Health and Human Performance: For Military Service and Beyond

KBR has a long history of helping improve the resilience of service members, including mitigating the effects of extreme conditions like high altitude. But the work doesn’t stop with defense and space. In this episode Dr. Bianca Cerqueira, lead senior technical professional in data science with KBR Science and Space, shares about her remarkable career and about the further-reaching implications of KBR’s health and human performance work into civilian clinical care and improved health outcomes.

Transcript

IN ORBIT: A KBR PODCAST

Season 4, Episode 13

Health and Human Performance: For Military Service and Beyond

DISCLAIMER

The views expressed in this podcast episode are those of the author and do not reflect the official views or policy of the United States Department of Defense or its components. The experiments reported herein were conducted according to the principles set forth in the National Research Council's Guide for the Care and use of Laboratory Animals eighth Edition and the Animal Welfare Act of 1966 as amended.

INTRODUCTION

John Arnold

Hello, I'm John, and this is In Orbit. Welcome to the podcast. If you've listened before, welcome back. If you're finding us for the first time, good job and thanks for tuning in. Whatever the case, we're thrilled you're with us and staying in our orbit. Earlier this season, we were very excited to have Dr. Holly Robles on the podcast to talk about the important work she and her colleagues do to support the behavioral health of professionals in the defense and space sectors.

If you haven't checked out that episode yet, I encourage you to go back and do so. It was an excellent discussion on some powerful subject matter. On this episode, we're going to return to the subject of the work KBR does to help improve the resilience of service members, including mitigating the effects of extreme conditions like high altitude and preparing those folks for action through trainings and simulations.

But the work doesn't stop with defense and space. It also has further-reaching implications that can be translated to civilian clinical care and improved health outcomes. And with me today to talk about it is Dr. Bianca Cerqueira, lead senior technical professional in data science with KBR Science and Space business, which is part of KBR Government Solutions, United States. Dr. Cerqueira is a biomedical and human performance engineer, neuroscience data analyst, research scientist, patent holder, and a member of an elite group of scientists and technical experts known as the ONE KBR Technical Fellows. Thanks so much for being on the podcast, Dr. Cerqueira.

Dr. Bianca Cerqueira

Thank you so much for having me.

John Arnold

Well, we're thrilled to have you. But before we get going on all the technical stuff and hearing about the very important work you're doing, we'd love to hear more about you. So you are a self-described military brat. So let's talk about going from that to first realizing you had an interest in biology and neuroscience.

Dr. Bianca Cerqueira

Yes, both of my parents were in the army. My dad served over 30 years. My mother was a pediatrician. She ended up joining the military later in life when she decided to go to medical school. But yeah, my whole life I grew up with it. We moved around all over the place. I went to 15 different schools before I graduated from high school. But I think it definitely gives you a unique perspective on life, specifically understanding people from all over the world and just having friends all over. It's definitely been a great experience.

Then to your second part of the question, realizing I first had an interest in biology and neuroscience. Well, my father is an immunohematologist, so I've been around science my whole life. So I think that probably sparked the first interest. But I've always liked science. When I was little, I was obsessed with sharks and dinosaurs and planets and all of that. So that just continued through my school.

When I was in high school, I really liked physics and math. So when I was deciding my major for college, I was having a hard time deciding on physics or biology or even art. So I switched my major around several times, ended up deciding with neurobiology and physiology. And then I graduated from the University of Maryland, and then I worked for a year in a blood testing lab. I had previously done blood research at WRAIR, Walter Reed Army Institute of Research. So that was my first entree into officially doing military research. So that was a great experience.

And then I was still trying to decide did I want to go to medical school or I was considering a degree in public health, and then also biomedical engineering. So I ended up choosing biomedical engineering because I feel like it gives you a little bit of flavor of the biology and physiology, but then also you get the engineering sides and it gives you great skills to be able to apply your science to the field. So that's kind of how I got to where I'm now as a biomedical engineer.

John Arnold

It sounds like an awesome journey, literally science in your blood.

Dr. Bianca Cerqueira

Yes.

John Arnold

What was your favorite dinosaur?

Dr. Bianca Cerqueira

Oh, man. Probably Tyrannosaurus rex. I feel like that's such a cliché answer, but I mean when you see it in person, it's just amazing. And I mean, just thinking about the scale of life and all of the different species that have existed over time, I love that part. It's so interesting to learn more about all of that.

John Arnold

I completely agree. I don't think it's cliche for the T rex to be your favorite either. I think it's an infinite-

Dr. Bianca Cerqueira

I think that's everyone's favorite.

