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Human Performance and Fatigue

This presentation summarizes some of the work completed by the Fatigue Countermeasures Lab work for the System-wide Safety Technical Challenge 1. Highlights include the development of the NASA PVT+ application, which includes a validated psychomotor vigilance task, fatigue ratings, hassle factors, fatigue countermeasures, and workload measures. The NASA PVT+ has been used in numerous studies in short and long-haul aviation operations. Two examples of how these have been used in the real world are described.

human performance↗

The Reusable Handheld Electrolyte and Lab Technology for Humans (rHEALTH) Sensor

The DNA Medicine Institute has produced a reusable microfluidic device that performs rapid, low-cost cell counts and measurements of electrolytes, proteins, and other biomarkers. The rHEALTH sensor is compact and portable, and it employs cutting-edge fluorescence detection optics, innovative microfluidics, and nanostrip reagents to perform a suite of hematology, chemistry, and biomarker assays from a single drop of blood. A handful of current portable POC devices provide generalized blood analysis, but they perform only a few tests at a time. These devices also rely on disposable components and depend on diverse detection technologies to complete routine tests-all ill-suited for space travelers on extended missions. In contrast, the rHEALTH sensor integrates sample introduction, processing, and detection with a compact, resource-conscious, and efficient design. Developed to monitor astronaut health on the International Space Station and during long-term space flight, this microscale lab analysis tool also has terrestrial applications that include POC diagnostics conducted at a patient's bedside, in a doctor's office, and in a hospital.

Chan, Eugene↗

Navigation of military and space unmanned ground vehicles in unstructured terrains

Development of unmanned vehicles for local navigation in terrains unstructured by humans is reviewed. Modes of navigation include teleoperation or remote control, computer assisted remote driving (CARD), and semiautonomous navigation (SAN). A first implementation of a CARD system was successfully tested using the Robotic Technology Test Vehicle developed by Jet Propulsion Laboratory. Stereo pictures were transmitted to a remotely located human operator, who performed the sensing, perception, and planning functions of navigation. A computer provided range and angle measurements and the path plan was transmitted to the vehicle which autonomously executed the path. This implementation is to be enhanced by providing passive stereo vision and a reflex control system for autonomously stopping the vehicle if blocked by an obstacle. SAN achievements include implementation of a navigation testbed on a six wheel, three-body articulated rover vehicle, development of SAN algorithms and code, integration of SAN software onto the vehicle, and a successful feasibility demonstration that represents a step forward towards the technology required for long-range exploration of the lunar or Martian surface. The vehicle includes a passive stereo vision system with real-time area-based stereo image correlation, a terrain matcher, a path planner, and a path execution planner.

Lescoe, Paul↗

An Oculometric Standard to Assess the Performance of the Ocular System for Long Duration Spaceflight

Changes in the human brain, due to spaceflight, have been a challenge to the space program since its inception; a challenge that is becoming more acute as extended International Space Station (ISS) missions become routine, a return to crewed lunar exploration is about to begin, and a multi-year crewed trip to Mars is being planned. Determining the extent to which neurophysiological adaptations may adversely impact performance in operational tasks, assessing the full-time course of these changes, and identifying/mitigating any potential long-term health consequences are crucial steps required to enable safe crew-autonomous, long-duration, deep-space missions. Vision is the predominant perceptual sense used to guide cognition and motor control in humans. Thus, it is critical for the success of any future, long-duration mission to understand how long-term exposure to microgravity and to other stressors of spaceflight and their interactions, impact visual function. This is an especially challenging task given the small and disparate samples from which we have been and will be able to collect human performance data. NASA has recently been carefully tracking spaceflight-induced ophthalmic changes, driven in large part by the fluid shifts related to microgravity. In particular, a recent study of Optical Coherence Tomography (OCT) postflight measures revealed that more than two-thirds of US crew members experience significant increases in retinal thickness after 6month or longer ISS missions. Space Associated Neuro-ocular Syndrome (SANS) also includes visual acuity decrements and other ocular structural changes that could adversely impact in-flight performance as missions become longer. However, the impact of spaceflight on the visual system is not limited to the retina. Recent comparisons of pre-and post-flight brain images have revealed structural changes throughout the brain that implicate visual, visuomotor, and visual-cognitive pathways, consistent with observed functional impacts (e.g., decreased speed/accuracy/timing of fine goal-oriented movements). Current limitations on inflight testing make it very difficult to determine when and under what conditions SANS and other disruptions of human neurological subsystems arise. Currently, one cannot anticipate the time course and extent of impairment and recovery. This study addresses this knowledge gap by creating an integrated framework of the relevant existing literature on visual and oculomotor function during spaceflight with an eye towards complementing current structural measures of visuomotor impairment with new oculometric standard measures. Using eye-movement based visual function assessment and diagnostics would provide a valuable enhancement of crew health and performance monitoring in support of deepspace exploration.

