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At least 361 records · Page 20
All sourcesNASA NTRSDOE OSTI
NASA NTRS2023

Exploration Medical Capability Clinical Decision Support System Architecture Recommendation

A new era in space exploration has arrived with the goal of establishing a long-term presence on the Moon and using those learning to take the next giant leap: sending the first astronauts to Mars. These ambitious goals will require significant changes in in-flight medical care due to constraints on mass, volume, power, crew time, and medical evacuation capabilities. Furthermore, while crews currently rely on real-time communications with ground-based medical providers, as distance from Earth increases, so do communication delays and disruptions. The crew will need to autonomously detect, diagnose, treat, and prevent medical events. These constraints require development of transformative solutions and new technologies. Through participation in the Human Research Program’s (HRP) Exploration Medical Capability (ExMC) research, NASA has developed and demonstrated a Medical Data Architecture (MDA), a platform upon which a robust capability of Clinical Decision Support (CDS) can be built. As a result, NASA is now positioned to build an advanced autonomous CDS System (CDSS) which will aid in crew health decision-making. The CDSS combines data management aspects of a system that would lead to the autonomy required by NASA-STD-3001, Section 3, Health and Medical Care Standards. The project addresses the ExMC gap Medical-701: 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. This architecture recommendation document introduces an integrated data architecture that provides self-sufficient medical care for crews on long-duration spaceflight missions.

ExMC↗
NASA NTRS2007

Space Medicine Issues and Healthcare Systems for Space Exploration Medicine

This viewgraph presentation reviews issues of health care in space. Some of the issues reviewed are: (1) Physiological adaptation to microgravity, partial gravity, (2) Medical events during spaceflight, (3) Space Vehicle and Environmental and Surface Health Risks, (4) Medical Concept of Operations (CONOPS), (4a) Current CONOPS & Medical Hardware for Shuttle (STS) and ISS, (4b) Planned Exploration Medical CONOPS & Hardware needs, (5) Exploration Plans for Lunar Return Mission & Mars, and (6) Developing Medical Support Systems.

Scheuring, Richard A.↗
NASA NTRSDate not supplied

Brace For Impact – It’s Coming, Do You Know What to Do With It?

Long-duration human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for providing in-mission medical care. Compared with the International Space Station, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to define and quantitatively estimate human system risk attributable to medical conditions. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a probabilistic risk assessment (PRA) and medical trade space analysis tool being developed by NASA to advance medical system design for exploration missions. IMPACT has made a number of enhancements on the Integrated Medical Model, the PRA tool currently used by NASA. These updates include a novel medical evidence base baselined to a long duration, deep space exploration environment; an expanded medical condition list; and a trade space analysis capability (e.g. comparing risk profiles and mass/volume constraints for medical capabilities and resources). IMPACT core functionality includes quantification of a medical capability set and assisting with identification of specific medical resources/hardware for exploration missions. In addition, IMPACT provides sophisticated trade space capabilities to estimate how human system risk varies with changes to the mission architecture or medical capability set. This presentation will provide a brief overview of the IMPACT tool, discuss representative use cases, and show example results.

Benjamin Easter↗
DOE OSTI2025

Results of a Geant4 benchmarking study for bio‐medical applications, performed with the G4‐Med system

