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Projects carried out by the UW-BATeam are reported. The following subjects were investigated: clinical opthalmic ultrasound improvements, magnetic cell sorters, hyperthermia treatment for cancer, joystick driving control for the handicapped, qualitative coronary artery imaging (MIPS), and speech autocuers.
BACKGROUND The medical capabilities necessary for long-duration exploration missions (LDEMs) will differ tremendously from those currently available to crew medical officers (CMOs) on the International Space Station (ISS). Ground support will be more challenging due to distance-related communication delays and data transmission, and resource utilization must be optimized given limited ability for resupply. Clinical decision support systems (CDSSs) can help mitigate these limitations. The recent launch of generative artificial intelligence (AI) tools based upon large language models (LLM) support the creation of a smart assistant for onboard triage, diagnosis, and guided treatment of medical conditions during these missions. The Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool can help predict which clinical problems and outcomes are likely to occur for a design reference mission (DRM) and assist Medical Operations and systems engineering teams in creating a medical system that may optimally mitigate the predicted risks. The purpose of this study was to identify AI tools currently available or in development for the assistive diagnosis and care of medical conditions predicted for an extended duration Lunar mission. METHODS The 119 medical conditions currently built into the IMPACT suite were categorized into systems, and these diagnoses were used as keywords for our literature search. Using PubMed and Google Scholar, we performed a literature survey of AI tools applicable to these conditions. Article inclusion criteria included publication between the years 2017-2023, as the sentinel paper discussing the “selective attention” driving ChatGPT and other generative transformer models was published in June 2017. Where applicable, we reviewed only the top 1000 research articles (based on relevance) for each of the keywords/phrases. AI tools whose training sets were exclusive to a pediatric patient population were excluded. We also excluded any medical diagnostic tools (such as CT, MRI, mass spectrometry) or procedures (such as endoscopy, surgery) that are unlikely to be available during LDEMs due to mass and volume constraints, CMO knowledge, skills, and abilities, and/or inherent procedural risks. RESULTS Our survey highlighted several AI-driven tools for the triage, diagnosis, and management of those medical conditions highlighted by IMPACT. Selected publications for each medical condition were then screened for inclusion within ten systems-based categories including: general diagnostic tools (25), tools to diagnose and manage respiratory (40), dermatologic (34), neurologic (28), auditory and vestibular (30), ophthalmic (34), musculoskeletal (104), infection-associated (92), and gynecologic (19) conditions, as well as tools that could be deployed in the setting of trauma and emergency (34). CONCLUSIONS Numerous AI-driven tools were highlighted within this literature survey, ranging from chatbot assistants that triage knee pain to vision transformer models for diagnosis of ophthalmic conditions using ocular surface images captured with a mobile phone. Remaining challenges include optimizing connectivity and integration of existing and developing systems into the vehicles or habitats. Notably, findings from this survey could help guide the initial design of an all-encompassing, onboard medical AI assistant for use during future LDEMs.
Topics discussed include: Optical Measurement of Mass Flow of a Two-Phase Fluid; Selectable-Tip Corrosion-Testing Electrochemical Cell; Piezoelectric Bolt Breakers and Bolt Fatigue Testers; Improved Measurement of B(sub 22) of Macromolecules in a Flow Cell; Measurements by a Vector Network Analyzer at 325 to 508 GHz; Using Light to Treat Mucositis and Help Wounds Heal; Increasing Discharge Capacities of Li-(CF)(sub n) Cells; Dot-in-Well Quantum-Dot Infrared Photodetectors; Integrated Microbatteries for Implantable Medical Devices; Oxidation Behavior of Carbon Fiber-Reinforced Composites; GIDEP Batching Tool; Generic Spacecraft Model for Real-Time Simulation; Parallel-Processing Software for Creating Mosaic Images; Software for Verifying Image-Correlation Tie Points; Flexcam Image Capture Viewing and Spot Tracking; Low-Pt-Content Anode Catalyst for Direct Methanol Fuel Cells; Graphite/Cyanate Ester Face Sheets for Adaptive Optics; Atomized BaF2-CaF7 for Better-Flowing Plasma-Spray Feedstock; Nanophase Nickel-Zirconium Alloys for Fuel Cells; Vacuum Packaging of MEMS With Multiple Internal Seal Rings; Compact Two-Dimensional Spectrometer Optics; and Fault-Tolerant Coding for State Machines.
