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NASA NTRSDate not supplied

Developing Mars-Based Clinical Scenarios for an Earth Independent Medical Operations (EIMO) – Based Decision Support Service

As crewed missions move beyond Low-Earth Orbit, pre-mission planning cannot fully buy down the medical risks of exploration-class missions. Martian missions, where increased hazards exist, (such as long-duration spaceflight, surface-level EVA operations, and communications delays) will require a paradigm shift in the structure of a medical system. An Earth-Independent Medical Operations-based Medical System (EIMO-MS) will need to optimize four critical domains to help provide medical care: utilization of Pre-Mission Planning, augmentation of Acute and Prolonged Medical Decision Making, automated tracking of Resource Management, and assistance in Task Load Balance. The ideal EIMO-MS will be able to accomplish this goal by having an interactive, adaptable interface that will be able to provide real-time medical services. It must respond based on the level of crewmember training, medical situation, and available medical and non-medical resources. To showcase the capabilities and requirements of such a sophisticated automated MS, a series of clinical scenarios of escalating complexity were developed with clinical and systems engineering input. These scenarios describe in clinical detail what a theoretical future medical system, enhanced with multiple information streams (such as a medical database, an AI-based Decision Support System, real-time monitoring, enhanced in-situ laboratory imaging, etc.) can achieve in conjunction with a trained and experienced crew. Scenarios are comprised of: a context section including objectives and applicable spaceflight environment, a highlighted assumptions section, a clinical narrative section, and a systems engineering activity diagram demonstrating the integrated Medical System (MS). The “swim lanes” of the activity diagram act as the logistical core of each scenario and show how the MS will interact with the crew, ground support, and other in-flight systems. The Design Reference Mission that is used for the scenarios is based on existing reference mission profiles [1] with a projected 30-sol stay on the Martian surface. Scenarios span the spectrum from planned evaluations, minor medical care, urgent care, surgical guidance, critical and expectant management, and behavioral health care. Mission complexity will exponentially increase during deep space and Mars exploration-class missions, and medical support for these missions will likewise need to increase in autonomy and adaptability. The integrated system that will support these missions will need to provide assistance in a variety of anticipated and unforeseen scenarios. These medical scenarios, guided by clinician input, are initial steps in crafting the requirements for an EIMO-based medical system. By working in a systems engineering framework, requirements and capabilities can be extracted and mapped while maintaining a clinical core.

Prashant Parmar↗

NASA NTRSDate not supplied

Clinical Decision Support Software: Modeling and Capabilities

With its distance from Earth and communication delays, exploration space flight will place new demands for crew autonomy. Crewmembers operating during such missions require a dedicated Clinical Decision Support System (CDSS) that enhances their earth independence by augmenting their knowledge, skills, and abilities in different medical scenarios. A CDSS is a software application that must function optimally in diverse and varied scenarios (while interfacing with and providing actionable information to appropriate vehicle systems) to augment crew performance by enhancing or adding knowledge, skills, and abilities that preserve health and wellness and ultimately helping to ensure mission success. In addition, the software tool should provide various functions and computational models to meet the demands of astronauts beyond low earth orbit.

B Russell↗

NASA NTRS2015

Human Research Program Advanced Exercise Concepts (AEC) Overview

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

Countermeasures↗

NASA NTRSDate not supplied

Developing Mission Segment-Specific Clinical Data for Impact

Space exploration missions represent a significant future objective for NASA’s human spaceflight operations for the near and long term. By operating missions during longer periods and over further distances, NASA’s mission planning models, hardware systems, and medical capabilities will be stretched beyond their original design constraints. The necessity of medical training and medical supply manifesting for such missions is likely to become incredibly intricate as trade-space analysis is performed over varying mission profiles. For this purpose, IMPACT was created to extend and improve the Integrated Medical Model (IMM) which is used for International Space Station (ISS) medical predications and consists of a probabilistic risk assessment tool that simulates missions to calculate risks given the constraints on crew complement, mission duration and activity (such as Extravehicular Activities), power, communication, mass, volume, and evacuation consideration as well as to predict mission outcomes. Currently, the medical evidence used to support IMPACT remains static, addressing risks of a medical condition and the impacts of the condition during spaceflight only, but is only calculated for a small number of mission parameters. Extended missions will consist of new and varied living environments, changing gravitational loads, and dynamic working requirements. Medical risks are not typically constant but will change depending upon the physical and physiological environment of the body during all phases of a mission. Risks are likely to shift during different mission segments, and understanding how components of a mission profile change risks will assist mission planners to increase chances for mission success.

