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Preliminary Medical Risk Estimates and Clinical Capability Needs for Artemis IV

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in- mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. METHODOLOGY: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for the Artemis IV mission. Artemis IV is currently scheduled for 2026 and will visit the Gateway space station in lunar orbit prior to the second lunar landing of the Artemis program. The baseline Artemis IV mission that was modeled was 28 days in duration with phases including Orion outbound, 4 days on the Gateway space station in lunar orbit, 2 crew on the surface of the Moon for approximately one week, an additional 5 days on Gateway, and then return to Earth. This baseline was compared to two alternative 34-day design reference missions (DRMs) that shifted the lunar sortie earlier or later in the mission profile. Assumptions included 2 female and 2 male crew and a notional medical system mass of 25 kg. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care – RTDC), and an estimate of crew time lost due to medical conditions (Task Time Lost – TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk. RESULTS: All three DRMs had very low probability of LOCL from medical conditions, primarily due to short duration. RTDC was also similar across the DRMs. In contrast, TTL was higher in the early lunar sortie DRM due to earlier occurrence of EVA-related medical conditions. Taken as a whole, there was no clinically significant difference in medical risk across the three missions. Results for clinical capabilities and an example medical equipment list will be discussed but were similar across DRMs.

D Hilmers↗

Preliminary Medical Risk Estimates and Clinical Capability Needs for Late Artemis Missions

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in- mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. METHODOLOGY: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for the Artemis IV mission. Artemis IV is currently scheduled for 2026 and will visit the Gateway space station in lunar orbit prior to the second lunar landing of the Artemis program. The baseline Artemis IV mission that was modeled was 28 days in duration with phases including Orion outbound, 4 days on the Gateway space station in lunar orbit, 2 crew on the surface of the Moon for approximately one week, an additional 5 days on Gateway, and then return to Earth. This baseline was compared to two alternative 34-day design reference missions (DRMs) that shifted the lunar sortie earlier or later in the mission profile. Assumptions included 2 female and 2 male crew and a notional medical system mass of 25 kg. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care – RTDC), and an estimate of crew time lost due to medical conditions (Task Time Lost – TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk. RESULTS: All three DRMs had very low probability of LOCL from medical conditions, primarily due to short duration. RTDC was also similar across the DRMs. In contrast, TTL was higher in the early lunar sortie DRM due to earlier occurrence of EVA-related medical conditions. Taken as a whole, there was no clinically significant difference in medical risk across the three missions. Results for clinical capabilities and an example medical equipment list will be discussed but were similar across DRMs.

D. Hilmers↗

NASA’s Space Launch System: Powering Artemis and Enabling Discovery

The debut launch of NASA’s super-heavy lift SLS (Space Launch System) rocket in November 2022 opened a new era of deep space exploration. Called the Artemis I mission, the launch sent an uncrewed Orion spacecraft more than 268,000 miles from Earth into a distant retrograde orbit (DRO) about the Moon, before splashing down in the Pacific Ocean 25 days later. While the mission was critical for multiple reasons to NASA’s Artemis campaign, the data collected during the first launch of SLS was vital to understanding how the launch vehicle performs in the flight environment. The test flight provided real-world data to ground and improve models, on-ground testing, and vehicle performance. Data returned show a nominal launch, with many parameters accurate to pre-flight predictions to within tenths of a percent. Equipped with the data, the SLS team is readying the Artemis II vehicle. Beginning with the fourth flight, SLS variants will have multiple upgrades, which increase the capability of the rocket to enable the nation’s most ambitious missions of returning astronauts to the Moon and lunar vicinity. Current hardware progress, as well as Artemis I flight data, will be provided. Additionally, the test programs that enabled the successful first flight will be discussed.

