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Fatigue‐Related Countermeasures for Long‐Duration Exploration Missions

The NASA Human Research Program's (HRP) Behavioral Health and Performance Element (BHP) supports and conducts research to mitigate deleterious outcomes related to fatigue, sleep loss, circadian desynchronization, and work overload. Objective evidence indicates that within the context of the International Space Station (ISS), sleep is reduced and there is circadian misalignment. Despite chronic sleep loss and high workloads; however, astronauts successfully complete their missions. Contributing to their success is not only the tremendous skills and capabilities of each astronaut, but also the collaborative team efforts amongst the crew, between flight and ground crews, and through real‐time care provided by medical personnel. It is anticipated that risks to human health and performance will increase in the context of exploration missions, where crewmembers will venture to deep space for extended durations and in small vehicles with limited communication with home. Hence, fatigue‐related countermeasures are being developed and/or validated that include unobtrusive monitoring technologies to detect fatigue‐related performance decrements, environmental countermeasures, and sleep education and training for flight and ground crews. Given that fatigue is an issue in current ISS missions, the BHP works collaboratively with Space Medicine operations to collect data in the operational environment, to validate fatigue-related countermeasures, and provide evidence‐based mitigations. Our presentation will summarize fatigue‐related operational research that is underway through NASA's BHP in partnership with its operational counterparts. Efforts include studies evaluating the effects of hypnotics, lighting protocols as countermeasures for circadian entrainment, and investigations involving education and training. This presentation will further identify, based on flight and terrestrial evidence, additional sleep and circadian countermeasures that may still be needed to support exploration missions. Lessons learned from transitioning research deliverables into ISS operations will also be discussed.

Whitmire, A.↗

Observing System Simulations for the AOS Mission

The Earth System Observatory (ESO) is NASA’s response to the recommendations of the 2017 Earth Sciences Decadal Survey conducted by the US National Academy of Sciences, Engineering and Medicine. The ESO is being conceived as a set of fully integrated missions addressing 4 main Earth science focus areas including aerosols, clouds, convection and precipitation (jointly re-ferred to as AOS, the Atmosphere Observing System). ESO ground breaking observations will provide critical measurements to address societally relevant problems in climate change, natural hazard mitiga-tion, fighting forest fires, and improving real-time agricultural processes. A critical element of the AOS observing strategy is to make extensive use of new passive and active sen-sors as well as of the so-called Program-of-Record (PoR), complemented by a fully integrated sub-orbital component. In order to achieve maximum benefit, all these observations need to be integrated into comprehensive observing and modeling/data assimilation systems. Such an approach requires compre-hensive model-data synthesis capabilities that needs to be conceived in conjunction with the space-based and suborbital components of AOS. In this presentation we will summarize the major science goals of AOS including cloud feedbacks, at-mospheric convection, emphasizing aerosol processes and aerosol radiative effects, and the synergistic aspects of clouds-precipitation-aerosol interactions. We will describe examples of the observing system simulation capabilities being developed for AOS, including global storm resolving nature runs, detailed instrument and retrieval simulators, as well as fast retrieval emulators for instrumenting climate models. This simulation environment, being developed under NASA’s open-source science initiative, will permit us to explore how AOS data will be used across space and time to better initialize forecasts and train modeling systems, and to infuse models and data assimilation systems with AOS data, well before launch.

Arlindo da Silva↗

Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions: ExMC Pharmacy Research Plan

