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NASA NTRS2017

Personalized Risk Assesment for Adverse Drug Reactions and Treatment Failures

As NASA and other space agencies prepare for future long-term space missions beyond the LEO, the cumulative impact of risk factors encountered in space increases substantially rising concerns about astronauts health. Application of on-board medications to mitigate clinical symptoms associated with certain medical conditions and illnesses is the first line of response to ensure sustainable health and performance of crew. Unfortunately, very limited research has been conducted to determine efficacy of the earth-based pharmaceuticals in a microgravity environment. In some instances, orally administered medications taken during flight were reported to be less effective than expected. Evaluation of series of experiments involving astronauts from shuttle flights shows notable individual variability to several pharmaceuticals during flight. These data provide reasonable assumption of perturbation in CYP450 enzymes during spaceflight, which contribute to the hepatic metabolism of the majority of drugs and therefore may have significant effects on therapeutic efficacy and increase treatment-related toxicity. The genes encoding the CYP450 enzymes are highly variable in humans. Inheritable variations of CYP450 hepatic metabolizer enzymes and transport proteins play a crucial role in the inter-individual variability of drug efficiency and risks of adverse drug reactions. Additionally, there are some reports that document changes in the levels of production of drug-metabolizing enzymes in microgravity. Therefore, in order to provide a safe and effective pharmaceutical treatment in space, medications selection should be based not only on the specific efficacy of medications but also on the individual drug sensitivity and flight-induced changes in metabolism of astronauts chosen for a particular mission. To our knowledge, there was no pre-flight drug sensitivity testing on a genetic level for any of the previous manned NASA space missions. Therefore, technologies capable of predicting and managing medication efficacy, side effects, and toxicity of drugs based on individual genetic variability of crew members are increasingly needed. In this report, we present results of testing the market available Personalized Prescribing System (PPS), a comprehensive, non-invasive solution for safer, targeted medication management for every crew member. Statistical accuracy and simplicity of non-invasive sample analysis demonstrate the feasibility of drug sensitivity assessment and record-keeping tool for flight surgeons and astronauts in applying the recommended medications for situations arising in flight. The information on individual drug sensitivity will translate into personalized risk assessment for adverse drug reactions and treatment failures for each drug from the medication kit as well as predefined outcome. This will address the HHC’s raised “Concern of Clinically Relevant Unpredicted Effects of Medication” as recently updated.

medications↗
NASA NTRS2020

Medics: Medical Decision Support System for Long-Duration Space Exploration

The Autonomous Medical Operations (AMO) group at NASA Ames is developing a “medical decision support system” to enable astronauts on long-duration exploration missions to operate autonomously. The system will support clinical actions by providing medical interpretation advice and procedural recommendations during emergent care and clinical work performed by crew. The current state of development of the system, called MedICS (Medical Interpretation Classification and Segmentation) includes two separate aspects: a set of machine learning diagnostic models trained to analyze organ images and patient health records, and an interface to ultrasound diagnostic hardware and to medical repositories. Three sets of images of different organs and medical records were utilized for training machine learning models for various analyses, as follows: 1. Pneumothorax condition (collapsed lung). The trained model provides a positive or negative diagnosis of the condition. 2. Carotid artery occlusion. The trained model produces a diagnosis of 5 different occlusion levels (including “normal”). 3. Ocular retinal images. The model extracts optic disc pixels (image segmentation). This is a precursor step for advanced autonomous fundus clinical evaluation algorithms to be implemented in FY20. 4. Medical health records. The model produces a differential diagnosis for any particular individual, based on symptoms and other health and demographic information. A probability is calculated for each of 25 most common conditions. The same model provides the likelihood of survival. All results are provided with a confidence level. Item 1 images were provided by the US Army and were part of a data set for the clinical treatment of injured battlefield soldiers. This condition is relevant to possible space mishaps, due to pressure management issues. Item 2 images were provided by Houston Methodist Hospital, and item 3 health records were acquired from the MIT laboratory of computational physiology. The machine learning technology utilized is deep multilayer networks (Deep Learning), and new models will continue to be produced, as relevant data is made available and specific health needs of astronaut crews are identified. The interfacing aspects of the system include a GUI for running the different models, and retrieving and storing data, as well as support for integration with an augmented reality (AR) system deployed at JSC by Tietronix Software Inc. (HoloLens). The AR system provides guidance for the placement of an ultrasound transducer that captures images to be sent to the MedICS system for diagnosis. The image captured and the associated diagnosis appear in the technician’s AR visual display.

