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Spaceflight Medical Evacuation Risk Assessment Principles - A Qualitative Investigation

BACKGROUND Future human space exploration beyond Low Earth Orbit (LEO) will require innovative solutions in many areas, primarily those that provide direct medical support to crew on long-duration missions and optimize their health and performance. The associated challenges therein will be numerous, including but not necessarily limited to extended one-way or "asynchronous" communication delays, minimal to non-existent resupply, and a prolonged transit time to "definitive care" ranging from 3-days to 9-months. At the same time, long-duration exploration spacecraft and crew will face restrictions on mass, power, volume, and data far more significant than that seen in current LEO settings. Given these limitations, medical risk assessment is of primary importance, especially evaluating the implications of a medical evacuation of an ill or injured crewmember. Such evacuations are complicated, potentially dangerous, and well may be impossible in certain phases of the mission. Regardless, such issues must be weighed against the risks of the injured crew remaining aboard a spacecraft with limited medical resources. OBJECTIVE This qualitative study drew from the experiences of subject matter experts (SMEs) in spaceflight and appropriate analog environments (i.e., military, disaster, and extreme environment fields) to identify unique principles common amongst medical evacuation considerations helpful in informing future risk assessment tools. Appropriate analog environments included austere operational settings where multiple factors (weather, logistics/limited resupply, denied/extreme environments, and patient condition) resulted in a limited ability to provide definitive local medical care. The fundamental principles in question revolved around scenarios where evacuation became a complicating yet necessary consideration and where life-threatening medical concerns had to be weighed against critical mission objective(s). The primary authors collected semi-structured data gathered through in-depth interviews with 16 subject matter experts (SMEs). Interview questions investigated how these SMEs consider and weigh the attendant risks present in medical evacuation scenarios. Among the critical questions posed were those that sought to understand how the SME balanced the challenges and requirements of medical evacuation (or keeping an injured patient "on-site" aka: "prolonged field care") against the evacuation operation's risks on impacting overarching mission success. The team analyzed interview transcripts for common themes and principles using the qualitative methods of thematic analysis based on consensus, co-occurrence, and comparison. As a result, nine primary risk consideration themes and nine contributing factor themes emerged, all of which will ideally inform future medical evacuation decision-making tools and operational decision-making for exploration class missions. Specific aims for this study included: 1. Identification of common principles used to assess risks and benefits of medical evacuations in extreme environments 2. Identification of common points of friction or complication and challenges in extreme environment evacuations

A T Almand↗

Status Update on the James Webb Space Telescope Project

The James Webb Space Telescope (JWST) is a large (6.6 m), cold <50 K), infrared (IR)-optimized space observatory that will be launched in approx.2018. The observatory will have four instruments covering 0.6 to 28 micron, including a multi-object spectrograph, two integral field units, and grisms optimized for exoplanets. I will review JWST's key science themes, as well as exciting new ideas from the recent JWST Frontiers Workshop. I will summarize the technical progress and mission status. Recent highlights: All mirrors have been fabricated, polished, and gold-coated; the mirror is expected to be diffraction-limited down to a wavelength of 2 microns. The MIRI instrument just completed its cryogenic testing. STScI has released exposure time calculators and sensitivity charts to enable scientists to start thinking about how to use JWST for their science.

Rigby, Jane R.↗

Report of the Ionosphere-Thermosphere-Mesosphere Panel

The scientific objectives and mission concept that emerged from the discussions of this panel are presented. The overall scientific theme of this report is the investigation of the ionosphere, thermosphere, and mesosphere (near Earth space environment) as a global, dynamic, and coupled system. Among the specific goals of this area of research are: (1) understanding the consequences of transition between turbulent and laminar flow and collisional and collisionless media; (2) understanding the thermospheric/mesospheric coupling due to gravity wave, tidal, and trace constituent transport processes; (3) understanding the electrodynamical coupling between the thermosphere/ionosphere and magnetosphere; (4) understanding the coupling processes between small scale plasma structures; and (5) determining the real-time evolution of the global ionosphere electric field in response to solar wind and magnetosphere coupling.

