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Exploration Medical Capability - Advancing Medical System Design and Risk-Informed Decision Making for Deep Space Exploration

BACKGROUND: Within NASA’s Human Research Program, the Exploration Medical Capability (ExMC) Element has three primary focus areas: clinical and scientific research, systems engineering and trade space analysis, and technology development and demonstrations. These focus areas feed into the overarching goal of enabling progressively Earth-Independent Medical Operations (EIMO), a new paradigm that will be necessary for future Artemis and Mars medical and vehicle systems. This EIMO end state aligns with NASA’s Moon to Mars Objectives, which clearly outline the need for NASA deep space exploration missions to reduce their reliance upon Earth and become increasingly autonomous, in preparation for the first human Mars mission. OVERVIEW: To advance exploration medical systems and ultimately, integrated crew health and performance systems, ExMC’s portfolio includes: funding ground development & testing of novel medical capabilities; creation of new approaches for the development of medical protocols and procedures; deployment of innovative technologies into analog environments; technology demonstrations in spaceflight; and eventual transition to operations of new capabilities for deep space exploration missions. The portfolio also includes: pharmaceutical research targeting stability, pharmacokinetics, and pharmacodynamics; integrated data architectures and clinical decision support tools; and systems engineering and trade space analysis tools to assist NASA in the development of future medical system models as well as the medical system requirements that can serve as a foundation for deep space exploration missions. All of these investments are done in a collaborative and coordinated fashion with other NASA stakeholders, such as the Environmental Control and Life Support Systems – Crew Health and Performance System Capability Leadership Team and the Health and Medical Technical Authority. DISCUSSION: In this presentation, ExMC will provide an overview of our work from across our portfolio, all of which will inform future EIMO efforts at NASA. ExMC’s research and development investments are targeted to reduce the human system risks associated with deep space exploration to the Moon and Mars.

Kris Lehnhardt↗

Tactile Sensing for Dexterous Robotic Hands

Robotic systems will be used as precursors to human exploration to explore the solar system and expand our knowledge of planetary surfaces. Robotic systems will also be used to build habitats and infrastructure required for human presence in space and on other planetary surfaces . Such robots will require a high level of intelligence and automation. The ability to flexibly manipulate their physical environment is one characteristic that makes humans so effective at these building and exploring tasks . The development of a generic autonomous grasp ing capability will greatly enhance the efficiency and ability of robotics to build, maintain and explore. To tele-operate a robot over vast distances of space, with long communication delays, has proven to be troublesome. Having an autonomous grasping capability that can react in real-time to disturbances or adapt to generic objects, without operator intervention, will reduce the probability of mishandled tools and samples and reduce the number of re-grasp attempts due to dropping. One aspect that separates humans from machines is a rich sensor set. We have the ability to feel objects and respond to forces and textures. The development of touch or tactile sensors for use on a robot that emulates human skin and nerves is the basis for this discussion. We will discuss the use of new piezo-electric and resistive materials that have emerged on the market with the intention of developing a touch sensitive sensor. With viable tacti le sensors we will be one step closer to developing an autonomous grasping capability.

Martin, Toby B.↗

Exploration Medical Capability Clinical Decision Support Use Cases for CDSS Test Bed

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data, and crew time), limited options for evacuation, and those associated with delayed or constrained communications. Each of these challenges necessitates greater degrees of crew autonomy as our distance from Earth increases. Specifically, as communication delays intensify - and evacuation capability diminishes the further we explore space - the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will become key to mission continuation and success. This need will be especially true should a crewmember become ill or injured wherein treatment and disposition “in-situ” ultimately falls to the crew itself to determine. To augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained exploration mission crew operating under stressful conditions, combatting fatigue, and facing a potential medical crisis, a robust clinical decision support system (CDSS) is a probable solution. A CDSS would facilitate, guide, and inform Earth-independent medical operations while assisting crewmembers through various clinical presentations. The CDSS would allow crewmembers to take advantage of pre-mission training tied to the in-flight/in-mission use of pre-planned protocols that offer both a range of diagnostic options and “just-in-time” (refamiliarization) training and assistance. CDSS will expand such capabilities by improving the utility and effectiveness of various available diagnostic, treatment, and health maintenance tools, techniques, and measures.

