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Earth-Independent Medical Operations (EIMO) Concept of Operations

In contrast to the current crew health paradigm for low-Earth orbit and Lunar missions, which depends on real-time communication with Mission Control, deep-space exploration missions will require a significant shift in medical operations. This shift is driven by the constraints of operating at a considerable distance from Earth, such as resource limitations—lack of resupply, restricted mass, power, volume, and data—as well as communication delays and the inability to evacuate back to Earth during emergencies. To move toward a more self-reliant medical model, a strategy is needed to gradually increase space-based crew autonomy and reduce risks to mission success in the challenging environment of deep space. This transformative change, known as "Earth-Independent Medical Operations" (EIMO), explores the gradual transfer of medical care and decision-making from Earth-based support to space-based systems. The goal of this transition is to enhance astronaut health and performance while minimizing mission risks. EIMO requires the development of a medical system that integrates seamlessly with mission planning, vehicle and spacesuit design, and data architecture. This integration is crucial for building a robust medical infrastructure that not only safeguards astronaut well-being but also ensures overall mission success. The Human Research Program (HRP) Exploration Medical Capability (ExMC) Element has revised the EIMO model-based Concept of Operations (ConOps) which outlines an initial vision for EIMO. The ConOps, which is built on the stakeholders’ need, system goals, and objectives (NGOs), presents an array of in-mission scenarios that span a wide range of medical conditions demonstrating the system’s capabilities from basic to complex events. Developed by a multidisciplinary team of systems engineers, scientists, and clinicians within ExMC, the ConOps revision includes two new scenarios(Barotrauma and Self-Medical Management and Behavioral Health and Chronic Medical Care), and implementation of findings from EIMO technical interchange meetings that focused on data and training. The envisioned EIMO Medical System (MS) operates as a system of systems, gathering data from various sources such as reference databases, real-time wearable sensors, point-of-care diagnostics, and environmental controls. The MS also incorporates advanced training tools to support autonomous medical care, assisting the Crew Medical Officer (CMO) during medical events where Ground Support is either unavailable or communication-delayed beyond practicality. Furthermore, MS functions and capabilities were decomposed from the scenarios to establish foundational requirements for EIMO and traced to the NASA Spaceflight Human-System Standard(NASA-STD-3001, Volumes 1 and 2). These traces were performed to gain insights on the alignment of EIMO requirements with the NASA standard. This work serves as an initial recommendation to increase crew autonomy gradually and safely for Mars missions and future deep-space exploration.

medical system↗

Wearable Health Monitoring Systems

The shrinking size and weight of electronic circuitry has given rise to a new generation of smart clothing that enables biological data to be measured and transmitted. As the variation in the number and type of deployable devices and sensors increases, technology must allow their seamless integration so they can be electrically powered, operated, and recharged over a digital pathway. Nyx Illuminated Clothing Company has developed a lightweight health monitoring system that integrates medical sensors, electrodes, electrical connections, circuits, and a power supply into a single wearable assembly. The system is comfortable, bendable in three dimensions, durable, waterproof, and washable. The innovation will allow astronaut health monitoring in a variety of real-time scenarios, with data stored in digital memory for later use in a medical database. Potential commercial uses are numerous, as the technology enables medical personnel to noninvasively monitor patient vital signs in a multitude of health care settings and applications.

Bell, John↗

Summary of Technical Interchange Meetings (TIMs) Designed to Enable Earth Independent Medical Operations (EIMO)

The Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program hosted a series of TIMs in 2023-2024 designed to stimulate discussion around specific topics with the goal of enabling EIMO. In context of the thematic constituent elements of EIMO, namely pre-mission planning, acute/emergent/prolonged medical decision making, supply/resource management and task load management, subject matter experts from industry, academia and government (NASA and other Agencies) provided valuable and actionable guidance and recommendations. Earth-based medical experts will remain indispensable for pre-mission planning, however, management of acute/emergent medical contingencies will require a gradual transition of medical care and decision making from terrestrial to space-based assets to enable support of astronaut health and performance and reduce overall mission risk. Key to achieving these enhancements is providing an integrated data system platform capable of utilizing multiple data streams in concert with a variety of on-board databases and passive monitoring of video and wearable sensors to enable a multi-modal, agentic AI-based clinical decision support system (CDSS) to support crew medical officer (CMO) medical decision-making. The EIMO series of TIMs (I-V) have proven to be instructive and portend a significant paradigm shift will be necessary to maintain crew health and performance on exploration class missions. Importantly, since the expected paradigm shift will be significantly different from the methods of operation that have been employed for the majority of missions from the inception of human spaceflight to date, any proposed methods must be deployed in the setting of ongoing operations early and be “tested, reviewed and practiced” while reliable back-up is available to facilitate an Enterprise-wide level of comfort and acceptance. Serious constraints on data transmission coupled with a large and expanding universe of on-board medical informatics data streams will necessitate implementation of a CDSS to supplant the current reliance on support provided by ground-based SMEs. Establishment of trust in the system by CMO/crew and the ground-based medical support team will be essential. Co-development of a CDSS with industry partners will assure that state of the art tools can be employed, and industry efficiencies can be leveraged. Training regimens, materials and tools must evolve to be responsive (just-in-time training) and facilitate autonomous execution of procedures. Proficiency metrics should be established and be based on validated competencies or milestones as opposed to a prescribed number of training hours. Training should be prioritized for broad, translatable skills that have universal application across a variety of medical conditions. Repetition was deemed to be the key to achieving proficiency and emphasis should lie in procedural training which is known to extinguish more rapidly than diagnostic skills. Advanced tools, e.g., extended reality, can provide more realistic and effective training. Use of advanced probabilistic risk assessment tools will be essential to optimize the medical system capability while carefully balancing risk relative to mass/power/volume limitations. Importance of factoring use-life of medical supplies and maintaining awareness of redundancy and opportunity to re-purpose under off nominal situations was emphasized. Consideration of adopting optimized performance standards vs. “good-enough” performance thresholds is warranted. The use of legacy systems as opposed to creating new systems may be preferable. Managing task load and associated cognitive load will be essential to maintain operational safety and behavioral health. ExMC aspires to create a shared EIMO paradigm and strategic vision for advancing medical system design through novel technologies, training, protocols, and support capabilities, built upon the spirit of successful strategies and innovations over the past six decades of space medicine operations.

Jay Lemery↗

Wearable Biosensor Monitor to Support Autonomous Crew Health and Readiness to Perform

For future human exploration missions, NASA needs a health monitoring system composed of hardware that is compact, fully interoperable with an integrated data management system, and requires minimal consumables. Such a system will be achieved through the integration of small, easy to use biomedical sensors that will have the ability to measure, store and transmit physiological parameters during operational and ambulatory activity. Since 2012, the Canadian Space Agency (CSA) has been active in funding the development of wearable biomonitoring sensors. The Astroskin is the first prototype and consists of a shirt-based garment and headband with embedded sensors, and associated software and technology that measure vital signs, sleep quality and activity level of the wearer. NASA and CSA have been collaborating since 2014 to test and validate this system in a lab environment at Ames Research Center and more recently in the Human Exploration Research Analog (HERA) located at Johnson Spaceflight Center. Specific objectives of the HERA study were: 1) to assess the performance of the Astroskin biosensor system for long-term health monitoring (24-hours) capabilities and during exercise as a measure of crew fitness; 2) to obtain crew feedback on comfort and usability of the Astroskin system; 3) to demonstrate performance of Bluetooth communication during real-time transmission and for verification of data in this environment; and 4) to obtain baseline data for further development of algorithms and tools that facilitate decision support for diagnosing and monitoring of a sick or injured crewmember. HERA Campaign 3 included four missions (each 30-days in duration) with four crewmembers assigned to each mission. A total of 9 men and 7 women participated in the Astroskin evaluation that included continuous physiological monitoring (24-hours) on mission days MD-11, MD1 (high workload), MD15 (low workload), MD19, MD29, and MD+7. Mission days 19 and 29 also included 30 minutes of sub-maximal exercise on a cycle ergometer. Following each 24-hour monitoring session crew physiological data were downloaded to laptops and each crewmember completed a 28 question survey on their experiences with the Astroskin hardware and software. This presentation will focus on lessons learned from the HERA missions. Specifically it will address Astroskin system performance in terms of data loss and data quality (no comparison to lab standard devices), wireless communication with the onboard mobile device, crew usability and comfort, and future development of a next generation biomonitoring system.