Szuszczewicz, Edward P.↗

Coordinated field study for CaPE: Analysis of energy and water budgets

The objectives of this hydrologic cycle study are to understand and model (1) surface energy and land-atmosphere water transfer processes, and (2) interactions between convective storms and surface energy fluxes. A surface energy budget measurement campaign was carried out by an interdisciplinary science team during the period July 8 - August 19, 1991 as part of the Convection and Precipitation/Electrification Experiment (CaPE) in the vicinity of Cape Canaveral, FL. Among the research themes associated with CaPE is the remote estimation of rainfall. Thus, in addition to surface radiation and energy budget measurements, surface mesonet, special radiosonde, precipitation, high-resolution satellite (SPOT) data, geosynchronous (GOES) and polar orbiting (DMSP SSM/I, OLS; NOAA AVHRR) satellite data, and high altitude airplane data (AMPR, MAMS, HIS) were collected. Initial quality control of the seven surface flux station data sets has begun. Ancillary data sets are being collected and assembled for analysis. Browsing of GOES and radar data has begun to classify days as disturbed/undisturbed to identify the larger scale forcing of the pre-convective environment, convection storms and precipitation. The science analysis plan has been finalized and tasks assigned to various investigators.

Goodman, Steven J.↗

Status Update on the James Webb Space Telescope Project

The James Webb Space Telescope (JWST) is a large (6.6 m), cold (<50 K), infrared (IR)-optimized space observatory that will be launched in approx.2018. The observatory will have four instruments covering 0.6 to 28 micron, including a multi-object spectrograph, two integral fie ld units, and grisms optimized for exoplanets. I will review JWST's k ey science themes, as well as exciting new ideas from the recent JWST Frontiers Workshop. I will summarize the technical progress and miss ion status. Recent highlights: All mirrors have been fabricated, polished, and gold-coated; the mirror is expected to be diffraction-limite d down to a wavelength of 2 micron. The MIRI instrument just complete d its cryogenic testing. STScI has released exposure time calculators and sensitivity charts to enable scientists to start thinking about how to use JWST for their science.

Rigby, Jane R.↗

Evaluation of small area crop estimation techniques using LANDSAT- and ground-derived data

Studies completed in fiscal year 1981 in support of the clustering/classification and preprocessing activities of the Domestic Crops and Land Cover project. The theme throughout the study was the improvement of subanalysis district (usually county level) crop hectarage estimates, as reflected in the following three objectives: (1) to evaluate the current U.S. Department of Agriculture Statistical Reporting Service regression approach to crop area estimation as applied to the problem of obtaining subanalysis district estimates; (2) to develop and test alternative approaches to subanalysis district estimation; and (3) to develop and test preprocessing techniques for use in improving subanalysis district estimates.

Amis, M. L.↗

Research on the International Space Station: Understanding Future Potential from Current Accomplishments

In November 2007, the International Space Station (ISS) will have supported seven years of continuous presence in space, with 15 Expeditions completed. These years have been characterized by the numerous technical challenges of assembly as well as operational and logistical challenges related to the availability of transportation by the Space Shuttle. During this period, an active set of early research objectives have also been accomplished alongside the assembly. This paper will review the research accomplishments on ISS to date, with the objective of drawing insights on the potential of future research following completion of ISS assembly. By the end of Expedition 15, an expected 121 U.S.-managed investigations will have been conducted on ISS, with 91 of these completed. Many of these investigations include multiple scientific objectives, with an estimated total of 334 scientists served. Through February 2007, 101 scientific publications have been identified. Another 184 investigations have been sponsored by ISS international partners, which independently track their scientists served and results publication. Through this survey of U.S. research completed on ISS, three different themes will be addressed: (1) How have constraints on transportation of mass to orbit affected the types of research successfully completed on the ISS to date? What lessons can be learned for increasing the success of ISS as a research platform during the period following the retirement of the Space Shuttle? (2) How have constraints on crew time for research during assembly and the active participation of crewmembers as scientists affected the types of research successfully completed on the ISS to date? What lessons can be learned for optimizing research return following the increase in capacity from 3 to 6 crewmembers (planned for 2009)? What lessons can be learned for optimizing research return after assembly is complete? (3) What do early research results indicate about the various scientific disciplines represented in investigations on ISS? Are there lessons specific to human research, technology development, life sciences, and physical sciences that can be used to increase future research accomplishments? Research has been conducted and completed on ISS under a set of challenging constraints during the past 7 years. The history of research accomplished on ISS during this time serves as an indicator of the value and potential of ISS when full utilization begins. By learning from our early experience in completing research on ISS, NASA and our partners can be positioned to optimize research returns as a full crew complement comes onboard, assembly is completed, and research begins in full.

