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NASA NTRS2016

Management of Asymptomatic Renal Stones in Astronauts

Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain significance. However, a small asymptomatic MRM or stone within the renal collecting system may become symptomatic, and so affect launch and flight schedules, cause incapacitation during flight, and ultimately require medical evacuation. For exploration class missions, evacuation is unlikely. The new screening and management algorithm allows better management of mission risks, and will define the true incidence of renal stones in U.S. astronauts. This information will be used to refine future screening, countermeasures and treatment methods; and will also inform the needed capabilities to be flown on exploration-class missions.

Reyes, David↗
NASA NTRS2016

Management of Asymptomatic Renal Stones in Astronauts

Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain significance. However, a small asymptomatic MRM or stone within the renal collecting system may become symptomatic, and so affect launch and flight schedules, cause incapacitation during flight, and ultimately require medical evacuation. For exploration class missions, evacuation is unlikely. The new screening and management algorithm allows better management of mission risks, and will define the true incidence of renal stones in U.S. astronauts. This information will be used to refine future screening, countermeasures and treatment methods; and will also inform the needed capabilities to be flown on exploration-class missions.

Reyes, David↗
NASA NTRS2008

Web Based Tool for Mission Operations Scenarios

A conventional practice for spaceflight projects is to document scenarios in a monolithic Operations Concept document. Such documents can be hundreds of pages long and may require laborious updates. Software development practice utilizes scenarios in the form of smaller, individual use cases, which are often structured and managed using UML. We have developed a process and a web-based scenario tool that utilizes a similar philosophy of smaller, more compact scenarios (but avoids the formality of UML). The need for a scenario process and tool became apparent during the authors' work on a large astrophysics mission. It was noted that every phase of the Mission (e.g., formulation, design, verification and validation, and operations) looked back to scenarios to assess completeness of requirements and design. It was also noted that terminology needed to be clarified and structured to assure communication across all levels of the project. Attempts to manage, communicate, and evolve scenarios at all levels of a project using conventional tools (e.g., Excel) and methods (Scenario Working Group meetings) were not effective given limitations on budget and staffing. The objective of this paper is to document the scenario process and tool created to offer projects a low-cost capability to create, communicate, manage, and evolve scenarios throughout project development. The process and tool have the further benefit of allowing the association of requirements with particular scenarios, establishing and viewing relationships between higher- and lower-level scenarios, and the ability to place all scenarios in a shared context. The resulting structured set of scenarios is widely visible (using a web browser), easily updated, and can be searched according to various criteria including the level (e.g., Project, System, and Team) and Mission Phase. Scenarios are maintained in a web-accessible environment that provides a structured set of scenario fields and allows for maximum visibility across the project. One key aspect is that the tool was built for a scenario process that accounts for stakeholder input, review, comment, and concurrence. By creating well-designed opportunities for stakeholder input and concurrence and by making the scenario content easily accessible to all project personnel, we maximize the opportunities for stakeholders to both understand and agree on the concepts for how their mission is to be carried out.

Boyles, Carole A.↗
NASA NTRS2014

Behavioral Health and Performance at NASA JSC: Recent Successes and Future Plan for BHP Research and Operations

The Behavioral Health and Performance discipline at NASA Johnson Space Center is organized into two distinct Divisions (Biomedical Research and Environmental Science Division and Space and Clinical Operations Division) but is integrated and interrelated in its day‐to‐day work. Ongoing operations supporting NASA's spaceflight goals benefit from the research portfolios that address risks to mission success. Similarly, these research portfolios are informed by operations to ensure investigations stay relevant given the dynamic environment of spaceflight. There are many success stories that can be presented where initial work begun as a BHP Research project, and funded through the Human Research Program, was fully implemented in operations or addressed an operational need. Examples include improving effectiveness of the debriefings used within Mission Control by the Mission Operations Directorate and countermeasures for fatigue management. There is also ongoing collaboration with research and operations for developing selection methods for future generation astronauts, and to enhance and inform the current family support function. The objective of this panel is to provide examples of recent success stories, describe areas where close collaboration is benefitting ongoing research and operations, and summarize how this will come together as NASA plans for the one year ISS mission - a unique opportunity for both BHP operations and research to learn more about preparing and supporting crewmembers for extended missions in space. The proposed panel will be comprised of six presentations, each describing a unique aspect of research or operations and the benefits to current and future spaceflight.