Geant4, a Monte Carlo Simulation Toolkit extensively used in bio-medical physics, is in continuous evolution to include newest research findings to improve its accuracy and to respond to the evolving needs of a very diverse user community. In 2014, the G4-Med benchmarking system was born from the effort of the Geant4 Medical Simulation Benchmarking Group, to benchmark and monitor the evolution of Geant4 for medical physics applications. The G4-Med system was first described in our Medical Physics Special Report published in 2021. Results of the tests were reported for Geant4 10.5. Purpose In this work, we describe the evolution of the G4-Med benchmarking system. Methods The G4-Med benchmarking suite currently includes 23 tests, which benchmark Geant4 from the calculation of basic physical quantities to the simulation of more clinically relevant set-ups. New tests concern the benchmarking of Geant4-DNA physics and chemistry components for regression testing purposes, dosimetry for brachytherapy with a 125 I source, dosimetry for external x-ray and electron FLASH radiotherapy, experimental microdosimetry for proton therapy, and in vivo PET for carbon and oxygen beams. Regression testing has been performed between Geant4 10.5 and 11.1. Finally, a simple Geant4 simulation has been developed and used to compare Geant4 EM physics constructors and physics lists in terms of execution times. Results In summary, our EM tests show that the parameters of the multiple scattering in the Geant4 EM constructor G4EmStandardPhysics_option3 in Geant4 11.1, while improving the modeling of the electron backscattering in high atomic number targets, are not adequate for dosimetry for clinical x-ray and electron beams. Therefore, these parameters have been reverted back to those of Geant4 10.5 in Geant4 11.2.1. The x-ray radiotherapy test shows significant differences in the modeling of the bremsstrahlung process, especially between G4EmPenelopePhysics and the other constructors under study (G4EmLivermorePhysics, G4EmStandardPhysics_option3, and G4EmStandardPhysics_option4). These differences will be studied in an in-depth investigation within our Group. Improvement in Geant4 11.1 has been observed for the modeling of the proton and carbon ion Bragg peak with energies of clinical interest, thanks to the adoption of ICRU90 to calculate the low energy proton stopping powers in water and of the Linhard–Sorensen ion model, available in Geant4 since version 11.0. Nuclear fragmentation tests of interest for carbon ion therapy show differences between Geant4 10.5 and 11.1 in terms of fragment yields. In particular, a higher production of boron fragments is observed with Geant4 11.1, leading to a better agreement with reference data for this fragment. Conclusions Based on the overall results of our tests, we recommend to use G4EmStandardPhysics_option4 as EM constructor and QGSP_BIC_HP with G4EmStandardPhysics_option4, for hadrontherapy applications. The Geant4-DNA physics lists report differences in modeling electron interactions in water, however, the tests have a pure regression testing purpose so no recommendation can be formulated.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
NASA NTRS2006

Spread and SpreadRecorder An Architecture for Data Distribution

The Space Acceleration Measurement System (SAMS) project at the NASA Glenn Research Center (GRC) has been measuring the microgravity environment of the space shuttle, the International Space Station, MIR, sounding rockets, drop towers, and aircraft since 1991. The Principle Investigator Microgravity Services (PIMS) project at NASA GRC has been collecting, analyzing, reducing, and disseminating over 3 terabytes of collected SAMS and other microgravity sensor data to scientists so they can understand the disturbances that affect their microgravity science experiments. The years of experience with space flight data generation, telemetry, operations, analysis, and distribution give the SAMS/ PIMS team a unique perspective on space data systems. In 2005, the SAMS/PIMS team was asked to look into generalizing their data system and combining it with the nascent medical instrumentation data systems being proposed for ISS and beyond, specifically the Medical Computer Interface Adapter (MCIA) project. The SpreadRecorder software is a prototype system developed by SAMS/PIMS to explore ways of meeting the needs of both the medical and microgravity measurement communities. It is hoped that the system is general enough to be used for many other purposes.

Wright, Ted↗
NASA NTRS1994

On the development of an expert system for wheelchair selection

The presentation of wheelchairs for the Multiple Sclerosis (MS) patients involves the examination of a number of complicated factors including ambulation status, length of diagnosis, and funding sources, to name a few. Consequently, only a few experts exist in this area. To aid medical therapists with the wheelchair selection decision, a prototype medical expert system (ES) was developed. This paper describes and discusses the steps of designing and developing the system, the experiences of the authors, and the lessons learned from working on this project. Wheelchair Advisor, programmed in CLIPS, serves as diagnosis, classification, prescription, and training tool in the MS field. Interviews, insurance letters, forms, and prototyping were used to gain knowledge regarding the wheelchair selection problem. Among the lessons learned are that evolutionary prototyping is superior to the conventional system development life-cycle (SDLC), the wheelchair selection is a good candidate for ES applications, and that ES can be applied to other similar medical subdomains.

Madey, Gregory R.↗
NASA NTRS2023

Progressively Enabling Earth Independent Medical Operations (EIMO)

