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NASA NTRS2014

Fatigue‐Related Countermeasures for Long‐Duration Exploration Missions

The NASA Human Research Program's (HRP) Behavioral Health and Performance Element (BHP) supports and conducts research to mitigate deleterious outcomes related to fatigue, sleep loss, circadian desynchronization, and work overload. Objective evidence indicates that within the context of the International Space Station (ISS), sleep is reduced and there is circadian misalignment. Despite chronic sleep loss and high workloads; however, astronauts successfully complete their missions. Contributing to their success is not only the tremendous skills and capabilities of each astronaut, but also the collaborative team efforts amongst the crew, between flight and ground crews, and through real‐time care provided by medical personnel. It is anticipated that risks to human health and performance will increase in the context of exploration missions, where crewmembers will venture to deep space for extended durations and in small vehicles with limited communication with home. Hence, fatigue‐related countermeasures are being developed and/or validated that include unobtrusive monitoring technologies to detect fatigue‐related performance decrements, environmental countermeasures, and sleep education and training for flight and ground crews. Given that fatigue is an issue in current ISS missions, the BHP works collaboratively with Space Medicine operations to collect data in the operational environment, to validate fatigue-related countermeasures, and provide evidence‐based mitigations. Our presentation will summarize fatigue‐related operational research that is underway through NASA's BHP in partnership with its operational counterparts. Efforts include studies evaluating the effects of hypnotics, lighting protocols as countermeasures for circadian entrainment, and investigations involving education and training. This presentation will further identify, based on flight and terrestrial evidence, additional sleep and circadian countermeasures that may still be needed to support exploration missions. Lessons learned from transitioning research deliverables into ISS operations will also be discussed.

Whitmire, A.↗

NASA NTRSDate not supplied

Space Radiation Technologies for Human Missions beyond Low-Earth-Orbit

Ionizing radiation exposure is a pervasive occupational risk to astronauts and remains a major health risk associated with human exploration beyond low-Earth-orbit. Sustained lunar and Mars exploration crew will be at increased risk of radiogenic cancers and cardiovascular disease, as well as, the potential for in-mission performance decrements, immune system decrements, and late neurodegenerative conditions impacting crew health. Optimizing astronaut space radiation protection will incorporate both physical and biological radiological aspects and will implement protection strategies that span pre-mission, in-flight, and post mission timelines. Major facets of physical risk mitigation include accuracy in predicting the space radiation solar environment, monitoring environmental and human exposures, and minimizing exposure through vehicle shielding and design. Biological mitigation facets include understanding and predicting biological response to the space environment, developing advanced medical countermeasures, and identifying appropriate surveillance strategies to preserve long-term health. Coordinated investments in these major capability areas will support development of an integrated radiation protection solution to minimize astronaut risk for moon to Mars exploration missions.

Lisa C Simonsen↗

NASA NTRS2009

Lunar Human Research Requirements (LHRR)

Biomedical research will be conducted during transit and on the surface of the Moon to prepare for extended stays on the Moon and to prepare for the exploration of Mars. The objective of the Human Research Program (HRP) is to preserve the health and enhance performance of astronaut explorers. Specific objectives of the HRP include developing the knowledge, capabilities, and necessary countermeasures and technologies in support of human space exploration; focusing on mitigating the highest risks to crew health and performance; and defining and improving human spaceflight medical, environmental, behavioral, and human factors standards. This document contains a detailed description of the resource accommodations, interfaces, and environments to be provided by the Constellation Program (CxP) to support the HRP research in transit and on the lunar surface. Covered, specifically, are the requirements for mass and volume transport; crew availability; ground operations, baseline data collection, and payload processing; power, and data. Volumes and mass are given for transport of conditioned samples only. They do not account for the engineering solution that the Constellation Program will implement (refrigerator/freezer volume/mass). This document does not account for requirements on the Orion vehicle for transportation to and from the International Space Station (ISS). The ISS Program has supplied requirements for this mission.

