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All sourcesNASA NTRSDOE OSTI
NASA NTRS2024

Earth-Independent Medical Operations (EIMO) Concept of Operations (ConOps)

Compared to the current paradigm for crew health in low-Earth orbit and Lunar missions that rely on constant communication with Mission Control, there is an anticipated shift in medical operations for deep-space exploration missions. This shift stems from mission constraints imposed by the considerable distance from Earth, which include resource limitations due to a lack of resupply, mass, power, volume, and data limitations, challenges imposed by communication latency and the inability to evacuate in case of emergencies. To transition towards a more self-reliant medical approach, a comprehensive strategy is essential to progressively enable crew autonomy and mitigate mission success risks in the challenging environment of space. This transformative shift is collectively referred to as "Earth-Independent Medical Operations" (EIMO), signifying the gradual transfer of medical care and decision-making from terrestrial resources to space-based assets. This transition is aimed at bolstering astronaut health and performance while simultaneously reducing the overall risks associated with space missions. The constraints related to EIMO necessitate an integrated development of medical systems, featuring interoperability with mission planning, vehicle design, spacesuit design, and data architecture. This integration is vital in establishing a robust medical infrastructure that not only supports the well-being of astronauts but also ensures the success of the mission as a whole. The Human Research Program (HRP) Exploration Medical Capability (ExMC) Element has developed a model-based Concept of Operations (ConOps) outlining an initial vision for EIMO. Within this ConOps, a comprehensive view is presented, encompassing stakeholder needs, system objectives, and system goals associated with EIMO. Additionally, it provides illustrative examples of the various activities (scenarios) for which the system will be employed during missions. The selection of these activities has been meticulous, aiming to encompass a wide spectrum of medical conditions, including those falling under different risk categories, such as low-likelihood-low-consequence, low-likelihood-high-consequence, and high-likelihood-low-consequence. The selection of these activities (scenarios) effectively encompasses the wide range of medical events situated within an assumed probability-consequence bell curve. In each scenario, at least one of the five main EIMO components identified is captured. Those EIMO components are: Pre-mission Planning, Acute and Emergent Management Decision Making, Prolonged Medical Management Decision Making, Supplies and Resource Management, and Task Load Management. The ConOps was developed by a multidisciplinary team consisting of systems engineers, scientists, and clinicians across NASA and aims to serve as an initial recommendation to gradually and safely enabling crew autonomy for Mars missions and beyond.

Earth Independent Medical Operations↗
NASA NTRS2023

Flight Surgeon Survey Results Review: Long-Duration Artemis Medical System ConOps

Background: The Artemis Mission Functional Medical Concept of Operation (ConOp) is an operational document that describes the functional medical capabilities and concept of operations for early Artemis missions of around 30 days duration. It is currently under revision for longer missions (180+ days), aiming to build a foundational diagnostic and treatment capabilities list considering mission parameters, crew selection and training, and mass/volume constraints. An interview of NASA operational flight surgeons was completed to start the revision of the medical ConOp. Methods: In the survey, 20 experienced NASA flight surgeons responded to 57 standardized questions covering 17 categories, 22 questions of which were covered in this analysis including 4 categories: Cardiovascular, Catastrophic Situations, Pulmonary, and Respiratory/O2 Support. These results were categorized into recommendations and observations. The recommendations were used to objectively quantify the responses to look for consensus, differences and uncertainty among responses. The observations remain important but were not included in this review. Analysis: Regarding questions related to changes in medical conditions treated for long-duration missions, percentage of “No Change” responses varied from 20% to 75%. In the “Change” treatment plan responses, a variety of recommendations were made, which were further made into graphics for better illustration. Additionally, recommendations on capability questions in multiple systems were visualized altogether in one product. Discussion: This work demonstrates the importance of collaboration and thorough analysis amongst experienced NASA flight surgeons for helping establish medical systems and contributing to the likelihood of mission success during Artemis long-duration missions. Through this review, we were able to identify some positive attributes as well as areas for improvement, which will facilitate further discussions.

