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At least 307 records · Page 17

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NASA NTRSDate not supplied

Assessing the Influence of Decompression Sickness on Medical Risk for Artemis

As NASA begins to shift its focus from LEO missions to the Moon and beyond, our understanding of the risk associated with human spaceflight is challenged by mission profiles and objectives far different from preceding missions. For Artemis, one of these aspects is surface Extra Vehicular Activity (EVA) tempo, in which the crew will perform 3 to 4 surface EVA’s in quick succession. The crew health and performance risk associated with EVA Decompression Sickness (DCS) and its associated countermeasures, is an important consideration for Artemis missions given this new and unprecedented EVA frequency. Successfully completing Artemis mission objectives relies heavily on the crew being able to perform and complete these EVAs. This analysis quantifies how medical risk changes when accounting for the expected increase in DCS risk due to the increase in EVA frequency. If there is an occurrence of DCS during a mission, appropriate downtime needs to be accounted for. Treatment for DCS requires crewmember to stop the current EVA and return to the habitat. This impacts the current EVA the crew is performing, could potentially delay the next EVA, and increases the chance of the crewmember being unable to perform future EVAs. Capturing the downtime and impact of that downtime based on the number of DCS occurrences allows us to better understand how the risk associated with DCS affects the overall medical risk and completion of missions that have more frequent EVA tempo. There are preventative strategies and mitigation countermeasures to decrease the chance of DCS occurring such as different prebreathe protocols, variable suit pressure, and vehicle pressure settings. Modeling the medical risk with and without different DCS countermeasures enables quantitative comparisons of risk reduction associated with each DCS countermeasure. We present results on how these countermeasures affect medical risks and quantify changes in the medical kit contents with respect to the countermeasures implemented within Artemis-class missions.

Clara Gasiewski↗

DOE OSTI2022

Comparative Effects of Radiation Sterilization Modality on Medical PVC Tubing

As the production volume of single-use, polymer-based medical devices increases each year, so does the need for throughput capacity to sterilize the devices. Around 80% of radiation-sterilized devices are processed using gamma-ray radiation from industrial cobalt-60 sources. Supply chain, security, and disposal concerns are prompting manufacturers and contract sterilizers to explore alternatives to irradiation using cobalt-60 gamma-rays, such as electron beam (E-beam) and X-ray radiation. Advantages of these ‘machine’ sources over radioisotope-based sources are that they do not decay, a characteristic that requires cobalt-60 to be replaced over time, they can be turned off when not in use, and they do not represent the same level of concern regarding misuse. One of the barriers to direct transition from gamma-ray sterilization to E-beam or X-ray sterilization is concern over the relatively unknown effects of sterilization dose of these alternative modalities on the performance of medical device polymers. Commercially available medical devices sterilized with gamma-ray irradiation exhibit acceptable device function, acceptable mechanical performance, and acceptable discoloration. To be viable, alternate sterilization methods must not only achieve acceptable sterilization, but the process must also result in a product with functional, mechanical, and visual effects acceptable to customers and the regulator. Flexible polyvinyl chloride (PVC) is a plastic material that is commonly found in single-use medical devices and is known for its sensitivity to radiation processing. For instance, transparent PVC is known to yellow upon irradiation. To encouraging sterilization alternatives to cobalt-60 gamma-ray, we directly compared the effects of gamma-ray, E-beam, and X-ray radiation exposure at similar sterilization-relevant doses on key properties of medical grade PVC tubing.

cobalt-60↗

DOE OSTI2022

Public Health Response and Medical Management of Internal Contamination in Past Radiological or Nuclear Incidents: A Review

Following a radiological or nuclear emergency, workers, responders and the public may be internally contaminated with radionuclides. Screening, monitoring and assessing any internal contamination and providing necessary medical treatment, especially when a large number of individuals are involved, is challenging. Experience gained and lessons learned from the management of previous incidents would help to identify gaps in knowledge and capabilities on preparedness for and response to radiation emergencies. In this paper, eight largescale and five workplace radiological and nuclear incidents are reviewed cross 14 technical areas, under the broader topics of emergency preparedness, emergency response and recovery processes. The review findings suggest that 1) new strategies, algorithms and technologies are explored for rapid screening of large populations; 2) exposure assessment and dose estimation in emergency response and dose reconstruction in recovery process are supported by complementary sources of information, including ‘citizen science’; 3) surge capacity for monitoring and dose assessment is coordinated through national and international laboratory networks; 4) evidence-based guidelines for medical management and follow-up of internal contamination are urgently needed; 5) mechanisms for international and regional access to medical countermeasures are investigated and implemented; 6) long-term health and medical follow up programs are designed and justified; and 7) capabilities and capacity developed for emergency response are sustained through adequate resource allocation, routine nonemergency use of technical skills in regular exercises, training, and continuous improvement.

