant. It’s a large grant from NASA through a cooperative agreement. Unlike contract — contract though we’re very free in terms of we have a lot of autonomy. But in addition to Baylor College of Medicine, we pulled in two of the most premier technological institutes in the country, one on the East Coast, MIT and one on the West Coast, Caltech. And so, we have people embedded in those communities that are working with us. And those institutions are also mandated through the relationship with the consortium with Baylor, to go out there and find things for NASA and to help build this program together with us.

Host: OK, so it is — it’s an even broader team than even just you guys? You’re working across the nation?

Dorit Donoviel: It’s huge. In fact, Kristin and I have been working on building and Rachael our Communication and Education Lead, building a community. That’s one of the mandates that NASA wanted is for us to build a community of experts that they can — NASA dipped its fingers into when it has a need.

Host: OK, so yeah. Kristin tell me about this —

Kristin Fabre: And this is absolutely needed because we ourselves, even though we are constantly seeking disruptive technologies or paradigm shifts in how we do science, we ourselves don’t know what’s going on out there and so we need our reach to be expanded across the entire country so that we have a good sense for some of that really cool cutting edge science and technology that we don’t know about yet, but we’re looking for them, and we want them to know that we exist because this is the challenge is being able to actually understand that and to invest in it and to implement it and to bring it to NASA. So, we ourselves are always having to force ourselves to not be comfortable in how we think. And that we’re constantly pushing ourselves to think outside the box.

Host: Well tell me about how you think. Tell me a little bit about your background and what you’ve worked on before and how that kind of translates to what you’re doing now.

Kristin Fabre: Sure, so my background — I stumbled into radiation biology research. At first, I was very interested in cancer research, and so I was at Colorado State University looking at breast cancer research. But there was an emphasis on radiation induced breast cancer. And so, I had to understand about radiation and learn about the biological damages that it does to tissues, so that I can understand how that connects to carcinogenesis. So, when I was ready for my postdoc I actually went to National Cancer Institute at NCI and looked at radiation mitigators. So, things that can protect or to sensitize to radiation. So, can we use radiation as a tool? For example, for cancer, or can we find approaches to protect against radiation? At that point I realized that I wanted to be more involved in communication and problem solving, working the problem from a higher level. I would talk to my selves and unfortunately, they wouldn’t talk back. I wanted to have conversations about science. And so, I went into the National Institute — the National Institute of Health has a great program for trainees and for fellows. And they have these, the Extra-Mural Program, which is essentially how NIH funds all of the research across the country. And so, I became a program manager looking at these micro-physiological systems or organs on chips or tissue chips, whatever you want to call them. But, they’re basically these human complex and future models that mimic the micro environment of an organ or a tissue of interest. And because of that effort that we pulled together, at the National Center for Advancing Translational Science or NCATS. I was pulled into pharma, because they wanted to look at these types of technologies on how they can use these tissue chips or micro physiological systems for drug development, trying to either identify new targets or how safe is their drug going to be. And because of all of that background, it really put me in a very unique place for really helping to read and the TRISH mission on how we can use our public private partnerships, how we can look at funding agencies, how we can look at pharmaceutical companies and industry to really drive the mission forward.

Host: What a whirlwind of a path. [Laughter]

Kristin Fabre: I have no idea how I got here honestly. [Laughter]

Host: What I like about your path is you’re saying you were — passionate about cancer research and then you know through this research you get pulled into these different areas. Next thing you know, you’re working on these tiny little technologies for drug development. But you started all the way back here with cancer research.

Kristin Fabre: You just allow yourself to go with the wind.

Host: Yeah, I love it.

Dorit Donoviel: And now it’s space.

Host: And now it’s space. Actually, you know funny enough we actually have had Lucie Low on the podcast to talk about –

Kristin Fabre: I know Lucie very well.

Host: Yeah to talk about tissue chips and what a fascinating technology. So — and I guess it’s through tissue chips that you got involved with space health and the space equitability.

Kristin Fabre: It was the start, I think that’s probably what peeked my interest in my background. That and the industry, and government experience, looking at being a part of a funding agency myself, having that background.

Dorit Donoviel: I searched high and low for just the perfect person and here she is. I mean it just like whoa. [Laughter]

Host: With a path like that, how can you not say “Yes, please come join our team.” So, you’re the Director of TRISH?

Dorit Donoviel: I am the Director, yes.

Host: So, what’s your background?

Dorit Donoviel: Well I have a very old background. I’m old — much older than Kristin. [Laughter] Yeah, I also never thought I’d end up in space. I actually was doing a lot of genetic engineering and mouse embryos and making genetic models for diseases at Lexicon Pharmaceuticals before I came to Baylor. And it was the once in a lifetime opportunity when people say you know, “come work with the space program and combine your love of science and biology and medicine and apply it in a whole new way, off the planet.”

Host: I know.

Dorit Donoviel: It was like what? OK let’s try this for a while. And it’s just turned out to be the most amazing experience and just blows your mind the kinds of things you see and learn. Every day is something new and delightful to work with people like Kristin and others. It’s just a joy.

Host: So, what about — what is it about the space applicability that sort of surprised you when you just started getting entered into that world?

Dorit Donoviel: This is a great question, probably the most important question you’re going to ask today. Because for your audience, people just don’t understand it until we explain it. So, number one, I always say that if you can do it in space, you can do it anywhere. In other words, and when I say do it, I mean healthcare. [Laughter]

Host: Healthcare, OK.

