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Derivation of Capabilities and Resources for Treating Medical Conditions in Deep Space

BACKGROUND: Medical care in spaceflight requires the adaptation of terrestrial standards to the constraints of the space environment. However, there is often conflict between the ideal resources required for treatment and diagnosis of a medical condition, and the constraints on their mass, volume, data needs, etc. This optimization of trades between medical risk and resources will be a significant challenge for deep space medical system design. METHODS: A team of physicians with a broad range of expertise reviewed the 120 medical conditions on the condition list for NASA’s Informing Mission Planning via analysis of Complex Tradespaces Medical Database (IMPACT-MD). Each team member was assigned a subset of conditions based on their experience and training. The assigned physician generated a proposed list of capabilities, definitions, and resources required to treat each condition based on terrestrial practice guidelines, medical literature, and subject matter expertise. Additional specialists were consulted for conditions where expertise was not present within the main group. The proposed list was then reviewed by the broader team and modified as needed to achieve consensus. Each capability and resource was then assigned parameters to define quantity required per medical event, necessity, training level required, and primacy order of any alternative resources. These capabilities and resources were placed into condition specific tables and delivered to a team of engineers who added mass and volume data for each specific resource and converted the table into a database for use as input to a computational model to simulate spaceflight (IMPACT) DISCUSSION: This process ensures that a minimum of three subject matter experts review and agree upon the scope of practice, medical diagnostic tools, and treatment modalities that would be necessary to address emergent and non-emergent conditions that may arise during spaceflight to inform requirements during the vehicle design phase. The method is scalable to any design reference mission and permits modification of the existing database as information, conditions or experience are added. By including specialists, generalists, and those with subject matter expertise in the spaceflight environment on the team, we ensure that the included capabilities represent a realistic and actionable foundation for planning deep space missions.

D R Levin↗

Developing Mars-Based Clinical Scenarios for an Earth Independent Medical Operations (EIMO) – Based Decision Support Service

As crewed missions move beyond Low-Earth Orbit, pre-mission planning cannot fully buy down the medical risks of exploration-class missions. Martian missions, where increased hazards exist, (such as long-duration spaceflight, surface-level EVA operations, and communications delays) will require a paradigm shift in the structure of a medical system. An Earth-Independent Medical Operations-based Medical System (EIMO-MS) will need to optimize four critical domains to help provide medical care: utilization of Pre-Mission Planning, augmentation of Acute and Prolonged Medical Decision Making, automated tracking of Resource Management, and assistance in Task Load Balance. The ideal EIMO-MS will be able to accomplish this goal by having an interactive, adaptable interface that will be able to provide real-time medical services. It must respond based on the level of crewmember training, medical situation, and available medical and non-medical resources. To showcase the capabilities and requirements of such a sophisticated automated MS, a series of clinical scenarios of escalating complexity were developed with clinical and systems engineering input. These scenarios describe in clinical detail what a theoretical future medical system, enhanced with multiple information streams (such as a medical database, an AI-based Decision Support System, real-time monitoring, enhanced in-situ laboratory imaging, etc.) can achieve in conjunction with a trained and experienced crew. Scenarios are comprised of: a context section including objectives and applicable spaceflight environment, a highlighted assumptions section, a clinical narrative section, and a systems engineering activity diagram demonstrating the integrated Medical System (MS). The “swim lanes” of the activity diagram act as the logistical core of each scenario and show how the MS will interact with the crew, ground support, and other in-flight systems. The Design Reference Mission that is used for the scenarios is based on existing reference mission profiles [1] with a projected 30-sol stay on the Martian surface. Scenarios span the spectrum from planned evaluations, minor medical care, urgent care, surgical guidance, critical and expectant management, and behavioral health care. Mission complexity will exponentially increase during deep space and Mars exploration-class missions, and medical support for these missions will likewise need to increase in autonomy and adaptability. The integrated system that will support these missions will need to provide assistance in a variety of anticipated and unforeseen scenarios. These medical scenarios, guided by clinician input, are initial steps in crafting the requirements for an EIMO-based medical system. By working in a systems engineering framework, requirements and capabilities can be extracted and mapped while maintaining a clinical core.