This panel presents the findings from a series of Technical Interchange Meetings (TIMs) hosted by the Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program. The topics for the TIMs were derived from a 2-day conference of senior leaders and subject matters experts that collectively outlined a multi-faceted strategy designed to optimize crew health and performance through an increasingly autonomous medical approach. The first abstract in this panel outlines the scope of issues related to data collection, usage, transmission and computing capacity to facilitate EIMO. The second presentation provides an overview of the challenges in developing curricula and advanced training tools to baseline knowledge, skills and abilities (KSA), verify clinical competency and assure retention during prolonged durations inherent in exploration-class missions. An overview of the complicated medical supply and resource chain necessary to facilitate EIMO is provided in the third presentation of this panel. The final presentation in this EIMO panel surveys the breadth and depth of demands on cognitive load expected to be experienced by crew on an exploration mission and proposes strategies to mitigate the prospect of cognitive overload through methods to shift task load from the crew to multi-modal artificial intelligence based medical support systems. Taken together, these presentations summarize the challenges to be expected and potential solution spaces to be explored and developed to progressively enable increasing autonomous medical operations to support crewed missions beyond low earth orbit. Through EIMO focused pre-mission planning, integrated data architecture design, innovative training development and AI-assisted task load management, the gradual transition of medical care and decision making from terrestrial to space-based assets enabling support of astronaut health and performance and reducing overall mission risk is achievable.

Jay Lemery↗
NASA NTRSDate not supplied

Progressively Enabling Earth Independent Medical Operations (EIMO)

This panel presents the findings from a series of Technical Interchange Meetings (TIMs) hosted by the Exploration Medical Capability Element (ExMC) in NASA’s Human Research Program. The topics for the TIMs were derived from a 2-day conference of senior leaders and subject matters experts that collectively outlined a multi-faceted strategy designed to optimize crew health and performance through an increasingly autonomous medical approach. The first abstract in this panel outlines the scope of issues related to data collection, usage, transmission and computing capacity to facilitate EIMO. The second presentation provides an overview of the challenges in developing curricula and advanced training tools to baseline knowledge, skills and abilities (KSA), verify clinical competency and assure retention during prolonged durations inherent in exploration-class missions. An overview of the complicated medical supply and resource chain necessary to facilitate EIMO is provided in the third presentation of this panel. The final presentation in this EIMO panel surveys the breadth and depth of demands on cognitive load expected to be experienced by crew on an exploration mission and proposes strategies to mitigate the prospect of cognitive overload through methods to shift task load from the crew to multi-modal artificial intelligence based medical support systems. Taken together, these presentations summarize the challenges to be expected and potential solution spaces to be explored and developed to progressively enable increasing autonomous medical operations to support crewed missions beyond low earth orbit. Through EIMO focused pre-mission planning, integrated data architecture design, innovative training development and AI-assisted task load management, the gradual transition of medical care and decision making from terrestrial to space-based assets enabling support of astronaut health and performance and reducing overall mission risk is achievable.

John Lemery↗
NASA NTRS1974

Skylab crew health and changes related to space flight

All three manned Skylab missions were supported by a cadre of medical personnel who were responsible not only for the management and conduct of the medical experiments but also for the operational planning and crew health. The day-to-day medical care of the crewmen and their families was left to a team of flight surgeons who were responsible for the health care during all phases of the mission, as well as the development and use of the inflight medical support system. The preventive medicine aspects of the preflight and postflight health stabilization program are discussed. The clinical problems encountered are identified and the significance of these medical entities are reviewed. The inflight physiological changes of a clinical nature are discussed in light of the significance of these changes as result of the space environment.

Hawkins, W. R.↗
NASA NTRS2016

The First Government Sanctioned Delivery of Medical Supplies by Remotely Controlled Unmanned Aerial System (UAS)

The first government sanctioned delivery of medical supplies by UAS occurred at Wise, Virginia, on July 17, 2015. The "Let's Fly Wisely" event was a demonstration of the humanitarian use of UAS to facilitate delivery of medical supplies to remote or otherwise difficult-to-reach areas. The event was the result of coordinated efforts by a partnership which included the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC), Virginia Polytechnic Institute, the Mid-Atlantic Aviation Partnership (MAAP), Flirtey Corporation, Lonesome Pine Airport, Remote Area Medical (RAM), Health Wagon, SEESPAN Aerial Interactive, Rx Partnership, and Wise County, Virginia. The historic event occurred during the annual Remote Area Medical clinic at the Wise County Fairgrounds. The medical supplies in small packages were delivered to the Wise County Fairgrounds from the Lonesome Pine Airport by UAS operated by Firtey. A larger supply of medical supplies were delivered to the Lonesome Pine Airport from the Tazewell County Airport by NASA Langley's SR22 UAS Surrogate Research aircraft. The UAS Surrogate aircraft was remotely controlled for most of the flight by a UAS Ground Control Station located at the Lonesome Pine Airport. The medical supplies were delivered from the UAS Surrogate to Flirtey for final delivery by Hex Multi-Rotor UAS in smaller packages and multiple trips to the fairgrounds. A Certificate of Authorization (COA) issued by the Federal Aviation Administration (FAA) designated the site as an authorized UAS test site. The paper will present additional details of the historic delivery of pharmaceuticals by UAS during the "Let's Fly Wisely" event. The paper will also provide details of NASA's SR22 UAS Surrogate Research aircraft. The UAS Surrogate was designed to investigate the procedures, aircraft sensors and other systems that may be required to allow Unmanned Aerial Systems (UAS) to safely operate with manned aircraft in the National Airspace System (NAS).