Dorit Donoviel: Although, there was recently an article about doing it another way, but the — so if you’re able to keep a human healthy and thriving on the way to Mars, which is a really long trip and bring them back safe and healthy, you can do it anywhere on Earth, which mean seniors in the home, not having to go into managed care facilities. You can do it in Third World nations; you can keep people healthy in remote places that they don’t have access to doctors. So that’s one, so we have a whole new model for healthcare in thinking about that mission to Mars.

Host: Wow, because there’s so much — there’s so much autonomy, you don’t have the doctors, you don’t have the right facilities, yet it has to be compact. So, all these issues and all these problems you have to address for spaceflight, yes, it would be applicable to remote areas, to that level of autonomy.

Kristin Fabre: As a matter of fact, every project that’s in our portfolio we have an impact for space and an impact for here on Earth. And a lot of that is how to reach the patients that are hard to reach or how do you get that autonomy? How can you make this easier for people to grasp so that we all have a chance to have good treatment and good monitoring, good diagnostics with the types of technologies that we support?

Dorit Donoviel: And it’s generally about prevention. You never want to get to a point where you have a major medical event. So, it’s monitoring and predicting and preventing. And that’s the model that should be there for healthcare, because we — we intervene too late. By then the outcomes are too late for healthcare. So, you know who is interested in working with us? Are the payers. The insurance companies, because they’re trying to reduce the cost of healthcare. And they’re wanting to move away from hospitals and a lot of you know expensive procedures and experts into the home and to prevent. So, that’s who’s talking to us and it’s great for NASA because we’re able to make those connections. We just don’t have enough money like you know the budget for the health-related research within NASA is much smaller than the NIH. And so, we need somebody to come up behind us and continue to support a lot of the things that we’re investing in.

Host: Yeah, they’re interested in the eat healthy now and exercise, so you don’t have to deal with it later.

Dorit Donoviel: That’s right.

Host: But, for spaceflight.

Dorit Donoviel: The second point I wanted to make about why space is such an important model for us to use here for Earth, you know all the applications. Because people ask me all the time, “Why should we spend all this money on four people who are going to live you know — what does that have to do with me?”

Host: Yeah, we hear that a lot.

Dorit Donoviel: Yeah, well space is an accelerated aging model. And so, everything that we see here on Earth, with probably the exception of diabetes, although we have seen in prolonged zero-gravity people becoming less sensitivity to insulin. You know astronauts generally are healthy people, that’s the majority of the population. But when you put them into space, all the aging things that we see like loss of muscle, loss of bone, deconditioning of the heart, change in vision, change in balance, hearing loss, isolation, some of the behavioral things that happen, even as resilient as they are. There are some behavioral issues. You know lack of appropriate nutrition, although we try to give them as much food as we can. But on the way to Mars we may not be able to give them fresh foods. So, all of those things, there’s you know so when you combine them, that astronaut is becoming an old person, prematurely. With the radiation as well. So, if we can solve all those problems, we’re actually making a difference here for many of the aging related issues here on Earth.

Kristin Fabre: Right, and really to tease those mechanisms apart. Because we know that the aging is similar — advance aging is similar in space. It’s not the same. I mean it’s not the exact same as somebody that’s just aging here on Earth. But to Dorit’s point there’s a lot of end points that are very similar. But actually, are reversed when they come back to Earth, which is where it’s different than how it is on Earth. So, if we can tease apart some of those mechanisms and understand you know, how is it that a lot of these components happen in space? But then are somehow reversed or reduced when they come back to Earth. Can we maybe understand the story about aging to the population a little bit better? Which is an exciting question in itself.

Host: I’m loving the passion that’s coming from both of you when it comes to all these things. But what I find fascinating is your backgrounds are so different, we’re talking genetics. We’re talking cancer research and then drug development. But now we’re talking about aging. Tell me about the team at TRISH and what — what all the expertise is and how you’re getting together to look at some of these problems that you’re talking about. Because it sounds like it’s cross-disciplinary.

Dorit Donoviel: Yeah, the thing is that you can never cover it all. You become really jack of all trades, master of none, which is actually a really good thing. Because if you start to think that you’re a master of something, that you think you know it all, when somebody comes in with a different point of opinion, you know a different opinion you’re like oh no, you dismiss it. So, if you allow yourself to sort of say OK, I know just enough to connect the dots. OK and to ask the right people if you know enough to know this is an expert. I’m going to go to them and take in what they have to say. That’s when you start to make those real innovations, those real connections because somebody over here is an expert in micro-fluidics. And somebody over here is a material scientist. And somebody over here is a physiologist. And by taking all those little pieces and putting them all in the room and say talk about this problem. They come up with things, but we’re the ones that put them together. So, we have such a diverse team. We have somebody at Caltech who is essentially comes from you know, biomedical engineering. We have somebody at MIT that is a brain scientist essentially; he uses technology to image the brain. We have an emergency medicine physician that’s working closely with Kristin. We have a former NASA biomedical engineer working with Kristin here in Houston. We have an orthopedic surgeon part time at UCSF. My Deputy James Hury is — comes from Texas Children’s Hospital and he’s done innovation for children in healthcare. So, you pull all these different people together and you get a real mix of opinions, which is delightful and really fun.

