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At least 307 records · Page 17

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

Connell, Linda J.↗

Wearable Biosensor Monitor to Support Autonomous Crew Health and Performance

During future human exploration missions, spaceflight crews will encounter adverse health outcomes and decrements in performance during the missions and for long term health. The Psychophysiological Research Lab is currently conducting a technology demonstration of a prototype wearable biosensor system (Astroskin) on astronaut surrogates during 30 day missions within NASAs Human Exploration Research Analog (HERA). HERA, located at Johnson Spaceflight Center, represents a flight analog for simulation of isolation, confinement and remote conditions of mission exploration scenarios. Astroskin, an autonomous medical monitoring system, consists of an intelligent garment for the upper body and a headband fitted with sensors, and associated software and hardware that can measure, transmit and store vital signs (ECG, respiration, blood pressure, etc.), sleep quality and activity level of the wearer. One of the main goals of the technology demonstration is to evaluate the performance of the Astroskin system (i.e., data quality), crew usability and comfort. To validate the Astroskin as a viable option for use during future spaceflight missions, crew data from HERA are sent to Ames researchers for processing and analyses. Crew surveys on usability and comfort will also be evaluated. This work supports the Exploration Medical Capabilities element within NASAs Human Research Program.

space analog↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During and After Spaceflight

Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, and cause loss of bone mineral density, and reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (~ 14 days) and long-duration (~ 6 months) missions on the International Space Station (ISS). Future space missions that are longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions that will last up to 3 years. This will require a more detailed understanding of the dynamic effects of spaceflight on human health and performance, and the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1-G and 0-G to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness, and muscle strength, and endurance, before, during and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with 2–3-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.

countermeasures↗

Temporal Changes in Astronauts’ Muscle and Cardiorespiratory Physiology Before, During, and After Spaceflight

Background: NASA’s planned space exploration missions will require astronauts to safely perform extravehicular activity (EVA) and to safely egress vehicles in a variety of landing scenarios. Prolonged exposure to spaceflight can diminish tolerance for physical activity, decrease cardiovascular and sensorimotor function, cause loss of bone mineral density, as well as reduced muscle mass and strength. Although exercise can mitigate these spaceflight-induced physiological decrements, little is known regarding the time-course of changes in muscle and aerobic performance during spaceflight. Furthermore, these exercise countermeasures are not fully protective. For example, maximal aerobic capacity (VO2pk), lower body muscle cross-sectional area, and strength decrease by about 10% to 15% after short- (≈14 days) and long-duration (≈6 months) missions on the International Space Station (ISS). Future space missions longer in duration and further from Earth will employ exploration vehicles that will have exercise hardware with less robust and more constrained exercise capabilities than of those available on the ISS. Thus, countermeasures will need to be optimized to protect crew health and performance on exploration-class missions lasting up to 3 years. This requires a more detailed understanding of the dynamic effects of spaceflight on human health and performance, the ability of exercise to protect against this deconditioning, and the interaction of exercise with interrelated factors like nutrition, sleep, and environmental conditions. Methods: We will use standardized research and medical testing protocols previously validated in 1g and microgravity to quantify the time course and the inter-individual variability of changes in physical performance, including cardiorespiratory fitness and muscle strength and endurance, before, during, and after spaceflight missions lasting 2 months, 6 months, and 1 year. Additionally, we will use an extrapolation model to predict changes associated with multi-year exploration missions. Additionally, we will monitor in-flight exercise, nutrition, and sleep using in-flight assessment tools. Significance: Our testing protocols will provide valuable information for determining time course of change and the interindividual variability of spaceflight-induced deconditioning of aerobic capacity and muscle strength and endurance over the course of spaceflight missions up to and beyond 1 year. This information will be vital to assess whether humans can be physically ready for deep space exploration, such as on a mission to Mars, using current technology, or if additional mitigation strategies are necessary.

