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NASA NTRS2012

Benefits of a Single-Person Spacecraft for Weightless Operations

Historically, less than 20 percent of crew time related to extravehicular activity (EVA) is spent on productive external work. For planetary operations space suits are still the logical choice; however for safe and rapid access to the weightless environment, spacecraft offer compelling advantages. FlexCraft, a concept for a single-person spacecraft, enables any-time access to space for short or long excursions by different astronauts. For the International Space Station (ISS), going outside is time-consuming, requiring pre-breathing, donning a fitted space suit, and pumping down an airlock. For each ISS EVA this is between 12.5 and 16 hours. FlexCraft provides immediate access to space because it operates with the same cabin atmosphere as its host. Furthermore, compared to the space suit pure oxygen environment, a mixed gas atmosphere lowers the fire risk and allows use of conventional materials and systems. For getting to the worksite, integral propulsion replaces hand-over-hand translation or having another crew member operate the robotic arm. This means less physical exertion and more time at the work site. Possibly more important, in case of an emergency, FlexCraft can return from the most distant point on ISS in less than a minute. The one-size-fits-all FlexCraft means no on-orbit inventory of parts or crew time required to fit all astronauts. With a shirtsleeve cockpit, conventional displays and controls are used, there is no suit trauma and because the work is not strenuous, no rest days are required. Furthermore, there is no need to collect hand tools because manipulators are equipped with force multiplying end-effectors that can deliver the precise torque for the job. FlexCraft is an efficient solution for asteroid exploration allowing all crew to use one vehicle with no risk of contamination. And, because FlexCraft is a vehicle, its design offers better radiation and micro-meteoroid protection than space suits.

Griffin, Brand Norman↗

NASA NTRS2012

Spaceflight Effects and Molecular Responses in the Mouse Eye: Observations after NASA Shuttle Mission STS-133

Background: Human space exploration implies a combination of stressors including microgravityinduced cephalad fluid shift and radiation exposure. Ocular changes in astronauts leading to visual impairment are of occupational health relevance. The effect of this complex environment on ocular morphology and function is poorly understood. Material and Methods: Mice were assigned to a Flight (FLT) group flown on shuttle mission STS133, Animal Enclosure Module (AEM), or vivarium (VIV) ground controls. Eyes were collected at 1, 5 and 7 days after landing, and were fixed for histological sectioning. The contralateral eye was used for gene expression profiling by qRT-PCR. Routine histology and immunohistochemistry using 8-hydroxy-2'-deoxyguanosine (8-OHdG), caspase-3, glial fibrillary acidic protein (GFAP) and beta-amyloid were used to study the eyes. Results and Conclusions: 8-OHdG and caspase-3 immunoreactivity was increased in the retina in FLT samples at return from flight (R+1) compared to ground controls, and decreased at day 7 (R+7), suggesting an increase in oxidative stress and cell apoptosis. FLT mice showed evidence of retinal pigment epithelium (RPE) apoptosis possibly secondary to oxidative damage. Although attenuation of RPE has been related to retinal choroidal folds in astronauts, it is yet to be determined whether or not increased RPE apoptosis may contribute to the formation of choroidal folds or may increase the risk for other retinal pathologies, such as AMD. beta-amyloid was seen in the nerve fibers at the post-laminar region of the optic nerve in the flight samples (R+7). Deposition of beta-amyloid has a strong correlation with mechanical trauma. The coexpression of GFAP in astrocytes and oligodentrocytes in these same areas supports the possible mechanical origin probably secondary to intracranial pressure that is transmitted into the nerve, as a result of an increase in venous pressure associated to microgravity-induced cephalic fluid shift. However, there is the need to further investigate the nature of the changes through additional experimental work. Gene expression of oxidative and cellular stress response genes was unregulated in the retina of FLT samples upon landing followed by lower levels by R+7. These results suggest that reversible molecular damage occurs in the retina of mice exposed to spaceflight and that protective cellular and molecular pathways are induced in the retina in response to these changes.