Howell, Charles T., III↗
NASA NTRS2001

Recovery from vestibular ototoxicity

OBJECTIVE: Determine whether subjects with documented vestibular ototoxicity recover vestibular function and, if so, investigate the recovery dynamics. STUDY DESIGN: Prospective and retrospective reviews and repeated measures. SETTING: Clinical research and technology center. SUBJECTS: Twenty-eight subjects who received vestibulotoxic medications were followed for at least 12 months after initial treatment. CONTROLS: Our subject sample was compared with a published database of normal individuals. INTERVENTIONS: All 28 subjects received systemically administered medications known to be ototoxic. The subjects' treating physicians controlled medication, dosage, and administration schedules. MAIN OUTCOME MEASURES: Tests of horizontal canal vestibulo-ocular function were performed. Subjects' auditory and vestibular symptoms were recorded. RESULTS: Eleven subjects (39%) showed changes in horizontal canal vestibulo-ocular gain constant (GC) and/or time constant (TC) consistent with vestibular ototoxicity. When tested 1 year after ototoxic drug administration, eight of the nine subjects who experienced ototoxic decrease in GC showed a recovery of GC to normal limits. Only one of the eight subjects who experienced ototoxic decrease in TC showed recovery of TC to within normal limits. Ototoxicity onset and recovery were independent of baseline vestibular function, and ototoxicity onset did not correlate with cumulative dose of ototoxic medication. There was no relationship between subjective symptoms and ototoxicity onset. CONCLUSIONS: Recovery of GC after vestibular ototoxicity is more commonly observed than recovery of TC. Because ototoxic changes developed and continued in an unpredictable time and manner in relation to ototoxic drug administration, we propose that once ototoxic changes in vestibulo-ocular reflex are detected, ototoxic medications should be discontinued as soon as possible.

NASA Discipline Neuroscience↗
NASA NTRS2000

A strategic vision for telemedicine and medical informatics in space flight

This Workshop was designed to assist in the ongoing development and application of telemedicine and medical informatics to support extended space flight. Participants included specialists in telemedicine and medical/health informatics (terrestrial and space) medicine from NASA, federal agencies, academic centers, and research and development institutions located in the United States and several other countries. The participants in the working groups developed vision statements, requirements, approaches, and recommendations pertaining to developing and implementing a strategy pertaining to telemedicine and medical informatics. Although some of the conclusions and recommendations reflect ongoing work at NASA, others provided new insight and direction that may require a reprioritization of current NASA efforts in telemedicine and medical informatics. This, however, was the goal of the Workshop. NASA is seeking other perspectives and views from leading practitioners in the fields of telemedicine and medical informatics to invigorate an essential and high-priority component of the International Space Station and future extended exploration missions. Subsequent workshops will further define and refine the general findings and recommendations achieved here. NASA's ultimate aim is to build a sound telemedicine and medical informatics operational system to provide the best medical care available for astronauts going to Mars and beyond.

Aerospace Medicine/organization & administration↗
NASA NTRS1976

Ambulance Handbook

Johnson Space Center has devised a checklist for the skylab inflight medical support system that has been transferred for public emergencies. The checklist illustrates a procedure for diagnosis, treatment, and stabilization of a wide variety of emergencies. Handbook presents comprehensive ordered description of emergency medical equipment and its use in treating victims. Paramedics assigned to the Houston Fire Department are now using the checklist.

