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At least 37 records · Page 2

Visual Impairment/lntracranial Pressure Risk Clinical Care Data Tools

Prior to 2010, several ISS crewmembers returned from spaceflight with changes to their vision, ranging from a mild hyperopic shift to frank disc edema. As a result, NASA expanded clinical vision testing to include more comprehensive medical imaging, including Optical Coherence Tomography and 3 Tesla Brain and Orbit MRIs. The Space and Clinical Operations (SCO) Division developed a clinical practice guideline that classified individuals based on their symptoms and diagnoses to facilitate clinical care. For the purposes of clinical surveillance, this classification was applied retrospectively to all crewmembers who had sufficient testing for classification. This classification is also a tool that has been leveraged for researchers to identify potential risk factors. In March 2014, driven in part by a more comprehensive understanding of the imaging data and increased imaging capability on orbit, the SCO Division revised their clinical care guidance to outline in‐flight care and increase post‐flight follow up. The new clinical guidance does not include a classification scheme

Van Baalen, Mary

NASA Perspective and Modeling of Thermal Runaway Propagation Mitigation in Aerospace Batteries

NASA has traditionally sought to reduce the likelihood of a single cell thermal runaway (TR) in their aerospace batteries to an absolute minimum by employing rigorous screening program of the cells. There was generally a belief that TR propagation resulting in catastrophic failure of the battery was a forgone conclusion for densely packed aerospace lithium-ion batteries. As it turns out, this may not be the case. An increasing number of purportedly TR propagation-resistant batteries are appearing among NASA partners in the commercial sector and the Department of Defense. In the recent update of the battery safety standard (JSC 20793) to address this paradigm shift, the NASA community included requirements for assessing TR severity and identifying simple, low-cost severity reduction measures. Unfortunately, there are no best-practice guidelines for this work in the Agency, so the first project team attempting to meet these requirements would have an undue burden placed upon them. A NASA engineering Safety Center (NESC) team set out to perform pathfinding activities for meeting those requirements. This presentation will provide contextual background to this effort, as well as initial results in attempting to model and simulate TR heat transfer and propagation within battery designs.

safety

Directed Research in Bone Discipline: Refining Previous Research Observations for Space Medicine

Dual-energy X-ray absorptiometry bone mass density, as a sole index, is an insufficient surrogate for fracture; Clinical Practice Guidelines using bone mass density (both World Health Organization and FRAX) are not specific for complicated subjects such as young, healthy persons following prolonged exposure to skeletal unloading (i.e. an attribute of spaceflight); Research data suggest that spaceflight induces changes to astronaut bones that could be profound, possibly irreversible and unlike age-related bone loss on Earth.; There is a need to objectively assess factors across human physiology that are also influenced by spaceflight (e.g., muscle) that contribute to fracture risk. Some of these objective assessments may require innovative technologies, analyses and modeling.; Astronauts are also exposed to novel situations that may overload their bones highlighting a need integrate biomechanics of physical activities into risk assessments.; As we accumulate data, which reflects the biomechanical competence of bone under specific mechanically-loaded scenarios (even activities of daily living), BONE expects Bone Fracture Module to be more sensitive and/or have less uncertainty in its assessments of fracture probability.; Fracture probability drives the requirement for countermeasures. Level of evidence will unlikely be obtained; hence, the Bone Research and Clinical Advisory Panel (like a Data Safety Monitoring Board) will provide the recommendations.

Sibonga, Jean D.

Analyses of Magnetic Resonance Imaging of Cerebrospinal Fluid Dynamics Pre and Post Short and Long-Duration Space Flights

