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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 NTRSDate not supplied

The Impact of Delayed Communication on NASA’s Human-Systems Operations: Preliminary Results of a Systematic Review

Throughout the history of human spaceflight, NASA has relied on a team of ground-based experts on Earth to manage its missions, vehicles, and crews to ensure crew safety and mission success. However, as missions progress beyond low-Earth orbit (LEO), this paradigm of dependence on ground must evolve. Beyond LEO, in missions to the moon and Mars, crews will confront new challenges: limited evacuation options, reduced resupply capabilities, and significant communication delays that impede real-time support from experts on the ground. This reduction in ground support amplifies the likelihood that crews will be unable to adequately respond to unanticipated, safety-critical events. Understanding the scope of these risks and identifying effective countermeasures hinges on understanding the impact of communication delays on complex operations, especially in urgent, unforeseen events. Real-time communication currently provides the crew with continuous access to a large, extensively resourced ground team skilled in anomaly resolution. However, as communication delays grow, the need to transfer some responsibilities from ground experts to onboard crew becomes evident. NASA has been exploring this shift in operational responsibilities and its effectiveness in managing complex operations for decades. Nevertheless, a comprehensive understanding of the specific challenges posed by communication delays and the necessary countermeasures to mitigate them remains a gap. In this paper, we present an update on our systematic review of the literature on communication delays, the first in-depth review since 2013 (Rader et al.). We introduce a coding taxonomy to capture key constructs from papers of interest and discuss preliminary findings. These preliminary results suggest two significant research gaps: limited studies have been conducted 1) with lunar-like latencies and 2) on problem-solving strategies for the maximum latencies expected in Mars missions. We outline plans and propose recommendations to address these gaps through ongoing and future research.

human-systems integration↗
NASA NTRSDate not supplied

Information Systems for Crew-Led Operations Beyond Low-Earth Orbit

On past and present human space missions, the management of vehicle health and status has primarily been executed from Earth. Missions such as Apollo, Space Shuttle, and ISS have relied on a safety net of ground-based experts with access to real-time telemetry data, broad and deep systems expertise, and powerful analytical and computing capabilities. The ground team monitors and manages the vehicle’s health in real-time and responds quickly to critical situations and malfunctions. Ground operators also provide real-time oversight and verbal guidance to flight crew members, especially during complex procedure execution and high-risk activities like extra-vehicular activities. However, this operational paradigm, in place for 60 years, will not transfer to long duration exploration missions beyond low Earth orbit (LEO). Lunar and deep-space crewed missions will encounter delayed communications that prohibit real-time operational and medical support. Additionally, there will be infrequent resupply and a diminished capacity to evacuate or rescue crew members. A small crew must operate independently, managing the vehicle’s state, responding to time-critical events, and executing complex procedures, all without the safety net of real-time support.

