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NASA NTRS2025

Limitations and Feasibility of Mini X-Ray Devices in Space Environments

LIMITATIONS AND FEASIBILITY OF MINI X-RAY DEVICES IN SPACE ENVIRONMENTS As space exploration advances toward long-duration missions, reliable medical diagnostic tools become increasingly critical. The miniature x-ray (XR) technology demonstrations by the Exploration Medical Capability (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) aim to assess the feasibility and utility of miniature XR devices in spaceflight. This abstract explores the limitations of current miniature XR systems, the challenges of training crew members, the potential role of clinical decision support systems (CDSS), and the feasibility of ground-based image interpretation. We also propose the integration of miniature XR into other ExMC efforts aimed at identifying the capabilities and resources needed for future exploration class missions. One of the primary challenges with miniature XR devices is the ability to achieve specific anatomical views, particularly in the confined and weightless conditions of a spacecraft. Operators may struggle to acquire diagnostic-quality images when space is limited for proper patient positioning and the volume of the imaging device. Since space radiation and detector limitations may further impact image quality, the flexibility of the operating procedures of these devices will be critical for their success in space applications. CHALLENGES IN TRAINING CREW TO OPERATE IMAGING DEVICES Training in the skills necessary to acquire diagnostic-quality scans may be a barrier for non-clinician crewmembers. The curriculum developed for crew medical officers (CMOs) will require simplification and adaptation to fit into the highly truncated pre-flight training period. Therefore, hands-on familiarization and simulation, both pre-flight and just-in-time training during missions, will be crucial to ensuring the crew can operate the devices in real-life situations. The ability to adjust acquisition parameters must be simplified or made automatic through exam selections on equipment user interfaces, and subject and operator positioning should be assisted with laser guidance and pictorial guides. POTENTIAL FOR CDSS OR ARTIFICIAL INTELLIGENCE (AI)-ASSISTED CDSS CDSS and AI-assisted CDSS offer significant promise in assisting crew members with limited medical training. These systems could provide real-time feedback on image quality and interpretation, helping to mitigate the risks of human error during space missions. Integrating procedural guidance tools, such as virtual and augmented reality, will support crewmembers in accurately positioning patients and obtaining high-quality images. However, the success of such systems will depend on the development of robust training datasets, integration with spaceflight-rated hardware, and the medical decision-making capabilities of operators. FEASIBILITY OF GROUND INTERPRETATION AND DATA TRANSMISSION Reliance on ground-based interpretation may prove difficult for acute care during exploration class-missions due to delays in transmission with increasing distance from Earth or complete communication blackout periods. In such instances where immediate interpretation for clinical intervention is required, crew must be able to interpret the images independently or utilize AI-based assistance to do so. File sizes for XR exams can also be large if numerous images are acquired and bandwidth constraints may limit data transmissions for both radiography and ultrasound exams. FUTURE WORK AND INTEGRATION INTO THE EVIDENCE LIBRARY Future work proposes integrating miniature XR devices into NASA’s Evidence Library to address medical conditions identified as significant contributors to crew morbidity and mortality. The possibility of combining miniature XR with other imaging modalities, such as ultrasound devices, is also under investigation. In conclusion, while miniature XR technology holds potential for extraterrestrial medical systems, there are significant challenges to overcome. Training, integration of AI tools, dedicated exam protocols for microgravity, and improved data transmission systems will be key to realizing the full benefits of miniature XR technology in space.

