Results for “Astronaut Health” — Page 7

NASA NTRSDate not supplied

Spaceflight Biospecimen and Data Sharing in Support of Science Discovery and Exploration

For decades, NASA and international partners have conducted biological experiments in space to understand effects of spaceflight and address potential hazards. To enable spaceflight back to the Moon, and then to Mars and beyond, it is imperative to further understand basic science and health risks associated with spaceflight, along with developing countermeasures. The sending of experiments and organisms into space is a costly endeavor. To maximize scientific return, sharing with the scientific community both space-flown biospecimens and data from completed experiments is essential. New fundamental, applied, and bioinformatic science insights can be gained from specimen and data sharing efforts. Data reuse enables spaceflight health risk modeling, analyzing adverse outcomes across spaceflight hazards, and deep space autonomous support for the flight medical officer. Space-flown biospecimens not required by mission Principal Investigators are regularly archived and made available for scientific request. The largest biorepository of these samples are found within NASA’s Institutional Scientific Collection at Ames Research Center (ISC-ARC), which stores over 32,000 specimens mostly from Shuttle and International Space Station (ISS) missions, but also some ground-based analog samples. The Ames Life Sciences Data Archive manages the ISC-ARC. Tissues are predominantly from mice and rats, though samples are also available from bacteria and quail. Only a handful of other similar collections exist worldwide. Rodent biospecimens exposed to simulated space radiation at Brookhaven National Laboratory are archived under the purview of NASA HRP Space Radiation Element. Microbial collection and analyses from 20 years of routine environmental monitoring of air, surfaces, and water systems of the ISS were performed to ensure a safe environment for astronauts. Samples from the ISC-ARC, space radiation and microbial collections are searchable and requestable through the NASA Life Sciences Data Archive (LSDA). Decades of planetary protection microbial isolates derived from spacecraft bioburden are archived in JPL’s microbial collection. Rodent biospecimens from spaceflight investigations conducted by the Japan Aerospace Exploration Agency (JAXA) are archived and available at the JAXA Biorepository at Tsukuba Space Center. The Russian Institute of Biomedical Problems also has a collection of animal, microbial, cellular, and fungi available for research from ground analog experiments. Several data repositories exist for scientists to utilize. The LSDA is the primary NASA source of life sciences research data and information. It contains decades of spaceflight and ground-analog research involving human, microbial, cellular, plant, and animal subjects. Data is collected from NASA-funded investigations through the Human Research Program and the Space Biology Program. The NASA Lifetime Surveillance of Astronaut Health collects and grants access to clinical and occupational health monitoring data from astronauts, with a list and description of data collected available for request through the LSDA. NASA GeneLab at ARC collects genomic, transcriptomic, proteomic, and metabolomic data from any species. It is a repository and platform for collaborative open-science bioinformatic approaches. JAXA is establishing an ‘omics-based repository in collaboration with the Tohoku Medical Megabank (ToMMo), called the JAXA-ToMMo Integrated Biobank for Space Life Science. Overall, the sharing of these biospecimen and data resources can assist researchers worldwide in understanding spaceflight effects on biology, along with enabling next generation data science applications for space exploration platforms. Websites: https://lsda.jsc.nasa.gov/ ; https://www.nasa.gov/ames/research/space-biosciences/isc-bsp ; https://www.nasa.gov/ames/research/space-biosciences/alsda

Ryan T. Scott↗

NASA NTRS2015

Lightweight, Wearable, Metal Rubber Sensor

For autonomous health monitoring. NanoSonic, Inc., has developed comfortable garments with multiple integrated sensors designed to monitor astronaut health throughout long-duration space missions. The combined high electrical conductivity, low mechanical modulus, and environmental robustness of the sensors make them an effective, lightweight, and comfortable alternative to conventional use of metal wiring and cabling.

Hill, Andrea↗

NASA NTRS2014

A Guideline for the Management of Renal Stones in Astronauts

There are no specific guidelines for the management of renal stones in astronauts. Given the increased risk for bone loss, hypercalcuria, and stone formation due to microgravity, a clinical practice guideline is needed. Methods An extensive review of the literature and current aeromedical standards for the management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. This information was used to create an algorithm for the management of renal stones in astronauts. Results Guidelines are proposed based on accepted standards of care, with consideration to the environment of spaceflight. In a usual medical setting, asymptomatic, small stones less than 7 mm are often observed over time. Given the constraints of schedule, and the risks to crew health and mission, this approach is too liberal. An upper limit of 3 mm stone diameter was adopted before requiring intervention, because this is the largest size that has a significant chance of spontaneous passage on its own. Other specific guidelines were also created. Discussion The spaceflight environment requires more aggressive treatment than would otherwise be found with the usual practice of medicine. A small stone can become a major problem because it may ultimately require medical evacuation from orbit. Thus renal stones are a significant mission threat and should be managed in a systematic way to mitigate risks to crew health and mission success.