N Strock↗

EFFECTS OF HIGH G CONDITIONS ON PILOT PERFORMANCE

The general development trend in space vehicle design suggests the desirability of maximally using the occupant to both control capsule attitude and to monitor vehicle systems during the boost (and reentry) acceleration phases, as well as during orbital flight. Consequently, much more information is needed concerning man's ability to perform certain control functions under conditions in which he is exposed to accelerations which approach not only his physiological tolerance limits, but also his performance tolerance limits. In addition to the need for more data concerning the acceleration stress that man can endure and still retain the ability to perform control functions, there is a need to know specifically the nature of performance errors which can arise, not only as the direct result of acceleration, but also as secondary effects of acceleration inter acting with other conditions such as the type of control task, the type of control device, the damping and stability parameters, and the pilot's physiological endurance8 . Current concern over the performance capabilities of the human pilot immersed in certain acceleration environments is well founded since there are very few experimental reports describing the effects of these conditions on performance. The present paper attempts to summarize some of the results of recent studies conducted at the Aviation Medical Acceleration Laboratory (AMAL) in which specific pilot performance capabilities were studied under several conditions of acceleration stress.

Gravity↗

Validation of Ultrasound Imaging to Rule-out Thoracic Trauma on the International Space Station

Introduction: Aboard the International Space Station (ISS) an intra-thoracic injury may be disastrous to the crew member if the diagnosis is missed or even delayed. Pneumothorax and hemothorax commonly seen in trauma patients; the diagnosis is usually confirmed by chest X-ray or computed tomography. In this study, the ability of ultrasound to rule out pneumothorax by the presence "lung sliding" and hemothorax by the absence of pleural fluid was validated. Methods: The research activities were approved by the NASA Johnson Space Center Committee for the Protection of Human Subjects, and the participating crewmembers signed informed consent prior to the activity. ISS crewmembers received 2-hours of "hands on" ultrasound training 8 months prior to the on-orbit ultrasound exam. Baseline ultrasound images of the thorax were acquired on the crewmebers of Increment 8 and 9 prior to launch from Bakonur, Russia. Ultrasound examination of the thorax were performed on crewmembers at 30 day intervals (n=??) throughout their flight. Post flight images were acquired on or about landing day 10. Ultrasound images were acquired using the ISS Health Research Facility ultrasound system and examined by experts on the ground to rule out the presence of pneumothorax and hemothorax. Results: The presence of "lung sliding" which excludes pneumothorax, was seen in all subjects. The absence of pleural fluid, which excludes hemothorax was seen in all subjects. The optimal position between sonographer and patient under microgravity conditions and the amount and type of training for a non-physician crew medical officer for these procedures was also established for this procedure. Conclusion: Ultrasound can be performed on orbit under microgravity condition to rule thoracic trauma, such as pneumothorax and hemothorax.

Hamilton, Douglas R.↗

A review of the influence of physical condition parameters on a typical aerospace stress effect: Decompression sickness

The study examines data on episodes of decompression sickness, particularly from recent Navy work in which the event occurred under multiple stress conditions, to determine the extent to which decompression sickness might be predicted on the basis of personal characteristics such as age, weight, and physical condition. Such information should ultimately be useful for establishing medical selection criteria to screen individuals prior to participation inactivities involving extensive changes in ambient pressure, including those encountered in space operations. The main conclusions were as follows. There is a definite and positive relationship between increasing age and weight and the likelihood of decompression sickness. However, for predictive purposes, the relationship is low. To reduce the risk of bends, particularly for older individuals, strenuous exercise should be avoided immediately after ambient pressure changes. Temperatures should be kept at the low end of the comfort zone. For space activities, pressure changes of over 6-7 psi should be avoided. Prospective participants in future missions such as the Space Shuttle should not be excluded on the basis of age, certainly to age 60, if their general condition is reasonably good and they are not grossly obese. (Modified author abstract)

West, V. R.↗

Pharmacokinetics of Acetaminophen in Hind Limbs Unloaded Mice: A Model System Simulating the Effects of Low Gravity on Astronauts in Space