Christopher Zahner↗

NASA NTRSDate not supplied

Derivation of the Most Influential Medical Conditions for An Extended Duration Artemis Mission

BACKGROUND: The risk of loss of mission due to medical conditions may be influenced by loss of crew life (LOCL), need for evacuation (RTDC; return to definitive care), and crew task time lost. Predicting what medical conditions are most likely to lead to crew morbidity and mortality may influence medical system design, clinical capability prioritization, and research strategies. NASA’s Informing Mission Planning via Analysis of Complex Tradespaces tool (IMPACT) applies Probabilistic Risk Assessment (PRA) methodology to assess these risks. OVERVIEW: A team of subject matter experts (SME) from a variety of medical disciplines developed a consensus-based process to determine 120 of the most clinically relevant medical conditions for long-duration exploration missions (LDEMs) . This IMPACT Condition List (ICL) expanded upon previous work done for Integrated Medical Model (IMM). For each condition a best-case and worst-case definition were derived. These definitions were used to identify probability of occurrence, proportion of cases that are best case vs. worst case, clinical phase duration, and risk of outcomes (task time loss [TTL], RTDC, and LOCL) for both treated and untreated states. These data were sources from existing spaceflight databases (e.g. Longitudinal Survey of Astronaut Health), relevant models (e.g. the ISS fire model), and/or terrestrial literature. Each condition was then tied to diagnostic and therapeutic resources and capabilities. IMPACT was then run for the LDLOLS DRM (see Abstract #2 for this panel). DISCUSSION: This abstract will present the process for generating the IMPACT condition list, the relevant data for each clinical condition, and present results for the ten most influential conditions impacting LOCL, RTDC, and TTL for a representative extended duration Artemis mission.

A Nelson↗

NASA NTRS2024

Alignment of NASA’s Human System Risks with Technological Capability Gaps to Enable Integrated Research and Technology Development Strategic Planning

BACKGROUND: Radiation, reduced gravity, distance from earth, isolation and confinement, and habitation within artificially created and controlled life support environments are hazards that present risk to human space explorers. NASA’s Human System Risk Board (HSRB) maintains a set of twenty-nine different Human System Risks with subject matter experts from across the agency providing regular updates to the estimated likelihood and consequence associated with each risk. The Human Research Program (HRP) has historically used these risk classifications as a primary basis for identifying and prioritizing human research investments aimed at characterizing and/or mitigating the respective human system risks. In many cases, technology development is required to mature and validate risk mitigation strategies, however, NASA’s primary technology development programs have not typically used Human System Risks as a basis for strategic planning. A primary function of the Environmental Control and Life Support Systems (ECLSS) – Crew Health and Performance (CHP) System Capability Leadership Team (SCLT) is to continually identify, review, and update technological capability gaps and to establish and oversee multiyear strategic roadmaps aimed at guiding NASA’s technology development priorities in these areas. These roadmaps are intended to be agency-wide and independent of any program, directorate, or other organization within NASA. DESCRIPTION: The SCLT and HRP collaborated to establish a set of Human System Capability Gaps, which establish a formal linkage between the capability gaps used to prioritize investments across much of NASA, and the Human System Risks that are primarily used to inform and prioritize human research. This set of twenty-eight gaps was developed by subject matter experts, and each gap mapped to the primary associated Human System Risks. The gaps and risk mapping were then reviewed and approved via the HSRB, thereby formally aligning the research-focused Human System Risks with the technology-focused capability gaps. DISCUSSION: This effort has enabled development of integrated roadmaps and budget coordination with research and technology development activities that are formally linked to agency-recognized capability gaps and Human System Risks. Close and ongoing coordination between the SCLT, HRP, Mars Campaign Office, and the Health & Medical Technical Authority (HMTA) is essential to ensure alignment and prioritization of CHP-related research and technology development to enable NASA’s future exploration missions.