The Exploration Medical Capabilities (ExMC) Element of NASA's Human Research Program is charged with identifying medical capabilities that can address the challenges of prevention, diagnosis, and treatment of disease and injuries that could occur during exploration missions beyond Earth's orbit. Faced with the obstacle of access to in-flight medical care, and limitations of vehicle space, time, and communications; it is necessary to prioritize what medical consumables are manifested for the flight, and which medical conditions are addressed. Studies of astronaut health establish the incidence of common and high risk medical conditions that require medical intervention during long-duration exploration missions. In 2000, the Institute of Medicine (IOM) convened a committee of experts, Committee on Creating a Vision for Space Medicine during Travel beyond Earth Orbit, to examine the issues surrounding astronaut health and safety for long duration space missions. Two themes run throughout the committee's final report: (1) that not enough is known about the risks to human health during long-duration missions beyond Earth's orbit or about what can effectively mitigate those risks to enable humans to travel and work safely in the environment of deep space and (2) that everything reasonable should be done to gain the necessary information before humans are sent on missions of space exploration (IOM, 2001). Although several spaceflight focused pharmaceutical research studies have been conducted, few have provided sufficient data regarding medication usage or potency changes during spaceflight. The Du pharmaceutical stability study assessed medications flown on space shuttles to and from the International Space Station (ISS) from 2006 until 2008; of which some medications were still viable beyond their expiration dates (Du et al, 2011). However, as with many spaceflight studies, the small 'n' associated with this study limits the ability to draw strong conclusions from it. Dr. Wotring and others have recently published articles containing information regarding medication usage, indications, and efficacy gleaned from spaceflight records (Wotring et al, 2015, 2016; Barger et al, 2014; Basner and Dinges, 2014). Although some conclusions can be drawn from these studies, the inability to fully quantify medication usage, indications, side effects, and effectiveness, limits insight as to which medications should be prioritized for further research.

Antonsen, Erik↗

NASA Astronaut Occupational Surveillance Program and Lifetime Surveillance of Astronaut Health, LSAH, Astronaut Exposures and Risk in the Terrestrial and Spaceflight Environment

United States Astronauts have a very unique occupational exposure profile. In order to understand these risks and properly address them, the National Aeronautics and Atmospheric Administration, NASA, originally created the Longitudinal Study of Astronaut Health, LSAH. The first LSAH was designed to address a variety of needs regarding astronaut health and included a 3 to 1 terrestrial control population in order to compare United States "earth normal" disease and aging to that of a microgravity exposed astronaut. Over the years that program has been modified, now termed Lifetime Surveillance of Astronaut Health, still LSAH. Astronaut spaceflight exposures have also changed, with the move from short duration shuttle flights to long duration stays on international space station and considerable terrestrial training activities. This new LSAH incorporates more of an occupational health and medicine model to the study of occupationally exposed astronauts. The presentation outlines the baseline exposures and monitoring of the astronaut population to exposures, both terrestrial, and in space.

Keprta, Sean R.↗

Strategy for Developing Technologies for Megawatt-class Nuclear Electric Propulsion Systems

