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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

Using Systems Engineering to Develop an Integrated Crew Health and Performance System to Mitigate Risk for Human Exploration Missions

New space exploration missions are currently being designed to take humanity beyond Low EarthOrbit (LEO) to cis-lunar space, the lunar surface, and eventually to Mars. These missions carryincreased risks due to a number of factors, including distance from Earth, exposure to deep spacehazards, reduced capacity and ability to resupply and evacuate, and increased communication delays.As distance from Earth grows and mission length increases, a growing proportion of overall missionrisk can be attributed to the “human system.” Almost twenty years ago, the Institute of Medicine in theUnited States recommended the early and complete integration of the human system into thespacecraft and mission design process to mitigate this increased risk inherent in exploration missions.Exploration missions will require increasing levels of crew self-sufficiency that will challenge thecurrent operational paradigms established in LEO. Enabling progressive Earth independence requiresmanagement of the increasingly complex interactions among spacecraft systems and integration of allthe data and functions that affect human health and performance into one coordinated system – theCrew Health and Performance (CHP) system. This system is a critical spacecraft system that isanalogous to other systems such as propulsion, guidance and navigation, or avionics. Design andintegration of the CHP system requires the evidence-based merger of typically disparate disciplinessuch as medicine, human factors, and physiological support system design, using systems engineering(SE) practices. The approach described here enables spacecraft and mission designers to align thescope of a CHP system with mission specific requirements, decrease risk to the crew, and increase theprobability of mission success.

Kerry Mcguire↗
NASA NTRS2019

Integrated Research Plan to Assess the Combined Effects of Space Radiation, Altered Gravity, and Isolation and Confinement on Crew Health and Performance: Implementation Strategy

This document supplements the white paper titled CBS Integrated Research Plan: Problem Statement. The Problem Statement describes why it is important to implement a fully integrated research plan to derive risk estimates for the combined, potentially synergistic, effects of the three major spaceflight hazards (space radiation; isolated, confined, and extreme environments; altered gravity). These risk estimates will help establish acceptable maximum decrement or change in a physiological or behavioral parameter during or after spaceflight, and the acceptable limit of exposure to the combined spaceflight hazards. This Implementation Strategy describes how the research plan will accomplish the CBS Integrated Research Plan goals. The Implementation Strategy includes approaches to evaluate relationships among biological responses underlying three risks that are managed by three of NASA’s Human Research Project (HRP) organizational “elements”. This CBS (Acute effects of radiation on CNS, BMed, Sensorimotor) Integrated Research Plan also identifies strategies to monitor and mitigate decrements to operationally relevant performance. Currently, the strategy that was initiated in 2018, includes an eight-year research plan and a four-year validation plan that extend to the year 2030. Once the monitoring tools and countermeasures are developed, they will be validated and refined during four years of early exploration missions. The planned tasks and their associated research products and deliverables have been mapped to the individual research emphases to clearly demonstrate how each research area helps ensure crew health and safety during exploration missions.

Susan Steinberg↗
NASA NTRS2009

The Skylab Medical Operations Project: Recommendations to Improve Crew Health and Performance for Future Exploration Missions

From May of 1973 to February of 1974, the National Aeronautics and Space Administration conducted a series of three manned missions to the Skylab space station, a voluminous vehicle largely descendant of Apollo hardware, and America s first space station. The crewmembers of these three manned missions spent record breaking durations of time in microgravity (28 days, 59 days and 84 days, respectively) and gave the U.S. space program its first experiences with long-duration space flight. The program overcame a number of obstacles (including a significant crippling of the Skylab vehicle) to conduct a lauded scientific program that encompassed life sciences, astronomy, solar physics, materials sciences and Earth observation. Skylab has more to offer than the results of its scientific efforts. The operations conducted by the Skylab crews and ground personnel represent a rich legacy of operational experience. As we plan for our return to the moon and the subsequent manned exploration of Mars, it is essential to utilize the experiences and insights of those involved in previous programs. Skylab and SMEAT (Skylab Medical Experiments Altitude Test) personnel have unique insight into operations being planned for the Constellation Program, such as umbilical extra-vehicular activity and water landing/recovery of long-duration crewmembers. Skylab was also well known for its habitability and extensive medical suite; topics which deserve further reflection as we prepare for lunar habitation and missions beyond Earth s immediate sphere of influence. The Skylab Medical Operations Summit was held in January 2008. Crewmembers and medical personnel from the Skylab missions and SMEAT were invited to participate in a two day summit with representatives from the Constellation Program medical operations community. The purpose of the summit was to discuss issues pertinent to future Constellation operations. The purpose of this document is to formally present the recommendations of the Skylab and SMEAT participants.

