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NASA NTRSDate not supplied

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↗

NASA NTRSDate not supplied

Development of Machine Learning-Derived Microbiological and Immune Signatures: Applications in Adaptive Risk Assessment of Infectious Disease During Spaceflight

Infectious diseases represent an urgent risk for spaceflight with consequences ranging from loss in crew performance to crew incapacitation or loss of life should an outbreak occur. The resident environmental microbiome on the International Space Station has been monitored through routine surveillance over almost twenty years, beginning with culture-based microbial detection which has advanced to molecular methods in recent years. This has created a wealth of data that we have begun mining to define the microbial ecology of the ISS. Summarized here is our analysis of data from the historical microbial population defined by culture-based monitoring from the past two decades, organized by their likelihood to cause disease into clinical categories. As expected, many residents of the normal microflora in environments where people work and live were detected. However, some known pathogens were also detected. As the spaceflight environment can predispose humans to infection, crew health records were used to source additional data for the set to uncover clinical relevance. Data mining was performed on crew health records to capture adverse health events that may be related to infectious disease. Machine learning, specifically Random Forest analysis, was used to analyze the microbial and crew health datasets. The symptom categories were not explained by the ranked bacteria, due to lack of sufficient data for some categories and due to poor ranking of the pathogens for others. Poor ranking of the bacteria could be due to the clinical symptoms being linked to other disease-causing factors, such as allergy or viral infection. These findings suggest a lack of relationship between bacteria detected on surfaces in the ISS and historical health events experienced by astronauts.

Kristyn Hoffman↗

NASA NTRSDate not supplied

Overview of Crew Operations for Transit to Mars

Crewed Mars missions are estimated to be 700-1,200 days in length which is two to three times longer than any continuous human spaceflight mission to date. When architecting a Mars mission there are numerous resources that must be considered, evaluated, and planned for, including—but not limited to—mass, cost, performance, and risk. Crew time is a limited resource that will need to be appropriately allocated during future Mars missions. NASA’s “Moon to Mars Objectives” specifically recognizes as Recurring Tenets the need to return crews safely to Earth while mitigating adverse impacts to crew health and maximizing crew time available for science and engineering activities within planned mission durations. Crew operations and the crew time allocation for a Mars missions will likely be different than current operational planning aboard the ISS due to communication delays, crew health and performance needs, transportation system needs, potential vehicle dormancy, and mass ejection. Crew will need to operate much more Earth independently and potentially be responsible for more operations since traditional Earth ground support will be delayed. Incidents requiring immediate crew action will therefore either be the responsibility of the crew or an automated feature of the transit vehicle. This paper discusses the operational challenges of a Mars transit mission and the associated activities that will need to take place during each operational phase of transit to and from Mars.

Crew Time↗

NASA NTRSDate not supplied

Overview of Crew Operations for Transit to Mars

Crew Time↗

NASA NTRS2009

Determining the Relative Criticality of Diverse Exploration Risks in NASA's Human Research Program

The mission of NASA s Human Research Program (HRP) is to understand and reduce the risk to crew health and performance in exploration missions. The HRP addresses 27 specific risks, primarily in the context of Continuous Risk Management. Each risk is evaluated in terms of two missions (a six month stay on the Moon and a thirty month round trip to Mars) and three types of consequences (in-mission crew health, post-mission crew health, and in-mission performance). The lack of a common metric between the three consequence scales, such as financial costs or quality adjusted life years lost, makes it difficult to compare the relative criticality of the risks. We are, therefore, exploring the use of a ternary scale of criticality based on the common metric of influencing an operational decision. The three levels correspond to the level of concern the risk generates for a "go/no-go" decision to launch a mission: 1) no-go; 2) go with significant reservations; 3) go. The criticality of each of the 27 risks is scored for the three types of consequence in both types of mission. The scores are combined to produce an overall criticality rating for each risk. The overall criticality rating can then be used to guide the prioritization of resources to affect the greatest amount of risk reduction.

