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Exploration Atmosphere Demonstration of A Multi-Functional Integrated Medical Device (Tempus Pro)

INTRODUCTION The Exploration Medical Capability (ExMC) element within the Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) within the Mars Campaign Office seek to advance medical system design and risk-informed decision-making for exploration missions. This includes assessment of candidate devices and their compatibility within a variety of increasingly Earth-independent medical scenarios. The Tempus Pro (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf (COTS), multi-functional integrated medical device capable of vital signs monitoring, with built-in procedure support (iAssist), patient record and telemedicine communication features, and medical imaging (e.g., camera, laryngoscope, ultrasound) that meets multiple exploration medical capability needs. One of several hypobaric atmospheres being considered for exploration vehicles is 8.2 psi with 34% oxygen. To assess the useability of the Tempus Pro in such environments by individuals without formal medical training, the unit was tested in May and June of 2023 at the Johnson Space Center 20-Foot Exploration Atmosphere Chamber in conjunction with the Exploration Atmospheres-2 (EA-2) study. TECHNOLOGY DEMONSTRATION Eight subjects in the EA-2 study were assigned roles as the caregiver or patient – or both in the case of a self-exam – and caregivers were asked to place sensors for 3-Lead ECG, non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature using Tempus Pro’s iAssist. Depending on the procedure, additional tasks included an oropharyngeal exam of the throat with the laryngoscope and capturing ultrasound images of a cardiac subxiphoid view or of the user’s choice from a pre-specified list. Scenarios ranged from remote-guided to fully autonomous operations and surveyed the effectiveness of support, amount of support desired, and importance of support by type (e.g., written crew procedures, iAssist and device guidance, remote console guidance, etc.). Feedback from the subjects and the support personnel was also gathered to inform future designs for training and support and to determine what operations are plausible given different levels of each. An unweighted NASA task load index (TLX) was used to profile the demands of using the device, however the sample size does not support statistics. The research was exploratory in nature and qualitative information was the main goal. Calibration checks on the Tempus Pro were conducted before and after chamber testing to ensure the device was in useable condition. RESULTS All subjects performed their tasks successfully and found the Tempus Pro easy to use with the support provided. The calibration checks outside the chamber showed that the Tempus Pro remained unchanged and measurements inside the chamber were within normal values. Caregivers taking the NASA TLX reported mean scores ≤ 41/100 showing the tasks to be undemanding and less demanding with repeated use (~20/100). Novice users were able to easily connect sensors and take vital signs with the guidance from Tempus Pro’s iAssist feature. For more complex tasks, such as the oropharyngeal exam and ultrasound image acquisition, guidance beyond iAssist was needed, primarily from a supporting physician. Feedback on the importance of support types varied by person and scenario but greater than 50% of the support used by each was non-native to the device. Overall opinions were positive, but the ultrasound users expressed a lack of confidence in their results and 3 out of 4 desired more time, training, or support. Subjects found the sensors to be comfortable and comparable to prior experiences with such devices, except for the blood pressure cuff, which squeezed too tightly for uncomfortably long periods. Many observations provoked discussion, especially regarding ultrasound, that will aide decisions about future demonstrations.

R. S. Miller↗

NASA NTRS1973

Crew report

A 56-day chamber simulation of Skylab was successfully completed. The atmosphere (5 psi, 70 percent oxygen, 30 percent nitrogen, 5 mm carbon dioxide) and medical features including a 21-day pre- and 18-day post-test medical protocols were closely simulated. No apparent crew health problems were induced by the atmosphere, semiclosed environment, or other test features; and no appreciable crew degradation appeared over this period. The chamber and associated systems performed without major problems.

Bobko, K. J.↗

NASA NTRS1996

Oxygen-Mass-Flow Calibration Cell

Proposed calibration standard for mass flow rate of oxygen based on conduction of oxygen ions through solid electrolyte membrane made of zirconia and heated to temperature of 1,000 degrees C. Flow of oxygen ions proportional to applied electric current. Unaffected by variations in temperature and pressure, and requires no measurement of volume. Calibration cell based on concept used to calibrate variety of medical and scientific instruments required to operate with precise rates of flow of oxygen.

