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The Innovative EDSN and Nodes Cubesat Missions

This presentation reviews and compares the Edison Demonstration of SmallSat Networks (EDSN) and Network and Operation Demonstration Satellites (Nodes) missions, launched in 2015. It highlights their onboard autonomy and its verification.

K. Michael Dalal↗

Building Identity and Community for Early Career Professionals in the Emerging Field of Astrobiology

To support training and foster retention in the emerging field of astrobiology, NASA has funded opportunities for graduate students and early career scientists to develop a community, foster interdisciplinarity, increase confidence, and showcase career options. The design of these opportunities builds on research on factors that increase retention, including feeling competent, having autonomy and a sense of purpose, having a sense of identity, and being connected to others in the field. Findings are reported from retrospective studies of two NASA career-building opportunities, the Astrobiology Graduate Conference and the International Astrobiology Summer School held in Santander, Spain. We present evidence that attendees gain confidence by presenting to, and working with, their peers, and feel competent to express their ideas and interests and build relationships in the field that continue after the experiences. Many say that they feel less isolated and go on to present or publish with colleagues they meet. Their career options also expand by meeting potential colleagues from different disciplines. Based on the findings, participating in either of these long-running programs shows clear positive impact on early career astrobiology professionals.

Early Career Researchers↗

Tradeoffs When Considering Deep Reinforcement Learning for Contingency Management in Advanced Air Mobility

Air transportation is undergoing a rapid evolution globally with the introduction of Advanced Air Mobility (AAM) and with it comes novel challenges and opportunities for transforming aviation. As AAM operations introduce increasing heterogeneity in vehicle capabilities and density, increased levels of automation are likely necessary to achieve operational safety and efficiency goals. This paper focuses on one example where increased automation has been suggested. Autonomous operations will need contingency management systems that can monitor evolving risk across a span of interrelated (or interdependent) hazards and, if necessary, execute appropriate control interventions via supervised or automated decision making. Accommodating this complex environment may require automated functions (autonomy) that apply artificial intelligence (AI) techniques that can adapt and respond to a quickly changing environment. This paper explores the use of Deep Reinforcement Learning (DRL) which has shown promising performance in complex and high-dimensional environments where the objective can be constructed as a sequential decision-making problem. An extension of a prior formulation of the contingency management problem as a Markov Decision Process (MDP) is presented and uses a DRL framework to train agents that mitigate hazards present in the simulation environment. A comparison of these learning-based agents and classical techniques is presented in terms of their performance, verification difficulties, and development process.

machine learning↗

ENLIGHTEN: Electrical Network Line Inspection Guided by High-Speed Technology & Electromagnetic Navigation

Natural disasters are a major cause of power outages, primarily due to their damage to power line infrastructure. As a result, the current state of power maintenance, with a heavy reliance on manual labor, is in trouble. Its lack of speed and autonomy must be addressed to ensure power security for households and institutions worldwide. This innovative approach explores how High-Speed Unmanned Aerial Vehicle (HSUAV) technology can inspect power line infrastructure rapidly in response to natural disaster scenarios. The HSUAV technology will be accompanied by enhanced sensory equipment including light detection and ranging (LiDAR), thermal imaging, and electromagnetic field (EMF) navigation. It would also be supplemented by innovative forms of machine learning models and recharging systems to efficiently detect anomalies in power line infrastructure. The proposed system, ENLIGHTEN, can help restore power in affected communities after a devastating natural disaster, greatly improving relief efforts. In the future, ENLIGHTEN can be expanded beyond the United States and shared worldwide, effectively mitigating the consequences on a larger scale.