A M Nelson↗

NASA NTRS2016

NASA Human System Risk Assessment Process

NASA utilizes an evidence based system to perform risk assessments for the human system for spaceflight missions. The center of this process is the multi-disciplinary Human System Risk Board (HSRB). The HSRB is chartered from the Chief Health and Medical Officer (OCHMO) at NASA Headquarters. The HSRB reviews all human system risks via an established comprehensive risk and configuration management plan based on a project management approach. The HSRB facilitates the integration of human research (terrestrial and spaceflight), medical operations, occupational surveillance, systems engineering and many other disciplines in a comprehensive review of human system risks. The HSRB considers all factors that influence human risk. These factors include pre-mission considerations such as screening criteria, training, age, sex, and physiological condition. In mission factors such as available countermeasures, mission duration and location and post mission factors such as time to return to baseline (reconditioning), post mission health screening, and available treatments. All of the factors influence the total risk assessment for each human risk. The HSRB performed a comprehensive review of all potential inflight medical conditions and events and over the course of several reviews consolidated the number of human system risks to 30, where the greatest emphasis is placed for investing program dollars for risk mitigation. The HSRB considers all available evidence from human research and, medical operations and occupational surveillance in assessing the risks for appropriate mitigation and future work. All applicable DRMs (low earth orbit for 6 and 12 months, deep space for 30 days and 1 year, a lunar mission for 1 year, and a planetary mission for 3 years) are considered as human system risks are modified by the hazards associated with space flight such as microgravity, exposure to radiation, distance from the earth, isolation and a closed environment. Each risk has a summary two-page assessment representing the state of knowledge/evidence of that risk, available risk mitigations, traceability to the Space Flight Human System Standards (SFHSS) and program requirements, and future work required. These data then can drive coordinated budgets across the Human Research Program, the International Space Station, Crew Health and Safety and Advanced Exploration System budgets to provide the most economical and timely mitigations. The risk assessments were completed for the 6 DRMs and serve as the baseline for which subsequent research and technology development and crew health care portfolios can be assessed. The HSRB reviews each risk at least annually or when new evidence/information is available that adds to the body of evidence. The current status of each risk can be reported to program management for operations, budget reviews and general oversight of the human system risk management program.

Francisco, D.↗

NASA NTRSDate not supplied

Preliminary Design of an 'Autonomous Medical Response Agent' Interface Prototype for Long Duration Spaceflight

Major challenges for astronauts in future long-duration exploration missions (LDEMs) will be that crewmembers are not expected to be medical professionals, may be under high workload and stress, are facing physiological challenges caused by spaceflight, and will have limited, delayed voice communications with medical support from Earth. An autonomous medical response agent (AMRA) is envisioned to help astronauts address medical complaints, develop a differential diagnosis, and guide self-treatment until a healthy state is restored. AMRA develops a process of personalized diagnosis and treatment through a Bayesian predictive control system that recommends therapeutic control actions including diagnostic tests and treatments to crewmembers (Menon, 2020). The Human Computer Interaction (HCI) lab from NASA Ames Research Center’s Human Systems Integration Division (Code TH) has collaborated with Nahlia Inc in human-centered design augmentation research for AMRA. The project, titled Design of ‘Autonomous Medical Response Agent Interface Prototype for Long Duration Spaceflight, has been funded by the Translational Research Institute for Space Health (TRISH) and introduces an interactive user-interface prototype that guides astronauts through self-diagnosis, treatment, and rehabilitation while communicating with remote specialists in ground support (most notably a patient’s flight surgeon). Our project develops the interaction design for the crewmember using AMRA through user research, iterative design, and usability testing to evaluate the user interface and workflow designed. The interface design deliverable for this project, titled AMRA Aggregate Information Display (AMRA AID) is an integrated information display system for comprehensive autonomous medical guidance, diagnosis, and treatment of in-flight medical conditions experienced by crewmembers. AMRA AID demonstrates how we might ensure crew autonomy, increase the crew’s medical capabilities, and decrease cognitive burden within a front-end user interface. AMRA AID refrains from relying on input from ground or mission control for self-treatment of medical issues—though ground awareness and communication with ground is maintained as a means of ensuring trust between mission control and crew. AMRA AID demonstrates how the crew’s on-board medical system might integrate with information from vehicle monitoring and crew schedule, without assuming causal relationships. AMRA AID’s comprehensive view enables efficient information access for both crew and ground support, reducing cognitive burden in the event of an unplanned or emergency medical incident and enabling informed analytical decisions to be made based on both crew and vehicle health. Human-centered design augmentation advanced within the prototype included: enhanced workflow and treatment guidance for two medical scenarios for a non-specialist user base with various levels of medical training, interaction design which considered speech (conversational user interface) elements and on-screen interactions to be developed in future iterations of the project, communication design and functional requirements relevant to self-care versus caring for another astronaut, as well as user testing of the prototype with an international space medical community. This project arrives at critical findings regarding usability needs, communication requirements, and integrated information requirements for a future technology interface functioning to increase confidence between ground support and LDEM crewmembers.

