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At least 253 records · Page 14

Lab-On-a-Chip Application Development (LOCAD): Bridging Technology Readiness for Exploration

At Marshall Space Flight Center we have established a capability to investigate the use of microfluidics for space flight. The Lab-On-a-Chip Application Development (LOCAD) team has created a program for advancing Technology Readiness Levels (TRL) of 1 and 2 to TRL 6 and 7, quickly and economically for Lab-On-a-Chip (LOC) applications. Scientists and engineers can utilize LOCAD'S process to efficiently learn about microfluidics and determine if microfluidics is applicable to their needs. Once the applicability has been determined, LOCAD can then perform tests to develop the new fluidic protocols which are different from macro-scale chemical reaction protocols. With this information new micro-fluidic devices can be created and tested. Currently, LOCAD is focused on using microfluidics for both Environmental Monitoring & Control, and Medical Systems. Eventually, handheld portable units utilizing LOC technology will perform rapid tests to determine water quality, and microbial contamination levels. Since LOC technology is drastically reduced in physical size, it thereby reduces power, weight, volume, and sample requirements, a big advantage considering the resource constraints associated with spaceflight. Another one of LOCAD's current activities is the development of a microfluidic system to aid in the search for life on Mars.

Spearing, Scott F.↗

Exploration Medical Capability (ExMC) Program

This document reviews NASA's Exploration Medical Capability (ExMC) program. The new space exploration program, outlined by the President will present new challenges to the crew's health. The project goals are to develop and validate requirements for reliable, efficient, and robust medical systems and treatments for space exploration to maximize crew performance for mission objectives.

Kalla, Elizabeth↗

The Integrated Medical Model

This slide presentation reviews the goals and approach for the Integrated Medical Model (IMM). The IMM is a software decision support tool that forecasts medical events during spaceflight and optimizes medical systems during simulations. It includes information on the software capabilities, program stakeholders, use history, and the software logic.

Butler, Douglas J.↗

An Ophthalmologic Summit for On-Orbit Care

Ophthalmologic issues are a source of concern for NASA flight surgeons, due to the remote nature of the space station as well as the microg ravity environment. Methods: A panel of external consultants was conv ened to evaluate the adequacy of the current in-flight medical system for the diagnosis and treatment of ophthalmologic issues. Participants were acknowledged experts in their field who also had experience in operational medicine. Results: Nine extramural experts provided assi stance, and six of them participated in a face to face meeting held a t NASA-Johnson Space Center. Changes were recommended for the space s tation pharmacopoeia, and diagnostic, therapeutic, and deorbit criteria protocols for a variety of ocular conditions were developed. Discus sion: The results of the panel provide an evidence based approach to the diagnosis and care of ophthalmologic conditions on the International Space Station

Bacal, Kira↗

Modelflow Estimates of Stroke Volume Do Not Correlate With Doppler Ultrasound Estimates During Upright Posture

Orthostatic intolerance affects 60‐80% of astronauts returning from long‐duration missions, representing a significant risk to completing mission‐critical tasks. While likely multifactorial, a reduction in stroke volume (SV) represents one factor contributing to orthostatic intolerance during stand and head up tilt (HUT) tests. Current measures of SV during stand or HUT tests use Doppler ultrasound and require a trained operator and specialized equipment, restricting its use in the field. BeatScope (Finapres Medical Systems BV, The Netherlands) uses a modelflow algorithm to estimate SV from continuous blood pressure waveforms in supine subjects; however, evidence supporting the use of Modelflow to estimate SV in subjects completing stand or HUT tests remain scarce. Furthermore, because the blood pressure device is held extended at heart level during HUT tests, but allowed to rest at the side during stand tests, changes in the finger arterial pressure waveform resulting from arm positioning could alter modelflow estimated SV. The purpose of this project was to compare Doppler ultrasound and BeatScope estimations of SV to determine if BeatScope can be used during stand or HUT tests. Finger photoplethysmography was used to acquire arterial pressure waveforms corrected for hydrostatic finger‐to‐heart height using the Finometer (FM) and Portapres (PP) arterial pressure devices in 10 subjects (5 men and 5 women) during a stand test while simultaneous estimates of SV were collected using Doppler ultrasound. Measures were made after 5 minutes of supine rest and while subjects stood for 5 minutes. Next, SV estimates were reacquired while each arm was independently raised to heart level, a position similar to tilt testing. Supine SV estimates were not significantly different between all three devices (FM: 68+/-20, PP: 71+/-21, US: 73+/-21 ml/beat). Upon standing, the change in SV estimated by FM (‐18+/-8 ml) was not different from PP (‐21+/-12), but both were significantly less than US (‐37+/-16 ml, p<.05). Raising finger BP devices to heart level caused no significant change in SV measured with any of the devices (FM: 1.5+/-19, PP: 1.7+/-26, US: 0.5+/-6), although variability was 3‐6x greater as assessed by both blood pressure devices compared to US. Retrospective analysis of blood pressure data to assess SV in 11 supine subjects revealed significantly different estimates between methods (FM: 95+/-17, US: 75+/-32, p<.05), but the change in SV resulting from HUT was similar between methods (FM: ‐37+/-9, US: ‐40+/-18 ml). However, the correlation coefficient determined from pairs of SV estimated by US and FM was weak (r2=0.03). These data suggest Modelflow cannot be used in lieu of Doppler ultrasound to estimate SV during stand or HUT tests. Further investigation should focus on identifying factors contributing to differences between these measurement techniques in order to make use of a simple method for assessing beat‐by‐beat changes in SV during postural changes, especially during field testing.