crew fitness↗

Integrated Ultra-Wideband Tracking and Carbon Dioxide Sensing System Design for International Space Station Applications

A three-dimensional (3D) Ultra-Wideband (UWB) Time-of-Arrival (TOA) tracking system has been studied at NASA Johnson Space Center (JSC) to provide the tracking capability inside the International Space Station (ISS) modules for various applications. One of applications is to locate and report the location where crew experienced possible high level of carbon-dioxide (CO2) and felt upset. Recent findings indicate that frequent, short-term crew exposure to elevated CO2 levels combined with other physiological impacts of microgravity may lead to a number of detrimental effects, including loss of vision. To evaluate the risks associated with transient elevated CO2 levels and design effective countermeasures, doctors must have access to frequent CO2 measurements in the immediate vicinity of individual crew members along with simultaneous measurements of their location in the space environment. To achieve this goal, a small, low-power, wearable system that integrates an accurate CO2 sensor with an ultra-wideband (UWB) radio capable of real-time location estimation and data communication is proposed. This system would be worn by crew members or mounted on a free-flyer and would automatically gather and transmit sampled sensor data tagged with real-time, high-resolution location information. Under the current proposed effort, a breadboard prototype of such a system has been developed. Although the initial effort is targeted to CO2 monitoring, the concept is applicable to other types of sensors. For the initial effort, a micro-controller is leveraged to integrate a low-power CO2 sensor with a commercially available UWB radio system with ranging capability. In order to accurately locate those places in a multipath intensive environment like ISS modules, it requires a robust real-time location system (RTLS) which can provide the required accuracy and update rate. A 3D UWB TOA tracking system with two-way ranging has been proposed and studied. The designed system will be tested in the Wireless Habitat Testbed which simulates the ISS module environment. This report describes the research and development effort for this prototype integrated UWB tracking and CO2 sensing system. The remainder of the report is organized as follows. In Section II, the TOA tracking methodology is introduced and the 3D tracking algorithm is derived. The simulation results are discussed in Section III. In Section VI, prototype system design and field tests are discussed. Some concluding remarks and future works are presented in Section V.

Ni, Jianjun (David)↗

Additively Printed Flexible Temperature Sensor for Wearable Applications

The flexible sensor has the capability to be mounted on any curved surfaces of applications and be used for portable devices. Additively printed sensors have received attention owing to their compact design and ability of application to non-planar surfaces. Wearable applications require capability of integration into a variety of surfaces with ability to flex, fold, twist and stretch under the stresses of daily motion. There is scarcity of data on the interaction of the process parameters with the realized performance. In addition, there is need for data focused on sensor accuracy, repeatability, and reliability. In this study, experimental analysis on function of the fabricated sensing board is conducted. The temperature sensors are made by direct write printing method with nScrypt printer. A calibration of the sensors has been conducted to confirm that resistance is well related to actual temperature and find TCR (temperature coefficient to resistance). The evolution of resistance has been correlated with the environmental temperature. The sensor hysteresis has been quantified using upswing and downswing of the environmental temperature. In addition, the effect of humidity on the temperature sensor accuracy and performance has been quantified. The effect of a polymide coat on the sensor to prevent humidity effects has also been quantified.