Kundrot, Craig E.↗

NASA NTRSDate not supplied

Earth Independent Medical Operations (EIMO)

Inherent in interplanetary space travel are unprecedented challenges that could threaten mission success and negatively impact crew health and performance. Return to definitive care is essentially untenable and resources will be constrained with practically no re-supply capability. Access to ground-based medical expertise will be significantly delayed under nominal conditions with exacerbation during conjunction or prolonged dust storms. Taken together, these challenges necessitate the development of a progressively autonomous medical operational support system to assist the crew medical officer (CMO). While support from ground based medical experts will remain indispensable for pre-mission planning, the approach to management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets, enabling support of astronaut health and performance and reducing overall mission risk. To progressively enable EIMO, a series of meetings were convened with subject matter experts from within NASA, academia and industry to facilitate mapping of the path to support autonomous medical operations. Topics explored in these meetings included the scope of data (storage capacity, usage, transmission rate and bandwidth, computing capacity), CMO training, supply and resource management and task load balance. Recommendations from these meetings will inform the EIMO Concept of Operations and definition of the associated requirements culminating in updates to the NASA 3001 standards. The EIMO project team will work with stakeholders to conceptualize a clinical decision support system (CDSS) to assist the CMO in response to medical contingencies when terrestrial support is delayed or otherwise unavailable. The CDSS will be a system of systems that will utilize data from numerous input vectors. Successful deployment of the CDSS will facilitate medical decision making while decreasing the cognitive load leading to an improvement in task load balancing. Additional benefits of the envisioned CDSS include assistance with inventory management, locating resources, storage/retrieval of medical records, highlighting trends in recorded data, in addition to providing a consult for diagnosis and treatment. More advanced features might include passive monitoring to identify early warning signs of behavioral or medical anomalies to possibly pre-empt onset of conditions that would compromise crew health and performance.

Benjamin Easter↗

NASA NTRS2012

Human Health Countermeasures (HHC) Element Management Plan: Human Research Program

NASA s Human Research Program (HRP) is an applied research and technology program within the Human Exploration and Operations Mission Directorate (HEOMD) that addresses human health and performance risk mitigation strategies in support of exploration missions. The HRP research and technology development is focused on the highest priority risks to crew health and safety with the goal of ensuring mission success and maintaining long-term crew health. Crew health and performance standards, defined by the NASA Chief Health and Medical Officer (CHMO), set the acceptable risk level for exploration missions. The HRP conducts research to inform these standards as well as provide deliverables, such as countermeasures, that ensure standards can be met to maximize human performance and mission success. The Human Health Countermeasures (HHC) Element was formed as part of the HRP to develop a scientifically-based, integrated approach to understanding and mitigating the health risks associated with human spaceflight. These health risks have been organized into four research portfolios that group similar or related risks. A fifth portfolio exists for managing technology developments and infrastructure projects. The HHC Element portfolios consist of: a) Vision and Cardiovascular; b) Exercise and Performance; c) Multisystem; d) Bone; and e) Technology and Infrastructure. The HHC identifies gaps associated with the health risks and plans human physiology research that will result in knowledge required to more fully understand risks and will result in validated countermeasures to mitigate risks.

Norsk, Peter↗

NASA NTRSDate not supplied

An Oculometric Standard to Assess the Performance of the Ocular System for Long Duration Spaceflight

Changes in the human brain, due to spaceflight, have been a challenge to the space program since its inception; a challenge that is becoming more acute as extended International Space Station (ISS) missions become routine, a return to crewed lunar exploration is about to begin, and a multi-year crewed trip to Mars is being planned. Determining the extent to which neurophysiological adaptations may adversely impact performance in operational tasks, assessing the full-time course of these changes, and identifying/mitigating any potential long-term health consequences are crucial steps required to enable safe crew-autonomous, long-duration, deep-space missions. Vision is the predominant perceptual sense used to guide cognition and motor control in humans. Thus, it is critical for the success of any future, long-duration mission to understand how long-term exposure to microgravity and to other stressors of spaceflight and their interactions, impact visual function. This is an especially challenging task given the small and disparate samples from which we have been and will be able to collect human performance data. NASA has recently been carefully tracking spaceflight-induced ophthalmic changes, driven in large part by the fluid shifts related to microgravity. In particular, a recent study of Optical Coherence Tomography (OCT) postflight measures revealed that more than two-thirds of US crew members experience significant increases in retinal thickness after 6month or longer ISS missions. Space Associated Neuro-ocular Syndrome (SANS) also includes visual acuity decrements and other ocular structural changes that could adversely impact in-flight performance as missions become longer. However, the impact of spaceflight on the visual system is not limited to the retina. Recent comparisons of pre-and post-flight brain images have revealed structural changes throughout the brain that implicate visual, visuomotor, and visual-cognitive pathways, consistent with observed functional impacts (e.g., decreased speed/accuracy/timing of fine goal-oriented movements). Current limitations on inflight testing make it very difficult to determine when and under what conditions SANS and other disruptions of human neurological subsystems arise. Currently, one cannot anticipate the time course and extent of impairment and recovery. This study addresses this knowledge gap by creating an integrated framework of the relevant existing literature on visual and oculomotor function during spaceflight with an eye towards complementing current structural measures of visuomotor impairment with new oculometric standard measures. Using eye-movement based visual function assessment and diagnostics would provide a valuable enhancement of crew health and performance monitoring in support of deepspace exploration.