Martin, Robert E.↗

NASA NTRS2007

Human Factors Assessment and Redesign of the ISS Respiratory Support Pack (RSP) Cue Card

The Respiratory Support Pack (RSP) is a medical pack onboard the International Space Station (ISS) that contains much of the necessary equipment for providing aid to a conscious or unconscious crewmember in respiratory distress. Inside the RSP lid pocket is a 5.5 by 11 inch paper procedural cue card, which is used by a Crew Medical Officer (CMO) to set up the equipment and deliver oxygen to a crewmember. In training, crewmembers expressed concerns about the readability and usability of the cue card; consequently, updating the cue card was prioritized as an activity to be completed. The Usability Testing and Analysis Facility at the Johnson Space Center (JSC) evaluated the original layout of the cue card, and proposed several new cue card designs based on human factors principles. The approach taken for the assessment was an iterative process. First, in order to completely understand the issues with the RSP cue card, crewmember post training comments regarding the RSP cue card were taken into consideration. Over the course of the iterative process, the procedural information was reorganized into a linear flow after the removal of irrelevant (non-emergency) content. Pictures, color coding, and borders were added to highlight key components in the RSP to aid in quickly identifying those components. There were minimal changes to the actual text content. Three studies were conducted using non-medically trained JSC personnel (total of 34 participants). Non-medically trained personnel participated in order to approximate a scenario of limited CMO exposure to the RSP equipment and training (which can occur six months prior to the mission). In each study, participants were asked to perform two respiratory distress scenarios using one of the cue card designs to simulate resuscitation (using a mannequin along with the hardware). Procedure completion time, errors, and subjective ratings were recorded. The last iteration of the cue card featured a schematic of the RSP, colors, borders, and simplification of the flow of information. The time to complete the RSP procedure was reduced by approximately three minutes with the new design. In an emergency situation, three minutes significantly increases the probability of saving a life. In addition, participants showed the highest preference for this design. The results of the studies and the new design were presented to a focus group of astronauts, flight surgeons, medical trainers, and procedures personnel. The final cue card was presented to a medical control board and approved for flight. The revised RSP cue card is currently onboard ISS.

Byrne, Vicky↗

DOE OSTI2023

Oxygen carrying materials with surface modification for redox-based catalysis and methods of making and uses thereof

Redox catalysts having surface medication, methods of making redox catalysts with surface modification, and uses of the surface modified redox catalysts are provided. In some aspects, the redox catalysts include a core oxygen carrier region such as CaMnO 3 , BaMnO 3−δ , SrMnO 3−δ , Mn 2 SiO 4 , Mn 2 MgO 4−δ , La 0.8 Sr 0.2 O 3−δ , La 0.8 Sr 0.2 FeO 3−δ , Ca 9 Ti 0.1 Mn 0.9 O 3−δ , Pr 6 O 11−δ , manganese ore, or a combination thereof; and an outer shell having an average thickness of about 1-100 monolayers surrounding the outer surface of the core region. The outer shell can include, for example a salt selected such as Li 2 WO 4 , Na 2 WO 4 , K 2 WO 4 , SrWO 4 , Li 2 MoO 4 , Na 2 MoO 4 , K 2 MoO 4 , CsMoO 4 , Li 2 CO 3 , Na 2 CO 3 , K 2 CO 3 , or a combination thereof.