61 RADIATION PROTECTION AND DOSIMETRY↗

NASA NTRS2019

International Space Station Multilateral Medical Policy Board Transitions in Space Medicine: 25 Years in Photos

This collection of photographic highlights covers the past 25 years of international collaboration in human space flight. Beginning in 1993, the international community came together to develop the medical systems for an international space station. Initially, this collaboration was bilateral in support of the Shuttle / Mir Space Station (Phase 1). However, the framework that was established to serve as the medical authority structure provided a foundation for the multilateral boards and panel, which were codified in the memoranda of understanding. The Multilateral Medical Policy Board, the Multilateral Space Medicine Board, and the Multilateral Medical Operations Panel were developed in a collegial and mutually beneficial environment by the men and women of the space agencies of Canada, Europe, Japan, Russia, and the United States. This collection of photographs from official and personal collections captures the spirit and collegiality to which we have grown accustomed. They are also presented to commemorate the integrity, professionalism, tenacity, and dedication to human space exploration consistently demonstrated by individuals involved in this amazing effort.

photographs↗

NASA NTRS2016

Integrated Medical Model (IMM) Optimization Version 4.0 Functional Improvements

The IMMs ability to assess mission outcome risk levels relative to available resources provides a unique capability to provide guidance on optimal operational medical kit and vehicle resources. Post-processing optimization allows IMM to optimize essential resources to improve a specific model outcome such as maximization of the Crew Health Index (CHI), or minimization of the probability of evacuation (EVAC) or the loss of crew life (LOCL). Mass and or volume constrain the optimized resource set. The IMMs probabilistic simulation uses input data on one hundred medical conditions to simulate medical events that may occur in spaceflight, the resources required to treat those events, and the resulting impact to the mission based on specific crew and mission characteristics. Because IMM version 4.0 provides for partial treatment for medical events, IMM Optimization 4.0 scores resources at the individual resource unit increment level as opposed to the full condition-specific treatment set level, as done in version 3.0. This allows the inclusion of as many resources as possible in the event that an entire set of resources called out for treatment cannot satisfy the constraints. IMM Optimization version 4.0 adds capabilities that increase efficiency by creating multiple resource sets based on differing constraints and priorities, CHI, EVAC, or LOCL. It also provides sets of resources that improve mission-related IMM v4.0 outputs with improved performance compared to the prior optimization. The new optimization represents much improved fidelity that will improve the utility of the IMM 4.0 for decision support.

risk assessment↗

NASA NTRSDate not supplied

Medical countermeasures for extraterrestrial environments: Current status and future prospects with focus on acute injuries

In all space exploratory activities involving humans there are associated risks to health and well-being. Exposure to ionizing radiation represents one of the more serious health concerns. Although medical issues can arise shortly following the rare acute exposures, the more likely radiation-associated injuries will manifest in a delayed fashion following sub-acute exposures or protracted exposures to relatively low radiation doses. The radiological conditions that present these health risks during extraterrestrial space travel are presented in this article, along with current physical and medical countermeasures for such exposure contingencies. The aim of this article is to discuss radiation medical countermeasures that may be considered for future space exploration and travel. Biomedical advances have occurred toward the control and minimization of acute, sub-acute, and fractionated radiation exposure injuries, whether they stem from intentional application of radio-therapeutic procedures or unintentional, accidental terrestrial-based exposures. Those advances, based largely on novel bioengineering, genetic, and combinatorial pharmaceutical strategies, are briefly reviewed here, along with the promising prospects of additional, new and improved medical countering systems/agents that will be forthcoming with additional research and development efforts.

