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NASA NTRS2019

NASA Proof-of-Concept 1-W Stirling Convertor Development for Small RPS

Low power Stirling convertors are being developed at NASA Glenn Research Center (GRC) to provide future small spacecraft with electrical power by converting heat from one or more Light Weight Radioisotope Heater Units (LWRHU). An initial design converts multiple watts of heat to one watt of electrical power output using a Stirling convertor. A variety of mission concepts have been studied by NASA and the U.S. Department of Energy (DOE) that would utilize low power Radioisotope Power Systems (RPS) for probes, landers, rovers, and repeaters. These missions would contain science instruments distributed across planetary surfaces or near objects of interest where solar flux is insufficient for using solar cells. Landers could be used to provide data such as, radiation, temperature, pressure, seismic activity, and other surface measurements for planetary science and to inform future mission planners. The studies propose using fractional versions of the General Purpose Heat Source (GPHS) or multiple LWRHUs to heat power conversion technologies for science instruments and communication. Dynamic power systems are capable of higher conversion efficiencies, which could enable equal power using less fuel or more power using equal fuel, when compared to less efficient static power conversion technologies. Providing spacecraft with more power would decrease duty cycling of basic functions and, therefore, increase the quality and abundance of science data. Efforts to develop the concept have focused on maturation of a 1-We (1-watt electrical) convertor and controller design and performance evaluation of an evacuated metal foil insulation. A proof-of-concept 1-We convertor, controller, and evacuated metal foil insulation package have been fabricated and are undergoing characterization testing. The current status, findings, and path forward for the effort are explained in this paper.

Stirling↗
NASA NTRS2019

NASA Proof-of-Concept 1-W(sub e) Stirling Convertor Development for Small Radioisotope Power Systems

Low power Stirling convertors are being developed at NASA Glenn Research Center to provide future small spacecraft with electrical power by converting heat from one or more Light Weight Radioisotope Heater Units (LWRHU). An initial design converts multiple watts of heat to one watt of electrical power output using a Stirling convertor. A variety of mission concepts have been studied by NASA and the U. S. Department of Energy that would utilize low power Radioisotope Power Systems (RPS) for probes, landers, rovers, and repeaters. These missions would contain science instruments distributed across planetary surfaces or near objects of interest where solar flux is insufficient for using solar cells. Landers could be used to provide data such as, radiation, temperature, pressure, seismic activity, and other surface measurements for planetary science and to inform future mission planners. The studies propose using fractional versions of the General Purpose Heat Source or multiple LWRHUs to heat power conversion technologies for science instruments and communication. Dynamic power systems are capable of higher conversion efficiencies, which could enable equal power using less fuel or more power using equal fuel, when compared to less efficient static power conversion technologies. Providing spacecraft with more power would decrease duty cycling of basic functions and, therefore, increase the quality and abundance of science data. Efforts to develop the concept have focused on maturation of a 1-We convertor and controller design and performance evaluation of an evacuated metal foil insulation. A proof-of-concept 1-We convertor, controller, and evacuated metal foil insulation package have been fabricated and are undergoing characterization testing. The current status, findings, and path forward for the effort are explained in this paper.

Schifer, Nicholas A.↗
NASA NTRSDate not supplied

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support↗
NASA NTRSDate not supplied

