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Critical Technology Determination for Future Human Space Flight

As the National Aeronautics and Space Administration (NASA) prepares to extend human presence throughout the solar system, technical capabilities must be developed to enable long duration flights to destinations such as near Earth asteroids, Mars, and extended stays on the Moon. As part of the NASA Human Spaceflight Architecture Team, a Technology Development Assessment Team has identified a suite of critical technologies needed to support this broad range of missions. Dialog between mission planners, vehicle developers, and technologists was used to identify a minimum but sufficient set of technologies, noting that needs are created by specific mission architecture requirements, yet specific designs are enabled by technologies. Further consideration was given to the re-use of underlying technologies to cover multiple missions to effectively use scarce resources. This suite of critical technologies is expected to provide the needed base capability to enable a variety of possible destinations and missions. This paper describes the methodology used to provide an architecture-driven technology development assessment ("technology pull"), including technology advancement needs identified by trade studies encompassing a spectrum of flight elements and destination design reference missions.

Mercer, Carolyn R.

Characterization of Evidence for Human System Risk Assessment

Understanding the kinds of evidence available and using the best evidence to answer a question is critical to evidenced-based decision-making, and it requires synthesis of evidence from a variety of sources. Categorization of human system risks in spaceflight, in particular, focuses on how well the integration and interpretation of all available evidence informs the risk statement that describes the relationship between spaceflight hazards and an outcome of interest. A mature understanding and categorization of these risks requires: 1) sufficient characterization of risk, 2) sufficient knowledge to determine an acceptable level of risk (i.e., a standard), 3) development of mitigations to meet the acceptable level of risk, and 4) identification of factors affecting generalizability of the evidence to different design reference missions. In the medical research community, evidence is often ranked by increasing confidence in findings gleaned from observational and experimental research (e.g., "levels of evidence"). However, an approach based solely on aspects of experimental design is problematic in assessing human system risks for spaceflight. For spaceflight, the unique challenges and opportunities include: (1) The independent variables in most evidence are the hazards of spaceflight, such as space radiation or low gravity, which cannot be entirely duplicated in terrestrial (Earth-based) analogs, (2) Evidence is drawn from multiple sources including medical and mission operations, Lifetime Surveillance of Astronaut Health (LSAH), spaceflight research (LSDA), and relevant environmental & terrestrial databases, (3) Risk metrics based primarily on LSAH data are typically derived from available prevalence or incidence data, which may limit rigorous interpretation, (4) The timeframe for obtaining adequate spaceflight sample size (n) is very long, given the small population, (5) Randomized controlled trials are unattainable in spaceflight, (6) Collection of personal and environmental data on the astronaut population may create opportunities for advanced analytics and human-environment modeling that goes beyond that achieved in isolated experimental designs; and (7) Translation of relevant research to operations is a complex, transdisciplinary enterprise in which the approach must apply across the physical, biological, behavioral, and social sciences. The approach to synthesizing evidence must address both source and fidelity of data, and reflect the most general attributes of quality of evidence in science and engineering: reliability and validity. The authors are developing a two-factor approach which includes the various kinds of evidence required to understand risks and for the integrated interpretation of all evidence that is essential to develop standards and countermeasures. A unified framework for aggregating and assessing different kinds of evidence provides a consistent, traceable, evidence-based decision-making process to translate research to operations in an environment where engineers, scientists, physicians, and managers all engage in analyzing the trade space of vehicle design, standards, requirements and solutions for spaceflight.

Steinberg, S. L.

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

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.

Ryan A. Lacinski

Implementation of a SysML Model-Based Concept of Operations for Level of Care IV: Long-Duration Lunar Orbital and Surface Operations