ExMC↗

Perspectives from the Wearable Electronics and Applications Research (WEAR) Lab, NASA Johnson Space Center

As NASA moves beyond exploring low earth orbit and into deep space exploration, increased communication delays between astronauts and earth drive a need for crew to become more autonomous (earth-independent). Currently crew on board the International Space Station (ISS) have limited insight into specific vehicle system performance because of the dependency on monitoring and real-time communication with Mission Control. Wearable technology provides a method to bridge the gap between the human (astronaut) and the system (spacecraft) by providing mutual monitoring between the two. For example, vehicle or environmental information can be delivered to astronauts through on-body devices and in return wearables provide data to the spacecraft regarding crew health, location, etc. The Wearable Electronics and Applications Research (WEAR) Lab at the NASA Johnson Space Center utilizes a collaborative approach between engineering and human factors to investigate the use of wearables for spaceflight. Zero and partial gravity environments present unique challenges to wearables that require collaborative, user-centered, and iterative approaches to the problems. Examples of the WEAR Lab's recent wearable projects for spaceflight will be discussed.

Moses, Haifa R.↗

Perspectives from the Wearable Electronics and Applications Research (WEAR) Lab, NASA, Johnson Space Center

As NASA moves beyond exploring low earth orbit and into deep space exploration, increased communication delays between astronauts and earth drive a need for crew to become more autonomous (earth-independent). Currently crew on board the International Space Station (ISS) have limited insight into specific vehicle system performance because of the dependency on monitoring and real-time communication with Mission Control. Wearable technology provides a method to bridge the gap between the human (astronaut) and the system (spacecraft) by providing mutual monitoring between the two. For example, vehicle or environmental information can be delivered to astronauts through on-body devices and in return wearables provide data to the spacecraft regarding crew health, location, etc. The Wearable Electronics and Applications Research (WEAR) Lab at the NASA Johnson Space Center utilizes a collaborative approach between engineering and human factors to investigate the use of wearables for spaceflight. Zero and partial gravity environments present unique challenges to wearables that require collaborative, user-centered, and iterative approaches to the problems. Examples of the WEAR Lab's recent wearable projects for spaceflight will be discussed.

Moses, Haifa R.↗

Advancing Autonomous Operations Technologies for NASA Missions

This paper discusses the importance of implementing advanced autonomous technologies supporting operations of future NASA missions. The ability for crewed, uncrewed and even ground support systems to be capable of mission support without external interaction or control has become essential as space exploration moves further out into the solar system. The push to develop and utilize autonomous technologies for NASA mission operations stems in part from the need to reduce cost while improving and increasing capability and safety. This paper will provide examples of autonomous technologies currently in use at NASA and will identify opportunities to advance existing autonomous technologies that will enhance mission success by reducing cost, ameliorating inefficiencies, and mitigating catastrophic anomalies

Cruzen, Craig↗

Advancing Autonomous Operations Technologies for NASA Missions

This paper discusses the importance of implementing advanced autonomous technologies supporting operations of future NASA missions. The ability for crewed, uncrewed and even ground support systems to be capable of mission support without external interaction or control has become essential as space exploration moves further out into the solar system. The push to develop and utilize autonomous technologies for NASA mission operations stems in part from the need to reduce operations cost while improving and increasing capability and safety. This paper will provide examples of autonomous technologies currently in use at NASA and will identify opportunities to advance existing autonomous technologies that will enhance mission success by reducing operations cost, ameliorating inefficiencies, and mitigating catastrophic anomalies.

Cruzen, Craig↗

Vision guided landing of an an autonomous helicopter in hazardous terrain

Future robotic space missions will employ a precision soft-landing capability that will enable exploration of previously inaccessible sites that have strong scientific significance. To enable this capability, a fully autonomous onboard system that identifies and avoids hazardous features such as steep slopes and large rocks is required. Such a system will also provide greater functionality in unstructured terrain to unmanned aerial vehicles. This paper describes an algorithm for landing hazard avoidance based on images from a single moving camera. The core of the algorithm is an efficient application of structure from motion to generate a dense elevation map of the landing area. Hazards are then detected in this map and a safe landing site is selected. The algorithm has been implemented on an autonomous helicopter testbed and demonstrated four times resulting in the first autonomous landing of an unmanned helicopter in unknown and hazardous terrain.