TRISH↗

NASA NTRS1982

STS-2 medical report

All medially related activities of the Space Transportation System 2 flight are described, ranging from preflight to postflight. Several medical problems occured during the flight. Their was marginal operation on-board potable water system caused by a malfunctioning fuel cell. Work and rest cycles by the crew were altered to maximize the scientific data acquisition. Inadequate time was allocated for food preparation and consumption. There was low water intake by the crew because of the water shortage.

Pool, S. L.↗

NASA NTRS1972

Technology applications

A summary of NASA Technology Utilization programs for the period of 1 December 1971 through 31 May 1972 is presented. An abbreviated description of the overall Technology Utilization Applications Program is provided as a background for the specific applications examples. Subjects discussed are in the broad headings of: (1) cancer, (2) cardiovascular disease, (2) medical instrumentation, (4) urinary system disorders, (5) rehabilitation medicine, (6) air and water pollution, (7) housing and urban construction, (8) fire safety, (9) law enforcement and criminalistics, (10) transportation, and (11) mine safety.

Anuskiewicz, T.↗

NASA NTRS1973

A survey study of teleoperators, robotics, and remote systems technology.

Survey of the current status and major R&D needs of remote systems technology in the medical, mining, and oceanographic areas of application. The review is limited to the most important teleoperator/robotic subsystems, including actuators, sensors, control and communication devices.

Alexander, A. D., III↗

NASA NTRS1993

Cockpit checklists - Concepts, design, and use

Although the aircraft checklist has long been regarded as a foundation of pilot standardization and cockpit safety, it has escaped the scrutiny of the human factors profession. The improper use, or nonuse, of the normal checklist by flight crews is often cited as a major contributing factor to aircraft accidents. This paper reports the results of a field study of flight deck checklists and examines this seemingly mundane yet critical device from several perspectives: its functions, format, design, length, and usage, and the limitations of the humans who must interact with it. Certain sociotechnical factors, such as the airline 'culture', cockpit resource management, and production pressures that influence the design and use of this device, are also discussed. Finally, a list of design guidelines for normal checklists is provided. Although the focus of this paper is on the air transport industry, most of the principles discussed apply equally well to other high-risk industries, such as maritime transportation, power production, weapons systems, space flight, and medical care.

Degani, Asaf↗

NASA NTRS1995

Stellar Interferometer Technology Experiment (SITE)

The MIT Space Engineering Research Center and the Jet Propulsion Laboratory stand ready to advance science sensor technology for discrete-aperture astronomical instruments such as space-based optical interferometers. The objective of the Stellar Interferometer Technology Experiment (SITE) is to demonstrate system-level functionality of a space-based stellar interferometer through the use of enabling and enhancing Controlled-Structures Technologies (CST). SITE mounts to the Mission Peculiar Experiment Support System inside the Shuttle payload bay. Starlight, entering through two apertures, is steered to a combining plate where it is interferred. Interference requires 27 nanometer pathlength (phasing) and 0.29 archsecond wavefront-tilt (pointing) control. The resulting 15 milli-archsecond angular resolution exceeds that of current earth-orbiting telescopes while maintaining low cost by exploiting active optics and structural control technologies. With these technologies, unforeseen and time-varying disturbances can be rejected while relaxing reliance on ground alignment and calibration. SITE will reduce the risk and cost of advanced optical space systems by validating critical technologies in their operational environment. Moreover, these technologies are directly applicable to commercially driven applications such as precision matching, optical scanning, and vibration and noise control systems for the aerospace, medical, and automotive sectors. The SITE team consists of experienced university, government, and industry researchers, scientists, and engineers with extensive expertise in optical interferometry, nano-precision opto-mechanical control and spaceflight experimentation. The experience exists and the technology is mature. SITE will validate these technologies on a functioning interferometer science sensor in order to confirm definitely their readiness to be baselined for future science missions.

