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At least 217 records · Page 12

Extravehicular Activity on the Lunar Surface: Mapping Mitigation Risk Consequence for Crew Needing Assistance or Rescue

The lunar environment offers unique challenges for human health and safety over the course of performing Extravehicular Activities (EVAs) during early Artemis missions. Driver medical conditions leading to an injured EVA crewmember needing assistance or rescue were analyzed and correlated to established, defined consequence categories. Catastrophic Drivers were identified, and three mitigation strategies were analyzed to determine if there was a potential change in consequence with their application. Risk consequence across the mitigations were compared with each other and the original risk without mitigations. Mitigations were further evaluated in a broader context with prospective preventions to understand the design and risk trade space associated with an early Artemis EVA.

Risk↗

Human Systems Risk Network - A Ranking Analysis of Risks

INTRODUCTION The Human Systems Risk Board (HSRB) is responsible for understanding, managing, and mitigating the risks associated with spaceflight. For a particular mission, the HSRB assigns each human system risk a rating on a 5x5 grid assessing its likelihood and consequence, which is ultimately used to compare and rank the risks. The HSRB approaches risk management by primarily establishing the context of each human system risk individually with the understanding that mitigating one risk might affect the likelihood, consequence, and mitigation approaches of another. To support this effort the HSRB, subject matter experts, and risk custodian teams created directed acyclic graphs (DAG), often called a causal graph, for the twenty-nine risks. In this presentation, we propose a new ranking algorithm for the risks which includes the downstream influence of each risk according to the information in the DAGs and provide an application of graph theoretic tools. METHODS In 2014, Mindock and Klaus proposed a taxonomy for human system risk influences which we have adopted to categorize the nodes in each DAG. Analyzing the nodes that correspond to the risks in this taxonomy allows us to analyze and understand how each risk influences the others. We construct an auxiliary network, which we call the Primary Risk Network (PRN), where the nodes are the twenty-nine space flight risks and, a directed edge connects Risk A to Risk B if Risk A has some influence on the likelihood or consequence of Risk B as described in the DAGS. We perform a variety of graph theoretic ranking methods on the nodes (or risks) in the PRN, including Katz centrality. RESULTS We rank the nodes in the PRN using the Katz centrality score. The ten risks with the highest score are pictured in Figure 1, colored (light to dark) according to their score. We analyze other centrality measures like betweenness centrality, eigenvector centrality, and the Estrada index, and provide the meaning of the corresponding rankings in terms of the risks. Future work includes analyzing the other categories in the taxonomy defined by Mindock and Klaus [1]. For example, we are interested in analyzing the nodes that are labeled as countermeasures or capabilities and perform similar analysis to measure their effect on certain medical conditions.

dag↗

Crew State and Risk Model (CSRM) - Medication Impacts on Physiologic Models for Exploration Class EVA Predictive Modeling and Operations

EVA and Environmental Physiology Laboratory (EEPL) wanted to expand upon the previous CSRM Physiologic Map to visually demonstrate the impact of medications on various modeling inputs that map to the seven physiologic models. It is acknowledged various physiologic states present during EVA could impact drug pharmacokinetics (i.e. pressure changes, core body temperature), which could impact pharmacodynamics. However, that is outside the scope of this document. The medications below represent the authors’ assumption of what medications will be available and able to impact an Artemis EVA and do not include the full ISS formulary, a final Artemis medical kit, or additional personal medications for individual crewmember’s chronic medical conditions.

Emma Ives↗

Exploration Medical Integrated Product Team Clinical Decision Support Market Survey

NASA’s Exploration Medical Integrated Product Team (XMIPT) has identified Clinical Decision Support (CDS) technology as a critical need for future human space exploration. Such technology will support real time diagnosis, monitoring, and treatment of spaceflight medical conditions. The need for such tools and support systems is critical for in-mission clinical decision-making, especially when Earth-based support is unavailable due to communication delays or blackouts. Supporting technologies may or may not involve Artificial Intelligence (AI), and would support astronaut crew with minimal clinical training, or even those with advanced training if they are, for example, in need of a refresher, experiencing multiple stressors, or temporarily overloaded with tasking. This need traces to the Development of Earth Independent Operations Technologies for NASA’s Mars Campaign Office. The CDS Market Survey purpose, methods, outcomes thus far, and near-term steps will be discussed.