Pradeep Lall↗

Medical Signal-Conditioning and Data-Interface System

A general-purpose portable, wearable electronic signal-conditioning and data-interface system is being developed for medical applications. The system can acquire multiple physiological signals (e.g., electrocardiographic, electroencephalographic, and electromyographic signals) from sensors on the wearer s body, digitize those signals that are received in analog form, preprocess the resulting data, and transmit the data to one or more remote location(s) via a radiocommunication link and/or the Internet. The system includes a computer running data-object-oriented software that can be programmed to configure the system to accept almost any analog or digital input signals from medical devices. The computing hardware and software implement a general-purpose data-routing-and-encapsulation architecture that supports tagging of input data and routing the data in a standardized way through the Internet and other modern packet-switching networks to one or more computer(s) for review by physicians. The architecture supports multiple-site buffering of data for redundancy and reliability, and supports both real-time and slower-than-real-time collection, routing, and viewing of signal data. Routing and viewing stations support insertion of automated analysis routines to aid in encoding, analysis, viewing, and diagnosis.

Braun, Jeffrey↗

Predicting Team Functioning in Long Term Space Missions Using Acoustic and Linguistic Measures

Maintaining optimal team functioning is critical for long-duration space exploration missions, yet traditional monitoring methods, such as self-reports and wearable sensors, often impose operational burdens or suffer from bias. This paper investigates a non-intrusive speech-based artificial intelligence (AI) framework to predict degradations in team functioning using data from the Human Exploration Research Analog (HERA) of the U.S. National Aeronautics and Space Administration (NASA). Using acoustic features, linguistic descriptors, and semantic embeddings, we evaluate static non-linear and temporal machine learning models to predict both objective (task accuracy) and subjective (self-reported efficacy and cohesion) team functioning outcomes. Results indicate that temporal models outperform static approaches, with prediction of objective task accuracy in Team Interaction Battery (TIB) improving from near chance to 71%. Self-reported outcomes, including team efficacy and cohesion, are predicted more reliably than task performance, achieving balanced accuracies of up to 85.56% and 78.12%, respectively, and are found to be most strongly associated with acoustic features. In a second interdependent task, the MMSEV–EVA, accuracies of up to 78% are achieved using temporal models with acoustic features. Furthermore, incorporating just 1–2 days of team-specific historical data systematically improved performance, and acoustic markers from informal pre-task interactions provided modest predictive gains. Finally, while automated preprocessing yielded viable accuracy, humancorrected data provided moderate performance gains, though transcription error rates did not significantly correlate with model performance. These findings highlight the potential of speech as a passive, high-fidelity monitoring tool for autonomous habitats.

Temporal modeling↗

Human Research Program Advanced Exercise Concepts (AEC) Overview

Exercise countermeasures provide benefits that are crucial for successful human spaceflight, to mitigate the spaceflight physiological deconditioning which occurs during exposure to microgravity. The NASA Human Research Program (HRP) within the Human Exploration and Operations Mission Directorate (HEOMD) is managing next generation Advanced Exercise Concepts (AEC) requirements development and candidate technology maturation to Technology Readiness Level (TRL) 7 (ground prototyping and flight demonstration) for all exploration mission profiles from Multi Purpose Crew Vehicle (MPCV) Exploration Missions (up to 21 day duration) to Mars Transit (up to 1000 day duration) missions. These validated and optimized exercise countermeasures systems will be provided to the ISS Program and MPCV Program for subsequent flight development and operations. The International Space Station (ISS) currently has three major pieces of operational exercise countermeasures hardware: the Advanced Resistive Exercise Device (ARED), the second-generation (T2) treadmill, and the cycle ergometer with vibration isolation system (CEVIS). This suite of exercise countermeasures hardware serves as a benchmark and is a vast improvement over previous generations of countermeasures hardware, providing both aerobic and resistive exercise for the crew. However, vehicle and resource constraints for future exploration missions beyond low Earth orbit will require that the exercise countermeasures hardware mass, volume, and power be minimized, while preserving the current ISS capabilities or even enhancing these exercise capabilities directed at mission specific physiological functional performance and medical standards requirements. Further, mission-specific considerations such as preservation of sensorimotor function, autonomous and adaptable operation, integration with medical data systems, rehabilitation, and in-flight monitoring and feedback are being developed for integration with the exercise countermeasures systems. Numerous technologies have been considered and evaluated against HRP-approved functional device requirements for these extreme mission profiles, and include wearable sensors, exoskeletons, flywheel, pneumatic, and closed-loop microprocessor controlled motor driven systems. Each technology has unique advantages and disadvantages. The Advanced Exercise Concepts project oversees development of candidate next generation exercise countermeasures hardware, performs trade studies of current and state of the art exercise technologies, manages and supports candidate systems physiological evaluations with human test subjects on the ground, in flight analogs and flight. The near term goal is evaluation of candidate systems in flight, culminating in an integrated candidate next generation exercise countermeasures suite on the ISS which coalesces research findings from HRP disciplines in the areas of exercise performance for muscle, bone, cardiovascular, sensorimotor, behavioral health, and nutrition for optimal benefit to the crew.