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. Crew members operating independently during long duration space exploration missions will require a clinical decision support system (CDSS) to increase autonomy by augmenting their knowledge, skills and abilities in different scenarios. Significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities are needed to increase crew autonomy and self-reliance in decision making and task performance. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. Clinical decision support (CDS) presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. A comprehensive crew health and performance CDSS is required to augment crew capability and will be used in different scenarios for several reasons. In general, the CDSS’s role is to assist the crew in prevention, detection, diagnosis and treatment of crew health and performance related conditions that may arise in exploration spaceflight. For example, CDSS would assist a high acuity scenario such as a heart attack by supplying clear instructions, vital signs and treatment reminders. A lower severity scenario such as kidney stone risk could interface to vehicle systems and display more complex predictive data during a diagnosis. A CDSS needs to contribute to successful missions by maintaining a high performing crew who can potentially exhibit countless medical conditions related to derangements from the space environment (sleep, cognition, nutrition and exercise) as well as conditions intrinsic to humans anywhere. While supporting the crew’s ability to make sound clinical decisions is desirable in any mission, it is essential for exploration missions with significant communication delays, no evacuation capability, and extended exposure to the flight environment. Such missions correspond with medical Level of Care V (LOC V), the highest level specified in NASA-STD-3001. The project focuses on CDS implementation research to derive requirements for LOC V, where the need for increased autonomy results in new practices and the inclusion of non-clinical data, such as vehicle environmental measures and physical exercise results, from other human and vehicle domains and advanced analytics. The CDS project describes how the CDSS is intended to be used by defining concepts of operations (ConOps). The process to derive ConOps focuses on increased autonomy that reduces the likelihood and consequences of accepted medical conditions. These crew health and performance inputs are grouped by common datasets and analysis models. Use cases are derived to research new clinical scenarios, architectural development and workflows. Implementation research is conducted with protypes to inform assumptions and derive requirements. The project also establishes how externally developed analysis and approaches can be added to expand a clinical decision support system and thus highlight how a comprehensive system can be globally developed with collaborators. This presentation will cover example scenarios from the CDS ConOps and the method to derive them. One example scenario will be CDSS alerting an increased kidney stone risk during a mission, with diagnosis and treatment options provided during the intervention.

clinical decision support↗
NASA NTRSDate not supplied

Clinical Decision Support - Overview and Update

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support system↗
NASA NTRSDate not supplied

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. Crew members operating independently during long duration space exploration missions will require a clinical decision support system (CDSS) to increase autonomy by augmenting their knowledge, skills and abilities in different scenarios. Significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities are needed to increase crew autonomy and self-reliance in decision making and task performance. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. Clinical decision support (CDS) presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. A comprehensive crew health and performance CDSS is required to augment crew capability and will be used in different scenarios for several reasons. In general, the CDSS’s role is to assist the crew in prevention, detection, diagnosis and treatment of crew health and performance related conditions that may arise in exploration spaceflight. For example, CDSS would assist a high acuity scenario such as a heart attack by supplying clear instructions, vital signs and treatment reminders. A lower severity scenario such as kidney stone risk could interface to vehicle systems and display more complex predictive data during a diagnosis. A CDSS needs to contribute to successful missions by maintaining a high performing crew who can potentially exhibit countless medical conditions related to derangements from the space environment (sleep, cognition, nutrition and exercise) as well as conditions intrinsic to humans anywhere. While supporting the crew’s ability to make sound clinical decisions is desirable in any mission, it is essential for exploration missions with significant communication delays, no evacuation capability, and extended exposure to the flight environment. Such missions correspond with medical Level of Care V (LOC V), the highest level specified in NASA-STD-3001. The project focuses on CDS implementation research to derive requirements for LOC V, where the need for increased autonomy results in new practices and the inclusion of non-clinical data, such as vehicle environmental measures and physical exercise results, from other human and vehicle domains and advanced analytics. The CDS project describes how the CDSS is intended to be used by defining concepts of operations (ConOps). The process to derive ConOps focuses on increased autonomy that reduces the likelihood and consequences of accepted medical conditions. These crew health and performance inputs are grouped by common datasets and analysis models. Use cases are derived to research new clinical scenarios, architectural development and workflows. Implementation research is conducted with protypes to inform assumptions and derive requirements. The project also establishes how externally developed analysis and approaches can be added to expand a clinical decision support system and thus highlight how a comprehensive system can be globally developed with collaborators. This presentation will cover example scenarios from the CDS ConOps and the method to derive them. One example scenario will be CDSS alerting an increased kidney stone risk during a mission, with diagnosis and treatment options provided during the intervention.

