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Investment of $1.5 million in medical simulation technology. Integration of medical simulation activities into the curriculum. Support from TCC leadership. Individual and team activities. Skill development and critical thinking/problem solving skills.
Urban Air Mobility (UAM) promises to revolutionize transportation in major cities, offering passenger travel, cargo delivery, and emergency medical services through a network of electric vertical takeoff and landing (eVTOL) aircraft. However, the limited range of current eVTOLs, due to the low specific energy of lithium-ion batteries along with a possibility of thermal runaway conditions poses significant safety concerns, leading to potentially compromising operational safety. To address this critical challenge, researchers are actively evaluating the impact of flight and environmental conditions on onboard lithium-ion battery health. This involves carefully assessing the performance of battery packs under laboratory and operational conditions for developing models to estimate future health using prognostics framework. This study examines the effectiveness of evaluating battery degradation leading to catastrophic failures under varying operational conditions in laboratory. These are captured using physics based models of underlying phenomenons and integrated into the prognostics framework. A fully charged battery undergoes controlled discharge cycles at varying C-rates based on the simulated power draw profile, with current and voltage, temperature data recorded throughout the experiment. The observed data provides valuable insights into how different operating conditions and mission profiles affect battery performance. This information is crucial for developing strategies to optimize battery systems, enhance range, and ultimately ensure the safe and reliable operation of UAM vehicles.
Urban Air Mobility (UAM) promises to revolutionize transportation in major cities, offering passenger travel, cargo delivery, and emergency medical services through a network of electric vertical takeoff and landing (eVTOL) aircraft. However, the limited range of current eVTOLs, due to the low specific energy of lithium-ion batteries along with a possibility of thermal runaway conditions poses significant safety concerns, leading to potentially compromising operational safety. To address this critical challenge, researchers are actively evaluating the impact of flight and environmental conditions on onboard lithium-ion battery health. This involves carefully assessing the performance of battery packs under laboratory and operational conditions for developing models to estimate future health using prognostics framework. This study examines the effectiveness of evaluating battery degradation leading to catastrophic failures under varying operational conditions in laboratory. These are captured using physics based models of underlying phenomenons and integrated into the prognostics framework. A fully charged battery undergoes controlled discharge cycles at varying C-rates based on the simulated power draw profile, with current and voltage, temperature data recorded throughout the experiment. The observed data provides valuable insights into how different operating conditions and mission profiles affect battery performance. This information is crucial for developing strategies to optimize battery systems, enhance range, and ultimately ensure the safe and reliable operation of UAM vehicles.
Urban Air Mobility (UAM) promises to revolutionize transportation in major cities, offering passenger travel, cargo delivery, and emergency medical services through a network of electric vertical takeoff and landing (eVTOL) aircraft. However, the limited range of current eVTOLs, due to the low specific energy of lithium-ion batteries along with a possibility of thermal runaway conditions poses significant safety concerns, leading to potentially compromising operational safety. To address this critical challenge, researchers are actively evaluating the impact of flight and environmental conditions on onboard lithium-ion battery health. This involves carefully assessing the performance of battery packs under laboratory and operational conditions for developing models to estimate future health using prognostics framework. This study examines the effectiveness of evaluating battery degradation leading to catastrophic failures under varying operational conditions in laboratory. These are captured using physics based models of underlying phenomenons and integrated into the prognostics framework. A fully charged battery undergoes controlled discharge cycles at varying C-rates based on the simulated power draw profile, with current and voltage, temperature data recorded throughout the experiment. The observed data provides valuable insights into how different operating conditions and mission profiles affect battery performance. This information is crucial for developing strategies to optimize battery systems, enhance range, and ultimately ensure the safe and reliable operation of UAM vehicles.