data representation↗
NASA NTRSDate not supplied

Effect of Vacuum on Force Response of an Ultrasonic Penetrator

Introduction: The Apollo astronauts encountered higher than expected resistances when interacting with the lunar soil via the Apollo Lunar Surface Drill (ALSD) and the trenching tool. Reducing the force required to move tools or other mechanical components through regolith will impact many steps of the resource extraction process. Force reduction has been achieved in soil materials by imparting vibration to tooling interfaces such as a vibratory farming cultivator, a percussive scoop, and ultrasonically resonant penetrators. Vibration-assisted tools in granular media reduce interaction forces by fluidizing a volume around the tool, allowing the tool to progress through a dynamic (fluid) medium instead of a static (solid) medium. This work seeks to quantify ultrasonic vibration’s effect on the force response of a penetrator in lunar soil simulant in vacuum sufficient to be within the molecular flow regime of any disturbed gases. Methods: A custom vacuum chamber setup, CUBEvac, was designed and built to facilitate penetration testing in a high vacuum environment, for comparison to penetration behavior in ambient terrestrial environment. A two-stage pumping system (Agilent Triscroll 600 roughing pump, Agilent VHS-6 oil diffusion pump) reached chamber pressures of about 5x10-6 Torr with regolith simulant in place. Figure 1 is a schematic of the heart of the assembly (note the penetration drive mechanisms above the chamber feedthrough and the regolith simulant sample in the bottom are not shown). The penetration actuation stack was comprised of a stepper motor driving a lead screw to move the ultra-sonic probe vertically inside the chamber. Motion was coordinated with an Arduino Uno. GRC-3 lunar simulant was used for this set of experiments. Samples were prepared in a four-liter stain-less steel, cylindrical pot with an internal diameter of approximately 15.56 cm (6.125 in) and a depth of 19.37 cm (7 5/8 in) for testing. The soil was baked out prior to compaction preparation as a measure to reduce soil moisture which interfered with pump down capacity. The soil was not baked again if it was removed from the vacuum chamber, prepped, and immediately returned to the vacuum chamber for pump down. The soil was compacted using a 60 Hz vibration table with a surcharge of 34 kg place on top of the soil in the container. Prepared soil samples weighed approximately 6.5 kg (bulk density 1.895-1.934 g/cm3). Two probe end effectors were tested: A cone penetrometer (static only) with a nominal diameter of 12.7 mm (0.5 in) and a nominal height of 28.6 mm (1.125 in); and a vibrating cylindrical probe measuring 12.7 mm in diameter and 50.8 mm in effective length from the tip (Figure 2). The cylindrical probe vibrated resonantly at 20 kHz with an amplitude 23 μm. The cone penetration tests were conducted to assess potential soil behavior differences in vacuum. The cylinder probe tests were conducted as the primary subject of this investigation to assess force response in vacuum. For each test, a regolith simulant sample was load-ed and compacted in the chamber, which was then evacuated for roughly 18 hours to reach the lowest possible pressure (approximately 5x10-6 Torr for most tests). The probe was then moved to about 10 mm above the soil surface before being pushed to a depth of 50 mm for the cylinder probe tests and to a depth of 100 mm for the cone penetrometer tests, both at a speed of 2 mm/s. The simulant samples were prepared the same for all tests. Ideally, they would respond consistently to probe penetration under ambient and vacuum conditions. This was evaluated by measuring the resistance of representative prepared simulant beds with a standard cone penetrometer in both environments. Results and Discussion: The resistance of the simulant samples in the vacuum tests was consistently lower than in the ambient tests as determined by the cone penetration tests. Thus, the ambient and vacuum results cannot be compared directly; work is underway to de-confound and better correlate the data. Still, figures 3-6 show that probe penetration forces are lower overall in the vacuum environment. In both environments, resonant vibration of the probe provides two useful effects: It reduces the probe penetration force and smooths the force-depth curve, significantly reducing local maxima. These effects have implications for various potential applications, such as astronaut hand-tools, where benefits (reducing astronaut effort) outweigh the cost of the additional energy re-quired to generate vibration. These results demonstrate that resonantly vibrating tools can meaningfully reduce the penetration force required for excavation, probing, and drilling tools in simulated lunar regolith deposits under vacuum levels approaching those that will be experience on the Moon’s surface. Lunar-gravity, ambient environment tests are scheduled soon. The effects of realistic temperatures and temperature gradients and deeper vacuum remain to be tested.

E Rezich↗
NASA NTRSDate not supplied

An Automated Medical Inventory System (AMIS) to Enable Earth-Independent Medical Operations

BACKGROUND: Inventory of medical consumables and durables (medications, treatment aids, diagnostic equipment, etc.) aboard the International Space Station is a manual process whereby crewmembers reach out to their flight surgeon to relay when items are used. Performing a full medical system inventory is time intensive. However, as exploration progresses to long duration missions with little to no resupply or evacuation capabilities, maintaining an accurate account of inventory and location for medical systems across the mission will become increasingly critical. A new system must be developed for future exploration missions to meet the need for a crew-facing, real time method of managing medical inventory. OVERVIEW: NASA’s Exploration Medical Integrated Product Team (XMIPT) is funding the AMIS project to mature the technology readiness level and to conduct a flight demonstration of a medical inventory capability. AMIS will leverage lessons learned from a Medical Consumables Tracking project previously demonstrated aboard the ISS in 2016 and 2017. Key components of AMIS include a database, supporting hardware and software, and interfaces to power, communications, or other vehicle or medical systems. Some medical inventory capability may be provided by the vehicle inventory management system which relies upon RFID-based technology and can track larger items such as medical kits or medical hardware. AMIS will augment these capabilities to enable tracking of individual medical kit contents. Efforts are underway to characterize the optimal solution trade space by comparing system specifications (e.g. mass and volume, etc.) across maintenance and operational use cases (e.g. crew time saved, total inventory automated, etc). DISCUSSION: The contents of a Mars Medical System have not been fully defined which poses challenges to defining an inventory system and requires assumptions regarding medical kit contents and medical system design. Other important considerations include minimizing crew time required, avoiding access restrictions to medical inventory in the event of an emergency, and ensuring that data is accessible to other medical system elements to enable crew autonomy in provision of medical care.

