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NASA Low Power Stirling Convertor for Small Landers, Probes, and Rovers Operating in Darkness

A variety of mission concepts have been studied by NASA and the U. S. Department of Energy that would utilize low power Radioisotope Power Systems (RPS) for probes, landers rovers, and repeaters. These missions would contain science instruments distributed across planetary surfaces or near objects of interest where solar flux is insufficient for using solar cells. Landers could be used to provide data like radiation, temperature, pressure, seismic activity, and other surface measurements for planetary science and to inform future mission planners. The studies proposed using fractional versions of the General Purpose Heat Source (GPHS) or multiple Light Weight Radioisotope Heater Units (LWRHU) to heat power conversion technologies for science instruments and communication. Dynamic power systems are capable of higher conversion efficiencies, which could enable equal power using less fuel or more power using equal fuel, when compared to less efficient static power conversion technologies. Providing spacecraft with more power would decrease duty cycling of basic functions and, therefore, increase the quality and abundance of science data. Low power Stirling convertors are being developed at NASA Glenn Research Center (GRC) to provide future micro spacecraft with electrical power by converting heat from one or more LWRHUs. An initial design converts multiple watts of heat to one watt of electrical power output using a Stirling convertor. Development of the concept includes maturation of convertor and controller designs, performance evaluation of an evacuated metal foil insulation, and development of system interfaces. Demonstration of the convertor is planned and represents a new class of RPS with power levels an order of magnitude lower than previous practical designs.

Wilson, Scott D.↗

Haughton-Mars Project/NASA 2006 Lunar Medical Contingency Simulation: Equipment and Methods for Medical Evacuation of an Injured Crewmember

Introduction: Achieving NASA's Space Exploration Vision scientific objectives will require human access into cratered and uneven terrain for the purpose of sample acquisition to assess geological, and perhaps even biological features and experiments. Operational risk management is critical to safely conduct the anticipated tasks. This strategy, along with associated contingency plans, will be a driver of EVA system requirements. Therefore, a medical contingency EVA scenario was performed with the Haughton-Mars Project/NASA to develop belay and medical evacuation techniques for exploration and rescue respectively. Methods: A rescue system to allow two rescuer astronauts to evacuate one in incapacitated astronaut was evaluated. The systems main components were a hard-bottomed rescue litter, hand-operated winch, rope, ground picket anchors, and a rover-winch attachment adapter. Evaluation was performed on 15-25deg slopes of dirt with embedded rock. The winch was anchored either by adapter to the rover or by pickets hammered into the ground. The litter was pulled over the surface by rope attached to the winch. Results: The rescue system was utilized effectively to extract the injured astronaut up a slope and to a waiting rover for transport to a simulated habitat for advanced medical care, although several challenges to implementation were identified and overcome. Rotational stabilization of the winch was found to be important to get maximize mechanical advantage from the extraction system. Discussion: Further research and testing needs to be performed to be able to fully consider synergies with the other Exploration surface systems, in conducting contingency operations. Structural attachment points on the surface EVA suits may be critical to assist in incapacitated evacuation. Such attach points could be helpful in microgravity incapacitated crewmember transport as well. Wheeled utility carts or wheels that may be attachable to a litter may also aid in extraction and transport. Utilizing parts of the rover (e.g. seats) to deploy as a litter may be considered. Testing in simulated 1/6-g to determine feasibility of winch operation and anchor establishment will further reduce implementation uncertainties.

Chappell, S. P.↗

IMPACT User Experience

NASA Human Research Project (HRP) and Exploration Medical Capabilities (ExMC) team identified a need to implement a human-centered design approach for a computational tool that performs detailed trade space analysis and research prioritization, known as Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT). IMPACT processes numerous parameters such as space vehicle design, mission objectives, evacuation capability, medical events, and mission constraint, including but not limited to; duration, mass, volume, equipment, and medical capability, each with complex and interconnected relationships. The ability for users to navigate through these complexities and provide an intuitive report is critical to aiding stakeholders in the decision-making process of future missions. In this presentation we will discuss how the IMPACT team has applied human-centered design strategies to improve system usability by modelling human-system integration (i.e., task analysis) with the MagicDraw SysML modelling application and performing A/B testing of user interface prototypes.