Mars Landing↗

X-HAB 2020 Academic Innovation Challenge: Next Generation User Interfaces for Gateway Autonomous Operations

NASA’s Gateway seeks to establish an autonomous platform in support of Artemis mission (boots on ground 2024). It is used to refine and mature short and long-duration deep space exploration capabilities through the 2020s. It is expected to be assembled in a lunar orbit where it can be used as a staging point for missions to the Moon and other destinations in deep space. Gateway can evolve for different mission needs involving exploration, science, commercial and international partners. User interfaces for autonomous systems is an emerging area where knowledge and implementation concepts are still in their infancy.

J. Cecil↗

Software Construction and Analysis Tools for Future Space Missions

NASA and its international partners will increasingly depend on software-based systems to implement advanced functions for future space missions, such as Martian rovers that autonomously navigate long distances exploring geographic features formed by surface water early in the planet's history. The software-based functions for these missions will need to be robust and highly reliable, raising significant challenges in the context of recent Mars mission failures attributed to software faults. After reviewing these challenges, this paper describes tools that have been developed at NASA Ames that could contribute to meeting these challenges; 1) Program synthesis tools based on automated inference that generate documentation for manual review and annotations for automated certification. 2) Model-checking tools for concurrent object-oriented software that achieve memorability through synergy with program abstraction and static analysis tools.

Lowry, Michael R.↗

Experimental Evaluation of Verification and Validation Tools on Martian Rover Software

To achieve its science objectives in deep space exploration, NASA has a need for science platform vehicles to autonomously make control decisions in a time frame that excludes intervention from Earth-based controllers. Round-trip light-time is one significant factor motivating autonomy capability, another factor is the need to reduce ground support operations cost. An unsolved problem potentially impeding the adoption of autonomy capability is the verification and validation of such software systems, which exhibit far more behaviors (and hence distinct execution paths in the software) than is typical in current deepspace platforms. Hence the need for a study to benchmark advanced Verification and Validation (V&V) tools on representative autonomy software. The objective of the study was to access the maturity of different technologies, to provide data indicative of potential synergies between them, and to identify gaps in the technologies with respect to the challenge of autonomy V&V. The study consisted of two parts: first, a set of relatively independent case studies of different tools on the same autonomy code, second a carefully controlled experiment with human participants on a subset of these technologies. This paper describes the second part of the study. Overall, nearly four hundred hours of data on human use of three different advanced V&V tools were accumulated, with a control group that used conventional testing methods. The experiment simulated four independent V&V teams debugging three successive versions of an executive controller for a Martian Rover. Defects were carefully seeded into the three versions based on a profile of defects from CVS logs that occurred in the actual development of the executive controller. The rest of the document is structured a s follows. In section 2 and 3, we respectively describe the tools used in the study and the rover software that was analyzed. In section 4 the methodology for the experiment is described; this includes the code preparation, seeding of defects, participant training and experimental setup. Next we give a qualitative overview of how the experiment went from the point of view of each technology; model checking (section 5), static analysis (section 6), runtime analysis (section 7) and testing (section 8). The find section gives some preliminary quantitative results on how the tools compared.

Brat, Guillaume↗

Spaceflight Flow Cytometry: Design Challenges and Applications

Future space exploration missions will require analytical technology capable of providing both autonomous medical care to the crew and investigative capabilities to researchers. While several promising candidate technologies exist for further development, flow cytometry is an attractive technology as it offers both crew health and a wide array of biochemistry and immunology assays. While flow cytometry has been widely used for cellular analysis in both clinical and research settings, the requirements for proper operation in spaceflight impose constraints on any instrument designs. The challenges of designing a spaceflight-ready flow cytometer are discussed, as well as some preliminary results using a prototype system.

Pappas, Dimitri↗

On-orbit demonstrations of automated closure and capture using ESA-developed proximity operations technologies and an existing serviceable NASA Explorer platform spacecraft

Since 1984 the European Space Agency (ESA) has been working to develop an autonomous rendezvous and docking capability to enable Hermes to dock automatically with Columbus. As a result, ESA (with Matra, MBB, and other space companies) have developed technologies that are directly supportive of the current NASA initiative for Automated Rendezvous and Capture. Fairchild and Matra would like to discuss the results of the applicable ESA/Matra rendezvous and capture developments and suggest how these capabilities could be used together with an existing NASA Explorer Platform satellite to minimize new development and accomplish a cost-effective automatic closure and capture demonstration program.