Decision support↗

Medical Signal-Conditioning and Data-Interface System

A general-purpose portable, wearable electronic signal-conditioning and data-interface system is being developed for medical applications. The system can acquire multiple physiological signals (e.g., electrocardiographic, electroencephalographic, and electromyographic signals) from sensors on the wearer s body, digitize those signals that are received in analog form, preprocess the resulting data, and transmit the data to one or more remote location(s) via a radiocommunication link and/or the Internet. The system includes a computer running data-object-oriented software that can be programmed to configure the system to accept almost any analog or digital input signals from medical devices. The computing hardware and software implement a general-purpose data-routing-and-encapsulation architecture that supports tagging of input data and routing the data in a standardized way through the Internet and other modern packet-switching networks to one or more computer(s) for review by physicians. The architecture supports multiple-site buffering of data for redundancy and reliability, and supports both real-time and slower-than-real-time collection, routing, and viewing of signal data. Routing and viewing stations support insertion of automated analysis routines to aid in encoding, analysis, viewing, and diagnosis.

Braun, Jeffrey↗

Impact-Identified Medical Capabilities with Largest Effect on Medical Risk for an Extended Duration Artemis Mission

Historically, identifying resources to include in a medical system has been based on heuristically guided clinical subject matter expert assessment. Probabilistic risk assessment (PRA) and tradespace analysis have the power to simplify and increase the fidelity of this traditional approach by providing initial risk estimates and system design solutions that fit within the specified constraints. This will be especially important as the increased mission complexity, distance from Earth, and duration of LDEMs is likely to drive an increase in mission medical risk. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) is designed to do just that. IMPACT uses an evidence based medical database of conditions likely to affect LDEM outcomes and a PRA computational engine to estimate how medical conditions and included medical capabilities affect mission outcomes. We identified the 10 medical conditions with the largest effect on medical risks and determined what medical system capabilities affected risk reduction the greatest.

Anderson A↗

Assessing the Added Value of Miniature X-Ray in the Setting of Portable Ultrasound in Spaceflight

INTRODUCTION: Point-of-care ultrasound (POCUS) has become the standard of care for imaging diagnosis and management in low-Earth Orbit (LEO) spaceflight and it has long been hypothesized that POCUS will also be the standard of care for exploration spaceflight. However, like the trajectory for which ultrasound became more portable and user-friendly, the mass, volume, and power requirements of radiography devices for both diagnostic and therapeutic applications have also been dramatically reduced. This study seeks to determine the clinical utility and added value of miniature x-ray (XR) for the diagnosis and management of each of the 119 conditions within NASA Exploration Medical Capability’s IMPACT Condition List (ICL) given that the medical system is presumed to already be carrying a handheld portable POCUS device. METHODS: For each condition, a team of reviewers performed a rapid systematic literature review seeking sensitivity and specificity data for both handheld portable ultrasound and miniature XR. When there was a paucity of data, subject matter expertise and clinical experience was added to semi-quantitatively score the added value of miniature XR, given an US was already available for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated in the setting of both the best- and worst-case scenario definitions included and defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS/DISCUSSION: Conditions for which it was determined that miniature XR added diagnostic or therapeutic value are provided in this presentation. Previously presented work by our team has demonstrated that XR provides diagnostic and management capabilities that are hypothesized to complement or surpass ultrasound for over one-third of medical conditions that may arise during exploration spaceflight (i.e., diagnosis of injuries to the axial skeleton, teeth, and lungs as well as management of orthopedic reductions, endotracheal tube placement, and drain placement confirmation). In the setting of known inclusion of a handheld portable POCUS device, there remains significant added value of portable miniature XR. Whether or not this added clinical benefit is worth the mass, volume, and power requirements of the radiography system remains yet unknown and is the focus of future work. LEARNING OBJECTIVES: 1) Understand the value of ultrasound and radiography in the diagnosis and management of medical comorbidities that may arise in exploration spaceflight; 2) Understand the medical conditions of highest concern on exploration class missions for which miniature x-ray may provide added value to portable ultrasound.