Acute/chronic radiation injuries↗

NASA NTRSDate not supplied

Architectural Framework for Conceptualizing Exploration Class Medical Operations

Currently, discrete projects within NASA’s Human Research Program (HRP) take aim at providing future exploration missions with the capabilities necessary to operate within a progressively Earth-independent operative environment. Realizing an entire ecosystem that can accomplish these goals requires a clear visualization on how each project contributes to the overall objectives of Human Health and Performance (HH&P) in that context. The Exploration Medical Capability (ExMC) Element has developed an architectural framework for exploration class medical operations by utilizing a systems engineering approach using model-based systems engineering (MBSE). This model, a System of Systems Architecture (SoSA), captures a means of integrating various independent but related efforts into a comprehensive view associated with HRP’s goal of providing progressively Earth-Independent Medical Operations (EIMO). This level of visibility is realized by identifying interfaces between development efforts and existing programs that contribute to the overall mission of EIMO even if those extend past the traditional boundary of HRP. Potential interfaces that are considered important when constructing an architecture include program/project Needs, Goals, and Objectives (NGOs), capabilities, envisioned use cases/scenarios, and system/subsystem structure. This presentation will focus on the processes that were used to generate the SoSA along with a means to realize its utility amongst other MBSE products from ExMC. Evaluation of the best architecture moving forward can then be achieved that promotes cohesion between various functional areas of HH&P. Additionally, the SoSA is developed with a long-term vision for the dynamic integration of novel technological developments that may be implemented in the future. The SoSA is intended to enable Stakeholders the ability to view the broader interconnections that exist and begin to create avenues of communication between various efforts. The benefits of a SoSA provide an essential step towards addressing the unique challenges of attaining the goals of broader exploration class medical missions of the future.

Systems engineering↗

NASA NTRS2024

Architectural Framework for Conceptualizing Exploration Class Medical Operations

Systems engineering↗

DOE OSTI2020

Survey of Image Denoising Methods for Medical Image Classification

Medical imaging devices, such as X-ray machines, inherently produce images that suffer from visual noise. Our objectives were to (i.) determine the effect of image denoising on a medical image classification task, and (ii.) determine if there exists a correlation between image denoising performance and medical image classification performance. We performed the medical image classification task on chest X-rays using the DenseNet-121 convolutional neural network (CNN) and used the peak signal-to-noise ratio (PSNR) and structural similarity (SSIM) metrics as the image denoising performance measures. We first found that different denoising methods can make a statistically significant difference in classification performance for select labels. We also found that denoising methods affect fine-tuned models more than randomly-initialized models and that fine-tuned models have significantly higher and more uniform performance than randomly-initialized models. Lastly, we found that there is no significant correlation between PSNR and SSIM values and classification performance for our task.

Michael, Peter↗

NASA NTRS1973

Medical operations: Crew surgeon's report

To assure the safety and well being of the Skylab environment simulation crewmembers it was necessary to develop a medical safety plan with emergency procedures. All medical and nonmedical test and operations personnel, except those specifically exempted, were required to meet the medical standards and proficiency levels as established. Implemented programs included health care of the test crew and their families, occupational medical services for chamber operating personnel, clinical laboratory support and hypobaric and other emergency support.

Ross, C. E.↗

NASA NTRS1975

The medical story

The paper discusses the medical program of the Skylab missions. The major medical systems discussed include the food system, the waste-management system, the personal-hygiene system, and the inflight medical support system. The life-sciences experiments conducted on Skylab are reviewed. These dealt with the cardiovascular system, mineral balance and bioassay of fluids, sleep, blood, metabolic activity, vestibular function, and time and motion studies. The medical operations were accomplished with only minor problems.

Johnston, R. S.↗

NASA NTRS1983

OSHA medical and workplace surveillance requirements and NIOSH recommendations (for employees exposed to toxic substances and other work hazards)

Both OSHA medical and work place surveillance requirements and NIOSH recommendations were prepared as a desk reference to help occupational health professionals to perform their duties. The medical surveillance information focuses on frequency of physical examinations, specific problems that may arise as a result of exposure (e.g., decreased immunocompetence, weight loss, ets.), conditions that intensify the harmful effects of exposure (e.g., medication an exposed employee may be taking, cigarette smoking, etc.), the areas that should be scrutinized in medical and work histories and during the physical exam, and specific clinical tests that should be conducted. Recordkeeping requirements are also specified. The workplace surveillance information consists of monitoring requirements, personal protective equipment requirements, and recordkeeping requirements. Such details as the sampling devices that should be used, the type of respirators that should be worn, and the frequency of inspections are included. This document does not specify the training, labeling and posting, and safe work practice requirements and recommendations due to space considerations.