Automated Medical Inventory System↗
NASA NTRS2024

ISS Technology Demonstrations for Future Spaceflight Medical Systems

Throughout the history of human spaceflight, crewmembers have experienced various in-flight medical conditions including illness and injury. Planned missions to the Moon and Mars will require capabilities to maintain the health of future space travelers. Mass, power, and volume available in the vehicles and habitats for these missions will be severely constrained; resupply of resources will be limited or non-existent, as will opportunities for evacuation to Earth. Furthermore, ground-based support will be hampered by communication latencies and blackouts. These vehicle and mission constraints will necessitate a medical system that has been efficiently planned, providing on-board procedural guidance in addition to a variety of medical devices and consumable resources. Medical capabilities required for the diagnosis and treatment of potential medical conditions during future spaceflight missions may include real-time health monitoring, medical imaging, and biomarker analyses ( e.g., blood or urine). Terrestrial medicine shares these needs, thus many of these medical capabilities could likely be satisfied by Commercial-Off-The-Shelf (COTS) devices and methodologies; however, in some cases the unique space environment and increased mission duration will drive the need to modify technologies and the way care is provided. NASA’s Human Research Program (HRP) Exploration Medical Capability (ExMC) Element and Mars Campaign Office’s Exploration Medical Integrated Product Team (XMIPT) are working together to decrease medical risk during exploration missions. Flight-tested medical diagnostic and treatment technologies are necessary to effectively manage medical conditions relevant to exploration missions while meeting vehicle constraints, integrating with medical decision-support tools, and enabling increasingly Earth-independent operations. Several projects have leveraged the ISS as a testbed for exploration, including 1) i n- situ blood analysis, 2) medical inventory, 3) intravenous fluid generation, and 4) autonomous medical procedure guidance. Management of several in-flight medical conditions, such as bacterial and viral infections and acute radiation syndrome, is dramatically improved with ability to assess blood cell populations, electrolytes, and metabolites. I n December 2020 and January 2021 ExMC performed an ISS technology demonstration (Tech Demo) of the HemoCue® WBC DIFF analyzer (HemoCue, Brea, CA), a COTS device that was modified to enable functionality in a spaceflight environment. This Tech Demo marked the first time that hematology measurements were successfully performed real-time in microgravity. Also modified and demonstrated was the reusable Handheld Electrolytes and Lab Technology for Humans (rHEALTH) ONE analyzer (rHEALTH, Bedford, MA), which uses flow cytometry and sheath-based hydrodynamic focusing methodologies. The rHEALTH ONE ISS Tech Demo in May 2022 demonstrated test results obtained in-flight matched those on the ground. NASA currently relies on crew self-reporting to manage and maintain medical inventory on ISS.The ability to maintain an accurate inventory becomes more critical during long duration missions since the crew will need to be increasingly autonomous in finding and utilizing medical items, including those scenarios when alternative treatments need to be considered due to limited or no resupply. HRP’s Medical Consumables Tracking (MCT) project was developed by ZIN Technologies, Inc. (Cleveland, OH), and demonstrated real-time tracking of medical supplies aboard the ISS between December 2016 and July 2018. The MCT system design utilized Radio Frequency Identification Device (RFID) technology to perform automated inventory and was installed in the Crew Health Care System (CHeCS) Resupply Stowage Rack (RSR). The challenge of limited shelf life, exacerbated by the lack of resupply opportunities, affects a plethora of medical system components including consumables, pharmaceuticals, and intravenous (IV) fluid. In 2010, ExMC funded ZIN Technologies, Inc. (Cleveland, OH), to develop the Intravenous Fluid Generation (IVGEN) system. IV fluids were successfully generated with IVGEN using the potable water supply on ISS during ISS Expedition 23. The XMIPT is in the process of developing a miniaturized version of the original IVGEN hardware for a future Tech Demo aboard the ISS. Current ISS medical operations rely heavily on preflight training and real-time remote guidance, both of which become impractical or impossible for exploration missions. The primary goal of the Autonomous Medical Officer Support (AMOS) Software Tech Demos on ISS was to confirm telemedical proof-of-concept for autonomous medical imaging in an operational setting. This novel software tool shifts emphasis from preflight training and real-time remote guidance to in-flight just-in-time instruction, a new and necessary paradigm for crew medical autonomy. AMOS introduces a novel, streamlined skill management concept for exploration missions featuring comprehensive training and guidance modules for ultrasound examinations using the ISS Ultrasound 2 (a modified GE Vivid-q™; General Electric HealthCare, Chicago, IL). With no prior crew training or remote guidance, two Tech Demos on the ISS (April 2020 and June 2022) resulted in high quality, clinically useful image sets. We will provide a review of historical, current, and planned medical devices and technologies considered for inclusion within future spaceflight medical systems and summarize hardware development activities and medical device tech demos conducted on the ISS.