J G Steller↗

Assessing the Added Value of Miniature X-Ray in the Setting of US in Spaceflight

INTRODUCTION: Point-of-care ultrasound (POCUS) has become the standard of care for imaging diagnosis and management in lowEarth Orbit (LEO) spaceflight and it has long been hypothesized that POCUS will also be the standard of care for exploration spaceflight. However, like the trajectory for which ultrasound became more portable and user-friendly, the mass, volume, and power requirements of radiography devices for both diagnostic and therapeutic applications have also been dramatically reduced. This study seeks to determine the clinical utility and added value of miniature x-ray (XR) for the diagnosis and management of each of the 119 conditions within NASA Exploration Medical Capability’s IMPACT Condition List (ICL) given that the medical system is presumed to already be carrying a handheld portable POCUS device. METHODS: For each condition, a team of reviewers performed a rapid systematic literature review seeking sensitivity and specificity data for both handheld portable ultrasound and miniature XR. When there was a paucity of data, subject matter expertise and clinical experience was added to semi-quantitatively score the added value of miniature XR, given an US was already available for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated in the setting of both the best- and worst-case scenario definitions included and defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS/DISCUSSION: Conditions for which it was determined that miniature XR added diagnostic or therapeutic value are provided in this presentation. Previously presented work by our team has demonstrated that XR provides diagnostic and management capabilities that are hypothesized to complement or surpass ultrasound for over one-third of medical conditions that may arise during exploration spaceflight (i.e., diagnosis of injuries to the axial skeleton, teeth, and lungs as well as management of orthopedic reductions, endotracheal tube placement, and drain placement confirmation). In the setting of known inclusion of a handheld portable POCUS device, there remains significant added value of portable miniature XR. Whether or not this added clinical benefit is worth the mass, volume, and power requirements of the radiography system remains yet unknown and is the focus of future work. LEARNING OBJECTIVES: 1) Understand the value of ultrasound and radiography in the diagnosis and management of medical comorbidities that may arise in exploration spaceflight; 2) Understand the medical conditions of highest concern on exploration class missions for which miniature x-ray may provide added value to portable ultrasound.

Jon Steller↗

Turning Limitations into Opportunities in the Development of the Orion Medical System: Incorporation of mHealth Devices

INTRODUCTION: Selection of medical devices for the Orion medical system is a complex task which is dependent on the current state of terrestrial technology. In this work we review the interplay between NASA requirements, constraints, and opportunities for synergy during the development of the Orion medical system. METHODS: The “plan to treat” list of conditions, and subsequently the medical resource list for the Orion Artemis II lunar flyby mission was completed using semi-quantitative methods. During this process, some medical resources were excluded to comply with mass and volume limits, while other resources applicable to multiple medical requirements were prioritized for inclusion. Choices were also examined considering NASA level of care standards for the Artemis design reference missions. As a means to optimize capabilities in spite of mass and volume constraints, ideas for integration of multiple devices into a single platform were explored, including a ‘hackathon’ challenge which was conducted to generate and evaluate concepts for combining medical devices into a single app-based mobile device (ultrasound, ECG, etc.). RESULTS: The Orion team identified 128 medical conditions that we “plan to treat”, with 139 unique medical resources to address these conditions, including 5 digital diagnostic devices (ECG, otoscope, stethoscope, pulse oximeter, and blood pressure monitor). During selection of these digital devices the team noted that miniaturized medical devices often use mobile device platforms (mHealth), some displaying and transmitting data exclusively via mobile device. Of the 5 initially selected devices, all are capable of mobile connection, one which cannot function without a mobile device (ECG). Furthermore, only one of these devices connects natively to a Windows platform, which is currently the only operating system available on Orion. DISCUSSION: Significant savings in mass and volume as well as training and usability improvements can be achieved by leveraging mHealth technologies. However, the platform presents significant challenges for deployment within the Artemis Program including lack of internet connectivity, incompatible operating systems, and radiation concerns. Each of these drawbacks are surmountable with investment in the supporting vehicle architecture, which may become necessary to support the technology trends seen in commercially available medical devices today. Objective: Learn about the opportunities and challenges of leveraging mHealth devices in the development of medical capabilities for austere environments. Learn about the constraints of the NASA spaceflight environment with regards to digital medical device integration.