In late fiscal year 2020, the Space Nuclear Propulsion (SNP) project began the process of formulating an investment strategy to support development of the technologies required for a high-power (megawatt-class) nuclear electric propulsion (NEP) system capable of performing human-scale missions. This activity was initiated concurrent with several high-level studies and assessments were either under way or had just concluded. Studies of human-scale Mars missions have been performed several times over the past two decades. One of the most recent studies examined opposition-class human Mars missions to occur in the late 2030s timeframe [1,2]. The mission architecture assumed a hybrid NEP/chem-propelled vehicle that used a high specific impulse (Isp) NEP-system and a liquid oxygen (LOx)-liquid methane high thrust chemical stage (two 110 kN (25 klbf) thrust, 365 s Isp engines) for maneuvers performed to enter and exit gravity wells. Trajectory analyses performed in this study showed that such a mission could be performed with 2-4 MWe directed into the electric propulsion system (operating for 20,000+ hours), with the large range representing different opposition-class Mars mission opportunities and permutations on the trajectory design, concept of operations, and technology choices. In 2020, the NASA Engineering and Safety Center (NESC) performed a study to evaluate the maturity of the different technologies required for nuclear propulsion systems [3]. The executive summary of this report provided the following top-level conclusions: • “The majority of critical technologies for… NEP/Chem… systems are relatively immature” • “TRLs [technology readiness levels] in the literature are often overestimated” • “The majority of critical technologies… for NEP/Chem… systems are at a relatively high level of advancement degree of difficulty (AD2 > 4) for maturation, requiring a dual development approach” • “The proper assessment of baseline TRL and AD2 values and the estimation of requirements and resources required for advancement have been consistent issues for NEP,” • “Non-advocate reviews should occur at the start of a technology program and at all key milestones.” In 2021, the National Academies of Science, Engineering, and Medicine (NASEM) issued a separate report [4] identifying the “primary technical and programmatic challenges, merits, and risks for maturing space nuclear propulsion technologies of interest to a future human Mars exploration mission.” That work contained several important findings, including: • “Developing a MWe-class NEP system for the baseline mission would require increasing power by orders of magnitude relative to NEP system flight- or ground-based technology demonstrations completed to date.” • “Subscale in-space flight testing of NEP systems cannot address many of the risks and potential failure modes associated with the baseline mission NEP system. With sufficient M&S [modeling & simulation] and ground testing, including modular subsystem tests at full scale and power, flight qualification requirements can be met by the cargo missions that will precede the first crewed mission to Mars. Fully integrated ground testing may not be required.” • “As a result of low and intermittent investment over the past several decades, it is unclear if even an aggressive program would be able to develop an NEP system capable of executing the baseline mission in 2039.” These efforts motivated the SNP project to investigate the technologies available for a megawatt-class high power nuclear electric propulsion system. That system is illustrated schematically in Figure 1 and is comprised of five separate top-level critical technology elements (CTEs). 1. Nuclear Reactor – Thermal power source for the system, utilizing high-assay low enriched uranium (HALEU) as the nuclear fuel. Reactor radiation shielding is also included in this CTE. 2. Power Conversion – Operates as a thermodynamic cycle, accepting nuclear reactor thermal power as an input and converting it to mechanical power. 3. Power Management and Distribution (PMAD) – Accepts as an input mechanical power from the power conversion system, which is used to generate electrical power. The PMAD system also distributes the generated electrical power to all other parts of the spacecraft, including the high-power EP system. The PMAD system may also perform duties such as isolation, fault detection, and power transformation/rectification for different spacecraft systems, including the thrusters. 4. Electric Propulsion (EP) – Accepts as an input electrical power, which is used to accelerate a propellant to high speeds to produce thrust. This system includes the power processing unit (PPU), which converts the power it receives to the correct current and voltage required by the thrusters, and the propellant storage and feed systems, which contain and meter the flow of propellant to the thrusters. 5. Thermal Management (Radiators/Heat Rejection) – The cold side of the thermodynamic power conversion cycle, accepts thermal power from the power conversion system and radiatively rejects that heat to space. In this paper, we describe the SNP project formulation and investment strategy that aims to accomplish the research and development required to advance the technology readiness for each CTE. The strategy relies heavily upon experimental testing supported by modeling and simulation to yield realistic assessments of the technologies, which in turn will be used to inform future NEP system-level design decisions and any potential technology downselects.

Kurt A Polzin↗

Immunological characterization of plant ornithine transcarbamylases

Pea (Pisum sativum L.) ornithine transcarbamylase (OTC) antisera were used to investigate the immunological relatedness of several plant and animal OTC enzymes. The antisera immunoprecipitated OTC activity in all monocot and dicot species tested, and sodium dodecyl sulfate polyacrylamide gel electrophoresis analysis of immunoprecipitated protein revealed monomeric proteins ranging from 35,200 to 36,800 daltons in size. Pea OTC antisera did not recognize mammalian OTC protein. OTC activity and protein levels detected on sodium dodecyl sulfate polyacrylamide gel electrophoresis immunoblots from homogenates of green leaf, etiolated epicotyl and cotyledon, and root tissues of pea were poorly correlated. This might result from differences in amounts of enzymatically active OTC protein in the homogenates. Alternatively, the antisera may fail to recognize different isozyme forms of OTC, which have been reported for some plant species. A putative cytosolic precursor OTC (pOTC) polypeptide exhibiting and Mr = 39,500 to 40,000 daltons was immunoprecipitated from in vitro translation mixtures of total pea leaf poly(A)+ RNA. The size of the pOTC polypeptide, as compared with mature OTC monomer (36,000 daltons), suggests that a 4 kilodalton N-terminal leader sequence, like that responsible for mitochondrial targeting of the mammalian enzyme, may be involved in organellar import of the plant enzyme.