Andrew Bushong↗
NASA NTRSDate not supplied

Early Systems Integration Strengthens Orion Medical Capabilities

The Orion spacecraft has significant mass and volume constraints, which limits resources that can be provided for medical use. Sharing of resources between vehicle systems is therefore required to meet design requirements. This presentation will illustrate resource sharing within the Orion vehicle using oxygen as a case study.

C Haas↗
DOE OSTI2024

Assessing the reliability of medical resource demand models in the context of COVID-19

Abstract Background Numerous medical resource demand models have been created as tools for governments or hospitals, aiming to predict the need for crucial resources like ventilators, hospital beds, personal protective equipment (PPE), and diagnostic kits during crises such as the COVID-19 pandemic. However, the reliability of these demand models remains uncertain. Methods Demand models typically consist of two main components: hospital use epidemiological models that predict hospitalizations or daily admissions, and a demand calculator that translates the outputs of the epidemiological model into predictions for resource usage. We conducted separate analyses to evaluate each of these components. In the first analysis, we validated various hospital use epidemiological models using a recent validation framework designed for epidemiological models. This allowed us to quantify the accuracy of the models in predicting critical aspects such as the date and magnitude of local COVID-19 peaks, among other factors. In the second analysis, we evaluated a range of demand calculators for ventilators, medical gowns, and COVID-19 test kits. To achieve this, we decoupled these demand calculators from the underlying epidemiological models and provided ground truth data for their inputs. This approach enabled a direct comparison of the demand calculators, comparing them against each other and actual usage data when available. The code is available athttps://doi.org/10.5281/zenodo.13712387. Results Performance varied greatly across the epidemiological models, with greater variability in COVID-19 hospital use predictions than for COVID-19 deaths as analyzed previously. Some models did not have any peaks. Among those that did, the models under-estimated date of peak approximately as often as they over-estimated, but were more likely to under-estimate magnitude of peak, with typical relative errors around 50%. Regarding demand calculator predictions, there was significant variability, including five-fold differences in predictions for gown models. Validation against actual or surrogate usage data illustrated the potential value of demand models while demonstrating their limitations. Conclusions The emerging field of demand modeling holds promise in averting medical resource shortages during future public health emergencies. However, achieving this potential necessitates focused efforts on standardization, transparency, and rigorous model validation before placing reliance on demand models in critical public health decision-making.

Medical Informatics↗
DOE OSTI2022

Antimicrobial Peptide Mimics for Clinical Use: Does Size Matter?

The search for efficient antimicrobial therapies that can alleviate suffering caused by infections from resistant bacteria is more urgent than ever before. Infections caused by multi-resistant pathogens represent a significant and increasing burden to healthcare and society and researcher are investigating new classes of bioactive compounds to slow down this development. Antimicrobial peptides from the innate immune system represent one promising class that offers a potential solution to the antibiotic resistance problem due to their mode of action on the microbial membranes. However, challenges associated with pharmacokinetics, bioavailability and off-target toxicity are slowing down the advancement and use of innate defensive peptides. Improving the therapeutic properties of these peptides is a strategy for reducing the clinical limitations and synthetic mimics of antimicrobial peptides are emerging as a promising class of molecules for a variety of antimicrobial applications. These compounds can be made significantly shorter while maintaining, or even improving antimicrobial properties, and several downsized synthetic mimics are now in clinical development for a range of infectious diseases. A variety of strategies can be employed to prepare these small compounds and this review describes the different compounds developed to date by adhering to a minimum pharmacophore based on an amphiphilic balance between cationic charge and hydrophobicity. These compounds can be made as small as dipeptides, circumventing the need for large compounds with elaborate three-dimensional structures to generate simplified and potent antimicrobial mimics for a range of medical applications. This review highlights key and recent development in the field of small antimicrobial peptide mimics as a promising class of antimicrobials, illustrating just how small you can go.

60 APPLIED LIFE SCIENCES↗
NASA NTRS1980

The concept of an integrated terrestrial/land mobile satellite system

Potential satellite markets in the Public Safety (disaster relief, emergency medical and law enforcement) and Common Carrier (mobile radio telephone) service areas are identified. The public mobile telephone segment is then examined to illustrate a methodology for identifying a potential satellite addressable market, including capacity requirements for roughly sizing a satellite. It is postulated that satellites could serve this lower density (mobiles/sq. km), thin-route markets at a competitive cost and thus complement terrestrial systems in the urban and more densely populated areas to provide an integrated nationwide mobile service.