Prashant Parmar↗

Probabilistic Modeling of the Renal Stone Formation Module

The Integrated Medical Model (IMM) is a probabilistic tool, used in mission planning decision making and medical systems risk assessments. The IMM project maintains a database of over 80 medical conditions that could occur during a spaceflight, documenting an incidence rate and end case scenarios for each. In some cases, where observational data are insufficient to adequately define the inflight medical risk, the IMM utilizes external probabilistic modules to model and estimate the event likelihoods. One such medical event of interest is an unpassed renal stone. Due to a high salt diet and high concentrations of calcium in the blood (due to bone depletion caused by unloading in the microgravity environment) astronauts are at a considerable elevated risk for developing renal calculi (nephrolithiasis) while in space. Lack of observed incidences of nephrolithiasis has led HRP to initiate the development of the Renal Stone Formation Module (RSFM) to create a probabilistic simulator capable of estimating the likelihood of symptomatic renal stone presentation in astronauts on exploration missions. The model consists of two major parts. The first is the probabilistic component, which utilizes probability distributions to assess the range of urine electrolyte parameters and a multivariate regression to transform estimated crystal density and size distributions to the likelihood of the presentation of nephrolithiasis symptoms. The second is a deterministic physical and chemical model of renal stone growth in the kidney developed by Kassemi et al. The probabilistic component of the renal stone model couples the input probability distributions describing the urine chemistry, astronaut physiology, and system parameters with the physical and chemical outputs and inputs to the deterministic stone growth model. These two parts of the model are necessary to capture the uncertainty in the likelihood estimate. The model will be driven by Monte Carlo simulations, continuously randomly sampling the probability distributions of the electrolyte concentrations and system parameters that are inputs into the deterministic model. The total urine chemistry concentrations are used to determine the urine chemistry activity using the Joint Expert Speciation System (JESS), a biochemistry model. Information used from JESS is then fed into the deterministic growth model. Outputs from JESS and the deterministic model are passed back to the probabilistic model where a multivariate regression is used to assess the likelihood of a stone forming and the likelihood of a stone requiring clinical intervention. The parameters used to determine to quantify these risks include: relative supersaturation (RS) of calcium oxalate, citrate/calcium ratio, crystal number density, total urine volume, pH, magnesium excretion, maximum stone width, and ureteral location. Methods and Validation: The RSFM is designed to perform a Monte Carlo simulation to generate probability distributions of clinically significant renal stones, as well as provide an associated uncertainty in the estimate. Initially, early versions will be used to test integration of the components and assess component validation and verification (V&V), with later versions used to address questions regarding design reference mission scenarios. Once integrated with the deterministic component, the credibility assessment of the integrated model will follow NASA STD 7009 requirements.

