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Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

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NASA NTRS2001

Stabilized NADH as a Countermeasure for Jet Lag

Current remedies for jet lag (phototherapy, melatonin, stimulant, and sedative medications) are limited in efficacy and practicality. The efficacy of a stabilized, sublingual form of reduced nicotin amide adenine dinucleotide (NADH, ENADAlert, Menuco Corp.) as a countermeasure for jet lag was examined. Because NADH increases cellular production of ATP and facilitates dopamine synthesis, it may counteract the effects of jet lag on cognitive functioning and sleepiness. Thirty-five healthy, employed subjects participated in this double-blind, placebo-controlled study. Training and baseline testing were conducted on the West Coast before subjects flew overnight to the East Coast, where they would experience a 3-hour time difference. Upon arrival, individuals were randomly assigned to receive either 20 mg of sublingual stabilized ADH (n=18) or identical placebo tablets (n=17). All participants completed computer-administered tests (including CogScreen7) to assess changes in cognitive functioning, mood, and sleepiness in the morning and afternoon. Jet lag resulted in increased sleepiness for over half the participants and deterioration of cognitive functioning for approximately one third. The morning following the flight, subjects experienced lapses of attention in addition to disruptions in working memory, divided attention, and visual perceptual speed. Individuals who received NADH performed significantly better on 5 of 8 cognitive and psychomotor test measures (P less than or equal to 0.5) and showed a trend for better performance on the other three measures (P less than or equal to .l0). Subjects also reported less sleepiness compared with those who received placebo. No adverse effects were observed with NADH treatment. Stabilized NADH significantly reduced jet lag-induced disruptions of cognitive functioning, was easily administered, and was found to have no adverse side effects.

Kay, Gary G.↗
NASA NTRS2024

Crew State and Risk Model Development to Predict Hydration Status During Extravehicular Activity Training Events

Introduction: Hydration is critical for optimal human health and performance and dehydration can lead to impaired cardiovascular function, thermal dysregulation, decreased blood plasma volume, and cognitive impacts, particularly during physical activity. Prolonged and repeated extravehicular activities (EVA) without sufficiently available drinking water may increase risk for dehydration, which could impair crew health and impact mission success. Understanding hydration needs and potential effects on health and performance are necessary to optimize crew well-being and enable successful EVA objectives. This study aims to develop a model of hydration status during EVA using water balance techniques. Methods: Water balance measures were collected on 15 healthy astronauts who performed ≈6-hour simulated microgravity extravehicular activity (EVA) training in the NASA Neutral Buoyancy Laboratory (NBL). Data collected included pre-and post-EVA nude body weight (BW), maximum absorption garment (MAG) weight, Disposable In-suit Drink Bag (DIDB) weight, urine specific gravity (USG), and extra pre-EVA intake (W). Variables were combined to create the water balance model as pre-EVA (Hn)= BWn+ MAGn+ DIDBn+ Wnand post EVA (Hn+1) = BWn+1+ MAGn+1+ DIDBn+1. Urine specific gravity values were used to refine water balance measures into hydration categories: Hydrated, Marginally Hydrated, and Dehydrated. Results: Pre-EVA modeling indicated53% of crew were hydrated, 20% were marginally hydrated, and 27% were dehydrated. Alternately, Hn+1 showed 13% of crew remained hydrated, 47% were marginally hydrated, and 40% were dehydrated at the end of the EVA. Furthermore, 75% of the crewmembers who started sufficiently hydrated finished the run marginally hydrated or dehydrated. According to USG indices presented by Casa and Lawrence, et al. (2000), only 25% of the crew started and remained hydrated throughout the EVA, and those who were dehydrated at the outset stayed dehydrated. Conclusion: Model outcomes assessing hydration status during 6-hour simulated microgravity EVAs demonstrate the necessity to further address hydration requirements for optimal human performance during spaceflight and EVA. This study enables additional baseline development of the Crew State and Risk Model Hydration, Nutrition, and Waste Management component that aims to provide individualized crew state and risk predictions during EVAs. Reference: Casa, D. J., Armstrong, L. E., et al. (2000). National Athletic Trainers’ Association Position Statement: Fluid Replacement for Athletes. Journal of Athletic Training, 35:212-224.