Bio-Imaging Research's technology that originated in an aerospace program has come full circle with a new aerospace adaptation called the Advanced Computed Tomography Inspection System, or ACTIS. The medical version of CT scans the human body for tumors or other abnormalities, the ACTIS system finds imperfections in aerospace structures and components, such as castings, assemblies, rocket motors and nozzles. ACTIS is described by its developer as the most versatile CT scanner available for non-destructive testing applications. ACTIS is a variable geometry system. ACTIS source and detectors can be moved closer together or farther apart to optimize the geometry for different sizes of test objects. The combination of variable geometry, three sources, and focusing detectors makes ACTIS cost effective for a broad range of applications. System can scan anything from very small turbine blades to large rocket assemblies.
Topics covered include: Water Treatment Technologies Inspire Healthy Beverages; Dietary Formulas Fortify Antioxidant Supplements; Rovers Pave the Way for Hospital Robots; Dry Electrodes Facilitate Remote Health Monitoring; Telescope Innovations Improve Speed, Accuracy of Eye Surgery; Superconductors Enable Lower Cost MRI Systems; Anti-Icing Formulas Prevent Train Delays; Shuttle Repair Tools Automate Vehicle Maintenance; Pressure-Sensitive Paints Advance Rotorcraft Design Testing; Speech Recognition Interfaces Improve Flight Safety; Polymers Advance Heat Management Materials for Vehicles; Wireless Sensors Pinpoint Rotorcraft Troubles; Ultrasonic Detectors Safely Identify Dangerous, Costly Leaks; Detectors Ensure Function, Safety of Aircraft Wiring; Emergency Systems Save Tens of Thousands of Lives; Oxygen Assessments Ensure Safer Medical Devices; Collaborative Platforms Aid Emergency Decision Making; Space-Inspired Trailers Encourage Exploration on Earth; Ultra-Thin Coatings Beautify Art; Spacesuit Materials Add Comfort to Undergarments; Gigapixel Images Connect Sports Teams with Fans; Satellite Maps Deliver More Realistic Gaming; Elemental Scanning Devices Authenticate Works of Art; Microradiometers Reveal Ocean Health, Climate Change; Sensors Enable Plants to Text Message Farmers; Efficient Cells Cut the Cost of Solar Power; Shuttle Topography Data Inform Solar Power Analysis; Photocatalytic Solutions Create Self-Cleaning Surfaces; Concentrators Enhance Solar Power Systems; Innovative Coatings Potentially Lower Facility Maintenance Costs; Simulation Packages Expand Aircraft Design Options; Web Solutions Inspire Cloud Computing Software; Behavior Prediction Tools Strengthen Nanoelectronics; Power Converters Secure Electronics in Harsh Environments; Diagnostics Tools Identify Faults Prior to Failure; Archiving Innovations Preserve Essential Historical Records; Meter Designs Reduce Operation Costs for Industry; Commercial Platforms Allow Affordable Space Research; Fiber Optics Deliver Real-Time Structural Monitoring; Camera Systems Rapidly Scan Large Structures; Terahertz Lasers Reveal Information for 3D Images; Thin Films Protect Electronics from Heat and Radiation; Interferometers Sharpen Measurements for Better Telescopes; and Vision Systems Illuminate Industrial Processes.