UAV systems, Power line management, Natural disast↗

Uncrewed Aerial Systems for Emergency Medical First Response: A Market Research Report

This report presents the findings from market research conducted for NASA’s Aerial Aid Convergent Aeronautics Solutions (CAS) exploration project, which aims to assess the current state of the market and technological readiness for Uncrewed Aerial Systems (UAS) for medical emergency first response. The research reveals a robust and rapidly growing market for UAS, with a notable emerging sector for Drones as First Responders (DFR). Despite this growth, DFR applications are currently limited by regulatory, technical, and other challenges, which restrict their use primarily to manned remote video surveillance, and therefore are primarily employed by police units. To our knowledge, there is no evidence of UAS being utilized by medical first responders for scene assessment. Limited evidence exists for closely related applications; however, these are mostly confined to pilot programs for the delivery of medical supplies or equipment. Although there has been discussion around fully autonomous DFR applications for medical purposes such as UAS ambulances or patient transport drones, these applications are generally not yet operational in practice. The technology for full autonomy, especially in guidance and control, has seen significant advancements, and recent Federal Aviation Administration (FAA)regulations are likely to accelerate adoption. Computer vision algorithms for fully autonomous medical emergency response scene surveillance are primed for advancement and deployment. A notable gap likely exists between advancements in computer vision research and what is being integrated in the commercial DFR sector. This gap is primarily due to challenges such as quality assurance for autonomous systems, the availability of application-specific training datasets for computer vision algorithms, regulatory constraints, and public perception and privacy concerns.

Joshua M Fody↗

Developing Mars-Based Clinical Scenarios for an Earth Independent Medical Operations (EIMO) – Based Decision Support Service

As crewed missions move beyond Low-Earth Orbit, pre-mission planning cannot fully buy down the medical risks of exploration-class missions. Martian missions, where increased hazards exist, (such as long-duration spaceflight, surface-level EVA operations, and communications delays) will require a paradigm shift in the structure of a medical system. An Earth-Independent Medical Operations-based Medical System (EIMO-MS) will need to optimize four critical domains to help provide medical care: utilization of Pre-Mission Planning, augmentation of Acute and Prolonged Medical Decision Making, automated tracking of Resource Management, and assistance in Task Load Balance. The ideal EIMO-MS will be able to accomplish this goal by having an interactive, adaptable interface that will be able to provide real-time medical services. It must respond based on the level of crewmember training, medical situation, and available medical and non-medical resources. To showcase the capabilities and requirements of such a sophisticated automated MS, a series of clinical scenarios of escalating complexity were developed with clinical and systems engineering input. These scenarios describe in clinical detail what a theoretical future medical system, enhanced with multiple information streams (such as a medical database, an AI-based Decision Support System, real-time monitoring, enhanced in-situ laboratory imaging, etc.) can achieve in conjunction with a trained and experienced crew. Scenarios are comprised of: a context section including objectives and applicable spaceflight environment, a highlighted assumptions section, a clinical narrative section, and a systems engineering activity diagram demonstrating the integrated Medical System (MS). The “swim lanes” of the activity diagram act as the logistical core of each scenario and show how the MS will interact with the crew, ground support, and other in-flight systems. The Design Reference Mission that is used for the scenarios is based on existing reference mission profiles [1] with a projected 30-sol stay on the Martian surface. Scenarios span the spectrum from planned evaluations, minor medical care, urgent care, surgical guidance, critical and expectant management, and behavioral health care. Mission complexity will exponentially increase during deep space and Mars exploration-class missions, and medical support for these missions will likewise need to increase in autonomy and adaptability. The integrated system that will support these missions will need to provide assistance in a variety of anticipated and unforeseen scenarios. These medical scenarios, guided by clinician input, are initial steps in crafting the requirements for an EIMO-based medical system. By working in a systems engineering framework, requirements and capabilities can be extracted and mapped while maintaining a clinical core.