L Cooper↗
NASA NTRS2005

Team Performance and Error Management in Chinese and American Simulated Flight Crews: The Role of Cultural and Individual Differences

This report describes results of a study conducted for NASA-Langley Research Center. This study is part of a program of research conducted for NASA-LARC that has focused on identifying the influence of national culture on the performance of flight crews. We first reviewed the literature devoted to models of teamwork and team performance, crew resource management, error management, and cross-cultural psychology. Davis (1999) reported the results of this review and presented a model that depicted how national culture could influence teamwork and performance in flight crews. The second study in this research program examined accident investigations of foreign airlines in the United States conducted by the National Transportation Safety Board (NTSB). The ability of cross-cultural values to explain national differences in flight outcomes was examined. Cultural values were found to covary in a predicted way with national differences, but the absence of necessary data in the NTSB reports and limitations in the research method that was used prevented a clear understanding of the causal impact of cultural values. Moreover, individual differences such as personality traits were not examined in this study. Davis and Kuang (2001) report results of this second study. The research summarized in the current report extends this previous research by directly assessing cultural and individual differences among students from the United States and China who were trained to fly in a flight simulator using desktop computer workstations. The research design used in this study allowed delineation of the impact of national origin, cultural values, personality traits, cognitive style, shared mental model, and task workload on teamwork, error management and flight outcomes. We briefly review the literature that documents the importance of teamwork and error management and its impact on flight crew performance. We next examine teamwork and crew resource management training designed to improve teamwork. This is followed by discussion of the potential influence of national culture on teamwork and crew resource management. We then examine the influence of other individual and team differences, such as personality traits, cognitive style, shared mental model, and task workload. We provide a heuristic model that depicts the influence of national culture and individual differences on teamwork, error management and flight outcomes. The results demonstrate the usefulness of the model for future research.

Davis, Donald D.↗
NASA NTRS1991

Human factors issues for interstellar spacecraft

Developments in research on space human factors are reviewed in the context of a self-sustaining interstellar spacecraft based on the notion of traveling space settlements. Assumptions about interstellar travel are set forth addressing costs, mission durations, and the need for multigenerational space colonies. The model of human motivation by Maslow (1970) is examined and directly related to the design of space habitat architecture. Human-factors technology issues encompass the human-machine interface, crew selection and training, and the development of spaceship infrastructure during transtellar flight. A scenario for feasible instellar travel is based on a speed of 0.5c, a timeframe of about 100 yr, and an expandable multigenerational crew of about 100 members. Crew training is identified as a critical human-factors issue requiring the development of perceptual and cognitive aids such as expert systems and virtual reality.

Cohen, Marc M.↗
NASA NTRSDate not supplied

Artificial Neural Networks to Predict Cognitive Impairment of Rodents Subjected to Space Radiation