Robinson, Julie A.↗

Topic Modeling of NASA Space System Problem Reports: Research in Practice

Problem reports at NASA are similar to bug reports: they capture defects found during test, post-launch operational anomalies, and document the investigation and corrective action of the issue. These artifacts are a rich source of lessons learned for NASA, but are expensive to analyze since problem reports are comprised primarily of natural language text. We apply topic modeling to a corpus of NASA problem reports to extract trends in testing and operational failures. We collected 16,669 problem reports from six NASA space flight missions and applied Latent Dirichlet Allocation topic modeling to the document corpus. We analyze the most popular topics within and across missions, and how popular topics changed over the lifetime of a mission. We find that hardware material and flight software issues are common during the integration and testing phase, while ground station software and equipment issues are more common during the operations phase. We identify a number of challenges in topic modeling for trend analysis: 1) that the process of selecting the topic modeling parameters lacks definitive guidance, 2) defining semantically-meaningful topic labels requires nontrivial effort and domain expertise, 3) topic models derived from the combined corpus of the six missions were biased toward the larger missions, and 4) topics must be semantically distinct as well as cohesive to be useful. Nonetheless,topic modeling can identify problem themes within missions and across mission lifetimes, providing useful feedback to engineers and project managers.

Data Mining↗

Prioritization methodology for chemical replacement

Since United States of America federal legislation has required ozone depleting chemicals (class 1 & 2) to be banned from production, The National Aeronautics and Space Administration (NASA) and industry have been required to find other chemicals and methods to replace these target chemicals. This project was initiated as a development of a prioritization methodology suitable for assessing and ranking existing processes for replacement 'urgency.' The methodology was produced in the form of a workbook (NASA Technical Paper 3421). The final workbook contains two tools, one for evaluation and one for prioritization. The two tools are interconnected in that they were developed from one central theme - chemical replacement due to imposed laws and regulations. This workbook provides matrices, detailed explanations of how to use them, and a detailed methodology for prioritization of replacement technology. The main objective is to provide a GUIDELINE to help direct the research for replacement technology. The approach for prioritization called for a system which would result in a numerical rating for the chemicals and processes being assessed. A Quality Function Deployment (QFD) technique was used in order to determine numerical values which would correspond to the concerns raised and their respective importance to the process. This workbook defines the approach and the application of the QFD matrix. This technique: (1) provides a standard database for technology that can be easily reviewed, and (2) provides a standard format for information when requesting resources for further research for chemical replacement technology. Originally, this workbook was to be used for Class 1 and Class 2 chemicals, but it was specifically designed to be flexible enough to be used for any chemical used in a process (if the chemical and/or process needs to be replaced). The methodology consists of comparison matrices (and the smaller comparison components) which allow replacement technology to be quantitatively compared in several categories, and a QFD matrix which allows process/chemical pairs to be rated against one another for importance (using consistent categories). Depending on the need for application, one can choose the part(s) needed or have the methodology completed in its entirety. For example, if a program needs to show the risk of changing a process/chemical one may choose to use part of Matrix A and Matrix C. If a chemical is being used, and the process must be changed; one might use the Process Concerns part of Matrix D for the existing process and all possible replacement processes. If an overall analysis of a program is needed, one may request the QFD to be completed.