Li, Fanxing↗

NASA NTRS1992

Utilization of the graded universal testing system to increase the efficiency for assessing aerobic and anaerobic capacity

The in-flight exercise test performed by cosmonauts as part of the Russian Exercise Countermeasure Program is limited to 5 minutes due to communication restrictions. During a recent graded exercise test on a U.S. Shuttle flight, the test was terminated early due to an upcoming loss of signal (LOS) with the ground. This exercise test was a traditional test where the subject's exercise capacity dictates the length of the test. For example, one crew member may take 15 minutes to complete the test, while another may take 18 minutes. The traditional exercise test limits the flight schedulers to large blocks of space flight time in order to provide medical and research personnel information on the fitness capacity (maximal oxygen uptake: VO2max) of crew members during flight. A graded exercise test that would take a finite amount of time and a set preparation and recovery time would ease this problem by allowing flight schedulers to plan exercise tests in advance of LOS. The Graded Universal Testing System (GUTS) was designed to meet this goal. Fitness testing of astronauts before and after flight provides pertinent data on many variables. The Detailed Supplemental Objective (DSO608) protocol (6) is one of the graded exercise tests (GXT) currently used in astronaut testing before and after flight. Test times for this protocol have lasted from 11 to 18 minutes. Anaerobic capacity is an important variable that is currently not being evaluated before and after flight. Recent reports (1,2,5) from the literature have suggested that the oxygen deficit at supramaximal exercise is a measure of anaerobic capacity. We postulated that the oxygen deficit at maximal exercise would be an indication of anaerobic capacity. If this postulate can be accepted, then the efficiency of acquiring data from a graded exercise test would increase at least twofold. To examine this hypothesis anaerobic capacity was measured using a modified treadmill test (3,4) designed to exhaust the anaerobic systems in approximately 45 to 75 seconds. Lactate concentration in the blood was analyzed after all tests, since lactate is the end-product of anaerobic energy production. Therefore, the peak lactate response is an additional indication of anaerobic capacity. A preliminary comparison of the GUTS and the DSO608 suggests that the GUTS protocol would increase the efficiency of VO2max testing of astronauts before and after flight. Results for anaerobic capacity have not been tabulated.

Rodgers, Sandra L.↗

NASA NTRS1992

A prototype Crew Medical Restraint System (CMRS) for Space Station Freedom

The Crew Medical Restrain System (CMRS) is a prototype system designed and developed for use as a universally deployable medical restraint/workstation on Space Station Freedom (SSF), the Shuttle Transportation System (STS), and the Assured Crew Rescue Vehicle (ACRV) for support of an ill or injured crewmember requiring stabilization and transportation to Earth. The CMRS will support all medical capabilities of the Health Maintenance Facility (HMF) by providing a restraint/interface system for all equipment (advance life support packs, defibrillator, ventilator, portable oxygen supply, IV pump, transport monitor, transport aspirator, and intervenous fluids delivery system) and personnel (patient and crew medical officers). It must be functional within the STS, ACRV, and all SSF habitable volumes. The CMRS will allow for medical capabilities within CPR, ACLS and ATLS standards of care. This must all be accomplished for a worst case transport time scenario of 24 hours from SSF to a definitive medical care facility on Earth. A presentation of the above design prototype with its subsequent one year SSF/HMF and STS/ACRV high fidelity mock-up ground based simulation testing will be given. Also, parabolic flight and underwater Weightless Test Facility evaluations will be demonstrated for various medical contingencies. The final design configuration to date will be discussed with future space program impact considerations.

Johnston, S. L.↗

NASA NTRS1975

Polarographic oxygen sensors

Polarographic oxygen sensors, which were originally developed for measuring oxygen in space cabin atmospheres, are examined for their use in medical, scientific, and industrial applications.

Source record↗

NASA NTRS2000

NIRS in Space?

Proponents of near infrared reflectance spectroscopy (NIRS) have been exceptionally successful in applying NIRS techniques to many instances of organic material analyses. While this research and development began in the 1950s, in recent years, stimulation of advancements in instrumentation is allowing NIRS to begin to find its way into the food processing systems, into food quality and safety, textiles and much more. And, imaging high spectral resolution spectrometers are now being evaluated for the rapid scanning of foodstuffs, such as the inspection of whole chicken carcasses for fecal contamination. The imaging methods are also finding their way into medical applications, such as the non-intrusive monitoring of blood oxygenation in newborns. Can these scientific insights also be taken into space and successfully used to measure the Earth's condition? Is there an analog between the organic analyses in the laboratory and clinical settings and the study of Earth's living biosphere? How are the methods comparable and how do they differ?