NASA Discipline Plant Biology↗

Exploring the Complexities of Drug Formulation Selection, Storage, and Shelf-Life for Exploration Spaceflight

Medications have been a part of space travel dating back as far as the Apollo missions. Currently, medical kits aboard the ISS contain medications and supplies to help crew members cope with a variety of possible medical events. NASA reported that 1,867 medical events occurred from 1981 to 1998 on space shuttle flights, STS-1 to STS-89; 498 out of the 508 crewmembers on those flights reported experiencing a medical event other than space motion sickness. In 2000, the Institute of Medicine (IOM) convened a committee of experts, Committee on Creating a Vision for Space Medicine during Travel beyond Earth Orbit, to examine the issues surrounding astronaut health and safety for long duration space missions. The primary theme of the committee’s final report is that there is not enough known about the risks to human health during long-duration missions beyond Earth’s orbit and ways to effectively mitigate those risks in an environment of deep space. In 2014, the IOM convened the Committee on Ethics Principles and Guidelines for Health Standards for Long Duration and Exploration Spaceflights and released a report emphasizing the importance of prevention, mitigation, and treatment of major risks to human health during exploration spaceflight. NASA’s Human Research Program has organized five distinct categories of spaceflight hazards summarized by the acronym “RIDGE” (Space Radiation, Isolation and Confinement, Distance from Earth, Gravity fields, and Hostile/Closed Environments) that astronauts may encounter during exploration spaceflight. From those hazards, NASA further derived 30 of the most critical human health and performance risks, including limits to medical care resulting from pharmaceutical degradation. As we prepare for more distant exploration missions to Mars and beyond, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. The present editorial will summarize the current state of knowledge regarding innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

drug degradation risk assessment↗

Improvements to the Ionizing Radiation Risk Assessment Program for NASA Astronauts

To perform dosimetry and risk assessment, NASA collects astronaut ionizing radiation exposure data from space flight, medical imaging and therapy, aviation training activities and prior occupational exposure histories. Career risk of exposure induced death (REID) from radiation is limited to 3 percent at a 95 percent confidence level. The Radiation Health Office at Johnson Space Center (JSC) is implementing a program to integrate the gathering, storage, analysis and reporting of astronaut ionizing radiation dose and risk data and records. This work has several motivations, including more efficient analyses and greater flexibility in testing and adopting new methods for evaluating risks. The foundation for these improvements is a set of software tools called the Astronaut Radiation Exposure Analysis System (AREAS). AREAS is a series of MATLAB(Registered TradeMark)-based dose and risk analysis modules that interface with an enterprise level SQL Server database by means of a secure web service. It communicates with other JSC medical and space weather databases to maintain data integrity and consistency across systems. AREAS is part of a larger NASA Space Medicine effort, the Mission Medical Integration Strategy, with the goal of collecting accurate, high-quality and detailed astronaut health data, and then securely, timely and reliably presenting it to medical support personnel. The modular approach to the AREAS design accommodates past, current, and future sources of data from active and passive detectors, space radiation transport algorithms, computational phantoms and cancer risk models. Revisions of the cancer risk model, new radiation detection equipment and improved anthropomorphic computational phantoms can be incorporated. Notable hardware updates include the Radiation Environment Monitor (which uses Medipix technology to report real-time, on-board dosimetry measurements), an updated Tissue-Equivalent Proportional Counter, and the Southwest Research Institute Radiation Assessment Detector. Also, the University of Florida hybrid phantoms, which are flexible in morphometry and positioning, are being explored as alternatives to the current NASA computational phantoms.