Douglas Ebert↗

Women's Health Issues in the Space Environment

Women have been an integral part of US space crews since Sally Ride's mission in 1983, and a total of 40 women have been selected as US astronauts. The first Russian female cosmonaut flew in 1963. This presentation examines the health care and reproductive aspects of flying women in space. In addition, the reproductive implications of delaying one's childbearing for an astronaut career and the impact of new technology such as assisted reproductive techniques are examined. The reproductive outcomes of the US female astronauts who have become pregnant following space flight exposure are also presented. Since women have gained considerable operational experience on the Shuttle, Mir and during EVA, the unique operational considerations for preflight certification, menstruation control and hygiene, contraception, and urination are discussed. Medical and surgical implications for women on long-duration missions to remote locations are still evolving, and enabling technologies for health care delivery are being developed. There has been considerable progress in the development of microgravity surgical techniques, including laparoscopy, thoracoscopy, and laparotomy. The concepts of prevention of illness, conversion of surgical conditions to medically treatable conditions and surgical intervention for women on long duration space flights are considered.

Jennings, Richard T.↗

Exploration Medical System Demonstration Project

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide better crew health via the reduction in crew errors, crew time, and ground time.

Chin, D. A.↗

The Pathway to a Safe and Effective Medication Formulary for Exploration Spaceflight

PURPOSE: Exploration space missions pose several challenges to providing a comprehensive medication formulary designed to accommodate the size and space limitations of the spacecraft; while addressing the individual medications needs and preferences of the Crew; the negative outcome of a degrading inventory over time, the inability to resupply before expiration dates; and the need to properly forecast the best possible medication candidates to treat conditions that will occur in the future. METHODS: The Pharmacotherapeutics Discipline has partnered with the Exploration Medical Capabilities (ExMC) Element to develop and propose a research pathway that is comprehensively focused on evidence-based models and theories, as well as on new diagnostic tools and treatments or preventive measures aimed at closure of the Med02 “Pharmacy” Gap; defined in the Human Research Program’s (HRP) risk-based research strategy. The Med02 Gap promotes the challenge to identify a strategy to ensure that medications used to treat medical conditions during exploration space missions are available, safe, and effective. It is abundantly clear that pharmaceutical intervention is an essential component of risk management planning for astronaut healthcare during exploration space. However, the quandary still remains of how to assemble a formulary that is comprehensive enough to prevent or treat anticipated medical events; and is also chemically stable, safe, and robust enough to have sufficient potency to last for the duration of an exploration space mission. In cases where that is not possible, addressing this Gap requires exploration of novel drug development techniques, dosage forms, and dosage delivery platforms that enhance chemical stability as well as therapeutic effectiveness. RESULTS: The proposed research pathway outlines the steps, processes, procedures, and a research portfolio aimed at identifying a capability that will provide a safe and effective pharmacy for any specific exploration Design Reference Mission (DRM). The proposed approach to building this research portfolio is to seek research projects that concentrate on four major focus areas; (1) Formulary selection, (2) Formulary potency and shelf life, (3) Formulary safety and toxicity, and (4) Novel technology and innovation such as portable real-time chemical analysis innovative drug therapies and dosage and delivery platforms. CONCLUSION: The research pathway has been completed and presented to the HRP. In spring 2017, it is scheduled to be reviewed by a panel of pharmaceutical and clinical experts that will evaluate the scientific merit and operational feasibility of the research pathway, as well as make suggestions for any warranted additions or improvements. Once finalized, the ExMC Element will proceed with the execution of this research pathway with the goal of gathering as much data, and learning as much as possible, to provide a safe and effective pharmaceutical formulary for use during exploration missions.