S Ozbek↗

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↗

The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

Risk Analysis↗

The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

Risk Analysis↗

Medical System Concept of Operations for Mars Exploration Mission-11: Exploration Medical Capability (ExMC) Element - Human Research Program

NASA’s exploration missions to Mars will have durations of 2-3 years and will take humans farther away from Earth than ever before. This will result in a paradigm shift for mission planning, spacecraft design, human systems integration, and in-flight medical care. Constraints on real-time communication, resupply, and medical evacuation are major architectural drivers. These constraints require medical system development to be tightly integrated with mission and vehicle design to provide crew autonomy and enable mission success. This concept of operations provides a common vision of medical care for developing a medical system for Mars exploration missions. It documents an overview of the stakeholder needs and goals of a medical system and provides examples of the types of activities the system will be used for during the mission. Development of the concept of operations considers mission variables such as distance from Earth, duration of mission, time to definitive medical care, communication protocols between crewmembers and ground support, personnel capabilities and skill sets, medical hardware and software, and medical data management. The information provided in this document informs the ExMC Systems Engineering effort to define the functions to be provided by the medical system. In addition, this concept of operations will inform the subsequent systems engineering process of developing technical requirements, system architectures, interfaces, and verification and validation approaches for the medical system. This document supports the closure of ExMC Gap Med01: We do not have a concept of operations for medical care during exploration missions, corresponding to the ExMC-managed human system risk: Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions. This document is applicable to the ExMC Element Systems Engineering process and may be used for collaboration within the Human Research Program.

Urbina, Michelle↗

Improving Quantification of Medical Evacuation Risk for Human Spaceflight in the IMPACT Model

Traditionally, mission planners have used a heuristic and qualitative approach to design medical systems based on prior experience however this approach may result in high variability and implicit bias to design and could put missions and crewmembers at risk. The Informing Mission Planning through Analysis of Complex Tradespaces (IMPACT) tool is a probabilistic risk assessment tool designed by NASA to model medical risk in long duration missions outside of low earth orbit (LEO). This tool can quantify risk metrics such as risk of crewmember death, loss of crew task time, and the need for medical evacuation to better inform and augment the more traditional approach to medical system design. The risk metric of Return to Definitive Care (RTDC) represents the likelihood of requiring medical evacuation and has been difficult to quantify in a reliable and standardized manner. Initial development of the RTDC metric was constrained due to the complexity of a medical evacuation decision and the lack of prior spaceflight data and this presentation will discuss the review and improvement process used to increase model accuracy and fidelity.

Prashant Parmar↗

Recommendation for a Medical System Concept of Operations for Gateway Missions

NASA’s exploration missions to cis-lunar space will establish a permanent gateway to future transport missions to Mars. These missions mandate a significant paradigm change for mission planning, spacecraft design, human systems integration, and in-flight medical care due to constraints on mass, volume, power, resupply, and medical evacuation capability. These constraints require medical system development to be tightly integrated with mission and habitat design to provide a sufficient medical infrastructure and enable mission success. This concept of operations provides a vision of medical care needs that will be used to guide the development of a medical system for the cis-lunar Gateway Habitat. This medical system will serve as the precursor to what is implemented in future exploration missions to Mars. This concept of operations documents an overview of the stakeholder needs and system goals of a medical system and provides examples of the types of activities for which the system will be used during the mission. This concept of operations informs the ExMC systems engineering effort to define the Gateway Habitat Medical System by documenting the medical activities and capabilities relevant to Gateway missions, as identified by the ExMC clinician community. In addition, this concept of operations will inform the subsequent systems engineering process of developing technical requirements, system architectures, interfaces, and verification and validation approaches for the medical system. This document supports the closure of ExMC Gap Med01: We do not have a concept of operations for medical care during exploration missions, corresponding to the ExMC-managed human system risk: Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions.