ProsperoPonce, Claudia Maria↗

NASA NTRS2013

Effects of the 8 psia / 32% O2 Atmosphere on the Human in the Spaceflight Environment

Extravehicular activity (EVA) is at the core of a manned space exploration program. There are elements of exploration that may be safely and effectively performed by robots, but there are critical elements of exploration that will require the trained, assertive, and reasoning mind of a human crewmember. To effectively use these skills, NASA needs a safe, effective, and efficient EVA component integrated into the human exploration program. The EVA preparation time should be minimized and the suit pressure should be low to accommodate EVA tasks without undue fatigue, physical discomfort, or suit-related trauma. Commissioned in 2005, the Exploration Atmospheres Working Group (EAWG) had the primary goal of recommending to NASA an internal environment that allowed efficient and repetitive EVAs for missions that were to be enabled by the former Constellation Program. At the conclusion of the EAWG meeting, the 8.0 psia and 32% oxygen (O2) environment were recommended for EVA intensive phases of missions. As a result of selecting this internal environment, NASA gains the capability for efficient EVA with low risk of decompression sickness (DCS), but not without incurring additional negative stimulus of hypobaric hypoxia to the already physiologically challenging spaceflight environment. This paper provides a literature review of the human health and performance risks associated with the 8 psia/32% O2 environment. Of most concern are the potential effects on the central nervous system including increased intracranial pressure, visual impairment, sensorimotor dysfunction, and oxidative damage. Other areas of focus include validation of the DCS mitigation strategy, incidence and treatment of acute mountain sickness (AMS), development of new exercise countermeasures protocols, effective food preparation at 8 psia, assurance of quality sleep, and prevention of suit-induced injury. As a first effort, the trade space originally considered in the EAWG was re-evaluated looking for ways to decrease the hypoxic dose by further enriching the O2% or increasing the pressure. After discussion with the NASA engineering and materials community, it was determined that the O2 could be enriched from 32% to 34% and the pressure increased from 8.0 to 8.2 psia without significant penalty. These two small changes increase alveolar O2 pressure by 11 mmHg, which is expected to significantly benefit crewmembers. The 8.2/34 environment (inspired O2 pressure = 128 mmHg) is also physiologically equivalent to the staged decompression atmosphere of 10.2 psia / 26.5% O2 (inspired O2 pressure = 127 mmHg) used on 34 different shuttle missions for approximately a week each flight. Once decided, the proposed internal environment, if different than current experience, should be evaluated through appropriately simulated research studies. In many cases, the human physiologic concerns can be investigated effectively through integrated multi-discipline ground-based studies. Although missions proposing to use an 8.2/34 environment are still years away, it is recommended that these studies begin early enough to ensure that the correct decisions pertaining to vehicle design, mission operational concepts, and human health countermeasures are appropriately informed.

Environmental control↗

NASA NTRS2014

Expanding the Description of Spaceflight Effects beyond Bone Mineral Density [BMD]: Trabecular Bone Score [TBS] in ISS Astronauts

Dual-energy x-ray absorptiometry [DXA] is the widely-applied bone densitometry method used to diagnose osteoporosis in a terrestrial population known to be at risk for age-related bone loss. This medical test, which measures areal bone mineral density [aBMD] of clinically-relevant skeletal sites (e.g., hip and spine), helps the clinician to identify which persons, among postmenopausal women and men older than 50 years, are at high risk for low trauma or fragility fractures and might require an intervention. The most recognized osteoporotic fragility fracture is the vertebral compression fracture which can lead to kyphosis or hunched backs typically seen in the elderly. DXA measurement of BMD however is recognized to be insufficient as a sole index for assessing fracture risk. DXA's limitation may be related to its inability to monitor changes in structural parameters, such as trabecular vs. cortical bone volumes, bone geometry or trabecular microarchitecture. Hence, in order to understand risks to human health and performance due to space exposure, NASA needs to expand its measurements of bone to include other contributors to skeletal integrity. To this aim, the Bone and Mineral Lab conducted a pilot study for a novel measurement of bone microarchitecture that can be obtained by retrospective analysis of DXA scans. Trabecular Bone Score (TBS) assesses changes to trabecular microarchitecture by measuring the grey color "texture" information extracted from DXA images of the lumbar spine. An analysis of TBS in 51 ISS astronauts was conducted to assess if TBS could detect 1) an effect of spaceflight and 2) a response to countermeasures independent of DXA BMD. In addition, changes in trunk body lean tissue mass and in trunk body fat tissue mass were also evaluated to explore an association between body composition, as impacted by ARED exercise, and bone microarchitecture. The pilot analysis of 51 astronaut scans of the lumbar spine suggests that, following an ISS mission, DXA BMD and TBS are detecting different effects of ARED exercise and of ARED + Bisphosphonate on the lumbar spine of astronauts. There is emerging evidence associating reduced TBS with terrestrial metabolic bone disorders where a TBS <1.200 is associated with "degraded" while > 1.350 is associated with "normal." However, it is not possible to conclude how the spaceflight-induced changes in TBS increase risk for vertebral fractures in the astronaut or if changes in body composition of the trunk region could be an indirect method of assessing exercise effect on bone microarchitecture. More importantly, this pilot analysis demonstrates a new, minimal risk approach for monitoring changes to vertebral bone microarchitecture. This method could help assess the combined skeletal effects of spaceflight with the effects of aging in the astronaut after return to Earth.