Reyes, David↗

NASA NTRS2008

Mission Medical Information System

This viewgraph presentation gives an overview of the Mission Medical Information System (MMIS). The topics include: 1) What is MMIS?; 2) MMIS Goals; 3) Terrestrial Health Information Technology Vision; 4) NASA Health Information Technology Needs; 5) Mission Medical Information System Components; 6) Electronic Medical Record; 7) Longitudinal Study of Astronaut Health (LSAH); 8) Methods; and 9) Data Submission Agreement (example).

Johnson-Throop, Kathy A.↗

NASA NTRS2009

Rashes and Exanthems on Long Duration Space Flights

INTRODUCTION: As NASA expands its human space exploration to the Moon, Mars and beyond, it will be presented with many challenges, not the least of which will be dealing with medical conditions, which on earth are simple, but take on new levels of complexity in space habitats. Skin conditions exemplify this complexity. METHODS AND RESULTS: While skin conditions account for 7 % of outpatient presentations to a primary care provider in the United States, NASA Longitudinal Study of Astronaut Health (LSAH) database indicates that cutaneous manifestations are significantly prevalent on-orbit. Reviewing this data for US astronauts, there have been 90 total cases of skin rashes during 27.34 person-years of spaceflight, or 3.29 cases/person. Specifically, STS-1 though 114 had 56 cases, ISS Expeditions 1 though 13 had 7 cases, Mir had 4 cases, Skylab had 5 cases and the Apollo program had 18 cases. If there was a period of 24 hours or more between rashes in the same crewmember, this was counted as an additional case. DISCUSSION: This prevalence is likely due, in some part, to constraints of hygiene and to immunologic changes that occur. The stresses of microgravity and austere Earth environments such as the Antarctic, submarine and military deployments, no doubt, similarly contribute to cutaneous reactions; but the difference of the environments are significant enough to warrant further study and discussion. This paper will discuss rashes, exanthems, and cutaneous reactions in space habitats; it will address diagnosis, causation, mitigation and treatment of skin conditions seen on orbit, to date, with a look to anticipating what may be seen with larger crews on future extended duration expeditions.

Ilscus, L.S.↗

NASA NTRSDate not supplied

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗

NASA NTRS1999

Nutritional Aspects of Crewmembers' Cardiovascular Health Indicated by Dietary Lipids

This summer's project examined the relationships between dietary and physiological factors on serum lipoproteins using data from past United States astronauts. Nutritional assessment was required to determine whether a relationship existed between dietary intake and risk of cardiovascular disease (CVD) in crewmembers. Risk for CVD was assessed by the measurement of preflight, inflight, and postflight serum lipoproteins. The purpose of this project was to evaluate the dietary practices of past crewmembers before and during flight, and to examine their relationship with blood indicators of lipid status. Because of mortality and morbidity associated with CVD, such assessments are critical for the maintenance of astronaut health before, during, and after space flight. It was anticipated that the results from this project would assess the effects space flight and diet have on cardiovascular health, thus, defining the adequacy of the current dietary recommendations during space travel. It was hypothesized that the mean preflight serum lipoproteins compared to mean postflight serum lipoproteins would not be statistically different and that the current inflight diet is adequate in nutrient content, having little or no effect on lipoprotein levels.

Thurston, Marcelle A.↗

NASA NTRS2023

Exploring the Complexities of Drug Formulation Selection, Storage, and Shelf-Life for Exploration Spaceflight

Medications have been a part of space travel dating back as far as the Apollo missions. Currently, medical kits aboard the ISS contain medications and supplies to help crew members cope with a variety of possible medical events. NASA reported that 1,867 medical events occurred from 1981 to 1998 on space shuttle flights, STS-1 to STS-89; 498 out of the 508 crewmembers on those flights reported experiencing a medical event other than space motion sickness. In 2000, the Institute of Medicine (IOM) convened a committee of experts, Committee on Creating a Vision for Space Medicine during Travel beyond Earth Orbit, to examine the issues surrounding astronaut health and safety for long duration space missions. The primary theme of the committee’s final report is that there is not enough known about the risks to human health during long-duration missions beyond Earth’s orbit and ways to effectively mitigate those risks in an environment of deep space. In 2014, the IOM convened the Committee on Ethics Principles and Guidelines for Health Standards for Long Duration and Exploration Spaceflights and released a report emphasizing the importance of prevention, mitigation, and treatment of major risks to human health during exploration spaceflight. NASA’s Human Research Program has organized five distinct categories of spaceflight hazards summarized by the acronym “RIDGE” (Space Radiation, Isolation and Confinement, Distance from Earth, Gravity fields, and Hostile/Closed Environments) that astronauts may encounter during exploration spaceflight. From those hazards, NASA further derived 30 of the most critical human health and performance risks, including limits to medical care resulting from pharmaceutical degradation. As we prepare for more distant exploration missions to Mars and beyond, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. The present editorial will summarize the current state of knowledge regarding innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