INTRODUCTION We use artificial neural networks (ANNs) as an example machine learning (ML) tool to predict the cognitive performance impairment of rats induced by irradiation. The experimental data in the analyses is attentional set-shifting (ATSET) test scores from a rodent model exposed to ≤15 cGy of individual galactic cosmic radiation (GCR) ions: 4He, 28Si, or 56Fe, expected for a Lunar or Mars mission [1]. This work investigates rats at a subject-based level and uses applied dose and performance scores taken before irradiation to predict whether a rat will be impaired when irradiated. The results of this study are significant to crewed space missions as they support the potential of predicting an astronaut’s impairment in a specific task before spaceflight through the implementation of appropriately trained ML tools. METHODS Data used in this work are scores from the ATSET, a multi-stage constrained cognitive flexibility test [2]. Our computational model utilizes the number of attempts to reach the criterion to pass a stage as a behavioral performance measure for rats. We use the post-irradiation scores, generate thresholds from cumulative distribution plots of non-irradiated rats, and calculate the percent of irradiated rats whose scores fall below the threshold to infer how each radiation type/dose affects a population. Rats scoring above the threshold are labeled impaired while the others are non-impaired. We then employ ANNs as a typical ML technique, and use each subject’s individual scores taken before radiation along with the applied dose, to predict their personal susceptibility to cognitive impairment due to space radiation exposure. RESULTS AND CONCLUSION A significant finding is the exhibition of a dose-dependent increasing probability of impairment for 1 to 10 cGy of 28Si or 56Fe in the simple discrimination (SD) stage of the ATSET, and for 1 to 10 cGy of 56Fe in the compound discrimination (CD) stage. On a subject-based level, implementing ML classifiers such as ANNs identifies rats that have a higher tendency for impairment after GCR exposure [1]. The receiver operating characteristic (ROC) and the precision-recall (PR) curves of the ML models show a better prediction of impairment when 56Fe is the ion in question in both SD (Figure 1) and CD stages. They, however, do not depict impairment due to 4He in SD (Figure 1) and 28Si in CD, suggesting no dose-dependent impairment response in these cases. In this work, “good” prediction pertains to “better-than-random-chance”, due to the limited sample size and the high inter- and intra-individual variabilities in response to brain stimulation paradigms, as applicable to both animals and humans. More behavioral tests and biomarkers should be investigated on the same subjects, to be fed to the ML models to capture the agents responsible for performance alterations of some individuals versus others.

machine learning↗
NASA NTRSDate not supplied

Machine Learning Models to Predict Cognitive Impairment of Rodents Subjected to Space Radiation

INTRODUCTION We use artificial neural networks (ANNs) as an example machine learning (ML) tool to predict the cognitive performance impairment of rats induced by irradiation. The experimental data in the analyses is attentional set-shifting (ATSET) test scores from a rodent model exposed to ≤15 cGy of individual galactic cosmic radiation (GCR) ions: 4He, 28Si, or 56Fe, expected for a Lunar or Mars mission [1]. This work investigates rats at a subject-based level and uses applied dose and performance scores taken before irradiation to predict whether a rat will be impaired when irradiated. The results of this study are significant to crewed space missions as they support the potential of predicting an astronaut’s impairment in a specific task before spaceflight through the implementation of appropriately trained ML tools. METHODS Data used in this work are scores from the ATSET, a multi-stage constrained cognitive flexibility test [2]. Our computational model utilizes the number of attempts to reach the criterion to pass a stage as a behavioral performance measure for rats. We use the post-irradiation scores, generate thresholds from cumulative distribution plots of non-irradiated rats, and calculate the percent of irradiated rats whose scores fall below the threshold to infer how each radiation type/dose affects a population. Rats scoring above the threshold are labeled impaired while the others are non-impaired. We then employ ANNs as a typical ML technique, and use each subject’s individual scores taken before radiation along with the applied dose, to predict their personal susceptibility to cognitive impairment due to space radiation exposure. RESULTS AND CONCLUSION A significant finding is the exhibition of a dose-dependent increasing probability of impairment for 1 to 10 cGy of 28Si or 56Fe in the simple discrimination (SD) stage of the ATSET, and for 1 to 10 cGy of 56Fe in the compound discrimination (CD) stage. On a subject-based level, implementing ML classifiers such as ANNs identifies rats that have a higher tendency for impairment after GCR exposure [1]. The receiver operating characteristic (ROC) and the precision-recall (PR) curves of the ML models show a better prediction of impairment when 56Fe is the ion in question in both SD (Figure 1) and CD stages. They, however, do not depict impairment due to 4He in SD (Figure 1) and 28Si in CD, suggesting no dose-dependent impairment response in these cases. In this work, “good” prediction pertains to “better-than-random-chance”, due to the limited sample size and the high inter- and intra-individual variabilities in response to brain stimulation paradigms, as applicable to both animals and humans. More behavioral tests and biomarkers should be investigated on the same subjects, to be fed to the ML models to capture the agents responsible for performance alterations of some individuals versus others.