Colombano, Silvano↗
NASA NTRSDate not supplied

Determining the Most Influencing Medical Conditions in MEDPRAT’s SIN Directed Graph

INTRODUCTION: The Susceptibility Inference Network (SIN) is a network of medical conditions, part of the Medical Extensible Probabilistic Risk Assessment Tool (MEDPRAT) developed by NASA to assess human health and medical risk to space exploration missions. The SIN is subject matter expert informed and acts as a prototype that provides relationships and dependencies between events modeled by MEDPRAT. Each vertex in the SIN has a weight which evaluates the severity of having the condition regardless of the progression from or to that condition. In this presentation, we consider two statistics to measure that stand alone risk: Quality Time Lost (QTL) and Loss of Crew Life (LOCL). Our goal is to identify the medical conditions that contribute the most to crew members QTL and LOCL risks due to progression of conditions in the network. We investigate how different computation parameters result in different condition rankings and address the choice of parameters that allows appropriate interventions to ensure space mission success. METHODS: The Katz score, one of many centrality measures created for ranking purposes in network analysis, takes into account all possible walks through the network, penalizing each additional step in a walk by a factor α called the Katz parameter. The literature does not provide specific values for the choice of α. We derive an analytical relationship between α and the maximum path length which has influence on the Katz score and ranking. Based on the probability of progression of each condition in the SIN, we identify that maximum path length of interest and calculate α that is then used in the Katz formula to rank the conditions in the SIN. RESULTS AND CONCLUSION: The effective probabilities of the SIN matrix generally fall below 10−6, which is below the level of the least influencing condition in the set. This corresponds to the probability of at most six consecutive progressions of a condition. Consequently, we calculate the Katz Parameter α and get 0.32. We rank the medical conditions and find that Acute Radiation Symptom is the condition the most prone to contribute to quality time loss due to progression.

risk analysis↗
NASA NTRS2025

Assessment of Model Outcomes Between the Integrated Medical Model (IMM) and the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT)

The Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) is a computational model that provides human health and medical risk predictions for crewed spaceflight missions. MEDPRAT utilizes discrete event modeling and dynamic probabilistic simulation to predict critical mission outcomes (total medical events, crew health index, quality time lost, loss of crew life, removal to definitive care), condition occurrences, and resource consumption. Input parameters for MEDPRAT include crew attributes (e.g., sex), types of mission activities (e.g., whether and where crew members perform an extravehicular activity (EVA)), available resources, treatment information, and probability distributions for medical conditions. As an evolution of the Integrated Medical Model (IMM), MEDPRAT provides enhanced capabilities and higher fidelity, and incorporates more appropriate assumptions for long-duration spaceflight. IMM is the currently accepted standard for quantifying spaceflight mission medical risk in NASA operations that uses a probabilistic risk assessment (PRA) approach. MEDPRAT builds on the same logical foundation as IMM but implements the model architecture through highly optimized Monte Carlo sampling methods. An analysis is performed comparing the outputs from IMM with those from MEDPRAT V1.0 and V2.0 for the same reference missions in order to quantify similarities and differences in the model outcomes. The juxtaposition between IMM and MEDPRAT V1.0 and 2.0 shown in this report demonstrates that these two models generate very similar results; where differences in outcomes are shown, these are in accordance with the underlying assumptions and differences in the model architectures. This validation effort further establishes the credibility and reliability of the MEDPRAT software.