Kristin Fabre: It’s actually a really unique team and I think that we talk about it all the time. We’re very fortunate because you know, I’ve been to a lot of places and I’ve seen a lot of backgrounds and TRISH is unique in terms of — as Dorit said we have a lot of different opinions. We have a lot of backgrounds that are different, but we somehow figure out a way to gel and move the mission forward. We’re all rock stars. Our communications lead, Rachael is a rock star. We have a genetics person that helps me with solicitation. She’s a rock star. We’re all really strong in our field, which makes it such a unique place to be is that we can really gel together and move the mission forward. But I also want to speak to not only that, but Dorit said earlier how we’re trying to build that space health community. That is crucial for us because as she said we are not experts in everything that we need to be experts in. So, it’s really important for us to reach out to people that have never even thought about space research. Have never thought about how their technologies could be useful for NASA or for space health in general. Because we need them to be our subject matter experts. We need them to come to us and say, “Hey have you thought about this?” “Hey, I know that this tool exists, but have you thought about it – using it this way?” So, in addition to our rock star team, it’s that space health community that we really need to continue to grow so that we can really have the subject matter experts and the ideas coming to us all the time.

Dorit Donoviel: So, I want to add something to that, which is really important. So, there’s a lot of brilliant people out in the world. They have a lot of great ideas. The problem for NASA is that they’re not focused or they’re not reasonable for what NASA needs. In other words, yeah you can suggest doing MRI’s in space, but you know, you have to educate people you can’t take an MRI machine. Or,” hey let’s do an x-ray;” well we really don’t want to introduce more radiation in space, we already have enough radiation. Or people come up with fantastic ideas. But what’s reasonable and what is the — the other thing is NASA everything’s a trade, right? So, if I’m going to choose to take this medical device, that means I can’t take this food. Or I have to take less water. Or, I have to reduce the habitable volume if I have to include this particular medical device. So, NASA is always thinking about what do I absolutely have to have, not what’s nice to have. So, there’s lots of wonderful things that people come up with and tell us about and they want to take it to space, or they want us to take it to space. And they’re lovely, wonderful inventions. But we always have to be thinking about NASA. So, our other job, other than reaching out and bringing those technologies in, is educating. We have to explain to people in layman’s terms or, “hey, I know you’re in love with your technology. You’re a researcher and you love your research and we get it. It’s important. But it doesn’t fit with NASA’s need or here’s why we need you to work on it differently.” So, it’s part of our job to sort of educate the public, so it’s a two-way communication, so we act as the go between. And I sort of call ourselves our mom and pop NASA. Because we’re much more approachable. Like it’s very hard to talk to somebody at NASA to get them to speak to you.

Host: We speak in acronyms. [Laughter]

Dorit Donoviel: You do, it’s a whole new thing. But we’re much more approachable. Like Kristin’s — we have a Salesforce is something we use, it’s used in business as a way to manage leads. And Rachael, our communication lead put together a community force, we call it the orbit. And people in there can ask questions where you can sort of have like a chat and get access to experts within NASA and us and so.

Host: This is what you — this is when you said community, this is what you mean. It’s not — you don’t want to be a resource. You don’t want to be a hub where everyone is coming to you. You want to make sure you build that community and establish that two-way communication. Because –

Dorit Donoviel: And educate them —

Host: And educate —

Kristin Fabre: And for them to have conversations with the community.

Host:With each other.

Kristin Fabre: So, we don’t need to always be a part of that conversation. We — there are examples where there are folks that have technologies that are going on to station soon. And they want to reach out to the community and say, “hey what kind of sales or what kind of questions do you have? I’ve got this technology, partner with me.” So, I also want to see not just a two-way communication between TRISH and the rest of the community. But I want to see the community talking amongst themselves.

Dorit Donoviel: It’s already happening. I get notes all the time of people talking, like what are they talking about? I have no idea what they’re talking about, but they went off.

Kristin Fabre: Absolutely and we’ve seen it time and time again, is allowing these people to be educated and think in a way that they never thought before. And it allows them to come up with a better, stronger idea for space health research. And that also makes them even a stronger candidate for a NASA grant in the future. And so, again, one of our deliverables is bringing people that are new to NASA in and have successful grants that can go to NASA as well.

Dorit Donoviel: Yeah so if people want to join in, anybody can. It’s open to everybody it’s called TRISH.force.com. And force because we’re the force. [Laughter]

[Multiple Speakers]

Host: Well tell me more about this community? Are we talking universities, are we talking industry?

Dorit Donoviel: We don’t exclude anybody. I mean obviously we moderate it and make sure there’s no crazy people with tin hats, which we do get a few of those. But, I want to make sure that I do speak to something else that we deliver to the community, to NASA too, is we run a lot of virtual workshops. We did one through Caltech organized for us on [Artificial Intelligence] AI and healthcare. We did one with MIT, media lab on how to enrich indoor environments to improve behavior health. And we brought in a lot of different speakers and companies to talk about. Even furniture companies are thinking about these things. We had one of the sponsors of the work shop was a furniture company. And they’re thinking about how to change indoor environments to improve your performance at work. So, you know —

Host: –Ergonomics.

Dorit Donoviel: Yeah you never know. It’s not just ergonomics. It’s like your mood, like the lighting, the sun. When you talk to some of the astronauts they’ll say, “You know it’s a whole year with no change in seasons.” It’s like the same air, the same smell, the same temperature, the same humidity —

Kristin Fabre: –Monochrome.