Vision↗

Using a Crew Resource Management Framework to Develop Human-Autonomy Teaming Measures

Recent developments in technology have permitted an increased use of autonomy. To work best with humans, autonomy should have the qualities of a good team member. But how can these qualities be measured? One way is to use similar measures to those used to measure good teams with human members. For example, the Non-Technical Skills (NOTECHS) framework measures Crew Resource Management (CRM) skills that allow pilots to work together as a team. The framework consists of skill categories, elements of those categories, and behavioral markers that demonstrate good or poor performance in the elements. This paper introduces CMSD (CooperationManagementSituation AwarenessDecision Making), a measurement system based on NOTECHS and other widely-used skill level systems, which provides quantitative measures of Human-Autonomy Teaming (HAT).

Crew Resource Manaagement↗

Measurement and Validation of Bidirectional Reflectance of Space Shuttle and Space Station Materials for Computerized Lighting Models

Task illumination has a major impact on human performance: What a person can perceive in his environment significantly affects his ability to perform tasks, especially in space's harsh environment. Training for lighting conditions in space has long depended on physical models and simulations to emulate the effect of lighting, but such tests are expensive and time-consuming. To evaluate lighting conditions not easily simulated on Earth, personnel at NASA Johnson Space Center's (JSC) Graphics Research and Analysis Facility (GRAF) have been developing computerized simulations of various illumination conditions using the ray-tracing program, Radiance, developed by Greg Ward at Lawrence Berkeley Laboratory. Because these computer simulations are only as accurate as the data used, accurate information about the reflectance properties of materials and light distributions is needed. JSC's Lighting Environment Test Facility (LETF) personnel gathered material reflectance properties for a large number of paints, metals, and cloths used in the Space Shuttle and Space Station programs, and processed these data into reflectance parameters needed for the computer simulations. They also gathered lamp distribution data for most of the light sources used, and validated the ability to accurately simulate lighting levels by comparing predictions with measurements for several ground-based tests. The result of this study is a database of material reflectance properties for a wide variety of materials, and lighting information for most of the standard light sources used in the Shuttle/Station programs. The combination of the Radiance program and GRAF's graphics capability form a validated computerized lighting simulation capability for NASA.

Fletcher, Lauren E.↗

Radiation Tests of the Extravehicular Mobility Unit Space Suit for the International Space Station Using Energetic Protons

Measurements using silicon detectors to characterize the radiation transmitted through the EMU space suit and a human phantom have been performed using 155 and 250 MeV proton beams at LLUMC. The beams simulate radiation encountered in space, where trapped protons having kinetic energies on the order of 100 MeV are copious. Protons with 100 MeV kinetic energy and above can penetrate many centimeters of water or other light materials, so that astronauts exposed to such energetic particles will receive doses to their internal organs. This dose can be enhanced or reduced by shielding - either from the space suit or the self-shielding of the body - but minimization of the risk depends on details of the incident particle flux (in particular the energy spectrum) and on the dose responses of the various critical organs. Data were taken to characterize the beams and to calibrate the detectors using the beam in a treatment room at LLUPTF, in preparation for an experiment with the same beams incident on detectors placed in a human phantom within the EMU suit. Nuclear interactions of high-energy protons in various materials produce a small flux of highly ionizing, low-energy secondary radiation. Secondaries are of interest for their biological effects, since they cause doses and especially dose-equivalents to increase relative to the values expected simply from ionization energy loss along the Bragg curve. Because many secondaries have very short ranges, they are best measured in passive track detectors such as CR-39. The silicon detector data presented here are intended to supplement the CR-39 data in regions where silicon has greater sensitivity, in particular the portion of the LET spectrum below 5 keV/micron. The results obtained in this study suggest that optimizing the radiation shielding properties of space suits is a formidable task. The naive assumption that adding mass can reduce risk is not supported by the data, which show that reducing the dose delivered at or near the skin by low-energy particles may increase the dose delivered by energetic particles to points deeper in the body.