Matthew T Prelich↗
NASA NTRS2015

Addressing Human System Risks to Future Space Exploration

NASA is contemplating future human exploration missions to destinations beyond low Earth orbit, including the Moon, deep-space asteroids, and Mars. While we have learned much about protecting crew health and performance during orbital space flight over the past half-century, the challenges of these future missions far exceed those within our current experience base. To ensure success in these missions, we have developed a Human System Risk Board (HSRB) to identify, quantify, and develop mitigation plans for the extraordinary risks associated with each potential mission scenario. The HSRB comprises research, technology, and operations experts in medicine, physiology, psychology, human factors, radiation, toxicology, microbiology, pharmacology, and food sciences. Methods: Owing to the wide range of potential mission characteristics, we first identified the hazards to human health and performance common to all exploration missions: altered gravity, isolation/confinement, increased radiation, distance from Earth, and hostile/closed environment. Each hazard leads to a set of risks to crew health and/or performance. For example the radiation hazard leads to risks of acute radiation syndrome, central nervous system dysfunction, soft tissue degeneration, and carcinogenesis. Some of these risks (e.g., acute radiation syndrome) could affect crew health or performance during the mission, while others (e.g., carcinogenesis) would more likely affect the crewmember well after the mission ends. We next defined a set of design reference missions (DRM) that would span the range of exploration missions currently under consideration. In addition to standard (6-month) and long-duration (1-year) missions in low Earth orbit (LEO), these DRM include deep space sortie missions of 1 month duration, lunar orbital and landing missions of 1 year duration, deep space journey and asteroid landing missions of 1 year duration, and Mars orbital and landing missions of 3 years duration. We then assessed the likelihood and consequences of each risk against each DRM, using three levels of likelihood (Low: less than or equal to 0.1%; Medium: 0.1%–1.0%; High: greater than or equal to 1.0%) and four levels of consequence ranging from Very Low (temporary or insignificant) to High (death, loss of mission, or significant reduction to length or quality of life). Quantitative evidence from clinical, operational, and research sources were used whenever available. Qualitative evidence was used when quantitative evidence was unavailable. Expert opinion was used whenever insufficient evidence was available. Results: A set of 30 risks emerged that will require further mitigation efforts before being accepted by the Agency. The likelihood by consequence risk assessment process provided a means of prioritizing among the risks identified. For each of the high priority risks, a plan was developed to perform research, technology, or standards development thought necessary to provide suitable reduction of likelihood or consequence to allow agency acceptance. Conclusion: The HSRB process has successfully identified a complete set of risks to human space travelers on planned exploration missions based on the best evidence available today. Risk mitigation plans have been established for the highest priority risks. Each risk will be reassessed annually to track the progress of our risk mitigation efforts.

Paloski, W. H.↗
NASA NTRS1995

Training for Aviation Decision Making: The Naturalistic Decision Making Perspective

This paper describes the implications of a naturalistic decision making (NDM) perspective for training air crews to make flight-related decisions. The implications are based on two types of analyses: (a) identification of distinctive features that serve as a basis for classifying a diverse set of decision events actually encountered by flight crews, and (b) performance strategies that distinguished more from less effective crews flying full-mission simulators, as well as performance analyses from NTSB accident investigations. Six training recommendations are offered: (1) Because of the diversity of decision situations, crews need to be aware that different strategies may be appropriate for different problems; (2) Given that situation assessment is essential to making a good decision, it is important to train specific content knowledge needed to recognize critical conditions, to assess risks and available time, and to develop strategies to verify or diagnose the problem; (3) Tendencies to oversimplify problems may be overcome by training to evaluate options in terms of goals, constraints, consequences, and prevailing conditions; (4) In order to provide the time to gather information and consider options, it is essential to manage the situation, which includes managing crew workload, prioritizing tasks, contingency planning, buying time (e.g., requesting holding or vectors), and using low workload periods to prepare for high workload; (5) Evaluating resource requirements ("What do I need?") and capabilities ("'What do I have?" ) are essential to making good decisions. Using resources to meet requirements may involve the cabin crew, ATC, dispatchers, and maintenance personnel; (6) Given that decisions must often be made under high risk, time pressure, and workload, train under realistic flight conditions to promote the development of robust decision skills.

Orasanu, Judith↗
NASA NTRS1984

Multi-crew Model Analytic Assessment of Landing Performance and Decision-making Demands

Some of the relative merits of the PROCRU approach to modelling multi-crew flight deck activity during approach to landing are discussed. On the basis of two realistic flight scenarios, the ability of the model to simulate different vectored approaches is demonstrated. A secondary exemplary analysis of a nominal and an accelerated final approach is performed, illustrating the potential of the expected net gain (ENGP) functions as a measure of decision-making load.