Astronaut health and performance↗
NASA NTRSDate not supplied

The Impact of Delayed Communications on NASA's Human-Systems Operations: Preliminary Results of a Systematic Review

Throughout the history of human spaceflight, NASA has relied on a team of ground-based experts on Earth to manage its missions, vehicles, and crews to ensure crew safety and mission success. However, as missions progress beyond low-Earth orbit (LEO), this paradigm of dependence on ground must evolve. Beyond LEO, in missions to the moon and Mars, crews will confront new challenges: limited evacuation options, reduced resupply capabilities, and significant communication delays that impede real-time support from experts on the ground. This reduction in ground support amplifies the likelihood that crews will be unable to adequately respond to unanticipated, safety-critical events. Understanding the scope of these risks and identifying effective countermeasures hinges on understanding the impact of communication delays on complex operations, especially in urgent, unforeseen events. Real-time communication currently provides the crew with continuous access to a large, extensively resourced ground team skilled in anomaly resolution. However, as communication delays grow, the need to transfer some responsibilities from ground experts to onboard crew becomes evident. NASA has been exploring this shift in operational responsibilities and its effectiveness in managing complex operations for decades. Nevertheless, a comprehensive understanding of the specific challenges posed by communication delays and the necessary countermeasures to mitigate them remains a gap. In this paper, we present an update on our systematic review of the literature on communication delays, the first in-depth review since 2013 (Rader et al.). We introduce a coding taxonomy to capture key constructs from papers of interest and discuss preliminary findings. These preliminary results suggest two significant research gaps: limited studies have been conducted 1) with lunar-like latencies and 2) on problem-solving strategies for the maximum latencies expected in Mars missions. We outline plans and propose recommendations to address these gaps through ongoing and future research.

earth-independence↗
NASA NTRS2024

Spacecraft Priming Analysis and Research Test Apparatus: Number 1 (SPARTAN 1), Test and Analysis Results

Spacecraft with Earth-storable propellants are required by range safety to launch with propellant isolated from the thrusters for ground operations, which is often accomplished by placing a pyrotechnic, or a latching isolation valve between the tank and the thrusters. Once on-orbit, downstream lines are vented out to space through the thrusters and are left evacuated and at vacuum pressure. Propellant isolation valve then opens and floods the lines with high velocity propellant which can lead to a significant pressure surge upon filling. Replicating this event during ground testing using water as a propellant simulant has always been difficult and costly to accurately perform due to the low vacuum pressure targeted on the downstream side of the system. This report describes the Spacecraft Priming Analysis and Research Test Apparatus (SPARTA) at Marshall Space Flight Center’s (MSFC) Component Development Area (CDA) and the initial test series meant to be a pathfinder for construction methods and test procedures to reduce the cost of future testing. The test data collected are critical to analytical models as the details to replicate prior ground tests are often lacking in enough detail to adequately model the test that was conducted. This report also describes the Thermal Desktop/FloCAD analysis that was performed alongside the test series. The test methods defined for this campaign showed a dramatic improvement on heritage test procedures. Test pace increased due to faster drying and pulling vacuum more effectively. Results generated in this test matched analytical predictions very well and provide a releasable set of test data to be leveraged on future NASA and commercial partner spacecraft development programs.