One goal of the Human Research Program (HRP) Exploration Medical Capability (ExMC) Element Systems Engineering (SE) team is to define the technical system needed to support crew medical system capabilities for future exploration missions, including orbital and surface operations for long duration lunar missions. This is accomplished through the development of a Medical System Foundation, which communicates medical system requirements, capabilities, conditions, and resources that define a starting point for a medical system that meets the specification for design reference missions and associated Levels of Care (as defined by NASA-STD-3001). The starting point for creating this Medical System Foundation Model is the development of a Concept of Operations (ConOps) that describes the operation of the system from the point of view of the users. It includes a comprehensive and thoroughly vetted list of the users, their specific needs, the goals of the system, key assumptions about the system, and definitions of the system’s operational environments. The use case scenarios included in the ConOps illustrate required medical system capabilities for Level of Care IV and enable the ExMC SE team to develop integrated medical system requirements and identify capabilities required to meet those requirements. For this “Long Duration” Medical System Foundation development effort, ExMC replaced the traditional document-based ConOps with a model-based ConOps using model-based systems engineering. This approach has several advantages, including the facilitation of more efficient understanding of the material through information-dense images with less opportunity for misinterpretation than text alone, the roll-out of changes to the ConOps to stakeholders in real-time as they are approved, and the consolidation of all salient information into one centralized location. This discussion will focus on both how the model represents the ConOps content and how the SE team utilized lessons learned in an agile environment to improve the way this information was created and presented to stakeholders.

M Kaetzer

Implementation of a SysML Model-Based Concept of Operations for Level of Care IV: Long-Duration Lunar Orbital and Surface Operations

One goal of the Human Research Program (HRP) Exploration Medical Capability (ExMC) Element Systems Engineering (SE) team is to define the technical system needed to support crew medical system capabilities for future exploration missions, including orbital and surface operations for long duration lunar missions. This is accomplished through the development of a Medical System Foundation, which communicates medical system requirements, capabilities, conditions, and resources that define a starting point for a medical system that meets the specification for design reference missions and associated Levels of Care (as defined by NASA-STD-3001). The starting point for creating this Medical System Foundation Model is the development of a Concept of Operations (ConOps) that describes the operation of the system from the point of view of the users. It includes a comprehensive and thoroughly vetted list of the users, their specific needs, the goals of the system, key assumptions about the system, and definitions of the system’s operational environments. The use case scenarios included in the ConOps illustrate required medical system capabilities for Level of Care IV and enable the ExMC SE team to develop integrated medical system requirements and identify capabilities required to meet those requirements. For this “Long Duration” Medical System Foundation development effort, ExMC replaced the traditional document-based ConOps with a model-based ConOps using model-based systems engineering. This approach has several advantages, including the facilitation of more efficient understanding of the material through information-dense images with less opportunity for misinterpretation than text alone, the roll-out of changes to the ConOps to stakeholders in real-time as they are approved, and the consolidation of all salient information into one centralized location. This discussion will focus on both how the model represents the ConOps content and how the SE team utilized lessons learned in an agile environment to improve the way this information was created and presented to stakeholders.

Mary Susan Kaetzer

Design and Parametric Sizing of Deep Space Habitats Supporting NASA'S Human Space Flight Architecture Team

NASA's Human Space Flight Architecture Team (HAT) is a multi-disciplinary, cross-agency study team that conducts strategic analysis of integrated development approaches for human and robotic space exploration architectures. During each analysis cycle, HAT iterates and refines the definition of design reference missions (DRMs), which inform the definition of a set of integrated capabilities required to explore multiple destinations. An important capability identified in this capability-driven approach is habitation, which is necessary for crewmembers to live and work effectively during long duration transits to and operations at exploration destinations beyond Low Earth Orbit (LEO). This capability is captured by an element referred to as the Deep Space Habitat (DSH), which provides all equipment and resources for the functions required to support crew safety, health, and work including: life support, food preparation, waste management, sleep quarters, and housekeeping.The purpose of this paper is to describe the design of the DSH capable of supporting crew during exploration missions. First, the paper describes the functionality required in a DSH to support the HAT defined exploration missions, the parameters affecting its design, and the assumptions used in the sizing of the habitat. Then, the process used for arriving at parametric sizing estimates to support additional HAT analyses is detailed. Finally, results from the HAT Cycle C DSH sizing are presented followed by a brief description of the remaining design trades and technological advancements necessary to enable the exploration habitation capability.