Ferguson, Connor R.↗

Programmatic Considerations to Reduce the Risk of Adverse Renal Stone Events in Spaceflight

Introduction: Microgravity exposure may alter the likelihood that astronauts will experience renal stones. The potential risk includes both acute and chronic health issues, with the potential for significant impact on mission objectives. Methods: To understand the role of the NASA's Human Research Program (HRP) research agenda in both preventing and addressing renal stones in spaceflight, current astronaut epidemiologic data and a summary of programmatic considerations are reviewed. Results: Although there has never been a symptomatic renal stone event in a U.S. crewmember during spaceflight, urine chemistry has been altered - likely due to induced changes in renal physiology as a result of exposure to microgravity. This may predispose astronauts to stone formation, leading the HRP to conduct and sponsor research to: 1) understand the risk of stone formation in space; 2) prevent stones from forming; and 3) address stones that may form by providing novel diagnostic and therapeutic approaches. Discussion: The development of a renal stone during spaceflight is a significant medical concern that requires the HRP to minimize this risk by providing the ability to prevent, diagnose, monitor and treat the condition during spaceflight. A discussion of the risk as NASA understands it is followed by an overview of the multiple mitigations currently under study, including novel ultrasound techniques for stone detection and manipulation, and how they may function as part of a larger exploration medical system.

Antonsen, Erik↗

Introduction to Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT)

A key component in the development of NASA Human Research Programs (HRP) next generation risk model, the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) intends to deliver a means to quantify how HRP products impact astronaut medical and health risks. MEDPRAT is extensible to the majority of exploration missions. Similar to other risk models, the tool utilizes the available space and terrestrial medical data. MEDPRAT is designed to be extended with additional human health research information, medical equipment, space and terrestrial standards and practices to assess space flight medical risk in a manner consistent with other risk measures used in spacecraft and mission design. This tool provides risk-based medical system design information necessary to evaluate new technologies, procedures, research insights and mission plans.

physiological response↗

A Qualitative Systematic Review Evaluating the Impact of Elevated Ambient Co2 in Atmosphere on Pharmaceutical Stability

Pharmaceuticals are an essential component of the medical system for crewed missions. Current research has identified decreased stability in space-flown pharmaceuticals compared to ground controls, and this presents a significant risk for future exploration-class missions where resupply will be limited. While the cause is not known, the elevated ambient carbon dioxide (CO2) in the spacecraft atmosphere has been postulated as a potential cause.

A Yuen↗

Planetary Protection Policy and Technology Developments for the Crewed Exploration of Mars

As part of planning for potential future crewed exploration of Mars, NASA is developing its planetary protection policy for crewed missions, building on concepts developed within the international space exploration community. COSPAR (The Committee on Space Research), together with participating space agencies, has over the last several years organized and held interdisciplinary meetings to consider next steps in addressing knowledge gaps for planetary protection for the first human missions to Mars. Beginning with these workshop discussions as a base, NASA has held follow-on planning activities to identify the necessary steps to be accomplished to close those knowledge gaps. Significant overlap was identified between the planetary protection needs, including; microbial monitoring requirements for crew health and medical systems; studies of the microbiome of the built environment; environmental control and life support system (ECLSS) venting and disinfection strategies; waste management, and; planetary surface operations. In many cases, efforts to mature exploration systems for Mars that are occurring in other technology domains can be leveraged with minor changes to address planetary protection gaps as well. In other cases, work planned for testing on ISS as an analog for Mars transit, or on the lunar surface as an analog for Mars surface operations, can be used to close gaps in current planetary protection capabilities. This presentation provides a status update on the findings of the COSPAR Meetings on this topic to date, together with NASA’s responses in terms of agency-level plans and activities.

James N Benardini↗

C14-radiorespirometry system for astronaut medical monitoring.

