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Application of information theory to eliminate redundant part of electrocardiogram or vectorcardiogram is described. Operation of medical equipment to obtain three dimensional study of patient is discussed. Use of fast Fourier transform to accomplish data compression is explained.
Livability aboard the space shuttle orbiter makes it possible for men and women scientists and technicians in reasonably good health to join superbly healthy astronauts as space travelers and workers. Features of the flight deck, the mid-deck living quarters, and the subfloor life support and house-keeping equipment are illustrated as well as the provisions for food preparation, eating, sleeping, exercising, and medical care. Operation of the personal hygiene equipment and of the air revitalization system for maintaining sea level atmosphere in space is described. Capabilities of Spacelab, the purpose and use of the remote manipulator arm, and the design of a permanent space operations center assembled on-orbit by shuttle personnel are also depicted.
The NASA Lewis Research Center in cooperation with the World Health Organization, U.S.A. I.D., the Pan American Health Organization and national government agencies in some developing countries sponsored the installation of twenty photovoltaic powered medical vaccine storage refrigerator-freezer (R/F) systems. The Solar Power Corporation was selected as the contractor to perform the design, development and installation of these twenty units. Solar Power's experiences are described herein.
Ground-based research and reevaluation of flight data is currently in progress in order to develop suitable and operationally acceptable medical standards for extended-duration manned space missions. The large amount of data obtained thus far constitutes a unique data base representative of the astronaut population. In this paper, preliminary 10-year findings of prospective studies established in 1977 are described, and results obtained from retrospective studies conducted on data accumulated prior to the 1977 establishment of medical selection standards are summarized.
A field study of an operational Emergency Medical Service (EMS) unit was conducted to investigate the relationships among geographical orientation, pilot decision making, and workload in EMS flights. The map data collected during this study were compared to protocols gathered in the laboratory, where pilots viewed a simulated flight over different types of unfamiliar terrain and verbally identified the features utilized to maintain geographical orientation. The EMS pilot's questionnaire data were compared with data from non-EMS helicopter pilots with comparable flight experience.
Space medicine research in the 21st century will continue to focus on the four major areas including: (1) expansion of the current incomplete knowledge base of clinical and subclinical physiological changes due to microgravity; (2) development of countermeasures to extend the capabilities of the human performance envelope in extended duration flights; (3) development of novel methods for delivering all aspects of a comprehensive health care system in extreme remote conditions: and (4) further research and application of systems for biological materials processing. New space transportation vehicles will place unique physiologic and human factors demands on the human system, while providing better access to platforms for materials processing. Success in meeting the demands in each of the noted research areas will require an extensive, interactive team approach. Personnel from the medical research,operational, developmental, and basic science communities will be essential to success.
A workshop entitled "Life Support and Habitation and Planetary Protection Workshop" was held in Houston, Texas on April 27-29, 2005 to facilitate the development of planetary protection guidelines for future human Mars exploration missions and to identify the potential effects of these guidelines on the design and selection of related human life support, extravehicular activity and monitoring and control systems. This report provides a summary of the workshop organization, starting assumptions, working group results and recommendations. Specific result topics include the identification of research and technology development gaps, potential forward and back contaminants and pathways, mitigation alternatives, and planetary protection requirements definition needs. Participants concluded that planetary protection and science-based requirements potentially affect system design, technology trade options, development costs and mission architecture. Therefore early and regular coordination between the planetary protection, scientific, planning, engineering, operations and medical communities is needed to develop workable and effective designs for human exploration of Mars.