Toups, Larry

Vehicle and Mission Design Options for the Human Exploration of Mars/Phobos Using "Bimodal" NTR and LANTR Propulsion

The nuclear thermal rocket (NTR) is one of the leading propulsion options for future human missions to Mars because of its high specific impulse (lsp~850-1000 s) capability and its attractive engine thrust-to-weight ratio (~3-10). To stay within the available mass and payload volume limits of a “Magnum” heavy lift vehicle, a high performance propulsion system is required for trans-Mars injection (TMI). An expendable TMI stage, powered by three 15 thousand pounds force (klbf) NTR engines is currently under consideration by NASA for its Design Reference Mission (DRM). However, because of the miniscule burnup of enriched uranium-235 during the Earth departure phase (~10 grams out of 33 kilograms in each NTR core), disposal of the TMI stage and its engines after a single use is a costly and inefficient use of this high performance stage. By reconfiguring the engines for both propulsive thrust and modest power generation (referred to as “bimodal” operation), a robust, multiple burn, “power-rich” stage with propulsive Mars capture and reuse capability is possible. A family of modular “bimodal” NTR (BNTR) vehicles are described which utilize a common “core” stage powered by three 15 klbf BNTRs that produce 50 kWe of total electrical power for crew life support, an active refrigeration / reliquification system for long term, zero-boiloff liquid hydrogen (LH 2 ) storage, and high data rate communications. An innovative, spine-like “saddle truss” design connects the core stage and payload element and is open underneath to allow supplemental “in-line” propellant tanks and contingency crew consumables to be easily jettisoned to improve vehicle performance. A “modified” DRM using BNTR transfer vehicles requires fewer transportation system elements, reduces IMLEO and mission risk, and simplifies space operations. By taking the next logical step—use of the BNTR for propulsive capture of all payload elements into Mars orbit—the power available in Mars orbit grows to 150 kWe compared to 30 kWe for the DRM. Propulsive capture also eliminates the complex, higher risk aerobraking and capture maneuver which is replaced by a simpler reentry using a standardized, lower mass “aerodescent” shell. The attractiveness of the “all BNTR” option is further increased by the substitution of the lightweight, inflatable “TransHab” module in place of the heavier, hard-shell hab module. Use of TransHab introduces the potential for propulsive recovery and reuse of the BNTR / Earth return vehicle (ERV). It also allows the crew to travel to and from Mars on the same BNTR transfer vehicle thereby cutting the duration of the ERV mission in half—from ~4.7 to 2.5 years. Finally, for difficult Mars options, such as Phobos rendezvous and sample return missions, volume (not mass) constraints limit the performance of the “all LH 2 ” BNTR stage. The use of “LOX-augmented” NTR (LANTR) engines, operating at a modest oxygen-to-hydrogen mixture ratio (MR) of 0.5, helps to increase “bulk” propellant density and total thrust during the TMI burn. On all subsequent burns, the bimodal LANTR engines operate on LH 2 only (MR=0) to maximize vehicle performance while staying within the mass limits of two Magnum launches.

Nuclear thermal rocket

Advantages of a Modular Mars Surface Habitat Approach

Early crewed Mars mission concepts developed by the National Aeronautics and Space Administration (NASA) assumed a single, large habitat would house six crew members for a 500-day Mars surface stay. At the end of the first mission, all surface equipment, including the habitat, -would be abandoned and the process would be repeated at a different Martian landing site. This work was documented in a series of NASA publications culminating with the Mars Design Reference Mission 5.0 (NASA-SP-2009-566). The Evolvable Mars Campaign (EMC) explored whether re-using surface equipment at a single landing site could be more affordable than the Apollo-style explore-abandon-repeat mission cadence. Initial EMC assumptions preserved the single, monolithic habitat, the only difference being a new requirement to reuse the surface habitat for multiple expedition crews. A trade study comparing a single large habitat versus smaller, modular habitats leaned towards the monolithic approach as more mass-efficient. More recent work has focused on the operational aspects of building up Mars surface infrastructure over multiple missions, and has identified compelling advantages of the modular approach that should be considered before making a final decision. This paper explores Mars surface mission operational concepts and integrated system analysis, and presents an argument for the modular habitat approach.

Rucker, Michelle A.