At NASA's Jet Propulsion Laboratory (JPL), NASA-developed Video Imaging Communication and Retrieval (VICAR) software laid the groundwork for analyzing images of all kinds. A project seeking to use imaging technology for health care diagnosis began when the imaging team considered using the VICAR software to analyze X-ray images of soft tissue. With marginal success using X-rays, the team applied the same methodology to ultrasound imagery, which was already digitally formatted. The new approach proved successful for assessing amounts of plaque build-up and arterial wall thickness, direct predictors of heart disease, and the result was a noninvasive diagnostic system with the ability to accurately predict heart health. Medical Technologies International Inc. (MTI) further developed and then submitted the technology to a vigorous review process at the FDA, which cleared the software for public use. The software, patented under the name Prowin, is being used in MTI's patented ArterioVision, a carotid intima-media thickness (CIMT) test that uses ultrasound image-capturing and analysis software to noninvasively identify the risk for the major cause of heart attack and strokes: atherosclerosis. ArterioVision provides a direct measurement of atherosclerosis by safely and painlessly measuring the thickness of the first two layers of the carotid artery wall using an ultrasound procedure and advanced image-analysis software. The technology is now in use in all 50 states and in many countries throughout the world.
OBJECTIVES: The risk of a urinary calculus during an extended duration mission into the reduced gravity environment of space is significant. For medical operations to develop a comprehensive strategy for the spaceflight stone risk, both preventive countermeasures and contingency management (CM) plans must be included. METHODS: A feasibility study was conducted to demonstrate the potential CM technique of endoscopic ureteral stenting with ultrasound guidance for the possible in-flight urinary calculus contingency. The procedure employed the International Space Station/Human Research Facility ultrasound unit for guide wire and stent localization, a flexible cystoscope for visual guidance, and banded, biocompatible soft ureteral stents to successfully stent porcine ureters bilaterally in zero gravity (0g). RESULTS: The study demonstrated that downlinked endoscopic surgical and ultrasound images obtained in 0g are comparable in quality to 1g images, and therefore are useful for diagnostic clinical utility via telemedicine transmission. CONCLUSIONS: In order to be successful, surgical procedures in 0g require excellent positional stability of the operating surgeon, assistant, and patient, relative to one another. The technological development of medical procedures for long-duration spaceflight contingencies may lead to improved terrestrial patient care methodology and subsequently reduced morbidity.
INTRODUCTION: Pulmonary altitude decompression sickness (DCS) is a rare condition. 'Chokes' which are characterized by the triad of substernal pain, cough, and dyspnea, are considered to be associated with severe accumulation of gas bubbles in the pulmonary capillaries and may rapidly develop into a life-threatening medical emergency. This study was aimed at characterizing early symptomatology and the appearance of venous gas emboli (VGE). METHODS: Symptoms of simulated-altitude DCS and VGE (with echo-imaging ultrasound) were analyzed in 468 subjects who participated in 22 high altitude hypobaric chamber research protocols from 1983 to 2001 at Brooks Air Force Base, TX. RESULTS: Of 2525 subject-exposures to simulated altitude, 1030 (41%) had symptoms of DCS. Only 29 of those included DCS-related pulmonary symptoms. Of these, only 3 subjects had all three pulmonary symptoms of chokes; 9 subjects had two of the pulmonary symptoms; and 17 subjects had only one. Of the 29 subject-exposures with pulmonary symptoms, 27 had VGE and 21 had severe VGE. The mean onset times of VGE and symptoms in the 29 subject-exposures were 42 +/- 30 min and 109 +/- 61 min, respectively. In 15 subjects, the symptoms disappeared during recompression to ground level followed by 2 h of oxygen breathing. In the remaining 14 cases, the symptoms disappeared with immediate hyperbaric oxygen treatment. CONCLUSIONS: Pulmonary altitude DCS or chokes is confirmed to be a rare condition. Our data showed that when diagnosed early, recompression to ground level pressure and/or hyperbaric oxygen treatment was 100% successful in resolving the symptoms.