machine learning↗
NASA NTRS1993

Toward an embedded training tool for Deep Space Network operations

There are three issues to consider when building an embedded training system for a task domain involving the operation of complex equipment: (1) how skill is acquired in the task domain; (2) how the training system should be designed to assist in the acquisition of the skill, and more specifically, how an intelligent tutor could aid in learning; and (3) whether it is feasible to incorporate the resulting training system into the operational environment. This paper describes how these issues have been addressed in a prototype training system that was developed for operations in NASA's Deep Space Network (DSN). The first two issues were addressed by building an executable cognitive model of problem solving and skill acquisition of the task domain and then using the model to design an intelligent tutor. The cognitive model was developed in Soar for the DSN's Link Monitor and Control (LMC) system; it led to several insights about learning in the task domain that were used to design an intelligent tutor called REACT that implements a method called 'impasse-driven tutoring'. REACT is one component of the LMC training system, which also includes a communications link simulator and a graphical user interface. A pilot study of the LMC training system indicates that REACT shows promise as an effective way for helping operators to quickly acquire expert skills.

Hill, Randall W., Jr.↗
NASA NTRS2000

Autogenic-feedback training exercise is superior to promethazine for control of motion sickness symptoms

Motion sickness symptoms affect approximately 50% of the crew during space travel and are commonly treated with intramuscular injections of promethazine. The purpose of this paper is to compare the effectiveness of three treatments for motion sickness: intramuscular injections (i.m.) of promethazine, a physiological training method (autogenic-feedback training exercise [AFTE]), and a no-treatment control. An earlier study tested the effects of promethazine on cognitive and psychomotor performance and motion sickness tolerance in a rotating chair. For the present paper, motion sickness tolerance, symptom reports, and physiological responses of these subjects were compared to matched subjects selected from an existing database who received either AFTE or no treatment. Three groups of 11 men, between the ages of 33 and 40 years, were matched on the number of rotations tolerated during their initial rotating-chair motion sickness test. The motion sickness test procedures and the 7-day interval between tests were the same for all subjects. The drug group was tested under four treatment conditions: baseline (no injections), a 25 mg dose of promethazine, a 50 mg dose of promethazine, and a placebo of sterile saline. AFTE subjects were given four 30-minute AFTE sessions before their second, third, and fourth motion sickness tests (6 hours total). The no-treatment control subjects were only given the four rotating-chair tests. Motion sickness tolerance was significantly increased after 4 hours of AFTE when compared to either 25 mg (p < 0.00003) or 50 mg (p < 0.00001) of promethazine. The control and promethazine groups did not differ. AFTE subjects reported fewer or no symptoms at higher rotational velocities than subjects in the control or promethazine groups. The primary physiological effect of promethazine was an inhibition of skin conductance level. The AFTE group showed significantly less heart rate and skin conductance variability during motion sickness tests administered after training.

Clinical Trial↗
NASA NTRS2000

A Preliminary Data Model for Orbital Flight Dynamics in Shuttle Mission Control

The Orbital Flight Dynamics group in Shuttle Mission Control is investigating new user interfaces in a project called RIOTS [RIOTS 2000]. Traditionally, the individual functions of hardware and software guide the design of displays, which results in an aggregated, if not integrated interface. The human work system has then been designed and trained to navigate, operate and integrate the processors and displays. The aim of RIOTS is to reduce the cognitive demands of the flight controllers by redesigning the user interface to support the work of the flight controller. This document supports the RIOTS project by defining a preliminary data model for Orbital Flight Dynamics. Section 2 defines an information-centric perspective. An information-centric approach aims to reduce the cognitive workload of the flight controllers by reducing the need for manual integration of information across processors and displays. Section 3 describes the Orbital Flight Dynamics domain. Section 4 defines the preliminary data model for Orbital Flight Dynamics. Section 5 examines the implications of mapping the data model to Orbital Flight Dynamics current information systems. Two recurring patterns are identified in the Orbital Flight Dynamics work the iteration/rework cycle and the decision-making/information integration/mirroring role relationship. Section 6 identifies new requirements on Orbital Flight Dynamics work and makes recommendations based on changing the information environment, changing the implementation of the data model, and changing the two recurring patterns.