Dorit Donoviel: Yeah and it’s very sterile. So, OK maybe they could put up with it for a year on the ISS, but on the way to Mars, that’s a whole different thing. So, we have that workshop. Everything is archived. We do a lot of — we call it the Red Risk Schools. So, NASA prioritized Human Research Program prioritized the risks by color. So red, stop you know. Yellow, medium and then green we’re probably OK to go. So, we call it the Red Risks, which are highest priority, “hey we need to solve these problems before we go to Mars.” So, we put on the Red Risk School. And so, you know for a whole week and there’s one coming up let’s see Rachael, when is it coming up? In February we’ll do the next one, but we also archived the last two years, we’ve also done it — we have experts speaking on it from NASA or the community about the top risks, what are the problems, what are the needs, how people’s research can fit in. So that’s all archived through our website and also the TRISH force, you can find links to it. And then we did recently a work shop with a local subject matter expert as a young entrepreneur started this company on [Virtual Reality] VR. Brought in experts from all over the world, I mean he had people because this was virtual, so you had people from you know the UK, Australia, Spain, you know obviously the U.S. Just from everywhere talking about how to use VR and what are the latest technologies, VR for training. VR for behavior health. VR to improve your exercise. Just how to use VR and then we had a NASA expert explaining OK what are the limitations in the space environment, so it was sort of like a comprehensive thing. So, we’re trying to provide a lot of that content, but I didn’t even get to the main thing that we do. That’s like the extra stuff. The main thing we do, most of our money is to fund research. So, we give a lot of research grants and they’re through solicitations, but they’re also like if you have a great idea come on in and tell Kristin about it. We have you know a dashboard where we can look at things, through — you can find it through our website or you can find it through TRISH.force.com. And you know Kristin — so we do solicitation. So, there — either to companies or universities and we give a lot of money away. We give a lot of money away, millions of dollars to various people. And we have a training program. We have post-doctoral fellows, actually the fellowship I think opportunity the current one closes today. We — I think I’ll save it for the next one for what we have current opportunities open. But Kristin why don’t you talk a little bit about the radiation solicitation.

Kristin Fabre: Sure, so we have just opened a radiation solicitation. So again, my background being at NCATS is that the tissue chips. And you — so you’re familiar with that with your discussion with Lucie Low so it’s on a previous podcast. And what we want to do, so tissue chips or micro physiological systems are not — they’re not very new anymore. They’ve been around for a while, lots of publications, pharmaceutical companies are starting to use them. Other agencies are starting to invest in them. But, we want to see how we can use these technologies for again looking at human tissue for the first time, physiological system, human tissue to look at space relevant radiation. So that’s — that’s goal number one, is can we use these as a human analog? And then can we look at multiple tissues of interest or organs of interest to see what would happen maybe with or connected, single or connected; so that’s goal one. And the other goal is countermeasures, and so there’s a lot of effort and there’s always been a lot of effort on radiation countermeasures, a lot of people have their favorite pharmaceutical or nutraceutical. And so, we’re allowing that to be tested as a proof of concept in the tissue chip as well. But, where I really want to — I’m going to say the word TRISH out, so where I wanted to go bold and beyond is that come up with another outside of the box countermeasure. And a lot of people, so right now are — our current portfolio has some work on looking at gene editing. Looking at tardigrades, so can we embrace our inner tardigrade or water bear system and the genes that make them radiation resistant? You know can we understand — can we understand that a little bit better? Is there any homologs that are within our DNA that we can transiently induce for a short period of time, and I know that can be controversial, but it’s kind of where we are sometimes, those provocative questions.

Host: Yes, this is the innovative ground-breaking technology that you’re talking about.

Kristin Fabre: Right, exactly.

Host: This is what you want to explore.

[Multiple Speakers]

Kristin Fabre: Let’s get a little queasy and we’re probably spot on. So, what about different types of materials? What about bio-electronics? What about a whole different approach? What about slowing down metabolism and seeing if we can allow the cells time to repair their DNA? What about saving the stem cell campaign? Can we have a batch of stem cells for astronauts that we can re-introduce them to and to the tissue later to see if we can keep like a fresh healthy batch of cells? These are just examples. I want people to come up with other ideas too, but that’s where we really want to push the boundaries with these types of technologies. And that’s ultimately the goal of this first solicitation on radiation and tissue chips.

Dorit Donoviel: I want to talk about — just because this — audience we have currently opened solicitations or programs. So, the other one, we call it the swap, which is our way of helping NASA again take its scientists and put them out in the community, so they can learn something new. And then take scientists who are out there and put them into NASA centers, so they can learn about NASA’s needs and requirements. And you know the constraints of spaceflight. So, it’s sort of an exchange of scientists, so it’s formally known as the Faculty Exchange or the Space Health Swap. So that just went live today. And that’s open to civil servants going out and open for scientists who want to spent their summer at a NASA center. And we’re going to make that happen for them. So, space camp for adults.

Host: Wow, yeah you said the main thing you do is you do research grants. But we’re talking about a whole bunch of other stuff too. It sounds like the education part is really important because what you’re trying to accomplish is when you get these ideas, you want them to be informed. So, you’re not missing out on well technically NASA needs this to be smaller. Well you really need to think about the weight of this thing. Or you need to think about the radiation aspect, because they have a ton of radiation. There’s a ton of education.