BACKGROUND: A previous study [1] reported that the instantaneous risk of developing a Herniated Nucleus Pulposus (HNP) was higher in astronauts who had flown at least one mission, as compared with those in the corps who had not yet flown. However, the study only analyzed time to HNP after the first mission (if any) and did not account for the possible effects of multiple missions. While many HNP's occurred well into astronauts' careers or in some cases years after retirement, the higher incidence of HNPs relatively soon after completion of space missions appears to indicate that spaceflight may lead to an increased risk of HNP. The purpose of this study was to support the Human System Risk Board assessment of back pain, evaluate the risk of injury due to dynamic loads, and update the previous dataset which contained events up to December 31, 2006. METHODS: Data was queried from the electronic medical record and provided by the Lifetime Surveillance of Astronaut Health. The data included all 330 United States astronauts from 1959 through February 2014. Cases were confirmed by Magnetic Resonance Imaging, Computerized Tomography, Myelography, operative findings, or through clinical confirmation with a neurologist or neurosurgeon. In this analysis, astronauts who had an HNP at selection into the corps or had an HNP diagnosis prior to their first flight were excluded. The statistical challenges in using the available data to separate effects of spaceflight from those associated with general astronaut training and lifestyle on propensity to develop HNPs are many. The primary outcome is reported date of first HNP (if any), which at best is only an approximation to the actual time of occurrence. To properly analyze this data with a survival analysis model, one must also know the "exposure" time - i.e. how long each astronaut has been at risk for developing an HNP. If an HNP is reported soon after a mission, is it mission caused or general? If the former, exposure time should be counted from the time of landing (assuming the risk of HNP occurring during a mission is zero). If the latter, exposure time should be counted from the time of selection; however we can't directly know which one to use. In our analysis we take both of these possibilities into account with a competing risks model, wherein two distinct stochastic processes are going on: TG = time to HNP (general) and TS = time to HNP (spaceflight). Under this type of model, whichever of these occurs first is what we observe; in other words we don't observe TG or TS, only min(TG, TS). Here, we parameterized the model in terms of separate Weibull hazard functions for each process and estimated all parameters using maximum likelihood. In addition, we allowed for a "cured fraction" - i.e. the possibility that some astronauts may never develop an HNP. RESULTS: Results will include a depiction of the competing hazard functions as well as a probability curve for the relative likelihood that an HNP reported at a given time after a mission is actually mission caused. Other factors, such as dwell time in microgravity and vehicle landing environment will be explored. An overall assessment as to whether spaceflight truly exacerbates HNP risk will be made.
Researchers at the Jet Propulsion Laboratory worked with the brain surgeon who directs the Skull Base Institute in Los Angeles to create the first endoscope fit for brain surgery and capable of producing 3D video images. It is also the first to be able to steer its lens back and forth. These improvements to visibility are expected to improve safety, speeding patient recovery and reducing medical costs.
As NASA plans for exploration missions into deep space, significant challenges are realized due to the distance from Earth. Beside the effects of microgravity and radiation exposure, the astronauts face the additional constraints of isolation, lack of resupply, increasingly difficult evacuation, and delayed and disrupted communication with ground-based medical care providers. These constraints require a paradigm shift from current medical care where crews rely on the real-time communications with ground-based medical care providers toward Earth-independent medical operations for astronaut medical care. Medical expertise and decision-making are ground-based for current International Space Station and planned Lunar missions. However, a deep space exploration crew will need to autonomously perform the detection, diagnosis, treatment, and prevention of medical conditions. One approach to provide Earth-independent medical operations is to augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained crew—operating under stressful conditions, combatting fatigue, and facing a potential medical crisis—with a robust clinical decision support system (CDSS). The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/data bases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that maintain a flexible platform for integrating new technology in the future. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addressed ap Medical-701 within the Inflight Medical Conditions risk: “We need to increase inflight medical capabilities and identify new capabilities that (a) maximize benefit and/or (b) reduce “costs” on human system/mission/vehicle resources.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology advances in this decade and beyond. Hence, data, software, and computational resources will play an essential and synergistic role in maintaining crew health, wellness, and performance in deep space missions. The focus of the CDS project was to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance, and medical care during exploration missions. In fiscal year 2022 (FY22), the CDS project was chartered to baseline and/or revise all CDS project related documentation and update the CDS project model to include the revised CDSS Concept of Operations, revised systems-based modeling language (SysML) activity diagrams, and baseline requirements. The focus of this presentation will be an overview of the CDS products and CDS model content.