clinical decision support↗
NASA NTRSDate not supplied

Medicine in the Final Frontier Technologies to Enable Autonomous Prolonged (Field) Care in Space

N: The planning and execution of comprehensive “Prolonged Care” strategies are increasingly considered as fundamental operational concepts within the spheres of both military and non-military expeditionary medicine. Numerous advances in recent years have enabled the decentralization of health-related technology that has empowered medical - and even non-medical providers - to offer quality care farther afield and for increasingly extended periods of separation from traditional support structures. However, the operational concepts behind today’s Prolonged Care paradigms are still largely dependent upon external support, including high-bandwidth telemedicine communications technologies (that allow ready access to centralized expertise), robust resupply pathways, and ultimately, on the timely evacuation of the sick and injured. What would happen if none of these support systems were readily available? Extremely remote Prolonged Care is one of the most significant challenges that the National Aeronautics and Space Administration (NASA) faces when preparing to expand human space exploration beyond the International Space Station (ISS) to deep space including the Moon and Mars. Continuous human presence on the International Space Station (ISS) in low Earth orbit for the past 20 years has demonstrated that indeed medical operations can be successfully executed with continuous real-time communications, frequent resupply missions, and the availability of rapid evacuation options. However, as time-distance factors from Earth increase with our pursuit and changing focus towards deep space missions, these resources and capabilities will no longer be available. As a result, space medicine operations will need to become more autonomous and less dependent upon mission support from Earth – requiring our attention and efforts to build robust capabilities that support the ultimate expression of the term “Prolonged Field Care.”

K R Lehnhardt↗
NASA NTRS2023

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

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

ExMC↗
NASA NTRSDate not supplied

Effects of Communication Delay on Human Spaceflight Missions

Missions onboard the International Space Station rely on the real-time availability of a large ground team of system experts to command the vehicle, solve safety-critical problems, and guide the crew during complex operations. Also, in Low Earth Orbit (LEO), supplies can be sent and crews evacuated quite quickly if needed. Future missions Beyond Low Earth Orbit (BLEO) will not have this 24/7, real-time safety net as communication latency increases, resupply difficulty increases, and evacuation opportunities diminish. There are few, if any, terrestrial analogs for human spaceflight missions BLEO that reflect the conditions—including extreme environments, long mission durations, and small crew sizes – that make these missions so high risk. Studies on specific conditions, such as communication delays and asynchronous interactions, have been performed in NASA Earth-based analog missions and have found that communication delays can disrupt ground-crew interactions and adversely impact team performance. However, there are gaps and limitations in studies conducted to date, notably on human spacecraft system failure response and recovery, the impacts of shorter lunar-relevant communication delays on complex operations, and the effectiveness of countermeasures. The work presented here breaks down real anomalies that occurred on ISS and Apollo missions and creates example scenarios fort Lunar Surface and Mars missions to explore the impact of communication delays of varying length on onboard operations and mission outcomes. Our analyses indicate that short communication delays (e.g., seconds to a minute) adversely impact the ability for ground to provide real-time oversight and guidance and to catch quickly emerging problems in time. Longer communication delays (e.g., up to 40 minutes on Mars missions) call for a shift of responsibility for tactical operations from ground to crew; crew must make time-critical decisions independently and respond to time-critical vehicle anomalies to prevent consequences.

human-systems integration↗
NASA NTRS2023

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↗
NASA NTRSDate not supplied