Daniels, V. R.↗

CLINICAL DECISION SUPPORT: PATH TO FUNCTIONAL REQUIREMENTS

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. To augment the requisite knowledge, skills and abilities (KSAs) of a time-constrained crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance this decade and beyond. Hence, data, software and computational resources will play an essential and synergistic role in maintaining crew health, wellness and performance in deep space missions. The focus of the CDS project is to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance and medical care during exploration missions. The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/databases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.

clinical decision support↗

Clinical Decision Support: Path to Functional Requirements

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. To augment the requisite knowledge, skills and abilities (KSAs) of a time-constrained crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance this decade and beyond. Hence, data, software and computational resources will play an essential and synergistic role in maintaining crew health, wellness and performance in deep space missions. The focus of the CDS project is to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance and medical care during exploration missions. The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/databases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.

Clinical decision support↗

Quantifying the Sensitivity of Condition Incidence Parameters in the Evidence Library

One approach to quantifying spaceflight risk at NASA makes use event driven probabilistic techniques. The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) is such a tool that estimates medical risk metrics via simulation and enables optimization of medical resources subject to mission constraints [1]. Previous analyses have informed medical set composition, exercise countermeasures, and water intake, where each analysis quantifies the risk associated with proposed variations in system design. As future mission profiles extend beyond Low-Earth Orbit (LEO) and lengthen in duration, understanding these risks and contributing factors is critical. MEDPRAT employs Monte Carlo sampling techniques to simulate missions and track the occurrence of medical events. These events follow fault-tree-like progressions through levels of severity and mitigation via medical treatment to many possible outcomes and these are reported throughout the mission. Making this possible, are the medical databases that contain evidence gathered by the Human Research Program (HRP). Quantifying the impact of uncertainty or variability in the input data is an important step in evaluating the credibility of modeling and simulation results. In this work, we investigate the sensitivity of medical risk metrics with respect to the condition incidence parameters within the Evidence Library (EL) [2] as the medical database input for MEDPRAT. The medical conditions, contained in the EL, are equipped with incidence rates that describe the likelihood that the condition will occur. These incidence rates reflect historical spaceflight data or when appropriate, terrestrial data. In this presentation, we will explore how uncertainty in these rates propagate to the medical risk described by MEDPRAT. These results identify the conditions and parameters with the largest contribution to medical risks.

Ian Lim↗

The “Hole” Story in Ionized Water from the Perspective of Ehrenfest Dynamics

The radiolysis of liquid water and the radiation-matter interactions that happen in aqueous environments are important to the elds of chemistry, materials, and environmental sciences, as well as biological and physiological response to extreme conditions and medical treatments. The initial stage of radiolysis is the ultrafast response, or hole dynamics, that trigger chemical processes within complex energetic landscapes that may include reactivity. A fundamental understanding necessitates the use of theoretical methods that are capable of simulating both ultrafast coherence and non-adiabatic energy transfer pathways. In this work, we carry out an ab initio Ehrenfest dynamic study in order to provide a more complete description of the ultrafast dynamics and reactive events initiated by photoionization of water. Furthermore, after sudden ionization, the range of processes that include hole trapping and transfer, large OH oscillations, proton transfer and subsequent relay, formation of the metastable Zundel complex, and long-lived coherence, are identied and new insight into their driving forces are elucidated.

37 INORGANIC, ORGANIC, PHYSICAL, AND ANALYTICAL CH↗

Soyuz-TM-based interim Assured Crew Return Vehicle (ACRV) for the Space Station Freedom

The concept of using the available Soyuz-TM Assured Crew Return Vehicle (ACRV) spacecraft for the assurance of the safety of the Space Station Freedom (SSF) crew after the departure of the Space Shuttle from SSF was proposed by the NPO Energia and was accepted by NASA in 1992. The ACRV will provide the crew with the capability to evacuate a seriously injured/ill crewmember from the SSF to a ground-based care facility under medically tolerable conditions and with the capability for a safe evacuation from SSF in the events SSF becomes uninhabitable or the Space Shuttle flights are interrupted for a time that exceeds SSF ability for crew support and/or safe operations. This paper presents the main results of studies on Phase A (including studies on the service life of ACRV; spacecraft design and operations; prelaunch processing; mission support; safety, reliability, maintenance and quality and assurance; landing, and search/rescue operations; interfaces with the SSF and with Space Shuttle; crew accommodation; motion of orbital an service modules; and ACRV injection by the Expendable Launch Vehicles), along with the objectives of further work on the Phase B.

Yu P Semenov↗