Hohweisner, Bill↗

ALI (Autonomous Lunar Investigator): Revolutionary Approach to Exploring the Moon with Addressable Reconfigurable Technology

Addressable Reconfigurable Technology (ART) based structures: Mission Concepts based on Addressable Reconfigurable Technology (ART), originally studied for future ANTS (Autonomous Nanotechnology Swarm) Space Architectures, are now being developed as rovers for nearer term use in lunar and planetary surface exploration. The architecture is based on the reconfigurable tetrahedron as a building block. Tetrahedra are combined to form space-filling networks, shaped for the required function. Basic structural components are highly modular, addressable arrays of robust nodes (tetrahedral apices) from which highly reconfigurable struts (tetrahedral edges), acting as supports or tethers, are efficiently reversibly deployed/stowed, transforming and reshaping the structures as required.

Clark, P. E.↗

rHealth One Demonstration Aboard ISS: A Microfluidic Bioanalyzer Based on Sheath/Hydrodynamic Focusing Flow Cytometry

The Exploration Medical Capability (ExMC) element aims to provide astronauts with the means for their own health monitoring, diagnosis, and treatment during exploration missions. As space flight ventures further from earth, the need for autonomous medical care increases under greater constraints on size, mass, and resources. One pillar for diagnosis that crew would be separated from is laboratory analysis. Even now on ISS, blood samples must be collected and returned to earth for testing. In response, ExMC is assessing how assays for hematology, bone health, radiation exposure etc. could be addressed through commercial-off-the-shelf (COTS) and Small Business Innovation Research (SBIR) funded bioanalyzers that are miniaturizing lab technology. Since missions will reach distances where there are no timely replacements, validation on the International Space Station (ISS) is a necessary part of that assessment. In partnership with NASA Johnson Space Center (JSC) Immunology Lab and the Research Operations and Integration (ROI) element, ExMC conducted a technology demonstration on ISS of the rHEALTH ONE, a flow cytometry based bioanalyzer, to assess future devices based on this design. In flow cytometry, there are predominantly three ways to focus the cells (or particles) into a single file stream: hydrodynamic focusing, microcapillary, and acoustic focusing. The rHEALTH ONE utilizes the commercial standard, sheath-based hydrodynamic focusing. rHEALTH itself represents both a company and a suite of medical tools NASA has funded through SBIR grants towards the development of a promising diagnosis instrument for exploration missions. rHEALTH ONE is the interim version of the technology, functional as a benchtop analyzer and test bed for the next generation of rHEALTH in development. Several modifications were made to the rHEALTH ONE analyzer for operation in microgravity. For function, fluid management was key. A sheath-based analyzer uses sheath fluid to flow the sample, cleaning fluid to prevent biological contamination, and a reservoir to collect the liquid waste. The rHEALTH ONE analyzer uses bottles dependent on gravity to separate the air and liquid pathways and keep the liquids contained. It uses only 1 psig of air pressure to directly push the liquid through the device, requiring little-to-no resistance at inlet and outlet. A microtubing assembly with self-sealing luer connectors was designed – featuring 0.014 mm thick durable medical balloons to hold water inside the supply bottles – to create safe containment and easy access for the crew while maintaining the analyzer’s function. For safety, copper tape was added to the interior of the plastic housing to reduce electromagnetic interference, fluid and electrical connections were secured against vibration and leaks, and gaps were further sealed to ensure containment of the optical block and lasers. Water as the sheath and cleaning fluid and TOX 0 samples were used to reduce the biohazard risk to the crew. In May 2022, European Space Agency astronaut Samantha Cristoforetti demonstrated the rHEALTH ONE aboard ISS for its sample loading, flow cytometry, and data collection capability in microgravity. The JSC Immunology Lab provided flow cytometry expertise, designed the sample test protocol, and manufactured and benchmarked the flight samples on a ‘gold-standard’ flow cytometer. The analyzer was primed with water, purged of air, and four calibration solutions of polystyrene microparticles were tested to characterize its performance. Tightly controlled procedures and excellent execution prevented air bubble interference during air/water separation, fluid transfer, sample mixing and loading. Data showed a slight increase in signal noise on 3 of 5 channels and an anomaly of fluorophores migrating in one sample (confirmed by JSC post-flight). Flight results correctly detected the change in sample, matched the analyzer’s ground performance, and were consistent with the gold-standard’s ground results. Although areas were noted for improvement, these outcomes signified complete mission success.