Polk, James D.↗
NASA NTRS2016

Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System

NASA is preparing for long duration manned missions beyond low-Earth orbit that will be challenged in several ways, including long-term exposure to the space environment, impacts to crew physiological and psychological health, limited resources, and no resupply. The food system is one of the most significant daily factors that can be altered to improve human health, and performance during space exploration. Therefore, the paramount importance of determining the methods, technologies, and requirements to provide a safe, nutritious, and acceptable food system that promotes crew health and performance cannot be underestimated. The processed and prepackaged food system is the main source of nutrition to the crew, therefore significant losses in nutrition, either through degradation of nutrients during processing and storage or inadequate food intake due to low acceptability, variety, or usability, may significantly compromise the crew's health and performance. Shelf life studies indicate that key nutrients and quality factors in many space foods degrade to concerning levels within three years, suggesting that food system will not meet the nutrition and acceptability requirements of a long duration mission beyond low-Earth orbit. Likewise, mass and volume evaluations indicate that the current food system is a significant resource burden. Alternative provisioning strategies, such as inclusion of bioregenerative foods, are challenged with resource requirements, and food safety and scarcity concerns. Ensuring provisioning of an adequate food system relies not only upon determining technologies, and requirements for nutrition, quality, and safety, but upon establishing a food system that will support nutritional adequacy, even with individual crew preference and self-selection. In short, the space food system is challenged to maintain safety, nutrition, and acceptability for all phases of an exploration mission within resource constraints. This document presents the evidence for the Risk of Performance Decrement and Crew Illness Due to an Inadequate Food System and the gaps in relation to exploration, as identified by the NASA Human Research Program (HRP). The research reviewed here indicates strategies to establish methods, technologies, and requirements that increase food stability, support adequate nutrition, quality, and variety, enable supplementation with grow-pick-and-eat salad crops, ensure safety, and reduce resource use. Obtaining the evidence to establish an adequate food system is essential, as the resources allocated to the food system may be defined based on the data relating nutritional stability and food quality requirements to crew performance and health.

Douglas, Grace L.↗
NASA NTRS2001

The Role of Space Medicine in Management of Risk in Spaceflight

The purpose of Space Medicine is to ensure mission success by providing quality and comprehensive health care throughout all mission phases to optimize crew health and performance and to prevent negative long-term health consequences. Space flight presents additional hazards and associated risks to crew health, performance, and safety. With an extended human presence in space it is expected that illness and injury will occur on orbit, which may present a significant threat to crew health and performance and to mission success. Maintaining crew health, safety and performance and preventing illness and injury are high priorities necessary for mission success and agency goals. Space flight health care should meet the standards of practice of evidence based clinical medicine. The function of Space Medicine is expected to meet the agency goals as stated in the 1998 NASA Strategic Plan and the priorities established by the Critical Path Roadmap Project. The Critical Path Roadmap Project is an integrated NASA cross-disciplinary strategy to assess, understand, mitigate, and manage the risks associated with long-term exposure to the space flight environment. The evidence based approach to space medicine should be standardized, objective process yielding expected results and establishing clinical practice standards while balancing individual risk with mission (programmatic) risk. The ability to methodically apply available knowledge and expertise to individual and mission health issues will ensure appropriate priorities are assigned and resources are allocated. NASA Space Medicine risk management process is a combined clinical and engineering approach. Competition for weight, power, volume, cost, and crew time must be balanced in making decisions about the care of individual crew with competing agency resources.

Clark, Jonathan B.↗
NASA NTRSDate not supplied

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

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

performance modeling↗
NASA NTRSDate not supplied

Recommendations For Developing Space Suit Integrated Food Systems and Delivering Nutrition Before, During, and After Lunar Eva

INTRODUCTION Artemis missions will include a higher tempo and frequency of extravehicular activities (EVAs) than any previous space program. Because of the physical demands expected from the crew, future space suit designs are required to incorporate nutritional support to the astronauts during lunar surface EVAs lasting longer than 4 hours. The purpose of this project was to provide recommendations to aid the development of an in-suit system that can adequately, safely, and acceptably deliver nutrition to a crewmember while confined to a space suit during EVA. METHODS Physiological, logistical, and engineering aspects of potential in-suit nutrition approaches were assessed through literature reviews, assessments of commercial off the shelf (COTS) foods, suit volumetric modeling, and feedback from subject matter experts and crewmembers. Key driving factors in the development of in-suit nutrition requirements included how much and what type of nutrition should be included, what food formulations are appropriate and safe, what are inherent limitations of space suits, what are the potential risks to the crewmember in the suit, and what practices and preferences from astronauts should be considered. Design references were conceptualized and assessed for strengths and limitations as potential in-suit nutrition systems for surface EVA. RESULTS Acute exogenous energy demands vary greatly depending on activity intensity and duration, and partial energy replenishment (i.e., 60–80 kcal∙hr-1 of EVA, or 460–680 kcal for EVAs lasting up to 8 hours) during activities could improve performance, safety, and recovery. COTS foods capable of providing these energy requirements exist; however, no COTS foods have been identified that pass NASA flight standards for microbiological safety and stability. In-suit nutrition delivery design references that were considered included in-suit concepts for a prefilled drink bag, a hydratable drink bag, and a solid food stick. In addition, a helmet feed port concept was considered for use with drink bags external to the suit. Volumetric models of the in-suit drink bag concepts, based on xEMU dimensions, indicate challenges of fitting formulations > 200 ml (equating to approximately 200 kcal). Astronaut feedback on the four concepts indicated that despite some individual preferences for inclusion of solid foods and helmet port designs, the prefilled drink bag concept was the most preferred. A prefilled drink bag can only be used if food safety and stability can be ensured, possibly requiring advancements in food delivery hardware. CONCLUSION The ability to meet the increased need for nutrition during surface EVAs through provision of nutrients in the suited configuration would benefit overall crew health, performance, and morale, and thus increase the likelihood of mission success. It is recommended that in-suit nutrition capabilities provide at least 400–600 kcal within the suit during EVAs lasting > 4 hours and that suit designs include a dedicated volume for food grade nutrition systems. The developed food system should either allow for 1) installation of prefilled (sealed sterile) liquid nutrition in the suit and provide a mechanism to break the seal at the time that consumption is desired or 2) demonstrate that the unsealed food product shelf life allows for safe consumption after at least 12 hours of EVA.