Countermeasures↗

Characterization and Measurement of Spacecraft Airborne Particulate Matter

The International Space Station (ISS) gives a 6-member astronaut crew the ability to live and work in low Earth orbit. It is a unique indoor environment, which has served as both home and workplace to over 230 people since the year 2000. In this low gravity environment, smoke does not rise and cookie crumbs do not settle the way they do on Earth, causing airborne particulate matter, or aerosols, to behave differently and pose unique hazards for crew members. In its existence, virtually the same volume of ISS air has been continuously conditioned and ‘revitalized,’ including the removal of particles by filtration. While gaseous constituents of ISS air are monitored meticulously, sparse data exists on the indoor aerosols. The quantity and types of ISS airborne debris have been investigated in NASA’s Aerosol Sampling Experiment. Both active and passive samplers successfully collected airborne particulate matter in U.S. segments of the ISS, which were returned to Earth for characterization by microscopy and other techniques. The resulting data has informed the design of candidate particle instruments for spacecraft. In 2020, a reference-quality aerosol instrument will be flown to ISS, and will provide real-time data of particle concentrations in various modules. Smaller, more compact instruments will be necessary in future space missions, for example, in smaller vehicles, in habitats on lunar and planetary surfaces with ubiquitous dust, and also for use as wearable technology throughout missions. Miniaturized aerosol sensors, though lower fidelity than reference-quality instruments, can monitor the environment well when calibrated appropriately. Indoor air quality in spacecraft is fundamentally important to human health and comfort, and several particulate monitoring technologies will be at sufficient technology readiness levels for operational use within the next two years. Results of the Aerosol Sampling Experiment will be presented, along with the status of NASA’s aerosol instrument technology demonstrations on ISS.

Meyer, Marit E.↗

Wearable Biosensor Monitor to Support Autonomous Crew Health and Performance

During future human exploration missions, spaceflight crews will encounter adverse health outcomes and decrements in performance during the missions and for long term health. The Psychophysiological Research Lab is currently conducting a technology demonstration of a prototype wearable biosensor system (Astroskin) on astronaut surrogates during 30 day missions within NASAs Human Exploration Research Analog (HERA). HERA, located at Johnson Spaceflight Center, represents a flight analog for simulation of isolation, confinement and remote conditions of mission exploration scenarios. Astroskin, an autonomous medical monitoring system, consists of an intelligent garment for the upper body and a headband fitted with sensors, and associated software and hardware that can measure, transmit and store vital signs (ECG, respiration, blood pressure, etc.), sleep quality and activity level of the wearer. One of the main goals of the technology demonstration is to evaluate the performance of the Astroskin system (i.e., data quality), crew usability and comfort. To validate the Astroskin as a viable option for use during future spaceflight missions, crew data from HERA are sent to Ames researchers for processing and analyses. Crew surveys on usability and comfort will also be evaluated. This work supports the Exploration Medical Capabilities element within NASAs Human Research Program.