Rubin, David↗

IMPACT Concept of Operations

NASA’s future exploration missions mandate a significant paradigm change for mission planning, spacecraft design, human systems integration, and in-flight medical care due to constraints on mass, volume, power, resupply missions, and medical evacuation capabilities. These constraints require further development of the human health and performance system, which includes the medical, task performance, wellness, data, human and other systems necessary to keep the crew healthy and functioning optimally. The human health and performance system will be tightly integrated with mission and habitat design to provide a sufficient human health and performance infrastructure to enable mission success. A suite of systems engineering tools will aid in the decision making process for the development of such a human health and performance system. This Concept of Operations provides a vision for a tool suite to conduct evaluations of human health and performance system options, inform research prioritization, and provide trade study support, based on evidence, risks, and systems engineering principles. The integrated tool suite under development is IMPACT.

Lumpkins, Sara↗

Clinical Decision Support Project

As NASA plans for exploration missions into deep space, significant challenges are realized due to the distance from Earth. Beside the effects of microgravity and radiation exposure, the astronauts face the additional constraints of isolation, lack of resupply, increasingly difficult evacuation, and delayed and disrupted communication with ground-based medical care providers. These constraints require a paradigm shift from current medical care where crews rely on the real-time communications with ground-based medical care providers toward Earth-independent medical operations for astronaut medical care. Medical expertise and decision-making are ground-based for current International Space Station and planned Lunar missions. However, a deep space exploration crew will need to autonomously perform the detection, diagnosis, treatment, and prevention of medical conditions. One approach to provide Earth-independent medical operations is to augment the requisite knowledge, skills, and abilities (KSAs) of a time-constrained crew—operating under stressful conditions, combatting fatigue, and facing a potential medical crisis—with a robust clinical decision support system (CDSS). The CDSS is envisioned as an integrated, software-based tool deployed on a laptop computer or handheld device. The CDSS will assist the crew and ground support when interacting with knowledge/data bases (e.g. records, pharmacy, schedule), instrumentation (e.g. imaging, physiological monitoring devices), and habitat (e.g. wellness system, task performance system) and vehicle systems (e.g. environmental system, communication system). In addition, the human interface will employ a context-based approach that accounts for the crew’s situation. Thus, extraneous and clinically/operationally non-relevant information are reduced to avoid an increase in cognitive load. The framework of an ideal spaceflight CDSS is to include core and advanced analytical features that maintain a flexible platform for integrating new technology in the future. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) is expanding the boundaries of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addressed ap Medical-701 within the Inflight Medical Conditions risk: “We need to increase inflight medical capabilities and identify new capabilities that (a) maximize benefit and/or (b) reduce “costs” on human system/mission/vehicle resources.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology advances in this decade and beyond. Hence, data, software, and computational resources will play an essential and synergistic role in maintaining crew health, wellness, and performance in deep space missions. The focus of the CDS project was to develop recommended requirements for an in-vehicle CDSS that acts as a ‘virtual assistant’ for delivering optimal health, performance, and medical care during exploration missions. In fiscal year 2022 (FY22), the CDS project was chartered to baseline and/or revise all CDS project related documentation and update the CDS project model to include the revised CDSS Concept of Operations, revised systems-based modeling language (SysML) activity diagrams, and baseline requirements. The focus of this presentation will be an overview of the CDS products and CDS model content.

Decision Support↗

Marin County Wildfires Ii: Improving Fire Suppression Modeling to Inform Fire Prevention and Suppression Decisions in Marin County, Ca