Cruit, Wendy↗

Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions: ExMC Pharmacy Research Plan

The Exploration Medical Capabilities (ExMC) Element of NASA's Human Research Program is charged with identifying medical capabilities that can address the challenges of prevention, diagnosis, and treatment of disease and injuries that could occur during exploration missions beyond Earth's orbit. Faced with the obstacle of access to in-flight medical care, and limitations of vehicle space, time, and communications; it is necessary to prioritize what medical consumables are manifested for the flight, and which medical conditions are addressed. Studies of astronaut health establish the incidence of common and high risk medical conditions that require medical intervention during long-duration exploration missions. 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. Two themes run throughout the committee's final report: (1) that not enough is known about the risks to human health during long-duration missions beyond Earth's orbit or about what can effectively mitigate those risks to enable humans to travel and work safely in the environment of deep space and (2) that everything reasonable should be done to gain the necessary information before humans are sent on missions of space exploration (IOM, 2001). Although several spaceflight focused pharmaceutical research studies have been conducted, few have provided sufficient data regarding medication usage or potency changes during spaceflight. The Du pharmaceutical stability study assessed medications flown on space shuttles to and from the International Space Station (ISS) from 2006 until 2008; of which some medications were still viable beyond their expiration dates (Du et al, 2011). However, as with many spaceflight studies, the small 'n' associated with this study limits the ability to draw strong conclusions from it. Dr. Wotring and others have recently published articles containing information regarding medication usage, indications, and efficacy gleaned from spaceflight records (Wotring et al, 2015, 2016; Barger et al, 2014; Basner and Dinges, 2014). Although some conclusions can be drawn from these studies, the inability to fully quantify medication usage, indications, side effects, and effectiveness, limits insight as to which medications should be prioritized for further research.

Antonsen, Erik↗

Acoustic Holography of the Solar Convection Zone with SOHO-MDI Observations

The original grant with the title stated above was NAG5-10984, awarded to the Solar Physics Research Corporation (SPRC) in July, 2001, and was to be a three-year project. The basic theme of the project was the development and application of computational seismic holography for imaging, diagnostics, and monitoring of magnetic anomalies beneath active regions, in the deep solar interior, and on the Sun's far surface. The project was roughly separated into the following five tasks: (1) A holographic survey of active regions. (2) p-Mode absorption diagnostics of magnetic regions. (3) Acoustic modeling of the shallow subphotospheres of active regions and the quiet-Sun supergranulation based on phase-correlation seismic holography. (4) Seismic holography of the deep convection zone. (5) Improvements in holographic imaging of the far surface of the Sun. Following the death of Karen Harvey, President of SPRC, during the first year, the grant was transferred to Northwest Research Associates as NAG5-12901. Substantial but progress had been made on most of the above tasks in the first year under NAG5-10984, but none were completed. This work was continued under NAG5-12901.

Lindsey, Charles↗

The partial volatilization of Mercury

During recent years research on the primitive solar nebula has followed two main themes: (1) Very early in the development of the nebula conditions probably favored the occurrence of major gaseous instabilities leading to the formation of giant gaseous protoplanets, but the rapid rise of the external temperature soon evaporated the envelopes of these protoplanets, possibly leaving behind precipitated solids which formed the cores and mantles of the terrestrial planets. (2) Models of the nebula indicate a later stage when conditions in the inner Solar System became very hot; at the position of Mercury the temperature was probably in the range 2500-3500 K. This leads to the hypothesis that the original protomercury was a body substantially more massive than the present planet and of normal composition, but that when it was immersed in the high-temperature field of the dissipating solar nebula, most of the rocky mantle was vaporized and mixed into the solar nebula gases and carried away by them. This hypothesis is investigated in the present paper. For simplicity the vaporization of a mantle composed of enstatite, MgSiO3, was computed for a planet with 2.25 the mass of Mercury at a temperature of 3000 K. It is argued that the mantle could probably be largely removed in the available time of 30,000 yrs. Subsequent accretion would restore some magnesium silicates to the mantle of the planet.

Cameron, A. G. W.↗

Proceedings of the NASA Conference on Space Telerobotics, volume 3

The theme of the Conference was man-machine collaboration in space. The Conference provided a forum for researchers and engineers to exchange ideas on the research and development required for application of telerobotics technology to the space systems planned for the 1990s and beyond. The Conference: (1) provided a view of current NASA telerobotic research and development; (2) stimulated technical exchange on man-machine systems, manipulator control, machine sensing, machine intelligence, concurrent computation, and system architectures; and (3) identified important unsolved problems of current interest which can be dealt with by future research.