Milgram, P.↗
NASA NTRS1994

Communication Research in Aviation and Space Operations: Symptoms and Strategies of Crew Coordination

The day-to-day operators of today's aerospace systems work under increasing pressures to accomplish more with less. They work in operational systems which are complex, technology-based, and high-risk; in which incidents and accidents have far-reaching and costly consequences. For these and other reasons, there is concern that the safety net formerly built upon redundant systems and abundant resources may become overburdened. Although we know that human ingenuity can overcome incredible odds, human nature can also fail in unpredictable ways. Over the last 20 years, a large percentage of aviation accidents and incidents have been attributed to human errors rather than hardware or environmental factors alone. A class of errors have been identified which are not due to a lack of individual, technical competencies. Rather, they are due to the failure of teams to utilize readily available resources or information in a timely fashion. These insights began a training revolution in the aviation industry called Cockpit Resource Management, which later became known as Crew Resource Management (CRM) as its concepts and applications extended to teams beyond the flightdeck. Then, as now, communication has been a cornerstone in CRM training since crew coordination and resource management largely resides within information transfer processes--both within flightcrews, and between flightcrews and the ground operations teams that support them. The research I will describe takes its roots in CRM history as we began to study communication processes in order to discover symptoms of crew coordination problems, as well as strategies of effective crew management. On the one hand, communication is often the means or the tool by which team members manage their resources, solve problems, maintain situational awareness and procedural discipline. Conversely, it is the lack of planning and resource management, loss of vigilance and situational awareness, and non-standard communications that are implicated in accidents and incidents. NASA/Ames Crew Factors researchers have been developing a model of effective crew coordination in order to understand the sources of performance breakdowns, and to develop effective solutions and interventions. Because communication is a primary mechanism by which information is received and transmitted, and because it is observable behavior, we focus on these group processes in order to identify patterns of communication that distinguish effective from less effective crew performance. Since a prime objective is to develop training recommendations for enhancing communication skills, we interpret our findings in the context of relevant task and environmental conditions, role and procedural constraints, and the normal real-time parameters of flight operations. Another research objective is to consider how communication and coordination can be enhanced through design. For example, flight deck and hardware design as well as procedural and software design may greatly influence the efficiency with which crews communicate and coordinate their work. In addition, teams and tasks may be designed, organized, and trained so that team interactions with each other are based upon appropriately shared knowledge, procedures and situation awareness. In short, we are interested in enhancing communication practices through (1) the training of specific communication skills, and (2) the design of equipment, tasks, procedures, and teams that optimize smooth, unambiguous communication processes. Two examples of communication research will be described; one in aviation and one in space operations. The first example is a high-fidelity full mission simulation study which investigates the affect of flightdeck automation on crew coordination and communication (contrasting crew performance in the DC-9 vs. MD88). Additional information is contained in the original extended abstract.

Kanki, Barbara G.↗
NASA NTRS1987

Communications indices of crew coordination

Verbal exchanges occuring during task execution during full mission two-person simulator flights are used to study the effect of the interactive communication process on crew coordination and performance. The ratio of initiator to response speech is calculated and speech variations are recorded. The results of this study are compared with the findings of Ginnett's (1986) study of leaders. It is shown that low-error crews adopt a standard form of communicating, allowing for the ability to predict one another's behavior, facilitating the coordination process. The higher performance of crews that have flown together before is believed to be due to the increased amount of time for establishing a conventional means of communication.

Kanki, Barbara G.↗
NASA NTRSDate not supplied

Oxidative Stress and the Neuroconsequences of Spaceflight Environment - Immune Dysregulation and Antioxidant Dietary Countermeasure Efficacy