Knouse, G. H.↗
DOE OSTI2022

Programmable soft valves for digital and analog control

In soft devices, complex actuation sequences and precise force control typically require hard electronic valves and microcontrollers. Existing designs for entirely soft pneumatic control systems are capable of either digital or analog operation, but not both, and are limited by speed of actuation, range of pressure, time required for fabrication, or loss of power through pull-down resistors. Using the nonlinear mechanics intrinsic to structures composed of soft materials—in this case, by leveraging membrane inversion and tube kinking—two modular soft components are developed: a piston actuator and a bistable pneumatic switch. These two components combine to create valves capable of analog pressure regulation, simplified digital logic, controlled oscillation, nonvolatile memory storage, linear actuation, and interfacing with human users in both digital and analog formats. Three demonstrations showcase the capabilities of systems constructed from these valves: 1) a wearable glove capable of analog control of a soft artificial robotic hand based on input from a human user’s fingers, 2) a human-controlled cushion matrix designed for use in medical care, and 3) an untethered robot which travels a distance dynamically programmed at the time of operation to retrieve an object. This work illustrates pathways for complementary digital and analog control of soft robots using a unified valve design.

42 ENGINEERING↗
NASA NTRS1983

The future of space - Space tomorrow: The Antarctica model

The exploration and settling of Antarctica with permanent bases are used as illustrative points for establishing a permanent human presence in near-earth space. NASA activities since 1958 have spawned the computer science, solid-state electronics, medical electronics, and communications satellites industries, which are also rapidly expanding in other countries, as are space-faring capabilities. Antarctica is a paradigm for space exploration in that it is hard to reach, hostile to human life, and a great amount of planning is necessary to arrive at the destination and survive. Aircraft made permanent settlements possible on Antarctica, just as the Shuttle does for space. A space station would provide the remote base from which exploration of other planets and settling on the moon could proceed.

Beggs, J.↗
NASA NTRS1978

Medical Image Analysis Facility

To improve the quality of photos sent to Earth by unmanned spacecraft. NASA's Jet Propulsion Laboratory (JPL) developed a computerized image enhancement process that brings out detail not visible in the basic photo. JPL is now applying this technology to biomedical research in its Medical lrnage Analysis Facility, which employs computer enhancement techniques to analyze x-ray films of internal organs, such as the heart and lung. A major objective is study of the effects of I stress on persons with heart disease. In animal tests, computerized image processing is being used to study coronary artery lesions and the degree to which they reduce arterial blood flow when stress is applied. The photos illustrate the enhancement process. The upper picture is an x-ray photo in which the artery (dotted line) is barely discernible; in the post-enhancement photo at right, the whole artery and the lesions along its wall are clearly visible. The Medical lrnage Analysis Facility offers a faster means of studying the effects of complex coronary lesions in humans, and the research now being conducted on animals is expected to have important application to diagnosis and treatment of human coronary disease. Other uses of the facility's image processing capability include analysis of muscle biopsy and pap smear specimens, and study of the microscopic structure of fibroprotein in the human lung. Working with JPL on experiments are NASA's Ames Research Center, the University of Southern California School of Medicine, and Rancho Los Amigos Hospital, Downey, California.