Sibonga, J. D.↗

NASA NTRS2014

Oculometric Assessment of Dynamic Visual Processing

Eye movements are the most frequent (~3 per second), shortest-latency (~150-250 ms), and biomechanically simplest (1 joint, no inertial complexities) voluntary motor behavior in primates, providing a model system to assess sensorimotor disturbances arising from trauma, fatigue, aging, or disease states (e.g., Diefendorf and Dodge, 1908). We developed a 15-minute behavioral tracking protocol consisting of randomized stepramp radial target motion to assess several aspects of the behavioral response to dynamic visual motion, including pursuit initiation, steadystate tracking, direction-tuning, and speed-tuning thresholds. This set of oculomotor metrics provide valid and reliable measures of dynamic visual performance (Stone and Krauzlis, 2003; Krukowski and Stone, 2005; Stone et al, 2009; Liston and Stone, 2014), and may prove to be a useful assessment tool for functional impairments of dynamic visual processing.

smooth pursuit↗

NASA NTRS2014

Evaluation of the First Transport Rotorcraft Airframe Crash Testbed (TRACT 1) Full-Scale Crash Test

In 2012, the NASA Rotary Wing Crashworthiness Program initiated the Transport Rotorcraft Airframe Crash Testbed (TRACT) research program by obtaining two CH-46E helicopters from the Navy CH-46E Program Office (PMA-226) at the Navy Flight Readiness Center in Cherry Point, North Carolina. Full-scale crash tests were planned to assess dynamic responses of transport-category rotorcraft under combined horizontal and vertical impact loading. The first crash test (TRACT 1) was performed at NASA Langley Research Center's Landing and Impact Research Facility (LandIR), which enables the study of critical interactions between the airframe, seat, and occupant during a controlled crash environment. The CH-46E fuselage is categorized as a medium-lift rotorcraft with fuselage dimensions comparable to a regional jet or business jet. The first TRACT test (TRACT 1) was conducted in August 2013. The primary objectives for TRACT 1 were to: (1) assess improvements to occupant loads and displacement with the use of crashworthy features such as pre-tensioning active restraints and energy absorbing seats, (2) develop novel techniques for photogrammetric data acquisition to measure occupant and airframe kinematics, and (3) provide baseline data for future comparison with a retrofitted airframe configuration. Crash test conditions for TRACT 1 were 33-ft/s forward and 25-ft/s vertical combined velocity onto soft soil, which represent a severe, but potentially survivable impact scenario. The extraordinary value of the TRACT 1 test was reflected by the breadth of meaningful experiments. A total of 8 unique experiments were conducted to evaluate ATD responses, seat and restraint performance, cargo restraint effectiveness, patient litter behavior, and photogrammetric techniques. A combination of Hybrid II, Hybrid III, and ES-2 Anthropomorphic Test Devices (ATDs) were placed in forward and side facing seats and occupant results were compared against injury criteria. Loads from ATDs in energy absorbing seats and restraints were within injury limits. Severe injury was likely for ATDs in forward facing passenger seats, legacy troop bench seats, and a three-tiered patient litter. In addition, two standing ATDs were used to evaluate the benefit of Mobile Aircrew Restraint Systems (MARS) versus a standard gunner's belt. The ATD with the MARS survived the impact, while fatal head blunt trauma occurred for the standing ATD held by the legacy gunner's belt. In addition to occupant loading, the structural response of the airframe was assessed based on accelerometers located throughout the airframe and using three-dimensional photogrammetric techniques. Analysis of the photogrammetric data indicated regions of maximum deflection and permanent deformation.