kidney stones↗

Human System Risk Management for Space Flight

This brief abstract reviews the development of the current day approach to human system risk management for space flight and the development of the critical components of this process over the past few years. The human system risk management process now provides a comprehensive assessment of each human system risk by design reference mission (DRM) and is evaluated not only for mission success but also for long‐term health impacts for the astronauts. The discipline of bioastronautics is the study of the biological and medical effects of space flight on humans. In 1997, the Space Life Sciences Directorate (SLSD) initiated the Bioastronautics Roadmap (Roadmap) as the "Critical Path Roadmap", and in 1998 participation in the roadmap was expanded to include the National Space Biomedical Research Institute (NSBRI) and the external community. A total of 55 risks and 250 questions were identified and prioritized and in 2000, the Roadmap was base-lined and put under configuration control. The Roadmap took into account several major advisory committee reviews including the Institute of Medicine (IOM) "Safe Passage: Astronaut care for Exploration Missions", 2001. Subsequently, three collaborating organizations at NASA HQ (Chief Health and Medical Officer, Office of Space Flight and Office of Biological & Physical Research), published the Bioastronautics Strategy in 2003, that identified the human as a "critical subsystem of space flight" and noted that "tolerance limits and safe operating bands must be established" to enable human space flight. These offices also requested a review by the IOM of the Roadmap and that review was published in October 2005 as "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap", that noted several strengths and weaknesses of the Roadmap and made several recommendations. In parallel with the development of the Roadmap, the Office of the Chief Health and Medical Officer (OCHMO) began a process in 2004 of evaluating the tolerance limits and safe operating bands called for in the Bioastronautics Strategy. Over the next several years, the concept of the "operating bands" were turned into Space Flight Human System Standards (SFHSS), developed by the technical resources of the SLSD at the NASA Johnson Space Center (JSC). These standards were developed and reviewed at the SLSD and then presented to the OCHMO for acceptance. The first set of standards was published in 2007 as the NASA‐STD‐3001, Volume 1, Crew Health that elaborated standards for several physiological areas such as cardiovascular, musculoskeletal, radiation exposure and nutrition. Volume 2, Human Factors, Habitability and Human Health was published in 2011, along with development guidance in the Human Integration Design Handbook (HIDH). Taken together, the SFHSS Volumes 1 and 2, and the HIDH replaced the NASA‐STD‐3000 with new standards and revisions of the older document. Three other changes were also taking place that facilitated the development of the human system risk management approach. In 2005, the life sciences research and development portfolio underwent a comprehensive review through the Exploration Systems Architecture Study (ESAS) that resulted in the reformulation of the Bioastronautics Program into Human Research Program (HRP) that was focused on appropriate mitigation results for high priority human health risks. The baseline HRP budget was established in August 2005. In addition, the OCHMO formulated the Health and Medical Technical Authority (HMTA) in 2006 that established the position of the Chief Medical Officer (CMO) at the NASA JSC along with other key technical disciplines, and the OCHMO became the responsible office for the SFHSS as noted above. The final change was the establishment in 2008 of the Human System Risk Board (HSRB), chaired by the CMO with representation from the HRP, SLSD management and technical experts. The HSRB then began to review all human system risks, established a comprehensive risk management and configuration management plan and data sharing policy. These major developments of standards, the HRP, the HMTA and a forum for review of human system risks (HSRB) facilitated the integration of human research, medical operations, systems engineering and many other disciplines in the comprehensive review of human system risks. The HSRB began a comprehensive review of all potential inflight medical conditions and events and over the course of several reviews consolidated the number of human system risks to 30 where the greatest emphasis is placed for investing program dollars for risk mitigation. The HSRB considers all available evidence from human research, medical operations and occupational surveillance in assessing the risks for appropriate mitigation and future work. All applicable DRMs (low earth orbit 6 and 12 months, deep space sortie for 30 days and 1 year, a one year lunar mission, and a planetary mission for 3 years) are considered as human system risks are modified by the hazards associated with space flight such as microgravity, exposure to radiation, distance from the earth, isolation and a closed environment. Each risk has a summary assessment representing the state of knowledge/evidence base for that risk, the available risk mitigations, traceability to the SFHSS and program requirements, and future work required. These data then can drive coordinated budgets across the HRP, the International Space Station, Crew Health and Safety and Advanced Exploration System budgets. These risk assessments were completed for 6 DRMs in December of 2014 and serve as the baseline for which subsequent research and technology development and crew health care portfolios can be assessed. The HSRB will review each risk at least annually and especially when new information is available that must be considered for effective risk mitigation. The current status of each risk can be reported to program management for operations, budget reviews and general oversight of the human system risk management program.

Davis, Jeffrey↗

Chromatic effects on the PSF and shear measurement for the Roman Space Telescope High-Latitude Wide Area Survey

Weak gravitational lensing (WL) is a key cosmological probe that requires precise measurement of galaxy images to infer shape distortions, or shear, and constrain cosmology. Accurate estimation of the point spread function (PSF) is crucial for shear measurement, but the wavelength dependence of the PSF introduces chromatic biases that can systematically impact shear inference. We focus on biases arising from spectral energy distribution (SED) differences between stars, used for PSF modelling, and galaxies, used for shear measurement. We investigate these effects in Roman’s four design reference mission WL bands (Y106, J129, H158, F184) and wide filter (W146). Using Roman-like image simulations, we quantify the induced shear biases and compare them to requirements on those biases. Multiplicative biases over all galaxies hover around ~0.2 per cent in the WL bands and 2 per cent in the wide filter, exceeding the mission requirement of |m| < 0.032 per cent and relaxed requirement of |m| < 0.1 per cent⁠. In individual redshift bins, biases can reach 0.4–0.9 per cent for the WL bands and 3–6 per cent for the wide filter. Additive biases remain acceptable in the WL bands but exceed systematic limits in the wide filter. We develop and test PSF-level corrections, showing that a first-order correction reduces biases within survey requirements for the WL bands; however, higher-order terms are necessary for the wide filter. Our results highlight the necessity of chromatic corrections for precision WL with Roman and provide a framework for mitigating these biases. Finally, we compare analytical colour-based corrections to self-organizing maps and find that both methods effectively reduce biases.

79 ASTRONOMY AND ASTROPHYSICS↗

Orbital lifetime capabilities of digital programs RMDAP and Monster

The orbital lifetime study capabilities of the Reference Mission Design and Analysis Program (RMDAP) and the Apollo Mission Planning and Real-Time Rendezvous Support Program (ARRS or Monster) were studied. Output and program versatility, that is, the methods with which each program permits user definition of the major factors affecting orbital lifetimes, are discussed. In addition, orbit maintenance is examined and sample runs are compared. Since each program has special capabilities in different areas, it is left to the investigator's discretion as to the preferable program to employ for his lifetime study purposes.