spacecraft↗
NASA NTRSDate not supplied

Numerical Implementation of Source Terms to Evaluate Active Porosity Control using a Transpiration Cooled Thermal Protection System

Transpiration cooling has renewed interest of study as a renewable system of thermal protection for atmospheric entry systems. The presence of coolant within the void space of a porous material changes its effective porosity and theorized to lend the external heatshield as a potential means of porous surface control. Effective porosity is explored in two forms: saturation of void space where exiting coolant creates ‘blowing’ over the surface, and partial evacuation of the void space where withdrawal of the coolant creates ‘suction’ on the surface. Thus this study evaluates using transpiration cooling as a as means of active aerodynamic control. The feasibility of the system is evaluated numerically using Reynolds-averaged Navier Stokes based computational fluid dynamics for the aerodynamic assessments by coding source terms of transpiration cooling products at a heat shield surface boundary at the wind side shoulder, creating an asymmetric scheme. Study results show induced moments about the pitch axis incurred following the source terms of a cooling fluid at a near-shoulder location on the heat shield. Lift and drag saw increasing modulation with increase in mass flux rate. Pitch moment was altered a total of 388 N-m between lowest and highest ‘suction’ rates and changed 194 N-m maximum between ‘blowing’ rates.

transpiration cooling↗
NASA NTRSDate not supplied

Comparison of Artemis 2 and Artemis 5 Model Outcomes Using the Impact Probabilistic Risk Assessment Tool

BACKGROUND The Artemis campaign is a Moon exploration program with a series of six planned missions, five of which will be crewed. These five crewed missions will contain a single mission segment (space flight), or multiple mission segments involving space flight (Orion), lunar landing (LTV) and/or space habitat (Gateway). Each crewed segment faces the risk of unique medical conditions, necessitating medical sets/kits tailored to those specificities. To support and enable a data-driven and evidence-based decision-making process through out a mission’s life cycle, a software tool called IMPACT was developed. Using probabilistic risk assessment (PRA) methodologies, IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a novel tool built for analyzing the possibility of encountering complex medical risks during space flight, and for identifying the medical resources and capabilities needed to treat those potential at-risk medical conditions. This presentation will seek to compare IMPACT’s computational results upon potential complex space medical conditions (e.g., sprain/strain back or sleep disturbance) using IMPACT’s risk metrics and the associated optimized medical sets/kits between two Artemis missions: single segment Artemis 2 and multi-segmented Artemis 5. OVERVIEW By identifying potential medical conditions in space using input criteria such as crew quantity and composition, certain crew physical characteristics, mission duration and mission activities, IMPACT can produce analyses on the type of medical resources and capabilities needed to produce an optimized medical set/kit to address those medical conditions. IMPACT achieves this by performing hundreds of thousands of Monte Carlo simulations of missions to build aggregate pictures of medical risk. IMPACT’s risk metrics include loss of crew life (LOCL) – a measure of crew mortality due to medical conditions in space, return to definitive care (RTDC) – the need to perform crew evacuation, and task time lost (TTL) – a measure of the inability to perform activities due to crew disability. These risk metrics are applied to every medical condition identified by IMPACT’s computation analyses for every segment of the mission. Medical sets/kits are optimized to address these medical conditions but must fit within the stated Artemis Design Reference Mission (DRM) request for mass and volume physical size constraints. ANTICIPATED ANALYSIS AND CONCLUSION Using two Artemis missions, Artemis 2 and Artemis 5, IMPACT will provide the analyses for comparison of medical set/kit contents based upon mass and/or volume requirements and identify the at-risk medical conditions within both missions. This paper serves as an initial exploration of probabilistic risk assessment (PRA) medical risk calculations between two crewed Artemis missions and is not intended to be deemed the official medical response for the Artemis campaign.