Annett, Martin S.↗

NASA NTRS2015

Evidence Report: Risk of Hypobaric Hypoxia from the Exploration Atmosphere

Extravehicular activity (EVA) is at the core of a manned space exploration program. Some elements of exploration may be safely and effectively performed by robots, but certain critical elements will require the trained, assertive, and reasoning mind of a human crewmember. To effectively use these skills, NASA needs a safe, effective, and efficient EVA component integrated into the human exploration program. The EVA preparation time should be minimized and the suit pressure should be low to accommodate EVA tasks without causing undue fatigue, physical discomfort, or suit-related trauma. Commissioned in 2005, the Exploration Atmospheres Working Group (EAWG) had the primary goal of recommending to NASA an internal environment that allowed efficient and repetitive EVAs for missions that were to be enabled by the former Constellation Program. At the conclusion of the EAWG meeting, the 8.0 psia and 32% oxygen (O2) environment were recommended for EVA-intensive phases of missions. After re-evaluation in 2012, the 8/32 environment was altered to 8.2 psia and 34% O2 to reduce the hypoxic stress to a crewmember. These two small changes increase alveolar O2 pressure by 11 mmHg, which is expected to significantly benefit crewmembers. The 8.2/34 environment (inspired O2 pressure = 128 mmHg) is also physiologically equivalent to the staged decompression atmosphere of 10.2 psia / 26.5% O2 (inspired O2 pressure = 127 mmHg) used on 34 different shuttle missions for approximately a week each flight. As a result of selecting this internal environment, NASA gains the capability for efficient EVA with low risk of decompression sickness (DCS), but not without incurring the additional negative stimulus of hypobaric hypoxia to the already physiologically challenging spaceflight environment. This report provides a review of the human health and performance risks associated with the use of the 8.2 psia / 34% O2 environment during spaceflight. Of most concern are the potential effects on the central nervous system (CNS), including increased intracranial pressure, visual impairment, sensorimotor dysfunction, and oxidative damage. Other areas of focus include validation of the DCS mitigation strategy, incidence and treatment of transient acute mountain sickness (AMS), development of new exercise countermeasure protocols, effective food preparation at 8.2 psia, assurance of quality sleep, and prevention of suit-induced injury. Although missions proposing to use an 8.2/34 environment are still years away, it is recommended that these studies begin early enough to ensure that the correct decisions pertaining to vehicle design, mission operational concepts, and human health countermeasures are appropriately informed.

Norcross, Jason R.↗

NASA NTRS2016

An Integrated Extravehicular Activity Research Plan

Multiple organizations within NASA and outside of NASA fund and participate in research related to extravehicular activity (EVA). In October 2015, representatives of the EVA Office, the Crew and Thermal Systems Division (CTSD), and the Human Research Program (HRP) at NASA Johnson Space Center agreed on a formal framework to improve multi-year coordination and collaboration in EVA research. At the core of the framework is an Integrated EVA Research Plan and a process by which it will be annually reviewed and updated. The over-arching objective of the collaborative framework is to conduct multi-disciplinary cost-effective research that will enable humans to perform EVAs safely, effectively, comfortably, and efficiently, as needed to enable and enhance human space exploration missions. Research activities must be defined, prioritized, planned and executed to comprehensively address the right questions, avoid duplication, leverage other complementary activities where possible, and ultimately provide actionable evidence-based results in time to inform subsequent tests, developments and/or research activities. Representation of all appropriate stakeholders in the definition, prioritization, planning and execution of research activities is essential to accomplishing the over-arching objective. A formal review of the Integrated EVA Research Plan will be conducted annually. External peer review of all HRP EVA research activities including compilation and review of published literature in the EVA Evidence Book is already performed annually. Coordination with stakeholders outside of the EVA Office, CTSD, and HRP is already in effect on a study-by-study basis; closer coordination on multi-year planning with other EVA stakeholders including academia is being actively pursued. Details of the current Integrated EVA Research Plan are presented including description of ongoing and planned research activities in the areas of: Benchmarking; Anthropometry and Suit Fit; Sensors; Human-Suit Modeling; Suit Trauma Monitoring and Countermeasures; EVA Workload and Duration Effects; Decompression Sickness Risk Mitigation; Deconditioned EVA Performance; and Exploration EVA Concept of Operations.