The pharmacokinetics (PK) of medications administered to astronauts could be altered by the conditions in Space. Low gravity and free floating (and associated hemodynamic changes) could affect the absorption, distribution, metabolism and excretion of the drugs. Knowledge of these alterations is essential for adjusting the dosage and the regimen of drug administration in astronauts. Acquiring of such knowledge has inherent difficulties due to limited opportunities for experimenting in Space. One of the approaches is to use model systems that simulate some of the Space conditions on Earth. In this study we used hind limbs unloaded mice (HLU) to investigate the possible changes in PK of acetaminophen, a widely used analgesic with high probability of use by astronauts. The HLU is recognized as an appropriate model for simulating the effects of low gravity on hemodynamic parameters. Mice were tail suspended (n = 24) for 24-96 hours prior to introduction of acetaminophen (150 - 300 mg/kg). The drug (in aqueous solution containing 10% ethyl alcohol by volume) was given orally by a gavage procedure and after the administration of acetaminophen mice were additionally suspended for 30 min, 1 and 2 hours. Control mice (n = 24) received the same dose of acetaminophen and were kept freely all the time. Blood specimens were obtained either from retroorbital venous sinuses or from heart. Acetaminophen concentration was measured in plasma by the fluorescent polarization immunoassay and the AxSYM analyzer (Abbott Laboratories). In control mice peak acetaminophen concentration was achieved at 30 min. By 1 hour the concentration decreased to less than 50% of the peak level and at 2 hours the drug was almost undetectable in the serum. HLU for 24 hours significantly altered the acetaminophen pharmacokinetic: at 30 min the acetaminophen concentrations were significantly (both statistically and medically significant) lower than in control mice. The concentrations also reduced less significantly after 1 and 2 hours. At 2 hours approximately 20% of the drug still remained in the circulation. After 96 hrs of HLU the changes in acetaminophen PK were less prominent. These data indicate that short term HLU causes significant changes in acetaminophen PK most likely associated with HUL-related hemodynamic changes. However, after 96 hour these changes diminished. This suggests hemodynamic adaptation to the HUL conditions that possibly occurs also in real space conditions.

Peterson, Amanda↗

MEDPRAT Treatment Clusters: Improving Representation of Mission Medical Risk

INTRODUCTION The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) implements a computational model that aims to quantify spaceflight medical risk by utilizing probabilistic techniques to simulate critical event incidence and outcomes over thousands of simulated mission trials. The goal of MEDPRAT is to characterize mission medical risk and provide insight into medical resource utilization. In order to analyze the medical resource space, treatment must be mapped from each simulated condition, and resources consumed as a result of this treatment must be tracked throughout the course of the mission. A new MEDPRAT feature, ‘treatment clusters’, provide a more sophisticated method of defining the structure and interaction between resources, more closely mimicking the way treatment is carried out clinically. METHODS Treatment clusters expand on the two existing treatment groupings (combination and alternate) adding a new grouping: bundled treatment. Treatment clusters may be combined to any depth, giving users the ability to specify complex treatment trees whose behavior is governed by several user-specified parameters. This approach emphasizes reusability, as treatment clusters, once defined, can be used to create more complex treatment trees or applied to many conditions. By configuring parameters for contribution, efficacy, necessity, primacy, and equivalence, resource relationships and dependencies can be more accurately represented, thereby allowing users to build capabilities with desired treatment properties, for example an intravenous capability for conditions such as anaphylaxis, acute radiation syndrome, etc. MEDPRAT v1.0 remains backward compatible with existing treatment structures, giving users the ability to define new treatment clusters as evidence becomes available, without having to recode their existing treatment databases. In addition to facilitating the representation of more complex treatment options, by pairing treatment clusters with the internal optimization routine, the MEDPRAT set selector, medical resources can be identified as organized in bundles, where appropriate, so that optimized resource sets include groups of highly-dependent resources only when all resources of the group are together. For example, it would be wasteful to include ultrasound gel but not an ultrasound machine, since the gel provides no benefit as a treatment without the ultrasound machine. With treatment clusters, the user may require that both resources are available to provide any benefit as treatment, so that if one resource is optimized out of the set, the other resource will be optimized out as well. RESULTS AND CONCLUSIONS We will report on MEDPRAT treatment clusters used in a bundling study under the IMPACT project of the ExMC element. We will discuss an example of a complex treatment tree. Through the implementation of this feature MEDPRAT enables treatment to be defined and applied in a way that is more representative of the real world, providing more accurate insight into mission medical risk and the medical resource space.