Zeitlin, C.↗

Acute Total and Chronic Partial Sleep Deprivation: Effects on Neurobehavioral Functions, Waking EEG and Renin-Angiotensin System

Total sleep deprivation leads to decrements in neurobehavioral performance and changes in electroencephalographic (EEG) oscillations as well as the incidence of slow eye movements ad detected in the electro-oculogram (EOG) during wakefulness. Although total sleep deprivation is a powerful tool to investigate the association of EEG/EOG and neurobehavioral decrements, sleep loss during space flight is usual only partial. Furthermore exposure to the microgravity environment leads to changes in sodium and volume homeostasis and associated renal and cardio-endocrine responses. Some of these changes can be induced in head down tilt bedrest studies. We integrate research tools and research projects to enhance the fidelity of the simulated conditions of space flight which are characterized by complexity and mutual interactions. The effectiveness of countermeasures and physiologic mechanisms underlying neurobehavioral changes and renal-cardio endocrine changes are investigated in Project 3 of the Human Performance Team and Project 3 of the Cardiovascular Alterations Team respectively. Although the. specific aims of these two projects are very different, they employ very similar research protocols. Thus, both projects investigate the effects of posture/bedrest and sleep deprivation (total or partial) on outcome measures relevant to their specific aims. The main aim of this enhancement grant is to exploit the similarities in research protocols by including the assessment of outcome variables relevant to the Renal-Cardio project in the research protocol of Project 3 of the Human Performance Team and by including the assessment of outcome variables relevant to the Quantitative EEG and Sleep Deprivation Project in the research protocols of Project 3 of the Cardiovascular Alterations team. In particular we will assess Neurobehavioral Function and Waking EEG in the research protocols of the renal-cardio endocrine project and renin-angiotensin and cardiac function in the research protocol of the Quantitative EEG and Waking Neurobehavioral Function project. This will allow us to investigate two additional specific aims: 1) Test the hypothesis that chronic partial sleep deprivation during a 17 day bed rest experiment results in deterioration of neurobehavioral function during waking and increases in EEG power density in the theta frequencies, especially in frontal areas of the brain, as well as the nonREM- REM cycle dependent modulation of heart-rate variability. 2) Test the hypothesis that acute total sleep deprivation modifies the circadian rhythm of the renin-angiotensin system, changes the acute responsiveness of this system to posture beyond what a microgravity environment alone does and affects the nonREM-REM cycle dependent modulation of heart-rate variability.

Dijk, Derk-Jan↗

Biomedical and Human Factors Requirements for a Manned Earth Orbiting Station

The primary objective of this study is to determine which biomedical and human factors measurements must be made aboard a space station to assure adequate evaluation of the astronaut's health and performance during prolonged space flights. The study has employed, where possible, a medical and engineering systems analysis to define the pertinent life sciences and space station design parameters and their influence on a measurement program. The major areas requiring evaluation in meeting the study objectives include a definition of the space environment, man's response to the environment, selection of measurement and data management techniques, experimental program, space station design requirements, and a trade-off analysis with final recommendations. The space environment factors that are believed to have a significant effect on man were evaluated. This includes those factors characteristic of the space environment (e. g. weightlessness, radiation) as well as those created within the space station (e. g. toxic contaminants, capsule atmosphere). After establishing the general features of the environment, an appraisal was made of the anticipated response of the astronaut to each of these factors. For thoroughness, the major organ systems and functions of the body were delineated, and a determination was made of their anticipated response to each of the environmental categories. A judgment was then made on the medical significance or importance of each response, which enabled a determination of which physiological and psychological effects should be monitored. Concurrently, an extensive list of measurement techniques and methods of data management was evaluated for applicability to the space station program. The various space station configurations and design parameters were defined in terms of the biomedical and human factors requirements to provide the measurements program. Research design of experimental programs for various station configurations, mission durations, and crew sizes were prepared, and, finally, a trade-off analysis of the critical variables in the station planning was completed with recommendations to enhance the confidence in the measurement program.

