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NASA NTRS2014

Arusha Rover Deployable Medical Workstation

The NSBE Arusha rover concept offers a means of human transport and habitation during long-term exploration missions on the moon. This conceptual rover calls for the availability of medical supplies and equipment for crew members in order to aid in mission success. This paper addresses the need for a dedicated medical work station aboard the Arusha rover. The project team investigated multiple options for implementing a feasible deployable station to address both the medical and workstation layout needs of the rover and crew. Based on layout specifications and medical workstation requirements, the team has proposed a deployable workstation concept that can be accommodated within the volumetric constraints of the Arusha rover spacecraft

Rover↗

NASA NTRS2015

Integrated Medical Model (IMM) Project Verification, Validation, and Credibility (VVandC)

The Integrated Medical Model (IMM) Project supports end user requests by employing the Integrated Medical Evidence Database (iMED) and IMM tools as well as subject matter expertise within the Project. The iMED houses data used by the IMM. The IMM is designed to forecast relative changes for a specified set of crew health and mission success risk metrics by using a probabilistic model based on historical data, cohort data, and subject matter expert opinion. A stochastic approach is taken because deterministic results would not appropriately reflect the uncertainty in the IMM inputs. Once the IMM was conceptualized, a plan was needed to rigorously assess input information, framework and code, and output results of the IMM, and ensure that end user requests and requirements were considered during all stages of model development and implementation, as well as lay the foundation for external review and application. METHODS: In 2008, the Project team developed a comprehensive verification and validation (VV) plan, which specified internal and external review criteria encompassing 1) verification of data and IMM structure to ensure proper implementation of the IMM, 2) several validation techniques to confirm that the simulation capability of the IMM appropriately represents occurrences and consequences of medical conditions during space missions, and 3) credibility processes to develop user confidence in the information derived from the IMM. When the NASA-STD-7009 (7009) [1] was published, the Project team updated their verification, validation, and credibility (VVC) project plan to meet 7009 requirements and include 7009 tools in reporting VVC status of the IMM. Construction of these tools included meeting documentation and evidence requirements sufficient to meet external review success criteria. RESULTS: IMM Project VVC updates are compiled recurrently and include updates to the 7009 Compliance and Credibility matrices. Reporting tools have evolved over the lifetime of the IMM Project to better communicate VVC status. This has included refining original 7009 methodology with augmentation from the HRP NASA-STD-7009 Guidance Document working group and the NASA-HDBK-7009 [2]. End user requests and requirements are being satisfied as evidenced by ISS Program acceptance of IMM risk forecasts, transition to an operational model and simulation tool, and completion of service requests from a broad end user consortium including operations, science and technology planning, and exploration planning. IMM v4.0 is slated for operational release in the FY015 and current VVC assessments illustrate the expected VVC status prior to the completion of customer lead external review efforts. CONCLUSIONS: The VVC approach established by the IMM Project of incorporating Project-specific recommended practices and guidelines for implementing the 7009 requirements is comprehensive and includes the involvement of end users at every stage in IMM evolution. Methods and techniques used to quantify the VVC status of the IMM Project represented a critical communication tool in providing clear and concise suitability assessments to IMM customers. These processes have not only received approval from the local NASA community but have also garnered recognition by other federal agencies seeking to develop similar guidelines in the medical modeling community.

Walton, M.↗

NASA NTRS2017

Updates and Overview of Spaceflight Medical Support in Russia and Kazakhstan

This panel presents recent updates to and a comprehensive overview of the operational medical support provided to ISS crewmembers in Star City, Russia and Kazakhstan as part of UTMB/KBRwyle's Human Health & Performance contract. With the current Soyuz training flow, physician support is required for nominal training evolutions involving pressure changes or other potential physical risks detailed in this presentation. In addition, full-time physician presence in Star City helps to address the disparity in access to health care in these relatively remote practice areas, while also developing and maintaining relationships with host nation resources. A unique part of standard training in Russia also involves survival training in both winter and water environments; logistic details and medical impacts of each of these training scenarios will be discussed. Following support of a successful training flow, UTMB/KBRwyle's Star City Medical Support Group (SCMSG) is also responsible for configuring medical packs in support of Soyuz launches and landings; we will present the rationale for current pack contents within the context of specific operational needs. With respect to contingency events, the group will describe their preparedness to respond appropriately by activating both local and global resources as necessary, detailing a specialized subset of the group who continually work and update these assets, given changes in international infrastructure and other impacts.