Preliminary results are based on analyses of data from 17 crewmembers. The initial analysis compares pre to post-flight changes in total cerebral blood flow (CBF) and craniospinal CSF flow volume. Total CBF is obtained by summation of the mean flow rates through the 4 blood vessels supplying the brain (right and left internal carotid and vertebral arteries). Volumetric flow rates were obtained using an automated lumen segmentation technique shown to have 3-4-fold improved reproducibility and accuracy over manual lumen segmentation (6). Two cohorts, 5 short-duration and 8 long-duration crewmembers, who were scanned within 3 to 8 days post landing were included (4 short-duration crewmembers with MRI scans occurring beyond 10 days post flight were excluded). The VIIP Clinical Practice Guideline (CPG) classification is being used initially as a measure for VIIP syndrome severity. Median CPG scores of the short and long-duration cohorts were similar, 2. Mean preflight total CBF for the short and long-duration cohorts were similar, 863+/-144 and 747+/-119 mL/min, respectively. Percentage CBF changes for all short duration crewmembers were 11% or lower, within the range of normal physiological fluctuations in healthy individuals. In contrast, in 4 of the 8 long-duration crewmembers, the change in CBF exceeded the range of normal physiological fluctuation. In 3 of the 4 subjects an increase in CBF was measured. Large pre to post-flight changes in the craniospinal CSF flow volume were found in 6 of the 8 long-duration crewmembers. Box-Whisker plots of the CPG and the percent CBF and CSF flow changes for the two cohorts are shown in Figure 4. Examples of CSF flow waveforms for a short and two long-duration (CPG 0 and 3) are shown in Figure 5. Changes in CBF and CSF flow dynamics larger than normal physiological fluctuations were observed in the long-duration crewmembers. Changes in CSF flow were more pronounced than changes in CBF. Decreased CSF flow dynamics were observed in a subject with VIIP signs. Study limitations include a slightly longer landing-to-MRI scan period for the short-duration cohort and limited sensitivity of the subjective discrete ordinal CPG scale. This limitation can be overcome by using imaging based parametric measures of VIIP severity such as globe deformation measures.

Alperin, Noam

Crowd Sourcing Approach for UAS Communication Resource Demand Forecasting

Congressional attention to Unmanned Aircraft Systems (UAS) has caused the Federal Aviation Administration (FAA) to move the National Airspace System (NAS) Integration project forward, but using guidelines, practices and procedures that are yet to be fully integrated with the FAA Aviation Management System. The real drive for change in the NAS will to come from both UAS operators and the government jointly seeing an accurate forecast of UAS usage demand data. This solid forecast information would truly get the attention of planners. This requires not an aggregate demand, but rather a picture of how the demand is spread across small to large UAS, how it is spread across a wide range of missions, how it is expected over time and where, in terms of geospatial locations, will the demand appear. In 2012 the Volpe Center performed a study of the overall future demand for UAS. This was done by aggregate classes of aircraft types. However, the realistic expected demand will appear in clusters of aircraft activities grouped by similar missions on a smaller geographical footprint and then growing from those small cells. In general, there is not a demand forecast that is tightly coupled to the real purpose of the mission requirements (e.g. in terms of real locations and physical structures such as wind mills to inspect, farms to survey, pipelines to patrol, etc.). Being able to present a solid basis for the demand is crucial to getting the attention of investment, government and other fiscal planners. To this end, Mosaic ATM under NASA guidance is developing a crowd sourced, demand forecast engine that can draw forecast details from commercial and government users and vendors. These forecasts will be vetted by a governance panel and then provide for a sharable accurate set of projection data. Our paper describes the project and the technical approach we are using to design and create access for users to the forecast system.

air traffic

Emergency Locator Transmitter System Performance During Three Full-Scale General Aviation Crash Tests

Full-scale crash tests were conducted on three Cessna 172 aircraft at NASA Langley Research Center's Landing and Impact Research facility during the summer of 2015. The purpose of the three tests was to evaluate the performance of commercially available Emergency Locator Transmitter (ELT) systems and support development of enhanced installation guidance. ELTs are used to provide location information to Search and Rescue (SAR) organizations in the event of an aviation distress situation, such as a crash. The crash tests simulated three differing severe but survivable crash conditions, in which it is expected that the onboard occupants have a reasonable chance of surviving the accident and would require assistance from SAR personnel. The first simulated an emergency landing onto a rigid surface, while the second and third simulated controlled flight into terrain. Multiple ELT systems were installed on each airplane according to federal regulations. The majority of the ELT systems performed nominally. In the systems which did not activate, post-test disassembly and inspection offered guidance for non-activation cause in some cases, while in others, no specific cause could be found. In a subset of installations purposely disregarding best practice guidelines, failure of the ELT-to-antenna cabling connections were found. Recommendations for enhanced installation guidance of ELT systems will be made to the Radio Technical Commission for Aeronautics (RTCA) Special Committee 229 for consideration for adoption in a future release of ELT minimum operational performance specifications. These recommendations will be based on the data gathered during this test series as well as a larger series of crash simulations using computer models that will be calibrated based on these data

Littell, Justin D.