EARTH ORBIT↗

Psychophysiology of Humans in Space

Psychophysiological methods can provide aerospace medicine investigators with a unique perspective on the diagnosis and treatment of biomedical problems of humans in space. As psychophysiologists, we measure physiological responses to environmental stressors as a means of assessing and modifying their effects on behavior and performance. In the course of an 20-year research program. we have determined that this approach can be used to: (1) objectively identify physiological correlates of discomfort, malaise and performance; and (2) correct autonomic nervous system (ANS) disturbance and thereby increase tolerance to environmental stressors without the need for pharmacological intervention. The research presented will describe the application of psychophysiological methods for studying human adaptation to space and developing behavioral medicine techniques for facilitating this adaptation as well a readaptation to Earth. The goal of this work is to enhance the safety, comfort and operational efficiency of passengers and crew during spaceflight.

Cowings, P.S.↗

Human performance evaluation in dual-axis critical task tracking

A dual axis tracking using a multiloop critical task was set up to evaluate human performance. The effects of control stick variation and display formats are evaluated. A secondary loading was used to measure the degradation in tracking performance.

Ritchie, M. L.↗

The Kinematics of Treadmill Locomotion in Space

Locomotion on a treadmill in 0 G will probably remain a centerpiece of NASA's exercise countermeasures programme. This form of physical activity has the potential to cause large bone and muscle forces as well as loading during a period of continuous treadmill exercise. A critical concern is the provision of a treadmill which can approximate 1 G performance in space. At this point, no adequate objective measurements of in-flight treadmill kinetics or of the human response to this activity have been made. Interpretation of the results obtained in the present study is limited by the following: (1) bungee tensions were not measured; (2) ground reaction forces were not measured in parallel with the kinematic measurements; and (3) the instrumentation used to film the astronauts could itself have been affected by microgravity. Despite these shortcomings, what is apparent is that exercise during NASA missions STS 7 and STS 8 resulted in leg motions that were similar to those found during 1 G locomotion on an inclined passive treadmill and on an active treadmill at an even steeper grade. In addition, it was apparent that the majority of the loads were transmitted through the forefoot, and one can surmise that this style of running would result in physiologically significant tensions in the calf musculature and resultant ankle compressive loading. Further speculation regarding limb loading is complicated by the fact that varying amounts of force are transmitted through (1) the treadmill handle and (2) bungee cords that act as a tether. New generations of treadmills are being manufactured that could provide I important information for planners of long-duration space missions. If these types of treadmill are flown on future missions, it will be possible to control bungee tensions more precisely, control for grade and speed, and, most importantly, provide data on the rates and magnitudes of limb loading. These data could then be incorporated into biomechanical models of the lower limb to more fully understand mechanisms of load transmission from distal to proximal structures and to optimize in-flight exercise protocols in such a way that muscle and bone loss could be reduced.

Thornton, W. E.↗

Stimulus information contaminates summation tests of independent neural representations of features

Many models of visual processing assume that visual information is analyzed into separable and independent neural codes, or features. A common psychophysical test of independent features is known as a summation study, which measures performance in a detection, discrimination, or visual search task as the number of proposed features increases. Improvement in human performance with increasing number of available features is typically attributed to the summation, or combination, of information across independent neural coding of the features. In many instances, however, increasing the number of available features also increases the stimulus information in the task, as assessed by an optimal observer that does not include the independent neural codes. In a visual search task with spatial frequency and orientation as the component features, a particular set of stimuli were chosen so that all searches had equivalent stimulus information, regardless of the number of features. In this case, human performance did not improve with increasing number of features, implying that the improvement observed with additional features may be due to stimulus information and not the combination across independent features.

NASA Discipline Space Human Factors↗

Pulmonary-impedance power spectral analysis: A facile means of detecting radiation-induced gastrointestinal distress and performance decrement in man

Changes in respiratory variance revealed by power spectral analysis of the pulmonary impedance pneumogram can be used to detect and measure stresses directly or indirectly affecting human respiratory function. When gastrointestinal distress occurred during a series of 5 total-body exposures of 30 R at a rate of 1.5 R/min, it was accompanied by typical shifts in pulmonary impedance power spectra. These changes did not occur after protracted exposure of 250 R (30 R daily) at 1.5 R/hr that failed to cause radiation sickness. This system for quantitating respiratory effort can also be used to detect alterations in one's ability to perform under controlled exercise conditions.