A future of increased wildfires requires greater integration of spatial analysis and local knowledge of emergency responders. We examine the application of a Potential Operational Delineations (PODs) framework for strategic pre-fire planning in Marin County. PODs are spatial units for wildfire management that combine predictive modeling and local firefighter expertise to identify potential control locations as unit boundaries and assess the difficulty of suppression within units. Additionally, this project explores the integration of road networks and social vulnerability to assess environmental justice in evacuation safety. This project constitutes a novel application of the PODs framework as it integrates expertise from Marin County senior firefighters with a Fireline Location Model (FLM) to achieve POD definition and uses a Suppression Difficulty Score (SDS) to rank each POD. The FLM uses network analysis and hydrologic modeling to identify key roads and ridgelines as boundaries and combines them with expert knowledge, in the form of workshops, to construct PODs. Once identified, PODs are classified using SDS, which includes processed inputs such as LiDAR-derived aboveground biomass, ECOSTRESS Evaporative Stress Index, land use cover type from Sentinel-2 Imagery, and a digital elevation model. Environmental justice for evacuation safety incorporated three key road metrics such as connectivity, travel area, and exit capacity, the Social Vulnerability Index from the Center for Disease Control, and cell coverage to determine a final Evacuation Difficulty Score. Results indicate a strong link between road networks as primary POD boundaries, with ridgelines and waterways as secondary and tertiary locations. Specifically, we find 78.5% of expertise-identified POD boundaries align with FLM-determined boundaries. More validation is needed to support this process; however, initial results signal a feasible framework to integrate expertise and spatial analysis in local level strategic fire planning

Wildfire modeling↗

iFair: Achieving Fairness in the Allocation of Scarce Resources for Senior Health Care

Efficient resource allocation is crucial in many domains, particularly in senior care, where assigning resources to older adults must consider uncertainties associated with vulnerable populations. In collaboration with Senior Health Facilities (SHFs) and domain experts, this paper presents iFair, a novel framework designed to assist decision-makers in equitably allocating scarce resources to older adults. iFair was prototyped in the context of ongoing work on a data exchange platform, CAREDEX, used for enhancing older adults' resilience during disasters. A key novelty of iFair focuses on aligning resident preferences with resources in urgent situations, expediting care, and enhancing task efficiency. We integrate static and dynamic environmental data, including facility layouts and sensor data, with detailed resident profiles to cater to the individual needs and preferences of residents. While our framework primarily focuses on allocation within facilities, it also extends to a regional scale to support the planning and transfer of seniors to mutual aid facilities. Our experiments adapt data from a real SHF to emulate resource allocation in an emergency fire evacuation setting and highlight the delicate balance that decision-makers can achieve between efficiency and fairness.

Kenne, Modeste Mefenya↗

Earth Observations to Assess Impact of Hurricane Katrina on John C. Stennis Space Center

The peril from hurricanes to Space Operations Centers is real and is forecast to continue; Katrina, Rita, and Wilma of 2005 and Charley, Frances, Ivan, and Jeanne of 2004 are sufficient motivation for NASA to develop a multi-Center plan for preparedness and response. As was demonstrated at SSC (Stennis Space Center) in response to Hurricane Katrina, NASA Centers are efficiently activated as local command centers, playing host to Federal and State agencies and first responders to coordinate and provide evacuation, relocation, response, and recovery activities. Remote sensing decision support provides critical insight for managing NASA infrastructure and for assisting Center decision makers. Managers require geospatial information to manage the federal city. Immediately following Katrina, SSC s power and network connections were disabled, hardware was inoperative, technical staff was displaced and/or out of contact, and graphical decision support tools were non-existent or less than fully effective. Despite this circumstance, SSC EOC (Emergency Operations Center) implemented response operations to assess damage and to activate recovery plans. To assist Center Managers, the NASA ASP (Applied Sciences Program) made its archive of high-resolution data over the site available. In the weeks and months after the immediate crisis, NASA supplemented this data with high-resolution, post-Katrina imagery over SSC and much of the affected coastal areas. Much of the high-resolution imagery was made available through the Department of Defense Clear View contract and was distributed through U.S. Geological Survey Center for Earth Resources Observation and Science "Hurricane Katrina Disaster Response" Web site. By integrating multiple image data types with other information sources, ASP applied an all-source solutions approach to develop decision support tools that enabled managers to respond to critical issues, such as expedient access to infrastructure and deployment of resources, provision of temporary shelter, logistical control of critical supplies, and the mobilization and coordination of assets from ground crews to aircraft/airspace management. Furthermore, ASP developed information products that illustrate risks to SSC's infrastructure from surge, inundation, and flood. Current plans include developing wind-risk prototype products for refinement and adoption into EOC plans.

Graham, William D.↗

Emergency preparedness and planning

Monsanto's emergency response plan in dealing with hazardous materials at their facilities is presented. Topics discussed include the following: CPR training; emergency medial training; incident reports; contractor injuries; hazardous materials transport; evacuation; and other industrial safety concerns.