Andrew F J Abercromby↗

NASA NTRS2015

Integrated Medical Model Overview

The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project.

Spae Adaptation Syndrome↗

DOE OSTI2023

Second Report of the Nuclear Data Subcommittee of the Nuclear Science Advisory Committee

The central importance of the nuclear data curated by the US Nuclear Data Program (USNDP) for clean energy generation, national security, nonproliferation, medical applications, and space exploration as well as basic science was described in a prior report issued by the DOE/NSF Nuclear Science Advisory Committee subcommittee on Nuclear Data (NSAC-ND) in September 2022. In this report, we present a set of fourteen (14) recommendations that will enhance and advance DOE-NP's stewardship of nuclear data. The first three recommendations focus on the existing core USNDP capabilities, namely: 1) Support the nuclear structure evaluation workforce to improve the currency, consistency, and accessibility of the Evaluated Nuclear Structure Data File (ENSDF); 2) Enhance nuclear reaction evaluation within the USNDP in support of the Evaluated Nuclear Data File (ENDF) through expansion of the workforce and integration of high-performance computing, automation, and machine learning and; 3) Continue atomic mass evaluation in support AME and NUBASE databases. This is followed by eight (8) recommendations representing new cross-cutting initiatives involving both measurement and evaluation to address outstanding nuclear data needs. These new initiatives require a highly trained, diverse workforce that includes personnel with expertise from both inside and outside the nuclear physics community from which evaluators have traditionally been recruited. As such, many of these initiatives are accomplished via a Topical Nuclear Data Collaborations (TNDC). A TNDC is made up of domestic and international stakeholders, subject matter and nuclear data experts, and nuclear data evaluators and features a workforce development plan to ensure that nuclear data evaluators maintain currency in the relevant applications and are seen as equity partners in the endeavor. These include: 1) Establish a coordinated effort to improve evaluation and modeling in nuclear astrophysics for stellar dynamics, multi-messenger astronomy and nucleosynthesis; 2) Initiate a TNDC to develop and maintain nuclear structure evaluation beyond discrete states, including nuclear level densities, photon strength functions and photonuclear data for improved reaction modeling, and exploring nuclear structure at finite temperature; 3) Create a TNDC to perform correlated fission data evaluation, including cross sections, fragment yields, v(A), v(E n ) for nuclear energy, national security, nonproliferation and basic science; 4) From a panel of subject matter experts to establish and annually update a roster of key decay data to nurture its accelerated dissemination including both measurement and evaluation for targeted high-value nuclides for national security, nonproliferation and medical applications; 5) Comprehensive, consistent neutron-induced structure and reaction data for nuclear energy, national security, nonproliferation and planetary nuclear spectroscopy; 6) Charged-particle stopping powers for detector design, space effects and ion beam therapy; 7) High-energy reactions for space exploration and medical nuclide production, and; 8) The creation of an infrastructure for open data and data preservation for use by the entire nuclear physics community. All told, these initiatives require approximately $6.5M increase in NP support of the USNDP in fiscal year 2023 dollars and would require at least 3-5 years to carry out due to the length of time needed to recruit and train new nuclear data researchers. This relatively modest investment would help ensure that the fruits of the nuclear data research carried out by DOE-NP and its collaborators would be brought to bear to address some of the most important needs of our nation and the world. To ensure effective execution of this plan, we present an overview of recruitment, training, and retention goals for the USNDP, the centerpiece of which is a mutually agreed upon code of conduct. Finally, we identify the facility and instrumentation needed to perform the recommended experimental activities. This includes a short review of target fabrication capabilities, reactors, neutron beam, light- and heavy-stable ion, gamma-ray, high-energy and radioactive ion beam facilities. Lastly, a more complete appendix of experimental facilities previously compiled is included with new input provided for 6 facilities.