Abercromby, Andrew F. J.↗

NASA NTRS2016

Numerical Simulation of Bolide Entry with Ground Footprint Prediction

As they decelerate through the atmosphere, meteors deposit mass, momentum and energy into the surrounding air at tremendous rates. Trauma from the entry of such bolides produces strong blast waves that can propagate hundreds of kilometers and cause substantial terrestrial damage even when no ground impact occurs. We present a new simulation technique for airburst blast prediction using a fully-conservative, Cartesian mesh, finite-volume solver and investigate the ability of this method to model far- field propagation over hundreds of kilometers. The work develops mathematical models for the deposition of mass, momentum and energy into the atmosphere and presents verification and validation through canonical problems and the comparison of surface overpressures, and blast arrival times with actual results in the literature for known bolides. The discussion also examines the effects of various approximations to the physics of bolide entry that can substantially decrease the computational expense of these simulations. We present parametric studies to quantify the influence of entry-angle, burst-height and other parameters on the ground footprint of the airburst, and these values are related to predictions from analytic and handbook-methods.

Simulation↗

NASA NTRS2017

Medical Support for ISS Crewmember Training in Star City, Russia

Medical support of spaceflight training operations across international lines is a unique circumstance with potential applications to other aerospace medicine support scenarios. KBRwyle's Star City Medical Support Group (SCMSG) has fulfilled this role since the Mir-Shuttle era, with extensive experience and updates to share with the greater AsMA community. OVERVIEW: The current Soyuz training flow for assigned ISS crewmembers takes place in Star City, Russia. Soyuz training flow involves numerous activities that pose potential physical and occupational risks to crewmembers, including centrifuge runs and pressurized suit simulations at ambient and hypobaric pressures. In addition, Star City is a relatively remote location in a host nation with variable access to reliable, Western-standard medical care. For these reasons, NASA's Human Health & Performance contract allocates full-time physician support to assigned ISS crewmembers training in Star City. The Star City physician also treats minor injuries and illnesses as needed for both long- and short-term NASA support personnel traveling in the area, while working to develop and maintain relationships with local health care resources in the event of more serious medical issues that cannot be treated on-site. The specifics of this unique scope of practice will be discussed. SIGNIFICANCE: ISS crewmembers training in Star City are at potential physical and occupational risk of trauma or dysbarism during nominal Soyuz training flow, requiring medical support from an on-duty aerospace medicine specialist. This support maintains human health and performance by preserving crewmember safety and well-being for mission success; sharing information regarding this operational model may contribute to advances in other areas of international, military, and civilian operational aerospace medicine.

Chough, Natacha↗

NASA NTRS2017

Autonomous Diagnostic Imaging Performed by Untrained Operators using Augmented Reality as a Form of "Just-in-Time" Training

We will address the Human Factors and Performance Team, "Risk of performance errors due to training deficiencies" by improving the JIT training materials for ultrasound and OCT imaging by providing advanced guidance in a detailed, timely, and user-friendly manner. Specifically, we will (1) develop an audio-visual tutorial using AR that guides non-experts through an abdominal trauma ultrasound protocol; (2) develop an audio-visual tutorial using AR to guide an untrained operator through the acquisition of OCT images; (3) evaluate the quality of abdominal ultrasound and OCT images acquired by untrained operators using AR guidance compared to images acquired using traditional JIT techniques (laptop-based training conducted before image acquisition); and (4) compare the time required to complete imaging studies using AR tutorials with images acquired using current JIT practices to identify areas for time efficiency improvements. Two groups of subjects will be recruited to participate in this study. Operator-subjects, without previous experience in ultrasound or OCT, will be asked to perform both procedures using either the JIT training with AR technology or the traditional JIT training via laptop. Images acquired by inexperienced operator-subjects will be scored by experts in that imaging modality for diagnostic and research quality; experts will be blinded to the form of JIT used to acquire the images. Operator-subjects also will be asked to submit feedback to improve the training modules used during the scans to improve future training modules. Scanned-subjects will be a small group individuals from whom all images will be acquired.