The continual and long-term habitation of enclosed environments, such as Antarctic stations, nuclear submarines and space stations, raises unique engineering, medical and operational challenges. There is no easy way out and no easy way to get supplies in. This situation elevates the importance of monitoring technology that can rapidly detect events within the habitat that affect crew safety such as fire, release of toxic chemicals and hazardous microorganisms. Traditional methods to monitor microorganisms on the International Space Station (ISS) have consisted of culturing samples for 3-5 days and eventual sample return to Earth. To augment these culture methods with new, rapid molecular techniques, we developed the Lab-on-a-Chip Application Development - Portable Test System (LOCAD-PTS). The system consists of a hand-held spectrophotometer, a series of interchangeable cartridges and a surface sampling/dilution kit that enables crew to collect samples and detect a range of biological molecules, all within 15 minutes. LOCAD-PTS was launched to the ISS aboard Space Shuttle Discovery in December 2006, where it was operated for the first time during March-May 2007. The surfaces of five separate sites in the US Lab and Node 1 of ISS were analyzed for endotoxin, using cartridges that employ the Limulus Amebocyte Lysate (LAL) assay; results of these tests will be presented. LOCAD-PTS will remain permanently onboard ISS with new cartridges scheduled for launch in February and October of 2008 for the detection of fungi (Beta-glucan) and Gram-positive bacteria (lipoteichoic acid), respectively.
The cell radiation experiment system (CRES) is a perfused-cell culture apparatus, within which cells from humans or other animals can (1) be maintained in homeostasis while (2) being exposed to ionizing radiation during controlled intervals and (3) being monitored to determine the effects of radiation and the repair of radiation damage. The CRES can be used, for example, to determine effects of drug, radiation, and combined drug and radiation treatments on both normal and tumor cells. The CRES can also be used to analyze the effects of radiosensitive or radioprotectant drugs on cells subjected to radiation. The knowledge gained by use of the CRES is expected to contribute to the development of better cancer treatments and of better protection for astronauts, medical-equipment operators, and nuclear-power-plant workers, and others exposed frequently to ionizing radiation.
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We envision an artificial intelligence (AI) based system that will provide support and recommendations to the crew medical officer (CMO) and ground flight surgeon during long-duration space missions. Such a system would be pretrained on the knowledgebase of clinical knowledge on Earth, minimizing the amount of Earth data that needs to be transferred into space. Then during deployment, the system would be constantly refined through active learning from diverse streams of data from sensors in the spacecraft, data collected daily from individual astronauts, and human-in-the-loop feedback from the crew. The model could be interrogated for predictions and recommendations on personalized crew health based on the overall status of the spacecraft, medicinal stores, and status of other crew members. Adaptation techniques would be used to incorporate spaceflight data that have very different distributions from the training data due to the extreme environment. Edge computing and the most advanced neuromorphic processing would enable computation in scenarios with low power and bandwidth, while dimensionality reduction would be employed to ensure that the input data streams from spaceflight are as small as possible. In order to realize this long-term vision, several hardware and software aspects need to be developed and assembled. First, models pretrained on Earth biomedical data would need to be evaluated for predictive accuracy, and the best one selected. That model would need to be adapted to learn from diverse, sparse, and inconsistently measured data streams, as well as human-in-the-loop feedback. A data integration, standardization, and dimensionality reduction methodology would need to be developed to handle all data types and feed them into the model. Once the software and data infrastructure is developed, it would need to be integrated with small footprint compute processors and tested in high-radiation, high-vibration, unregulated temperature situations. As a short-term goal, we recommend to focus on the development of the data and model software structure. Several large language models (LLM) already exist that have been trained on Earth biomedical and clinical knowledgebases, including BioMedLLM, Med-PaLM, SPOKE LLM, and Foresight. These models need to be evaluated for accuracy and the best one chosen for a proof-of-concept structure, while maintaining awareness of the accelerating AI field and incorporating any newly improved model architectures as needed. Then, we recommend to develop a database of synthetic data types to mimic the diverse data streams that are expected in a long-duration space mission. This should include environmental and microbial data from the spacecraft, non-invasive data from wearables and point-of-care devices employed by astronauts, and more invasive molecular and physiological monitoring of clinical and biomarker data from astronauts. The data standardization methodology should be developed, and these data streams used to refine the clinical LLM. Several scenarios should be developed that could plausibly come up in a long-duration space mission, and changes or aberrations introduced to the data at specific times to mimic these scenarios. Then, question and answer tasks should be designed to interrogate the model for predictions and recommendations, with acceptable answers already identified.