Chough, Natacha↗

NASA NTRS2020

Dynamic Medical Risk Assessment Supported by Inference Networks

The Human Research Program's next generation risk model, the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT), provides researchers with estimates of astronaut medical and health risk. MEDPRATs Susceptibility Inference Network (SIN) facilitates the dynamic component of this tool. The SIN provides MEDPRAT with a "memory" that allows the system to use knowledge of what simulation events have occurred to alter the representative probability that future simulation events will occur during a given trial. The SIN allows for the medical events being simulated to be related to, and influence the likelihood of one another, providing a more robust risk estimate. We present initial work of our efforts to mathematically quantify and represent these dependent relationships between medical events.

McIntyre, L.↗

NASA NTRSDate not supplied

Inflight Medical Conditions Risk – Overview and Strategic Approach

The risk of adverse health outcomes and decrements in performance due to inflight medical conditions is among NASA’s “red” risks for Mars missions, scored at the highest likelihood and consequence on the rating scale. Importantly, this risk encompasses all possible medical conditions that might occur in spaceflight. At thesame time, exploration spaceflight will have significant resource constraints (mass, power, volume, data, etc.) and supplying the full complement of medical capabilities available on Earth will be impossible. Inevitably, medical conditions will develop during a human Mars mission and having inadequate inflight capabilities will have a negative impact on the health and performance of the astronauts, leading to adverse crew and/or mission outcomes.

B D Easter↗

NASA NTRSDate not supplied

Spaceflight Medical Evacuation Risk Assessment Principles – A Qualitative Investigation

Future human space exploration beyond Low Earth Orbit (LEO) will require innovative solutions in many areas, especially to support the crew medically and optimize their health and performance. Challenges will be numerous, including: extended one-way communication delays, minimal to non-existent resupply and a transit time to a “definitive care” facility ranging from 3-days to 9-months. At the same time, exploration spacecraft will face even more significant restrictions on mass-power-volume-data than in present operational settings. Given these limitations, medical risk assessment is of primary importance, especially evaluating the implications of a medical evacuation of an ill or injured crewmember. Such evacuations are complicated and potentially dangerous, and may be impossible in certain phases of the mission, but this must be weighed against the risks of the injured crew remaining aboard a spacecraft with limited medical resources.

A T Almand↗

NASA NTRSDate not supplied

Medical Lessons Learned from the Exploration Atmospheres Study

Background: The National Aeronautics and Space Administration’s (NASA) Exploration Atmospheres study (EA) was done to evaluate alternative cabin atmospheres for future spacecraft designs and planetary surface exploration of the Moon, Mars and beyond. Deep space exploration involves creating habitats and environments safe for human occupancy and means to explore the outside environment (extravehicular activities, EVA). In order to validate alternative atmospheres and pre-spacewalk procedures, the EA study was conducted to evaluate factors such as hypoxia risks, denitrogenation protocols, food limitations, medications, and the impact of other factors on human performance. Overview: Space travel is constrained by mass, volume, power and the cost of vehicle development, which creates tradeoffs in various capabilities, including breathing gasses. Higher atmospheric pressure in a vehicle means more gas, and a stronger containment vessel/habitat; while lower pressure requires higher oxygen partial pressure, which may increase fire risk. NASA’s EA study evaluated a proposed alternative cabin environment (8.2 psia, 34% Oxygen), for future spacecraft habitat, and planetary EVAs. EA included both a 3-day and a 11-day trial. These trials included a depressurization and saturation to 8.2psi at 34% O2 with additional depresses to 4.3 psia at 85% O2 for simulated EVAs, (1 EVA during the 3-day and 5 during the 11-day trials). Discussion: Planning for and executing the medical monitoring and response plan for a trial of this scope was a huge undertaking with no prior practice to fall back on. Food obstacles, sleeping issues, medications, joint injury, equipment limitations, medical privacy, multiple cases of decompression sickness, and even a COVID outbreak among the support team proved challenging. Conclusion: Testing of this nature is an essential part NASA’s preparation for the upcoming Lunar Artemis missions. As spaceflight transitions beyond low earth orbit, to planetary, even more trials of this nature will be required to learn what are the optimal atmospheric and associated operational constraints to maintain the optimal health of the crew and achieve mission objectives.