John Honeycutt↗

Assessing the Influence of Decompression Sickness on Medical Risk for Artemis

As NASA begins to shift its focus from LEO missions to the Moon and beyond, our understanding of the risk associated with human spaceflight is challenged by mission profiles and objectives far different from preceding missions. For Artemis, one of these aspects is surface Extra Vehicular Activity (EVA) tempo, in which the crew will perform 3 to 4 surface EVA’s in quick succession. The crew health and performance risk associated with EVA Decompression Sickness (DCS) and its associated countermeasures, is an important consideration for Artemis missions given this new and unprecedented EVA frequency. Successfully completing Artemis mission objectives relies heavily on the crew being able to perform and complete these EVAs. This analysis quantifies how medical risk changes when accounting for the expected increase in DCS risk due to the increase in EVA frequency. If there is an occurrence of DCS during a mission, appropriate downtime needs to be accounted for. Treatment for DCS requires crewmember to stop the current EVA and return to the habitat. This impacts the current EVA the crew is performing, could potentially delay the next EVA, and increases the chance of the crewmember being unable to perform future EVAs. Capturing the downtime and impact of that downtime based on the number of DCS occurrences allows us to better understand how the risk associated with DCS affects the overall medical risk and completion of missions that have more frequent EVA tempo. There are preventative strategies and mitigation countermeasures to decrease the chance of DCS occurring such as different prebreathe protocols, variable suit pressure, and vehicle pressure settings. Modeling the medical risk with and without different DCS countermeasures enables quantitative comparisons of risk reduction associated with each DCS countermeasure. We present results on how these countermeasures affect medical risks and quantify changes in the medical kit contents with respect to the countermeasures implemented within Artemis-class missions.

Clara Gasiewski↗

Artemis I Space Launch System Base Heat Shield Thermal Protection System Performance

The Space Launch System (SLS) Core Stage base heat shield experienced the highest external heating environments on the entire launch vehicle during Artemis I ascent flight. This result was consistent with design predictions. The base heat shield experiences P50 cork combustion dynamics at low altitudes, plume-induced recirculation at moderate altitudes and then in-space base flow physics out to Main Engine Cut-Off (MECO). The base heat shield thermal protection system (TPS) is composed of a P50 cork ablator which is bonded to a substrate. The heat shield protects the gimbal actuation system, RS-25 turbomachinery systems and other aft section sensitive components during ascent. This paper estimates the base heat shield TPS performance from Artemis I using flight data from the NASA Langley Research Center’s Scientifically Calibrated In-Flight Imagery (SCIFLI) Airborne Multispectral Imager (SAMI), development flight instrumentation (DFI) and other TPS recession flight measurements. Predictions from computational and ground test-derived engineering ablation models and observations are also applied. Since no base heat shield substrate thermocouple data were obtained for Artemis I, an estimate of the TPS performance data is derived here. This data assesses thermal margin of the SLS Core Stage base heat shield and best informs the Artemis II Crewed mission to the moon.

aerothermodynamics↗

NASA’s SLS (Space Launch System) Rocket Ready for Artemis II Lunar Mission

In early 2026, NASA will launch the Artemis II mission, an approximately 10-day long lunar mission that will fly three NASA astronauts and one CSA (Canadian Space Agency) astronaut on a free-return trajectory around the Moon, following a one-day checkout of their Orion spacecraft in Earth orbit. The mission will be the first to launch astronauts aboard NASA’s Orion spacecraft and on top of the agency’s SLS (Space Launch System) rocket. The mission will also deploy four 12U CubeSats as secondary payloads from the Orion stage adapter, following Orion separation and departure. The payloads, developed by four of NASA’s international partners, will perform a variety of science and technology investigations. The SLS and Orion for the mission are currently stacked in the Vehicle Assembly Building (VAB) at NASA’s Kennedy Space Center in Florida and are undergoing final preparations to rollout to Launch Pad 39B for a tanking test before launch. In addition to preparations for the Artemis II mission, significant progress is being made on the SLS for the Artemis III mission, which is targeted to return astronauts to the lunar surface no later than 2029. Major components of the core stage and solid rocket boosters are already at NASA Kennedy undergoing build-up for the mission. Data from the Artemis II launch and mission, as well as progress to subsequent missions, as available, will be presented.

