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NASA NTRSDate not supplied

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗
NASA NTRS2025

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↗
NASA NTRS2024

Quantifying Medical Risk on a Long Duration Lunar Mission: A Demonstration of NASA’s IMPACT Tradespace Analysis Tool

Background NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. The distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the medical evacuation of astronauts. Mass, volume, power, and data will be limited while higher demands will be placed on the crew to manage medical care. NASA’s Moon to Mars exploration strategy lays out increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human medical risk to inform a traditional heuristic approach to medical risk. Prior tools have been developed for missions in low Earth orbit, but a new tool is required to plan for future exploration missions. Methods IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; the addition of medical resources; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to represent a sustained exploration Artemis mission. Results/Discussion Overall, IMPACT successfully quantified medical risk and derived an optimized medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to overall medical risk were decompression sickness, trauma conditions, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions. This systematic analysis demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Missions to Mars↗
NASA NTRS2024

Current Status of Martian Moons eXploration (MMX) Contamination Control and Curation Activity

Martian Moons eXploration (MMX) is a sample return mission from the Martian moon Phobos. The MMX spacecraft is scheduled to launch in 2026 and return to Earth in 2031. The main science goals of MMX are “to reveal the origin of the Martian moons and make progress in the understanding of planetary system formation and material transport in the solar system, and to observe processes that impact the circumplanetary and surface environments of Mars”. MMX has two sampling systems: coring (C)-sampler and pneumatic (P)-sampler and plans to bring back >10 g of Phobos sample. The retuned sample in the sample capsule will be transferred to the curation facility in ISAS/JAXA for sample curation and subsequent sample analysis. Contamination control of the sample return mission requires special care to prevent terrestrial contamination to the spacecraft, which would ruin the scientific value of the returned sample. Retaining the pristineness of the retuned sample is an important task of the MMX Curation and Sampler Science teams. The basis of the contamination control is (1) to minimize and understand the nature and amount of contaminants, (2) to perform contamination assessment and evaluate the effect of contaminants in the spacecraft on the retuned sample, (3) to employ a contamination knowledge (CK) material coupon in the spacecraft to identify the contaminants in the returned samples. In the MMX contamination control plan, the allowable contamination level for each contaminant is carefully defined. They are mostly set to be 1/1000 of the expected amount of each material in the returned sample and are divided into two main categories: organic and inorganic. The allowable atmospheric leakage rate to the sample container is also defined. The allowable contamination level of the organic materials is based on the composition of carbonaceous chondrites. The target contaminants are amino acids, aliphatic and aromatic hydrocarbons, carboxylic acids, etc. In case of the inorganic materials, the target contaminants are important elements to permit distinguishing the origin of the Martian moon by nucleosynthetic isotope anomalies (Cr, Ti, and Mo) and to reveal the evolution of the Martian moon by chronology (Hf, W, U, Pb, Rb, Sr, Sm, and Nd). The key instrument of contamination control in the sample return mission is the sampler system. The C-sampler has been developed by JAXA and the P-sampler was provided by Honeybee/NASA. In MMX, materials used in the two samplers (C- and P- sampler) were carefully selected to avoid potential contamination from the design stage of the system. The individual parts of the C-sampler FM (Flight Model) were thoroughly cleaned at the curation facility in ISAS/JAXA by the full-course cleaning procedure, which is an ultrasonic cleaning with organic solvents and ultrapure water in several steps. The equivalent level of cleaning was also carried out on the P-Samper FM as well by Honeybee Robotics in the USA. Now, MMX is in the critical phase for contamination control called ATLO: Assembly, Test, and Launch Operations. During the ATLO phase, sampler FM is constantly purged with nitrogen gas and maintained at positive pressure to prevent environmental contamination. The surrounding environments of the sampler FM are also simultaneously monitored using the CK Monitoring Coupon Set, which consists of several witness materials such as a glass petri dish, sapphire glass disk, and carbon adhesive tape (Figure 1). The detailed environmental assessment of each clean room used for the assembly and test of the sampler FM has also been conducted. This assessment includes microbial analysis, which was performed for OSIRIS-REx. Regarding the sample recovery and sample curation, we have started the designing of Sample Container Disassembling Instrument for the sample recovery from the sample container and the MMX curation chamber for sample curation. The curation protocol for the Phobos returned sample has also been discussed by the MMX Sample Analysis Working Team (SAWT). The MMX curation protocol consists of three phases: (1) quick analysis, (2) pre-basic characterization, and (3) basic characterization. (1) is extraction of the sample gas from the sample container and analysis by mass spectrometry, (2) is observation in bulk level, and (3) is observation in grain level and allocation of the sample aliquots. In parallel with the curation protocol, the returned sample undergoes preliminary examination for scientific investigations to achieve science goals. In addition, the CK witness plates made of sapphire glass are on board the sampler system. The CK witness plates will be recovered from the sampler system and analyzed by SAWT for the assessment of in-flight contamination.