Effects of Communication Delay on Human Spaceflight Missions

Missions onboard the International Space Station rely on the real-time availability of a large ground team of system experts to command the vehicle, solve safety-critical problems, and guide the crew during complex operations. Also, in Low Earth Orbit (LEO), supplies can be sent and crews evacuated quite quickly if needed. Future missions Beyond Low Earth Orbit (BLEO) will not have this 24/7, real-time safety net as communication latency increases, resupply difficulty increases, and evacuation opportunities diminish. There are few, if any, terrestrial analogs for human spaceflight missions BLEO that reflect the conditions—including extreme environments, long mission durations, and small crew sizes – that make these missions so high risk. Studies on specific conditions, such as communication delays and asynchronous interactions, have been performed in NASA Earth-based analog missions and have found that communication delays can disrupt ground-crew interactions and adversely impact team performance. However, there are gaps and limitations in studies conducted to date, notably on human spacecraft system failure response and recovery, the impacts of shorter lunar-relevant communication delays on complex operations, and the effectiveness of countermeasures. The work presented here breaks down real anomalies that occurred on ISS and Apollo missions and creates example scenarios fort Lunar Surface and Mars missions to explore the impact of communication delays of varying length on onboard operations and mission outcomes. Our analyses indicate that short communication delays (e.g., seconds to a minute) adversely impact the ability for ground to provide real-time oversight and guidance and to catch quickly emerging problems in time. Longer communication delays (e.g., up to 40 minutes on Mars missions) call for a shift of responsibility for tactical operations from ground to crew; crew must make time-critical decisions independently and respond to time-critical vehicle anomalies to prevent consequences.

human-systems integration↗
NASA NTRSDate not supplied

Improving the Fidelity of Capability & Resource Weighting in A Probalistic Risk Assessment Model for Spaceflight

INTRODUCTION NASA’s Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) tool uses Probabilistic Risk Assessment (PRA) to provide an evidence-based, data-driven estimate of how medical system capabilities affect mission outcomes. IMPACT maps condition incidence to available resources thereby facilitating the calculation of outcome metrics that allow the estimation of mission medical risk. Conditions can be nominally categorized as either treated or untreated depending on the availability of necessary diagnostic and therapeutic capabilities. This categorization enables IMPACT to estimate the effect of various medical system configurations on mission outcomes such as crew mortality, disability, crew member down-time, return to duty/recovery, and need for evacuation. IMPACT currently employs an equal weighting, “partial credit” approach to define treatment in which each of the capabilities associated with a given condition contributes an equal amount to management of the condition. This feature enables IMPACT to report values in between “fully untreated” and “fully treated” based on the proportion of capabilities available within the model. However, as is normal in medical/clinical practice, not all individual capabilities contribute equally to medical care. For example, the ability to provide intramuscular epinephrine during an anaphylactic episode contributes more likelihood of overall management success than does the administration of oral diphenhydramine. We hypothesize that weighting the relative contribution of each capability to each specific condition will improve outcome prediction and therefore will better provide mission planners with more nuanced and accurate options when designing space medical systems. METHODS Using a five-point Fibonacci scaling sequence (1, 2, 3, 5, 8) subject matter experts from NASA’s Exploration Medical Capabilities (ExMC) element assigned relative contribution weighting values to each identified capability within IMPACT. Since the relative importance of each capability varies depending on the specific condition, the resulting “partial” weighting was completed for more than 1,600 individual weighting assignments for 666 capabilities across 121 conditions. Each assignment required three-physician concurrence based on the overall importance of the capability to the diagnosis and management of the condition being considered and the difficulty with which it could be improvised by the crew. Once complete, 100,000 IMPACT simulations were run for a 6-month Lunar mission with a 30-day surface stay to evaluate the effect of this modification of the model. RESULTS Partial weighting significantly decreased predicted task time loss (TTL), evacuation, and loss of crew life without causing significant changes to the recommended medical system design. CONCLUSIONS The paucity of real-world referent data to support long-duration space missions of this type limits the ability to judge one predictive analytics method as superior to another. However, since the proposed method significantly reduces and optimizes outcome risks—without changing the medical system design—incorporating a partial weighting methodology is likely to provide a more accurate and operationally-relevant representation of medical risk without compromising IMPACTs ability to inform overarching medical system requirements.