In this project, we will test the hypothesis that Ionizing Radiation (IR), microgravity and social isolation combine synergistically to trigger an oxidative stress response that alters immune homeostasis, brain structure and function, and neurobehavioral and cognitive performance. Specific Aims for this project are: (1) Determine dose-response curves for acute ‘Five-Ion GCR Simulation’ exposure for immune, brain and performance responses in crew age-matched adult male and female mice; (2) Determine effects of acute ‘Five-Ion GCR Simulation’ exposure singly and in combination with simulated microgravity and social isolation, on immune, brain and performance responses in crew age-matched male and female mice mimicking deep space missions; and (3) Determine efficacy of the dietary antioxidant, Nicotinamide Mononucleotide (NMN), a key intermediate in nicotinamide adenine dinucleotide (NAD+) biosynthesis. The project relies on established and highly translatable ground-based mouse models and assays with IR exposures to be performed at the NASA Space Radiation Laboratory (NSRL). The experimental approach will provide definitive data on the timing and mechanisms involved in the oxidative stress response, immune and brain changes, and ensuing functional (behavioral/cognitive) impairments expected during human transit to Mars. This project will identify potential biomarkers for, and mechanisms underlying, structural and functional changes in the immune and nervous systems leading to behavioral/cognitive performance deficits, and its potential application to develop effective countermeasures to mitigate negative health effects of long duration space habitation. The project will address NASA’s efforts to rapidly advance the characterization of risks and identify appropriate countermeasures in anticipation of future deep space missions. Ensuring crew health and performance during extended transits necessitates that sensorimotor and cognitive abilities remain strong to avoid potentially catastrophic health and safety outcomes. Further, despite historically low numbers of female astronauts, the two most recent NASA Astronaut Corps class selections, comprised of ~50% women as compared to men, signal the need to understand how sex differences affect physiological adaptation and health in the space environment. Here, we will determine how key features of the deep space environment may interact to increase risk to crewmembers by negatively impacting health and performance, and identify and develop strategies to characterize and mitigate the potential risks via countermeasures. Supported by the NASA Human Research Program (HRP) Human Factors Behavioral Performance Element Grant 18-18FLAG_2-0028.

radiation↗
NASA NTRSDate not supplied

Oxidative Stress and Neuroconsequences of the Spaceflight Environment –A 5-ion GCRsim Dose-response Study

The overall scope of this project is to test the hypothesis that Ionizing Radiation (IR), microgravity and social isolation combine synergistically to trigger an oxidative stress response that alters immune homeostasis, brain structure/function, and neurobehavioral/cognitive performance. Specific Aims for this project are to: (1) Determine dose-response curves for acute ‘Five-Ion GCR Simulation’ exposure for immune, brain and performance responses in crew age-matched adult male and female mice; (2) Determine effects of acute ‘Five-Ion GCR Simulation’ exposure singly and in combination with simulated microgravity and social isolation, on immune, brain and performance responses in crew age-matched male and female mice mimicking deep space missions; and (3) Determine efficacy of the dietary antioxidant, Nicotinamide Mononucleotide (NMN), a key intermediate in nicotinamide adenine dinucleotide (NAD+) biosynthesis. Here we exposed mature (23-24-week-old) male and female mice to simulated 5-Ion GCR (either 0, 5, 15, or 50cGy) at the NASA Space Radiation Laboratory (NSRL). Across ‘Acute’ (IR+72hrs and IR+14 days) and ‘Delayed’ (IR+28 to IR+124 days) phases of the 6-month-long study, we assessed immune, neural, and functional (sensorimotor/behavioral/cognitive) responses anticipated during a transit to Mars. This presentation will report on dose-response curves for 5-ion GCRsim related to potential biomarkers; structural/functional changes in the immune and nervous systems; and behavioral/cognitive performance deficits. This project addresses NASA’s efforts to characterize risks and identify appropriate countermeasures in anticipation of future deep space missions. Ensuring crew health and performance during extended transits necessitates that sensorimotor and cognitive abilities remain strong to avoid potentially catastrophic health and safety outcomes.

deep space↗
NASA NTRS2011

Examination of Communication Delays on Team Performance: Utilizing the International Space Station (ISS) as a Test Bed for Analog Research

Operational conjectures about space exploration missions of the future indicate that space crews will need to be more autonomous from mission control and operate independently. This is in part due to the expectation that communication quality between the ground and exploration crews will be more limited and delayed. Because of potential adverse effects on communication quality, both researchers and operational training and engineering experts have suggested that communication delays and the impact these delays have on the quality of communications to the crew will create performance decrements if crews are not given adequate training and tools to support more autonomous operations. This presentation will provide an overview of a research study led by the Behavioral Health and Performance Element (BHP) of the NASA Human Research Program that examines the impact of implementing a communication delay on ISS on individual and team factors and outcomes, including performance and related perceptions of autonomy. The methodological design, data collection efforts, and initial results of this study to date will be discussed . The results will focus on completed missions, DRATS and NEEMO15. Lessons learned from implementing this study within analog environments will also be discussed. One lesson learned is that the complexities of garnishing a successful data collection campaign from these high fidelity analogs requires perseverance and a strong relationship with operational experts. Results of this study will provide a preliminary understanding of the impact of communication delays on individual and team performance as well as an insight into how teams perform and interact in a space-like environment . This will help prepare for implementation of communication delay tests on the ISS, targeted for Increment 35/36.