Dorit Donoviel: It’s particularly interesting with industry. So, let’s talk about industry. So, we have an upcoming solicitation in the spring specifically for companies, because it’s really not fair to companies to put them in the same mix with academics who write proposals for a living. I mean they write grant proposals for a living. And they’re very, very good at writing proposals. Companies have a different approach. They generally have a slide deck that they share with an investor, they have a different time line, they’re very, very good at delivering products fairly efficiently and you know especially the scrappy ones, the startups. They can do it for very little money. So that’s a great bargain for NASA. We’ve come across quite a lot of small companies that have delivered things for very little money. And so that’s wonderful, but the problem is that they need to be educated on how — what they’re already doing for their so-called Earth market, we laugh about that. The space market they’re like “oh who is going to buy this?” Like NASA and one other person, maybe Elon Musk. Maybe they’ll buy four; you know how is that important for my business model? Well, all the things that they’re doing for Earth, we’re going to make it better for Earth because it’s going to be miniaturized. It’s going to be cheaper. It’s going to be used by non-expert user and so the high dollar in really complicated equipment, we’re not really interested in, but all the things that are — the small companies are developing for in the home care, elderly monitoring, the kiosks that are going to be going up in Walgreens that will do all of your health surveillance. The smart mirrors in the bathrooms, all of those technologies and the AI that goes behind that is very much applicable for what we’re thinking about for space the autonomous healthcare model. So, it’s an education of companies to realize that what they’re going to do for us is actually down the path of their own Earth market. We are not going to distract them. That’s what investors are worried about that they’re going to get distracted by this NASA thing over here. But no what the NASA thing is exactly in line with the market that they’re going after, which is reducing cost to healthcare. And what we’re going to focus on in this upcoming solicitation is behavior health. And you know this is — people don’t like to talk about it. Because astronauts are incredibly resilient human beings. I mean they’re screened for this, right? But nobody has ever been in a tin can for three years, far away from Earth. Like we’ve done isolation studies, but nowhere near the length and the kind of danger they’re going to be under. And so small of volume, and you’re going to be with three people that your boss picked out for you. And you’re going to smell their smell for three years. So, the behavior aspect is actually something that NASA is worried about. So, what are companies doing on monitoring behavioral health and improving behavior health and providing people with tools that they can apply themselves? We all have times of depression. And so, what can we do to mines what’s out there, to help the astronauts on that — on that long duration mission?

Host: So, what you’re looking at — you’re looking at what it takes to have the resilience of an astronaut to live in a tin can for three years far away from home with the same people. Take those same applicability’s and maybe check on like — try to come up with ways for — to improve behavior health or be resilient here on Earth. Is that sort of it? Maybe I’m on the wrong track?

Dorit Donoviel: It’s not about what it takes to be resilient. We know these people are resilient. These astronauts are resilient. We know that. No. Even resilient people need cues that something is off. OK? And OK say for example I’ll just give you — I’ll just paint the picture, it’s always better. So, say you know an astronaut is just starting to feel down, maybe the exercise equipment broke down. Hasn’t been able to exercise, is not feeling really well. Maybe the — maybe one of the vitamins went down and now they don’t have vitamin D anymore. Something like that. There’s something going on right? And so that astronaut starts to maybe sleep a little more, maybe spend less time with other crew mates, maybe smile less, maybe use language that’s more negative. So, there are ways to pick up on those things and the AI system would maybe inform the commando or the medical — the medical officer of the mission. “Hey, this crew member is a little off, check in on him.” So maybe — so it alerts and then maybe they make sure they get him a vitamin D. Maybe they make sure that they figure out another way to exercise. So, it starts to alert you before it actually becomes a problem, or it can alert the person themselves. “Hey, you’re a little off today. What’s going on? Maybe write in your journal. Maybe share this, maybe talk to the AI, maybe talk to the medical officer. Maybe try to call home and talk to your flight surgeon about what might be going on with you.” So that’s what I’m talking about is to put the tools in your hand to recognize, but also have a strategy. There’s no point to recognizing if you can’t do anything about it. So, it’s all about the countermeasures as well.

Host: The countermeasures as well, but there’s that technology for identifying monitoring and realizing–

Kristin Fabre: And that’s one aspect, but I’m also very interested in the physiological aspect because we do know that diet and nutrition and the microbiome can play a role in this. So, there’s a lot of new research on this gut brain axis. And how what we eat can impact our mood or what’s happening with our microbiome that could induce inflammation that could also impact our mood. And we don’t know what radiation can do to our behavioral health or our cognitive function. So, there’s also this physiological underlying that I think is also really interesting for TRISH to pursue and to invest in that address’s cognitive performance and behavioral health.

Host: So, along the lines of what we’re talking about, we’re investigating different examples right now. We’re investigating all these different ways that you guys — tell me about what’s going on — what else is going on right now that you’re doing at TRISH?

Kristin Fabre: So, well there’s — we’ve recently funded something in the category of what we call “just in time medicine.” So rather than having an entire pharmaceutical kit that you have to take with you, can you make drugs on the fly? Can we take with us let’s just call them ingredients for formulations for the pharmaceutical ingredient to say OK, you know we don’t know what we can face or what we’re going to be up against, but let’s try to take a kit with us and build these drugs as needed. So, we’re actually funding a couple of projects where we’ve selected a couple projects that can tackle this from a small molecule component. So, having the right formulations in pieces where you can build these small molecules like basically kind of in a kit where you can say I need this type of small molecule. I need this type of —

Dorit Donoviel: Can I just jump in and explain to the listeners; small molecule is the typical drugs that you take by mouth. Large molecules and pharma, because Kristin and I both came from pharma. Large molecules are the antibodies you have to inject or proteins like [Erythropoietin] EPO. So small molecules are the things that you generally take by mouth.

Host: Oral medication.

Kristin Fabre: Yeah most of our drugs are small molecules.

Host: OK.