Applying Research-Based Training Principles: Towards Crew-Centered, Mission-Oriented Space Flight Training

This chapter describes a training approach that applies empirically derived principles of training to re-imagining the overall design of NASA’s space flight training program. The chapter is focused specifically on the design of astronaut training for NASA’s future deep space, exploration missions to Mars. We briefly describe NASA’s space flight training practices during the Apollo and Space Shuttle eras as well as NASA’s current practices for training astronauts for their missions to the International Space Station. We provide an overview of NASA’s current concepts for a mission to Mars to scope our training approach. We envision a new space flight training approach which we term “crew-centered, mission oriented” training, inspired by the design approach offered in the context of airline pilot training by Barshi (2015). We apply some of the training principles reviewed by Kole and his colleagues in the companion volume (Kole, Healy, Schneider & Barshi, 2019), as well as by other researchers in training science (e.g., Ericsson, Krampe, & Tesch-Römer, 1993; Healy & Bourne, 2012; Salas, Wilson, Priest and Guthrie, 2006), into real-world, practical guidelines for the particular context of training astronauts for a mission to Mars.processes over very long retention intervals.

Training

Controlled Rest on the Flight Deck: Profile of Use, Challenges, and Best Practices

Managing fatigue in 24/7 operations is complex; fatigue and performance degradation can have health and safety consequences for the workers and can have economic and community consequences. We will present new findings on sleep, circadian misalignment, and performance in operational personnel. The presentations will shed light on how sleep and circadian misalignment affect workers' performance, safety, and health across multiple operations, and their application in fatigue risk management.As part of this symposium, I will discuss how pilots can use short naps (controlled rest) as a countermeasure to elevated sleepiness in-flight. My presentation will describe how and when controlled rest is used operationally and outline best practice guidelines for maximizing the benefits while managing the associated risks.

aviation

Towards Crew-Centered, Mission-Oriented Space Flight Training

This poster describes a training approach that applies empirically derived principles of training to reimagining the overall design of NASA's space flight training program. The poster is focused specifically on the design of astronaut training for NASA's future deep space, exploration missions to Mars. We briefly describe NASA's space flight training practices during the Apollo and Space Shuttle eras as well as NASA's current practices for training astronauts for their missions to the International Space Station. We provide an overview of NASA's current concepts for a mission to Mars to scope our training approach. We envision a new space flight training approach which we term crew-centered, mission oriented training, inspired by the design approach offered in the context of airline pilot training by Barshi. We apply research-based training principles reviewed by Kole and his colleagues, as well as by other researchers in training science, into real-world, practical guidelines for the particular context of training astronauts for a mission to Mars.

Dempsey, Donna L.