drug degradation risk assessment↗

NASA NTRS2011

NASA Life Sciences Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗

NASA NTRS2005

Extravehicular mobility unit training and astronaut injuries

BACKGROUND: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility. METHODS: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures. RESULTS: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet. CONCLUSIONS: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

Non-programmatic↗

NASA NTRS2009

Human Research Program Human Health Countermeasures Element Bone and Muscle Risk Standing Review Panel (SRP)

The Bone and Muscle Risk Standing Review Panel (SRP) met at the NASA Johnson Space Center (JSC) on October 4-6, 2009 to discuss the areas of current and future research targeted by the Human Health Countermeasures (HHC) Element of the Human Research Program (HRP). Using evidence-based knowledge as a background for identified risks to astronaut health and performance, NASA had identified gaps in knowledge to address those risks. Ongoing and proposed tasks were presented to address the gaps. The charge to the Bone and Muscle Risk SRP was to review the gaps, evaluate whether the tasks addressed these gaps and to make recommendations to NASA s HRP Science Management Office regarding the Panel's review. The Bone and Muscle Risk SRP consisted of scientists who are experts in muscle, bone, or both and could evaluate the existing evidence with sufficient knowledge of the potential effects of long duration exposure to microgravity. More important, although expertise in basic science is important, the SRP was requested to evaluate the practicality of the proposed efforts in light of the realistic demands placed on the HRP. In short, all tasks presented in the Integrated Research Plan (IRP) should address specific questions related to the challenges faced by the astronauts as a result of prolonged exposure to microgravity. All tasks proposed to fill the gaps in knowledge should provide applied, translational data necessary to answer the specific questions. Several presentations were made to the SRP during the site visit and the SRP spent sufficient time to address the panel charge, either as a group or in separate sessions for the Bone and Muscle Risk subgroups. The SRP made a final debriefing to the HRP Program Scientist, Dr. John B. Charles, on October 6, 2009. Taking the evidence and identified risks as givens, the SRP concluded that 1) integration of information should lead to a more comprehensive approach to identifying the gaps, 2) not all tasks addressed the gaps as stated in the IRP, 3) better access should be given to the SRP to existing data to include in its review, and 4) there were some missing gaps and tasks. As a result the SRP recommended 1) combining certain gaps, which in some cases were addressed with identical tasks, 2) additional gaps and tasks to address some of the gaps, 3) deleting some gaps and tasks to better focus the efforts of NASA s HRP in prioritizing their efforts, and 4) prioritizing gaps to address significant issues needing resolution in the short term while maintaining an awareness of long-term goals. The SRP commended the efforts by the HHC Element to integrate knowledge gaps and design tasks to address the higher order questions. This integration did not apply to the Bone and Muscle Risk alone, but the musculoskeletal system as its functions integrate with issues in

Glowacki, Julie↗

NASA NTRS2011

Integration and Cooperation in the Next Golden Age of Human Space Flight Data Repositories: Tools for Retrospective Analysis and Future Planning

As NASA transitions from the Space Shuttle era into the next phase of space exploration, the need to ensure the capture, analysis, and application of its research and medical data is of greater urgency than at any other previous time. In this era of limited resources and challenging schedules, the Human Research Program (HRP) based at NASA s Johnson Space Center (JSC) recognizes the need to extract the greatest possible amount of information from the data already captured, as well as focus current and future research funding on addressing the HRP goal to provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration. To this end, the Science Management Office and the Medical Informatics and Health Care Systems Branch within the HRP and the Space Medicine Division have been working to make both research data and clinical data more accessible to the user community. The Life Sciences Data Archive (LSDA), the research repository housing data and information regarding the physiologic effects of microgravity, and the Lifetime Surveillance of Astronaut Health Repository (LSAH-R), the clinical repository housing astronaut data, have joined forces to achieve this goal. The task of both repositories is to acquire, preserve, and distribute data and information both within the NASA community and to the science community at large. This is accomplished via the LSDA s public website (http://lsda.jsc.nasa.gov), which allows access to experiment descriptions including hardware, datasets, key personnel, mission descriptions and a mechanism for researchers to request additional data, research and clinical, that is not accessible from the public website. This will result in making the work of NASA and its partners available to the wider sciences community, both domestic and international. The desired outcome is the use of these data for knowledge discovery, retrospective analysis, and planning of future research studies.