Martin, D. S.↗

NASA NTRS2017

Autonomous Diagnostic Imaging Performed by Untrained Operator Using Augmented Reality as a Form of "Just-in-Time" Training

Martin, David S.↗

NASA NTRS2017

Medical Support for ISS Crewmember Training in Star City, Russia

Chough, Natacha↗

NASA NTRS2018

Biomedical Science and Technology on the International Space Station - Benefits for Humanity (Ciencia Y Tecnologia Biomedica En La Estacion Espacial Internacional - Beneficios Para La Humanidad)

The International Space Station is a unique laboratory for performing investigations that affect human health both in space and on Earth. During its time in orbit, the space station has enabled research that is providing a better understanding of many aspects of human health including aging, trauma, disease and environmental impacts. Driven by the need to support astronaut health, several biological and human physiological investigations have yielded important results that we on Earth can also benefit from. These results include new ways to mitigate bone loss, insights into bacterial behavior, and innovative wound-healing techniques. Advances in telemedicine, disease models, psychological stress response systems, nutrition and cell behavior are just a few more examples of the benefits that have been gained from applying studies in orbit to human health back on Earth.

Love, John E.↗

NASA NTRS2019

Oculometric Assessment of Mild Neural Impairment

For over 100 years, neurologists have used eye movements to identify neural impairment, disease, or injury. Prior to the age of modern imaging, qualitative assessment of eye movements was a critical, routine component of diagnosis and remains today a routine law-enforcement tool for detecting impaired driving due to drugs or alcohol. We will describe the application of a simple 5-minute oculomotor tracking task coupled with a broad range of quantitative analyses of high-resolution oculomotor measurements for the sensitive detection of sub-clinical neural impairment and for the potential differentiation of various causes. Specifically, we will show that there are distinct patterns of impairment across our set of oculometric parameters observed with brain trauma, sleep and circadian disruption, and alcohol consumption. Such differences could form the basis of a self-administered medical monitoring or diagnostic support tool.

Stone, Lee↗

NASA NTRSDate not supplied

Results of the 2022 Mental Health Survey of the Planetary Science Community

The mental health struggles within academia and research are well recognized in the science community and have been further illustrated by the numerous cultural memes and comics (e.g., PhD Comics). With the recent COVID-19 pandemic, mental health has become a topic of concern more so than ever before, as depression and anxiety have become an invisible consequence of social isolation and distancing. In addition, recent social events in the United States have reignited attention towards important social injustices surrounding people of color, women, and LGBTQ+ in academia. If diversity, equity, inclusion, and accessibility are to become major components of improving planetary science, it is also important to understand the mental health status of the community, as it could expose deeply embedded policies, rules, and culture that may hinder any work in sustaining and advancing people belonging to marginalized groups. Studies have been conducted to further understand the mental health of those in academia. These studies have shown that before the pandemic, there was a mental health crisis among graduate students, which became a larger problem with increasing anxiety and depression due to the pandemic. Soon after, the planetary science community recognized this concern in the recent 2023 Planetary Science Decadal White Paper, which proposed that NASA should invest in understanding the scope and impact of mental health problems within the planetary science community and how to address the issue. In this study, we conducted a mental health survey to examine the mental health of the planetary science community. We examined the overall anxiety, depression, and stress severity of the community, rather than diagnosing the community’s condition or determining the proportion of the population having a clinical anxiety, depressive, stress, or trauma-related diagnosis. To emphasize, the results are not intended to make clinical diagnoses, nor are they being used to do so for the purpose of this study.

D Trang↗

NASA NTRSDate not supplied

Harnessing Artificial Intelligence for Medical Diagnosis and Treatment During Space Exploration Missions

