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At least 235 records · Page 13

Assessing the Added Value of Miniature X-Ray in the Setting of US in Spaceflight

INTRODUCTION: Point-of-care ultrasound (POCUS) has become the standard of care for imaging diagnosis and management in lowEarth Orbit (LEO) spaceflight and it has long been hypothesized that POCUS will also be the standard of care for exploration spaceflight. However, like the trajectory for which ultrasound became more portable and user-friendly, the mass, volume, and power requirements of radiography devices for both diagnostic and therapeutic applications have also been dramatically reduced. This study seeks to determine the clinical utility and added value of miniature x-ray (XR) for the diagnosis and management of each of the 119 conditions within NASA Exploration Medical Capability’s IMPACT Condition List (ICL) given that the medical system is presumed to already be carrying a handheld portable POCUS device. METHODS: For each condition, a team of reviewers performed a rapid systematic literature review seeking sensitivity and specificity data for both handheld portable ultrasound and miniature XR. When there was a paucity of data, subject matter expertise and clinical experience was added to semi-quantitatively score the added value of miniature XR, given an US was already available for both diagnosis and management. Diagnostic utility of a modality for a condition was evaluated in the setting of both the best- and worst-case scenario definitions included and defined by the ICL. Evidence tracing and quality of evidence scores were also recorded. RESULTS/DISCUSSION: Conditions for which it was determined that miniature XR added diagnostic or therapeutic value are provided in this presentation. Previously presented work by our team has demonstrated that XR provides diagnostic and management capabilities that are hypothesized to complement or surpass ultrasound for over one-third of medical conditions that may arise during exploration spaceflight (i.e., diagnosis of injuries to the axial skeleton, teeth, and lungs as well as management of orthopedic reductions, endotracheal tube placement, and drain placement confirmation). In the setting of known inclusion of a handheld portable POCUS device, there remains significant added value of portable miniature XR. Whether or not this added clinical benefit is worth the mass, volume, and power requirements of the radiography system remains yet unknown and is the focus of future work. LEARNING OBJECTIVES: 1) Understand the value of ultrasound and radiography in the diagnosis and management of medical comorbidities that may arise in exploration spaceflight; 2) Understand the medical conditions of highest concern on exploration class missions for which miniature x-ray may provide added value to portable ultrasound.

Jon Steller↗

Leveraging Medical Operations in the Work of HRP Exploration Medical Capability

Aerospace Medicine focuses on humans in the space and aviation environments. Particularly, through medical system design, advancing technologies for clinical care in remote and extreme environments, and studying the complex physiological changes that occur when humans are placed in these extreme environments, it seeks to prepare humans for the next step of exploration. For reasons of organization and funding, there has historically been a division between NASA’s medical operations team, responsible for clinical care and near-term operations, and the research team, responsible for longer-term exploration mission work. Clinicians typically work for one group or the other. Recently, however, a new “blended clinician” position was created that functions as a bridge between medical operations and research, bringing insight and expertise to both teams.

E.R. Stratton↗

Heart Imaging System

Johnson Space Flight Center's device to test astronauts' heart function in microgravity has led to the MultiWire Gamma Camera, which images heart conditions six times faster than conventional devices. Dr. Jeffrey Lacy, who developed the technology as a NASA researcher, later formed Proportional Technologies, Inc. to develop a commercially viable process that would enable use of Tantalum-178 (Ta-178), a radio-pharmaceutical. His company supplies the generator for the radioactive Ta-178 to Xenos Medical Systems, which markets the camera. Ta-178 can only be optimally imaged with the camera. Because the body is subjected to it for only nine minutes, the radiation dose is significantly reduced and the technique can be used more frequently. Ta-178 also enables the camera to be used on pediatric patients who are rarely studied with conventional isotopes because of the high radiation dosage.