Denkins, Pamela↗

NASA NTRS2002

A Survey of Emerging Materials for Revolutionary Aerospace Vehicle Structures and Propulsion Systems

The NASA Strategic Plan identifies the long-term goal of providing safe and affordable space access, orbital transfer, and interplanetary transportation capabilities to enable scientific research, human, and robotic exploration, and the commercial development of space. Numerous scientific and engineering breakthroughs will be required to develop the technology required to achieve this goal. Critical technologies include advanced vehicle primary and secondary structure, radiation protection, propulsion and power systems, fuel storage, electronics and devices, sensors and science instruments, and medical diagnostics and treatment. Advanced materials with revolutionary new capabilities are an essential element of each of these technologies. A survey of emerging materials with applications to aerospace vehicle structures and propulsion systems was conducted to assist in long-term Agency mission planning. The comprehensive survey identified materials already under development that could be available in 5 to 10 years and those that are still in the early research phase and may not be available for another 20 to 30 years. The survey includes typical properties, a description of the material and processing methods, the current development status, and the critical issues that must be overcome to achieve commercial viability.

Harris, Charles E.↗

NASA NTRSDate not supplied

Assessing Crew Medical Officer Preparedness for International Space Station Missions

INTRODUCTION Astronaut crew medical officers (CMO) undergo additional, specialized training to provide medical support onboard the International Space Station (ISS). CMO training focuses on utilizing resources on-station and optimizing communication with ground-based expertise to manage both common minor conditions as well as emergency/trauma situations. As NASA moves towards future Artemis and exploration class missions, we sought CMO perspectives on past, present, and future CMO training and medical resourcing to help inform mission planners regarding medical risk mitigation considerations. We present an interview-based qualitative assessment of CMO preparedness for the International Space Station with the aim to help iterate future training flows for Low Earth Orbit, Artemis, and exploration-class missions. METHODS A semi-structured interview tool was developed to assess CMO experience and their recommendations for future mission training considerations. Participants were recruited from former or current US astronauts who were designated as CMO and subsequently flew to the International Space Station. 10 former CMOs took part in the study. Interview transcripts were deidentified and evaluated for qualitative thematic analysis by two independent coders with NVivo Software suite (Lumivero, Denver, CO), and emergent themes were compiled. RESULTS Former CMO crew expressed appropriate preparedness for current ISS medical capabilities and requirements. They identified the role of the CMO as serving as a healthcare extender to ground-based flight surgeons for ISS and other LEO missions. Individuals with prior medical experience were preferred though not felt to be necessary for LEO missions. For exploration class missions with limitations in ground communication, a physician-as-CMO and more rigorous training curricula for both the CMO and astronaut crew were desired. DISCUSSION Former NASA astronaut crew were interviewed to retrospectively assess their preparedness as ISS crew medical officers and hypothesize future medical knowledge, skill, and ability needs. Along with medical operations subject matter expert opinion and advanced probabilistic risk assessment modeling, past CMO experience can help inform future CMO training considerations and responsibilities for future Artemis and exploration class missions.

M A Labarbera↗

NASA NTRS2010

Interplanetary Transit Simulations Using the International Space Station

We evaluated the space life sciences utility of the International Space Station (ISS) to simulate the outbound transit portion of missions to Mars and Near Earth Asteroids (NEA) to investigate biomedical and psychological aspects of such transits, to develop and test space operation procedures compatible with communication delays and outages, and to demonstrate and validate technologies and countermeasures. Two major categories of space life sciences activities can capitalize on ISS capabilities. The first includes studies that require ISS (or a comparable facility), typically for access to prolonged weightlessness. The second includes studies that do not strictly require ISS but can exploit it to maximize their scientific return more efficiently and productively than in ground-based simulations. For these studies, ISS offers a high fidelity analog for fundamental factors on future missions, such as crew composition, mission control personnel, operational tasks and workload, real-world risk, and isolation, and can mimic the effects of distance and limited accessibility. In addition to conducting Mars- and NEA-transit simulations on 6-month ISS increments, extending the current ISS increment duration from 6 months to 9 or even 12 months will provide opportunities for enhanced and focused research relevant to long duration Mars and NEA missions. Increasing the crew duration may pose little additional risk to crewmembers beyond that currently accepted on 6-month increments, but additional medical monitoring capabilities will be required beyond those currently used for ISS operations. Finally, while presenting major logistical challenges, such a simulation followed by a post-landing simulation of Mars exploration could provide quantitative evidence of capabilities in an actual mission. Thus, the use of ISS to simulate aspects of Mars and NEA missions seems practical. If it were to be implemented without major disruption of on-going ISS activities, then planning should begin soon, in close consultation with all international partners.