73 NUCLEAR PHYSICS AND RADIATION PHYSICS↗

DOE OSTI2023

CRADA Number NFE-19-07859 with Purist, Inc. (CRADA Final Report)

Cooperative Research and Development Agreement (CRADA) NFE-19-07859 between Oak Ridge National Laboratory (ORNL) and Purist Inc. (Purist) focused on developing a technology for production of high purity radioisotopes using small-scale underutilized research nuclear reactors. Purist is developing a novel production mechanism that will produce, and efficiently isolate radioisotopes with high specific activity at small-scale research reactors. The goal of this technology is to enable underutilized smaller scale reactors, typically not capable of producing medical grade radioisotopes, to be utilized as a production supply source. Such radioisotope production facilities will complement production efforts of the few larger production facilities to reduce and prevent risk in the medical isotope supply chain. The work done under this CRADA explored target development, to maximize isotope production and separation using Purist’s technology to ultimately obtain a radioisotope product with high specific activity for use in medical applications. Furthermore, under this CRADA post production, capture, concentration and encapsulation of the radioisotope product was studied by developing post irradiation midi to microscale processes to capture, store and release the separated radioisotopes from large volumes of the capture matrix after production, via automated High-Pressure Ion Chromatography (HPIC) and microfluidic purification/separation systems. This will enable concentration of the radioisotope product obtained into small volumes, which will aid in packaging and transporting the final radioisotope product to users.

07 ISOTOPE AND RADIATION SOURCES↗

NASA NTRS2010

Human Health and Performance Considerations for Exploration of Near-Earth Asteroids

This presentation will describe the human health and performance issues that are anticipated for the human exploration of near-Earth asteroids (NEA). Humans are considered a system in the design of any such deep-space exploration mission, and exploration of NEA presents unique challenges for the human system. Key factors that define the mission are those that are strongly affected by distance and duration. The most critical of these is deep-space radiation exposure without even the temporary shielding of a nearby large planetary body. The current space radiation permissible exposure limits (PEL) restrict mission duration to 3-10 months depending on age and gender of crewmembers and stage of the solar cycle. Factors that affect mission architecture include medical capability; countermeasures for bone, muscle, and cardiovascular atrophy during continuous weightlessness; restricted food supplies; and limited habitable volume. The design of a habitat that can maintain the physical and psychological health of the crew and support mission operations with limited intervention from Earth will require an integrated research and development effort by NASA s Human Research Program, engineering, and human factors groups. Limited abort and return options for an NEA mission are anticipated to have important effects on crew psychology as well as influence medical supplies and training requirements of the crew. Other important factors are those related to isolation, confinement, communication delays, autonomous operations, task design, small crew size, and even the unchanging view outside the windows for most of the mission. Geological properties of the NEA will influence design of sample handling and containment, and extravehicular activity capabilities including suit ports and tools. A robotic precursor mission that collects basic information on NEA surface properties would reduce uncertainty about these aspects of the mission as well as aid in design of mission architecture and exploration tasks.

Kundrot, Craig↗

NASA NTRS2007

Zero-Gravity Locomotion Simulators: New Ground-Based Analogs for Microgravity Exercise Simulation