Exploration missions will present significant new challenges to crew health, including effects of variable gravity environments, limited communication with Earth-based personnel for diagnosis and consultation for medical events, limited resupply, and limited ability for crew return. Providing health care capabilities for exploration class missions will require system trades be performed to identify a minimum set of requirements and crosscutting capabilities which can be used in design of exploration medical systems. Current and future medical data, information, and knowledge must be cataloged and put in formats that facilitate querying and analysis. These data may then be used to inform the medical research and development program through analysis of risk trade studies between medical care capabilities and system constraints such as mass, power, volume, and training. These studies will be used to define a Medical Concept of Operations to facilitate stakeholder discussions on expected medical capability for exploration missions. Medical Capability as a quantifiable variable is proposed as a surrogate risk metric and explored for trade space analysis that can improve communication between the medical and engineering approaches to mission design. The resulting medical system approach selected will inform NASA mission architecture, vehicle, and subsystem design for the next generation of spacecraft.
NASA intends to construct a First Response Facility for integrated emergency response and health management. This facility will consolidate the Stennis Space Center fire department, medical clinic, security operations, emergency operations and the energy management and control center. The alternative considered is the "No Action Alternative". The proposed action will correct existing operational weaknesses and enhance capabilities to respond to medical emergencies and mitigate any other possible threats. Environmental impacts include are emissions, wetlands disturbance, solid waste generation, and storm water control.
The anticipated advent of the U.S. Government sponsoring human-tended research on commercial suborbital flights necessitates the establishment of safety review procedures for federal agencies to allow government-sponsored spaceflight participants (SFPs) aboard these vehicles. Safety practices for National Aeronautics & Space Administration (NASA) personnel aboard aircraft, orbital rockets and platforms, and a non- NASA vehicle, the Soyuz, are summarized. The valuable “Recommended Practices for Human Space Flight Occupant Safety,” published by the FAA Office of Commercial Space Transportation (FAA-AST) in 2014, are summarized. Medical recommendations for operationally critical flight crewmembers, published by the Aerospace Medical Association Commercial Spaceflight Working Group, are reviewed. FAA-AST approved SFP training available at three U.S. commercial companies is summarized. Activities of ASTM International Committee F47 on Commercial Spaceflight, formed in 2016, are reviewed. Finally, safety comparisons are made with another challenging environment, deep sea submersibles.
The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.
The Human Research Program (HRP) Exploration Medical Capability (ExMC) Element has developed a Medical System Foundation for Level of Care IV, as defined by NASA’s space flight human-system standards, for long-duration lunar orbit and surface operation missions by employing a systems engineering approach using model-based systems engineering tools. This Foundation model includes a concept of operations; functional decomposition; clinical content (medical conditions, capabilities, and resources); associated functional, interface and non-functional technical requirements; and traces to the current versions of NASA standards documents and parent-level (Program- and Vehicle habitat system level) requirements. Collectively, these components constitute a foundation that serves as a starting point for a medical system that meets the Level of Care IV requirement. The Foundation was developed by a multidisciplinary team consisting of systems engineers, scientists, and clinicians across NASA, and information is presented in an easily accessible format that is understandable across disciplines. Stakeholders can use the Foundation to analyze the traces between medical capabilities, medical conditions, medical resources, and requirements and to identify medical system interfaces with other vehicle systems/subsystems. It can also be used as a basis for performing trades on risks vs. medical system mass and volume allocation. This discussion will focus on the processes through which the Medical System Foundation was developed, how the Foundation builds a bridge between the medical and engineering domains and facilitates communication between these communities, and how these processes can be applied more broadly to a crew health and performance system and other system domains. The presentation also discusses Foundation modifications based on the recently updated versions of the NASA 3001 Standards.
The shift of the Space Transportation System (STS) flight tests of the orbiter vehicle to the preparation and flight of the payloads is discussed. Part of this change is the transition of the medical and life sciences aspects of the STS flight operations to reflect the new state. The medical operations, the life sciences flight experiments support requirements and the intramural research program expected to be at KSC during the operational flight period of the STS and a future space station are analyzed. The adequacy of available facilities, plans, and resources against these future needs are compared; revisions and/or alternatives where appropriate are proposed.