Crawley, Edward F.↗

NASA NTRS1993

EMS helicopter incidents reported to the NASA Aviation Safety Reporting System

The objectives of this evaluation were to: Identify the types of safety-related incidents reported to the Aviation Safety Reporting System (ASRS) in Emergency Medical Service (EMS) helicopter operations; Describe the operational conditions surrounding these incidents, such as weather, airspace, flight phase, time of day; and Assess the contribution to these incidents of selected human factors considerations, such as communication, distraction, time pressure, workload, and flight/duty impact.

Connell, Linda J.↗

NASA NTRS1996

Spectral imaging applications: Remote sensing, environmental monitoring, medicine, military operations, factory automation and manufacturing

This paper reviews the activities at OKSI related to imaging spectroscopy presenting current and future applications of the technology. The authors discuss the development of several systems including hardware, signal processing, data classification algorithms and benchmarking techniques to determine algorithm performance. Signal processing for each application is tailored by incorporating the phenomenology appropriate to the process, into the algorithms. Pixel signatures are classified using techniques such as principal component analyses, generalized eigenvalue analysis and novel very fast neural network methods. The major hyperspectral imaging systems developed at OKSI include the Intelligent Missile Seeker (IMS) demonstration project for real-time target/decoy discrimination, and the Thermal InfraRed Imaging Spectrometer (TIRIS) for detection and tracking of toxic plumes and gases. In addition, systems for applications in medical photodiagnosis, manufacturing technology, and for crop monitoring are also under development.

National Defense↗

NASA NTRS1999

Electrorheological Fluid Based Force Feedback Device

Parallel to the efforts to develop fully autonomous robots, it is increasingly being realized that there are applications where it is essential to have a fully controlled robot and "feel" its operating conditions, i.e. telepresence. This trend is a result of the increasing efforts to address tasks where humans can perform significantly better but, due to associated hazards, distance, physical limitations and other causes, only robots can be employed to perform these tasks. Such robots need to be assisted by a human that remotely controls the operation. To address the goal of operating robots as human surrogates, the authors launched a study of mechanisms that provide mechanical feedback. For this purpose, electrorheological fluids (ERF) are being investigated for the potential application as miniature haptic devices. This family of electroactive fluids has the property of changing the viscosity during electrical stimulation. Consequently, ERF can be used to produce force feedback haptic devices for tele-operated control of medical and space robotic systems. Forces applied at the robot end-effector due to a compliant environment are reflected to the user using an ERF device where a change in the system viscosity will occur proportionally to the transmitted force. Analytical model and control algorithms are being developed taking into account the non-linearities of these type of devices. This paper will describe the concept and the developed mechanism of ERF based force feedback. The test process and the physical properties of this device will be described and the results of preliminary tests will be presented.