Keeton, K. E.↗
NASA NTRS2013

Apollo Medical Operations Project: Recommendations for EVA and Lunar Surface Operations

The potential risk of injury to crewmembers is inherent in aggressive surface activities, whether they be Moon-, Mars-, or asteroid-based. In December 2005, the Space Medicine Division at JSC requested a study to identify Apollo mission issues that had an impact to crew health or performance or both. This talk focused on the Apollo EVA suit and lunar surface operations concerning crew health and performance. There were roughly 20 recommendations from this study of Apollo for improving these two areas for future exploration missions, a few of which were incorporated into the Human Systems Integration Requirements (HSIR). Dr. Richard Scheuring covered these topics along with some of the analog work that has been done regarding surface operations and medical contingencies.

Scheuring, R. A.↗
NASA NTRS2005

Microbial Air and Surface Monitoring Results from International Space Station Samples

Over the course of long-duration spaceflight, spacecraft develop a microbial ecology that directly interacts with the crew of the vehicle. While most microorganisms are harmless or beneficial to the inhabitants of the vehicle, the presence of medically significant organisms appearing in this semi-closed environment could adversely affect crew health and performance. The risk of exposure of the crew to medically significant organisms during a mission is estimated using information gathered during nominal and contingency environmental monitoring. Analysis of the air and surface microbiota in the habitable compartments of the International Space Station (ISS) over the last four years indicate a high presence of Staphylococcus species reflecting the human inhabitants of the vehicle. Generally, air and surface microbial concentrations are below system design specifications, suggesting a lower risk of contact infection or biodegradation. An evaluation of sample frequency indicates a decrease in the identification of new species, suggesting a lower potential for unknown microorganisms to be identified. However, the opportunistic pathogen, Staphylococcus aureus, has been identified in 3 of the last 5 air samples and 5 of the last 9 surface samples. In addition, 47% of the coagulase negative Staphylococcus species that were isolated from the crew, ISS, and its hardware were found to be methicillin resistance. In combination, these observations suggest the potential of methicillin resistant infectious agents over time.

Ott, C. Mark↗
NASA NTRS2009

International Space Station USOS Crew Quarters Ventilation and Acoustic Design Implementation

The International Space Station (ISS) United States Operational Segment (USOS) has four permanent rack sized ISS Crew Quarters (CQ) providing a private crewmember space. The CQ uses Node 2 cabin air for ventilation/thermal cooling, as opposed to conditioned ducted air from the ISS Temperature Humidity Control System or the ISS fluid cooling loop connections. Consequently, CQ can only increase the air flow rate to reduce the temperature delta between the cabin and the CQ interior. However, increasing airflow causes increased acoustic noise so efficient airflow distribution is an important design parameter. The CQ utilized a two fan push-pull configuration to ensure fresh air at the crewmember s head position and reduce acoustic exposure. The CQ interior needs to be below Noise Curve 40 (NC-40). The CQ ventilation ducts are open to the significantly louder Node 2 cabin aisle way which required significantly acoustic mitigation controls. The design implementation of the CQ ventilation system and acoustic mitigation are very inter-related and require consideration of crew comfort balanced with use of interior habitable volume, accommodation of fan failures, and possible crew uses that impact ventilation and acoustic performance. This paper illustrates the types of model analysis, assumptions, vehicle interactions, and trade-offs required for CQ ventilation and acoustics. Additionally, on-orbit ventilation system performance and initial crew feedback is presented. This approach is applicable to any private enclosed space that the crew will occupy.