Charles, John B.↗

NASA NTRS2013

Biomedical Results of the Space Shuttle Program

The Space Shuttle Program (SSP), which was triumphantly completed by the flight of STS-135 on July 21, 2011, holds a special place in the history of Human Space Exploration. For the first time, a vehicle was built that could perform multiple flights in space and return to Earth. Many important questions regarding the ability of humans to adapt and function in space have been answered during the 30 years since the SSP was launched and many lessons have been learned. The multidisciplinary studies conducted during this program allowed NASA to define the normal responses and potential pathologic changes of the major physiological systems to short-duration space flights. The program significantly contributed to the development of in-flight medical care capabilities and multiple countermeasures. A comprehensive system of preflight, in-flight, and post-flight monitoring of the astronauts was built. It is important to emphasize that the SSP was essential for building the International Space Station (ISS) that significantly expanded the boundaries of space research, allowing for planning of long-term near-terrestrial and extraterrestrial missions. As the program was coming to completion, a decision was made by the NASA Lyndon B. Johnson Space Center Human Research Program senior management to summarize the medico-biological results of the SSP in one comprehensive edition. This was quite an ambitious goal. It required selection of a group of experts in different areas to become the chapters lead authors. These experts were charged with the task of reviewing what was learned in the consequent fields to make the chapters a comprehensive source of information for planning of research, operational activities, and medical care for future missions. We hope that we were able to accomplish this goal and the book will serve as a reliable reference edition for the international space biomedicine community, for new generation of space researchers and Flight Surgeons, as well as for all those interested in space exploration. As space exploration continues, the major question of whether humans are capable of adapting to long-term presence and adequately functioning in space habitats will remain open for a long time. we expect that the comprehensive review of the medico-biological results of the SSP along with the data collected during the missions on the space stations (the Russian space station _Mir_ and ISS) provides a good starting point in seeking the answer to this question.

Diana Risin↗

NASA NTRSDate not supplied

Results of the Field Test and Defining Sensormotor Fitness for Duty Standards

The primary goals of the Field Test were (1) to determine functional abilities associated with long-duration space flight crews beginning as soon after landing as possible (< 2 hours), and (2) to characterize the time course of recovery with additional follow-up measurement sessions within 24 hours after landing. The NASA and Russian teams have collected data on a total of 39 different United States Orbital Segment (USOS) and Russian crewmembers, with 9 Russian crewmembers being tested twice (total of 48 tests). Eighteen subjects (7 Russian, 11 USOS) completed a reduced Field Test (pilot) protocol and 30 subjects (19 Russian and 11 USOS) participated in the full Field Test. This presentation will focus on a subset of the measures that will be used in the upcoming ground study to determine sensorimotor fitness for duty standards, namely: tandem walk, obstacle walk, eye-hand coordination task, finger-to-nose task, and Computerized Dynamic Posturography (CDP). Exploration-class missions including Artemis, Gateway, and beyond will require a new level of autonomy around periods of gravitational transition, where sensorimotor disturbances increase. The operational support that is available upon return to Earth including rescue teams, medical interventions, and the ability to rest as needed will not be available after landing on the lunar or Martian surface. Because of this, there is a need to define fitness for duty standards that will help inform crew capabilities during and soon after gravitational transitions. Due to the new requirements of the exploration environment, we must utilize a set of exploration field measures, for which no previous spaceflight data exists to define fitness for duty standards. A Sensorimotor Adaptation Analog (SAA) that can provide different levels of acute disorientation through combined vestibular, visual, and proprioceptive disruptions will be used to increase the range of performance in exploration field measures, simulating the moderate-to-severe performance decrements observed in spaceflight. The levels of SAA will be titrated and validated by comparison to gold standard measures that have a wealth of spaceflight data at different time points during recovery. These data will be pulled directly from the results of Field Test and help ensure the range of performance while being exposed to SAA mimics the range of performance from pre-flight to immediately postflight in Field Test subjects. Specifically, we will be using the tandem walk, obstacle walk, eye-hand coordination task, finger-to-nose task, and CDP as the gold standard measures. Referencing this Field Test data in the form of gold standard measures will also help us characterize and contextualize how each magnitude of SAA disorientation compares to recovery from long-term microgravity exposure.