Rising sea levels due to climate change increasingly threaten medical infrastructure through flooding. This study develops machine learning models to predict flood exposure for 11,508 medical facilities in the southeastern coastal regions of the United States by integrating datasets including meteorological, hydrological, topographic, and geological data, the Natural Risk Index, and historical flood records from NASA, HIFLD, and FEMA. Six regression models, namely Linear Regression, Support Vector Regression, Random Forest, k-Nearest Neighbors, XGBoost, and Artificial Neural Networks, are trained using 16 explanatory variables identified through literature review and correlation analysis. Data preprocessing employs the SMOGN for class imbalance and Winsorization for outliers. Model performance is evaluated using MAE, MSE, and RMSE, with Random Forest and XGBoost models achieving the highest performance (MSE of 2.58e-5 and 3.69e-5, respectively). This multifactorial approach allows the models to capture complex flood-influencing relationships, enhancing adaptability and performance across geographic regions. Future work focuses on expanding across the U.S. and developing a near real-time flood monitoring system.
BACKGROUND: Future Human Exploration missions introduce a new paradigm as crews move further from the resupply and near real-time ground support typical of Low Earth Orbit missions today. Without immediate support from ground-based personnel, exploration crews will be more reliant on inflight data and technology to respond to emergencies and anomalies. A data architecture to support a new generation of technologies, employing advanced analytical and predictive modeling techniques, is needed to enable crew autonomy. OVERVIEW: The Crew Health and Performance Integrated Data Architecture (CHP-IDA) project funded by NASA’s Exploration Medical Integrated Product Team (XMIPT) is laying a foundation for future in-flight informatics by providing a back-end architecture for collecting, storing, and integrating multiple sources of data generated by and around the crew. CHP-IDA provides a platform for common data models and Application Programming Interfaces to access, integrate, process, and display CHP data (e.g., environmental, exercise, medical, sleep, performance, etc.). This will facilitate the increased situation awareness and decision support required by the crew and remote support of exploration missions. This presentation will describe the currently ongoing effort to develop and evaluate a path-to-flight concept of the CHP-IDA software and its core capabilities. Current integrations will be discussed, including analytics for Extravehicular Activity metabolic rate and data ingestion from a multi-functional integrated medical device. The presentation will also provide examples of scenarios used to demonstrate the CHP-IDA through human-in-the-loop test bed activities as well as examples of appropriate system performance metrics. DISCUSSION: Today, in-flight data is often siloed, unsynchronized, and largely inaccessible in real time. Many data sets require manual entry and/or data transfer between vehicles and the ground. These issues contribute to risks in supporting exploration medical capabilities. The CHP-IDA is a back-end data system providing core capabilities needed for timely and meaningful data insights across CHP domains to crew and remote personnel to enable increased crew autonomy. Future work includes collaboration with additional CHP domains, new technology integrations, and further demonstrations of the IDA within different vehicle and communication latency contexts. LEARNING OBJECTIVES 1. The audience will understand that the CHP-IDA is a back-end system, providing a platform to facilitate access, promote decision tools, and provide meaningful insights to crew and to remote stakeholders during exploration missions. 2. The audience will gain insight into human-centered research and activities used to discover CHP domain data needs and pain points and how this information is used to guide development of the IDA.
Currently, discrete projects within NASA’s Human Research Program (HRP) take aim at providing future exploration missions with the capabilities necessary to operate within a progressively Earth-independent operative environment. Realizing an entire ecosystem that can accomplish these goals requires a clear visualization on how each project contributes to the overall objectives of Human Health and Performance (HH&P) in that context. The Exploration Medical Capability (ExMC) Element has developed an architectural framework for exploration class medical operations by utilizing a systems engineering approach using model-based systems engineering (MBSE). This model, a System of Systems Architecture (SoSA), captures a means of integrating various independent but related efforts into a comprehensive view associated with HRP’s goal of providing progressively Earth-Independent Medical Operations (EIMO). This level of visibility is realized by identifying interfaces between development efforts and existing programs that contribute to the overall mission of EIMO even if those extend past the traditional boundary of HRP. Potential interfaces that are considered important when constructing an architecture include program/project Needs, Goals, and Objectives (NGOs), capabilities, envisioned use cases/scenarios, and system/subsystem structure. This presentation will focus on the processes that were used to generate the SoSA along with a means to realize its utility amongst other MBSE products from ExMC. Evaluation of the best architecture moving forward can then be achieved that promotes cohesion between various functional areas of HH&P. Additionally, the SoSA is developed with a long-term vision for the dynamic integration of novel technological developments that may be implemented in the future. The SoSA is intended to enable Stakeholders the ability to view the broader interconnections that exist and begin to create avenues of communication between various efforts. The benefits of a SoSA provide an essential step towards addressing the unique challenges of attaining the goals of broader exploration class medical missions of the future.
