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Space exploration requires the characterization and management or mitigation of a variety of human health risks. Exposure to space radiation is one of the main health concerns because it has the potential to increase the risk of cancer, cardiovascular disease, and both acute and late neurodegeneration. Space radiation-induced decrements to the vascular system may impact the risk for cerebrovascular disease and consequent dementia. These risks may be independent or synergistic with direct damage to central nervous system tissues. The purpose of this work is to review epidemiological and experimental data regarding the impact of low-to-moderate dose ionizing radiation on the central nervous system and the cerebrovascular system. A proposed framework outlines how space radiation-induced effects on the vasculature may increase risk for both cerebrovascular dysfunction and neural and cognitive adverse outcomes. The results of this work suggest that there are multiple processes by which ionizing radiation exposure may impact cerebrovascular function including increases in oxidative stress, neuroinflammation, endothelial cell dysfunction, arterial stiffening, atherosclerosis, and cerebral amyloid angiopathy. Cerebrovascular adverse outcomes may also promote neural and cognitive adverse outcomes. However, there are many gaps in both the human and preclinical evidence base regarding the long-term impact of ionizing radiation exposure on brain health due to heterogeneity in both exposures and outcomes. The unique composition of the space radiation environment makes the translation of the evidence base from terrestrial exposures to space exposures difficult. Additional investigation and understanding of the impact of low-to-moderate doses of ionizing radiation including high (H) atomic number (Z) and energy (E) (HZE) ions on the cerebrovascular system is needed. Furthermore, investigation of how decrements in vascular systems may contribute to development of neurodegenerative diseases in independent or synergistic pathways is important for protecting the long-term health of astronauts.

Type 1 diabetes (T1D), previously known as juvenile diabetes, has a large impact on everyday life and can pose a number of challenges for both children and their parents. A patient-centered design company, Sproutel, has designed and developed Jerry the Bear®—an interactive augmented reality (AR) stuffed animal toy bear designed to provide children with T1D with comfort and education about their diabetes management through play. We evaluated the AR device in a research study that involved participation over the course of approximately two weeks; the overall research project spanned three years and involved a variety of partners. We investigated whether Jerry the Bear offered psychosocial support to children with T1D and their parents and whether a new prototype version (equipped with audio feedback) offered any additional benefits. We conducted two versions of the study—a lab study ( n = 11) and a remote study without any in-person component ( n = 14). We found two major takeaways: (1) The results from the remote study closely paralleled the more time- and effort-intensive lab study, pointing to a promising avenue of research for hard-to-reach populations. (2) Jerry the Bear had a positive impact on children with T1D and their parents in almost all cases—in some the impact was more neutral, but never markedly negative. We did not find evidence for a consistent preference between the current Jerry the Bear and the new prototype. We also discuss the challenges of conducting rigorous research in highly specific target populations.