space analog↗

On-Demand Manufacturing of Electronics

The On-Demand Manufacturing of Electronics (ODME) project develops materials, processes, and device designs to enable electronics, sensors, and semiconductors to be produced in microgravity environments. The demonstration of these technologies provides a pathway for space-based manufacturing of circuits, wearables, energy storage devices, and other electronics. This has facilitated the terrestrial production of devices including a wide range of sensors, printed batteries, and circuits that are additively manufactured using techniques available on the Advanced Toolplate System (ATS). Recent parabolic flight campaigns conducted with the ATS suggest that direct ink write (DIW) technology is suitable for depositing functional material inks in reduced gravity environments. The development of the Advanced Toolplate system also includes several other new tools, including miniaturized versions of the direct write head, fused filament fabrication head, micro-mill, component pick & place head, and two newly developed deposition technologies, the Electrohydrodynamic (EHD) inkjet head (for semiconductors), and the Electrodeposition head (for high performance circuits). These experiments are designed to compare processing and material behavior in zero gravity versus ground-based data for validation of microgravity advantages and de-risking of future orbital demonstrations of these technologies. The ability to conduct experiments in microgravity is a pivotal step in enabling electronic manufacturing technology in space for both terrestrial and deep space applications.

Cadre Francis↗

Elastomeric Sensing of Pressure with Liquid Metal and Wireless Inductive Coupling

This project describes resistance-based soft sensors filled with liquid metal, which permit measurements of large strains (0 percent to 110 percent), associated with small forces of less than 30 Newtons. This work also demonstrates a methodology for wireless transfer of these strain measurements without connected electrodes. These sensors allow intermittent detection of pressure on soft membranes with low force. Adapting these sensors for passive wireless pressure sensing will eliminate the need for embedded batteries, and will allow the sensors to transmit pressure data through non-conductive materials including glass and acrylic. The absence of batteries allows us to embed these sensors into materials for long-term use because the sensors only use passive analog circuit elements. We found the oxidation of the liquid metal (eutectic gallium indium) plays a role in the repeatability of the soft sensors. We investigated how the oxidation layer affected the behavior of the sensor by encapsulating materials (silicone, fluorosilicone, and PVC) with varied permeabilities to oxygen. We measured the effects of mechanical loading on the oxidation layer and the effects of wireless inductive coupling on the oxidation layer. We concluded our research by investigating the effects of embedding self-resonant circuits into polydimethylsiloxane (PDMS). Efforts to design engineered systems with soft materials are a growing field with progress in soft robotics, epidermal electronics, and wearable electronics. In the field of soft robotics, PDMS-based grippers are capable of picking up delicate objects because their form-fitting properties allow them to conform to the shape of objects more easily than conventional robotic grippers. Epidermal devices also use PDMS as a substrate to hold electronic components such as radios, sensors, and power supply circuits. Additionally, PDMS-based soft sensors can monitor human motion with liquid metal embedded within micro-channels. Passive wireless sensors have applications in structural health monitoring and medical health monitoring. Doctors can take wireless blood pressure measurements inside arteries to monitor the progression of heart disease. Glaucoma patients can use this technology to monitor the pressure in their eyes to track the progression of the disease.

Dick, Jacob↗

Optimal Stimulus Amplitude for Vestibular Stochastic Stimulation to Improve Sensorimotor Function