Bruce R Askins↗

NASA’s SLS (Space Launch System) Rocket Ready for Artemis II Lunar Mission

In early 2026, NASA will launch the Artemis II mission, an approximately 10-day long lunar mission that will fly three NASA astronauts and one CSA (Canadian Space Agency) astronaut on a free-return trajectory around the Moon, following a one-day checkout of their Orion spacecraft in Earth orbit. The mission will be the first to launch astronauts aboard NASA’s Orion spacecraft and on top of the agency’s SLS (Space Launch System) rocket. The mission will also deploy four 12U CubeSats as secondary payloads from the Orion stage adapter, following Orion separation and departure. The payloads, developed by four of NASA’s international partners, will perform a variety of science and technology investigations. The SLS and Orion for the mission are currently stacked in the Vehicle Assembly Building (VAB) at NASA’s Kennedy Space Center in Florida and are undergoing final preparations to rollout to Launch Pad 39B for a tanking test before launch. In addition to preparations for the Artemis II mission, significant progress is being made on the SLS for the Artemis III mission, which is targeted to return astronauts to the lunar surface no later than 2029. Major components of the core stage and solid rocket boosters are already at NASA Kennedy undergoing build-up for the mission. Data from the Artemis II launch and mission, as well as progress to subsequent missions, as available, will be presented.

Bruce Askins↗

Artemis CubeSats Help Advance Exploration of the Moon, Mars, and Beyond

On April 1, NASA launched the Artemis II mission – the first crewed mission of the Artemis campaign. The nine-day lunar flyby launched on the agency’s SLS (Space Launch System) rocket and had four astronauts test the Orion spacecraft in high Earth orbit and in deep space. Four 12U CubeSats also launched on the mission, housed within the SLS’s Orion stage adapter (OSA). The spacecraft were deployed approximately five-and-a-half hours into the flight, following Orion separation and departure from SLS, as the SLS interim cryogenic propulsion stage (ICPS) and the attached OSA were in a high Earth orbit on an atmospheric disposal trajectory. All four CubeSats were successfully deployed from the launch vehicle. Deployment statuses of the spacecraft, along with updates about the SLS rocket and Artemis missions, are reported in this paper. The paper will also discuss opportunities for CubeSat payloads on future Artemis missions.

Russell Lane↗

Artemis CubeSats Help Advance Exploration of the Moon, Mars, and Beyond

On April 1, NASA launched the Artemis II mission – the first crewed mission of the Artemis campaign. The nine-day lunar flyby launched on the agency’s SLS (Space Launch System) rocket and had four astronauts test the Orion spacecraft in high Earth orbit and in deep space. Four 12U CubeSats also launched on the mission, housed within the SLS’s Orion stage adapter (OSA). The spacecraft were deployed approximately five-and-a-half hours into the flight, following Orion separation and departure from SLS, as the SLS interim cryogenic propulsion stage (ICPS) and the attached OSA were in a high Earth orbit on an atmospheric disposal trajectory. All four CubeSats were successfully deployed from the launch vehicle. Deployment statuses of the spacecraft, along with updates about the SLS rocket and Artemis missions, are reported in this paper. The paper will also discuss opportunities for CubeSat payloads on future Artemis missions.

David Hitt↗

A History of Orion Mission Design, Copernicus Software Development, and the Artemis I Trajectory

This paper describes the history of the on-orbit trajectory design and optimization for the Orion spacecraft at NASA JSC, from the initial design through the execution of the Artemis I test flight. In parallel, the Copernicus trajectory optimization tool was also being developed and was the main tool used for Orion trajectory design during this period. Finally, the paper gives an overview of the Artemis I trajectory that was flown during the Artemis I mission from November 16 - December 11, 2022.

Orion↗

Lunar Pickup Ions Observed by ARTEMIS: Spatial and Temporal Distribution and Constraints on Species and Source Locations

ARTEMIS observes pickup ions around the Moon, at distances of up to 20,000 km from the surface. The observed ions form a plume with a narrow spatial and angular extent, generally seen in a single energy/angle bin of the ESA instrument. Though ARTEMIS has no mass resolution capability, we can utilize the analytically describable characteristics of pickup ion trajectories to constrain the possible ion masses that can reach the spacecraft at the observation location in the correct energy/angle bin. We find that most of the observations are consistent with a mass range of approx. 20-45 amu, with a smaller fraction consistent with higher masses, and very few consistent with masses below 15 amu. With the assumption that the highest fluxes of pickup ions come from near the surface, the observations favor mass ranges of approx. 20-24 and approx. 36-40 amu. Although many of the observations have properties consistent with a surface or near-surface release of ions, some do not, suggesting that at least some of the observed ions have an exospheric source. Of all the proposed sources for ions and neutrals about the Moon, the pickup ion flux measured by ARTEMIS correlates best with the solar wind proton flux, indicating that sputtering plays a key role in either directly producing ions from the surface, or producing neutrals that subsequently become ionized.