Rodriguez, Guillermo↗

Astrophysical Adaptation of Points, the Precision Optical Interferometer in Space

POINTS (Precision Optical INTerferometer in Space) would perform microarcsecond optical astrometric measurements from space, yielding submicroarcsecond astrometric results from the mission. It comprises a pair of independent Michelson stellar interferometers and a laser metrology system that measures both the critical starlight paths and the angle between the baselines. The instrument has two baselines of 2 m, each with two subapertures of 35 cm; by articulating the angle between the baselines, it observes targets separated by 87 to 93 deg. POINTS does global astrometry, i.e., it measures widely separated targets, which yields closure calibration, numerous bright reference stars, and absolute parallax. Simplicity, stability, and the mitigation of systematic error are the central design themes. The instrument has only three moving-part mechanisms, and only one of these must move with sub-milliradian precision; the other two can tolerate a precision of several tenths of a degree. Optical surfaces preceding the beamsplitter or its fold flat are interferometrically critical; on each side of the interferometer, there are only three such. Thus, light loss and wavefront distortion are minimized. POINTS represents a minimalistic design developed ab initio for space. Since it is intended for astrometry, and therefore does not require the u-v-plane coverage of an imaging, instrument, each interferometer need have only two subapertures. The design relies on articulation of the angle between the interferometers and body pointing to select targets; the observations are restricted to the 'instrument plane.' That plane, which is fixed in the pointed instrument, is defined by the sensitive direction for the two interferometers. Thus, there is no need for siderostats and moving delay lines, which would have added many precision mechanisms with rolling and sliding parts that would be required to function throughout the mission. Further, there is no need for a third interferometer, as is required when out-of-plane observations are made. An instrument for astrometry, unlike those for imaging, can be compact and yet scientifically productive. The POINTS instrument is compact and therefore requires no deployment of precision structures, has no low-frequency (i.e., under 100 Hz) vibration modes, and is relatively easy to control thermally. Because of its small size and mass, it is easily and quickly repointed between observations. Further, because of the low mass, it can be economically launched into high Earth orbit which, in conjunction with a solar shield, yields nearly unrestricted sky coverage and a stable thermal environment.

Reasenberg, Robert D.↗

Keeping the dream alive: Managing the Space Station Program, 1982 to 1986

The management is described and analyzed of the formative years of the NASA Space Station Program (1982 to 1986), beginning with the successful initiative for program approval by Administrator James M. Beggs through to the decision to bring program management to Reston, Virginia. Emphasis is on internal management issues related to the implementation of the various phases of the program. Themes examined are the problem of bringing programmatic and institutional interests together and focusing them to forward the program; centralized versus decentralized control of the program; how the history of NASA and of the individual installations affected the decisions made; and the pressure from those outside NASA. The four sections are: (1) the decision to build the space station, (2) the design of the management experiment, (3) the experiment comes to life, and (4) the decision reversal.

Lewin, Thomas J.↗

Idiomatic Correctness-Checking via Julienne in Fortran 2023

This paper presents a unified approach to unit testing and runtime assertion checking using Fortran 2023. The paper describes the support for our approach in the Julienne framework. Julienne leverages recent Fortran standards to implement object-oriented design patterns, support testing parallel programs, and implement functional programming patterns in order to craft idioms inspired by natural-language expressions. The presented idioms employ novel operators to write expressions that evaluate to a test-diagnosis object encapsulating two components: (1) the test outcome or assertion outcome and (2) an automatically generated diagnostic string. Two other novel aspects of the approach include (1) the ability to enforce assertions inside pure procedures and (2) the ability to output rich diagnostic information inside pure procedures during error termination when assertions fail. The latter capability mitigates against a reason that Fortran programmers commonly cite for not writing pure procedures: difficulty obtaining useful program output inside pure procedures when debugging code. This paper demonstrates how the adoption of the proposed idioms leads naturally to a unifying theme across two otherwise disparate technologies: unit testing and runtime assertion checking. Finally, this paper describes the usage of the Julienne testing framework for writing unit tests and assertions in the Matcha high-performance computing application and the Fiats deep learning library.