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Contingency Operations Support to NASA Johnson Space Center Medical Operations Division

The Wyle Laboratories Contingency Operations Group provides support to the NASA Johnson Space Center (JSC) Medical Operations Division in the event of a space flight vehicle accident or JSC mishap. Support includes development of Emergency Medical System (EMS) requirements, procedures, training briefings and real-time support of mishap investigations. The Contingency Operations Group is compliant with NASA documentation that provides guidance in these areas and maintains contact with the United States Department of Defense (DOD) to remain current on military plans to support NASA. The contingency group also participates in Space Operations Medical Support Training Courses (SOMSTC) and represents the NASA JSC Medical Operations Division at contingency exercises conducted worldwide by the DOD or NASA. The events of September 11, 2001 have changed how this country prepares and protects itself from possible terrorist attacks on high-profile targets. As a result, JSC is now considered a high-profile target and thus, must prepare for and develop a response to a Weapons of Mass Destruction (WMD) incident. The Wyle Laboratories Contingency Operations Group supports this plan, specifically the medical response, by providing expertise and manpower.

Stepaniak, Philip↗

Evaluation of the Accuracy of Astroskin as a Behavioral Health Self-Monitoring System for Spaceflight

In space, there is a need to monitor astronauts' vital signs and assess their readiness to perform specific tasks during a mission. Currently, NASA does not have the capability to noninvasively monitor crew for extended periods of time. The Canadian Space Agency is working with the Psychophysiology Lab at NASA ARC to determine if the Astroskin could be used as a solution to this problem. Astroskin, a commercially available garment with built-in biosensors, can be comfortably worn under clothing or a spacesuit and relay information to the crewman's own mobile device. Data can also be sent wirelessly to the on-board Exploration Medical System. To determine if Astroskin meets requirements for health monitoring, it must first be validated in spaceflight analog environments. In the current study Astroskin data will be compared to traditional biomedical instrument measures of electrocardiography (ECG), respiration rate, and systolic blood pressure. The data will be recorded during Autogenic Feedback Training Exercise (AFTE), which is a type of physiological self-regulation training designed for astronauts. The data will also be recorded during simulations of the Orion spacecraft re-entry. The results to date suggest that Astroskin is a suitable ambulatory monitoring system that allows astronauts to self-diagnose and self-regulate adverse autonomic nervous system responses to sustained exposure to microgravity of spaceflight.

biomedical↗

Medical support and technology for long-duration space missions

The current philosophy and development directions being taken towards realization of medical systems for use on board space stations are discussed. Data was gained on the performance of physical examinations, venipuncture and blood flow, blood smear and staining, white blood cell differential count, throat culture swab and colony count, and microscopy techniques during a 28-day period of the Skylab mission. It is expected that the advent of Shuttle flights will rapidly increase the number of persons in space, create a demand for in-space rather than on-earth medical procedures, and necessitate treatments for disorders without the provision for an early return to earth. Attention is being given to pressurized environment and extravehicular conditions of treatment, the possibilities of the use of the OTV for moving injured or ill crewmembers to other space stations, and to isolation of persons with communicable diseases from station crews.

Furukawa, S.↗

Impact Outputs for A Representative Extended Duration Artemis Mission

BACKGROUND: As NASA and private industry begin preparation for long-duration spaceflight, quantifying the impact that potential human health and performance capabilities have on crew health outcomes is imperative for medical risk mitigation. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to estimate these outcomes. OVERVIEW: As NASA prepares to return to the Moon, medical system planning has already begun for extended Artemis missions, which will see humans spending months at a time in cis-lunar space and on the surface of the Moon. The Long Duration Lunar Orbital and Lunar Surface (LDLOLS) design reference mission (DRM) lasts 9 months, including 3 months on the lunar surface, and involves 2 male and 2 female crewmembers. LDLOLS assumes no extravehicular activities (EVAs) in orbit, but, while on the lunar surface, involves 2-4 EVAs/month in a pressurized rover and 2-4 EVAs/month in an unpressurized rover or on foot. This DRM assumes a physician level Crew Medical Officer with commensurate knowledge, skills, and abilities. The IMPACT tool was utilized to estimate in-flight medical risk for this mission. More specifically, 100,000 simulations of this DRM were modeled, and overall estimates for loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost (TTL; a measure of disability) were calculated. A recommended medical capability set, with appropriate mass and volume constraints, was also generated. DISCUSSION: This abstract reviews the IMPACT-derived risk for these mission outcomes with and without treatment, a macroscopic look at the total mass and volume necessary for full diagnostic and treatment capability, and how these change with input mission parameters.