Artemis↗

Understanding Temporal and Spatial Variability of the Lunar Helium Atmosphere Using Simultaneous Observations from LRO, LADEE, and ARTEMIS

Simultaneous measurements of helium in the exosphere of the Moon are made from the Lunar Reconnaissance Orbiter (LRO) Lyman Alpha Mapping Project (LAMP) and the Lunar Atmosphere and Dust Environment Explorer (LADEE) Neutral Mass Spectrometer (NMS) through the entire 5-month span of the LADEE mission. In addition, the ARTEMIS mission monitored the solar wind alpha particle flux to the Moon. Modeling the lunar helium exosphere, we relate the LAMP polar observations to the LADEE equatorial observations. Further, using the ARTEMIS alpha flux in the Monte Carlo model reproduces the temporal variations in helium density. Comparing the LAMP data to the LADEE data shows excellent agreement. Comparing those with the ARTEMIS data reveals that the solar wind alpha flux is the primary driver to variability in the helium exosphere throughout the LADEE mission. Using a decay time for exospheric helium of 5 days, we determine that the solar wind contributes 64 +/- 5% of the helium to the lunar exosphere. The remaining 36 +/- 5% is presumed to come from outgassing of radiogenic helium from the interior of the Moon. Furthermore, the model reproduces the measurements if 63 +/- 6% of the incident alpha particles are converted to thermalized helium atoms through the interaction between the alphas and the lunar surface. However, these values are dependent on both inferred source rates from LAMP and LADEE observations and on the assumed time constant of the exospheric decay rate.

Moon↗

End-to-End Assessment of Artemis-1 Development Flight Instrumentation

As the space industry continues to strive for more efficient launch vehicles they must rely on increasingly accurate predictive models. Verification of models typically requires physical testing. Flight data measurements offer the most real and therefore the most accurate data for model correlation. As NASA prepares for the inaugural launch of their new Space Launch System (SLS), Artemis-1, they must rely heavily on predictive system models to ensure flight safety. Artemis-1 will be an unmanned scientific mission with the intent of blazing a trail for future manned missions. NASA has implemented a system of Development Flight Instrumentation (DFI) in the hopes of recovering useful flight data during liftoff and ascent to aid in correlating their predictive models to ensure human safety in future missions. An end-to-end assessment of the DFI system was performed to verify data acquired during Artemis-1 would be adequate for the targeted flight test objectives (FTOs). This was accomplished using a computational simulation of all sensors and Data Acquisition (DAQ) parameters to investigate any potential problem areas in the current architecture. Input nominal signals were approximated and injected into the system model. Synthesized acquired signals were recovered to verify FTO success.

Flight measurement↗

Training Artemis Astronauts to Explore the Moon

To prepare for human exploration of the Moon in the mid-2020s, NASA is developing a program to provide geoscience and planetary science classroom training and geologic eld training to astronauts and other mission personnel. The Artemis geoscience training plan builds on a long legacy: NASA has trained astronauts in geology, planetary science, and geological eld work for more than 50 years. From ~1965-1972, the geology focus for astronauts included orbital Earth observations during the early NASA missions, but the endgame was preparation for the Apollo missions to the Lunar surface [see Phinney (2015), NASA-SP-2015-626; Lofgren et al.(2011);Schmitt, et al. (2011); and El Baz (2011), all from GSA SP483]. From the mid 1970s through2017, the primary purpose for geoscience training was to prepare astronauts to observe theEarth and document a wide variety of Earth processes from orbital platforms (Skylab, SpaceShuttle and International Space Station). Astronaut observations of Earth from the InternationalSpace Station remain an important activity today, but the prospect of exploration of the lunar surface through the Artemis Program lends additional purpose to the geoscience content and eld experiences that we provide the astronauts. We recently completed the geology and eld training with Astronaut Class 22 and are now planning both focused eld exercises and simulations for future Artemis crews, as well as the accompanying classroom lessons on lunar and planetary sciences. The training we offer extends beyond the astronaut office – we partner across operational and engineering organizations at NASA and provide eld work exercises and opportunities to personnel in the Flight Operations Directorate (responsible for the overall training and certification), as well as the exploration Extravehicular Activity Oce (developing spacewalk suits and tools). These partnerships contribute to building a common language and sense of purpose, and also help to ensure that NASA’s geoscience training and science operations are fully integrated with the teams and systems responsible for getting the next generation of astronauts to the surface of the Moon.