Rouson, Damian↗

Principles for Termination of Medical Care in Austere Analog Environments for Development of Spaceflight Protocols

INTRODUCTION: When compared to operations in low earth orbit, exploration class missions will have substantially limited resources and ground medical support while the risk of a significant medical event is projected to be higher. Termination of care (TOC) may need to be considered in certain instances. We aim to utilize data from earth-based analogs to identify common principles that can help develop future guidelines to this complex medical and ethical challenge. METHODS: A comprehensive literature review was conducted in medline, nasa.gov, Defense Technical Information Center(DTIC) and google scholar. Key search terms including “withdrawal of care, termination of care, termination of CPR, military medicine, wilderness medicine, futility, potentially inappropriate” and others were used to identify analog studies of relevance. These were qualitatively evaluated for recurring principles or themes that were reviewed and structured. RESULTS: Mission planning termination of care principles: definitions of clear medical goals, separate protocols for each relevant condition, protocols developed using best available evidence, crew involvement in development, protocols rehearsal pre-launch, and inclusion of palliative capabilities. In-mission termination of care principles: 1. Crew Medical Officer directed stabilization of the patient; 2. Consultation with mission control with standardized information exchange; 3. Multidisciplinary medical and ethical conference among the mission directors, flight surgeons and relevant specialist experts; 4. Multidisciplinary risk review examining both medical and mission risks for relevant options; 5. Provision of a transparent explanation of the process and decision to crew; 6. Allowing crew feedback and inquiry to review board; 7. Support of the crew in the enacted decision. DISCUSSION: By utilizing the best available evidence in conjunction with expert opinion we have identified common principles from earth-based analogs that could be used to help design future TOC protocols.

Samuel Stephenson↗

Institute for Catalysis in Energy Processes (ICEP) (Final Report)

The Institute for Catalysis in Energy Processes (ICEP) was a multi-PI program located at the Northwestern University Center for Catalysis and Surface Science from 2006-2024. Over several renewal cycles and several organizing themes, ICEP addressed fundamental questions in catalysis science. In turn, the scientific questions addressed were directly relevant to the efficient use of the nation’s resources to produce fuels and commodity chemicals, harness alternate energy sources for chemical reactions such as light or electricity, reduce emissions and waste, and minimize the impact of our use of plastics. Selective oxidation, (oxidative) dehydrogenation, deNOx, CO 2 reduction, hydrogen release, polymer decomposition / depolymerization, and many other reactions of intense interest to the US Department of Energy were studied in the center. Major ICEP strengths were in catalyst synthesis, in measurements that elucidated catalyst properties, in reaction mechanisms and kinetics, and in predictive theory and modeling. ICEP researchers were often the inventors or developers of materials and methods that were brought to bear on the Institute’s catalytic systems. Key characterization tools advanced through this project included resonance Raman and related techniques, sum frequency generation, and X-ray standing wave spectroscopy. Center members relied extensively on computational tools such as density functional theory and microkinetic modeling to fully investigate catalyst structures and catalytic mechanisms. ICEP researchers were early developers of atomic layer deposition (ALD) for catalyst synthesis and were early pioneers of metal organic frameworks for catalysis. ICEP innovations are found in areas of intense research such as single-atom catalysts, catalytic deconstruction of plastics, and catalytic MOFs, to name a few. Research areas initiated by ICEP indirectly led to DOE EFRCs, startup companies, and other achievements. Over its 18 years of existence, ICEP involved two different PIs (Stair and Notestein) and 24 senior investigators across several academic disciplines at Northwestern University. There were tight collaborations with Argonne National Laboratory, including specialized equipment and experiments permanently located there. The center supported ~400 person-years of effort by graduate students and postdocs, either directly through DOE support or indirectly by leveraging independent support provided to the trainees, e.g. through the NSF GRFP or internal fellowships. The project resulted in 328 manuscripts and numerous conference presentations.

36 MATERIALS SCIENCE↗