Kristin Fabre: So, can we build those on the fly as needed? And then also going to those larger, those types of drugs that are the biologics to those larger proteins, those larger molecules, can we also build those on the fly as well? And we’ve actually selected a project that can or that is suggesting that they can make these larger therapeutics, these larger drugs, these biologics in lettuce. So, can you eat your drugs? So that’s something that we’re trying to explore as well. We’re also thinking about stability of our drugs. So, we have a group that is looking at using silk protein to basically have a pouch or a case where you can put your drugs in that will protect against some of the hazards like radiation, for example. So, we’re very keen on how we can keep that pharmaceutical kit fresh and relevant and safe and effective on our way to Mars and back.

Host: That’s the space application, right? Is like if you buy an over the counter medicine that has an expiration date, you know you can’t have it sitting on the shelf for three years. So, this would be a way to make sure that you can have the medicine you need for the entire duration –

Kristin Fabre: Correct, correct.

Dorit Donoviel: It’s a Red Risk. It’s what we call the Red Risk.

Host: Red Risk.

Dorit Donoviel: It’s called medication.

Host: OK.

Dorit Donoviel: And like you just said most pharmaceutical companies they don’t need this to last that long. They want you to dump it out, so you can buy more, right? In fact, I just put something in the garbage this morning. It expired after a year. So, on the way to Mars as Kristin says, we need to protect those drugs or make them as needed.

Host: I see another benefit too, because that means you may, correct me if I’m wrong, you may have to take less with you. Because now you just have ingredients and you put them together as you need them. So, you don’t need this — a bottle of this, a bottle of that. Now you’re limiting mass as well.

Kristin Fabre: And it’s a multi-purpose. So, say we went with the plant route. So, we’re going to be growing lettuce anyway, well the hope is that we’ll have some fresh fruits to be growing. So, can we use plants for multiple purposes and so for nutrition, for CO2, scrubbing for — can we use them to make our drugs and ingest that way? So, trying to come up with clever ways on how we can use the tools that are on the craft for the needs, for the crew.

Host: Like — I’m thinking about other applications too. I’m thinking about Earth applications, so what would be nice on Earth to have the build your own pharma kit?

Dorit Donoviel: Yeah so actually this whole idea started at [Defense Advanced Research Projects Agency] DARPA. So, — Geoffrey Ling who was a former DARPA manager, whose military guy. He was basically deployed in Afghanistan and Iraq. And the biggest problem they had is they didn’t have the drugs on-site. They like simple drugs that you would just take for granted here on Earth. In battle, you know where you’re — the farthest corridor of the world it was really hard to get drugs. It would take two or three days to get an antibiotic in. And the person died. So, he was the one that actually initiated what he calls 3D printing of pharmaceuticals and he started a company after he left DARPA and it’s actually I think he’s partnered up with some folks at either Hopkins or MIT and I apologize for not knowing. But that whole concept of 3D printing is critical because here’s the other thing is hospitals right now, they run out of stock. Certain drugs they run out of. And if the manufacturer of generics for example in India or in China, Israel or Canada is behind or there’s a shortage, you’ve got people who are depending on these drugs. You’re not able to make them. So, think about it, if you’re a hospital administrator and you need to crank out a whole bunch of drugs you can make them right there. So, there’s a lot of Earth applications for these things as well.

Host: Very important timely earthy applications is incredible.

Kristin Fabre: And those hard to reach places so some of the places that don’t have access to hospitals or healthcare that you can maybe get to the — get to these communities earlier and quicker to give them their medications.

Dorit Donoviel: We want people to understand that we realize, we’re not going to be growing a whole lot of plants on that tiny craft to Mars. It’s the concept and maybe we have a Mars colony and maybe there, we can grow not potatoes, but lettuce. We also funded a project that the tomatoes, space tomatoes that are highly miniaturized plant, big fruit but they scrub CO2. So, talk about helping with the green gas. You know becoming a green technology.

Host: Nutrition and for the environment. For the contained environment.

Dorit Donoviel: It’s about really you know learning what we can learn about using functional foods, if you will.

Host: Yeah, wow that was just one example that I — after I asked for examples? [Laughter]

Kristin Fabre: We have a variety. We try to keep our portfolio pretty diverse in terms of how we address the risks that NASA has. We think about cognitive function. We think about radiation. We think about cardio vasculature function and just health. We think about the visual problems that astronauts have. We think about immune. There’s — we have quite a diverse portfolio and we think we need it.

Dorit Donoviel: It’s quite humbling because we don’t know nearly enough as we should. We know just enough to be dangerous about all these things. [Laughter] Yeah, a couple other examples like Kristin was just mentioning, the ophthalmic issues. So ophthalmic, vision care and making sure that the optic nerve is healthy, and the eyeballs are healthy. And we see this in a lot of the astronauts now and it’s not new problem. But we really — nobody has ever lost vision as a result. We just don’t know over three years what will happen. And so again it’s that length of time when they go up for a year, in the ISS and they’re in zero-gravity. They have change in vision, they have swelling of the optic nerve and they come back to Earth and things get back to normal. We just don’t know about three years. Up to three years on that Mars mission, we just don’t know. Or, maybe in accommodation with the space radiation, which they’re not getting a whole — I mean they’re getting some radiation on the ISS right now, but not nearly what they’re going to get on deep space.

Host: And not the right kinds too. [Galactic Cosmic Radiation] GCR’s, all these other things –

Dorit Donoviel: That’s right.

Kristin Fabre: Correct, exactly.

Dorit Donoviel: In combination with that they may have a problem. So, what we’ve invested in is from ophthalmic technology is do it yourself ophthalmology. OK. So, you stick your eyeball into the viewfinder and that thing will adjust the — prescription for you so that you can see what you need to see. And it will take a retinal scan of you, basically right now. You need to have another person helping you or an expert to help you align your pupil and everything.