Leveton, L. B.↗
NASA NTRS2024

Autonomous Medical Officer Support (AMOS) Software Technology Demonstrations on the International Space Station (ISS)

Performance of medical procedures in spaceflight beyond low Earth orbit (LEO) requires novel solutions to replace real-time ground support because as distance from Earth increases, communication latencies increase, hampering remote guidance. The Autonomous Medical Officer Support Software (AMOS) Technology Demonstrations on the International Space Station (ISS) trialed a novel software tool that shifts the emphasis from preflight training and real-time remote guidance (current ISS paradigm) to a new standard of multi-dimensional in-flight just-in-time (JIT) instruction. The AMOS platform is a skill management tool for all mission phases and currently features comprehensive training and guidance modules for urinary bladder and renal ultrasound examinations. Variability in Subject anatomy, Operator experience, and Operator receptiveness to instruction during autonomous exams are persistent but manageable limitations. Here we report the first successful demonstrations of autonomous imaging activities in the operational setting of spaceflight, validating this autonomous guidance proof of concept.

Douglas Ebert↗
NASA NTRS2009

Spaceflight Systems Training: A Comparison and Contrasting of Techniques for Training Ground Operators and Onboard Crewmembers

When developing techniques and products for instruction on manned spaceflight systems, training organizations are often faced with two very different customers: ground operators and onboard crewmembers. Frequently, instructional development focuses on one of these customers with the assumption that the other s needs will be met by default. Experience teaches us that differing approaches are required when developing training tailored to the specific needs of each customer. As a rule, ground operators require focused instruction on specific areas of expertise. Their knowledge should be of the details of the hardware, software, and operational techniques associated with that system. They often benefit from historical knowledge of how their system has operated over its lifetime. Since several different ground operators may be interfacing with the same system, each individual operator must understand the agreed-to principles by which that system will be run. In contrast, onboard crewmembers require a more broad, hands-on awareness of their operational environment. Their training should be developed with an understanding of the physical environment in which they live and work and the day-to-day tasks they are most likely to perform. Rarely do they require a deep understanding of the details of a system; it is often sufficient to teach them just enough to maintain situational awareness and perform basic tasks associated with maintenance and operation of onboard systems. Crewmembers may also develop unique onboard operational techniques that differ from preceding crews. They should be taught what flexibility they have in systems operations and how their specific habits can be communicated to ground support personnel. This paper will explore the techniques that can be employed when developing training for these unique customers. We will explore the history of International Space Station training development and how past efforts can guide us in creating training for users of future manned spaceflight efforts.

Balmain, Clinton↗
NASA NTRS1997

On-Orbit Measurement of the Superconductive Transition Temperatures of YBa2Cu3O(7-x) Thick Films

Thick film superconductors were integrated into hybrid circuits and tested in the Materials In Devices As Superconductors (MIDAS) spaceflight experiment which operated autonomously aboard the MIR space station for 90 days. MIDAS was designed to cool the circuits from 300 to 75K, maintain the temperature at 75K for 28 days, and warm the circuits back to 300K. This cycle was performed a total of three times, during which the superconductive transition temperature was measured during each cool-down and warm-up portion of the experiment. All of the thick films used in this experiment exhibited superconductive transition temperatures of approximately 87K, and no significant differences in the resistance versus temperature properties of the materials were observed among the data collected during pre-flight, flight, and post-flight operations.