Vision↗

NASA NTRSDate not supplied

ExMC Systems Engineering Developments

The Exploration Medical Capability (ExMC) Element within the Human Research Program (HRP) applies systems engineering (SE) principles along with the use of Model-Based Systems Engineering (MBSE) tools to identify and communicate the requirements for medical and crew health and performance (CHP) systems. In the past fiscal year, the MBSE approach sought to advance the digital engineering toolset for medical and CHP system representation. These digital artifacts provide enhanced views of the relationships among requirements, standards, functions, and capabilities, to name a few, that is best suited for a user’s objectives. The MBSE tools and SE practices were applied to the development of the revised Earth Independent Medical Operations (EIMO) medical system and the Artemis III and IV CHP System models. In addition, a System of Systems concept was integrated into the EIMO model to facilitate the identification of system interfaces that interact with the medical system. Finally, the ExMC SE team has initiated several efforts to bring operationally relevant digital engineering practices to the Human Health and Performance Directorate (HHPD). This included the development of a pilot program within the directorate to help foster utilization of tools such as MagicDraw for system modeling and Power BI for visualizing extracted data in an easily accessible dashboard format. Additionally, with the increase in complexity of the integration effort for Artemis missions, ExMC has endeavored to bring digital engineering strategies to potentially increase efficiency in review processes. This talk will provide a high-level overview of the ExMC SE team accomplishments since the last Investigators’ Workshop, an introduction to upcoming SE talks, and the ongoing systems engineering work.

systems engineering↗

NASA NTRSDate not supplied

ExMC Systems Engineering Status

The Exploration Medical Capability (ExMC) Element within the Human Research Program (HRP) applies systems engineering principles along with the use of Model-Based Systems Engineering (MBSE) tools to identify and communicate the requirements for medical and crew health and performance (CHP) systems. The MBSE approach to medical system design offers a paradigm shift toward greater integration between the vehicle and a human health and performance system. In addition, the MBSE tools provide a means in which systems engineers can develop different views of the relationships between and among requirements, standards, functions, and capabilities, to name a few, that is best suited for a user’s objectives. Applying these tools, ExMC Systems Engineering (SE) developed three MBSE models in support of multiple projects in fiscal year (FY) 2023. These included the Long-Duration Lunar Orbit and Lunar Surface (LDLOLS) Medical System Foundation, Earth-Independent Medical Operations (EIMO) medical system ConOps, and the 2023 Artemis CHP System model. This talk will provide a high-level overview of what the ExMC SE team has accomplished since the last Investigators’ Workshop, an introduction to upcoming SE talks, and the ongoing systems engineering work.

Systems engineering↗

NASA NTRSDate not supplied

ExMC Systems Engineering Status

Systems engineering↗

NASA NTRS2018

Validation and Norms of Cognition and Spaceflight Assessments with Senior Military Leaders

Spaceflight hazards include risks to cognitive performance. NASA requires sensitive neuropsychological screening tools to determine changes to cognitive risks to crew health and performance. Currently, NASA uses WinSCAT (Spaceflight Cognitive Assessment Tool for Windows) for neurocognitive screening and to monitor the status of astronauts during spaceflight. The CognitionTest Battery was recently developed by NASA-funded researchers at UPenn as part of the Behavioral Health and Performance component of NASA Standard Measures. This research provides independently validated norms and psychometric properties to compare WinSCAT to Cognition using a military population who operates in high demand, extreme environments similar to those experienced by astronauts (deployments, isolation, extreme environments).

Williams, T. J.↗

NASA NTRS2011

Human Research Program Integrated Research Plan

Crew health and performance are critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes (1) HRP's approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and (2) the method of integration for risk mitigation. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.

Steinberg, Susan↗

NASA NTRS2009

Human Research Program Integrated Research Plan

The Integrated Research Plan (IRP) describes the portfolio of Human Research Program (HRP) research and technology tasks. The IRP is the HRP strategic and tactical plan for research necessary to meet HRP requirements. The need to produce an IRP is established in HRP-47052, Human Research Program - Program Plan, and is under configuration management control of the Human Research Program Control Board (HRPCB). Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) is essential to enabling extended periods of space exploration because it provides knowledge and tools to mitigate risks to human health and performance. Risks include physiological and behavioral effects from radiation and hypogravity environments, as well as unique challenges in medical support, human factors, and behavioral or psychological factors. The Human Research Program (HRP) delivers human health and performance countermeasures, knowledge, technologies and tools to enable safe, reliable, and productive human space exploration. Without HRP results, NASA will face unknown and unacceptable risks for mission success and post-mission crew health. This Integrated Research Plan (IRP) describes HRP s approach and research activities that are intended to address the needs of human space exploration and serve HRP customers and how they are integrated to provide a risk mitigation tool. The scope of the IRP is limited to the activities that can be conducted with the resources available to the HRP; it does not contain activities that would be performed if additional resources were available. The timescale of human space exploration is envisioned to take many decades. The IRP illustrates the program s research plan through the timescale of early lunar missions of extended duration.