Steller JG↗
NASA NTRSDate not supplied

Preliminary Medical Risk Estimates and Clinical Capability Needs for Artemis IV

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in- mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. METHODOLOGY: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for the Artemis IV mission. Artemis IV is currently scheduled for 2026 and will visit the Gateway space station in lunar orbit prior to the second lunar landing of the Artemis program. The baseline Artemis IV mission that was modeled was 28 days in duration with phases including Orion outbound, 4 days on the Gateway space station in lunar orbit, 2 crew on the surface of the Moon for approximately one week, an additional 5 days on Gateway, and then return to Earth. This baseline was compared to two alternative 34-day design reference missions (DRMs) that shifted the lunar sortie earlier or later in the mission profile. Assumptions included 2 female and 2 male crew and a notional medical system mass of 25 kg. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care – RTDC), and an estimate of crew time lost due to medical conditions (Task Time Lost – TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk. RESULTS: All three DRMs had very low probability of LOCL from medical conditions, primarily due to short duration. RTDC was also similar across the DRMs. In contrast, TTL was higher in the early lunar sortie DRM due to earlier occurrence of EVA-related medical conditions. Taken as a whole, there was no clinically significant difference in medical risk across the three missions. Results for clinical capabilities and an example medical equipment list will be discussed but were similar across DRMs.

D Hilmers↗
NASA NTRSDate not supplied

Medical Risk Estimates and Clinical Capability Needs for A Long Duration Artemis Mission

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. DISCUSSION: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for an extended duration Artemis mission of approximately 9 months, with phases including outbound transit, 3 months on the Lunar Gateway space station, 3 months on the Lunar surface with EVAs, 3 months on Gateway (simulating the return phase of a Mars mission), and transit back to Earth. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care – RTDC), and an estimate of crew time lost due to medical conditions (Task Time Lost – TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk.

W Thompson↗
NASA NTRSDate not supplied

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↗
NASA NTRSDate not supplied

Global Rescue Response to a Multivehicle Deorbit from the International Space Station

The U.S. Department of Defense (DoD) has been tasked to support rescue efforts in the event of an off-nominal landing of a Commercial Crew Program vehicle transporting NASA crewmembers to or from the International Space Station. The DoD is further tasked to support returning U.S. and International Partner crewmembers on Russian Soyuz spacecraft missions, specifically to ensure aeromedical evacuation capability in the event of a crewmember injury at the time of launch or landing. This DoD mission is primarily considered during planned launch and landing operations, with forces placed in an alert posture to support if needed. However, overall mission concept of operations encompasses a no-notice rescue capability in the event of an on-orbit emergency. Such contingency scenarios are pre-coordinated and simulated to ensure a ready posture of associated DoD assets and to promote coordination of government, commercial, and military stakeholders. To date, planning and simulations have focused on execution of a single rescue mission; the possibility of a multi-vehicle evacuation and rescue scenario has not been adequately explored. This presentation will examine the process of responding to an emergency onboard the International Space Station that results in the early departure and deorbit of multiple docked vehicles to preserve the health and safety of the crew. We will highlight the complexity of this recovery scenario and discuss potential complications that could arise, as well as identify areas in which deliberate planning and simulation can better ensure successful preparation for such a multifaceted recovery operation.

Travis Levon Houser↗
NASA NTRSDate not supplied

Informing Wildfire Needs: The Expanded User Interface of NASA's Fire Information for Resource Management System (Firms)