ONeill, John↗
NASA NTRS2003

Enabling computer decisions based on EEG input

Multilayer neural networks were successfully trained to classify segments of 12-channel electroencephalogram (EEG) data into one of five classes corresponding to five cognitive tasks performed by a subject. Independent component analysis (ICA) was used to segregate obvious artifact EEG components from other sources, and a frequency-band representation was used to represent the sources computed by ICA. Examples of results include an 85% accuracy rate on differentiation between two tasks, using a segment of EEG only 0.05 s long and a 95% accuracy rate using a 0.5-s-long segment.

Validation Studies↗
NASA NTRS1985

Research opportunities in human behavior and performance

Extant information on the subject of psychological aspects of manned space flight are reviewed; NASA's psychology research program is examined; significant gaps in knowledge are identified; and suggestions are offered for future research program planning. Issues of human behavior and performance related to the United States space station, to the space shuttle program, and to both near and long term problems of a generic nature in applicable disciplines of psychology are considered. Topics covered include: (1) human performance requirements for a 90 day mission; (2) human perceptual, cognitive, and motor capabilities and limitations in space; (3) crew composition, individual competencies, crew competencies, selection criteria, and special training; (4) environmental factors influencing behavior; (5) psychosocial aspects of multiperson space crews in long term missions; (6) career determinants in NASA; (7) investigational methodology and equipment; and (8) psychological support.

Christensen, J. M.↗
NASA NTRS1984

Alerting prefixes for speech warning messages

A major question posed by the design of an integrated voice information display/warning system for next-generation helicopter cockpits is whether an alerting prefix should precede voice warning messages; if so, the characteristics desirable in such a cue must also be addressed. Attention is presently given to the results of a study which ascertained pilot response time and response accuracy to messages preceded by either neutral cues or the cognitively appropriate semantic cues. Both verbal cues and messages were spoken in direct, phoneme-synthesized speech, and a training manipulation was included to determine the extent to which previous exposure to speech thus produced facilitates these messages' comprehension. Results are discussed in terms of the importance of human factors research in cockpit display design.

Bucher, N. M.↗
NASA NTRS1993

Development of interactive multimedia applications

Multimedia is making an increasingly significant contribution to our informational society. The usefulness of this technology is already evident in education, business presentations, informational kiosks (e.g., in museums), training and the entertainment environment. Institutions, from grade schools to medical schools, are exploring the use of multifaceted electronic text books and teaching aids to enhance course materials. Through multimedia, teachers and students can take full advantage of the cognitive value of animation, audio, video and other types in a seamless application. The Software Technology Branch at NASA Johnson Space Center (NASA/JSC) is taking similar approaches to apply the state-of-the-art technology to space training, mission operations and other applications. This paper discusses the characteristics and development of multimedia applications at the NASA/JSC.

Leigh, Albert↗
NASA NTRS1989

Exercise-training protocols for astronauts in microgravity

Based on physical working requirements for astronauts during intra- and extravehicular activity and on the findings from bed-rest studies that utilized exercise training as a countermeasure for the reduction of aerobic power, deterioration of muscular strength and endurance, decrements in mood and cognitive performance, and possibly for bone loss, two exercise protocols are proposed. One assumes that, during microgravity, astronaut exercise physiological functions should be maintained at 100 percent of ground-based levels. The other assumes that maximal aerobic power in flight can be reduced by 10 percent of the ground-based level.