Pfeiffer, Charles↗

NASA NTRS2001

Application of Computer Tomography for Life Detection

Perhaps one of the most fundamentally difficult challenges facing those who would search for life is that of scale determination. Spatial scales of life on Earth range over more than 15 orders of magnitude in mass and volume, and more than 8 orders of magnitude in 2 dimensional space. If the distribution of life is sparse in comparison to the background on which it is found, then the choice of the right scale is critical to finding that life. But how does one identify the proper scale? To put this in other words, how does one recognize the "haystacks" in which the needles (biosignatures and evidence of life) might be most profitably searched for? The problem is further exacerbated when conditions get extreme because much of the life moves from the clement surface environment into the pores and more clement environments inside of rocks, minerals and soils. Once encased in their lithic homes, these microbes become nearly impossible to study by standard techniques because of the opacity of the rocks. It is this problem that we propose to address in the work proposed here. Computer Tomography (CT) has been a very valuable tool in medicine, where the best resolution available has typically been of the order of about 0.5 mm. However, to adapt the approach for life detection of microbial endoliths, the resolution needs to be moved to the micrometer and even submicrometer levels. Thus for the studies proposed here, we begin with a commercially available instrument that can yield resolution of approximately 10 micrometers. The rational for this is twofold: first, this is the "state of the art" in laboratory instruments; and second, that while the usual size of a microbial cell is about 1 micron, microorganisms tend to live in communities that usually exceed the 10 micrometer size range. The resolution also depends on the sample size itself, so having a small lab instrument into which small samples can be placed will be beneficial to the resolution. We have now used several different CT systems, beginning with the medical scanners (Arcadia CT group) for the detection of layered communities in sandstone rocks from Antarctica. Even this crude instrument was able to point to the areas of the rock that were dominated by microbial populations - this provides the critical first information that says, "Go back and look at these sites with other methods." We showed that without sample preparation or destruction it was possible to gain knowledge as to the presence of density differences suggestive of life.

Tsapin, A.↗

NASA NTRS2007

Development and Operation of a Modern Information Portal for the ISS Medical Groups

This viewgraph presentation begins with a review of some of the problems inherent in running medical services for the International Space Station. Part of the solution for the problems is the development of the information portal for the ISS medical groups. The presentation shows the tools that have been developed to assist in collaboration for the medical services, the security system and the capabilities of the portal.

Damann, V.↗

NASA NTRS2005

Frontiers of Life Sciences: The Human Exploration of the Moon and Mars

The rapid development of the productive processes after World War II extended human settlements into new ecological niches. Advances in Life Sciences played a decisive role supporting the establishment of human presence in areas of the planet where human life could have not existed otherwise. The evolution of life support systems, and the fabrication of new materials and technologies has enabled humans to inhabit Polar Regions, ocean surfaces and depths; and to leave Earth and occupy Low Earth Orbit. By the end of the 20 th Century, stations in the Antarctic and Arctic, off shore oil platforms, submarines, and space stations had become the ultimate demonstration of human ability to engineer habitats at Earth extreme environments and outer space. As we enter the 21st Century, the next development of human settlements will occur through the exploration of the Moon, Mars, and beyond. The major risks of space exploration derive from long exposure of humans and other life systems to radiation, microgravity, isolation and confinement, dependence on artificial life support systems, and unknown effects (e.g., altered magnetic fields, ultrahigh vacuum on bacteria, fungi, etc.). Countermeasures will require a complete characterization of human and other biological systems adaptation processes. To sustain life in transit and on the surface of the Moon and Mars will require a balance of spacecraft, cargo, astronaut crews, and the use of in situ resources. Limitations on the number of crewmembers, payloads, and the barrenness of the terrain require a novel design for the capabilities needed in transit and at exploration outpost sites. The planned destinations have resources that may be accessed to produce materials, food, shelter, power, and to provide an environment compatible with successful occupation of longterm exploration sites. Once more, the advancements of Life Sciences will be essential for the design of interplanetary voyages and planetary surface operations. This presentation delineates the role of Life Sciences and its frontiers, especially Cell Science, in the context of human exploration. Life support systems, food production, and medical equipment encompass many of vital aspects related to the new vision for NASA.