M J F Rosenberg↗

NASA NTRS2019

IMPACT Concept of Operations

NASA’s future exploration missions mandate a significant paradigm change for mission planning, spacecraft design, human systems integration, and in-flight medical care due to constraints on mass, volume, power, resupply missions, and medical evacuation capabilities. These constraints require further development of the human health and performance system, which includes the medical, task performance, wellness, data, human and other systems necessary to keep the crew healthy and functioning optimally. The human health and performance system will be tightly integrated with mission and habitat design to provide a sufficient human health and performance infrastructure to enable mission success. A suite of systems engineering tools will aid in the decision making process for the development of such a human health and performance system. This Concept of Operations provides a vision for a tool suite to conduct evaluations of human health and performance system options, inform research prioritization, and provide trade study support, based on evidence, risks, and systems engineering principles. The integrated tool suite under development is IMPACT.

Lumpkins, Sara↗

NASA NTRS2009

SURGE: Smart Ultrasound Remote Guidance Experiment

Exploration-class missions lead to longer communication delays with mission control. May not always have communication capability to stream real-time ultrasound images. SURGE explores use of a "just-in-time" learning tool, called OPEL = On-Board Proficiency Enhancer Light as an aid to a hypothetical crew medical officer working autonomously.

Peterson, Sean↗

NASA NTRS2015

Integrated Medical Model Project - Overview and Summary of Historical Application

Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions: Historically, IMM simulations support Science and Technology planning, Exploration mission planning, and ISS program operations by supplying simulation support, iMED data information, and subject matter expertise to Crew Health and Safety and the HRP. Upcoming release of IMM version 4.0 seeks to provide enhanced functionality to increase the quality of risk decisions made using the IMM through a more accurate representation of the real world system.

Myers, J.↗

NASA NTRSDate not supplied

Performance Risk Model (PRisM) Proof-of-Concept: An Operational Decision Support Tool to Predict Crew Performance in Space from Available Performance Tests

The Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) team at NASA Glenn Research Center has developed a range of tools to evaluate astronaut health during spaceflight and to optimize the medical set required for missions. Among these, the Performance Risk Model (PRisM) represents a novel advancement, extending CHP-PRA’s focus beyond medical systems into the domain of human performance. Such tool could be pivotal in optimizing astronaut capabilities during space travel, thereby enhancing overall mission success. PRisM leverages data from well-established performance assessments conducted during previous crewed space missions and Earth analogs to strategically predict outcomes for planned tasks, even when direct performance testing has not been conducted for those specific tasks. To evaluate performance, PRisM references the various metrics outlined in NASA-STD-3001 and employs a methodology to integrate different performance scales. This framework analyzes the contribution of various human system task categories (HSTCs) to task execution and compares these contributions to the HSTCs’ involvement in other known tests. The model further employs a Monte Carlo simulation to sample performance scores from their distribution in operationally relevant tests such as those in Mulavara et al. (2018) and, by leveraging similarities in HSTC involvement, transfers this knowledge to actual mission tasks, such as those outlined in the "Human Exploration of Mars: Preliminary List of Crew Tasks”. The current PRisM proof-of-concept includes analyses of the impact of exercise and specific medications on astronauts’ performance, with provisions to incorporate additional countermeasures as data becomes available. Furthermore, the tool is customizable to include any system necessary to fully encompass the domain of human systems and can be adapted to evaluate performance for any spaceflight activities as requested by operational stakeholders. PRisM has the potential to assist the Human Research Program in exploring the capabilities trade space for optimized crew performance.

performance modeling↗

NASA NTRS2011

Technology Development to Support Human Health and Performance in Exploration Beyond Low Earth Orbit

In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.

Kundrot, C.E.↗

NASA NTRS2003

Multiphase flow and phase change in microgravity: Fundamental research and strategic research for exploration of space

NASA is preparing to undertake science-driven exploration missions. The NASA Exploration Team's vision is a cascade of stepping stones. The stepping-stone will build the technical capabilities needed for each step with multi-use technologies and capabilities. An Agency-wide technology investment and development program is necessary to implement the vision. The NASA Exploration Team has identified a number of areas where significant advances are needed to overcome all engineering and medical barriers to the expansion of human space exploration beyond low-Earth orbit. Closed-loop life support systems and advanced propulsion and power technologies are among the areas requiring significant advances from the current state-of-the-art. Studies conducted by the National Academy of Science's National Research Council and Workshops organized by NASA have shown that multiphase flow and phase change play a crucial role in many of these advanced technology concepts. Lack of understanding of multiphase flow, phase change, and interfacial phenomena in the microgravity environment has been a major hurdle. An understanding of multiphase flow and phase change in microgravity is, therefore, critical to advancing many technologies needed. Recognizing this, the Office of Biological and Physical Research (OBPR) has initiated a strategic research thrust to augment the ongoing fundamental research in fluid physics and transport phenomena discipline with research especially aimed at understanding key multiphase flow related issues in propulsion, power, thermal control, and closed-loop advanced life support systems. A plan for integrated theoretical and experimental research that has the highest probability of providing data, predictive tools, and models needed by the systems developers to incorporate highly promising multiphase-based technologies is currently in preparation. This plan is being developed with inputs from scientific community, NASA mission planners and industry personnel. The fundamental research in multiphase flow and phase change in microgravity is aimed at developing better mechanistic understanding of pool boiling and ascertaining the effects of gravity on heat transfer and the critical heat flux. Space flight experiments conducted in space have shown that nucleate pool boiling can be sustained under certain conditions in the microgravity environment. New space flight experiments are being developed to provide more quantitative information on pool boiling in microgravity. Ground-based investigations are also being conducted to develop mechanistic models for flow and pool boiling. An overview of the research plan and roadmap for the strategic research in multiphase flow and phase change as well as research findings from the ongoing program will be presented.