Rick, R. C.↗

Short Duration Bioastronautics Investigation 1904: Human Factors Assessment of Vibration Effects on Visual Performance during Launch

The primary objective of the Short Duration Bioastronautics Investigation (SDBI) 1904 was to determine visual performance limits during Shuttle operational vibration and g-loads, specifically through the determination of minimal usable font sizes using Orion-type display formats. Currently there is little to no data available to quantify human visual performance under the extreme g- and vibration conditions of launch. Existing data on shuttle vibration magnitude and frequency is incomplete and does not address human visual performance. There have been anecdotal reports of performance decrements from shuttle crews, but no structured data have been collected. Previous work by NASA on the effects of vibration and linear g-loads on human performance was conducted during the Gemini era, but these experiments were performed using displays and controls that are dramatically different than current concepts being considered by the Constellation Program. Recently, three investigations of visual performance under vibration have been completed at NASA Ames Research Center: the first examining whole-body vibration, the second employing whole-body vibration coupled with a sustained g-load, and a third examining the effects of peak versus extended duration vibration. However, all of these studies were conducted using only a single x-axis direction (eyeballs in/out). Estimates of thrust oscillations from the Constellation Ares-I first stage are driving the need for realistic human performance requirements. SDBI 1904 was an opportunity to address the need for requirements by conducting a highly focused and applied evaluation in a relevant spaceflight environment. The SDBI was a companion effort to Detailed Test Objective (DTO) 695, which measured shuttle seat accelerations (vibration) during ascent. Data from the SDBI will serve an important role in interpreting the DTO vibration data. Both SDBI 1904 and DTO 695 were low impact with respect to flight resources, and combined, they represent an efficient and focused problem solving approach. This project provided (a) immediate data for developing preliminary human performance vibration requirements; (b) flight validated inputs for ongoing and future ground-based research; and (c) preliminary information related to Orion display format design.

Thompson, Shelby↗

Assessments of Physiology and Cognition in Hybrid-Reality Environments (APACHE)