Thomas, D.↗

NASA NTRS1996

A Boon for Bone Research

NASA studies for astronaut health in long-term space missions led to the development of the Mechanical Response Tissue Analyzer (MRTA), a research tool for astronaut disuse, osteoporosis and related bone disorders among the general population. Ames Research Center and Stanford University generated a workable device and with Gait Scan, Inc., refined and commercialized it. The MRTA is a portable dsinstrument that measures the bending stiffness of bones using electrically-induced vibration and detects and analyzes the frequencies of the resonating bone. Unlike some other methods, the MRTA uses no radiation and is fast, simple and relatively inexpensive.

Source record↗

NASA NTRS2005

MRI-Based Computational Fluid Dynamics in Experimental Vascular Models: Toward the Development of an Approach for Prediction of Cardiovascular Changes During Prolonged Space Missions

A priority of NASA is to identify and study possible risks to astronauts health during prolonged space missions [l]. The goal is to develop a procedure for a preflight evaluation of the cardiovascular system of an astronaut and to forecast how it will be affected during the mission. To predict these changes, a computational cardiovascular model must be constructed. Although physiology data can be used to make a general model, a more desirable subject-specific model requires anatomical, functional, and flow data from the specific astronaut. MRI has the unique advantage of providing images with all of the above information, including three-directional velocity data which can be used as boundary conditions in a computational fluid dynamics (CFD) program [2,3]. MRI-based CFD is very promising for reproduction of the flow patterns of a specific subject and prediction of changes in the absence of gravity. The aim of this study was to test the feasibility of this approach by reconstructing the geometry of MRI-scanned arterial models and reproducing the MRI-measured velocities using CFD simulations on these geometries.

Spirka, T. A.↗

NASA NTRS2019

Spaceflight Microbiology

Microbiological Areas of Concern: Astronaut Health; Vehicle integrity; Life support and other systems failure -Biofilm formation/biofouling -Bio-corrosion and biodegradation -Trash and human waste containment -Risk of condensation -Astronaut hygiene areas; Spaceflight foods -Impact of “pick and eat” foods on the environment -Impact of the environment on “pick and eat” foods -Rinsing food with potable water is impractical; Planetary protection -How do we track what we are leaving versus what we are finding in our search for life on other planets?

Ott, C. Mark↗

NASA NTRSDate not supplied

Earth Independent Medical Operations (EIMO) Datascope: Challenges and Potential Solutions

Data flows and storage/retrieval capacity are severely constrained during missions in space and challenges will become even greater during exploration class missions. There is a need for an artificial intelligence (AI)-based clinical decision support system (CDSS) to monitor and analyze data to provide real-time consultative support for crew medical officer (CMO) decision-making. EIMO is defined as the 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. While a hallmark of this paradigm shift from low-earth orbit is that on-board care will increasingly become the responsibility of the astronauts for primary management and decision making, terrestrial assets will continue to be paramount in pre-mission screening and planning, as well as prevention, health maintenance and long-term care contingencies. New capabilities and systems that enable progressively more robust and resilient systems and crews will be necessary to reduce risk and increase probability of deep space exploration mission success. An aspiration for EIMO is to develop AI-enhanced solutions for analysis of crew health & performance data and to facilitate clinical decision support for autonomous medical operations. A “system of systems” approach is envisioned whereby EIMO will deploy AI-supported natural language processing and machine learning (ML) techniques to utilize embedded reference databases and real-time data streams [input vectors] from multiple data sources. Constituent input vectors may include environmental controls, countermeasures data, behavioral data, physiologic wearables, point-of-care laboratory tests, personalized medical records, inventory trade space risk assessments, COTS medical databases, and ground support inputs. An ideal AI capability would possess trained fusion algorithms to cross reference input vectors with medical ‘knowledge’ [cultivated database] to stratify relevant data streams for predictive and actionable capabilities. In addition, EIMO will feature mobility, in that it can be accessed and can push/pull data within and between multiple vehicles/habitats. Large amounts and variable sources of data can be leveraged to diagnose, inform treatment strategies, and potentially predict medical events and performance decrements. Inclusion of advanced training tools using extended reality will enable increasingly autonomous medical care to aid a CMO when ground support is unavailable or time-delayed beyond required action window, e.g., emergent medical situations. EIMO CDSS would require very large datasets to train pre-flight and significant amounts of data are needed to support ML via in-flight CDSS operations. An additional challenge will be to find sufficient data to train a model relevant to astronaut demographics. The rapid, accelerating evolution of this field creates a propitious solution space to leverage multi-modal AI through public-private partnership(s). The status of multi-modal AI systems today would preclude their use for long duration missions as they remain unreliable and are subject to “digital hallucinations” and other errors that could pose operational risk. A federated labs structure is being considered to test and optimize data flow from the multiple input vectors leading to field testing in suitable ground/flight analogs. Critical to the success of an EIMO CDSS will be integration and interoperability and success will be defined by a system that can serve as an in-flight medical consult for the CMO providing critical support during medical contingencies. Benefits to terrestrial medicine may be significant as an outflow of the EIMO medical system, particularly for remote areas and communities lacking significant infrastructure, personnel and resources.