Broyan, James Lee, Jr.↗
NASA NTRS2010

International Space Station Crew Quarters Ventilation and Acoustic Design Implementation

The International Space Station (ISS) United States Operational Segment has four permanent rack sized ISS Crew Quarters (CQs) providing a private crew member space. The CQs use Node 2 cabin air for ventilation/thermal cooling, as opposed to conditioned ducted air-from the ISS Common Cabin Air Assembly (CCAA) or the ISS fluid cooling loop. Consequently, CQ can only increase the air flow rate to reduce the temperature delta between the cabin and the CQ interior. However, increasing airflow causes increased acoustic noise so efficient airflow distribution is an important design parameter. The CQ utilized a two fan push-pull configuration to ensure fresh air at the crew member's head position and reduce acoustic exposure. The CQ ventilation ducts are conduits to the louder Node 2 cabin aisle way which required significant acoustic mitigation controls. The CQ interior needs to be below noise criteria curve 40 (NC-40). The design implementation of the CQ ventilation system and acoustic mitigation are very inter-related and require consideration of crew comfort balanced with use of interior habitable volume, accommodation of fan failures, and possible crew uses that impact ventilation and acoustic performance. Each CQ required 13% of its total volume and approximately 6% of its total mass to reduce acoustic noise. This paper illustrates the types of model analysis, assumptions, vehicle interactions, and trade-offs required for CQ ventilation and acoustics. Additionally, on-orbit ventilation system performance and initial crew feedback is presented. This approach is applicable to any private enclosed space that the crew will occupy.

Broyan, James L., Jr.↗
NASA NTRS2011

Crew Office Evaluation of a Precision Lunar Landing System

A representative Human System Interface for a precision lunar landing system, ALHAT, has been developed as a platform for prototype visualization and interaction concepts. This facilitates analysis of crew interaction with advanced sensors and AGNC systems. Human-in-the-loop evaluations with representatives from the Crew Office (i.e. astronauts) and Mission Operations Directorate (MOD) were performed to refine the crew role and information requirements during the final phases of landing. The results include a number of lessons learned from Shuttle that are applicable to the design of a human supervisory landing system and cockpit. Overall, the results provide a first order analysis of the tasks the crew will perform during lunar landing, an architecture for the Human System Interface based on these tasks, as well as details on the information needs to land safely.

Major, Laura M.↗
NASA NTRSDate not supplied

Clinical Decision Support: Path to Functional Requirements

Long-duration, deep-space exploration missions present significant challenges to crew health and performance. These challenges include the individual and combined effects of microgravity, radiation exposure, isolation, limited resources (mass, volume, power, data and crew time), limited options for evacuation and those associated with delayed or constrained communications, all of which demand greater crew autonomy. Specifically, as the communication delays intensify the further we explore space, the unqualified need for Earth-independent medical operations focused on autonomous diagnosis, treatment and prevention will be key to mission continuation and success. 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, a robust clinical decision support system (CDSS) is a probable solution that would facilitate, guide and inform Earth-independent medical operations, while assisting crewmembers through various clinical presentations. 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. ExMC is actively identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses gap Medical-701 within the Inflight Medical Conditions risk: “Enhance medical capabilities within an exploration medical system.” Though mass, volume, and power will face increasing constraints, the projected computational capabilities of spacecraft systems will increase exponentially as information technology continues to advance 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 is 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. 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/databases (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 incorporate work from collaborators yet maintain a flexible platform for integrating new technology in the future. In fiscal year 2021 (FY21), the CDS project identified requirements through two primary mechanisms: (i) the development of software implementation prototypes and (ii) the application of systems engineering processes. The CDS project developed and tested a series of increasingly complex system prototypes that were based on use cases derived from the CDSS concept of operations (ConOps). These software implementations yielded insights on CDSS functionality as well as lessons learned that provided the initial requirements for CDSS capability. By applying a systems engineering (SE) approach, medical scenarios provided in the ConOps and the use cases for software implementation underwent functional decomposition to identify CDSS functionality. Also, systems-based modeling language (SysML) tools such as activity diagrams were developed from the same ConOps and use cases to identify CDSS functionality. The lessons learned from software implementation defined both specific requirements and broad areas of requirements. Within these defined broad requirement areas, further analysis of the SE products identified specific capability that resulted in the final functional requirements. In summary, the software prototypes, functional decomposition of the ConOps and use cases, and SysML diagrams provided the basis for the CDSS requirements developed in FY21. In the upcoming year, these requirements will be refined for their final ExMC baseline review in latter FY22.

Clinical decision support↗