Source record↗
NASA NTRS2024

NASA Spaceflight Medical Selection, Recertification and Mission Evaluation Standards

This NASA Technical Standard provides medical requirements and clinical procedures designed to ensure crew health and safety and occupational longevity of NASA career astronauts. This NASA Technical Standard used for selection and annual recertification of astronauts reflects the medical requirements to successfully complete specific mission tasks and the multifaceted training and performance required of a NASA astronaut. These include, but are not limited to, flying in high performance aircraft, exposure to hypobaric and hyperbaric conditions, exposure to unique environments (e.g., microgravity), and conducting specialized operations (e.g., extra-vehicular activities, robotic arm operations). NASA policy for establishing standards to protect the health and safety of crew and for providing health and medical programs for astronauts during all phases of space flight is authorized by NPD 1000.3 - The NASA Organization, and by NPD 8900.5B - NASA Health and Medical Policy for Human Space Exploration. This document includes medical evaluations for private astronauts and NASA Suborbital Research Specialist (NSRS). Private astronauts are defined as a crew member who is not a NASA career (U.S. government) astronaut or international partner astronaut. NASA Suborbital Research Specialist is an individual who is employed by NASA or funded by NASA to conduct research, technology testing, training, or other activities onboard a sub-orbital vehicle. This excludes those individuals who are the commercially employed crew of the suborbital vehicle. This NASA Technical Standard also provides mission specific medical evaluations which include both clinical and occupational requirements that may be tailored for future missions.

Standards↗
NASA NTRS1992

A surgical support system for Space Station Freedom

Surgical techniques in microgravity are being developed for the Health Maintenance Facility (HMF) on Space Station Freedom (SSF). This will be a presentation of the proposed surgical capabilities and ongoing hardware and procedural investigations. Methods: Procedures and prototype hardware, which include a medical restraint system, a surgical overhead isolation canopy, a suction device, and a regional laminar flow device were evaluated. This was accomplished by realistic sterile surgical simulations involving both mannequins and animals during KC-135 parabolic flight and in a high fidelity ground based HMF mockup. Results: Animal surgery in the environment of microgravity allowed the observation of unique arterial and venous bleeding characteristics for the first time. The ability to control bleeding and to prevent cabin atmosphere contamination was also demonstrated. Conclusions: The procedures and prototype hardware tested provided valuable information and should be investigated and developed further. The use of standard surgical techniques are possible in microgravity if the principles of personnel and supply restraint and operative field containment are adhered to.

Campbell, M. R.↗
NASA NTRS1970

Biomedical recording system

System collects medical data directly from patients and permanently records and displays several parameters - electrocardiograph, electroencephalograph, heart rate, respiration rate, auscultatory blood pressure, leg circumference changes, body temperature, and time. Components and operation of the system are described.

Vick, H. A.↗
NASA NTRS2009

SPACE MEDICINE and Medical Operations Overview

This presentation is an overview of the function of the work of the Space Medicine & Health Care Systems Office. The objective of the medical operations is to ensure the health, safety and well being of the astronaut corps and ground support team during all phases of space flight. There are many issues that impact the health of the astronauts. Some of them are physiological, and others relate to behavior, psychological issues and issues of the environment of space itself. Reviews of the medical events that have affected both Russian, and Americans while in space are included. Some views of shuttle liftoff, and ascent, the medical training aboard NASA's KC-135 and training in weightlessness, the Shuttle Orbiter Medical system (SOMS), and some of the medical equipment are included. Also included are a graphs showing Fluid loading countermeasures, and vertical pursuit tracking with head and eye. The final views are representations of the future crew exploration vehicle (CEV) approaching the International Space Station, and the moon, and a series of perspective representations of the earth in comparison to the other planets and the Sun, the Sun in relation to other stars, and a view of where in the galaxy the Sun is.

Dervay, Joe↗
NASA NTRS2017

Advances in Medical Analytics Solutions for Autonomous Medical Operations on Long-Duration Missions

A review will be presented on the progress made under STMDGame Changing Development Program Funding towards the development of a Medical Decision Support System for augmenting crew capabilities during long-duration missions, such as Mars Transit. To create an MDSS, initial work requires acquiring images and developing models that analyze and assess the features in such medical biosensor images that support medical assessment of pathologies. For FY17, the project has focused on ultrasound images towards cardiac pathologies: namely, evaluation and assessment of pericardial effusion identification and discrimination from related pneumothorax and even bladder-induced infections that cause inflammation around the heart. This identification is substantially changed due to uncertainty due to conditions of fluid behavior under space-microgravity. This talk will present and discuss the work-to-date in this Project, recognizing conditions under which various machine learning technologies, deep-learning via convolutional neural nets, and statistical learning methods for feature identification and classification can be employed and conditioned to graphical format in preparation for attachment to an inference engine that eventually creates decision support recommendations to remote crew in a triage setting.

Medical Decision Support Systems↗