John Arnold

It's a very cool dinosaur.

Dr. Bianca Cerqueira

Yes.

John Arnold

Well, your expertise, as we've heard, it covers a lot of ground, but the overarching goal of your work at KBR is improving the resilience of service members. And in reading about you very helpfully divided your work into five main categories, and the first one that I saw there was mitigating the effects of extreme conditions that many service people face. Can you tell us about what some of those conditions are and how your work's helping address them?

Dr. Bianca Cerqueira

Yes, definitely. So one area of research that we focus on is the field of aerospace medicine. So specifically understanding how high-altitude exposure, also known as hyperbaria or varying degrees of oxygen concentration, hyperoxia, we have more oxygen, a hundred percent oxygen or hypoxia where you don't have enough oxygen. So just understanding how all of that affects service member function and performance.

So the group that I support primarily, or the research group started focusing on neurologic decompression sickness in U-2 pilots. So back in 2010, there was a higher incidence of U-2 pilots who suffered from neurologic decompression sickness. So they underwent neuroimaging and the research group saw that they had these increased white matter hyperintensity lesions, pretty much. On an MRI scan sequence, they had these lesions that you wouldn't expect to see. So then that expanded into a research portfolio that involved imaging of the entire U-2 cohort, and then also comparing that to active duty service members who would serve as a control and then out to chamber physiologists.

So a result of the research program was implementation of the CARE program, which increased the cabin pressurization of the U-2 platform from 30,000 feet equivalent to 15,000 feet equivalent. So that greatly reduces the risk of neurologic decompression sickness, and we haven't seen increased rates like we did previously. But that expanded into portfolio to understand, "Okay, we have seen these white matter hyperintensities with chronic high-altitude exposure, but is it unique to U-2 platform or are there other characteristics?" Or just understanding there's still a lot of pieces that I think aren't known, although the CARE program I think has reduced that risk, but just a better understanding of all of that.

So then our research portfolio expanded into looking to see, "Okay, if you have people who are undergoing a single hypo-baric event at 25,000 feet where they're hypoxic for only five minutes," which is what people experience when they undergo air crew training. So they are in the altitude chamber, they have a hundred percent oxygen, and then they remove their masks so they can understand what the symptoms of hypoxia are. So if there's some sort of event in the aircraft, they're able to recognize that and respond properly.

So all our crew go through this training. So we were trying to understand, "Okay, how does that affect their cerebral blood flow before and after?" And then we have had animal studies to replicate the flight sorties associated with U-2 flights. So there are many different aspects that you can apply to this domain.

We also have had projects in collaboration with AAPL, at what was formerly Brooks Air Force Base looking at, "Okay, if you have somebody who is using a reduced oxygen breathing device, which is sometimes used for crew training, and it mimics the oxygen concentration that you would have at high altitude, how does that compare to actually being in the chamber?"

Because one benefit of our ROBD [reduced oxygen breathing device] is, it's a lot less expensive than the chamber, but we want to make sure that the symptoms that people experience are the same so they can recognize when they may be experiencing a hypoxic event while they're flying. So we have studies measuring their cognitive performance, whether they do specific cognitive tasks while they're at altitude, and then we can measure their physiology with different wearable sensors. So there's a lot of interesting work in this space. So it's definitely an exciting place to do research.

John Arnold

Yeah, that's so fascinating. We've talked about it on the podcast before that KBR does a lot to help prepare service people for the real thing through trainings and simulation. And that's obviously another important aspect of your work around pilot training. How is what you do being translated into more effective training scenarios or programs in addition to the ones you were just talking about?

Dr. Bianca Cerqueira

Yes, yes. And that's one thing that I really enjoy about doing research in this space is that you can see the real world impact of what you're doing. When I was in my graduate studies, it's a very niche space, and there's a part of me that just felt like, "Okay, well, when is this ever going to be translated?" It seems like it's one small component of the entire world of science, but I feel like the research that we do here is really focused on translating benefits to the end user, whether that be the service member or the general public if we're investigating general health topics, but specifically with enhancing pilot training.

So we have a new program starting now where we are trying to better understand the neurobiology of pilot performance. In general pilots, they have to do many different tasks at the same time. A lot of it is physical. If they know that they're going to experience G, they have to do anti-G strain maneuver, and they can do training to prepare the leg muscles and everything to be able to do the maneuver. But if you're trying to train for cognitive performance, it's a little bit more difficult. And also to be able to quantify changes in cognitive performance.