Prashant Parmar↗

Objective Structured Clinical Evaluation (OSCE) of an Artificial Intelligence (AI) Clinical Decision Support System (CDSS) Tool

BACKGROUND Objective Structured Clinical Evaluations (OSCEs) have long been established as a robust methodology for summative assessment of clinical skills and decision-making during medical education. The recent integration of Artificial Intelligence (AI) into clinical decision-making processes has prompted the need for novel evaluation frameworks to assess the efficacy and reliability of AI clinical decision support system (CDSS) tools. This abstract outlines the process of quantitatively evaluating a novel CDSS (“Doc in a Box” Google 2024) trained on curated medical spaceflight data in the psychomotor domain as it interfaces with a human volunteer acting as the crew medical officer (CMO). PURPOSE The AI CDSS under review was developed as part of the Lunar Command and Control Interoperability (LuCCI) project, which is intended to address a gap in how Lunar Surface Systems (LSS) would interoperate across multiple programs, commercial partners, and international partners. The project objective is to define, prototype, integrate, and evaluate an interoperable lunar command, control, data, and software reference architecture to enable autonomy and informatics capability through common standards across LSS. A multi-modal AI-based CDSS compatible with Federated LSS will assist clinicians in diagnosing and managing complex medical conditions by providing evidence-based recommendations through predictive analytics. Given the critical role of decision-support as NASA continues to evolve its Earth-independent medical operations (EIMO), it is imperative to ensure that such AI tools perform reliably and align with clinical standards during progressive lunar and Martian exploration class missions. METHODS The OSCE framework, traditionally used for evaluating human clinicians, was adapted to assess the AI tool's decision-making capabilities in simulated clinical scenarios. In this adapted OSCE, the AI CDSS was tested across a series of structured clinical scenarios designed to mimic real-life spaceflight patient cases. These scenarios included a range of conditions and complexities, allowing for comprehensive assessment of the tool's performance. Key evaluation metrics included accuracy of diagnosis, timeliness of decision-making, and appropriate recommendations for therapies. The OSCE was scored by human physician evaluators who assessed the AI's recommendations in comparison with expert clinicians' medical decision making to ensure alignment with best practices and the standard of care. RESULTS Preliminary results indicate that the AI CDSS demonstrated high accuracy in diagnostic recommendations and decision support across various scenarios. However, certain limitations were noted, such as occasional discrepancies in handling complex or nuanced cases that required a more contextual understanding. Additionally, the tool scored higher on the diagnostic portion of the rubric, with lower scores in the therapeutic recommendations. These findings highlight the importance of continuous refinement and validation of AI tools through rigorous evaluation frameworks like the OSCE. The adaptation of OSCEs for AI tools presents several advantages, including a structured and reproducible approach to evaluation, the ability to test AI systems in diverse clinical scenarios, and the opportunity to benchmark AI performance against established clinical standards to permit charting of future progress as aerospace medicine evolves as a discipline. Remaining challenges include ensuring that these evaluations capture the full spectrum of clinical decision-making scenarios that will be confronted by CMOs during missions and adequately reflecting real-world variability of the austere spaceflight environment. CONCLUSION Employing OSCEs to evaluate AI clinical decision support tools offers a promising approach to validating their clinical utility and efficacy. This methodology not only provides insights into the tool's performance but also fosters ongoing improvement and alignment with standard of care practices. Future research should focus on refining these evaluation processes and addressing limitations to enhance the integration of AI tools in clinical spaceflight settings. REFERENCES Scott S, Hearns V, Barker MA. Testing Clinical Skills: A Look at the OSCE and USMLE Clinical Skills Exams. S D Med. 2019 Oct;72(10):451-453. Majumder MAA, Kumar A, Krishnamurthy K, Ojeh N, Adams OP, Sa B. An evaluative study of objective structured clinical examination (OSCE): students and examiners perspectives. Adv Med Educ Pract. 2019 Jun 5;10:387-397. Karam VY, Park YS, Tekian A, Youssef N. Evaluating the validity evidence of an OSCE: results from a new medical school. BMC Med Educ. 2018 Dec 20;18(1):313.