Semones, E. J.↗

Regulation of Vascular Growth in the Chorioallantoic Membrane of Japanese Quail Eggs

The Microgravity Research Program is part of NASA's Office of Biological and Physical Research (OBPR). The mission of the Microgravity Fluid Physics research program is to facilitate and conduct the best possible fluid physics research using the space environment and make this knowledge available to the scientific community and the public at large. During the summer of 2004, I worked in this division with Dr. Patricia Parsons-Wingerter. Dr. Parsons was working on several projects that used the chorioallantoic membrane (CAM) of Japanese quail eggs. The CAM develops in the eggs of birds and reptiles and is a very vascular fetal membrane composed of the fused chorion and adjacent wall of the allantois. The CAM is formed on day 4 of incubation and its primary job is to mediate gas exchanges with the extra embryonic environment. The CAM of our Japanese quail eggs is easily identifiable to us because it is transparent and it sits on top of the yolk with the embryo in the center. The CAM is of interest because of its many applications in the field of medicine as it relates to vascular remodeling and angiogenesis. Angiogenesis is simply the growth or formation of new blood vessels and anti-angiogenesis is the inhibition of said vessels. Angiogenesis occurs naturally in a healthy body for healing wounds and for restoring blood flow to tissues after injury and in females during the monthly reproductive cycle. In many serious diseases, like several types of cancer and those that affect the heart and cardiovascular system, the body loses control over angiogenesis. These diseases, which are dependent on angiogenesis, result when new blood vessels either grow excessively or insufficiently. The chorioallantoic membrane of our Japanese quail eggs gives a good model of angiogenesis. We used angiogenic regulators to inhibit or stimulate vascular growth in the CAM in a healthy manner and they induced distinct vascular patterns in vivo. Certain dominant regulators can be recognized by their unique vascular patterns and from these patterns; we can deduce specific alterations in vascular remodeling and angiogenesis. This will aid us in early-stage diagnosis and customized therapies for patients with angiogenic-dependent diseases. This particular research is important to NASA because cardiovascular health issues are the second highest of ten categories that have been defined as risk factors in human space exploration. Also, cardiovascular-related diseases have been the leading cause of death in America since 1981. Therefore, this kind of research in the field of cardiovascular health is of great importance to humans on earth and in space. This particular research is important to NASA because cardiovascular health is of great importance to humans on earth and in space.

Montague, Idoreyin P.↗

Preparing for Mars: the physiologic and medical challenges

As the twentieth century closes, retrospectives cite the Apollo moon missions as one of the important events of the past 100 years. A trip to Mars, however, would be even more challenging and significant. A round-trip Mars journey would require nearly three years away from Earth, a significant leap in complexity compared to the two week long Moon trips or the record-breaking fourteen-month flight on Mir. What would be the physiologic and medical challenges of a Mars flight? Two key areas of physiology present the greatest potential problems--calcium metabolism and radiation exposure. Data from Mir missions show that bone loss continues in space despite an aggressive countermeasure program. Average losses were 0.35% per month, but some load bearing areas lost >1% per month. A 1% loss rate, if it continued unabated for 30 months, could produce osteoporosis. Smaller losses could still increase fracture risk. Some bone loss can be well tolerated, particularly if the bone can be regained after the mission. But the effectiveness of post-flight rehabilitation to restore the density and quality of bone after spaceflight is not well known. Bone loss estimates are based on continuous weightlessness exposure, but this is not a requirement for a Mars trip. Most of the time on a Mars trip will be spent in the 1/3 Earth's gravity environment on Mars, and either intermittent or continuous artificial gravity can be provided for the transit between planets (although at an engineering cost). The dosing of the gravity exposure (e.g. the level and duration), however, has not been established. Radiation protection also requires a balance between engineering cost and human health. Excessive shielding could add billions of dollars to the cost of a mission. Trips in interplanetary space, however, expose the crew to heavy high-energy particles from cosmic rays (HZE particles), which have a high linear energy transfer. This high energy leads to significant biological damage (e.g. chromosomal aberrations, cancer induction). A recent report from the Committee on Space Biology and Medicine notes that only one systematic study of cancer induction from high-energy particles has been conducted (using the mouse Harderian gland). Predictions of cancer risk and acceptable radiation exposure in space are extrapolated from minimal data. Other areas of physiology also present problems, such as muscle loss, cardiovascular deconditioning, and vestibular adaptation. Despite all the issues, however, a focussed, aggressive research program that uses the resources of the International Space Station should pave the way for mankind's greatest adventure--a trip to Mars.