Maintaining health and fitness in crewmembers during space missions is essential for preserving performance for mission-critical tasks. NASA's Exercise Countermeasures Project (ECP) provides space exploration exercise hardware and monitoring requirements that lead to devices that are reliable, meet medical, vehicle, and habitat constraints, and use minimal vehicle and crew resources. ECP will also develop and validate efficient exercise prescriptions that minimize daily time needed for completion of exercise yet maximize performance for mission activities. In meeting these mission goals, NASA Glenn Research Center (Cleveland, OH, USA), in collaboration with the Cleveland Clinic (Cleveland, Ohio, USA), has developed a suite of zero-gravity locomotion simulators and associated technologies to address the need for ground-based test analog capability for simulating in-flight (microgravity) and surface (partial-gravity) exercise to advance the health and safety of astronaut crews and the next generation of space explorers. Various research areas can be explored. These include improving crew comfort during exercise, and understanding joint kinematics and muscle activation pattern differences relative to external loading mechanisms. In addition, exercise protocol and hardware optimization can be investigated, along with characterizing system dynamic response and the physiological demand associated with advanced exercise device concepts and performance of critical mission tasks for Exploration class missions. Three zero-gravity locomotion simulators are currently in use and the research focus for each will be presented. All of the devices are based on a supine subject suspension system, which simulates a reduced gravity environment by completely or partially offloading the weight of the exercising test subject s body. A platform for mounting treadmill is positioned perpendicularly to the test subject. The Cleveland Clinic Zero-g Locomotion Simulator (ZLS) utilizes a pneumatic subject load device to apply a near constant gravity-replacement load to the test subject during exercise, and is currently used in conjunction with the General Clinical Research Center for evaluating exercise protocols using a bedrest analog. The enhanced ZLS (eZLS) at NASA Glenn Research Center features an offloaded treadmill that floats on a thin film of air and interfaces to a force reaction frame via variably-compliant isolators, or vibration isolation system. The isolators can be configured to simulate compliant interfaces to the vehicle, which affects mechanical loading to crewmembers during exercise, and has been used to validate system dynamic models for new countermeasures equipment designs, such as the second International Space Station treadmill slated for use in 2010. In the eZLS, the test subject and exercise device can be pitched at the appropriate angle for partial gravity simulations, such as lunar gravity (1/6th earth gravity). On both the eZLS and the NASA-Johnson Space Center standalone ZLS installed at the University of Texas Medical Branch in Galveston, Texas, USA, the subject's body weight relative to the treadmill is controlled via a linear motor subject load device (LM-SLD). The LM-SLD employs a force-feedback closed-loop control system to provide a relatively constant force to the test subject during locomotion, and is set and verified for subject safety prior to each session. Locomotion data were collected during parabolic flight and on the eZLS. The purpose was to determine the similarities and differences between locomotion in actual and simulated microgravity. Subjects attained greater amounts of hip flexion during walking and running during parabolic flight. During running, subjects had greater hip range of motion. Trunk motion was significantly less on the eZLS than during parabolic flight. Peak impact forces, loading rate, and impulse were greater on the eZLS than during parabolic while walking with a low external load (EL) and rning with a high EL. Activation timing differences existed between locations in all muscles except for the rectus femoris. The tibialis anterior and gluteus maximus were active for longer durations on the eZLS than in parabolic flight during walking. Ground reaction forces were greater with the LM-SLD than with bungees during eZLS locomotion. While the eZLS serves as a ground-based analog, researchers should be aware that subtle, but measurable, differences in kinematics and leg musculature activities exist between the environments. Aside from space applications, zero-gravity locomotion simulators may help medical researchers in the future with development of rehabilitative or therapeutic protocols for injured or ill patients. Zero-gravity locomotion simulators may be used as a ground-based test bed to support future missions for space exploration, and eventually may be used to simulate planetary locomotion in partial gravity environments, including the Moon and Mars. Figure: Zero-gravity Locomotion Simulator at the Cleveland Clinic, Cleveland, Ohio, USA

Perusek, Gail P.↗

NASA NTRSDate not supplied

Crew Health and Performance Integrated Data System Platform Project Updates

Future human exploration missions introduce a new paradigm as crews move further from the resupply and near real-time ground support typical of Low Earth Orbit missions today. Without immediate support from ground-based personnel, exploration crews will be more reliant on inflight data and technology to respond to emergencies and anomalies. Today, in-flight data is often siloed, unsynchronized, and largely inaccessible in real time. Many data sets require manual entry and/or data transfer between vehicles and the ground. These issues contribute to risks in supporting crew autonomy for future exploration missions. An integrated data system platform is needed to mitigate these risks by supporting a new generation of technologies and employing advanced analytical and predictive modeling techniques to enable crew autonomy for future exploration missions. The Crew Health and Performance Integrated Data System Platform (CHP-IDSP) project is laying a foundation for future in-flight informatics by providing a back-end architecture for collecting, storing, and integrating multiple sources of data generated by and around the crew. This cohesive integration point will streamline the management of CHP data (e.g., environmental, exercise, medical, sleep, performance, etc.) and facilitate situation awareness and decision support required by the crew and remote support of exploration missions. This presentation will describe the ongoing development effort of the path-to-flight CHP-IDSP software and the demonstration of its core capabilities. This includes a brief history of the project, the human-centered process used to identify data needs and workflows feeding the development of scenarios and requirements, and current subsystem development status. Current integrations, including the Chiron exploration electronic health record application, will be discussed. Future work includes collaboration with additional CHP domains and a flight technology demonstration.