Ariana M Nelson↗

Expanding Ketamine Application for Treatment of Acute Suicidality in Long-Duration Spaceflight

Introduction. The transition to exploration missions places a heightened risk on behavioral health in spaceflight. Although serious psychiatric emergencies during spaceflight have been rare, longer duration missions increase the possibility of emergence in latent mental health disorders due to genetic predisposition, increased autonomy, isolation, helplessness, loss of family member, or catastrophic events. Complicated grief and bereavement have the highest rate of suicidal ideation. Recently, ketamine has been used as an emergent intervention for acute suicidality, promoting its stability, ease of administration, favorable safety profile, and outcomes for reduction of suicidal intent. The goal of this study was to review current literature and collate the understanding of ketamine as a safe, effective pharmacological adjunct for acute suicidality in spaceflight. Methods. This literature review was conducted to collate data on ketamine use for acute suicidality and inform on stability, limitations and utilization of ketamine within extreme environments. Results. 122 publications were reviewed for relevance including 23 randomized-control trials for ketamine use in behavioral emergencies. Discussion. Ketamine is a diverse pharmaceutical with multiple advantageous indications, including acute suicidality, pain, and sedation. Terrestrial use of ketamine suggests a rapidly efficacious medication for reduction in acute suicidality. As behavioral stressors expand related to extended missions, contingencies for behavioral emergencies become increasingly important. Although this review is not intended to re-develop current International Space Station (ISS) protocols, it is the first to discuss the benefits of ketamine in spaceflight as a potential safe, effective multifaceted tool for future exploration missions and treatment for acute suicidal ideation.

Ketamine, Suicidality, Spaceflight↗

Development and Validation of Sensorimotor Assessment Tasks Using Spaceflight Analogs

INTRODUCTION Exploration class missions will require a new level of crew autonomy to self-assess and treat their sensorimotor dysfunction around periods of gravitational transition, where sensorimotor disturbances are at their highest. There is a need to define sensorimotor assessment thresholds that indicate when performance in early extravehicular activities (EVAs) might be impacted or unsafe. The purpose of this study was to develop and validate a set of assessment tasks using sensorimotor spaceflight analogs including the Sensorimotor Disorientation Analog (SDA) and +3G x sustained centrifugation. METHODS For the SDA, forty-one healthy non-astronaut subjects (21 males, 20 females; Mean ± SD, Age: 34.0 ± 7.8 years) volunteered to participate in this study. Subjects attended two testing sessions: 1) familiarization to the tasks and baseline data collection, and 2) tasks completed under two levels of sensorimotor disorientation. Subjects performed a series of seven sensorimotor assessment tasks followed by two operationally relevant EVA analog tasks. The sensorimotor assessments tasks, ordered from least to most provocative of the sensorimotor system, included: postural stability, step test, prone/supine recovery from fall (RFF), four-square-step-test, obstacle negotiation with turns (OTT), kneel-and-reach, and augmented reality full-body coordination. The operational analog tasks included a top-hatch capsule egress and a 5-minute EVA traversal. Disorientation was applied via the SDA which utilized galvanic vestibular stimulation and weighted trunk, wrists, and ankles to target the vestibular and proprioceptive systems such that performance while wearing the SDA mimicked astronaut postflight performance at R+0 and R+1. Sixteen healthy non-astronaut subjects (10 males, 6 females; Age: 35.0 ± 9.5 years) completed +3G x 60-minute sustained centrifugation as an established spaceflight analog replicating the vestibular disruptions seen postflight. Subjects completed a pre-session which included familiarization to the tasks and a 5-minute centrifuge spin. The data collection session included, in order, a baseline data collection, 60-minute centrifuge spin, immediate post-centrifuge data collection, 45-minute seated recovery, and a final data collection. The same assessment and operational analog tasks were conducted as described above. RESULTS Pearsons’ correlation r-values were calculated between assessment and operational analog tasks. The two assessment tasks with the strongest correlations to the operational analog tasks were the RFF (SDA: r≥ 0.57, Centrifuge: r ≥0.55) and OTT (SDA: r≥ 0.66, Centrifuge: r ≥ 0.49). For brevity, repeated measures ANOVA with follow-up paired t-tests are discussed for these two assessment tasks. The SDA found significant differences between all three levels of disorientation for both RFF and OTT (p < 0.001). Significant differences were also found between baseline and immediate post centrifuge testing for both the RFF (p≤ 0.011) and OTT (p = 0.001). Additional results are forthcoming for both disorientation paradigms. DISCUSSION These validation studies provide evidence for down-selection of the assessment tasks that were able to distinguish between levels of sensorimotor disorientation and correlate to performance in operationally relevant tasks for use in upcoming Artemis missions.