Kristin Fabre: You have to dilate your pupil.

Dorit Donoviel: You have to dilate to get the back of the retina and so that — do it yourself eye exam that will give you all the information you need. That does not exist today. So, guess where the company is going to take it? CVS and Walgreen. So just like now you have those machines you stick your arm into it and get a blood pressure, you can go in there and do the scan on your eye. Why is this important? There is so many people at risk for losing vision because of diabetic retinopathy. A lot of diabetics — it’s a silent vision killer. You have no idea you have diabetic retinopathy. If your doctor is good they’re going to be sending you to an ophthalmologist every year to make sure you’re OK. But there are a lot of people with unmanaged or even undiagnosed diabetes. So, what if you go into your Walgreens to pick up the prescription for something an you’re in there buying you know a box of diapers, and you go up and you stick your eyeball on this thing, put in ten bucks, or something like that and it says hey your optic nerve is really swollen, and you better go see a doctor. You might lose your vision. So that’s going to save a lot of eyeballs. And it’s about the technology we’re developing for space.

Host: Yeah, yeah but it’s — the theme is all the same when it comes to spaceflight. It’s that autonomy, it’s that compactness. It’s that level of you know you don’t need this gigantic machine and these professionals. That’s an incredible idea that you can take something that you needed to dilate your pupil. You needed this big machine, you needed a professional standing right in front of you. And you can just put it in like a — in your corner store.

Kristin Fabre: The user interface is going to be key. We need to make sure that anybody can use these types of technologies, that you do not have to be medically trained to understand how to use the equipment and what the data means when it comes back. So that’s one of our priorities and all of the types of technologies that we consider.

Dorit Donoviel: So, talk about scary. So, my son is just finishing med school, he’s going to be an orthopedic surgeon, right.

Host: All right.

Dorit Donoviel: Yeah, and so when I talk about do it yourself medicine, it freaks him out, right? Especially surgery. People talk about surgery in space. So, we’re going to send a doctor to Mars for sure. Maybe, it will probably be a surgeon or an emergency medicine doctor because they — they can do the more complicated things. If somebody breaks something, if somebody has to have an emergency appendectomy, if somebody has a foreign particle in the zero-gravity embedded in their airways, what are you going to do? What are you going to do? So, another project we’re kind of excited about is working with a game — a medical gaming company. So, these people came from like Lucas Films and Disney and Pixar. They’re developing games for doctor to train them on procedures, so even doctors who learn how to do things get rusty with procedures. And so, they basically create visualization tools. The doctors could even use on their smart phones. You don’t have to have a big station, VR headset or anything like that, you can just use it on your smart phone. And you could practice while you’re sitting at the airport waiting for your flight. You can practice removing a foreign object from your airways. You can practice doing a scoping. You can practice doing a certain complicated ultrasound scan. And they made these really fun. They’re gaming people so they — and doctors are very competitive so they’re competing with each other on how quickly they got this done without killing the patient or, so they made it extremely realistic. It’s based on mathematics and the physical model of physiology. They used — it’s not just a game for fun. It’s like based in medicine and physiology and a lot of doctors advise them, so we partnered up with them. We gave them some money. We said make this for zero-gravity. What will this look like in zero-gravity? Because fluids behave differently, tissues behave differently. Organs shift in zero-gravity. You have swelling of tissues. An object will float, you can’t just put down your you know, scope and it will stay there. It will actually float away. So, you want to simulate that so that when your geologist is having to do a procedure on the doctor, who inhaled some object, now you could practice, you could actually go through this training and have it be realistic in zero-gravity before you have to do this emergency procedure on the doctor who was supposed to be the one that’s helping.

Host: Wow, yeah, I could definitely recognize that application for space. But it also makes me feel pretty good to have doctors just on the ground, regularly fine tuning their skills and competing with each other. It’s got to feel good from a patient perspective. That they have that dexterity. That familiarization with their motions to — in case they need to operate on someone.

Kristin Fabre: And what I love about his example is that this is, as Dorit said their background is gaming. They were not trained scientists. They did not go through the university route. This, these are just people that had a tool that if we could modify it for space, it’s a game changer. And that’s what I love about how we think at TRISH. You don’t have to be a traditional scientist that went down a traditional path to engage with us or for us to invest in you. We just want to see a tool that is going to be a game changer. And this is a great example of how that — how that came to be.

Dorit Donoviel: And talk about educating them. I mean, they have no idea. And so, we brought in astronauts, we brought in flight surgeons, we brought in space physiologists, we brought in people who work at NASA. We brought in people who’ve been doing this for years together with this group and together you know, they’re making something that’s going to be useful and fun and engaging and relevant for NASA with real science and physiology behind it.

Host: That’s wonderful. Yeah, I like — when you talk about thinking about new things and new technologies, who would have thought oh let’s bring a gaming — let’s bring some gaming folks on to solve this space health problem.

Dorit Donoviel: Do you want to hear something funny? So most of these guys are young, software engineers or gaming people, right? Like you know the type, right? And their families are all like, “you’re just a gamer, we don’t even take you seriously. You don’t really have a real job.” They’re like, “No we’re building tools for doctors.” But as soon as we came in, all of a sudden, they became legit. You’re working with NASA, you must be legit. So, we bring legitimacy. [Laughter]

Host: I love that. I think another theme and I kind of want to end with this, what we’re talking about when it comes to space health technologies and you’ve met — you’ve had this term a few times. Mars forward, when you’re talking about problems for space, it’s not just general spaceflight. You’re thinking — you’re thinking ahead. You’re thinking man if we’re on Mars and you’re gone and you’re far away and you don’t have the right communication, 20-minute communication delays. And you’re going to be there for an extended period of time. We’re talking three years. These are the problems that you’re solving. Tell me about like something coming up in the near future, maybe on the Moon where were definitely looking forward to this Artemis program for NASA returning humans to the Moon. What are we looking forward to that maybe we can apply there, and that is truly Mars forward?