J Lemery↗

NASA NTRS2024

Earth Independent Medical Operations (EIMO) Datascope: Challenges and Potential Solutions

Data flows and storage/retrieval capacity are severely constrained during missions in space and challenges will become even greater during exploration class missions. There is a need for an artificial intelligence (AI)-based clinical decision support system (CDSS) to monitor and analyze data to provide real-time consultative support for crew medical officer (CMO) decision-making. EIMO is defined as the 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. While a hallmark of this paradigm shift from low-earth orbit is that on-board care will increasingly become the responsibility of the astronauts for primary management and decision making, terrestrial assets will continue to be paramount in pre-mission screening and planning, as well as prevention, health maintenance and long-term care contingencies. New capabilities and systems that enable progressively more robust and resilient systems and crews will be necessary to reduce risk and increase probability of deep space exploration mission success. An aspiration for EIMO is to develop AI-enhanced solutions for analysis of crew health & performance data and to facilitate clinical decision support for autonomous medical operations. A “system of systems” approach is envisioned whereby EIMO will deploy AI-supported natural language processing and machine learning (ML) techniques to utilize embedded reference databases and real-time data streams [input vectors] from multiple data sources. Constituent input vectors may include environmental controls, countermeasures data, behavioral data, physiologic wearables, point-of-care laboratory tests, personalized medical records, inventory trade space risk assessments, COTS medical databases, and ground support inputs. An ideal AI capability would possess trained fusion algorithms to cross reference input vectors with medical ‘knowledge’ [cultivated database] to stratify relevant data streams for predictive and actionable capabilities. In addition, EIMO will feature mobility, in that it can be accessed and can push/pull data within and between multiple vehicles/habitats. Large amounts and variable sources of data can be leveraged to diagnose, inform treatment strategies, and potentially predict medical events and performance decrements. Inclusion of advanced training tools using extended reality will enable increasingly autonomous medical care to aid a CMO when ground support is unavailable or time-delayed beyond required action window, e.g., emergent medical situations. EIMO CDSS would require very large datasets to train pre-flight and significant amounts of data are needed to support ML via in-flight CDSS operations. An additional challenge will be to find sufficient data to train a model relevant to astronaut demographics. The rapid, accelerating evolution of this field creates a propitious solution space to leverage multi-modal AI through public-private partnership(s). The status of multi-modal AI systems today would preclude their use for long duration missions as they remain unreliable and are subject to “digital hallucinations” and other errors that could pose operational risk. A federated labs structure is being considered to test and optimize data flow from the multiple input vectors leading to field testing in suitable ground/flight analogs. Critical to the success of an EIMO CDSS will be integration and interoperability and success will be defined by a system that can serve as an in-flight medical consult for the CMO providing critical support during medical contingencies. Benefits to terrestrial medicine may be significant as an outflow of the EIMO medical system, particularly for remote areas and communities lacking significant infrastructure, personnel and resources.

Medical Operations↗

NASA NTRS1992

Neurology of microgravity and space travel

Exposure to microgravity and space travel produce several neurologic changes, including SAS, ataxia, postural disturbances, perceptual illusions, neuromuscular weakness, and fatigue. Inflight SAS, perceptual illusions, and ocular changes are of more importance. After landing, however, ataxia, perceptual illusions, neuromuscular weakness, and fatigue play greater roles in astronaut health and readaptation to a terrestrial environment. Cardiovascular adjustments to microgravity, bone demineralization, and possible decompression sickness and excessive radiation exposure contribute further to medical problems of astronauts in space. A better understanding of the mechanisms by which microgravity adversely affects the nervous system and more effective treatments will provide healthier, happier, and longer stays in space on the space station Freedom and during the mission to Mars.

Fujii, M. D.↗