Haruna Sugahara↗
NASA NTRSDate not supplied

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↗
NASA NTRS2002

MIMIC II: a massive temporal ICU patient database to support research in intelligent patient monitoring

Development and evaluation of Intensive Care Unit (ICU) decision-support systems would be greatly facilitated by the availability of a large-scale ICU patient database. Following our previous efforts with the MIMIC (Multi-parameter Intelligent Monitoring for Intensive Care) Database, we have leveraged advances in networking and storage technologies to develop a far more massive temporal database, MIMIC II. MIMIC II is an ongoing effort: data is continuously and prospectively archived from all ICU patients in our hospital. MIMIC II now consists of over 800 ICU patient records including over 120 gigabytes of data and is growing. A customized archiving system was used to store continuously up to four waveforms and 30 different parameters from ICU patient monitors. An integrated user-friendly relational database was developed for browsing of patients' clinical information (lab results, fluid balance, medications, nurses' progress notes). Based upon its unprecedented size and scope, MIMIC II will prove to be an important resource for intelligent patient monitoring research, and will support efforts in medical data mining and knowledge-discovery.

NASA Discipline Cardiopulmonary↗
NASA NTRS1991

NASA spinoffs to bioengineering and medicine

Through the active transfer of technology, the National Aeronautics and Space Administration (NASA) Technology Utilization (TU) Program assists private companies, associations, and government agencies to make effective use of NASA's technological resources to improve U.S. economic competitiveness and to provide societal benefit. Aerospace technology from areas such as digital image processing, space medicine and biology, microelectronics, optics and electrooptics, and ultrasonic imaging have found many secondary applications in medicine. Examples of technology spinoffs are briefly discussed to illustrate the benefits realized through adaptation of aerospace technology to solve health care problems. Successful implementation of new technologies increasingly requires the collaboration of industry, universities, and government, and the TU Program serves as the liaison to establish such collaborations with NASA. NASA technology is an important resource to support the development of new medical products and techniques that will further advance the quality of health care available in the U.S. and worldwide.

Biomedical Engineering/instrumentation/trends↗
NASA NTRS2008

Johnson Space Center Astronaut and Flight Surgeon Survey Report (January 2008)

In early 2007, an incident involving former astronaut, Lisa Nowak, led NASA to conduct several reviews including internal and external evaluations of astronaut behavioral health and medical care. The internal NASA review, led by Johnson Space Center (JSC), focused on two elements: 1) current astronaut behavioral medicine practices and 2) a review of relevant records and information to determine whether any leading indicators that could have averted the incident were missed. The external review, conducted by the NASA Astronaut Health Care System Review Committee (comprised of external experts from the behavioral health and aerospace medical communities), focused on space medicine operations at JSC.

Johnson Space Center(JSC)↗
NASA NTRS1970

Thermodynamics of the internal combustion engine

The ubiquitous automobile has played both the role of hero and villain during the course of its history. At the present time it is being cast as the villain with increasing frequency because it has been indicted as a major source of air pollution. It is just this characterization that is responsible for our renewed interest in the automobile. When we speak of the automobile as a source of air pollution, we really mean the heart of the automobile, the internal combustion engine. The prototype of the modern internal combustion engine was first successfully operated by Nicholas August Otto in 1876. In spite of its long history, the internal combustion engine is still poorly understood in terms of the details of the physical processes that take place during its operations. The internal combustion engine operates on what is known as the Otto cycle, and Otto cycle calculations have been with us for many years. The emphasis in earlier calculations was usually on the performance rather than on the pollution aspects. Performance characteristics can often be estimated reasonably accurately even with a considerable degree of simplification. We are interested in the pollution aspects of the internal combustion engine, and therefore the calculations must be performed with more care. Our extensive experience with equilibrium calculations places us in a position to carry out such careful calculations. We have just recently begun such an analysis, and its objective is the prediction of exhaust gas properties. I will describe our progress by first reviewing the Otto cycle, and then I will illustrate the effect of various assumptions on the calculated results.

Frank J. Zeleznik↗
NASA NTRS1971

NASA's contributions to patient monitoring, appendix

Health care problems, and markets for patient monitoring equipment are discussed along with contributions to all phases of patient monitoring, and technology transfer to nonaerospace problems. Health care medical requirements, and NASA achievements in patient monitoring are described, and a summary of the technology transfer is included.

Murray, D. M.↗
NASA NTRS1974

Technique for recovery of voice data from heat damaged magnetic tape

A method for conditioning, and thus enabling retrieval of intelligence from, magnetic tapes after damage from heat has caused the tape to wrinkle and curl severely thereby reducing tape width to less than one-half its original size. The damaged tape is superposed on a first piece of splicing tape with the oxide side of the magnetic tape in contact with the adhesive side of the splicing tape and then carefully smoothed by a special tool. A second piece of splicing tape is placed on the backing side of the magnetic tape then the resulting tape stack is trimmed to the original width of the magnetic tape. After the first piece of splicing tape is carefully removed from the oxide side of the damaged magnetic tape, the resulting magnetic tape is then ready to be placed into a recorder for playback.