R Sanders↗

NASA NTRS2024

Earth Independent Medical Operations (EIMO) DATASCOPE Technical Interchange Meeting 21st August 2023: Background and Summary of Discussion

An aspiration for EIMO datascope is to realize artificial intelligence-enhanced solutions for analysis of crew health & performance data and to facilitate clinical decision support for autonomous medical operations. A vision proposed to the meeting participants was that of a “system of systems,” whereby EIMO will utilize AI-supported natural language processing and machine learning techniques to synthesize embedded reference databases and real-time data streams [input vectors] from multiple data sources to continuously and seamlessly assess crew health & performance. Constituent input vectors may include environmental controls, countermeasures data, behavioral data, physiologic wearables, point-of-care laboratory tests, personalized medical records, inventory trade space risk assessments, COTS medical databases, and ground support inputs. An ideal AI capability would possess trained fusion algorithms to cross reference input vectors with medical ‘knowledge’ [cultivated database] to stratify relevant data streams for predictive and actionable capabilities. In addition, EIMO will ideally have a degree of mobility, in that it can be accessed and can push/pull data within and between multiple vehicles/habitats.

Artificial Intelligence↗

NASA NTRSDate not supplied

Developing the Foundations of an Exploration Class Medical System: Bridging the Capability Gap between LEO and Mars

NASA's overarching mission is to drive advances in science, technology, aeronautics, and space exploration to enhance knowledge, education, innovation, economic vitality, and Earth stewardship. Its Artemis Program encompasses the next steps in human space exploration, critical elements of which include the Orion vehicle and Gateway outpost in lunar orbit. Artemis is the first "exploration class" space travel system with the stated mission to establish sustainable exploration of the lunar surface and serve as a bridge to future human exploration of Mars. Success requires understanding both the commonalities and the differences between our experience to date, predominantly in Low-Earth-Orbit, and the challenges expected in long-duration exploration missions. In addition, these missions will incur significant constraints on both vehicle and human systems. To that end, NASA Exploration Medical Capability (ExMC) element clinicians, engineers, and scientists are developing the "foundation" for a fully vehicle-integrated exploration-class medical system using model-based systems engineering to trace and leverage clinical and engineering content to expand and refine the fidelity and confidence in the medical system itself.

MEDICAL SYSTEMS↗

NASA NTRS2018

Space Technology - Game Changing Development NASA Facts: Autonomous Medical Operations

The AMO (Autonomous Medical Operations) Project is working extensively to train medical models on the reliability and confidence of computer-aided interpretation of ultrasound images in various clinical settings, and of various anatomical structures. AI (Artificial Intelligence) algorithms recognize and classify features in the ultrasound images, and these are compared to those features that clinicians use to diagnose diseases. The acquisition of clinically validated image assessment and the use of the AI algorithms constitutes fundamental baseline for a Medical Decision Support System that will advise crew on long-duration, remote missions.

Autonomous Medical Operations Project↗

NASA NTRSDate not supplied

Human Monitoring for Medical Operator Assistance

Measurement of multiple biologic and non-biologic signals can be exploited for the task of monitoring the physiological status of individuals - either as patients during and following illness or injury or as those engaged in operational activities. Assessing physiological status is accomplished by measuring vital signs and wellness measures that support clinical decision-making for physical optimization, illness/injury prevention and treatment, recovery progression, and general delivery of care, or monitoring an operator's moment-to-moment personal "readiness" state. Physiological measures are beneficial for monitoring the medical state of vehicle operators, for example, through the detection of incapacitation in the realm of transportation safety. Measuring physiological signals or control inputs can also be beneficial for monitoring operator state to optimize human-autonomy-teaming performance for safety and efficiency. Similarly, monitoring a health care provider during the performance of medical procedures could provide valuable feedback on optimizing human-robot interactions and human teaming with autonomous systems. In this sense, the provider can be seen as a "Medical Operator" in the same way other "operators" drive, aviate, or control vehicles by performing manual, attention-demanding tasks during safety-critical activities.