North, Regina M.↗

NASA NTRS2011

Telemedicine in Space Flight - Summary of a NASA Workshop

The Exploration Medical Capability Element of the Human Research Program at NASA Johnson Space Center hosted the Telemedicine Workshop in January 2011 to discuss the medical operational concept for a crewed mission to a near-Earth asteroid (NEA) and to identify areas for future work and collaboration. With the increased likelihood of a medical incident on a long duration exploration mission to a near-Earth asteroid, as well as the fact that there will likely be limited medical capabilities and resources available to diagnose and treat medical conditions, it is anticipated that a more structured use of telemedicine will become highly desirable. The workshop was convened to solicit expert opinion on current telemedicine practices and on medical care in remote environments. Workshop Objectives: The workshop brought together leaders in telemedicine and remote medicine from The University of Texas Medical Branch, Henry Ford Hospital, Ontario Telemedicine Network, U.S. Army Institute of Surgical Research, University of Miami, American Telemedicine Association, Doctors Without Borders, and the Pan American Health Organization. The primary objectives of the workshop were to document the medical operations concept for a crewed mission to a NEA, to determine gaps between current capabilities and the capabilities outlined in the operations concept, to identify research required to close these gaps, and to discuss potential collaborations with external-to-NASA organizations with similar challenges. Summary of Discussions and Conclusions: The discussions held during the workshop and the conclusions reached by the workshop participants were grouped into seven categories: Crew Medical Officers, Patient Area in Spacecraft, Training, Electronic Medical Records, Intelligent Care Systems, Consultation Protocols, Prophylactic Surgical Procedures, and Data Prioritization. The key points discussed under each category will be presented.

Barsten, K. N.↗

NASA NTRS2017

Biocompatible Capsules and Methods of Making

Embodiments of the invention include capsules for containing medical implants and delivery systems for release of active biological substances into a host body. Delivery systems comprise a capsule comprising an interior enclosed by walls, and a source of active biological substances enclosed within the capsule interior, wherein the active biological substances are free to diffuse across the capsule walls. The capsule walls comprise a continuous mesh of biocompatible fibers and a seal region where two capsule walls overlap. The interior of the capsule is substantially isolated from the medium surrounding the capsule, except for diffusion of at least one species of molecule between the capsule interior and the ambient medium, and prevents cell migration into or out of the capsule. Methods for preparing and using the capsules and delivery systems are provided.

Loftus, David J.↗

NASA NTRS2018

Bridging the Engineering and Medicine Gap

A primary challenge NASA faces is communication between the disparate entities of engineers and human system experts in life sciences. Clear communication is critical for exploration mission success from the perspective of both risk analysis and data handling. The engineering community uses probabilistic risk assessment (PRA) models to inform their own risk analysis and has extensive experience managing mission data, but does not always fully consider human systems integration (HSI). The medical community, as a part of HSI, has been working 1) to develop a suite of tools to express medical risk in quantitative terms that are relatable to the engineering approaches commonly in use, and 2) to manage and integrate HSI data with engineering data. This talk will review the development of the Integrated Medical Model as an early attempt to bridge the communication gap between the medical and engineering communities in the language of PRA. This will also address data communication between the two entities in the context of data management considerations of the Medical Data Architecture. Lessons learned from these processes will help identify important elements to consider in future communication and integration of these two groups.

Walton, M.↗

NASA NTRS2012

Autonomous Mission Operations

NASA's Advanced Exploration Systems Autonomous Mission Operations (AMO) project conducted an empirical investigation of the impact of time-delay on todays mission operations, and of the effect of processes and mission support tools designed to mitigate time-delay related impacts. Mission operation scenarios were designed for NASA's Deep Space Habitat (DSH), an analog spacecraft habitat, covering a range of activities including nominal objectives, DSH system failures, and crew medical emergencies. The scenarios were simulated at time-delay values representative of Lunar (1.2-5 sec), Near Earth Object (NEO) (50 sec) and Mars (300 sec) missions. Each combination of operational scenario and time-delay was tested in a Baseline configuration, designed to reflect present-day operations of the International Space Station, and a Mitigation configuration in which a variety of software tools, information displays, and crew-ground communications protocols were employed to assist both crews and Flight Control Team (FCT) members with the long-delay conditions. Preliminary findings indicate: 1) Workload of both crew members and FCT members generally increased along with increasing time delay. 2) Advanced procedure execution viewers, caution and warning tools, and communications protocols such as text messaging decreased the workload of both flight controllers and crew, and decreased the difficulty of coordinating activities. 3) Whereas crew workload ratings increased between 50 sec and 300 sec of time-delay in the Baseline configuration, workload ratings decreased (or remained flat) in the Mitigation configuration.

Mission Operations↗