Sensorimotor changes such as postural and gait instabilities can affect the functional performance of astronauts when they transition across different gravity environments. We are developing a method, based on stochastic resonance (SR), to enhance information transfer by applying non-zero levels of external noise on the vestibular system (vestibular stochastic resonance, VSR). Our previous work has shown the advantageous effects of VSR in a balance task of standing on an unstable surface. This technique to improve detection of vestibular signals uses a stimulus delivery system that is wearable or portable and provides imperceptibly low levels of white noise-based binaural bipolar electrical stimulation of the vestibular system. The goal of this project is to determine optimal levels of stimulation for SR applications by using a defined vestibular threshold of motion detection. A series of experiments were carried out to determine a robust paradigm to identify a vestibular threshold that can then be used to recommend optimal stimulation levels for SR training applications customized to each crewmember. Customizing stimulus intensity can maximize treatment effects. The amplitude of stimulation to be used in the VSR application has varied across studies in the literature such as 60% of nociceptive stimulus thresholds. We compared subjects' perceptual threshold with that obtained from two measures of body sway. Each test session was 463s long and consisted of several 15s sinusoidal stimuli, at different current amplitudes (0-2 mA), interspersed with 20-20.5s periods of no stimulation. Subjects sat on a chair with their eyes closed and had to report their perception of motion through a joystick. A force plate underneath the chair recorded medio-lateral shear forces and roll moments. First we determined the percent time during stimulation periods for which perception of motion (activity above a pre-defined threshold) was reported using the joystick, and body sway (two standard deviation of the noise level in the baseline measurement) was detected by the sensors. The percentage time at each stimulation level for motion detection was normalized with respect to the largest value and a logistic regression curve fit was applied to these data. The threshold was defined at the 50% probability of motion detection. Comparison of threshold of motion detection obtained from joystick data versus body sway suggests that perceptual thresholds were significantly lower, and were not impacted by system noise. Further, in order to determine optimal stimulation amplitude to improve balance, two sets of experiments were carried out. In the first set of experiments, all subjects received the same level of stimuli and the intensity of optimal performance was projected back on subjects' vestibular threshold curve. In the second set of experiments, on different subjects, stimulation was administered from 20-400% of subjects' vestibular threshold obtained from joystick data. Preliminary results of our study show that, in general, using stimulation amplitudes at 40-60% of perceptual motion threshold improved balance performance significantly compared to control (no stimulation). The amplitude of vestibular stimulation that improved balance function was predominantly in the range of +/- 100 to +/- 400 micro A. We hypothesize that VSR stimulation will act synergistically with sensorimotor adaptability (SA) training to improve adaptability by increasing utilization of vestibular information and therefore will help us to optimize and personalize a SA countermeasure prescription. This combination will help to significantly reduce the number of days required to recover functional performance to preflight levels after long-duration spaceflight.

Goel, R.↗

Artificial Intelligence Medical Support for Long-Duration Space Missions

We envision an artificial intelligence (AI) based system that will provide support and recommendations to the crew medical officer (CMO) and ground flight surgeon during long-duration space missions. Such a system would be pretrained on the knowledgebase of clinical knowledge on Earth, minimizing the amount of Earth data that needs to be transferred into space. Then during deployment, the system would be constantly refined through active learning from diverse streams of data from sensors in the spacecraft, data collected daily from individual astronauts, and human-in-the-loop feedback from the crew. The model could be interrogated for predictions and recommendations on personalized crew health based on the overall status of the spacecraft, medicinal stores, and status of other crew members. Adaptation techniques would be used to incorporate spaceflight data that have very different distributions from the training data due to the extreme environment. Edge computing and the most advanced neuromorphic processing would enable computation in scenarios with low power and bandwidth, while dimensionality reduction would be employed to ensure that the input data streams from spaceflight are as small as possible. In order to realize this long-term vision, several hardware and software aspects need to be developed and assembled. First, models pretrained on Earth biomedical data would need to be evaluated for predictive accuracy, and the best one selected. That model would need to be adapted to learn from diverse, sparse, and inconsistently measured data streams, as well as human-in-the-loop feedback. A data integration, standardization, and dimensionality reduction methodology would need to be developed to handle all data types and feed them into the model. Once the software and data infrastructure is developed, it would need to be integrated with small footprint compute processors and tested in high-radiation, high-vibration, unregulated temperature situations. As a short-term goal, we recommend to focus on the development of the data and model software structure. Several large language models (LLM) already exist that have been trained on Earth biomedical and clinical knowledgebases, including BioMedLLM, Med-PaLM, SPOKE LLM, and Foresight. These models need to be evaluated for accuracy and the best one chosen for a proof-of-concept structure, while maintaining awareness of the accelerating AI field and incorporating any newly improved model architectures as needed. Then, we recommend to develop a database of synthetic data types to mimic the diverse data streams that are expected in a long-duration space mission. This should include environmental and microbial data from the spacecraft, non-invasive data from wearables and point-of-care devices employed by astronauts, and more invasive molecular and physiological monitoring of clinical and biomarker data from astronauts. The data standardization methodology should be developed, and these data streams used to refine the clinical LLM. Several scenarios should be developed that could plausibly come up in a long-duration space mission, and changes or aberrations introduced to the data at specific times to mimic these scenarios. Then, question and answer tasks should be designed to interrogate the model for predictions and recommendations, with acceptable answers already identified.

Artificial Intelligence↗