Advantages of a Modular Mars Surface Habitat Approach

Early crewed Mars mission concepts developed by the National Aeronautics and Space Administration (NASA) assumed a single, large habitat would house six crew members for a 500-day Mars surface stay. At the end of the first mission, all surface equipment?including the habitat--would be abandoned and the process would be repeated at a different Martian landing site. This work was documented in a series of NASA publications culminating with the Mars Design Reference Mission 5.0 (NASA-SP-2009-566). The Evolvable Mars Campaign (EMC) explored whether re-using surface equipment at a single landing site could be more affordable than the Apollo-style explore-abandon-repeat mission cadence. Initial EMC assumptions preserved the single, monolithic habitat?the only difference being a new requirement to reuse the surface habitat for multiple expedition crews. A trade study comparing a single large habitat versus smaller, modular habitats leaned towards the monolithic approach as more mass-efficient. More recent work has focused on the operational aspects of building up Mars surface infrastructure over multiple missions, and has identified compelling advantages of the modular approach that should be considered before making a final decision. This paper explores Mars surface mission operational concepts and integrated system analysis, and presents an argument for the modular habitat approach.

Rucker, Michelle

Vehicle and Mission Design Options for the Human Exploration of Mars/Phobos Using "Bimodal" NTR and LANTR Propulsion

The nuclear thermal rocket (NTR) is one of the leading propulsion options for future human missions to Mars because of its high specific impulse (Isp-850-1000 s) capability and its attractive engine thrust-to-weight ratio (approximately equal 3-10). To stay within the available mass and payload volume limits of a "Magnum" heavy lift vehicle, a high performance propulsion system is required for trans-Mars injection (TMI). An expendable TMI stage, powered by three 15 thousand pounds force (klbf) NTR engines is currently under consideration by NASA for its Design Reference Mission (DRM). However, because of the miniscule burnup of enriched uranium-235 during the Earth departure phase (approximately 10 grams out of 33 kilograms in each NTR core), disposal of the TMI stage and its engines after a single use is a costly and inefficient use of this high performance stage. By reconfiguring the engines for both propulsive thrust and modest power generation (referred to as "bimodal" operation), a robust, multiple burn, "power-rich" stage with propulsive Mars capture and reuse capability is possible, A family of modular "bimodal" NTR (BNTR) vehicles are described which utilize a common "core" stage powered by three 15 klbf BNTRs that produce 50 kWe of total electrical power for crew life support, an active refrigeration / reliquification system for long term, "zero-boiloff" liquid hydrogen (LH 2 ) storage, and high data rate communications. An innovative, spine-like "saddle truss" design connects the core stage and payload element and is open underneath to allow supplemental "in-line" propellant tanks and contingency crew consumables to be easily jettisoned to improve vehicle performance. A "modified" DRM using BNTR transfer vehicles requires fewer transportation system elements, reduces IMLEO and mission risk, and simplifies space operations. By taking the next logical step--use of the BNTR for propulsive capture of all payload elements into Mars orbit--the power available in Mars orbit grows to 150 kWe compared to 30 kWe for the DRM. Propulsive capture also eliminates the complex, higher risk aerobraking and capture maneuver which is replaced by a simpler reentry using a standardized, lower mass "aerodescent" shell. The attractiveness of the "all BNTR" option is further increased by the substitution of the lightweight, inflatable "TransHab" module in place of the heavier, hard-shell hab module. Use of TransHab introduces the potential for propulsive recovery and reuse of the BNTR/ERV. It also allows the crew to travel to and from Mar on the same BNTR transfer vehicle thereby cutting the duration of the ERV mission in half--from approximately 4.7 to 2.5 years. Finally, for difficult Mars options, such as Phobos rendezvous and sample return missions, volume (not mass) constraints limit the performance of the "all LH 2 " BNTR stage. The use of "LOX-augmented" NTR (LANTR) engines, operating at a modest oxygen-to-hydrogen mixutre ratio (MR) of 0.5, helps to increase "bulk" propellant density and total thrust during the TMI burn. On all subsequent burns, the bimodal LANTR engines operate on LH 2 only (MR=0) to maximize vehicle performance while staying within the lift capability of two Magnum launches.