So here, we're trying to develop a task where we can quantify their performance in a pilot-relevant task. So here we're using X-Plane, which is a flight simulator, and they are doing a precision instrument control task where they have to maintain a certain speed, altitude, and heading, and we have that integrated into an MRI scanner. So we can do functional imaging while they're doing that and see what parts of their brain are activated during that. And then we can also follow them as they go through training.

So we have it designed so that they will be evaluated before and after training. And then in addition to seeing what parts of their brain light up with functional imaging, we can also look at their diffusion tracked imaging, which is a way to visualize the white matter tracks so we can see, "Okay, within this area where they have functional activation in the task, what white matter tracks are connected to that?" And then we can see how that changes over time.

And then we can also capture metrics on the type of training that they're involved in and seeing, "Okay, if someone participates in more physical training, how does that correlate to how they have changes in their flight performance using the flight simulator?" And then if there are any imaging metrics that we can capture as well as that, and the overall goal is to understand how we can make more pilots better, faster. So in a way, our goal is to have more precision training for these pilots. So say you come in and you can see, "Okay, you are performing really well in this aspect, but you need a little bit of help in this other aspect, how we can tailor the cognitive training to support that aspect so that everyone is performing excellently."

John Arnold

Well, number one, that is unbelievably cool to put it in my own scientific terms. Number two, some awesome perspective that you just offered, that there are a lot of scientists in different fields who may work their entire lives without necessarily seeing the tangible fruit of their labor, but it's so wonderful that what you're working on is immediately translated into something that is helping these pilots excel at their duty.

Dr. Bianca Cerqueira

Definitely, it is so exciting to see the impact. And then also I think in research in general, it's really important to have dialogue with the ultimate end users of whatever you're trying to develop, because you can develop some sort of technology that is the best thing in the world, but there's some sort of hindrance that isn't necessarily specific to what you develop, but just like, "Okay, that plug doesn't work with this plug, so we can't use it," or something that seems ridiculous, but a lot of times can impact research being translated. So I think having early dialogue with these stakeholders helps you refine studies better to address their needs, and then they have a higher chance of being translated to the ultimate end user.

John Arnold

Absolutely. Well, let's pivot away from that for a second. Over to the world of infectious disease, not necessarily something you think one topic flow right into another, but infectious disease is another important of the part of the work that you do. And one recent example was your involvement working with the COVID-19 International Research Team, or COV-IRT back in, what was it, 2020. Would you tell us about that experience?

Dr. Bianca Cerqueira

Yes. So I got involved I think in mid 2020 during that summer, and it started with an email request of, "Oh, do you know someone who has a BSL level 3 lab?" And a friend of a friend had one. So I connected them, and then that's how I got connected to this COV-IRT group. And it was such a distinct point in time. We're all in early stages of lockdown, and I feel like the entire field of science was coming together to find solutions to address the pandemic. And it was just amazing to see researchers from all over the world, all aspects of life coming together to address this problem.

So that's how I got connected to the COVID-19 International Research Team. And then since then, we all met together and it was a great resource to provide collaboration because there were people that I would've never interfaced with otherwise. And at that time, I felt like it was a transition to realizing what we can do through Zoom and Teams and all of that.

John Arnold

Right, exactly.

Dr. Bianca Cerqueira

That we would've never imagined before. But it provided great access to resources and collaborators. And then since then, I've developed a really great collaboration with several researchers, including Afshin [Bahesti, former KBR employee], and we have had several projects funded together. And again, it started with COVID, but a lot of the applications and methods can be applied to all sorts of fields. So we're combined together with a goal of addressing CO, and then we realize, "Oh, well, we can apply this to cancer, or we can apply this to radiation biology," or whatever the case may be. So I'm so grateful that I joined that team and we're connected to all those great people because it's been a great experience and a great resource to be able to provide really fruitful collaborations.

John Arnold

And what research have you been involved in since then?

Dr. Bianca Cerqueira

Yes. So with the collaborators that I met through COV-IRT, we have gotten several projects funded through the Air Force Research Lab looking at creating knowledge graph databases. So our first grant together was just proof of concept, can we integrate different data sources, whether they be DOD owned and then public databases. So we did that.

And then the second project, which was KBR funded through SDI Award, was looking to see, "Okay, we are able to integrate these databases. Can we pull in additional databases that have information about drug-drug interaction or protein-drug interaction or microRNA proteins to be able to see, okay, if we have a specific microRNA expression associated with lymphoma, can we identify drugs that target that microRNA expression that could be used for repurposing to treat lymphoma?"