Source record↗
NASA NTRS2000

Hardware Development Process for Human Research Facility Applications

The simple goal of the Human Research Facility (HRF) is to conduct human research experiments on the International Space Station (ISS) astronauts during long-duration missions. This is accomplished by providing integration and operation of the necessary hardware and software capabilities. A typical hardware development flow consists of five stages: functional inputs and requirements definition, market research, design life cycle through hardware delivery, crew training, and mission support. The purpose of this presentation is to guide the audience through the early hardware development process: requirement definition through selecting a development path. Specific HRF equipment is used to illustrate the hardware development paths. The source of hardware requirements is the science community and HRF program. The HRF Science Working Group, consisting of SCientists from various medical disciplines, defined a basic set of equipment with functional requirements. This established the performance requirements of the hardware. HRF program requirements focus on making the hardware safe and operational in a space environment. This includes structural, thermal, human factors, and material requirements. Science and HRF program requirements are defined in a hardware requirements document which includes verification methods. Once the hardware is fabricated, requirements are verified by inspection, test, analysis, or demonstration. All data is compiled and reviewed to certify the hardware for flight. Obviously, the basis for all hardware development activities is requirement definition. Full and complete requirement definition is ideal prior to initiating the hardware development. However, this is generally not the case, but the hardware team typically has functional inputs as a guide. The first step is for engineers to conduct market research based on the functional inputs provided by scientists. CommerCially available products are evaluated against the science requirements as well as modifications needed to meet program requirements. Options are consolidated and the hardware development team reaches a hardware development decision point. Within budget and schedule constraints, the team must decide whether or not to complete the hardware as an in-house, subcontract with vendor, or commercial-off-the-shelf (COTS) development. An in-house development indicates NASA personnel or a contractor builds the hardware at a NASA site. A subcontract development is completed off-site by a commercial company. A COTS item is a vendor product available by ordering a specific part number. The team evaluates the pros and cons of each development path. For example, in-bouse developments utilize existing corporate knowledge regarding bow to build equipment for use in space. However, technical expertise would be required to fully understand the medical equipment capabilities, such as for an ultrasound system. It may require additional time and funding to gain the expertise that commercially exists. The major benefit of subcontracting a hardware development is the product is delivered as an end-item and commercial expertise is utilized. On the other hand, NASA has limited control over schedule delays. The final option of COTS or modified COTS equipment is a compromise between in-house and subcontracts. A vendor product may exist that meets all functional requirements but req uires in-house modifications for successful operation in a space environment. The HRF utilizes equipment developed using all of the paths described: inhouse, subcontract, and modified COTS.

Bauer, Liz↗
NASA NTRS1989

Research and technology of the Lyndon Johnson Space Center

Johnson Space Center accomplishments in new and advanced concepts during 1988 are highlighted. This year, reports are grouped in sections Space System Technology, Solar System Sciences, Space Transportation Technology, and Medical Sciences. Summary sections describing the role of Johnson Space Center in each program are followed by descriptions of significant tasks. Descriptions are suitable for external consumption, free of technical jargon, and illustrated to increase ease of comprehension.

Source record↗
NASA NTRS1997

NASA Worldwide Emergency Medical Assistance

In an effort to maintain employee health and welfare, ensure customer satisfaction, and to deliver high quality emergency medical care when necessary to employees located overseas, NASA has instituted a new contract with International SOS Assistance INC. International SOS Assistance INC. will provide civil servants and contractors engaged in official NASA business with many services upon request during a medical or personal emergency. Through the years, International SOS Assistance INC. has developed the expertise necessary to provide medical service in all remote areas of the world. One phone call connects you to the SOS network of multilingual staff trained to help resolve travel, medical, legal, and security problems. The SOS network of critical care and aeromedical specialists operates 24 hours a day, 365 days a year from SOS Alarm Centers around the world. This exhibit illustrates the details of the NASA-International SOS Assistance INC. agreement.

Martin, George A.↗
NASA NTRS1978

Infant Transport Monitoring

The photo sequence illustrates the movement of an ill infant to a special care hospital by means of a new Pediatric Monitoring and Transport System, in which NASA technology and technical assistance are being applied to an urgent medical problem. Development of the system is a collaborative effort involving several organizations, principally, NASA Ames Research Center and Children's Hospital Medical Center, Oakland, California. Key to the system's efficacy is a custom-designed ambulance-to-hospital and hospital-to-hospital communications network, including two-way voice capability and space-derived biotelemetry; it allows a specialist at the destination hospital to monitor continuously the vital signs of the patient during transit.

Source record↗
NASA NTRS2003

Automated Monitoring with a BSP Fault-Detection Test

The figure schematically illustrates a method and procedure for automated monitoring of an asset, as well as a hardware- and-software system that implements the method and procedure. As used here, asset could signify an industrial process, power plant, medical instrument, aircraft, or any of a variety of other systems that generate electronic signals (e.g., sensor outputs). In automated monitoring, the signals are digitized and then processed in order to detect faults and otherwise monitor operational status and integrity of the monitored asset. The major distinguishing feature of the present method is that the fault-detection function is implemented by use of a Bayesian sequential probability (BSP) technique. This technique is superior to other techniques for automated monitoring because it affords sensitivity, not only to disturbances in the mean values, but also to very subtle changes in the statistical characteristics (variance, skewness, and bias) of the monitored signals.