S C Moudy↗

Federal USS Synthesis Effort: 2023 Flight Test Report. A NASA and Department of Defense Joint Evaluation of Multi-Domain Airspace Integration

In recent years, advancements in technology have greatly improved the utility and applicability of Uncrewed Aircraft Systems (UAS) and have highlighted the need for and importance of UAS Traffic Management (UTM). Onboard sense and avoid systems, ground-based sensors, and long- range command and control (C2) systems have significantly expanded the possibilities for UAS beyond visual line of sight (BVLOS) operations. Initially, research on UTM flights focused on their interactions with other UTM operations, but that has since been expanded to include interactions with the flight profiles of Advanced Air Mobility (AAM) and upper Class E Traffic Management (ETM) operations. Recognizing the potential of these systems and the increase in UAS autonomy, the Department of Defense (DoD) is working towards integrating these missions and systems into a unified DoD Federal ecosystem. The Federal USS Synthesis Effort (FUSE) aims to develop a live system that can efficiently combine this wide range of UTM, AAM, and ETM systems, thus enabling expanded operations within a single common operating environment. The goal of the Federal USS Synthesis Effort (FUSE) is for NASA and the DoD to develop a live system that can efficiently combine UTM, AAM, and ETM systems. The most recent endeavor in this effort was a live flight test conducted near Grand Forks Air Force Base in June, 2023, where the FUSE ecosystem successfully demonstrated integrating UTM, AAM, and ETM operations while providing a single, shared COP to users. Additional investigations were made during the test, including assessing the usefulness of the system and its capability to support UAS weighing over 55 lbs.; testing user messaging capabilities and a DoD adaptation of a Federal USS; and assessing user workload, automated vs manual control, and the usability of NASA’s XTMClient.

Federal USS↗

Towards Computational Functional Hazard Assessment (CFHA): A Gap Analysis and Concept for Emerging Aviation Systems

Given the current evolution of the National Airspace and future trajectory towards novel and evolving operations with varying levels of autonomy, complexity, and acceptable risk, there is an opportunity to support safety assurance by extending existing methodologies, such as Functional Hazard Assessment (FHA). In response to challenges in performing FHA for novel aviation concepts, we propose a concept for Computational Functional Hazard Assessment (CFHA), which provides processes, methods, and tools for incorporating external data to facilitate further exploration of the hazard space iterativelty throughout the design process. The core components of CFHA involve knowledge capture from historical and operational data, functional architecture specification via a formal modeling language, and simulation for hazardous scenario analysis. Through this concept, we aim to adapt conventional safety assessment to address the increasingly complex hazard space generated from emerging operations.

Seydou Mbaye↗

m:N Operations High Complexity Simulation

The Human Autonomy Teaming Laboratory at NASA Ames Research Center (ARC) is planning to conduct an experiment investigating system-level effects operational vertiport disruptions on Urban Air Mobility (UAM) traffic in a simulated vertiport network in Denver, CO. The simulation will involve two parties, one at NASA ARC and another at NASA Langley Research Center (LaRC), each playing the role of a UAM Operator. This study, referred to as the "High Complexity Sim," features a 3-by-2-by-2 mixed subjects design. The variables to be manipulated are the scale of the disruption (Disruption, three levels: Small, Medium, and Large, affecting 1, 2, and 3+, vertiports, respectively), m:N ratio (Ratio, two levels: 2:6 and 2:12), and the assumption of UAM corridors (Corridors, two levels: With and Without). Local and system-wide capacity (i.e., throughput), efficiency (scale and number of flight delays, filed-vs-flown flight times), and human performance metrics (workload, situation awareness, heart rate/heart rate variability, eye gaze/fixation and saccades, stress) will be measured. This presentation details the experimental design and planned timeline for the study.