J G Steller↗

LLMs and GenAI Tools to Depict Contributions of Human Systems to Spaceflight Tasks Execution

Recent advancements in Artificial Intelligence and Machine Learning (AI/ML) technologies, particularly Large Language Models (LLMs) capable of sophisticated syntax analysis, offer substantial potential in automating complex processes, thereby saving time and human resources. This study explores the development of an LLM-driven model designed to analyze and categorize a diverse set of Mars mission tasks into 18 predefined Human System Task Categories (HSTCs) based on their textual descriptions. As part of developing the Crew Health and Performance – Probabilistic Risk Assessment (CHP-PRA projects Performance Risk Model (PRisM) proof-of-concept, we established a framework to project performance scores from small-scale tests onto a preliminary list of Mars tasks. The foundation of our model was a comprehensive spreadsheet populated by NASA experts and clinicians, which detailed each Mars task alongside binary indicators of HSTC involvement. This dataset enabled the initial application of supervised ML, training and testing on existing HSTC labels. The HSTCs were originally defined from a medical system perspective, focusing on task impairments due to deteriorated human health. To expand our model's scope to include categories impacting performance, we face the challenge of generating binary labels (0 or 1) for new categories without pre-existing data. We address this by employing Generative AI (GenAI) software to determine whether a given task involved a new category by asking, "Does task A involve using category B?" We validate our approach by comparing the GenAI's binary classifications with the expert-provided labels for existing HSTCs. Notably, we utilize Ollama [4], a locally hosted GenAI tool that does not require cloud access, thus safeguarding NASA's proprietary data from unauthorized exposure. This study demonstrates the feasibility of leveraging cutting-edge AI tools to advance research, paving the way for automation and rapid decision-making in space exploration.

Mona Matar↗

Human-Computer Interaction with Medical Decisions Support Systems

Decision Support Systems (DSSs) have been available to medical diagnosticians for some time, yet their acceptance and use have not increased with advances in technology and availability of DSS tools. Medical DSSs will be necessary on future long duration space missions, because access to medical resources and personnel will be limited. Human-Computer Interaction (HCI) experts at NASA's Human Factors and Ergonomics Laboratory (HFEL) have been working toward understanding how humans use DSSs, with the goal of being able to identify and solve the problems associated with these systems. Work to date consists of identification of HCI research areas, development of a decision making model, and completion of two experiments dealing with 'anchoring'. Anchoring is a phenomenon in which the decision maker latches on to a starting point and does not make sufficient adjustments when new data are presented. HFEL personnel have replicated a well-known anchoring experiment and have investigated the effects of user level of knowledge. Future work includes further experimentation on level of knowledge, confidence in the source of information and sequential decision making.

Adolf, Jurine A.↗

International Conference on Remote Emergency Medical Services

An emergency medical system is characterized. Applications of NASA technology in biomedical telecommunication and bioinstrumentation are explored. The training and effectiveness of paramedics, technicians, nurses, and physicians are evaluated as applied to emergency situations and the operations of trauma centers. Civilian and military aeromedical evacuation is discussed.

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Market study: Whole blood analyzer

A market survey was conducted to develop findings relative to the commercialization potential and key market factors of the whole blood analyzer which is being developed in conjunction with NASA's Space Shuttle Medical System.