Bickford, Randall L.↗
NASA NTRS1990

Research and Technology

Johnson Space Center (JSC) accomplishments in new and advanced concepts during 1989 are highlighted. This year, reports are grouped in sections, Medical Science, Solar System Sciences, Space Transportation Technology, and Space Systems Technology. Summary sections describing the role of JSC in each program are followed by descriptions of significant tasks. Descriptions are suitable for external consumption, free of technical jargon, and illustrated to increase ease of comprehension.

Source record↗
NASA NTRSDate not supplied

CHP-PRA Proof-of-Concept [Simulation] Sensitivity Assessment

An effort is underway to establish a Crew Health and Performance system (CHP) tradespace tool using a Probabilistic Risk Assessment (PRA) modeling and simulation system. The goal of the CHP-PRA effort is to provide a means of quantifying the integrated influence of CHP functions and capabilities on risk outcome metrics associated with health, performance, and long-term health. These metrics can then be used to establish potential risk-based trades on CHP system designed functionality and capabilities. Previously, our team demonstrated a proof-of-concept PRA approach that estimated the integrated influence of exercise countermeasures on 8 human system risks (Figure 1a) with outcomes associated with health and medical risk metrics. We reported that the change in the integrated relative health risk was small (Figure 1b) and that the small change in overall risk resulted from compounding and competing contribution levels of the individual risks. This interesting observation illustrates the emergent complexity of even straightforward representations of the human health and performance risk space and the ability of PRA models to capture this balance of global risk concerns. A key question that is not addressed in the initial analysis is “even though the global risk is relatively nominal, do any of the local risks become unacceptable?” In essence, we seek to determine what relative change in the human system risks are contributing to the relatively muted sensitivity of the proof-of-concept model combined risk assessments. Evaluations at the component risk level should elucidate if any individual risk reaches a high level that is subsequentially balanced by reductions in other areas. To further understand the relative changes in the component risks in the proof-of-concept model, and to elucidate how future refinements can be targeted, a means of establishing the contributions of the robustness of the proof-of-concept approach will be demonstrated.

astronaut health↗
DOE OSTI2021

Species- and site-specific genome editing in complex bacterial communities

Knowledge of microbial gene functions comes from manipulating the DNA of individual strains in isolation from their natural communities. While this approach to microbial genetics has been foundational, its requirement for culturable microorganisms has left the majority of microbes and their interactions genetically unexplored. Here, we describe a generalizable strategy for editing the genomes of specific organisms within microbial communities. We identified genetically tractable bacteria within a community using Environmental Transformation Sequencing (ET-Seq), an approach in which non-targeted transposon integrations are mapped and quantified following community delivery. We next developed and used DNA-editing All-in-one RNA-guided CRISPR-Cas Transposase (DART) systems for targeted DNA insertion into organisms identified as tractable by ET-Seq, enabling organism- and locus-specific genetic manipulation within the community context. To illustrate the utility of our approach, we selectively edited closely related strains, measured gene fitness, and enriched targeted members within soil and infant gut microbiota. These results establish a new paradigm for targeted community editing relevant to research and applications on medical, agricultural, and industrial microbiomes.

59 BASIC BIOLOGICAL SCIENCES↗
NASA NTRS1976

Long-duration exposure facility - A new capability for space testing and basic research

The reusable Long-Duration Exposure Facility (LDEF), which can accommodate experiments requiring large exposure surface areas, large volumes and/or massive hardware, offers to researchers a new inexpensive opportunity to conduct extended technology and basic research testing in the space environment. Many researchers with interest varying from medical research to astrophysics research will have their experiments performed in the 80 large experiment trays on the first LDEF flight. This paper describes the LDEF and a number of experiments now being developed for the first mission. In particular, this paper illustrates the value of the LDEF features which allow the return of the experiment hardware and repeated flights.

Dibattista, J. D.↗