Singh, Bhim S.↗

NASA NTRS2017

Medical Data Architecture Capabilities and Design

Mission constraints will challenge the delivery of medical care on a long-term, deep space explorationmission. This type of mission will be restricted in the availability of medical knowledge, skills, procedures and resourcesto prevent, diagnose, and treat in-flight medical events. Challenges to providing medical care are anticipated, includingresource and resupply constraints, delayed communications and no ability for medical evacuation. The Medical DataArchitecture (MDA) project will enable medical care capability in this constrained environment.The first version of thesystem, called Test Bed 1, includes capabilities for automated data collection, data storage and data retrieval to provideinformation to the Crew Medical Officer (CMO). Test Bed 1 seeks to establish a data architecture foundation and developa scalable data management system through modular design and standardized interfaces. In addition, it will demonstrateto stakeholders the potential for an improved, automated, flow of data to and from the medical system over the currentmethods employed on the International Space Station (ISS). It integrates a set of external devices, software andprocesses, and a Subjective, Objective, Assessment, and Plan (SOAP) note commonly used by clinicians. Medical datalike electrocardiogram plots, heart rate, skin temperature, respiration rate, medications taken, and more are collectedfrom devices and stored in the Electronic Medical Records (EMR) system, and reported to crew and clinician. Devicesintegrated include the Astroskin biosensor vest and IMED CARDIAX electrocardiogram (ECG) device with INEED MDECG Glove, and the NASA-developed Medical Dose Tracker application.The system is designed to be operated as astandalone system, and can be deployed in a variety of environments, from a laptop to a data center. The system isprimarily composed of open-source software tools, and is designed to be modular, so new capabilities can be added. Thesoftware components and integration methods will be discussed.

Exploration medical system↗

NASA NTRS2001

A Revolution in the Making: Advances in Materials That May Transform Future Exploration Infrastructures and Missions

The NASA Strategic Plan identifies the long-term goal to provide safe and affordable space access, orbital transfer, and interplanetary transportation capabilities to enable research, human exploration, and the commercial development of space; and to conduct human and robotic missions to planets and other bodies in our solar system. Numerous scientific and engineering breakthroughs will be required to develop the technology necessary to achieve this goal. Critical technologies include advanced vehicle primary and secondary structure, radiation protection, propulsion and power systems, fuel storage, electronics and devices, sensors and science instruments, and medical diagnostics and treatment. Advanced materials with revolutionary new capabilities are an essential element of each of these technologies. This paper discusses those materials best suited for aerospace vehicle structure and highlights the enormous potential of one revolutionary new material, carbon nanotubes.

Harris, Charles E.↗

NASA NTRSDate not supplied

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

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

Prashant Parmar↗

NASA NTRSDate not supplied

Clinical Decision Support Software: Modeling and Capabilities

With its distance from Earth and communication delays, exploration space flight will place new demands for crew autonomy. Crewmembers operating during such missions require a dedicated Clinical Decision Support System (CDSS) that enhances their earth independence by augmenting their knowledge, skills, and abilities in different medical scenarios. A CDSS is a software application that must function optimally in diverse and varied scenarios (while interfacing with and providing actionable information to appropriate vehicle systems) to augment crew performance by enhancing or adding knowledge, skills, and abilities that preserve health and wellness and ultimately helping to ensure mission success. In addition, the software tool should provide various functions and computational models to meet the demands of astronauts beyond low earth orbit.

B Russell↗