Data integration↗

NASA NTRSDate not supplied

Crew Health and Performance Integrated Data Service Platform (CHP-IDSP): Project Updates

Future human exploration missions introduce a new paradigm as crews move further from the resupply and near real-time ground support typical of Low Earth Orbit missions today. Without immediate support from ground-based personnel, exploration crews will be more reliant on inflight data and technology to respond to emergencies and anomalies. Today, in-flight data is often siloed, unsynchronized, and largely inaccessible in real time. Many data sets require manual entry and/or data transfer between vehicles and the ground. These issues contribute to risks in supporting crew autonomy for future exploration missions. An integrated data services platform is needed to mitigate these risks by supporting a new generation of technologies and employing advanced analytical and predictive modeling techniques to enable crew autonomy for future exploration missions. The Crew Health and Performance Integrated Data System Platform (CHP-IDSP) project is laying a foundation for future in-flight informatics by providing a back-end architecture for collecting, storing, and integrating multiple sources of data generated by and around the crew. This cohesive integration point will streamline the management of CHP data (e.g., environmental, exercise, medical, sleep, performance, etc.) and facilitate situation awareness and decision support required by the crew and remote support of exploration missions. This presentation will describe the ongoing development effort of the path-to-flight CHP-IDSP software and the demonstration of its core capabilities. This includes a brief history of the project, the human-centered process used to identify data needs and workflows feeding the development of scenarios and requirements, and current subsystem development status. Current integrations, including the Chiron exploration electronic health record application, will be discussed. Future work includes collaboration with additional CHP domains and a flight technology demonstration.

Software↗

NASA NTRS2016

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploration Symposium

Surgical capabilities in human space flight, whether on a space-based platform in low Earth orbit or on a long duration planetary exploration mission, will be challenging to conduct for a variety of reasons, some of which will be ameliorated by training, technology, and pre-flight planning. Nevertheless, inherent risks and challenges remain. Early space missions did not have any surgical capability. It was not until NASA's Skylab mission that serious consideration was given to this fundamental medical care capability. Over the past 30 years, subject matter experts have been brought together for discussion on the myriad of challenges and opportunities in this endeavor. The last such meeting was held in 2005 at the NASA Johnson Space Center. As we continue to move forward with human space flight activities for the International Space Station and beyond, the capabilities of information technology, robotics, sensors and imaging have rapidly changed since the last gathering of expertise. In December 2015, through sponsorship of the National Space Biomedical Research Institute (NSBRI), a diverse group of individuals from government, academia, and industry representing three countries gathered at the NSBRI Space 4 Biomedicine facility in Houston, TX. This two day symposia included comprehensive sessions that addressed the challenges that we all face in developing, deploying, and utilizing surgical care capabilities in all human space missions, regardless of mission duration or profile. The symposium benefited from the knowledge and experience of three seasoned NASA physician astronauts, Drs. Jay Buckey, Thomas Marshburn, and Lee Morin. At the end of the first day, the assembled group heard from the crew members about their experiences and their ideas. It is clear that the discussion of surgical capabilities is part of the larger discussion of consideration of advanced healthcare, including critical care, on exploration space missions. This report represents the culmination of the symposium, capturing knowledge, experience, conceptual dialogue, and a narrative that can be used in supporting the development of future programs and potential policy. Each of the presentations that were provided by the guest speakers is included in the appendices. Those presentations that are not included were due to sensitivity of the material or at the request of the speaker. In addition, each speaker was offered an opportunity to provide comments in a 'lightning round' format. All of these comments and speaker abstracts also appear in the appendices. At the conclusion of the second day, a discussion was held that reviewed the priorities that perhaps add value to decision makers. These are also summarized. This report will serve as the final product of this symposium. Additional material may be produced for the peer-reviewed literature.