Peterson, David L.↗

NASA NTRS2011

Human-in-the-Loop Integrated Life Support Systems Ground Testing

Human exploration missions beyond low earth orbit will be long duration with abort scenarios of days to months. This necessitates provisioning the crew with all the things they will need to sustain themselves while carrying out mission objectives. Systems engineering and integration is critical to the point where extensive integrated testing of life support systems on the ground is required to identify and mitigate risks. Ground test facilities (human-rated altitude chamber) at the Johnson Space Center are being readied to integrate all the systems for a mission along with a human test crew. The relevant environment will include deep space habitat human accommodations, sealed atmosphere of 8 psi total pressure and 32% oxygen concentration, life support systems (food, air, water), communications, crew accommodations, medical, EVA, tools, etc. Testing periods will approximate those of the expected missions (such as a near Earth asteroid, Earth-Moon L2 or L1, the moon). This type of integrated testing is needed for research and technology development as well as later during the mission design, development, test, and evaluation (DDT&E) phases of an approved program. Testing will evolve to be carried out at the mission level fly the mission on the ground . Mission testing will also serve to inform the public and provide the opportunity for active participation by international partners.

Henninger, Donald L.↗

NASA NTRS2012

Human Exploration Missions - Maturing Technologies to Sustain Crews

Human exploration missions beyond low earth orbit will be long duration with abort scenarios of days to months. Providing crews with the essentials of life such as clean air and potable water means recycling human metabolic wastes back to useful products. Individual technologies are under development for such things as CO2 scrubbing, recovery of O2 from CO2, turning waste water into potable water, and so on. But in order to fully evaluate and mature technologies fully they must be tested in a relevant, high-functionality environment; a systems environment where technologies are challenged with real human metabolic wastes. It is for this purpose that an integrated systems ground testing capability at the Johnson Space Center is being readied for testing. The relevant environment will include deep space habitat human accommodations, sealed atmosphere of 8 psi total pressure and 32% oxygen concentration, life support systems (food, air, water), communications, crew accommodations, medical, EVA, tools, etc. Testing periods will approximate those of the expected missions (such as a near Earth asteroid, Earth ]Moon L2 or L1, the moon, and Mars). This type of integrated testing is needed not only for research and technology development but later during the mission design, development, test, and evaluation phases of preparing for the mission.

Mukai, Chiaki↗

DOE OSTI2024

Gallium oxide semiconductor-based large volume ultrafast radiation hard spectroscopic scintillators

We report on the development of the first-ever inorganic radiation-hard moisture-insensitive large volume spectroscopic semiconductor-based scintillator with less than 2 ns decay time and light yields as high as 8000 ph/MeV. Despite extensive research into scintillator materials, the quest for an ideal scintillator combining ultrafast decay times (akin to BaF 2 and Yb-doped scintillators such as Lu 2 O 3 :Yb), high light yields (exceeding 2000 photons per MeV), spectroscopic capabilities, and exceptional radiation hardness remain unfulfilled. In this study, we demonstrate and report for the first time the viability of large-volume (up to 20 mm thickness) gallium oxide (β-Ga 2 O 3 ) semiconductor-based scintillators for applications requiring these properties. These β-Ga 2 O 3 scintillators were grown using the fast turnaround (~2 days) crucible-free optical float zone (FZ) technique. The high light yield and ultrafast decay time of these high-purity n-type semiconductors with free carrier concentration of 6 × 10 17 cm –3 are attributed to native defects, specifically oxygen vacancies (V O ) and gallium–oxygen vacancy pairs (V Ga –V O ), generated during optimized FZ growth. The ultrafast decay, along with high light yield, enables excellent timing resolution and high count rate detection for applications like time-of-flight positron emission tomography, physics experiments, and nuclear safety. The radiation hardness of these devices has been documented in a separate publication.