Source record↗

Satellite services system analysis study. Volume 2, part 2: Study results

The development of an effective satellite services system was investigated. Satek Satellite user market, design reference missions, satellite service functions, service equipment, and cost estimates are discussed. Extensive program plans for a satellite service system implementation are included.

Source record↗

Space platform accommodations

The results of studies performed at NASA of five space platform design reference missions (DRM) are presented. The DRM's were planned in an effort to eliminate problems, rather than to enhance optimization. A diagram of each payload is included, and the space platform concept is presented with the most important features being a continuous total power supply of 12.5 kW to the payloads at 30 and/or 120 Vdc regulated, a high-rate multiplexer with a total output of 48 Mbps, and and a thermal control system capable of dissipating the platform power output at payload fluid temperatures of 0 C to 3 C. Payload interface requirements were analyzed and appropriate integration hardware was added. Payload viewing characteristics are considered, and resource use is discussed. It is concluded that, in payload applications, efficient use of STS transportation and the platform must be considered.

Bailey, W.↗

Analysis of satellite servicing cost benefits

Under the auspices of NASA/JSC a methodology was developed to estimate the value of satellite servicing to the user community. Time and funding precluded the development of an exhaustive computer model; instead, the concept of Design Reference Missions was involved. In this approach, three space programs were analyzed for various levels of servicing. The programs selected fall into broad categories which include 80 to 90% of the missions planned between now and the end of the century. Of necessity, the extrapolation of the three program analyses to the user community as a whole depends on an average mission model and equivalency projections. The value of the estimated cost benefits based on this approach depends largely on how well the equivalency assumptions and the mission model match the real world. A careful definition of all assumptions permits the analysis to be extended to conditions beyond the scope of this study.

Builteman, H. O.↗

Satellite services system analysis study, part 3

The background, ground rules and assumptions, individual design reference mission results and total user benefit projection for the economic benefit analysis are discussed. Radiation protection, extravehicular activity (EVA) operational pressure, mobility effects, tool/glove/effects, anthropometric definition, EVA lighting, and equipment turnaround for the advanced extravehicular maneuvering unit are also discussed.

Source record↗

Lifting-body option for a Space Station rescue vehicle

With the proposed development of the Space Station Freedom, the need for an assured crew return capability (ACRC) has been identified. During the past 2 years within NASA, there has been an ongoing activity to establish the design requirements for such a vehicle and to identify candidate vehicle concepts that can satisfy these requirements. From this activity, three primary design reference missions and four candidate vehicle concepts have been identified. In support of this activity, the emphasis at Langley has been to assess the potential application of a lifting-body concept derived from work on the HL-10 and X-24 programs in the late sixties. A vehicle systems analysis has been completed including wind-tunnel tests, aerodynamic heating predictions, six-degree-of-freedom entry simulations, and a global landing opportunities assessment. This report summarizes the results of work at Langley over the past 2 years to define the candidate lifting-body ACRC vehicle and provides insight into potential benefits of the higher cross range of this concept in accomplishing the Space Station rescue mission.

Hook, W. Ray↗

Satellite Servicer System flight demonstration program

The major hardware elements, demonstration objectives, and technical approaches, as well as existing and developing technologies for applicability to the Satellite Servicer System (SSSFD) program are presented. In a project to develop the capability of servicing satellites in remote locations, NASA and SDI have planned a series of flights to demonstrate autonomous rendezvous and docking, supervised autonomous fluid transfer, and supervised autonomous orbital replacement unit exchange. Program objectives, design reference mission, and flight demonstrations are described. The expanded capability demonstrated by the SSSFD program will provide alternatives to excessive dependence on ground operations personnel and training, increase the reach into unique space environments, and decrease the costs of managing and operating space assets.

Moore, James S.↗

Operations influence on Space Station Freedom

The Space Station Freedom is the first experience for NASA and its international partners in building a spacecraft that will be operated and maintained over a multi-year lifetime and that will be permanently manned. To ensure it functions safely and effectively, the operations community has become involved much earlier than in previous U.S. programs. This involvement has taken the form of defining requirements and analyzing the configuration, systems, and elements in terms of operations suitability and supportability. This early participation has had many effects on the definition and design of the Freedom Station. Examples of operations participation include the development of various operations concepts, design reference missions, contingency operations scenarios, and assembly operations assessments.