Doarn, Charles R.↗

DOE OSTI2023

Deep learning applications in visual data for benign and malignant hematologic conditions: a systematic review and visual glossary

Deep learning (DL) is a subdomain of artificial intelligence algorithms capable of automatically evaluating subtle graphical features to make highly accurate predictions, which was recently popularized in multiple imaging-related tasks. Because of its capabilities to analyze medical imaging such as radiology scans and digitized pathology specimens, DL has significant clinical potential as a diagnostic or prognostic tool. Coupled with rapidly increasing quantities of digital medical data, numerous novel research questions and clinical applications of DL within medicine have already been explored. Similarly, DL research and applications within hematology are rapidly emerging, although these are still largely in their infancy. Given the exponential rise of DL research for hematologic conditions, it is essential for the practising hematologist to be familiar with the broad concepts and pitfalls related to these new computational techniques. This narrative review provides a visual glossary for key deep learning principles, as well as a systematic review of published investigations within malignant and non-malignant hematologic conditions, organized by the different phases of clinical care. In order to assist the unfamiliar reader, this review highlights key portions of current literature and summarizes important considerations for the critical understanding of deep learning development and implementations in clinical practice.

60 APPLIED LIFE SCIENCES↗

NASA NTRS2009

Results From the John Glenn Biomedical Engineering Consortium. A Success Story for NASA and Northeast Ohio

The John Glenn Biomedical Engineering Consortium was established by NASA in 2002 to formulate and implement an integrated, interdisciplinary research program to address risks faced by astronauts during long-duration space missions. The consortium is comprised of a preeminent team of Northeast Ohio institutions that include Case Western Reserve University, the Cleveland Clinic, University Hospitals Case Medical Center, The National Center for Space Exploration Research, and the NASA Glenn Research Center. The John Glenn Biomedical Engineering Consortium research is focused on fluid physics and sensor technology that addresses the critical risks to crew health, safety, and performance. Effectively utilizing the unique skills, capabilities and facilities of the consortium members is also of prime importance. Research efforts were initiated with a general call for proposals to the consortium members. The top proposals were selected for funding through a rigorous, peer review process. The review included participation from NASA's Johnson Space Center, which has programmatic responsibility for NASA's Human Research Program. The projects range in scope from delivery of prototype hardware to applied research that enables future development of advanced technology devices. All of the projects selected for funding have been completed and the results are summarized. Because of the success of the consortium, the member institutions have extended the original agreement to continue this highly effective research collaboration through 2011.

Nall, Marsha M.↗

NASA NTRS2024

NASA’s Top Human System Research and Technology Needs for Mars

NASA is working with industry and international partners to return humans to the Moon and to eventually enable humans to explore Mars. Within NASA, several organizations work together to identify, prioritize, fund, execute, and operationalize the research and technology development (R&TD) that will be necessary to enable crew health and performance (CHP) during these future missions. These organizations include flight programs, the Health and Medical Technical Authority (HMTA), the Human Research Program, the Space Technology Mission Directorate, System Capability Leadership Teams, and other organizations, many of which existed for several years prior to the creation of the Moon-to-Mars (M2M) Program Office in 2023. A variety of constructs, vocabularies, and processes exist for managing risks and supporting strategic planning across these organizations. For example, M2M objectives, program risks, human system risks, human research gaps, capability gaps, and envisioned futures are all constructs currently used within NASA to identify and prioritize R&TD needs. These strategic planning constructs are evolving to allow M2M objectives and R&TD investments to be aligned and traced at a detailed level. A recognized need exists among stakeholder organizations to identify and communicate the highest CHP R&TD priorities in a unified and digestible way that addresses the perspectives of NASA’s CHP community. To achieve this, the HMTA arranged a series of discussions with representatives of NASA’s CHP community, during which the 8 highest priority CHP capabilities that will enable human missions to Mars, referred to as the “top human system capability needs for Mars”, were identified. The list includes Earth-independent human operations; Mars-duration food system; Mars-duration effects on human physiology; risk mitigations for vehicle atmospheres; computational injury and anthropometric models; exploration exercise countermeasures; individual variability in responses to spaceflight; and sensorimotor countermeasures. Existing tools and processes for strategic planning and risk management were evaluated, as well as the technical practicalities, cost, and schedule feasibility associated with potential R&TD investments in different capability need areas. This capability needs report is not owned by any one NASA organization and does not replace existing strategic or program planning processes; rather it aims to complement and inform them with a unified set of community generated priorities. These top capability needs will be re-evaluated periodically based on R&TD progress and the evolving M2M architecture.

technology gaps↗

NASA NTRSDate not supplied

NASA’s Top Human System Research and Technology Needs for Mars

technology gaps↗