Nuclear thermal rocket

International Space Station Evolution Data Book: Evolution Concepts - Volume 2

This report provides a focused and in-depth look at the opportunities and drivers for the enhancement and evolution of the International Space Station (ISS) during assembly and beyond the assembly complete stage. These enhancements would expand and improve the current baseline capabilities of the ISS and help to facilitate the commercialization of the ISS by the private sector. Volume 1 provides the consolidated overview of the ISS baseline systems; information on the current facilities available for pressurized and unpressurized payloads; and information on current plans for crew availability and utilization, resource timelines and margin summaries including power, thermal, and storage volumes; and an overview of the vehicle traffic model. Volume 2 includes discussions of advanced technologies being investigated for use on the ISS and potential commercial utilization activities being examined including proposed design reference missions (DRM's) and the technologies being assessed by the Pre-planned Program Improvement (P(sup 3) I) Working Group. This information is very high level and does not provide the relevant information necessary for detailed design efforts. This document is meant to educate readers on the ISS and to stimulate the generation of ideas for enhancement and utilization of the ISS, either by or for the government, academia, and commercial industry.

Jorgensen, Catherine A.

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Teresa Reiber

Development of the Suited Injury Modes and Effects Analysis for Identification of Top Injury Risks in Lunar Missions and Training

A new Exploration Extravehicular Activity Suit (xEVAS) is being designed to replace the current Extravehicular Mobility Unit (EMU) for the National Aeronautics and Space Administration’s (NASA’s) Artemis program to return astronauts to the lunar surface. This new suit will allow for increased range of motion compared the current EMU and Apollo era suits and will have additional features that will enhance the health and safety of exploration. With the design of lunar missions and the xEVAS progressing, it is important to consider possible injuries and injury mechanisms that could occur in the suit. To address these concerns, the suited Injury Modes and Effects Analysis (IMEA) was developed to outline suited injury scenarios and rank them based on risk score. The IMEA documents possible scenarios and underlying mechanisms of injury while wearing an extravehicular activity (EVA) suit. Tasks during lunar surface EVA as well as training events to prepare for lunar missions were considered as history has shown that more suit injuries occur during training than in flight. Each scenario is ranked with a consequence and likelihood scoring based on our current understanding of the suit and Artemis design reference missions to identify high-risk cases that will drive further work in suited injury. Injuries, mechanisms of injury, and mitigation strategies are evaluated within each scenario. The Suited Injury Summit was held on January 5, 2022, to vet the IMEA with external experts. This was an all-day virtual meeting with the suited injury team, ergonomists, suit engineers, safety engineers, the flight operations directorate, flight doctors, astronauts, astronaut strength, conditioning, and rehabilitation specialists (ASCRS), and external subject matter experts (SMEs). External SMEs consisted of surgeons with varying specialties. The intent of this meeting was to walk through the top injury risks identified in the analysis, identify any gaps that were not captured, and discuss mitigations. With participation from all groups, countless lessons-learned came from the Summit meeting. Using the lessons-learned and discussion from the Summit, the top 10 risks have been identified: neutral buoyancy laboratory training, hand/glove injuries, poor suit fit, field training, specific EVA tasks/design of task, boots/ankle injuries, falls from heights, background radiation, repetitive contact, and ambulation/long-distance ambulation. Mitigation steps have also been determined for each of the top risks. The IMEA and documentation of top risks is a living document. Yearly meetings are planned to update the analysis and reevaluate top risks and mitigations. The IMEA is being used to drive work in suited injury, and this work will continue to evolve with IMEA and lunar mission updates.