BACKGROUND The medical capabilities necessary for long-duration exploration missions (LDEMs) will differ tremendously from those currently available to crew medical officers (CMOs) on the International Space Station (ISS). Ground support will be more challenging due to distance-related communication delays and data transmission, and resource utilization must be optimized given limited ability for resupply. Clinical decision support systems (CDSSs) can help mitigate these limitations. The recent launch of generative artificial intelligence (AI) tools based upon large language models (LLM) support the creation of a smart assistant for onboard triage, diagnosis, and guided treatment of medical conditions during these missions. The Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool can help predict which clinical problems and outcomes are likely to occur for a design reference mission (DRM) and assist Medical Operations and systems engineering teams in creating a medical system that may optimally mitigate the predicted risks. The purpose of this study was to identify AI tools currently available or in development for the assistive diagnosis and care of medical conditions predicted for an extended duration Lunar mission. METHODS The 119 medical conditions currently built into the IMPACT suite were categorized into systems, and these diagnoses were used as keywords for our literature search. Using PubMed and Google Scholar, we performed a literature survey of AI tools applicable to these conditions. Article inclusion criteria included publication between the years 2017-2023, as the sentinel paper discussing the “selective attention” driving ChatGPT and other generative transformer models was published in June 2017. Where applicable, we reviewed only the top 1000 research articles (based on relevance) for each of the keywords/phrases. AI tools whose training sets were exclusive to a pediatric patient population were excluded. We also excluded any medical diagnostic tools (such as CT, MRI, mass spectrometry) or procedures (such as endoscopy, surgery) that are unlikely to be available during LDEMs due to mass and volume constraints, CMO knowledge, skills, and abilities, and/or inherent procedural risks. RESULTS Our survey highlighted several AI-driven tools for the triage, diagnosis, and management of those medical conditions highlighted by IMPACT. Selected publications for each medical condition were then screened for inclusion within ten systems-based categories including: general diagnostic tools (25), tools to diagnose and manage respiratory (40), dermatologic (34), neurologic (28), auditory and vestibular (30), ophthalmic (34), musculoskeletal (104), infection-associated (92), and gynecologic (19) conditions, as well as tools that could be deployed in the setting of trauma and emergency (34). CONCLUSIONS Numerous AI-driven tools were highlighted within this literature survey, ranging from chatbot assistants that triage knee pain to vision transformer models for diagnosis of ophthalmic conditions using ocular surface images captured with a mobile phone. Remaining challenges include optimizing connectivity and integration of existing and developing systems into the vehicles or habitats. Notably, findings from this survey could help guide the initial design of an all-encompassing, onboard medical AI assistant for use during future LDEMs.

R A Lacinski↗

NASA NTRS2024

Quantifying Risk to Improve Medical System Design for Long Duration Artemis Missions: A Demonstration of NASA's IMPACT Tradespace Analysis Tool

BACKGROUND NASA’s human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. A greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and constraints on the evacuation of ill or injured crew. Mass, volume, and power will be limited while higher demands will be placed on the crews to manage medical events. NASA’s Moon to Mars exploration strategy outlines increasingly complex Artemis missions both in terms of duration and operations. In these more challenging deep space missions, it is important to quantitatively estimate the human system risk attributable to medical conditions and use these estimates to advance medical system design. METHODS IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and tradespace analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 includes a novel evidence library baselined to exploration environments; an expanded list of 119 medical conditions; a large increase in the number of medical resources and the flexibility of their use; and the ability for rapid and iterative analysis. Medical system risk estimates include loss of crew life, consideration of the need for return to definitive care (medical evacuation), and an estimate of crew time affected due to medical conditions. A notional long duration lunar orbit and lunar surface design reference mission (DRM) was chosen with a 4-astronaut crew to mimic a foundational exploration Artemis mission. The DRM profile includes outbound transit on Orion, Gateway space station rendezvous in lunar orbit, 6 months on the Lunar surface with extravehicular activity (EVA), return rendezvous with Gateway, and transit back to Earth. RESULTS/DISCUSSION: Overall, IMPACT successfully quantified medical risk and derived an optimal medical system to support crew on a long duration lunar mission. In this DRM, the calculated loss of crew life from a medical event was 0.008 events per mission, risk of potential need for evacuation was 0.30 events per mission, and cumulative crew time affected by medical conditions was 103 days. The medical conditions that most contributed to medical risk were decompression sickness, trauma, and respiratory failure. The conditions that had the largest effects on crew performance included musculoskeletal injuries and lunar dust exposure. The IMPACT-generated medical system included resources that target the most common and highest risk conditions and performed as expected. This demonstrates the value of the IMPACT tool in medical system design for human exploration spaceflight missions.

Arian Anderson↗