Lawrence Leinweber↗

Exploration Medical System Trade Study Tools Overview

ExMC is creating an ecosystem of tools to enable well-informed medical system trade studies. The suite of tools address important system implementation aspects of the space medical capabilities trade space and are being built using knowledge from the medical community regarding the unique aspects of space flight. Two integrating models, a systems engineering model and a medical risk analysis model, tie the tools together to produce an integrated assessment of the medical system and its ability to achieve medical system target requirements. This presentation will provide an overview of the various tools that are a part of the tool ecosystem. Initially, the presentation's focus will address the tools that supply the foundational information to the ecosystem. Specifically, the talk will describe how information that describes how medicine will be practiced is captured and categorized for efficient utilization in the tool suite. For example, the talk will include capturing what conditions will be planned for in-mission treatment, planned medical activities (e.g., periodic physical exam), required medical capabilities (e.g., provide imaging), and options to implement the capabilities (e.g., an ultrasound device). Database storage and configuration management will also be discussed. The presentation will include an overview of how these information tools will be tied to parameters in a Systems Modeling Language (SysML) model, allowing traceability to system behavioral, structural, and requirements content. The discussion will also describe an HRP-led enhanced risk assessment model developed to provide quantitative insight into each capability's contribution to mission success. Key outputs from these various tools, to be shared with the space medical and exploration mission development communities, will be assessments of medical system implementation option satisfaction of requirements and per-capability contributions toward achieving requirements.

Mindock, J.↗

Computer-aided Abnormality Detection in Chest Radiographs in a Clinical Setting via Domain-adaptation

Deep learning (DL) models are being deployed at medical centers to aid radiologists for diagnosis of lung conditions from chest radiographs. Such models are often trained on a large volume of publicly available labeled radiographs. These pre-trained DL models’ ability to generalize in clinical settings is poor because of the changes in data distributions between publicly available and privately held radiographs. In chest radiographs, the heterogeneity in distributions arises from the diverse conditions in X-ray equipment and their configurations used for generating the images. In the machine learning community, the challenges posed by the heterogeneity in the data generation source is known as domain shift, which is a mode shift in the generative model. In this work, we introduce a domain-shift detection and removal method to overcome this problem. Our experimental results show the proposed method’s effectiveness in deploying a pre-trained DL model for abnormality detection in chest radiographs in a clinical setting.

Dubey, Abhishek↗

Lightning Discharges to Aircraft and Associated Meteorological Conditions

A summary is given of information on atmospheric electrical discharges to aircraft and associated meteorological conditions. Information is given that is designed to give a fairly comprehensive view of the underlying principles of meteorology and atmospheric electricity. Of special interest to pilots are lists of procedures of flight conduct and aircraft maintenance recommended foe avoiding or minimizing the hazards of disruptive electrical discharges and other severe conditions near thunderstorms.

MEDICAL PROBLEMS OF FLIGHT - LIGHTNING↗

Low Level Leaks

NASA has transferred the improved portable leak detector technology to UE Systems, Inc.. This instrument was developed to detect leaks in fluid systems of critical launch and ground support equipment. This system incorporates innovative electronic circuitry, improved transducers, collecting horns, and contact sensors that provide a much higher degree of reliability, sensitivity and versatility over previously used systems. Potential commercial uses are pipelines, underground utilities, air-conditioning systems, petrochemical systems, aerospace, power transmission lines and medical devices.

Source record↗

Advances in Nanotechnology for Efficacious and Stable Formulation Development

Current operational medical kits aboard the International Space Station (ISS) include an array of medications intended for the treatment of minor ambulatory care symptoms, first aid, and basic life support. All medications contained in the flight kits are commercially available off-the-shelf formulations used for treatment of illnesses on Earth. However, transport and stowage of supplies including medications for space missions are exposed to adverse environmental conditions and extended shelf-life demands. Proposed missions to Mars and near-Earth objects such as asteroid 1999 AO10 will present crew health risk that is different both quantitatively and qualitatively from those encountered on ISS missions. Few drug options are available at the present time for mitigation of crew health risk of planned space exploration missions. Alternatives to standard oral formulations that include sustained and targeted delivery technologies for preventive healthcare in space will be a welcome addition to the space formulary and may include controlled release topical, sub-cutaneous, intranasal and inhalation dosage forms. An example of such a technology development endeavor can be nanotechnology-based multi-stage drug cocktail and vaccine delivery systems. Nanostructures also have the ability to protect drugs encapsulated within them from physiologic degradation, target their delivery with sustained release and are suitable for per oral routes of administration. The use of nanostructures such as polymeric nanoparticles offers a non-invasive approach for penetrating the blood brain barrier. Finally, nanotechnology offers great potential for the development of safe and efficacious drug delivery systems for preventive health care in space and on Earth.