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Terrestrial applications from space technology

NASA's Technology Utilization Program, which is concerned with transferring aerospace technologies to the public and private sectors, is described. The strategy for transferring the NASA technologies to engineering projects includes: (1) identification of the problem, (2) selection of an appropriate aerospace technology, (3) development of a partnership with the company, (4) implementation of the project, and (5) commercialization of the product. Three examples revealing the application of aerospace technologies to projects in biomedical engineering, materials, and automation and robotics are presented; the development of a programmable, implantable medication system and a programmable, mask-based optical correlator, and the improvement of heat and erosion resistance in continuous casting are examined.

Clarks, H.↗

Towards industrial development in space

NASA's role in the industrial and commercial development of space is examined. The objectives of the Office of Commercial Programs are discussed. The technology dissemination and technology applications of the Technology Utilization Program are described; examples of successful technology transfers such as the programmable implantable medication system, automatic implantable defibrillation, and the ultrasonic residual stress monitor are provided. Future goals of this program are considered. The Center for Commercial Development of Space program is designed to stimulate space-related research which will produce new products with commercial applications. Examples of NASA-supported R&D projects are presented.

Gillam, I. T., IV↗

Space Station Freedom (SSF) crew systems SE&I

Space Station program office planning and requirements activity has accelerated during the past year to bring the Space Station Freedom Program (SSF) through the program requirements review phase during 1988. The preliminary design review cycle began in Jan. 89, and is now planned for completion, with formal preliminary design reviews between Apr. and Sept., 1990. This paper briefly describes the PROGRAMMATIC aspects of the engineering and integration management of the SSF crew systems. Emphasis is given to the Crew Health Care System, which includes the Health Maintenance Facility, the Exercise Countermeasure Facility, and the Environmental Health System; all managed within the Man-Systems, one of the twelve 'distributed systems.' Medical and engineering requirements to meet the needs of the mature Space Station operations environment and highlights of critical technologies and equipment in development will be reviewed.

Austin, Frank H., Jr.↗

Human support issues and systems for the space exploration initiative: Results from Project Outreach

The analyses and evaluations of the Human Support panel are discussed. The Human Support panel is one of eight panels created by RAND to screen and analyze submissions to the Space Exploration Initiative (SEI) Outreach Program. Submissions to the Human Support panel were in the following areas: radiation protection; microgravity; life support systems; medical care; and human factors (behavior and performance).

Aroesty, J.↗

U.S. commercial space policies - Implications for developing countries

Recent U.S. policy developments on the commercial use of space are summarized and their international implications are considered. Attention is given to successful applications of technology developed in space, including an implantable cancer medication system, an implantable defibrillator, an ultrasonic residual stress monitor, and aquaculture treatment techniques. NASA projects involving bioengineering and rehabilitation applications are summarized, and plans to investigate high-temperature superconductors in space are addressed. Recent agreements entred into by NASA for space commercial studies are reviewed.

Gillam, Isaac T., IV↗

Critical issues for space life sciences

Human exploration of space requires the interaction of three general systems: environmental health and life support systems, countermeasure systems, and medical care systems. These systems address atmospheric pressure, uncertainties associated with space radiation, the potential for exposure to toxic materials in the closed environment, spacecraft habitability, human physiology, and microgrvaity. While these interdependent systems serve the same overall goal -- the protection of the human crewmember from the hostile space environment -- each has specific essential roles. Individually and in combination the three systems should be responsive to a strategy of risk reduction, so that the scientific possibilities of exploration missions may be maximized.

Nicogossian, Arnauld E.↗

Portable X-Ray Device

Portable x-ray instrument developed by NASA now being produced commercially as an industrial tool may soon find further utility as a medical system. The instrument is Lixiscope - Low Intensity X-Ray Imaging Scope -- a self-contained, battery-powered fluoroscope that produces an instant image through use of a small amount of radioactive isotope. Originally developed by Goddard Space Flight Center, Lixiscope is now being produced by Lixi, Inc. which has an exclusive NASA license for one version of the device.

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