Currently, discrete projects within NASA’s Human Research Program (HRP) take aim at providing future exploration missions with the capabilities necessary to operate within a progressively Earth-independent operative environment. Realizing an entire ecosystem that can accomplish these goals requires a clear visualization on how each project contributes to the overall objectives of Human Health and Performance (HH&P) in that context. The Exploration Medical Capability (ExMC) Element has developed an architectural framework for exploration class medical operations by utilizing a systems engineering approach using model-based systems engineering (MBSE). This model, a System of Systems Architecture (SoSA), captures a means of integrating various independent but related efforts into a comprehensive view associated with HRP’s goal of providing progressively Earth-Independent Medical Operations (EIMO). This level of visibility is realized by identifying interfaces between development efforts and existing programs that contribute to the overall mission of EIMO even if those extend past the traditional boundary of HRP. Potential interfaces that are considered important when constructing an architecture include program/project Needs, Goals, and Objectives (NGOs), capabilities, envisioned use cases/scenarios, and system/subsystem structure. This presentation will focus on the processes that were used to generate the SoSA along with a means to realize its utility amongst other MBSE products from ExMC. Evaluation of the best architecture moving forward can then be achieved that promotes cohesion between various functional areas of HH&P. Additionally, the SoSA is developed with a long-term vision for the dynamic integration of novel technological developments that may be implemented in the future. The SoSA is intended to enable Stakeholders the ability to view the broader interconnections that exist and begin to create avenues of communication between various efforts. The benefits of a SoSA provide an essential step towards addressing the unique challenges of attaining the goals of broader exploration class medical missions of the future.
Risk associated with human systems is challenging to quantify but is critical for the mission planning and decision making required to enable future Lunar and Martian missions. To address this gap, the Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) project is developing an integrated computational model for CHP mission risk. Much like how MEDPRAT is designed to allow medical resource trades informed by medical risk, CHP-PRA will enable analogous trades in human system risks across multiple CHP functions and capabilities. Human performance is one component of the risk intended to be captured by CHP-PRA through the Performance Risk Model (PRisM). The sensorimotor risk area provides a good frame of reference for investigating the structure of a performance model because most tasks that astronauts are expected to perform require input from the sensory system and/or movement/motor control. Additionally, sensorimotor countermeasures are an area of particular concern for NASA’s Human Research Program because of the increased sensorimotor risk associated with surface operations in Lunar and Martian missions. Thus, a tool that can quickly compare risk reductions of potential countermeasures would be beneficial in guiding research and development of effective countermeasures. In this proof of concept, we present a systematic way to combine multiple performance data sets for humans subjected to different countermeasures such that we can predict the countermeasure(s) that optimize astronaut performance on relevant tasks. PRisM assumes that both the tests that are used to measure countermeasure effectiveness (input data) and the tasks we use to represent astronaut performance, can be broken down and represented as a function/vector of the human systems required to perform that test/task. Through mathematical combination, test data are used to predict performance on astronaut tasks that use similar systems. We propose that when combining countermeasures evaluated using the same test, that only one value should be used to represent their combined effectiveness. We start our analysis with the assumption that two countermeasures together will perform better than each countermeasure individually. Our initial implementation of this framework compares various space motion sickness countermeasures and the most up to date analysis will be demonstrated at the IWS.
A recognized side effect of prolonged microgravity exposure is visual impairment and intracranial pressure (VIIP) syndrome. The medical understanding of this phenomenon is at present preliminary, although it is hypothesized that the headward shift of bodily fluids in microgravity may be a contributor. Computational models can be used to provide insight into the origins of VIIP. In order to further investigate this phenomenon, NASAs Digital Astronaut Project (DAP) is developing an integrated computational model of the human body which is divided into the eye, the cerebrovascular system, and the cardiovascular system. This presentation will focus on the development and testing of the computational model of an integrated model of the cardiovascular system (CVS) and central nervous system (CNS) that simulates the behavior of pressures, volumes, and flows within these two physiological systems.