12 MANAGEMENT OF RADIOACTIVE AND NON-RADIOACTIVE W↗

DOE OSTI2025

A scalable and autoclavable oxygen nanosensor platform for metabolic monitoring of Saccharomyces cerevisiae in a bioreactor and other in situ systems

Polymer-encapsulated dye nanoparticle sensors are a valuable approach to achieving in situ analyte measurements with luminescence; however, typical emulsion-based nanosensors are poorly suited for large-scale biological samples due to limitations of synthesis scalability and stability. Branched polyethylenimine (PEI) is a versatile polymer scaffold ideal for constructing nanoparticles with various covalently conjugated moieties due to their high density of reactive primary amines, high water solubility, and biological stability. In this work, we used branched polyethylenimine as a scaffold-based approach for making a stable and scalable ratiometric oxygen sensor. Pt (II) tetracarboxyporphine was used as an oxygen-sensing dye and coumarin 343 as a reference dye, all covalently linked to the PEI scaffold producing a product that could withstand sterilization procedures and easily be scaled. To minimize toxicity from the PEI scaffold, we conjugated it with 2000 MW PEG. The applicability of the sensors was demonstrated in a 200 mL Saccharomyces cerevisiae yeast culture, using orthogonal luminescent and electrochemical oxygen measurements to validate sensor response and measure the metabolic activity of the yeast in our culture. Further, this approach was able to match the sensitivity of our electrochemical measurements while improving upon drawbacks of other luminescent methods of oxygen detection, demonstrating effective monitoring for at least 20 h. Our scaffold-based approach is a modular and easily translatable technology that could be useful in various biotechnological applications.

59 BASIC BIOLOGICAL SCIENCES↗

NASA NTRS2001

Effects of exercise pressor reflex activation on carotid baroreflex function during exercise in humans

1. This investigation was designed to determine the contribution of the exercise pressor reflex to the resetting of the carotid baroreflex during exercise. 2. Ten subjects performed 3.5 min of static one-legged exercise (20 % maximal voluntary contraction) and 7 min dynamic cycling (20 % maximal oxygen uptake) under two conditions: control (no intervention) and with the application of medical anti-shock (MAS) trousers inflated to 100 mmHg (to activate the exercise pressor reflex). Carotid baroreflex function was determined at rest and during exercise using a rapid neck pressure/neck suction technique. 3. During exercise, the application of MAS trousers (MAS condition) increased mean arterial pressure (MAP), plasma noradrenaline concentration (dynamic exercise only) and perceived exertion (dynamic exercise only) when compared to control (P < 0.05). No effect of the MAS condition was evident at rest. The MAS condition had no effect on heart rate (HR), plasma lactate and adrenaline concentrations or oxygen uptake at rest and during exercise. The carotid baroreflex stimulus-response curve was reset upward on the response arm and rightward to a higher operating pressure by control exercise without alterations in gain. Activation of the exercise pressor reflex by MAS trousers further reset carotid baroreflex control of MAP, as indicated by the upward and rightward relocation of the curve. However, carotid baroreflex control of HR was only shifted rightward to higher operating pressures by MAS trousers. The sensitivity of the carotid baroreflex was unaltered by exercise pressor reflex activation. 4. These findings suggest that during dynamic and static exercise the exercise pressor reflex is capable of actively resetting carotid baroreflex control of mean arterial pressure; however, it would appear only to modulate carotid baroreflex control of heart rate.