multi-vehicle↗

Preliminary Development of Multi-Vehicle (m:N) Operations with NASA Langley’s Remote Vehicle Operations Center

To achieve the vision of Advanced Air Mobility (AAM), a transition from localized operations of aircraft to remote operations is being pursued across many use cases. This transition will allow fewer human operators to manage more increasingly autonomous aircraft (i.e., m operators managing N vehicles, or m:N). To study this operational concept, the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) has developed a prototype remote vehicle operations center and ground control station (GCS) software to conduct research with simulated and real flight operations. To date, flight operations at LaRC have been limited to one vehicle per operator. However, the current paper describes initial development and considerations for enabling m:N flight operations at LaRC. Further, the research described in this paper provides the foundation for a concept of operations (ConOps) that will be developed to support remote operators managing multiple increasingly autonomous vehicles, with the goal of exploring human-autonomy teaming (HAT) concepts that enable more advanced m:N operations. Two key enablers have been identified to facilitate successful m:N operations: GCS software updates for multi-vehicle management and procedural updates for vehicle handoffs during off-nominal events. Additionally, specific modifications were identified across five key areas: technology and software, team structure, inter-team communication, contingency plans, and operator decision flows. Next steps in forming the LaRC m:N ConOps will include working with subject-matter experts to identify off-nominal scenarios, implementing the recommended GCS functionality for m:N operations, and performing integration testing of facility capabilities and new operational procedures. Although the future m:N ConOps will be tailored to the NASA LaRC remote operations facility and flight range, it is intended to be a transparent, accessible, and reality-based exemplar for external organizations seeking to create or evaluate their own m:N operational concepts.

m:N↗

EdgeCortix SAKURA-I Machine-Learning, PCIe Accelerator SEE Heavy Ion Test Report

To enable autonomy in space, machine-learning and computer vision applications become invaluable for sensor processing. However, these algorithms are computationally complex and unfeasible for many embedded central processing units (CPUs) and usually require external coprocessors, such as graphics processing units (GPUs) or accelerators specific to the application, including application specific integrated circuits (ASICs). In power-constrained systems, GPUs tend to consume more power than is acceptable (>40W), so lower-power accelerators have shown promise to provide the performance needed under spacecraft constraints. For radiation engineers, developing methodologies that can properly test CPUs, GPUs, and accelerators, and enable comparisons between them remains a necessary complication to solve as the devices become more complex. The methodology in this test aims to be a start in developing a baseline single-event effect (SEE) test for client-device machine learning accelerators. This category of devices do not host their own operating system. This testing campaign is a continuation of a previous 200 MeV proton test performed in January 2024. This report covers two heavy ion tests of the SAKURA-I card: one in April 2024, and one in June 2024. Additional data was needed after the April test due to ion-range issues experienced at higher linear-energy transfers (LETs). These range issues are described in more detail in Section 8. This experiment characterizes SEEs and data error susceptibility of the EdgeCortix SAKURA-I machine-learning accelerator under heavy ions. The device was monitored for single event upsets (SEUs) and single event functional interrupts (SEFIs) at the Lawrence Berkeley National Laboratory’s 88-inch cyclotron. The SAKURA-I board accelerates machine-learning inference applications on a host computer through a PCIex16 connection. For the purposes of devising an end to end automated analysis workflow for this experiment, the YOLO-V5 and SSD300 objection-detection models, and the ResNet-50, EfficientNet, and MobileNetV2 image classification models were used as a representative suite of analytical machine-learning models.