Dorit Donoviel: So, I’ll start and then Kristin can give the specific example. So that’s a great question, so my understanding right now and speaking with NASA and all of our colleagues is that there’s so much that’s needed to — so many resources and money and effort to put boots on the ground on surface of the Moon in 2024. That I think using the Moon as an analog for Mars, which is what we were hoping for is to learn how to do the Mars things on the Moon surface where it’s more dangerous than ISS, oh heck yeah. But still close enough to Earth that you can have you know, some — you could have a medical evacuation if you need to, within two days, two three days you’d be back on Earth. But as we understand it, there’s just not a lot of capability that’s being built right now. And so, everything is about getting the boots on the ground and not having the — a place where we can do all the testing of the Mars forward things. So, when NASA is ready for that, we will have the tool box, we’re developing a future tool box that we can let them have their pick, whatever you guys need here are the things that we want to test on the Moon and that is forward thinking that in terms of Artemis I really — there’s no specific things that we’re building for Artemis. But, Kristin has a great idea of how we’re going to use Artemis. So, I’m going to let her finish with that. [Laughter]

Kristin Fabre: So, I’m already thinking about the next steps for these tissue chips that I mentioned earlier, so currently we have the organ on chip solicitation that slide. And we want to see if it’s good — a good analog for human tissue and looking at countermeasures. But I’m already thinking about the next steps. So, a lot of these tissues – they can survive for up to 28 days. But I’d like to see is that if we can expand the tissue viability and have everything automated so that these tissues can survive and be viable and functional for up to six months, and I want to launch these guys onto the Moon. And I want to be able to have everything automated so that I can just pick up my phone and say what’s the cytokine expression in the tissues right now? So, can I measure inflammation in the vasculature tissue right now? How is the flow? Are these vasculature tissues being leaky? Can I take an image and look at the — the cell structure or the tissue structure, does it still look OK? And this way it can be a complete non-invasive way of studying human tissue exposed to GCR and in a way that we can — that we’ve never done before. And so, this is really my vision for what we can do with these technologies for TRISH is to take this several steps forward and say let’s keep these alive for a long time. That’s going to take a lot of ingenuity and engineering to say, how do we use the media? Or what the nutrition that’s delivered to these tissues? How do we keep that fresh and relevant? How do we automate all of our censors to see what’s going on in these tissues? How do we take images and how does that all going to go back to us on Earth where we can look at it on our phone? But that’s exactly the type of mission that TRISH has, and this is a vision I think I get most excited about when I think about these types of technologies at our next steps.

Host: Yeah what I love, what I love about everything that you’ve mentioned so far is your thinking about all of these areas and you’re truly doing your best to try and be innovative, to think of brand-new ways and technologies to solve our problems. But, I think what I’m really getting from this conversation is just how excited the both of you are about all of these incredible technologies. It seems like you love your jobs.

Dorit Donoviel: It’s the best job ever. And you know NASA is sometimes bogged down with bureaucracy so to be working with NASA and not to be bogged down by the bureaucracy as much as some of my friends are, is a joy. [Laughter]

Host: Yeah, yeah.

Kristin Fabre: But, it’s also I feel like we get to play in a meaningful way. It’s sci-fi come to life. And sometimes we joke around saying, “gosh like we need to be inspired, let’s put on our favorite sci-fi movie and see if we can pick something up there.” Because it is, it’s a way for us to use our imagination. It’s a way for us to look at art and say how can this inspire us in our scientists and our space health community to come up with the next step. So of course, this is going to be a great job. It’s — we really do have fun.

Host: Yeah. Well Dorit and Kristin this was so fun. Thank you so much for coming on.

Dorit Donoviel: It’s been a pleasure. Thank you so much.

Kristin Fabre: Thanks Gary. Take care.

Host: Yeah – thank you.

[ Music]

Host: Hey thanks for sticking around. Really fun conversation we had with Dorit and Kristin today about TRISH. Notice that some of the solicitations that we mentioned throughout today’s episode have already passed at this point, but they’re really good examples of what you can expect, so if you go to our show notes at NASA.gov/podcast, click on Houston We Have a Podcast and then go to this specific episode, you can see some of the links that they mentioned throughout the transcript. And you can find that again, at NASA.gov/podcast plus the many other podcasts that we have throughout NASA. You can find TRISH, the link to the website TRISH, right on our home page of NASA.gov/HRP. We tweet out and post on Facebook and post on Instagram, using the NASA Johnson Space Center pages. Use the hashtag #AskNASA on your favorite platform to submit an idea for the show. Just make sure to mention it’s for Houston We Have a Podcast. This episode was recorded on January 22, 2020. Thanks to Alex Perryman, Pat Ryan, Norah Moran, Belinda Pulido, Jennifer Hernandez and NASA’s Human Research Program. Thanks again to Dorit Donoviel and Kristin Fabre for taking the time to come on the show. Give us a rating and feedback on whatever platform you’re listening to, to tell us how we did. Special thanks to Rachael Dempsey for coordinating this effort as well. We’ll be back next week.