NASA is planning to return to the Moon in the mid-2020s as a stepping stone to Mars missions in the 2030s. Spacewalks, or extravehicular activities (EVAs), performed on the Moon and Mars will differ in a variety of ways from those that have been performed in decades past. NASA has identified multiple risks to human health and performance associated with a crewed mission to Mars, especially those associated with exploration EVAs which are expected to be a primary mission activity. Crew may be expected to conduct up to 24 hours of EVA per person per week, where the likelihood of injury and/or mental mistakes are increased compared to ground-based training or current microgravity EVAs and the consequences of which can be catastrophic. Current test environments for exploration EVA research and technology development are large, costly facilities that are limited in their availability or capabilities. Spacesuit testing in a reduced gravity environment such as NASA’s Neutral Buoyancy Laboratory, while a good representation of the crew’s physical workload during exploration EVAs, typically has small datasets and is difficult to integrate physiological sensors or other types of crew performance measures. Meanwhile, scientific field-based testing such as NASA’s Desert Research and Technology Studies offers an operationally relevant environment for exploration EVAs, particularly for cognitive workload, but is also limited by small datasets, lack of a pressurized spacesuit, and obtrusive measures. The limitations of current analogs for exploration EVAs identify a need for a new test environment that can approximate both the physical and cognitive demands associated with exploration EVAs to enable rapid, controlled, and repeatable evaluations of human health and performance risks of exploration missions. In response, the Human Physiology, Performance, Protection, and Operations Laboratory (H-3PO) at NASA Johnson Space Center has developed a hybrid reality exploration EVA analog named the Assessments of Physiology And Cognition in Hybrid-reality Environments (APACHE) to address these limitations using a combination of virtual, physical, and hybrid reality techniques. The APACHE facility resides at NASA Johnson Space Center and serves as a large “sandbox” for EVA research and simulation. At its center is a roughly 15x20ft space surrounded by a 14” tall sandbox partially filled with lunar regolith simulant to emulate the physical feeling of walking on a planetary surface and to allow for simulated geology operations. Nearby, a curved passive treadmill (Skillmill Connect, Technogym, Fairfield, NJ) and an omnidirectional treadmill (Infinadeck, Infinadeck, Rocklin, CA) are included to enable exploration of these large virtual environments while also imposing the physical demands, representative timelines, and cognitive burdens required to navigate and traverse these distances during exploration EVA. A 6DOF motion platform is used to simulate rover operations and supports various human performance evaluations and associated risks. Lastly, APACHE can support two extravehicular (EV) crewmembers working in tandem. A computer workstation is located nearby and also supports an intravehicular (IV) crewmember as part of a full mission simulation. The IV crewmember has direct video and audio communication with the EV crew in VR to provide operational and procedural support. The software used in APACHE was created by the JSC Engineering Directorate, in partnership with Buendea, powered by a custom Unreal Engine 5 (UE5.3, Epic Games) project. APACHE currently utilizes the HTC Vive Pro Eye in a wireless configuration for VR simulations. There are two virtual environments that subjects can explore within APACHE, a Lunar and Martian surface. The virtual Lunar surface was created from LIDAR data of the Lunar South Pole to create roughly 16 sq km of explorable terrain. The virtual Martian surface contains roughly 400 sq km of explorable terrain derived from Mars Reconnaissance Orbiter LIDAR data of the Jezero Crater. The immersion and related cognitive burdens of conducting a planetary EVA is simulated through a series of EVA-relevant tasks performed in the VR environment, using these high-fidelity visual representations. Additionally, APACHE includes biosensor driven informatics, such as real-time heart rate monitoring and/or derived values from model simulations, for active monitoring by the EV crew and added cognitive demand. A “Wizard of Oz” control panel enables test operators to activate contingency events such as simulated spacesuit malfunctions, loss of communications, and/or limited visibility. Embedded performance measures such as accuracy, completeness, and execution time have been developed for various exploration tasks to objectively quantify crew performance during an EVA and compare impacts to performance when different environmental stressors, both physical and cognitive, are added to or removed from the simulation. Additionally, validated cognitive and operational performance measures such as the Digit Symbol Substitution Task have been recreated and embedded in VR for direct and relatively unobtrusive measurement of motor perception. The APACHE environment currently supports multiple research studies at NASA. Examples include the CHAPEA project, a series of simulated year-long missions on Mars by a 4-person crew; and the CO2 Contingency Walk Back Study, an investigation of elevated CO2 exposure on crew performance during a contingency EVA scenario. APACHE also provides a test environment to support the development of the Crew State and Risk Model, which is a collection of individualized, mathematical models of crew physical and cognitive state; and the Personalized EVA Informatics and Decision Support system, an operational tool for flight controllers, and eventually a self-reliant Martian crew, to make biomedically-informed decisions in real-time to optimize the EVA planning and execution with respect to crew health and performance. Some technical challenges associated with developing the APACHE environment, as well as current limitations, include VR limitless natural walking with a hybrid spacesuit simulator, optimizing performance for wireless PC VR streaming while maintaining a high degree of visual fidelity, and the integration of various physiological (metabolic masks) and psychometric (eye tracking) sensors with the VR headset.