Seth S Roffe↗

Towards Functional Hazard Assessment (CFHA): A Gap Analysis and Concept for Emerging Aviation Systems

Given the current evolution of the National Airspace and future trajectory towards novel and evolving operations with varying levels of autonomy, complexity, and acceptable risk, there is an opportunity to support safety assurance by extending existing methodologies, such as Functional Hazard Assessment (FHA). In response to challenges in performing FHA for novel aviation concepts, we propose a concept for Computational Functional Hazard Assessment (CFHA), which provides processes, methods, and tools for incorporating external data to facilitate further exploration of the hazard space iterativelty throughout the design process. The core components of CFHA involve knowledge capture from historical and operational data, functional architecture specification via a formal modeling language, and simulation for hazardous scenario analysis. Through this concept, we aim to adapt conventional safety assessment to address the increasingly complex hazard space generated from emerging operations.

Seydou Mbaye↗

Refinement of Selection of a Campaign of Analog Subjects for NASA Human Exploration Research Analog

The NASA Research Operations and Integration (ROI) Human Exploration Research Analog (HERA) is a 650-square foot habitat that supports isolation and confinement research topics including behavioral health and performance, team dynamics, and autonomy studies. Campaign 6 (C6), a complement of fifteen science experiments and operational tasks was a simulated mission to the Mars moon Phobos. For Campaign 7 (C7), the most recent HERA campaign, a complement of eighteen science experiments and operational tasks were completed by four crew members over a 45-day simulated mission to Mars. Prior to each mission, a crew of 4 primary crew members and 2 alternates are selected from a pool of candidates. Applicants must meet astronaut-like criteria and be composed of an equal gender ratio. After a comprehensive screening and interview process the crew and alternates are selected.

M J Maciejewski↗

Innovative Drug Selection, Storage, and Shelf-Life Strategies for Exploration Spaceflight

Medications have been a part of space travel dating back to the Apollo missions. A safe and effective medication formulary is essential to maintaining crew health and performance during long-duration spaceflight outside of low Earth orbit (LEO). Distance from Earth creates four key operational changes that increase medical risks, including communication, resupply, crewmember health, and evacuation. The current spaceflight pharmaceutical formulary consists of medications indicated to treat a variety of anticipated medical events and healthcare needs during spaceflight, but depends on a robust consumables resupply chain, which may be strained for a Lunar, and possibly non-existent for a Mars mission. The specific medications selections for the formulary may change to optimally align with the mission, crew compliment, and spacecraft design. Medical support at long-duration exploration missions will differ from LEO missions due to mission duration, lack of consumables resupply, prolonged exposure to space radiation, and the absence of emergency medical return capability. Loss of medication resupply limits or removes the ability to replace medications that have been exhausted or degraded, potentially exacerbating the medical risk posture. To address these anticipated risks, long-duration missions must consider use of novel medical technologies, treatment modalities, and smart medical systems that offer greater crew autonomy, such as physiologically based pharmacokinetic modeling, drug repurposing, on demand drug synthesis, or wearable drug delivery / monitoring devices. Once an ideal formulary for exploration space is determined, it is essential to establish the chemical and physical stability of each medication compound, as well as its safety by identifying its degradation profiles and products. Although few studies have been conducted to provide evidence on the physicochemical stability of pharmaceuticals during space missions, the data suggests that the spaceflight environment may promote degradation in some pharmaceuticals. Formulary drug purity and efficacy should be verified by pharmaceutical stability assessments, and can be realized non-destructively, and accessed in remote environments. Non-destructive pharmaceutical analysis and statistical modelling techniques could optimize exploration spaceflight medical care by enabling early detection of suboptimal therapeutics. Likewise, novel packaging, storage strategies, and dosage form innovations are promising countermeasures to optimize pharmaceutical shelf life, purity, and quality of exploration spaceflight medications. As we prepare for more distant exploration missions, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. Following extensive review of the literature, we will present innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

Vernie R Daniels↗