Source record↗

NASA NTRS2009

Lunar Human Research Requirements (LHRR)

Biomedical research will be conducted during transit and on the surface of the Moon to prepare for extended stays on the Moon and to prepare for the exploration of Mars. The objective of the Human Research Program (HRP) is to preserve the health and enhance performance of astronaut explorers. Specific objectives of the HRP include developing the knowledge, capabilities, and necessary countermeasures and technologies in support of human space exploration; focusing on mitigating the highest risks to crew health and performance; and defining and improving human spaceflight medical, environmental, behavioral, and human factors standards. This document contains a detailed description of the resource accommodations, interfaces, and environments to be provided by the Constellation Program (CxP) to support the HRP research in transit and on the lunar surface. Covered, specifically, are the requirements for mass and volume transport; crew availability; ground operations, baseline data collection, and payload processing; power, and data. Volumes and mass are given for transport of conditioned samples only. They do not account for the engineering solution that the Constellation Program will implement (refrigerator/freezer volume/mass). This document does not account for requirements on the Orion vehicle for transportation to and from the International Space Station (ISS). The ISS Program has supplied requirements for this mission.

Denkins, Pamela↗

NASA NTRS2007

Recommendations for Exploration Space Medicine from the Apollo Medical Operations Project

Introduction: A study was requested in December, 2005 by the Space Medicine Division at the NASA-Johnson Space Center (JSC) to identify Apollo mission issues relevant to medical operations that had impact to crew health and/or performance. The objective was to use this new information to develop medical requirements for the future Crew Exploration Vehicle (CEV), Lunar Surface Access Module (LSAM), Lunar Habitat, and Advanced Extravehicular Activity (EVA) suits that are currently being developed within the exploration architecture. Methods: Available resources pertaining to medical operations on the Apollo 7 through 17 missions were reviewed. Ten categories of hardware, systems, or crew factors were identified in the background research, generating 655 data records in a database. A review of the records resulted in 280 questions that were then posed to surviving Apollo crewmembers by mail, face-to-face meetings, or online interaction. Response analysis to these questions formed the basis of recommendations to items in each of the categories. Results: Thirteen of 22 surviving Apollo astronauts (59%) participated in the project. Approximately 236 pages of responses to the questions were captured, resulting in 107 recommendations offered for medical consideration in the design of future vehicles and EVA suits based on the Apollo experience. Discussion: The goals of this project included: 1) Develop or modify medical requirements for new vehicles; 2) create a centralized database for future access; and 3) take this new knowledge and educate the various directorates at NASA-JSC who are participating in the exploration effort. To date, the Apollo Medical Operations recommendations are being incorporated into the exploration mission architecture at various levels and a centralized database has been developed. The Apollo crewmembers input has proved to be an invaluable resource, prompting ongoing collaboration as the requirements for the future exploration missions continue to evolve and be refined.

Scheuring, R. a.↗

NASA NTRS2014

Human Research Program Opportunities

The goal of HRP is to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. The Human Research Program was designed to meet the needs of human space exploration, and understand and reduce the risk to crew health and performance in exploration missions.

Kundrot, Craig E.↗

NASA NTRS1992

A systems approach to water recovery testing for space life support - Initial biomedical results from the ECLSS Water Recovery Test and plans for testbed utilization

Among the challenges of designing and constructing Space Station Freedom is the development of the water system. A review of past efforts in reclaiming waste water in enclosed environments reveals that there are many gaps in the biomedical understanding of this process. Some of the key uncertainties of human interaction with a closed water system include determining potential contaminants and establishing safe levels of multiple compounds in the enclosed system of Space Station. Another uncertainty is the microbial constituency of such a system and what impact it could have on crew health and performance. The use of iodine as the passive biocide may have both an indirect and direct impact on the crew. In this paper the initial results of the Water Recovery Test are reviewed from a biomedical perspective, revealing areas where more information is needed to develop the ECLSS water system. By including the approach of 'man as a subsystem', consideration is given to how man interacts with the total water system. Taking this systems approach to providing the crew with a safe source of water gives useful insight into the most efficient design and utilization of closed system testbeds.

Aten, Laurie A.↗