STS-90 Shuttle Project↗

Applications of telemedicine in the United States space program

Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

Review, Tutorial↗

Development of an Accepted Medical Condition List for Exploration Medical Capability Scoping

Future NASA human spaceflight programs are on the verge of moving beyond Low Earth Orbit (LEO) to implement missions in lunar space and ultimately Mars. The mission constraints for these types of missions are expected to be progressively challenging for integration of Human Systems requirements into the vehicle and mission architectures. Mass and volume allocations are expected to become increasingly restrictive at the same time that mission realities will drive an increasing need for crew self-sufficiency in the maintenance and repair of both vehicle systems and human systems. To meet these challenges, a systematic, traceable, and repeatable approach to identifying, defining, and prioritizing medical capabilities is required. To provide a systematic and repeatable approach to defining and prioritizing clinical capabilities for spaceflight medicine, a clear process is required for delivering a list of prioritized medical capabilities to the Systems Engineering process that will delineate the mass, power, volume, and similar needs and the trade space analysis for a given space vehicle and mission architecture.

Rebecca Blue↗

NASA Tech Briefs, September 2013

Topics include: ISS Ammonia Leak Detection Through X-Ray Fluorescence; A System for Measuring the Sway of the Vehicle Assembly Building; Fast, High-Precision Readout Circuit for Detector Arrays; Victim Simulator for Victim Detection Radar; Hydrometeor Size Distribution Measurements by Imaging the Attenuation of a Laser Spot; Quasi-Linear Circuit; High-Speed, High-Resolution Time-to-Digital Conversion; Li-Ion Battery and Supercapacitor Hybrid Design for Long Extravehicular Activities; Ultrasonic Low-Friction Containment Plate for Thermal and Ultrasonic Stir Weld Processes; High-Powered, Ultrasonically Assisted Thermal Stir Welding; Next-Generation MKIII Lightweight HUT/Hatch Assembly; Centrifugal Sieve for Gravity-Level-Independent Size; Segregation of Granular Materials; Ion Exchange Technology Development in Support of the Urine Processor Assembly; Nickel-Graphite Composite Compliant Interface and/or Hot Shoe Material; UltraSail CubeSat Solar Sail Flight Experiment; Mechanism for Deploying a Long, Thin-Film Antenna From a Rover; Counterflow Regolith Heat Exchanger; Acquisition and Retaining Granular Samples via a Rotating Coring Bit; Very-Low-Cost, Rugged Vacuum System; Medicine Delivery Device With Integrated Sterilization and Detection; FRET-Aptamer Assays for Bone Marker Assessment, C-Telopeptide, Creatinine, and Vitamin D; Multimode Directional Coupler for Utilization of Harmonic Frequencies from TWTAs; Dual-Polarization, Multi-Frequency Antenna Array for use with Hurricane Imaging Radiometer; Complementary Barrier Infrared Detector (CBIRD) Contact Methods; Autonomous Control of Space Nuclear Reactors; High-Power, High-Speed Electro-Optic Pockels Cell Modulator; Covariance Analysis Tool (G-CAT) for Computing Ascent, Descent, and Landing Errors; Enigma Version 12; Micrometeoroid and Orbital Debris (MMOD) Shield Ballistic Limit Analysis Program; Spitzer Telemetry Processing System; Planetary Protection Bioburden Analysis Program; Wing Leading Edge RCC Rapid Response Damage Prediction Tool (IMPACT2); ISSM: Ice Sheet System Model; Automated Loads Analysis System (ATLAS); Integrated Main Propulsion System Performance Reconstruction Process/Models. Phoenix Telemetry Processor; Contact Graph Routing Enhancements Developed in ION for DTN; GFEChutes Lo-Fi; Advanced Strategic and Tactical Relay Request Management for the Mars Relay Operations Service; Software for Generating Troposphere Corrections for InSAR Using GPS and Weather Model Data; Ionospheric Specifications for SAR Interferometry (ISSI); Implementation of a Wavefront-Sensing Algorithm; Sally Ride EarthKAM - Automated Image Geo-Referencing Using Google Earth Web Plug-In; Trade Space Specification Tool (TSST) for Rapid Mission Architecture (Version 1.2); Acoustic Emission Analysis Applet (AEAA) Software; Memory-Efficient Onboard Rock Segmentation; Advanced Multimission Operations System (ATMO); Robot Sequencing and Visualization Program (RSVP); Automating Hyperspectral Data for Rapid Response in Volcanic Emergencies; Raster-Based Approach to Solar Pressure Modeling; Space Images for NASA JPL Android Version; Kinect Engineering with Learning (KEWL); Spacecraft 3D Augmented Reality Mobile App; MPST Software: grl_pef_check; Real-Time Multimission Event Notification System for Mars Relay; SIM_EXPLORE: Software for Directed Exploration of Complex Systems; Mobile Timekeeping Application Built on Reverse-Engineered JPL Infrastructure; Advanced Query and Data Mining Capabilities for MaROS; Jettison Engineering Trajectory Tool; MPST Software: grl_suppdoc; PredGuid+A: Orion Entry Guidance Modified for Aerocapture; Planning Coverage Campaigns for Mission Design and Analysis: CLASP for DESDynl; and Space Place Prime.