Bouvier, Kenneth↗

The Integrated Medical Model - Optimizing In-flight Space Medical Systems to Reduce Crew Health Risk and Mission Impacts

The Integrated Medical Model (IMM) is a decision support tool used by medical system planners and designers as they prepare for exploration planning activities of the Constellation program (CxP). IMM provides an evidence-based approach to help optimize the allocation of in-flight medical resources for a specified level of risk within spacecraft operational constraints. Eighty medical conditions and associated resources are represented in IMM. Nine conditions are due to Space Adaptation Syndrome. The IMM helps answer fundamental medical mission planning questions such as What medical conditions can be expected? What type and quantity of medical resources are most likely to be used?", and "What is the probability of crew death or evacuation due to medical events?" For a specified mission and crew profile, the IMM effectively characterizes the sequence of events that could potentially occur should a medical condition happen. The mathematical relationships among mission and crew attributes, medical conditions and incidence data, in-flight medical resources, potential clinical and crew health end states are established to generate end state probabilities. A Monte Carlo computational method is used to determine the probable outcomes and requires up to 25,000 mission trials to reach convergence. For each mission trial, the pharmaceuticals and supplies required to diagnose and treat prevalent medical conditions are tracked and decremented. The uncertainty of patient response to treatment is bounded via a best-case, worst-case, untreated case algorithm. A Crew Health Index (CHI) metric, developed to account for functional impairment due to a medical condition, provides a quantified measure of risk and enables risk comparisons across mission scenarios. The use of historical in-flight medical data, terrestrial surrogate data as appropriate, and space medicine subject matter expertise has enabled the development of a probabilistic, stochastic decision support tool capable of optimizing in-flight medical systems based on crew and mission parameters. This presentation will illustrate how to apply quantitative risk assessment methods to optimize the mass and volume of space-based medical systems for a space flight mission given the level of crew health and mission risk.

Kerstman, Eric↗

IMPACTing Medical System Design with a Risk Analysis Tool [“IMPACT” sur la Conception du Système Médical avec un Outil d'Analyse des Risques]

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair↗

IMPACTing Medical System Design with a Risk Analysis Tool

Background: Following the success of Artemis I, NASA is preparing for human extended duration missions. Ongoing efforts are focused on mitigating mission-related risks, including those affecting crew health and performance. Communication latency, logistics of resupply and time frame of medical evacuation are barriers to provision of healthcare for these missions, especially with respect to constraints in mass, volume, and crew training. An in-depth assessment of medical risks, capabilities and resources for a specific mission design is necessary to determine an optimal balance that maximizes likelihood of mission success. Overview: IMPACT (Informed Mission Planning via Analysis of Complex Tradespaces) is a dynamic tool designed to estimate medical risk and outcomes for a specific mission design. In its current iteration, a list of medical conditions selected based on likelihood of occurrence and/or consequence was linked to a set of clinical capabilities and resources necessary for diagnosis and management. A probabilistic risk analysis tool was then used to identify and estimate the likelihood and consequence of risks through the following outcome metrics: loss of crew life (inflight mortality due to medical conditions), need for medical evacuation (return to definitive care), and crew disability (task time affected based on how medical conditions influence the ability to perform specific exploration mission crew tasks). Finally, the model’s optimization algorithm provides recommendations for medical capabilities that maximize risk mitigation relative to mass and volume constraints. In the Spring of 2023, IMPACT was utilized to estimate outcome metrics for a design reference mission that would be representative of an extended duration Artemis mission. Notional data generated were then used to determine a recommended set of medical capabilities and resources relative to user-defined mass and volume constraints. A multidisciplinary team has also been updating IMPACT to strengthen the model’s fidelity. Figure 1 shows how updates to outcome metric inputs for the conditions resulted in different capability and resource allocation recommendations. Discussion: This presentation will discuss the IMPACT tool and share the latest data generated for a representative extended duration Artemis mission. Efforts to improve the fidelity of data generated by the model’s algorithm will also be discussed.

K A Shair↗