Hooker, Matthew W.↗
NASA NTRS2001

Proceedings from the 2001 NASA Occupational Health Conference: Risk Assessment and Management in 2001

This Conference convened approximately 86 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Two days' Professional Development Courses on Exposure Assessment Strategies and Statistics and on Advanced Cardiac Life Support training and recertification preceded the Conference. With the theme, 'Risk Assessment and Management in 2001,' conferees were first provided updates from the Program Principal Center Office and the Headquarters Office. Plenary sessions elaborated on several topics: biological terrorism, OSHA recordability, Workers' Compensation issues, Federal ergonomic standards, bridging aerospace medicine and occupational health-especially in management of risk in spaceflight, and EAP operations with mission failures. A keynote address dealt with resiliency skills for 21st century workers and two NASA astronaut speakers highlighted a tour of the Johnson Space Center. During discipline specific breakout sessions, current issues in occupational health management and policy, credentialing and privileging, health risk assessment, measurement and standardization, audits, database development, prevention and rehabilitation, international travel and infection control, employee assistance, nursing process, and environmental health were presented.

Roberson, Sheri↗
NASA NTRS2011

Building a Shared Definitional Model of Long Duration Human Spaceflight

In 1956, on the eve of human space travel Strughold first proposed a simple classification of the present and future stages of manned flight that identified key factors, risks and developmental stages for the evolutionary journey ahead. As we look to optimize the potential of the ISS as a gateway to new destinations, we need a current shared working definitional model of long duration human space flight to help guide our path. Initial search of formal and grey literature augmented by liaison with subject matter experts. Search strategy focused on both the use of term long duration mission and long duration spaceflight, and also broader related current and historical definitions and classification models of spaceflight. The related sea and air travel literature was also subsequently explored with a view to identifying analogous models or classification systems. There are multiple different definitions and classification systems for spaceflight including phase and type of mission, craft and payload and related risk management models. However the frequently used concepts of long duration mission and long duration spaceflight are infrequently operationally defined by authors, and no commonly referenced classical or gold standard definition or model of these terms emerged from the search. The categorization (Cat) system for sailing was found to be of potential analogous utility, with its focus on understanding the need for crew and craft autonomy at various levels of potential adversity and inability to gain outside support or return to a safe location, due to factors of time, distance and location.

Orr, M.↗
NASA NTRS2012

A Proposed Strategy for the U.S. to Develop and Maintain a Mainstream Capability Suite ("Warehouse") for Automated/Autonomous Rendezvous and Docking in Low Earth Orbit and Beyond

The ability of space assets to rendezvous and dock/capture/berth is a fundamental enabler for numerous classes of NASA fs missions, and is therefore an essential capability for the future of NASA. Mission classes include: ISS crew rotation, crewed exploration beyond low-Earth-orbit (LEO), on-orbit assembly, ISS cargo supply, crewed satellite servicing, robotic satellite servicing / debris mitigation, robotic sample return, and robotic small body (e.g. near-Earth object, NEO) proximity operations. For a variety of reasons to be described, NASA programs requiring Automated/Autonomous Rendezvous and Docking/Capture/Berthing (AR&D) capabilities are currently spending an order-of-magnitude more than necessary and taking twice as long as necessary to achieve their AR&D capability, "reinventing the wheel" for each program, and have fallen behind all of our foreign counterparts in AR&D technology (especially autonomy) in the process. To ensure future missions' reliability and crew safety (when applicable), to achieve the noted cost and schedule savings by eliminate costs of continually "reinventing the wheel ", the NASA AR&D Community of Practice (CoP) recommends NASA develop an AR&D Warehouse, detailed herein, which does not exist today. The term "warehouse" is used herein to refer to a toolbox or capability suite that has pre-integrated selectable supply-chain hardware and reusable software components that are considered ready-to-fly, low-risk, reliable, versatile, scalable, cost-effective, architecture and destination independent, that can be confidently utilized operationally on human spaceflight and robotic vehicles over a variety of mission classes and design reference missions, especially beyond LEO. The CoP also believes that it is imperative that NASA coordinate and integrate all current and proposed technology development activities into a cohesive cross-Agency strategy to produce and utilize this AR&D warehouse. An initial estimate indicates that if NASA strategically coordinates the development of a robust AR&D capability across the Agency, the cost of implementing AR&D on a spacecraft could be reduced from roughly $70M per mission to as low as $7M per mission, and the associated development time could be reduced from 4 years to 2 years, after the warehouse is completely developed. Table 1 shows the clear long-term benefits to the Agency in term of costs and schedules for various missions. (The methods used to arrive at the Table 1 numbers is presented in Appendices A and B.)