probabilistic risk assessment↗
NASA NTRS2025

Evaluating the Viability of Compact and Portable X-Ray Systems for an Exploration Medical System in a Ground Demonstration

MOTIVATION FOR INCLUDING X-RAY CAPABILITIES For upcoming exploration missions, the need for enhanced medical care becomes critical due to extended mission durations, significant communication delays, and minimal evacuation opportunities. Previous evidence by our team has revealed that among the 119 medical conditions targeted for management during spaceflight within NASA Exploration Medical Capability’s IMPACT Condition List, at least 36 could benefit from radiography (XR). Utilizing XR for diagnosis and management is hypothesized to significantly improve management of crew health by enabling the immediate evaluation and confirmation of potential injuries or illnesses. Beyond clinical applications, XR also holds potential for non-destructive testing (NDT). This includes applications such as assessing the structural integrity of the spacecraft, analyzing surface and meteorite samples, and inspecting onboard electronics. THREE CANDIDATE X-RAY SYSTEMS CHOSEN FOR GROUND DEMONSTRATION The Exploration Medical Capability Element (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) of the Mars Campaign Office initiated early background work for ground demonstrations. In FY21, ExMC published a Concept of Operations to guide requirements development. By FY23, XMIPT and yet2, a technology scouting and open innovation consulting firm, had completed a market survey and trade study to identify potential miniature XR systems. Selection criteria included commercial-off-the-shelf availability, low mass and volume, and regulatory compliance. The top three candidate devices—Remedi REMEX-KA6, MinXray Impact, and FujiFilm Xair—were acquired to characterize the requirements and capabilities of each device. To facilitate testing, phantoms, and radiographic personal protective equipment (PPE) were purchased, and a dedicated space was designated for XRS usage at Glenn Research Center. During this presentation, the mass, volume, and power requirements for each of the three piloted devices are revealed, as well as information regarding the detector, mA, and kV of the devices. GOAL AND OBJECTIVES OF A MINI XRS GROUND DEMONSTRATION The primary goal of ExMC/XMIPT technology demonstrations is to bridge the gap in available, flight-ready medical device technology by flight-testing diagnostic and treatment technologies essential for managing medical conditions during exploration missions. These technologies must adhere to vehicle constraints such as mass, volume, power, and data requirements, integrate seamlessly with medical decision-support tools, and support increasingly Earth-independent operations. There are three main objectives for the future ground demonstration of these three devices. First, we aim to determine the full capabilities of these three miniature XR systems within the context of the spaceflight environment. While medical applications are the primary focus for the miniature XR, a comprehensive exploration of non-medical uses has been initiated by an XMIPT-sponsored NASA SPARK campaign to identify collaborators. Second, we plan to establish criteria and to use insights gained from evaluating each miniature XR against those criteria to select the most suitable system among the three candidates. Third, we intend to evaluate their suitability for flight certification, which includes assessing its durability for launch, reentry, and exposure to high background radiation, as well as its compatibility with existing data architecture systems. Numerous subject matter experts from NASA and partner institutions will support these objectives.