Greenleaf, J. E.↗
NASA NTRSDate not supplied

Scenario-Based Task Design for Airline Pilot Anticipatory Behaviors: Asynchronous Assessment of Complex Cognitive Skills

Airline pilots must anticipate potential threats to passenger safety and efficient flight. Such anticipation needs to occur at both the system and individual levels, yet no formal training for these anticipatory behaviors currently exists. The emerging field of resilience engineering provides a framework to explore this problem. Given the complex nature of this problem, the assessment portion of the project constituted a challenge. Simulator time is expensive as simulators are costly to run, and they are extremely limited in number. Also, by the nature of their work, pilots as a group are hard to connect with in person; thus, asynchronous methods were adopted. Further, to ensure that authentic pilot behaviors were observed, task-based scenarios were used rather than focus group or interview protocols. This session explores the design of asynchronous learning and a measure for assessing pilot anticipatory behaviors outside of a simulator to help design learning opportunities for pilots. The scenario-based and active assessment items will be discussed in detail, and demonstrations of these items will be shared. These items constitute the bulk of the challenge for this work. At the time of this writing, data is being collected to assess the effectiveness of the interactive training module and validate the measures. This data will be analyzed and presented as part of the session. This will include any linkages between the scenario-based and traditional assessment items.

task design↗
NASA NTRS1993

Reducing the cognitive workload: Trouble managing power systems

The complexity of space-based systems makes monitoring them and diagnosing their faults taxing for human beings. Mission control operators are well-trained experts but they can not afford to have their attention diverted by extraneous information. During normal operating conditions monitoring the status of the components of a complex system alone is a big task. When a problem arises, immediate attention and quick resolution is mandatory. To aid humans in these endeavors we have developed an automated advisory system. Our advisory expert system, Trouble, incorporates the knowledge of the power system designers for Space Station Freedom. Trouble is designed to be a ground-based advisor for the mission controllers in the Control Center Complex at Johnson Space Center (JSC). It has been developed at NASA Lewis Research Center (LeRC) and tested in conjunction with prototype flight hardware contained in the Power Management and Distribution testbed and the Engineering Support Center, ESC, at LeRC. Our work will culminate with the adoption of these techniques by the mission controllers at JSC. This paper elucidates how we have captured power system failure knowledge, how we have built and tested our expert system, and what we believe are its potential uses.

Manner, David B.↗
NASA NTRS2021

Machine Learning Models to Predict Cognitive Impairment of Rodents Subjected to Space Radiation

This research uses machine-learned computational analyses to predict the cognitive performance impairment of rats induced by irradiation. The experimental data in the analyses is from a rodent model exposed to ≤ 15 cGy of individual Galactic Cosmic Radiation (GCR) ions: 4He, 16O, 28Si, 48Ti, or 56Fe, expected for a Lunar or Mars mission. This work investigates rats at a subject-based level and uses performance scores taken before irradiation to predict impairment in Attentional Set-shifting (ATSET) data post-irradiation. Here, the worst performing rats of the control group define the impairment thresholds based on population analyses via cumulative distribution functions, leading to the labeling of impairment for each subject. A significant finding is the exhibition of a dose-dependent increasing probability of impairment for 1 to 10 cGy of 28Si or 56Fe in the Simple Discrimination (SD) stage of the ATSET, and for 1 to 10 cGy of 56Fe in the Compound Discrimination (CD) stage. On a subject-based level, implementing Machine Learning (ML) classifiers such as the Gaussian Naïve Bayes, Support Vector Machine, and Artificial Neural Networks identifies rats that have a higher tendency for impairment after GCR exposure. The algorithms employ the experimental prescreenperformance scores as multidimensional input features to predict each rodent’s susceptibility to cognitive impairment due to space radiation exposure. The receiver operating characteristic and the precision-recall curves of the ML models show a better prediction of impairment when 56Feis the ion in question in both SD and CD stages. They, however, do not depict impairment due to 4Hein SD and 28Siin CD, suggesting no dose-dependent impairment response in these cases. One key finding of our study is that prescreen performance scores can be used to predict the ATSET performance impairments. This result is significant to crewed space missions as it supports the potential of predicting an astronaut’s impairment in a specific task before spaceflight through the implementation of appropriately trained ML tools. Future research can focus on constructing ML ensemble methods to integrate the findings from the methodologies implemented in this study for morerobust predictionsof cognitive decrements due to space radiation exposure.

space radiation↗
NASA NTRSDate not supplied

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery↗