Krishnakumar, Kalmanje S.↗
NASA NTRS2014

Monitoring for Renal Stone Recurrence in Astronauts With History of Stone

After an initial stone episode persons are at increased risk for future stone formation. A systematic approach is required to monitor the efficacy of treatment and preventive measures, and to assess the risk of developing new stones. This is important for persons working in critical jobs or austere environments, such as astronauts. A literature review of the current standards of care for renal stone monitoring and imaging was done. Military and civil aviation standards were also reviewed, as well as the medical precedents from the space program. Additionally, a new, more effective, renal stone ultrasound protocol has been developed. Using this work, a monitoring algorithm was proposed that takes into consideration the unique mission and operational environment of spaceflight. The approach to imaging persons with history of renal stones varies widely in the literature. Imaging is often done yearly or biannually, which may be too long for mission critical personnel. In the proposed algorithm astronauts with a history of renal stone, who may be under consideration for assignment, are imaged by a detailed, physiciandriven, ultrasound protocol. Unassigned personnel are monitored by yearly ultrasound and urine studies. Any positive ultrasound study is then followed by low-dose renal computed tomography scan. Other criteria are also established. The proposed algorithm provides a balanced approach between efficacy and reduced radiation exposure for the monitoring of astronauts with a renal stone history. This may eventually allow a transition from a risk-averse, to a risk-modifying approach that can enable continued service of individuals with history of renal stone that have adequately controlled risk factors.

Reyes, David P.↗
NASA NTRS2015

Using Empirical Models for Communication Prediction of Spacecraft

A viable communication path to a spacecraft is vital for its successful operation. For human spaceflight, a reliable and predictable communication link between the spacecraft and the ground is essential not only for the safety of the vehicle and the success of the mission, but for the safety of the humans on board as well. However, analytical models of these communication links are challenged by unique characteristics of space and the vehicle itself. For example, effects of radio frequency during high energy solar events while traveling through a solar array of a spacecraft can be difficult to model, and thus to predict. This presentation covers the use of empirical methods of communication link predictions, using the International Space Station (ISS) and its associated historical data as the verification platform and test bed. These empirical methods can then be incorporated into communication prediction and automation tools for the ISS in order to better understand the quality of the communication path given a myriad of variables, including solar array positions, line of site to satellites, position of the sun, and other dynamic structures on the outside of the ISS. The image on the left below show the current analytical model of one of the communication systems on the ISS. The image on the right shows a rudimentary empirical model of the same system based on historical archived data from the ISS.

Quasny, Todd↗
NASA NTRS2016

Options for Staging Orbits in Cis-Lunar Space

NASA has been studying options to conduct missions beyond Low Earth Orbit, but within the Earth‐Moon system, in preparation for deep space exploration including human missions to Mars. Referred to as the Proving Ground, this arena of exploration activities will enable the development of human spaceflight systems and operations to satisfy future exploration objectives beyond the cis‐lunar environment. One option being considered includes the deployment of a habitable element or elements, which could be used as a central location for aggregation of supplies and resources for human missions in cis‐lunar space and beyond. Characterizing candidate orbit locations for this asset and the impacts on system design and mission operations is important in the overall assessment of the options being considered. The orbits described in this paper were initially selected by taking advantage of previous studies conducted by NASA and the work of other authors. In this paper orbits are assessed for their relative attractiveness based on various factors. A set of constraints related to the capability of the combined Orion and SLS system to deliver humans and cargo to and from the orbit are evaluated. Deployed assets intended to spend multiple years in the Proving Ground would ideally require minimal station keeping costs to reduce the mass budget allocated to this function. Additional mission design drivers include eclipse frequency, potential for uninterrupted communication with deployed assets, thermal, attitude control, communications, and other operational implications. Also the ability to support potential lunar surface activities and excursion missions beyond Earth‐Moon space is considered. The results of the characterization and evaluation of the selected orbits indicate a Near Rectilinear Orbit (NRO) is an attractive candidate as an aggregation point or staging location for operations. In this paper, the NRO is further described in terms which balance a number of key attributes that favor a variety of mission classes to meet multiple, sometimes competing, constraints.