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

From May 8th to June 9th, 2023, I had the opportunity to participate in an experiential learning experience at Johnson Space Center in Houston, TX with Exploration Medical Capability (ExMC), an element of the NASA Human Research Program. During this research experience, I was not only able to work on the above titled research project, but also gain an immense exposure to the field of aerospace medicine, make numerous connections within the field, tour NASA facilities, as well as travel to the Aerospace Medical Association Annual Conference (AsMA) in New Orleans. To briefly introduce my project, it is well understood that the medical capabilities available to crew medical officers (CMOs) on the International Space Station will be different than the capabilities available and needed during deep space exploration missions to the Moon, Mars, and beyond. Ground support is particularly limited due to distance, communication delays (or lack of communication), and lack of resupply. Therefore, to support medical care by CMOs on these missions, robust clinical decision support systems (CDSSs) must be designed. The recent publication and public launch of generative artificial intelligence (AI) tools based upon large language models (LLM) such as ChatGPT provides the opportunity to create a smart assistant for onboard triage, diagnosis, and treatment of medical conditions. Ultimately, the overall purpose of the project was to research what AI tools currently exist or are in development, and to see how they might be implemented onboard during exploration class spaceflights of the future. The ExMC element is actively developing several tools to be used in preparation for and during deep space exploration missions. One of those tools, known as IMPACT, is a probabilistic risk assessment model which can be used to propose a desired medical system (based on mass and volume) and suggest the clinical outcomes likely to occur for a design reference mission (DRM). The group recently presented the IMPACT model and a DRM of interest titled “Modified Long Duration Lunar Orbital and Lunar Surface” (mLDLOLS) at the recent AsMA conference. The mLDLOLS mock mission is a 9 month and 6-day deep space exploration mission consisting of time in Moon’s orbit (3 months on the Gateway space station), on the lunar surface (3 months within habitat), and another 3 months on Gateway before return to Earth. For this DRM, IMPACT ultimately outlined a preferred medical system that was then associated with medical conditions considered to be most likely based on frequency, most likely to cause astronaut task time loss (TTL), most likely to cause return to definitive care (RTDC), and most likely cause loss of crew life (LOCL). IMPACT also highlighted the medical capabilities/skills that would be required to care for those medical conditions, such as performing a history of present illness or musculoskeletal exam with ultrasound. The primary objective of the project was to perform a survey of the AI tools and systems applicable to the conditions outlined for the proposed mLDLOLS mission. Using PubMed (including most relevant MeSH terms) and Google Scholar, we then created a robust annotated bibliography organized by condition. The 56-page and over 500 reference annotated bibliography was subsequently used to create a review outline that would become the basis for drafting of a future publication. For the review outline, we took those medical conditions researched within the annotated bibliography (condition-based approach) and deployed a systems-based approach, combining those medical conditions and related tools into ten categories. These categories included general/all-purpose CDSSs, tools to diagnose or manage respiratory, dermatologic, neurologic, auditory and vestibular, ophthalmic, musculoskeletal, infection-associated, and gynecologic conditions, as well as tools that could be deployed in the setting of trauma/emergency. With the completion of the 30-page outline, we then began drafting the review paper. To conclude the research experience, I presented the findings from our survey to the ExMC Clinical and Science team. With these objectives, I ultimately learned about the number of AI tools that exist today to assist medical professionals with the triage, diagnosis, and management of several medical conditions. These tools can span from chatbot assistants to help triage knee pain to vision transformer models that can identify ophthalmic conditions based on ocular surface images captured with a cell phone. We also highlighted the current gaps that exist in the literature alongside the advancements that are needed to make the desired CDSS for deep space exploration missions. With this experience, I certainly confirmed an existing career goal and identified several additional skills needed to become an aerospace medical doctor including knowledge of critical care in an extreme medicine setting, aerospace engineering and human integration systems, artificial intelligence, machine learning, and risk models. I also identified numerous transferable skills for this career goal including the basic knowledge of medicine (MD), deployment of the scientific method for critical thought about new scientific questions (PhD), review of published literature, including creating an annotated bibliography (PhD), as well as detailed scientific writing (PhD). The results of my research will likely guide the design of an all-encompassing onboard medical assistant for use during deep space exploration missions of the future. I plan on sharing the outcomes from this experience with my peers at a student seminar in the Fall semester on August 30th. During the seminar, I will detail the project, my experience at NASA and AsMA, as well as offer best practice guidelines for students entertaining similar experiences or careers. In conclusion, I would like to thank the WVU School of Medicine, Research and Graduate Education office, as well as NASA ExMC for the unwavering support of this life-changing experience.

Ryan A. Lacinski

Review of the Natural History of Renal Stones in U.S. Astronauts

BACKGROUND: The formation of renal stones in astronauts may pose a considerable threat to crew health and to the completion of mission objectives. Although a history of prior renal stones is an exclusion criterion for initial selection, there have been reported cases of renal stones that have developed after selection. This led to the establishment, nine years ago, of a standardized protocol to screen for the development of renal stones pre-and post-spaceflight in all active astronauts. OVERVIEW: Literature regarding stone makeup, size, location, time to passage, and outcomes were reviewed, as well as incidence of renal stones in astronaut analog populations such as military pilots and the general population. The Lifetime Surveillance of Astronaut Health (LSAH) database was queried and as of 2015 there have been 22 crew members who have reported 36 renal stone events from a population of 357 astronauts, with an incidence of 0.32 events per year. This compares favorably to the incidence of 0.37 to 0.46events per year in commercial pilots. DISCUSSION: The physiologic changes associated with spaceflight have been thought to present an increased risk for the development of stones, including hypercalciuria, decreased urine pH, and reduced urine volume. NASA’s screening program, based on a rigorous ultrasound method, has now provided nine years of clinical data used to reduce the risk of flying an astronaut with a renal stone that could threaten health and mission objectives. This work and data from the ultrasound screening program was used to update the clinical practice guideline for renal stone surveillance and treatment, and other NASA documents and programs that track this risk.