R. S. Miller↗

Simulation-Based Verification of Livingstone Applications

AI software is viewed as a means to give greater autonomy to automated systems, capable of coping with harsh and unpredictable environments in deep space missions. Autonomous systems pose a serious challenge to traditional test-based verification approaches, because of the enormous space of possible situations that they aim to address. Before these systems are put in control of critical applications, appropriate new verification approaches need to be developed. This article describes Livingstone PathFinder (LPF), a verification tool for autonomous diagnosis applications based on NASA's Livingstone model-based diagnosis system. LPF applies state space exploration algorithms to an instrumented testbed, consisting of the Livingstone diagnosis system embedded in a simulated operating environment. The article describes different facets of LPF and reports some experimental results from applying LPF to a Livingstone model of the main propulsion feed subsystem of the X-34 space vehicle. This paper describes Livingstone PathFinder (LPF), a verification tool for autonomous diagnosis applications based on NASA's Livingstone model-based diagnosis system. LPF applies state space exploration algorithms to an instrumented testbed, consisting of the Livingstone diagnosis system embedded in a simulated operating environment. Section 2 provides an overview of Livingstone; Section 3 describes the LPF architecture; Section 4 discusses its applicability; Section 5 reviews some experimental results; Section 6 compares LPF to related verification approaches; Section 7 draws conclusions and discusses some perspectives.

Lindsey, Anthony E.↗

A Survey of Formal Methods for Intelligent Swarms

Swarms of intelligent autonomous spacecraft, involving complex behaviors and interactions, are being proposed for future space exploration missions. Such missions provide greater flexibility and offer the possibility of gathering more science data than traditional single spacecraft missions. The emergent properties of swarms make these missions powerful, but simultaneously far more difficult to design, and to assure that the proper behaviors will emerge. These missions are also considerably more complex than previous types of missions, and NASA, like other organizations, has little experience in developing or in verifying and validating these types of missions. A significant challenge when verifying and validating swarms of intelligent interacting agents is how to determine that the possible exponential interactions and emergent behaviors are producing the desired results. Assuring correct behavior and interactions of swarms will be critical to mission success. The Autonomous Nano Technology Swarm (ANTS) mission is an example of one of the swarm types of missions NASA is considering. The ANTS mission will use a swarm of picospacecraft that will fly from Earth orbit to the Asteroid Belt. Using an insect colony analogy, ANTS will be composed of specialized workers for asteroid exploration. Exploration would consist of cataloguing the mass, density, morphology, and chemical composition of the asteroids, including any anomalous concentrations of specific minerals. To perform this task, ANTS would carry miniaturized instruments, such as imagers, spectrometers, and detectors. Since ANTS and other similar missions are going to consist of autonomous spacecraft that may be out of contact with the earth for extended periods of time, and have low bandwidths due to weight constraints, it will be difficult to observe improper behavior and to correct any errors after launch. Providing V&V (verification and validation) for this type of mission is new to NASA, and represents the cutting edge in system correctness, and requires higher levels of assurance than other (traditional) missions that use a single or small number of spacecraft that are deterministic in nature and have near continuous communication access. One of the highest possible levels of assurance comes from the application of formal methods. Formal methods are mathematics-based tools and techniques for specifying and verifying (software and hardware) systems. They are particularly useful for specifying complex parallel systems, such as exemplified by the ANTS mission, where the entire system is difficult for a single person to fully understand, a problem that is multiplied with multiple developers. Once written, a formal specification can be used to prove properties of a system (e.g., the underlying system will go from one state to another or not into a specific state) and check for particular types of errors (e.g., race or livelock conditions). A formal specification can also be used as input to a model checker for further validation. This report gives the results of a survey of formal methods techniques for verification and validation of space missions that use swarm technology. Multiple formal methods were evaluated to determine their effectiveness in modeling and assuring the behavior of swarms of spacecraft using the ANTS mission as an example system. This report is the first result of the project to determine formal approaches that are promising for formally specifying swarm-based systems. From this survey, the most promising approaches were selected and are discussed relative to their possible application to the ANTS mission. Future work will include the application of an integrated approach, based on the selected approaches identified in this report, to the formal specification of the ANTS mission.

Truszkowski, Walt↗