Putcha, Lakshimi↗

Challenges to Health During Deep Space Exploration Missions

Long duration missions outside of low Earth orbit will present unique challenges to the maintenance of human health. Stressors with physiologic and psychological impacts are inherent in exploration missions, including reduced gravity, increased radiation, isolation, limited habitable volume, circadian disruptions, and cabin atmospheric changes. Operational stressors such as mission timeline and extravehicular activities must also be considered, and these varied stressors may act in additive or synergistic fashions. Should changes to physiology or behavior manifest as a health condition, the rendering of care in an exploration environment must also be considered. Factors such as the clinical background of the crew, inability to evacuate to Earth in a timely manner, communication delay, and limitations in available medical resources will have an impact on the assessment and treatment of these conditions. The presentations associated with this panel will address these unique challenges from the perspective of several elements of the NASA Human Research Program, including Behavioral Health and Performance, Human Health Countermeasures, Space Radiation, and Exploration Medical Capability.

Watkins, S.↗

Medical science in Siberia: Oxygen exchange in the Far North

Differences in oxygen conditions between the native and migrant Siberian population were studied in relation to respiratory function, arterial and venous blood indicators and acid-base indicators. Significant adaptation differences were ascertained between the two populations.

Kulikov, V.↗

Medical examinations for radiation workers

The NASA radiological protection policy allows an employee to be assigned work in a radiologically controlled area only if all of the following conditions are met: (1) The area must be radiologically safe for the intended operations; (2) the employee must be medically fit; (3) the employee must be properly trained; (4) appropriate radiation protection procedures must be prepared; (5) appropriate dosimetric, survey, surveillance and reporting procedures must be implemented; and (6) adequate controls and records must be established.

Alexander, R. E.↗

Results of Speciation Determination Measurements of Insulating Sulfur Hexafluoride Gas

Under the direction of the NNSA NA-231 Mo-99 Program, SRNL has provided technical assistance to U.S. companies under cooperative agreements. One such area of technical assistance has been for the recommendation for contamination management methods in the eventuality that tritium contaminates the insulating gas of a high-voltage ion source used in the accelerator-based process developed by SHINE Medical Technologies to produce Mo-99. The SHINE accelerator process uses tritium as the target of a deuterium ion beam, where the ion beam is produced within a high-voltage ion source insulated with sulfur hexafluoride (SF 6 ), and is separated from the tritium target by an extensive pump train. Normal operating conditions preclude the conditions necessary for contamination of the insulating gas, however certain atypical conditions could result in a tritium contamination event. Accelerator based processes for medical isotope production represent an anomalous tritium contamination challenge due to the presence of SF 6 . SF 6 decomposes through normal use as an insulator gas, and the exact speciation of the decomposition byproducts depends on a variety of factors. This creates a scenario where the anticipation of species present in the insulating gas mixture is difficult. In turn, the fate of tritium within such a chemical system is unclear. This document discusses the results of measurements made in-situ of the SF 6 insulating gas in use within a SHINE Medical Technology’s high-voltage ion source. This was done in an effort to determine the chemical speciation of the gas, allowing for the recommendation of management strategies in the event that tritium contaminates the insulating gas. The results of the measurements reported in this work suggest that tritium contamination in the insulating gas may result in two chemical forms of tritium in the system, tritiated water and molecular tritium. These two forms of tritium would be captured by two methods. Tritiated water may be captured and removed from the SF 6 by an adsorbent canister already present within the pressure vessel that houses the insulating gas while in use. It may also be separated from the SF 6 during routine purification of the SF 6 , which is performed by SHINE personnel routinely. The purification cart will perform all non-embedded systems cleanup necessary to remediate tritiated species in the system. The purification cart passes the insulating gas through several filters, followed by the liquefication of the SF 6 . The filters will separate tritiated water from the SF 6 at this stage. It is expected that molecular tritium will accumulate in the gas-phase during the liquification step, which is separated and stored. Tritium may be recovered from this mixture through more conventional hydrogen purification methods such as a palladium diffuser.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