System Levers Within Impact
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We present here an investigation of Ryugu particles recovered by the Hayabusa2 space mission and their extracted carbonaceous acid residues using Raman spectroscopy. Raman parameters of Ryugu intact grains and their acid residues are characterized by broad D (defect induced) and G (graphite) band widths, indicating the presence of polyaromatic carbonaceous matter with low thermal maturity. Raman spectra of Ryugu particles and CI (type 1) chondrites exhibit stronger laser-induced fluorescence backgrounds compared to Type 2 and Type 3 carbonaceous chondrites. The high fluorescence signatures and wide bandwidths of the D and G bands of Ryugu intact grains are similar to the Raman spectra observed in CI chondrites, reflecting the low structural order of their aromatic carbonaceous matter, and strengthening the link between Ryugu particles and CI chondrites. The high fluorescence background intensity of the Ryugu particles is due to multiple causes, but it is likely that the relative abundance of geometry-bearing macromolecular organic matter in total organic carbon contents makes a large contribution to the fluorescence intensities. Locally observed high fluorescence in the acid-extracted residues of Ryugu is due to nitrogen-bearing outlier phase. The high fluorescence signature is one consequence of the low degree of thermal maturity of the organic matter and supports evidence that the Ryugu particles have escaped significant parent body thermal metamorphism.
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.
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.
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.
In contrast to the current crew health paradigm for low-Earth orbit and Lunar missions, which depends on real-time communication with Mission Control, deep-space exploration missions will require a significant shift in medical operations. This shift is driven by the constraints of operating at a considerable distance from Earth, such as resource limitations—lack of resupply, restricted mass, power, volume, and data—as well as communication delays and the inability to evacuate back to Earth during emergencies. To move toward a more self-reliant medical model, a strategy is needed to gradually increase space-based crew autonomy and reduce risks to mission success in the challenging environment of deep space. This transformative change, known as "Earth-Independent Medical Operations" (EIMO), explores the gradual transfer of medical care and decision-making from Earth-based support to space-based systems. The goal of this transition is to enhance astronaut health and performance while minimizing mission risks. EIMO requires the development of a medical system that integrates seamlessly with mission planning, vehicle and spacesuit design, and data architecture. This integration is crucial for building a robust medical infrastructure that not only safeguards astronaut well-being but also ensures overall mission success. The Human Research Program (HRP) Exploration Medical Capability (ExMC) Element has revised the EIMO model-based Concept of Operations (ConOps) which outlines an initial vision for EIMO. The ConOps, which is built on the stakeholders’ need, system goals, and objectives (NGOs), presents an array of in-mission scenarios that span a wide range of medical conditions demonstrating the system’s capabilities from basic to complex events. Developed by a multidisciplinary team of systems engineers, scientists, and clinicians within ExMC, the ConOps revision includes two new scenarios(Barotrauma and Self-Medical Management and Behavioral Health and Chronic Medical Care), and implementation of findings from EIMO technical interchange meetings that focused on data and training. The envisioned EIMO Medical System (MS) operates as a system of systems, gathering data from various sources such as reference databases, real-time wearable sensors, point-of-care diagnostics, and environmental controls. The MS also incorporates advanced training tools to support autonomous medical care, assisting the Crew Medical Officer (CMO) during medical events where Ground Support is either unavailable or communication-delayed beyond practicality. Furthermore, MS functions and capabilities were decomposed from the scenarios to establish foundational requirements for EIMO and traced to the NASA Spaceflight Human-System Standard(NASA-STD-3001, Volumes 1 and 2). These traces were performed to gain insights on the alignment of EIMO requirements with the NASA standard. This work serves as an initial recommendation to increase crew autonomy gradually and safely for Mars missions and future deep-space exploration.
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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.
The present invention is directed to a method of detecting microbial stress. The method comprises the following: providing an electrochemical device having at least one reference electrode and one working electrode wherein the electrochemical device also contains a fermenting microbe, setting an electrochemical potential, providing a source of electrical energy electrically connected to the at least one working electrode, detecting a transfer of electrons from the working electrode to the fermenting microbe, wherein the detection is an indication of microbial stress, and providing a remedial action in response to the indication of microbial stress.
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