Martinez, Roland↗
NASA NTRS2015

Options for Staging Orbits in Cis-Lunar Space

NASA has been studying options to conduct missions beyond Low Earth Orbit, but within the Earth-Moon system, in preparation for deep space exploration including human missions to Mars. Referred to as the Proving Ground, this arena of exploration activities will enable the development of human spaceflight systems and operations to satisfy future exploration objectives beyond the cis-lunar environment. One option being considered includes the deployment of a habitable element or elements, which could be used as a central location for aggregation of supplies and resources for human missions in cis-lunar space and beyond. Characterizing candidate orbit locations for this asset and the impacts on system design and mission operations is important in the overall assessment of the options being considered. The orbits described in this paper were initially selected by taking advantage of previous studies conducted by NASA and the work of other authors. In this paper orbits are assessed for their relative attractiveness based on various factors. First, a set of constraints related to the capability of the combined Orion and SLS system to deliver humans and cargo to and from the orbit are evaluated. Second, the ability to support potential lunar surface activities is considered. Finally, deployed assets intended to spend multiple years in the Proving Ground would ideally require minimal station keeping costs to reduce the mass budget allocated to this function. Additional mission design drivers include potential for uninterrupted communication with deployed assets, thermal, communications, and other operational implications. The results of the characterization and evaluation of the selected orbits indicate a Near Rectilinear Orbit (NRO) is an attractive candidate as an aggregation point or staging location for operations. In this paper, the NRO is further described in terms which balance a number of key attributes that favor a variety of mission classes to meet multiple, sometimes competing, constraints.

Whitley, Ryan↗
NASA NTRSDate not supplied

End-to-End Mission Design & Trajectory Optimization

The ability to compute end-to-end mission optimized trajectories is a critical component needed for the next generation of complex human spaceflight design and operations (Orion, HLS, Gateway, Mars). This project created a new interface for two of NASA’s trajectory tools: Copernicus and Genesis, enabling them to be used together for end-to-end mission design and optimization of all flight phases, including Earth ascent, lunar ascent, rendezvous, and lunar descent. This capability can also serve as a pathfinder for developing a future autonomous, onboard trajectory optimizer.

Software↗
NASA NTRS2023

Executive Summary for CIF22 Project: End-to-End Mission Design & Trajectory Optimization

The goal of this project was the integration of NASA's Copernicus and Genesis trajectory design tools to create a new capability for end-to-end mission design and optimization of all flight phases, including Earth ascent, lunar ascent, rendezvous, and lunar descent. This capability is a critical component needed for the next generation of complex human spaceflight design and operations (Orion, HLS, Gateway, Mars) and can serve as a pathfinder for developing a future autonomous, onboard trajectory optimizer. The result was the creation of a new Copernicus/Genesis plugin, which allows a Genesis trajectory (e.g., ascent or descent) to be incorporated into a Copernicus mission, enabling an end-to-end optimization. Inputs from Copernicus are sent to Genesis, which runs and produces output sent back to Copernicus. Thus, the full power of the Genesis tool is available in Copernicus and can be used for a wide variety of applications.

Jacob Williams↗
NASA NTRSDate not supplied

End-to-End Mission Design & Trajectory Optimization

The ability to compute end-to-end mission optimized trajectories is a critical component needed for the next generation of complex human spaceflight design and operations (Orion, HLS, Gateway, Mars). This project created a new interface for two of NASA’s trajectory tools: Copernicus and Genesis, enabling them to be used together for end-to-end mission design and optimization of all flight phases, including Earth ascent, lunar ascent, rendezvous, and lunar descent. This capability can also serve as a pathfinder for developing a future autonomous, onboard trajectory optimizer.

Software↗