Artemis↗

Extended Kalman Filter Performance on the Artemis-1 Mission

The Artemis Program is NASA’s campaign to explore the Moon and beyond. Artemis-1, the uncrewed exoLEO test flight of the Orion spacecraft, was completed in 2022. There were four navigation Extended Kalman Filters (EKFs) that are part of the Orion navigation system. The Atmospheric Extended Kalman Filter (ATMEKF) estimates the vehicle position, velocity, and attitude (referred to as the vehicle state) during the ascent and entry phases of flight. Once Orion is outside of Earths atmosphere, the Earth Orbit Extended Kalman Filter (EOEKF) and CisLunar Extended Kalman Filter (CLEKF) estimate the translational states, depending on the phase of flight, while the Attitude Extended Kalman Filter (ATTEKF) estimates the rotational state of the vehicle. The Kalman filters propagate the vehicle state forward in time using a combination of dynamics models and the output data from the Inertial Measurement Unit (IMU). The filters update the vehicle states and associated uncertainties, in the form of the covariance matrix, using pseudorange measurements from GPS (in ATMEKF/EOEKF), optical navigation measurements of the Earth or Moon (in CLEKF), and star tracker measurements (in ATTEKF). Simultaneously, the Kalman filters estimate error sources in the sensors, which are included in the state vectors as Exponentially Correlated Random Variables (ECRVs). This paper will summarize the performance of these filters during the Artemis-1 mission.

Artemis-1↗

Planetary Science Training for Artemis Missions

Planetary geology training for Artemis crews and mission support teams is well underway. We recently reported on the development of our geology/planetary science training flow, and the cross-agency coordination efforts necessary for implementing the training [1, 2]. We discussed our progressive geology training program that starts with incoming astronaut classes, offers opportunities to maintain the geology proficiency between flight assignments, and trains the broader Artemis engineering-operations management community in geology and basic field methods [3, 4]. In this abstract, we outline and discuss our 2023 accomplishments and near-term plans for continued development of lunar science classroom content, field training objectives, and the delivery of geology training to astronauts and the Artemis mission engineers.

Artemis↗

Artemis Radiation Environment

NASA’s Artemis program is tasked with going back to the Moon sustainably, paving the way for Mars crewed missions. The long-term architecture of living around and on the Moon necessitates a more comprehensive understanding of the radiation environment that is much different than what is seen in low-Earth orbit on the International Space Station. Without the Earth’s protective magnetic field, high-energy charged particles from the Sun and galactic space can affect both avionics and crew if mitigation strategies are not considered. Programs under Artemis such as Gateway, the Human Landing System, the Space Launch System, Orion, and others use the space environments as defined in the Design Specification for Natural Environments for all engineering design partners. In this paper, the space radiation environments applicable to the Artemis program are discussed.

Artemis↗

Solar Array Performance Modeling for NASA’s Artemis Missions

NASA’s Artemis exploration campaign includes multiple elements that utilize photovoltaic power generation. Artemis mission profiles feature a variety of events that can limit solar array generation and stress electrical power system (EPS) performance, including eclipses, propulsive or navigational maneuvers which constrain the positioning of the solar arrays, and spiral trajectories with significant radiation degradation. These features make predicting the performance of the power system particularly important and requires accurate modeling of power generation by the solar arrays under a variety of conditions. One of the tools used to predict spacecraft EPS performance is the System Power Analysis for Capability Evaluation (SPACE) model developed at NASA Glenn Research Center. SPACE is used by NASA to model EPS performance for the Orion crew transport vehicle and the Power and Propulsion Element (PPE) of the Gateway space station. This presentation will provide an overview of how SPACE calculates solar array performance, including degradation factors considered and environmental conditions that drive the solar array designs. Additionally, Orion array performance predictions generated by SPACE will be compared to flight data collected during the Artemis I mission.

Photovoltaic↗