Cooper, L. P.↗

NASA NTRS1989

Interactive displays in medical art

Medical illustration is a field of visual communication with a long history. Traditional medical illustrations are static, 2-D, printed images; highly realistic depictions of the gross morphology of anatomical structures. Today medicine requires the visualization of structures and processes that have never before been seen. Complex 3-D spatial relationships require interpretation from 2-D diagnostic imagery. Pictures that move in real time have become clinical and research tools for physicians. Medical illustrators are involved with the development of interactive visual displays for three different, but not discrete, functions: as educational materials, as clinical and research tools, and as data bases of standard imagery used to produce visuals. The production of interactive displays in the medical arts is examined.

Mcconathy, Deirdre Alla↗

NASA NTRS1991

ATLS-stowage and deployment testing of medical supplies and pharmaceuticals

The objective is to evaluate stowage and deployment methods for the Health Maintenance Facility (HMF) during microgravity. The specific objectives of this experiment are: (1) to evaluate the stowage and deployment mechanisms for the medical supplies; and (2) to evaluate the procedures for performing medical scenarios. To accomplish these objectives, the HMF test mini-racks will contain medical equipment mounted in the racks; and self-contained drawers with various mechanisms for stowing and deploying items. The medical supplies and pharmaceuticals will be destowed, handled, and restowed. The in-flight test procedures and other aspects of the KC-135 parabolic flight test to simulate weightlessness are presented.

Gosbee, John↗

NASA NTRS1991

Telemedicine and international disaster response: Medical consultation to Armenia and Russia via a telemedicine spacebridge

The Telemedicine Spacebridge, a satellite mediated audio-video-fax link between four U.S. and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa. During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. 209 patients were discussed, requiring expertise in 20 specialty areas. Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47, and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several U.S. medical centers was judged beneficial; quality of data transmission was judged excellent. These results suggest that interactive consultation by remote specialists can provide valuable assistance to onsite physicians and favorably influence clinical decisions in the aftermath of major disasters.

Houtchens, Bruce A.↗

NASA NTRS1991

The National Disaster Medical System

The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

Reutershan, Thomas P.↗

NASA NTRS1997

NASA Worldwide Emergency Medical Assistance

In an effort to maintain employee health and welfare, ensure customer satisfaction, and to deliver high quality emergency medical care when necessary to employees located overseas, NASA has instituted a new contract with International SOS Assistance INC. International SOS Assistance INC. will provide civil servants and contractors engaged in official NASA business with many services upon request during a medical or personal emergency. Through the years, International SOS Assistance INC. has developed the expertise necessary to provide medical service in all remote areas of the world. One phone call connects you to the SOS network of multilingual staff trained to help resolve travel, medical, legal, and security problems. The SOS network of critical care and aeromedical specialists operates 24 hours a day, 365 days a year from SOS Alarm Centers around the world. This exhibit illustrates the details of the NASA-International SOS Assistance INC. agreement.

Martin, George A.↗

NASA NTRS1999

The Russian-U.S. Experience with Development Joint Medical Support Procedures for Before and After Long-Duration Space Flights

As the Russian Space Agency (RSA) and the U.S. National Aviation and Space Administration (NASA) began in the mid 1990s to plan a preliminary cooperative flight program in anticipation of the International Space Station, programmatic and philosophical differences became apparent in the technical and medical approaches of the two agencies. This paper briefly describes some of these differences and the process by which the two sides resolved differences in their approaches to the medical selection and certification of Shuttle-Mir crew members. These negotiations formed the basis for developing policies on other aspects of the medical support function for international missions, including crew training, preflight and postflight data collection, and rehabilitation protocols. The experience gained through this cooperative effort has been invaluable for developing medical care capabilities for the International Space Station.

Morgun, V. V.↗