As the global community continues to experience, and respond to, living in a changing environment, access to tools, technologies, and timely data utilized by an increasingly diverse set of stakeholders is increasing. This year, 2023, has thus far seen an unprecedented number of extreme events, increasingly driven by changes in the climate and a strong 2023 ENSO pattern. In Canada, a record number of wildfires, and associated weather events, evacuations, and infrastructure and habitat destruction has taken place, and is ongoing. Large swaths of Greece have experienced similar wildfire destruction. Most recently, Maui has experienced destructive wildfires, and early 2023 saw massive wildfires in Chile. NASA's Fire Information for Resource Management System, or FIRMS, has a fifteen-year history of providing timely and comprehensive data and information on wildfires to stakeholders. FIRMS was initially developed in 2007 by the University of Maryland, with funds from NASA's Applied Sciences Program and the United Nations Food and Agriculture Organization (UN FAO), to provide near real-time active fire Locations to natural resource managers that faced challenges obtaining timely satellite-derived fire information. FIRMS has consistently evolved to address the needs of stakeholders Living in a changing environment; in 2012 it transitioned to NASA LANCE and in 2021 through a partnership between NASA and the US Forest Service, an updated version of FIRMS was released for the US and Canada. As NASA and other federal agencies continue to accelerate Open Science through integrated efforts such as the Year of Open Science, the provision of readily discoverable, findable, accessible, interoperable, reusable data represents a major focus to facilitate equitable outcomes. FIRMS supports this acceleration in Open Science by continuing to provision data and information for its traditional user base, while addressing the novel user needs of an increasingly diverse set of stakeholders seeking robust, reliable, transparently generated data and information. Increasingly, FIRMS is utilized by citizen scientists and individuals directly affected by wildfires - through evacuations, risks to structures/homes, poor air quality. etc. FIRMS has also been Leveraged to detect and assess the impacts resulting from ongoing conflicts. This further highlights the multi-faceted impacts of wildfires and other events. In the Fall of 2023, FIRMS will release an expanded User Interface (UI). This interface captures and reflects the needs of, and input from, a multitude of users. These users range from federal agency representatives to non-government organizations to the private sector to citizen science entities. To respond to this expansive and diverse user need base, the updated FIRMS UI will capture a range of features to support those beginning to explore the range of data and tools available to inform wildfire awareness and knowledge. These users are supported through a Basic Mode interface, furnishing access to a light set of functionalities that provision straight-forward, readily usable information and data, and ingestible knowledge. The Advanced Mode interface supports those stakeholder groups already proficient in navigating FIRMS. These stakeholders, representing fire managers and others, perform active fire management and tactical wildfire response activities. For these stakeholders, additional datasets have been included which require in-depth knowledge of both the utility as well as the caveats of such datasets. Additional functionalities have also been embedded to aid specific user queries. The expanded UI will introduce a new Experimental Mode. The focus of this UI will be to support the provision of emerging and innovative datasets that are in development for review and comment by the user community Examples include post-fire products generated by NASA's Earth Information System (EIS) Fire. This presentation will provide an overview of the expanded FIRMS UI. We will discuss how this UI is designed to be scalable and support the unique needs of an expanding and diverse user base. We will highlight key features, elements, and datasets, and describe how user needs have informed and guided the design of the UI. We will also share recent use cases to convey, and increase awareness, among conference participants. As the global community faces more extreme wildfires, due to climate variability and change, there is an increased need for reliable data to inform, manage, and mitigate the impacts of these events. Through this work, NASA FIRMS is striving to level the playing field, by making information accessible to all; from policy makers to the private sector to historically marginalized communities. In doing so, NASA is promoting the all-hands-on-deck response needed to minimize the impacts of wildfires and harness the strengths of open science to address the greatest environmental challenge faced.

Jenny Hewson↗
NASA NTRS2022

Medical Risk Estimates and Clinical Capability Needs for a Late Artemis Mission

BACKGROUND Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT v1.0 improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 119 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. DISCUSSION: This abstract will present IMPACT estimates of medical system risk and clinical capability needs for an extended duration Artemis mission of approximately 9 months, with phases including outbound transit, 3 months on the Lunar Gateway space station, 3 months on the Lunar surface with EVAs, 3 months on Gateway (simulating the return phase of a Mars mission), and transit back to Earth. Medical system risk estimates include loss of crew life (LOCL), consideration of medical evacuation (known as return to definitive care –RTDC), and an estimate of crew time list due to medical conditions (Task Time Lost –TTL). The presentation will also describe the medical conditions that are the greatest drivers of risk as well as the clinical capabilities and resources that have the largest effect on risk.

A Anderson↗