From May 8th to June 9th, 2023, I had the opportunity to participate in an experiential learning experience at Johnson Space Center in Houston, TX with Exploration Medical Capability (ExMC), an element of the NASA Human Research Program. During this research experience, I was not only able to work on the above titled research project, but also gain an immense exposure to the field of aerospace medicine, make numerous connections within the field, tour NASA facilities, as well as travel to the Aerospace Medical Association Annual Conference (AsMA) in New Orleans. To briefly introduce my project, it is well understood that the medical capabilities available to crew medical officers (CMOs) on the International Space Station will be different than the capabilities available and needed during deep space exploration missions to the Moon, Mars, and beyond. Ground support is particularly limited due to distance, communication delays (or lack of communication), and lack of resupply. Therefore, to support medical care by CMOs on these missions, robust clinical decision support systems (CDSSs) must be designed. The recent publication and public launch of generative artificial intelligence (AI) tools based upon large language models (LLM) such as ChatGPT provides the opportunity to create a smart assistant for onboard triage, diagnosis, and treatment of medical conditions. Ultimately, the overall purpose of the project was to research what AI tools currently exist or are in development, and to see how they might be implemented onboard during exploration class spaceflights of the future. The ExMC element is actively developing several tools to be used in preparation for and during deep space exploration missions. One of those tools, known as IMPACT, is a probabilistic risk assessment model which can be used to propose a desired medical system (based on mass and volume) and suggest the clinical outcomes likely to occur for a design reference mission (DRM). The group recently presented the IMPACT model and a DRM of interest titled “Modified Long Duration Lunar Orbital and Lunar Surface” (mLDLOLS) at the recent AsMA conference. The mLDLOLS mock mission is a 9 month and 6-day deep space exploration mission consisting of time in Moon’s orbit (3 months on the Gateway space station), on the lunar surface (3 months within habitat), and another 3 months on Gateway before return to Earth. For this DRM, IMPACT ultimately outlined a preferred medical system that was then associated with medical conditions considered to be most likely based on frequency, most likely to cause astronaut task time loss (TTL), most likely to cause return to definitive care (RTDC), and most likely cause loss of crew life (LOCL). IMPACT also highlighted the medical capabilities/skills that would be required to care for those medical conditions, such as performing a history of present illness or musculoskeletal exam with ultrasound. The primary objective of the project was to perform a survey of the AI tools and systems applicable to the conditions outlined for the proposed mLDLOLS mission. Using PubMed (including most relevant MeSH terms) and Google Scholar, we then created a robust annotated bibliography organized by condition. The 56-page and over 500 reference annotated bibliography was subsequently used to create a review outline that would become the basis for drafting of a future publication. For the review outline, we took those medical conditions researched within the annotated bibliography (condition-based approach) and deployed a systems-based approach, combining those medical conditions and related tools into ten categories. These categories included general/all-purpose CDSSs, tools to diagnose or manage respiratory, dermatologic, neurologic, auditory and vestibular, ophthalmic, musculoskeletal, infection-associated, and gynecologic conditions, as well as tools that could be deployed in the setting of trauma/emergency. With the completion of the 30-page outline, we then began drafting the review paper. To conclude the research experience, I presented the findings from our survey to the ExMC Clinical and Science team. With these objectives, I ultimately learned about the number of AI tools that exist today to assist medical professionals with the triage, diagnosis, and management of several medical conditions. These tools can span from chatbot assistants to help triage knee pain to vision transformer models that can identify ophthalmic conditions based on ocular surface images captured with a cell phone. We also highlighted the current gaps that exist in the literature alongside the advancements that are needed to make the desired CDSS for deep space exploration missions. With this experience, I certainly confirmed an existing career goal and identified several additional skills needed to become an aerospace medical doctor including knowledge of critical care in an extreme medicine setting, aerospace engineering and human integration systems, artificial intelligence, machine learning, and risk models. I also identified numerous transferable skills for this career goal including the basic knowledge of medicine (MD), deployment of the scientific method for critical thought about new scientific questions (PhD), review of published literature, including creating an annotated bibliography (PhD), as well as detailed scientific writing (PhD). The results of my research will likely guide the design of an all-encompassing onboard medical assistant for use during deep space exploration missions of the future. I plan on sharing the outcomes from this experience with my peers at a student seminar in the Fall semester on August 30th. During the seminar, I will detail the project, my experience at NASA and AsMA, as well as offer best practice guidelines for students entertaining similar experiences or careers. In conclusion, I would like to thank the WVU School of Medicine, Research and Graduate Education office, as well as NASA ExMC for the unwavering support of this life-changing experience.