Neuroergonomics↗

NASA NTRS1971

Medical technology advances from space research.

NASA-sponsored medical R & D programs for space applications are reviewed with particular attention to the benefits of these programs to earthbound medical services and to the general public. Notable among the results of these NASA programs is an integrated medical laboratory equipped with numerous advanced systems such as digital biotelemetry and automatic visual field mapping systems, sponge electrode caps for electroencephalograms, and sophisticated respiratory analysis equipment.

Pool, S. L.↗

NASA NTRS1972

An integrated medical system for long-duration space missions.

A description is given of the Integrated Medical and Behavioral Laboratory Measurement System (IMBLMS) being developed for onboard medical support of the crew and for medical research during space missions. The system is suitable for use during early extended space flights and for accommodating measurement and diagnostic apparatus as well as treatment and surgical facilities developed for later missions.

Pool, S. L.↗

NASA NTRS1972

Medical technology advances from space research

Details of medical research and development programs, particularly an integrated medical laboratory, as derived from space technology are given. The program covers digital biotelemetry systems, automatic visual field mapping equipment, sponge electrode caps for clinical electroencephalograms, and advanced respiratory analysis equipment. The possibility of using the medical laboratory in ground based remote areas and regional health care facilities, as well as long duration space missions is discussed.

Pool, S. L.↗

NASA NTRS1974

Video requirements for remote medical diagnosis

Minimal television system requirements for medical telediagnosis were studied. The experiment was conducted with the aid of a simulated telemedicine system. The first step involved making high quality videotape recordings of actual medical examinations conducted by a skilled nurse under the direction of a physician watching on closed circuit television. These recordings formed the baseline for the study. Next, these videotape recordings were electronically degraded to simulate television systems of less than broadcast quality. Finally, the baseline and degraded video recordings were shown (via a statistically randomized procedure) to a large number of physicians who attempted to reach a correct medical diagnosis and to visually recognize key physical signs for each patient. By careful scoring and analysis of the results of these viewings, the pictorial and diagnostic limitations as a function of technical video characteristics were to be defined.

Davis, J. G.↗

NASA NTRS1974

The medical story

An overview of the Skylab medical program is given. All medical subsystems provided in the orbital workshop functioned satisfactorily. Major systems included the food system, the waste management system, and provisions per personal hygiene. A series of lockers in the wardroom was used to stow the inflight medical support system. Cardiovascular counter pressure garments were launched in the orbital workshop for all three crews. Life services experiments were carried out. Two experiments were conducted in the Skylab missions to study the performance of the cardiovascular system during weightless flight and return to earth and the one g environment. A series of experiments was conducted to study mineral balance and the bioassay of body fluids.

Johnston, R. S.↗

NASA NTRS1974

Skylab medical technology utilization

To perform the extensive medical experimentation on man in a long-term, zero-g environment, new medical measuring and monitoring equipment had to be developed, new techniques in training and operations were required, and new methods of collecting and analyzing the great amounts of medical data were developed. Examples of technology transfers to the public sector resulted from the development of new equipment, methods, techniques, and data. This paper describes several of the examples that stemmed directly from Skylab technology.

Stonesifer, J. C.↗

NASA NTRS1974

Evaluation of life in Skylab from a medical viewpoint

The Skylab program established the opportunity for the first time to perform extensive medical experimentation on man in a long-term zero-g environment. This experimentation involved metabolic studies, cardiovascular systems, nutrition and mineral balance, hematology, vestibular function, and many other related investigations. This report presents an overview of the significant results of the medical experiments performed during the program and a summary of the medical observations gathered by the team of life scientists.

Hordinsky, J. R.↗