Source record↗

Telemedicine in Space Flight - Summary of a NASA Workshop

The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

Barsten, K. N.↗

Mishap Investigation Team (MIT) - Barksdale AFB, Louisiana

The Shuttle Program is organized to support a Shuttle mishap using the resources of the MIT. The afternoon of Feb. 1, 2003, the MIT deployed to Barksdale AFB. This location became the investigative center and interim storage location for crewmembers received from the Lufkin Disaster Field Office (DFO). Working under the leadership of the MIT Lead, the medical team executed a short-term plan that included search, recovery, and identification including coordination with the Armed Forces Institute of Pathology Temporary operations was set up at Barksdale Air Force Base for two weeks. During this time, coordination with the DFO field recovery teams, AFIP personnel, and the crew surgeons was on going. In addition, the crewmember families and NASA management were updated daily. The medical team also dealt with public reports and questions concerning biological and chemical hazards, which were coordinated with SPACEHAB, Inc., Kennedy Space Center (KSC) Medical Operations and the Johnson Space Center (JSC) Space Medicine office. After operations at Barksdale were concluded the medical team transitioned back to Houston and a long-term search, recovery and identification plan was developed.

Stepaniak, Philip↗

Evaluating Trauma Sonography for Operational Use in the Microgravity Environment

Sonography is the only medical imaging modality aboard the ISS, and is likely to remain the leading imaging modality in future human space flight programs. While trauma sonography (TS) has been well recognized for terrestrial trauma settings, the technique had to be evaluated for suitability in space flight prior to adopting it as an operational capability. The authors found the following four-phased evaluative approach applicable to this task: 1) identifying standard or novel terrestrial techniques for potential use in space medicine; 2) developing and testing these techniques with suggested modifications on the ground (1g) either in clinical settings or in animal models, as appropriate; 3) evaluating and refining the techniques in parabolic flight (0g); and 4) validating and implementing for clinical use in space. In Phase I of the TS project, expert opinion and literature review suggested TS to be a potential screening tool for trauma in space. In Phase II, animal models were developed and tested in ground studies, and clinical studies were carried out in collaborating trauma centers. In Phase III, animal models were flight-tested in the NASA KC-135 Reduced Gravity Laboratory. Preliminary results of the first three phases demonstrated potential clinical utility of TS in microgravity. Phase IV studies have begun to address crew training issues, on-board imaging protocols, and data transfer procedures necessary to offer the modified TS technique for space use.