C A Haddix↗
NASA NTRS2025

Human Spaceflight Applications of Novel Miniature X-Ray Technologies

INTRODUCTION: Radiography (XR) has long been a cornerstone of terrestrial medical imaging, though it has not yet been used in the spaceflight environment. Medical systems for human spaceflight missions are constrained by mass, volume, and power, and until recently, XR systems have been considered too large and power-consuming for spaceflight diagnostic and therapeutic applications. However, the rise of commercial spaceflight and NASA’s refocused efforts on returning crews to the Moon for long-duration missions have introduced a higher degree of medical risk to human spaceflight and require a re-evaluation when optimizing medical system design. Over the last decade, XR devices have miniaturized while maintaining good diagnostic and therapeutic sensitivity and specificity, making new in-flight medical and non-medical XR applications a possibility. Initial research identified several medical conditions where miniature XR would be beneficial for the diagnosis and/or management of medical conditions arising in space, though a more in-depth analysis is required to identify whether XR may add value to the management of such conditions. With this presentation, we aim to introduce the potential utility of miniature XR, review prior work highlighting where XR may be beneficial, and evaluate how miniature XR may reduce medical risk in human spaceflight missions. METHODS: IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a risk assessment tool developed by NASA to advance exploration mission medical system design by quantitatively estimating mission medical risk. IMPACT v1.0 includes a novel evidence library baselined to exploration environments, an expanded list of 119 medical conditions, medical capabilities and resources critical for management of these medical conditions, and the ability for rapid and iterative analysis in the setting of modifiable design reference missions (DRMs). Our first analysis identified which of the 119 medical conditions XR had diagnostic or therapeutic utility for. Subject matter experts (SMEs) recorded which XR views would be performed under ideal terrestrial circumstances for diagnosis/management of each condition, as well as which views are pragmatic for spaceflight limitations. A second analysis utilized IMPACT to identify significant conditions that contribute greatest to medical risk during a notional long-duration Lunar orbit and Lunar surface DRM. Medical system risk estimates include loss of crew life (LOCL), need for return to definitive care (RTDC; medical evacuation), and an estimate of crew task time affected (TTA). Using a standardized semi-quantitative scoring methodology, a deeper evaluation of each of the most significant medical conditions was performed. Data from both of these separate analyses were used to hypothesize what ideal and pragmatic XR studies may impact clinical management of the most significant conditions predicted to lead to medical risk. RESULTS: Approximately 1/3 of the IMPACT conditions were identified as being more effectively or comprehensively assessed or treated with the addition of miniature XR technology. The resulting conditions benefitting diagnostically and therapeutically from XR are revealed, as well as the ideal and pragmatic XR views and medical procedures benefitting from XR. The conditions of clinical significance and those most contributing to risk are also displayed. Among the conditions that contribute greatest to LOCL, four conditions for which XR may improve the diagnosis and management of include: decompression sickness, traumatic shock, dental abscess, and respiratory failure. Among conditions that contributed to RTDC, the evaluation and management of wrist fracture is likely improved by XR. For conditions leading to crew TTA, evaluation and management of EVA shoulder injuries, upper and lower extremity strains, back strains, and EVA hand injuries are likely improved by XR. DISCUSSION: Miniature XR in spaceflight has the potential to improve the evaluation and management of a substantial portion of conditions that most contribute to medical risk. This presentation is an introduction to the possibilities miniature XR provides for future human spaceflight missions and subsequent presenters will expand on potential applications in more detail. LEARNING OBJECTIVES: 1) Understand the previous limitations of using radiography in the management of spaceflight medical conditions; 2) Evaluate the findings from the IMPACT tool analysis, which allows quantification of the benefit miniature XR could provide for managing high-risk medical conditions in long-duration lunar orbit and surface missions, focusing on improvements in crew health outcomes; 3) Analyze case studies where miniature XR technology could reduce the medical risks associated with spaceflight missions, specifically in diagnosing and managing conditions such as decompression sickness, traumatic shock, and EVA-related injuries.

A Anderson↗
NASA NTRSDate not supplied

Earth-Independent Medical Operations (EIMO) Concept of Operations

In contrast to the current crew health paradigm for low-Earth orbit and Lunar missions, which depends on real-time communication with Mission Control, deep-space exploration missions will require a significant shift in medical operations. This shift is driven by the constraints of operating at a considerable distance from Earth, such as resource limitations—lack of resupply, restricted mass, power, volume, and data—as well as communication delays and the inability to evacuate back to Earth during emergencies. To move toward a more self-reliant medical model, a strategy is needed to gradually increase space-based crew autonomy and reduce risks to mission success in the challenging environment of deep space. This transformative change, known as "Earth-Independent Medical Operations" (EIMO), explores the gradual transfer of medical care and decision-making from Earth-based support to space-based systems. The goal of this transition is to enhance astronaut health and performance while minimizing mission risks. EIMO requires the development of a medical system that integrates seamlessly with mission planning, vehicle and spacesuit design, and data architecture. This integration is crucial for building a robust medical infrastructure that not only safeguards astronaut well-being but also ensures overall mission success. The Human Research Program (HRP) Exploration Medical Capability (ExMC) Element has revised the EIMO model-based Concept of Operations (ConOps) which outlines an initial vision for EIMO. The ConOps, which is built on the stakeholders’ need, system goals, and objectives (NGOs), presents an array of in-mission scenarios that span a wide range of medical conditions demonstrating the system’s capabilities from basic to complex events. Developed by a multidisciplinary team of systems engineers, scientists, and clinicians within ExMC, the ConOps revision includes two new scenarios(Barotrauma and Self-Medical Management and Behavioral Health and Chronic Medical Care), and implementation of findings from EIMO technical interchange meetings that focused on data and training. The envisioned EIMO Medical System (MS) operates as a system of systems, gathering data from various sources such as reference databases, real-time wearable sensors, point-of-care diagnostics, and environmental controls. The MS also incorporates advanced training tools to support autonomous medical care, assisting the Crew Medical Officer (CMO) during medical events where Ground Support is either unavailable or communication-delayed beyond practicality. Furthermore, MS functions and capabilities were decomposed from the scenarios to establish foundational requirements for EIMO and traced to the NASA Spaceflight Human-System Standard(NASA-STD-3001, Volumes 1 and 2). These traces were performed to gain insights on the alignment of EIMO requirements with the NASA standard. This work serves as an initial recommendation to increase crew autonomy gradually and safely for Mars missions and future deep-space exploration.