Accola, Anne L.↗

Intelligent perturbation algorithms for space scheduling optimization

Intelligent perturbation algorithms for space scheduling optimization are presented in the form of the viewgraphs. The following subject areas are covered: optimization of planning, scheduling, and manifesting; searching a discrete configuration space; heuristic algorithms used for optimization; use of heuristic methods on a sample scheduling problem; intelligent perturbation algorithms are iterative refinement techniques; properties of a good iterative search operator; dispatching examples of intelligent perturbation algorithm and perturbation operator attributes; scheduling implementations using intelligent perturbation algorithms; major advances in scheduling capabilities; the prototype ISF (industrial Space Facility) experiment scheduler; optimized schedule (max revenue); multi-variable optimization; Space Station design reference mission scheduling; ISF-TDRSS command scheduling demonstration; and example task - communications check.

Kurtzman, Clifford R.↗

Mars exploration study workshop 2

A year-long NASA-wide study effort has led to the development of an innovative strategy for the human exploration of Mars. The latest Mars Exploration Study Workshop 2 advanced a design reference mission (DRM) that significantly reduces the perceived high costs, complex infrastructure, and long schedules associated with previous Mars scenarios. This surface-oriented philosophy emphasizes the development of high-leveraging surface technologies in lieu of concentrating exclusively on space transportation technologies and development strategies. As a result of the DRM's balanced approach to mission and crew risk, element commonality, and technology development, human missions to Mars can be accomplished without the need for complex assembly operations in low-Earth orbit. This report, which summarizes the Mars Exploration Study Workshop held at the Ames Research Center on May 24-25, 1993, provides an overview of the status of the Mars Exploration Study, material presented at the workshop, and discussions of open items being addressed by the study team. The workshop assembled three teams of experts to discuss cost, dual-use technology, and international involvement, and to generate a working group white paper addressing these issues. The three position papers which were generated are included in section three of this publication.

Duke, Michael B.↗

NGST: Exploring the Fossil Record of Galaxy Formation

During this grant period the investigator has accomplished the following: developed and researched the science case for high resolution optical imaging with NGST (Next Generation Space Telescope); presented to the ASWG (Ad-Hoc Science Working Group) on the use of NGST to image and measure the proper motions of white dwarf stars that could account for the MACHO events toward the LMC (Large Magellanic Cloud); wrote proposals for the Design Reference Mission. Three proposals have been written on the following topics: Measuring the faint end of the white dwarf luminosity function to get an independent measure of the age of the oldest stars, measurement of the stellar luminosity function over the full range of age, abundance, and population type, and deep imaging of Local Group halos to measure the relative ages of the oldest stars in the Milky Way and other galaxies; he has introduced simulations of crowded field stellar photometry on a hypothetical population in the M31 halo. Using a physically correct luminosity function and a surface brightness of 24.5 mag/sq. arcsec, NGST imaging in 10 hours easily measures the turnoff and reaches 3 mags down the main sequence in the halo of M31; and has delivered talks at the NGST workshop in Liege, and at the meeting in Paris entitled "Connecting the Distant Universe with the Local Fossil Record".

Rich, R. Michael↗

Aerodynamic Characteristics, Database Development and Flight Simulation of the X-34 Vehicle

An overview of the aerodynamic characteristics, development of the preflight aerodynamic database and flight simulation of the NASA/Orbital X-34 vehicle is presented in this paper. To develop the aerodynamic database, wind tunnel tests from subsonic to hypersonic Mach numbers including ground effect tests at low subsonic speeds were conducted in various facilities at the NASA Langley Research Center. Where wind tunnel test data was not available, engineering level analysis is used to fill the gaps in the database. Using this aerodynamic data, simulations have been performed for typical design reference missions of the X-34 vehicle.

Pamadi, Bandu N.↗

Aerodynamic Characteristics, Database Development and Flight Simulation of the X-34 Vehicle

An overview of the aerodynamic characteristics, development of the preflight aerodynamic database and flight simulation of the NASA/Orbital X-34 vehicle is presented in this paper. To develop the aerodynamic database, wind tunnel tests from subsonic to hypersonic Mach numbers including ground effect tests at low subsonic speeds were conducted in various facilities at the NASA Langley Research Center. Where wind tunnel test data was not available, engineering level analysis is used to fill the gaps in the database. Using this aerodynamic data, simulations have been performed for typical design reference missions of the X-34 vehicle.

Pamadi, Bandu N.↗