Tessa Reiber

Design and Application of the Exploration Maintainability Analysis Tool

Conducting human exploration missions beyond Low Earth Orbit (LEO) will present unique challenges in the areas of supportability and maintainability. The durations of proposed missions can be relatively long and re-supply of logistics, including maintenance and repair items, will be limited or non-existent. In addition, mass and volume constraints in the transportation system will limit the total amount of logistics that can be flown along with the crew. These constraints will require that new strategies be developed with regards to how spacecraft systems are designed and maintained. NASA is currently developing Design Reference Missions (DRMs) as an initial step in defining future human missions. These DRMs establish destinations and concepts of operation for future missions, and begin to define technology and capability requirements. Because of the unique supportability challenges, historical supportability data and models are not directly applicable for establishing requirements for beyond LEO missions. However, supportability requirements could have a major impact on the development of the DRMs. The mass, volume, and crew resources required to support the mission could all be first order drivers in the design of missions, elements, and operations. Therefore, there is a need for enhanced analysis capabilities to more accurately establish mass, volume, and time requirements for supporting beyond LEO missions. Additionally, as new technologies and operations are proposed to reduce these requirements, it is necessary to have accurate tools to evaluate the efficacy of those approaches. In order to improve the analysis of supportability requirements for beyond LEO missions, the Space Missions Analysis Branch at the NASA Langley Research Center is developing the Exploration Maintainability Analysis Tool (EMAT). This tool is a probabilistic simulator that evaluates the need for repair and maintenance activities during space missions and the logistics and crew requirements to support those activities. Using a Monte Carlo approach, the tool simulates potential failures in defined systems, based on established component reliabilities, and then evaluates the capability of the crew to repair those failures given a defined store of spares and maintenance items. Statistical analysis of Monte Carlo runs provides probabilistic estimates of overall mission safety and reliability. This paper will describe the operation of the EMAT, including historical data sources used to populate the model, simulation processes, and outputs. Analysis results are provided for a candidate exploration system, including baseline estimates of required sparing mass and volume. Sensitivity analysis regarding the effectiveness of proposed strategies to reduce mass and volume requirements and improve mission reliability is included in these results.

Stromgren, Chel

IMPACTing Medical System Design with a Risk Analysis Tool [“IMPACT” sur la Conception du Système Médical avec un Outil d'Analyse des Risques]

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair

IMPACTing Medical System Design with a Risk Analysis Tool

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair

Study of a High-Energy Upper Stage for Future Shuttle Missions

Space Shuttle Orbiters are likely to remain in service to 2020 or beyond for servicing the International Space Station and for launching very high value spacecraft. There is a need for a new STS-deployable upper stage that can boost certain Orbiter payloads to higher energy orbits, up to and including Earth-escape trajectories. The inventory of solid rocket motor Inertial Upper Stages has been depleted, and it is unlikely that a LOX/LH2-fueled upper stage can fly on Shuttle due to safety concerns. This paper summarizes the results of a study that investigated a low cost, low risk approach to quickly developing a new large upper stage optimized to fly on the existing Shuttle fleet. Two design reference missions (DRMs) were specified: the James Webb Space Telescope (JWST) and the Space Interferometry Mission (SIM). Two categories of upper stage propellants were examined in detail: a storable liquid propellant and a storable gel propellant. Stage subsystems 'other than propulsion were based largely on heritage hardware to minimize cost, risk and development schedule span. The paper presents the ground rules and guidelines for conducting the study, the preliminary conceptual designs margins, assessments of technology readiness/risk, potential synergy with other programs, and preliminary estimates of development and production costs and schedule spans. Although the Orbiter Columbia was baselined for the study, discussion is provided to show how the results apply to the remaining STS Orbiter fleet.

Dressler, Gordon A.

ExMC Work Prioritization Process

Last year, NASA's Human Research Program (HRP) introduced the concept of a "Path to Risk Reduction" (PRR), which will provide a roadmap that shows how the work being done within each HRP element can be mapped to reducing or closing exploration risks. Efforts are currently underway within the Exploration Medical Capability (ExMC) Element to develop a structured, repeatable process for prioritizing work utilizing decision analysis techniques and risk estimation tools. The goal of this effort is to ensure that the work done within the element maximizes risk reduction for future exploration missions in a quantifiable way and better aligns with the intent and content of the Path to Risk Reduction. The Integrated Medical Model (IMM) will be used to identify those conditions that are major contributors of medical risk for a given design reference mission. For each of these conditions, potential prevention, screening, diagnosis, and treatment methods will be identified. ExMC will then aim to prioritize its potential investments in these mitigation methods based upon their potential for risk reduction and other factors such as vehicle performance impacts, near term schedule needs, duplication with external efforts, and cost. This presentation will describe the process developed to perform this prioritization and inform investment discussions in future element planning efforts. It will also provide an overview of the required input information, types of process participants, figures of merit, and the expected outputs of the process.

Simon, Matthew