Stress is an integral element of the operational conditions experienced by combat medics. The effects of stress can compromise the performance of combat medics who must reach and treat their comrades under often threatening circumstances. Examples of these effects include tunnel vision, loss of motor control, and diminished hearing, which can result in an inability to perceive further danger, satisfactorily treat the casualty, and communicate with others. While many training programs strive to recreate this stress to aid in the experiential learning process, stress inducement may not always be feasible or desired. In addition, live simulations are not always a practical, convenient, and repeatable method of training. Instead, presenting situational training on a personal computer is proposed as an effective training platform in which the effects of stress can be addressed in a different way. We explore the cognitive and motor effects of stress, as well as the benefits of training for mitigating these effects in real life. While many training applications focus on inducing stress in order to "condition" the stress response, the author explores the possibilities of modeling stress to produce a similar effect. Can presenting modeled effects of stress help prepare or inoculate soldiers for stressful situations in which they must perform at a high level? This paper investigates feasibility of modeling stress and describes the preliminary design considerations of a combat medic training system that utilizes this method of battlefield preparation.
In recent years, data-driven, deep-learning-based models have shown great promise in medical risk prediction. By utilizing the large-scale Electronic Health Record data found in the U.S. Department of Veterans Affairs, the largest integrated healthcare system in the United States, we have developed an automated, personalized risk prediction model to support the clinical decision-making process for localized prostate cancer patients. This method combines the representative power of deep learning and the analytical interpretability of parametric regression models and can implement both time-dependent and static input data. To collect a comprehensive evaluation of model performances, we calculate time-dependent C-statistics C td over 2-, 5-, and 10-year time horizons using either a composite outcome or prostate cancer mortality as the target event. The composite outcome combines the Prostate-Specific Antigen (PSA) test, metastasis, and prostate cancer mortality. Our longitudinal model Recurrent Deep Survival Machine (RDSM) achieved C td 0.85 (0.83), 0.80 (0.83), and 0.76 (0.81), while the cross-sectional model Deep Survival Machine (DSM) attained C td 0.85 (0.82), 0.80 (0.82), and 0.76 (0.79) for the 2-, 5-, and 10-year composite (mortality) outcomes, respectively. In addition to estimating the survival probability, our method can quantify the uncertainty associated with the prediction. The uncertainty scores show a consistent correlation with the prediction accuracy. We find PSA and prostate cancer stage information are the most important indicators in risk prediction. Our work demonstrates the utility of the data-driven machine learning model in prostate cancer risk prediction, which can play a critical role in the clinical decision system.
Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI's patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.
Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI s patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.
Astronauts embarking on missions beyond low Earth orbit (LEO) will be exposed to a radiation field that may increase the risks of developing cancer, cardiovascular diseases, central nervous system disorders, and immune decrements. Operational parameters will be the primary determinants of crew radiation exposure. NASA uses integrated design tools and risk models to optimize these parameters to minimize radiation exposure. NASA is also considering medical countermeasures (MCMs) to reduce radiation-associated health risks. MCMs for potential use in space-based applications can be developed from a variety of sources, including: a) population-based chemoprevention trials against targeted diseases b) drug development efforts focused on treating acute effects from accidental radiation exposures c) drug development to mitigate side effects of radiotherapy d) mechanistic studies of distinct damage caused by high charge (Z) and energy (HZE) radiation. Use of agents developed for other applications, or repurposed, is advantageous because long-term safety in humans is already established.
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.
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.