So we worked through that. We developed all the tooling and pipeline for that. Collaborators, Justin Reiss and Diego Galeano have been integral to that work, and we all work together. And then we applied for funding through AFRL to apply the same methods, but to do it to identify drugs that could be used for repurposing for high altitude exposure. So that's where we're pulling in some of our prior studies related to U-2 flight and then combining the machine learning tooling that we developed within artists with KBR.

So that's been a great opportunity. It's been a really exciting work. I feel like drug repurposing is such a powerful tool, especially as we saw with COVID, right? It took a long time before people were like, "Okay, this medication might be useful or that medication might be useful." And I think going through that experience helped us understand the power of data analytics and the power of data that exists. A lot of the effort is in trying to integrate that data. So that's what we've done through these projects is of saying, "Okay, we can find ways to integrate the data. Once it's aligned properly, then we can apply machine learning." And then the next time there's a pandemic, then we have the infrastructure set up in place where we just need to look at differential gene expression or RNA-seq data from individuals with some novel next pandemic, whatever the case may be. And then we can quickly identify drugs that can be used to treat them.

John Arnold

That's just fascinating. Well, we've been talking about improving resilience in service people, but the results of your work have further-reaching implications in that they can be and will be eventually translated to civilian clinical care and improved health outcomes. Could you give us some examples?

Dr. Bianca Cerqueira

Yes. So we had one project where we were looking to see if people who had COVID, what was the incidence of cardiac injury after COVID infection, and then if there is a microRNA associated with that. So a lot of the research goals within service members like public health, it's not just for the general public. It also has great applicability to the military population in making sure that you have good readiness. You want to make sure that everyone is healthy, that everyone is prepared to do what they need to do. So understanding that even though this is focused on a military population, the findings from that can be applied to the general population.

And there's a long history of research that starts within the DOD, but then ends up having impact in broader society. So that's just one example of the research that we do that can be translated, but I mean, even with the high-altitude exposure, there are other fields like astronauts, they're also exposed to hypobaria. So understanding how that translates, whatever medications or methods that we can understand to mitigate those risks can also be applied to commercial space travel or astronauts or whatever the case may be.

John Arnold

Right. And that's such a huge topic right now, the low-earth orbit economy.

Dr. Bianca Cerqueira

Yes.

John Arnold

So you are a member of a special cohort of technical experts at KBR, and this might be a little bit inside baseball, but it's a good plug for this program. And these folks are called the ONE KBR Technical Fellows. Would you tell us about the program and your experience so far in it?

Dr. Bianca Cerqueira

Yes. So I am a member of the second cohort of this program. So it's been a great experience so far. The goal of this program is to have better collaboration amongst technical experts within KBR. So they had a summer event where we all got together and we got to learn about what everyone is doing and meet everyone. And then the program also provides you additional funding to attend conferences, professional development, and then we also receive funding to do a special project that we want that's supposed to be outside the scope of our current work, but still is aligned to the broader KBR goals.

John Arnold

Interesting.

Dr. Bianca Cerqueira

So the project that I'm working on is looking at direct air carbon capture. So again, it's very distinct and outside of human performance and health and neuroscience and that sort of thing, but it's an area that is a passion for me and I think is really interesting. So I am grateful that this program allows me the opportunity to do research in a space that is kind of outside my niche.

And then again, meeting with all of the other KBR Tech Fellows has been a great opportunity. And then you can learn to see where, okay, somebody's working on technology that you would think wouldn't be applicable in your space, but then you speak more and you're like, "Oh, well actually I could apply it here, or that would be good there, or I should connect you to someone else." So I think it helps expand our collaboration within our group, and then also have a further understanding about all of the deep technical work that we do at KBR.

John Arnold

Where did the interest in direct air carbon capture come from?

Dr. Bianca Cerqueira

I think I heard about it on NPR, and I was like, "Oh, that's so cool." It was the diet room show several years ago. And then I went down a rabbit hole learning all about direct air carbon capture, and just with the rate of carbon that's in our atmosphere. And even if we were to stop all carbon production at this time, there would still be an excess of carbon that we need to remove. So really, I think direct air carbon capture is one of the only ways that you can address that. And then understanding. And it seems like there are pilot sites that have been established for direct air carbon capture, but it hasn't really been largely operationalized.