A C14-CO2 radiorespirometry-computer system for monitoring human metabolism during space missions is described. Data collection using this apparatus is an effective 'real time' system allowing rapid, low-cost data processing which is ideal for telemetering signals from spacecraft to earth.

Feller, D. D.↗

Computer Program and User Documentation Medical Data Input System

Several levels of documentation are presented for the program module of the NASA medical directorate minicomputer storage and retrieval system. The biomedical information system overview gives reasons for the development of the minicomputer storage and retrieval system. It briefly describes all of the program modules which constitute the system. A technical discussion oriented to the programmer is given. Each subroutine is described in enough detail to permit in-depth understanding of the routines and to facilitate program modifications. The program utilization section may be used as a users guide.

Anderson, J.↗

Microminiaturized, biopotential conditioning system (MBCS)

Multichannel, medical monitoring system allows almost complete freedom of movement for subject during monitoring periods. System comprises monitoring unit (biobelt), transmission line, and data acquisition unit. Belt, made of polybenzimidizole fabric, is wrapped around individual's waist and held in place by overlapping sections of Velcro closure material.

Belasco, N.↗

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

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

Joshua M Fody↗

Medical evaluations on the KC-135 1991 flight report summary

The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.

Lloyd, Charles W.↗

Exploration Medical Capability Clinical Decision Support System Concept of Operations

The Clinical Decision Support (CDS) project supports the Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP). Specifically, the CDS project addresses the ExMC gap, Medical-701: 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 as we enter a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant change in in-flight medical care due to constraints on mass, volume, power, crew time, skills reduction over time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. Unlike the current paradigm for crew health in low-Earth orbit missions that rely on constant communication with Mission Control, the deep space missions will experience communication delays and possibly, no communications for finite periods of time. Hence, crew health management will benefit from analytics’ capabilities to augment decision support. A comprehensive, multi-functional on-board clinical decision support system (CDSS) will help crews assess and diagnose conditions, decide appropriate responses, and guide the provision of tailored and evidence-based treatments, while reflecting contextual factors and constraints. The context may include present and historical data, viable diagnostic equipment, available supplies and medications, and vehicle and environmental health. Communication time with ground-based personnel is delayed or non-existent during significant portions of the mission so the crew will need to autonomously respond to health, performance and medical situations, particularly those that are unplanned. The CDSS must also provide additional capabilities as complex as training for an emergency situation while augmenting non-expert practitioner skillsets if the Crew Medical Officer (CMO) is incapacitated, and as routine as facilitating delayed communication with flight surgeons on the ground. The CDSS must connect complex issues involving health, wellness, task performance and environmental domains. Furthermore, CDSS functionality will focus on semi-autonomous and autonomous decision-making by the crew that is necessary to address challenges in executing a self-contained medical system that enables health care without assistance from ground clinical experts. The document, ExMC CDSS Architecture Recommendation, (HRP- 48032) establishes a description of the envisioned CDSS architecture. The analytics, descriptive or advanced, contained in a CDSS will interface with the integrated crew health and performance architecture that provides the appropriate data sets. The aim of the CDS project is to develop requirements for a CDSS through a series of test-bed prototype developments and demonstrations.

HRP↗

Medical Information Management System (MIMS): A generalized interactive information system

An interactive information system is described. It is a general purpose, free format system which offers immediate assistance where manipulation of large data bases is required. The medical area is a prime area of application. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

Alterescu, S.↗

Expert Witness: A system for developing expert medical testimony

Expert Witness in an expert system designed to assist attorneys and medical experts in determining the merit of medical malpractice claims in the area of obstetrics. It substitutes the time of the medical expert with the time of a paralegal assistant guided by the expert system during the initial investigation of the medical records and patient interviews. The product of the system is a narrative transcript containing important data, immediate conclusions from the data, and overall conclusions of the case that the attorney and medical expert use to make decisions about whether and how to proceed with the case. The transcript may also contain directives for gathering additional information needed for the case. The system is a modified heuristic classifier and is implemented using over 600 CLIPS rules together with a C-based user interface. The data abstraction and solution refinement are implemented directly using forward chaining production and matching. The use of CLIPS and C is essential to delivering a system that runs on a generic PC platform. The direct implementation in CLIPS together with locality of inference ensures that the system will scale gracefully. Two years of use has revealed no errors in the reasoning.

Lewandowski, Raymond↗

Medical Information Management System (MIMS): An automated hospital information system

An automated hospital information system that handles all data related to patient-care activities is described. The description is designed to serve as a manual for potential users, nontechnical medical personnel who may use the system. Examples of the system's operation, commentary on the examples, and a complete listing of the system program are included.

Alterescu, S.↗