Thermal Remote Anemometer Device developed for remote, noncontacting, passive measurement of thermal properties of sample. Model heated locally by scanning laser beam and cooled by wind in tunnel. Thermal image of model analyzed to deduce pattern of airflow around model. For materials applications, system used for evaluation of thin films and determination of thermal diffusivity and adhesive-layer contact. For medical applications, measures perfusion through skin to characterize blood flow and used to determine viabilities of grafts and to characterize tissues.
Broadband multispectral imaging can be very helpful in showing differences in energy being radiated and is often employed by NASA satellites to monitor temperature and climate changes. In addition, hyperspectral imaging is ideal for advanced laboratory uses, biomedical imaging, forensics, counter-terrorism, skin health, food safety, and Earth imaging. Lextel Intelligence Systems, LLC, of Jackson, Mississippi purchased Photon Industries Inc., a spinoff company of NASA's Stennis Space Center and the Institute for Technology Development dedicated to developing new hyperspectral imaging technologies. Lextel has added new features to and expanded the applicability of the hyperspectral imaging systems. It has made advances in the size, usability, and cost of the instruments. The company now offers a suite of turnkey hyperspectral imaging systems based on the original NASA groundwork. It currently has four lines of hyperspectral imaging products: the EagleEye VNIR 100E, the EagleEye SWIR 100E, the EagleEye SWIR 200E, and the EagleEye UV 100E. These Lextel instruments are used worldwide for a wide variety of applications including medical, military, forensics, and food safety.
A method of sensitive detection of bacterial spores within delays of no more than a few hours has been developed to provide an alternative to a prior three-day NASA standard culture-based assay. A capability for relatively rapid detection of bacterial spores would be beneficial for many endeavors, a few examples being agriculture, medicine, public health, defense against biowarfare, water supply, sanitation, hygiene, and the food-packaging and medical-equipment industries. The method involves the use of a commercial rapid microbial detection system (RMDS) that utilizes a combination of membrane filtration, adenosine triphosphate (ATP) bioluminescence chemistry, and analysis of luminescence images detected by a charge-coupled-device camera. This RMDS has been demonstrated to be highly sensitive in enumerating microbes (it can detect as little as one colony-forming unit per sample) and has been found to yield data in excellent correlation with those of culture-based methods. What makes the present method necessary is that the specific RMDS and the original protocols for its use are not designed for discriminating between bacterial spores and other microbes. In this method, a heat-shock procedure is added prior to an incubation procedure that is specified in the original RMDS protocols. In this heat-shock procedure (which was also described in a prior NASA Tech Briefs article on enumerating sporeforming bacteria), a sample is exposed to a temperature of 80 C for 15 minutes. Spores can survive the heat shock, but nonspore- forming bacteria and spore-forming bacteria that are not in spore form cannot survive. Therefore, any colonies that grow during incubation after the heat shock are deemed to have originated as spores.