Kirkpatrick, Andrew W.↗

The Near Earth Asteroid Medical Conditions List

Purpose: The Exploration Medical Capability (ExMC) element is one of six elements within NASA s Human Research Program (HRP) and is responsible for addressing the risk of "the inability to adequately recognize or treat an ill or injured crewmember" for exploration-class missions. The Near Earth Asteroid (NEA) Medical Conditions List, constructed by ExMC, is the first step in addressing the above-mentioned risk for the 13-month long NEA mission. The NEA mission is being designed by NASA's Human Space Flight Architecture Team (HAT). The purpose of the conditions list is to serve as an evidence-based foundation for determining which medical conditions could affect a crewmember during the NEA mission, which of those conditions would be of concern and require treatment, and for which conditions a gap in knowledge or technology development exists. This information is used to focus research efforts and technology development to ensure that the appropriate medical capabilities are available for exploration-class missions. Scope and Approach: The NEA Medical Conditions List is part of a broader Space Medicine Exploration Medical Conditions List (SMEMCL), which incorporates various exploration-class design reference missions (DRMs). The conditions list contains 85 medical conditions which could occur during space flight and which are derived from several sources: Long-Term Surveillance of Astronaut Health (LSAH) in-flight occurrence data, The Space Shuttle (STS) Medical Checklist, The International Space Station (ISS) Medical Checklist, and subject matter expert opinion. Each medical condition listed has been assigned a clinical priority and a clinical priority rationale based on incidence, consequence, and mitigation capability. Implementation: The conditions list is a "living document" and as such, new conditions can be added to the list, and the priority of conditions on the list can be adjusted as the DRM changes, and as screening, diagnosis, or treatment capabilities change. The NEA medical conditions list was used recently as the basis for identifying gaps in in-flight medical evaluation (screening) capabilities. Learning Objectives: The audience will become familiar with the approach taken by NASA's Exploration Medical Capability element in addressing the risk of inability to recognize and treat medical conditions in the setting of a Near Earth Asteroid mission. Which one of the following statements is incorrect? a) The Near Earth Asteroid (NEA) medical conditions list includes 85 medical conditions which could occur during space flight. b) Each condition on the NEA medical conditions list has been assigned a clinical priority and a clinical priority rationale. c) The NEA medical conditions list targets a mission to Mars. d) The NEA medical conditions list should be viewed as a "living document" where new conditions can be added and clinical priorities adjusted to address changes in the design reference mission or medical capabilities. The incorrect answer is c). The NEA medical conditions list targets a mission to a Near Earth Asteroid.

Barr, Yael R.↗

The Stratospheric Aerosol and Gas Experiment (SAGE) IV Pathfinder

Atmospheric aerosols and ozone are designated as observing system priorities in the 2017–2027 Decadal Survey report [1]. Accurate records of stratospheric aerosols are a vital piece of the puzzle regarding climate change. Stratospheric ozone has been the subject of observation and research for decades. Its importance is exhibited in the United States Clean Air Act [2], which mandates that NASA monitor atmospheric ozone. Measurements from satellites provided data on the initial decline of ozone in the late 1970s and early 1980s that supported the adoption of the Montreal Protocol, and current observations hint at a potential recovery. Adequate determination of that recovery requires continuous and, in the case of multiple instruments, overlapping data records. However, most current satellite systems are well beyond their expected lifetimes, and so we look towards the future of satellite observations of stratospheric ozone and aerosols to develop the Stratospheric Aerosol and Gas Experiment (SAGE) IV Pathfinder. Enabled by the NASA Earth Science Technology Office (ESTO)’s Instrument Incubator Program (IIP), the SAGE IV Pathfinder project has developed and validated a prototype demonstration that paves the way for a future SAGE IV spaceflight mission. Utilizing solar occultation imaging, SAGE IV will be capable of measuring ozone, aerosol, and other trace gas species with the same quality as previous SAGE instruments but with greatly improved pointing knowledge. Furthermore, current technological advancements allow SAGE IV to fit within a CubeSat framework and make use of commercial hardware, significantly reducing the size and cost when compared with traditional missions and enabling sustainability of future measurements. SAGE IV will meet the definition of the newly-recommended Venture-Continuity missions by “bringing forward innovative approaches to sustain measurements at lower costs”. The latest results from development of the SAGE IV Pathfinder are presented. [1] “Thriving on Our Changing Planet: A Decadal Strategy for Earth Observation from Space,” National Academies of Sciences, Engineering, and Medicine, 2018. [2] “United State Clean Air Act,” 42 U.S.C. 767 1b(d)(2).

Robert Damadeo↗