C McNerlin

Findings From 9 Years of Renal Stone Surveillance of U.S. Astronauts

INTRODUCTION: Renal stones are thought to be a risk for spaceflight due to urine chemistry changes, induced by microgravity. Asymptomatic stone can have significant medical and mission impact.For9 years astronauts travelling to the International Space Station (ISS) have received pre-and post-flight renal ultrasound, according to a specialized renal ultrasound protocol, to look for renal calcifications or mineralized renal material (MRM).A new ultrasound machine was put in service halfway through the screening program. METHODS: MRM screening data from pre-and post-flight were compared, to look for changes in MRM burden. Pre-and post-flight scans from 42 subjects were compared. Studies were further stratified by old versus new machine. Measures were modeled using the analysis of variance (ANOVA) as defined by the interaction between pre-to postflight, and machine-to-machine. RESULTS: There was no observed statistical change seen in MRM burden pre-to postflight using the new higher-resolution ultrasound machine. DISCUSSION: The new machine gives more precise measurements and allows us to differentiate MRMs from other bright objects seen on ultrasound, such as small blood vessels. These data imply that spaceflight does not increase the risk of renal stone formation, at least out to the length of ISS missions. This data will be used to update NASA’s Human System Risk Board’s risk tracking documents, in-flight Concept of Operations, and our Clinical Practice Guideline.

K Cortez

Evolution of Spaceflight Renal Stone Risks and Update to the NASA Human Research Program (HRP) Renal Stone Evidence Report and Integrated Concept of Operations

BACKGROUND: The NASA HRP Evidence Report on the Risk of Renal Stone Formation is being updated based on new information obtained from 9 years of data from NASA’s astronaut renal stone surveillance program. In addition, the Concept of Operations for missions beyond Low Earth Orbit (LEO) was created to supplement the Evidence Report, and the NASA clinical practice guideline(CPG)for renal stone surveillance was updated. OVERVIEW: A literature review was performed to evaluate the state of literature regarding renal stone prevention, mitigation, and management both in terrestrial and spaceflight environments. Current renal stone treatment guidelines for the ISS, which were created by the Inflight Clinical Medicine Working Group and approved by the Multilateral Medical Operations Panel (MMOP)were reviewed, as well as recent ultrasound technology demonstrations onboard the ISS. This information was used in conjunction with emerging evidence from the surveillance program to update the Evidence Report and in-flight Concept of Operations. DISCUSSION: There are known and emerging renal stone prevention strategies including astronaut selection, the use of medications and resistive exercise, early diagnosis with regular urine studies and ultrasound imaging. In-flight treatment options include pharmaceuticals, use of lithotripsy and propulsive ultrasound, placement of percutaneous drains and other modalities. This information is useful to gauge future risks and update our strategies for prevention and management of renal stones in astronauts to reduce the risk of in-flight renal stone colic that could cause morbidity and mission impact.

E Stratton

NASA Agile Community of Practice

This 2023-2024 report provides a comprehensive summary of the products and activities executed by the NASA Agile Community of Practice over its first year from being formally stood up. The report highlights the community's ongoing efforts to advance Agile values and principles, improve practices, and foster innovation within teams across NASA centers. The report delves into key initiatives, including the development of a strategic plan, executive summary, and best practice guidelines; as well as the facilitation of knowledge-sharing events such as webinars with internal and external speakers, workshops, and technical interchange meeting.

Agile

Electric Propulsion Qualification Guidelines and Best Practices for NASA Small Spacecraft Missions

Electric propulsion being developed for CubeSats and other small satellites with the taught expectation that high risk is generally acceptable are resulting in devices that do not meet a minimum expectation of engineering rigor for many missions, including appropriate qualification testing. This paper proffers a preliminary set of recommended guidelines and best practices in dialogue with the smallsat community to strike a better balance between engineering rigor and cost effectiveness for the qualification of EP technologies under consideration for NASA small spacecraft.

Thomas M. Liu