opics covered include: Filtering Water by Use of Ultrasonically Vibrated Nanotubes; Computer Code for Nanostructure Simulation; Functionalizing CNTs for Making Epoxy/CNT Composites; Improvements in Production of Single-Walled Carbon Nanotubes; Progress Toward Sequestering Carbon Nanotubes in PmPV; Two-Stage Variable Sample-Rate Conversion System; Estimating Transmitted-Signal Phase Variations for Uplink Array Antennas; Board Saver for Use with Developmental FPGAs; Circuit for Driving Piezoelectric Transducers; Digital Synchronizer without Metastability; Compact, Low-Overhead, MIL-STD-1553B Controller; Parallel-Processing CMOS Circuitry for M-QAM and 8PSK TCM; Differential InP HEMT MMIC Amplifiers Embedded in Waveguides; Improved Aerogel Vacuum Thermal Insulation; Fluoroester Co-Solvents for Low-Temperature Li+ Cells; Using Volcanic Ash to Remove Dissolved Uranium and Lead; High-Efficiency Artificial Photosynthesis Using a Novel Alkaline Membrane Cell; Silicon Wafer-Scale Substrate for Microshutters and Detector Arrays; Micro-Horn Arrays for Ultrasonic Impedance Matching; Improved Controller for a Three-Axis Piezoelectric Stage; Nano-Pervaporation Membrane with Heat Exchanger Generates Medical-Grade Water; Micro-Organ Devices; Nonlinear Thermal Compensators for WGM Resonators; Dynamic Self-Locking of an OEO Containing a VCSEL; Internal Water Vapor Photoacoustic Calibration; Mid-Infrared Reflectance Imaging of Thermal-Barrier Coatings; Improving the Visible and Infrared Contrast Ratio of Microshutter Arrays; Improved Scanners for Microscopic Hyperspectral Imaging; Rate-Compatible LDPC Codes with Linear Minimum Distance; PrimeSupplier Cross-Program Impact Analysis and Supplier Stability Indicator Simulation Model; Integrated Planning for Telepresence With Time Delays; Minimizing Input-to-Output Latency in Virtual Environment; Battery Cell Voltage Sensing and Balancing Using Addressable Transformers; Gaussian and Lognormal Models of Hurricane Gust Factors; Simulation of Attitude and Trajectory Dynamics and Control of Multiple Spacecraft; Integrated Modeling of Spacecraft Touch-and-Go Sampling; Spacecraft Station-Keeping Trajectory and Mission Design Tools; Efficient Model-Based Diagnosis Engine; and DSN Simulator.
Ongoing projects described address: (1) intracranial pressure monitoring; (2) versatile portable speech prosthesis; (3) cardiovascular magnetic measurements; (4) improved EMG biotelemetry for pediatrics; (5) ultrasonic kidney stone disintegration; (6) pediatric roentgen densitometry; (7) X-ray spatial frequency multiplexing; (8) mechanical impedance determination of bone strength; (9) visual-to-tactile mobility aid for the blind; (10) Purkinje image eyetracker and stabilized photocoalqulator; (11) neurological applications of NASA-SRI eyetracker; (12) ICU synthesized speech alarm; (13) NANOPHOR: microelectrophoresis instrument; (14) WRISTCOM: tactile communication system for the deaf-blind; (15) medical applications of NASA liquid-circulating garments; and (16) hip prosthesis with biotelemetry. Potential transfer projects include a person-portable versatile speech prosthesis, a critical care transport sytem, a clinical information system for cardiology, a programmable biofeedback orthosis for scoliosis a pediatric long-bone reconstruction, and spinal immobilization apparatus.
Live footage shows the Apollo 11 crew, Commander Neil A. Armstrong, Lunar Module Pilot Edwin E. Aldrin, Jr., and Command Module Pilot Michael Collins, preparing for their mission. The crewmembers are seen getting their medical examinations, suiting up, and walking out to the Astro-van. Scenes include a brief view of the Launch Control Center (LCC), ignition, liftoff, and shell and engine skirt separation. The most important images are those of the moon landing and astronauts walk on the moon. Also shown are the parachute landing of the shuttle and the celebration of the world.
Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. To augment the requisite knowledge, skills and abilities (KSAs) of a time-constrained crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance this decade and beyond. Hence, data, software and computational resources will play an essential and synergistic role in maintaining crew health, wellness and performance in deep space missions. The focus of the CDS project is to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance and medical care during exploration missions. The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/databases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.