E L Dillon↗
NASA NTRSDate not supplied

Recommendations for Developing Space Suit Integrated Food Systems and Delivering Nutrition Before, During, and After Lunar EVA

INTRODUCTION Artemis missions will include a higher tempo and frequency of extravehicular activities (EVAs) than any previous space program. Because of the physical demands expected from the crew, future space suit designs are required to incorporate nutritional support to the astronauts during lunar surface EVAs lasting longer than 4 hours. The purpose of this project was to provide recommendations to aid the development of an in-suit system that can adequately, safely, and acceptably deliver nutrition to a crewmember while confined to a space suit during EVA. METHODS Physiological, logistical, and engineering aspects of potential in-suit nutrition approaches were assessed through literature reviews, assessments of commercial off the shelf (COTS) foods, suit volumetric modeling, and feedback from subject matter experts and crewmembers. Key driving factors in the development of in-suit nutrition requirements included how much and what type of nutrition should be included, what food formulations are appropriate and safe, what are inherent limitations of space suits, what are the potential risks to the crewmember in the suit, and what practices and preferences from astronauts should be considered. Design references were conceptualized and assessed for strengths and limitations as potential in-suit nutrition systems for surface EVA. RESULTS Acute exogenous energy demands vary greatly depending on activity intensity and duration, and partial energy replenishment (i.e., 60–80 kcal∙hr-1 of EVA, or 460–680 kcal for EVAs lasting up to 8 hours) during activities could improve performance, safety, and recovery. COTS foods capable of providing these energy requirements exist; however, no COTS foods have been identified that pass NASA flight standards for microbiological safety and stability. In-suit nutrition delivery design references that were considered included in-suit concepts for a prefilled drink bag, a hydratable drink bag, and a solid food stick. In addition, a helmet feed port concept was considered for use with drink bags external to the suit. Volumetric models of the in-suit drink bag concepts, based on xEMU dimensions, indicate challenges of fitting formulations > 200 ml (equating to approximately 200 kcal). Astronaut feedback on the four concepts indicated that despite some individual preferences for inclusion of solid foods and helmet port designs, the prefilled drink bag concept was the most preferred. A prefilled drink bag can only be used if food safety and stability can be ensured, possibly requiring advancements in food delivery hardware. CONCLUSION The ability to meet the increased need for nutrition during surface EVAs through provision of nutrients in the suited configuration would benefit overall crew health, performance, and morale, and thus increase the likelihood of mission success. It is recommended that in-suit nutrition capabilities provide at least 400–600 kcal within the suit during EVAs lasting > 4 hours and that suit designs include a dedicated volume for food grade nutrition systems. The developed food system should either allow for 1) installation of prefilled (sealed sterile) liquid nutrition in the suit and provide a mechanism to break the seal at the time that consumption is desired or 2) demonstrate that the unsealed food product shelf life allows for safe consumption after at least 12 hours of EVA.

space suit↗
NASA NTRSDate not supplied

Integrating Human System Information with the Systems Platform for Aggregating and Relating Capabilities (SPARC)

Within Human Health and Performance, there exists a wealth of human system information that’s used a regular basis in support of NASA human exploration objectives, but the challenge is that all of this information was stored in multiple different locations and organized for specific uses, limiting its effectiveness and straining communication across multiple groups. To address this challenge, our project, the Systems Platform for Aggregating and Relating Capabilities (SPARC) was tasked with developing a new NASA internal web application that aggregates and relates multiple programs’ human system products, such as technical standards, program requirements and verifications, human system risks, research and evidence, and exploration capabilities, into one centralized platform that addresses the needs of human health and performance from multiple different perspectives. Using agile development methodologies, user-experience (UX) driven design principles, data visualization, and a strong emphasis on continuous improvement though consistent stakeholder engagement, the SPARC project released a beta version in less than 4 months, broadly launched version 1.0.0 Agency-wide three months after the beta, and has over 180 users in the first year of development. Our second year of development will see us moving from our initial capabilities to increasingly robust and complex integrations and visualizations, including Directed Acyclical Graphs (DAGs), natural language processing (NLP) for dynamic generation of relationships between the sources of truth, and an expansion into hierarchical levels of system design in support of the human exploration programs.

Data science↗