So understanding, "Okay, what are the hindrances at that point? What technology or expertise does KBM have in other domains that could be applied to direct air carbon capture," especially since we do a lot of work in the energy space. So just learning more about that and then figuring out, once you collect the carbon, then what do you do with it? And right now, sometimes it's used for additional extraction and wells, although I feel like that doesn't really help the overall trying to lower the carbon in the atmosphere, but there are other methods that you can try to fix it. So just learning about those technologies and seeing how we can incorporate that into what we do here.

John Arnold

Goodness, everything that you've talked about previously has been a noble pursuit, but even this side project for carbon capture, I look forward to hearing more about your findings and or the solutions that come as a result. So that's just outstanding. What would you tell an expert at KBR who's thinking about applying to be a tech fellow?

Dr. Bianca Cerqueira

I would say definitely apply. There is an application process that you have to submit, but it's maybe two or three pages worth of narrative. But I think it's a great opportunity to learn more about what other people are doing at KBR. And then as I mentioned, they provide you that resource to be able to research your niche topic or whatever you're interested in. So I think that provides people opportunity to nurture their intellectual curiosity in spaces where they may not have funding with or the customer may not be directly doing work in that space. So I feel like it's a really nice opportunity, a nice gift to be able to do that type of work.

John Arnold

And there may be a budding up and coming neuroscientist or data analyst or human performance researcher out there who's thinking about taking the leap in their career or thinking about looking at KBR as a landing place. Any words of advice for those folks?

Dr. Bianca Cerqueira

I would have to say that I feel like I am very fortunate that I ended up where I am here. If you asked me 10 years ago, "Do you think that you're going to be where you are now?" I would've never imagined it. And I think one unique aspect that I've had here in my career at KBR is that I feel like people really invest in you and they nurture you. So if you speak up, people will listen to you. It's not like you're giving suggestions out into the void. People really listen to you and take what you're saying into consideration. So I've been grateful for that.

And then also I think that one thing that I've really appreciated is that leadership here has given me the opportunity to develop my own curiosities. So with the direct air carbon capture, I was like, "Oh, this is really outside of my space. I don't know if they're going to approve this," but they did. So it shows you that they give you the room to grow and they give you the support to grow. So I feel very fortunate to be here. And then also I feel like the research that we're doing, you see the impact of it, so it makes you feel like you're really making a difference. So that's been very satisfying to me, and I feel like everyone is very collaborative and open to new ideas. So it's been a really great space to work in.

John Arnold

That's wonderful and very encouraging to hear that you are so supported. I love hearing from experts. It seems to be a recurring theme. Lots of people talking about how don't be afraid to speak up because people want to hear those ideas.

Dr. Bianca Cerqueira

Yes, definitely so. The whole reason that I got pulled into all of this work, because prior to COVID, I was doing my work focused on aerospace medicine, but I didn't really interface with the broader KBR community. But then during COVID, then we started having online meetings and it was like, "Oh, look, this is all of the amazing stuff, which I didn't know that we did." And then I was like, "Oh, well this is cool. Can I be in these meetings?" So then I'm so glad that I spoke up because otherwise I would've never ended up being where I am now. So I think it's really important to not be afraid to speak up because you never know what opportunity may present yourself. You just kind of have to put yourself out there.

John Arnold

I just want to say thank you so much for your time. I appreciate you being here, and I appreciate the work that you're doing so much.

Dr. Bianca Cerqueira

Thank you so much. I appreciate speaking with you.

John Arnold

We'll look forward to speaking with you again and hear some updates on all of your projects. But in the meantime, thanks again, and we'll talk to you soon.

Dr. Bianca Cerqueira

Great. Thank you so much.

CONCLUSION

John Arnold

So what do you think? Are you not entertained? It's pretty cool stuff, right?

We want to thank Dr. Bianca Cerqueira for taking time out of her schedule to join us on the podcast and for telling us about the extraordinary work she's doing to keep people safe and make a lot of people's lives a whole lot better.

I want to thank my colleague, Melissa Calhoun, director of talent development at KBR for helping us get this episode off the ground. And as always, many thanks to you, dear listeners. If you like what you heard today or if you have an idea for a future episode, or if you just want to say hi, let us hear from you by emailing us at inorbit@Kbr.com. We also hope you'll take some time, go back and check out three previous seasons of interesting and informative In Orbit content available whenever you want it, wherever you get your podcasts.

We know you got a lot of different things vying for your attention in this crazy world, and we appreciate you checking in with us and keeping us in your orbit. Take care.