Non-NASA Center↗

NASA NTRS2012

Hydrostatic Hyperbaric Chamber Ventilation System

The hydrostatic hyperbaric chamber (HHC) represents the merger of several technologies in development for NASA aerospace applications, harnessed to directly benefit global health. NASA has significant experience developing composite hyperbaric chambers for a variety of applications. NASA also has researched the application of water-filled vessels to increase tolerance of acceleration forces. The combination of these two applications has resulted in the hydrostatic chamber, which has been conceived as a safe, affordable means of making hyperbaric oxygen therapy (HBOT) available in the developing world for the treatment of a variety of medical conditions. Specifically, HBOT is highly-desired as a possibly curative treatment for Buruli Ulcer, an infectious condition that afflicts children in sub-Saharan Africa. HBOT is simply too expensive and too dangerous to implement in the developing world using standard equipment. The HHC technology changes the paradigm. The HHC differs from standard hyperbaric chambers in that the majority of its volume is filled with water which is pressurized by oxygen being supplied in the portion of the chamber containing the patient s head. This greatly reduces the amount of oxygen required to sustain a hyperbaric atmosphere, thereby making the system more safe and economical to operate. An effort was taken to develop an HHC system to apply HBOT to children that is simple and robust enough to support transport, assembly, maintenance and operation in developing countries. This paper details the concept for an HHC ventilation and pressurization system to provide controlled pressurization and adequate washout of carbon dioxide while the subject is enclosed in the confined space during the administration of the medical treatment. The concept took into consideration operational complexity, safety to the patient and operating personnel, and physiological considerations. The simple schematic, comprised of easily acquired commercial hardware, supports sustainability.

Sarguisingh, Miriam J.↗

NASA NTRS2005

Human Factors Assessment of Respiratory Support Pack (RSP) Cue Card

Whitmore, Mihriban↗

NASA NTRS2012

Human in the Loop Integrated Life Support Systems Ground Testing

Human exploration missions beyond low earth orbit will be long duration with abort scenarios of days to months. This necessitates provisioning the crew with all the things they will need to sustain themselves while carrying out mission objectives. Systems engineering and integration is critical to the point where extensive integrated testing of life support systems on the ground is required to identify and mitigate risks. Ground test facilities (human-rated altitude chambers) at the Johnson Space Center are being readied to integrate all the systems for a mission along with a human test crew. The relevant environment will include deep space habitat human accommodations, sealed atmosphere capable of 14.7 to 8 psi total pressure and 21 to 32% oxygen concentration, life support systems (food, air, and water), communications, crew accommodations, medical, EVA, tools, etc. Testing periods will approximate those of the expected missions (such as a near Earth asteroid, Earth-Moon L2 or L1, the moon, Mars). This type of integrated testing is needed for research and technology development as well as later during the mission design, development, test, and evaluation (DDT&E) phases of an approved program. Testing will evolve to be carried out at the mission level fly the mission on the ground . Mission testing will also serve to inform the public and provide the opportunity for active participation by international, industrial and academic partners.

Henninger, Donald L.↗

NASA NTRS2002

Airline Chair-rest Deconditioning: Induction of Immobilization Thromboemboli?

Air passenger miles will likely double by year 2020. The altered and restrictive environment in an airliner cabin can influence hematological homeostasis in passengers and crew. Flight-related deep various thromboemboli (DVT) have been associated with at least 577 deaths on 42 of 120 airlines from 1977 to 1984 (25 deaths/million departures), whereas many such cases go unreported. However, there are four major factors that could influence formation of possible flight-induced DVT: sleeping accomodations (via sitting immobilization), travelers' medical history (via tissue injury), cabin environmental factors (via lower partial pressure of oxygen and lower relative humidity), and the more encompassing chair-rest deconditioning (C-RD) syndrome. There is ample evidence that recent injury and surgery (especially in deconditioned hospitalized patients) facilitate thrombophlebitis and formation of DVT that may be exacerbated by the immobilization of prolonged air travel. In the healthy flying population immobilization factors associated with prolonged (> 5 hr) C-RID such as total body dehydration, hypovolemia and increased blood viscosity, and reduced various blood flow (pooling) in the legs may facilitate formation of DVT. However, data from at least four case-controlled epidemiological studies did not confirm a direct causative relationship between air travel and DART, but factors such as history of vascular thromboemboli, various insufficiency, chronic heart failure, obesity, immobile standing position, more than 3 pregnancies, infectious disease, long-distance travel, muscular trauma and violent physical effort were significantly more frequent in DVT patients than in controls. Thus, there is no clear, direct evidence yet that prolonged sitting in airliner seats, or prolonged experimental chair-rest- or bed- rest-deconditioning treatments cause deep various thromboemboli in healthy people.

Greenleaf, J. E.↗