Melugin, J. F.↗
NASA NTRS1974

Correlations and linkages between the sun and the earth's atmosphere: Needed measurements and observations

A summary of needed measurements and observations is reported to identify the sequence of processes leading from change in solar input to change in tropospheric circulation and weather. Changes in the solar electromagnetic radiation have to be carefully monitored since variations over the solar cycle are small (less than one percent). It is suggested that changes in the ionization at the Pfotzer maximum could influence the formation of thunderstorms by changing the electric potential gradient. This could be checked by measuring the global atmospheric electric field. As an example of spacecraft observations, a worldwide distribution plot of nocturnal thunderstorms compiled from OSO-5 data shown; no obvious correlation with solar data had been found, but the time span of the data is rather limited and more sophisticated observation techniques could be used. Continuous and careful monitoring is recommended of the input of electromagnetic and particle radiation into the earth's atmosphere ozone distributions in the region above 30 km, and wind systems in the mesosphere and lower thermosphere. In addition, special phenomena suspected to be important in the causal chain, such as cirrus cloud formation at high latitudes and thunderstorm activity, should be monitored on a global basis.

Kellogg, W. W.↗
NASA NTRS1974

Eutectic solidification

The possibilities of using the low-gravity space environment for the processing of directionally solidified materials in order to remove the limitations imposed by the L-g earth environment have led to a careful evaluation of the directional solidification process and the results commonly obtained. Defects in the regularity of the microstructure have been identified as one of the most important areas where present processing technology needs to be improved. One-g environment material processing must also be carefully characterized before it can be determined if zero-g processing will produce significant benefits in eutectic and off-eutectic solidification. It is suggested that a combination of experimental and analytical thermal studies will be required to optimize the solidification process in order to minimize the structural defects which occur due to present processing techniques.

Douglas, F. C.↗
NASA NTRS1973

Bio-medical electrical disconnects

Improvements in medical care during the last two decades have resulted in the survival of an ever-increasing group of patients with severe neuro-muscular disabilities who otherwise would have succumbed to their diseases or injuries. This has created a sizeable population of severely paralyzed persons totally dependent upon society for care. It has been estimated that this population may grow beyond 5,000,000 persons by 1980. A rather fortunate confluence of complementing technologies and surgical techniques offer promise of solving this growing socially significant problem.

Parsons, W. E.↗
NASA NTRS1974

Skylab crew health and changes related to space flight

All three manned Skylab missions were supported by a cadre of medical personnel who were responsible not only for the management and conduct of the medical experiments but also for the operational planning and crew health. The day-to-day medical care of the crewmen and their families was left to a team of flight surgeons who were responsible for the health care during all phases of the mission, as well as the development and use of the inflight medical support system. The preventive medicine aspects of the preflight and postflight health stabilization program are discussed. The clinical problems encountered are identified and the significance of these medical entities are reviewed. The inflight physiological changes of a clinical nature are discussed in light of the significance of these changes as result of the space environment.

Hawkins, W. R.↗
NASA NTRS1975

Satellite broadcasting - Capabilities for public service

Satellite broadcast services to support health-care and educational transmissions must work with small, low-cost terminals in allocated radio-frequency bands. The ATS-6 spacecraft has successfully demonstrated such capability in the bands of non-technical users. It supports interactive television broadcasting to simple, low-cost terminals in a nationwide series of experiments in the delivery of health-care and educational services. ATS-6 achieves this capability with a very large antenna and moderate transmitter power. The coverage limitations inherent in this approach will be overcome by the joint U.S.-Canadian Communications Technology Satellite to be launched in December 1975. The CTS will demonstrate broadcast capability with new, high-power technology in a newly-allocated radio-frequency band. This will make it possible to use smaller antennas, greatly enlarging the area coverage available to the many nontechnical experimenters using CTS for their own needs. A practical application of these technologies is now in development for operational broadcasting services in Japan.

Marsten, R. B.↗
NASA NTRS1976

STARPAHC - Operational findings

Delivery of quality health care to passengers of extended-mission spacecraft and to remote populations on earth (a major national problem) requires extending the knowledge and skills of the physician many kilometers distant from his physical location. The STARPAHC telemedicine system accomplishes this by using physician's assistants complemented with space technology in communications, data handling, and systems engineering. It is presently in operation and undergoing a 2-year evaluation on the Papago Indian Reservation, Arizona. Results have established its feasibility as a solution for remote area health care on earth, while providing information useful to the planners of advanced manned spacecraft missions.

Belasco, N.↗
NASA NTRS1976

STARPAHC Interim Evaluation Report, May 1975 - April 1976

The primary goals of the STARPAHC Program are to provide data for developing health care for future manned spacecraft, and to establish the feasibility of the STARPAHC concept for improving the delivery of health care to remote areas on earth. Accordingly, the hardware and medical evaluations initiated during the first 6 months of system operation were continued and expanded during the second 6-month period. The evaluations are based on what has proven to be a relatively stabilized 6-month period wherein system failures which occurred during the initial shakedown period in the first 6 months have been minimized. Early trends and performance data reported in the first semi-annual report were reexamined to either verify, modify or change earlier conclusions. The highlights are given of the total year of operation with emphasis on comparisons between the first and second semi-annual reporting period. In addition, an early analysis of costs is summarized.

Source record↗