Human Performance↗

ISS Technology Demonstrations for Future Spaceflight Medical Systems

Throughout the history of human spaceflight, crewmembers have experienced various in-flight medical conditions including illness and injury. Planned missions to the Moon and Mars will require capabilities to maintain the health of future space travelers. Mass, power, and volume available in the vehicles and habitats for these missions will be severely constrained; resupply of resources will be limited or non-existent, as will opportunities for evacuation to Earth. Furthermore, ground-based support will be hampered by communication latencies and blackouts. These vehicle and mission constraints will necessitate a medical system that has been efficiently planned, providing on-board procedural guidance in addition to a variety of medical devices and consumable resources. Medical capabilities required for the diagnosis and treatment of potential medical conditions during future spaceflight missions may include real-time health monitoring, medical imaging, and biomarker analyses ( e.g., blood or urine). Terrestrial medicine shares these needs, thus many of these medical capabilities could likely be satisfied by Commercial-Off-The-Shelf (COTS) devices and methodologies; however, in some cases the unique space environment and increased mission duration will drive the need to modify technologies and the way care is provided. NASA’s Human Research Program (HRP) Exploration Medical Capability (ExMC) Element and Mars Campaign Office’s Exploration Medical Integrated Product Team (XMIPT) are working together to decrease medical risk during exploration missions. Flight-tested medical diagnostic and treatment technologies are necessary to effectively manage medical conditions relevant to exploration missions while meeting vehicle constraints, integrating with medical decision-support tools, and enabling increasingly Earth-independent operations. Several projects have leveraged the ISS as a testbed for exploration, including 1) i n- situ blood analysis, 2) medical inventory, 3) intravenous fluid generation, and 4) autonomous medical procedure guidance. Management of several in-flight medical conditions, such as bacterial and viral infections and acute radiation syndrome, is dramatically improved with ability to assess blood cell populations, electrolytes, and metabolites. I n December 2020 and January 2021 ExMC performed an ISS technology demonstration (Tech Demo) of the HemoCue® WBC DIFF analyzer (HemoCue, Brea, CA), a COTS device that was modified to enable functionality in a spaceflight environment. This Tech Demo marked the first time that hematology measurements were successfully performed real-time in microgravity. Also modified and demonstrated was the reusable Handheld Electrolytes and Lab Technology for Humans (rHEALTH) ONE analyzer (rHEALTH, Bedford, MA), which uses flow cytometry and sheath-based hydrodynamic focusing methodologies. The rHEALTH ONE ISS Tech Demo in May 2022 demonstrated test results obtained in-flight matched those on the ground. NASA currently relies on crew self-reporting to manage and maintain medical inventory on ISS.The ability to maintain an accurate inventory becomes more critical during long duration missions since the crew will need to be increasingly autonomous in finding and utilizing medical items, including those scenarios when alternative treatments need to be considered due to limited or no resupply. HRP’s Medical Consumables Tracking (MCT) project was developed by ZIN Technologies, Inc. (Cleveland, OH), and demonstrated real-time tracking of medical supplies aboard the ISS between December 2016 and July 2018. The MCT system design utilized Radio Frequency Identification Device (RFID) technology to perform automated inventory and was installed in the Crew Health Care System (CHeCS) Resupply Stowage Rack (RSR). The challenge of limited shelf life, exacerbated by the lack of resupply opportunities, affects a plethora of medical system components including consumables, pharmaceuticals, and intravenous (IV) fluid. In 2010, ExMC funded ZIN Technologies, Inc. (Cleveland, OH), to develop the Intravenous Fluid Generation (IVGEN) system. IV fluids were successfully generated with IVGEN using the potable water supply on ISS during ISS Expedition 23. The XMIPT is in the process of developing a miniaturized version of the original IVGEN hardware for a future Tech Demo aboard the ISS. Current ISS medical operations rely heavily on preflight training and real-time remote guidance, both of which become impractical or impossible for exploration missions. The primary goal of the Autonomous Medical Officer Support (AMOS) Software Tech Demos on ISS was to confirm telemedical proof-of-concept for autonomous medical imaging in an operational setting. This novel software tool shifts emphasis from preflight training and real-time remote guidance to in-flight just-in-time instruction, a new and necessary paradigm for crew medical autonomy. AMOS introduces a novel, streamlined skill management concept for exploration missions featuring comprehensive training and guidance modules for ultrasound examinations using the ISS Ultrasound 2 (a modified GE Vivid-q™; General Electric HealthCare, Chicago, IL). With no prior crew training or remote guidance, two Tech Demos on the ISS (April 2020 and June 2022) resulted in high quality, clinically useful image sets. We will provide a review of historical, current, and planned medical devices and technologies considered for inclusion within future spaceflight medical systems and summarize hardware development activities and medical device tech demos conducted on the ISS.

Astronaut health and performance↗

Highlights of contractor initiatives in quality enhancement and productivity improvement

The NASA/Contractor Team efforts are presented as part of NASA's continuing effort to facilitate the sharing of quality and productivity improvement ideas among its contractors. This complilation is not meant to be a comprehensive review of contractor initiative nor does it necessarily express NASA's views. The submissions represent samples from a general survey, and were not edited by NASA. The efforts are examples of quality and productivity programs in private industry, and as such, highlight company efforts in individual areas. Topics range from modernization of equipment, hardware, and technology to management of human resources. Of particular interest are contractor initiatives which deal with measurement and evaluation data pertaining to quality and productivity performance.

Source record↗