medical system↗
NASA NTRSDate not supplied

The Future of Integrated Performance Modeling in the Crew Health and Performance – Probabilistic Risk Assessment Project

The NASA engineering community utilizes event-driven and fault-tree probabilistic techniques to classify risks in the space environment by taking advantage of the inherent knowledge of complex spaceflight system design and testing to quantify failure risk. In harmonizing the risk of human space flight, answering the question of ‘How do we balance health, performance and resource risks with other engineering risks on long duration space missions?’ remains a deeply challenging and largely qualitative practice. The Human Research Program’s Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT) was a significant step forward in efforts to robustly quantify the risk to crew health for exploration missions. However, there remains a significant gap in the ability to comprehensively assess and characterize risk across the disparate functionalities and capabilities which comprise the Crew Health and Performance (CHP) system. The Crew Health and Performance – Probabilistic Risk Assessment (CHP-PRA) project seeks to characterize CHP risks by expanding beyond the foundation established by its PRA predecessors like IMM and MEDPRAT, that simulate medical risk metrics like loss of crew life and evacuations. One of the new risk measures in the CHP-PRA system is embodied in our Performance Risk Model (PRisM). PRisM provides a novel way of assessing crew performance on mission tasks, using a generalized framework which relates back to NASA-STD-3001. This approach allows PRisM to capture and integrate data from a variety of different domains into a single, unified, reproducible representation of astronaut performance. In this presentation, we discuss the motivation for the CHP-PRA work and give a high level overview of the goals of the project, outline the forward work for PRisM, and discuss collaboration opportunities for the community who might explore if their domain knowledge and data could be represented, integrated, and quantified with these tools, whose outcomes are metrics useful for supporting operational mission planning and decision making.

Lauren McIntyre↗
NASA NTRSDate not supplied

Content and Representation of Information Needed to Support Time-Constrained Problem Solving

NASA’s current mission-operations paradigm originated with Project Mercury and endured with minimum evolution through the Apollo Program, Space Shuttle Program, and ISS missions. At its foundation is a near-complete real-time dependence on a ground team to manage the combined state of the mission, vehicle, and crew. Utilizing many engineers and operators with broad and deep expertise; large, distributed datasets including extensive telemetry; and expansive analytical and computing power, this ground team has served as the safety net for crewed spaceflight missions over the past 60 years. This approach must change to address challenges associated with missions beyond low Earth orbit (BLEO), including infrequent resupply, reduced ability to evacuate, and delayed communications that prohibit real-time operational support. We anticipate that a necessary part of this change will be increased independence for the crew, as roles and responsibilities traditionally performed by ground teams move on board the vehicle. While many risks are associated with Earth-independent operations, one particular concern is ensuring that the crew will have adequate onboard support to perform urgent problem solving when communication with the ground is delayed or intermittent. A key resource that enables the ground team to respond to anomalies quickly and effectively is the extraordinary expertise and experience it possesses. It is comprised of 80+ experts on at any given time, with a combined 600+ years of system-specific experience across 22 unique console disciplines. A small crew will face the unprecedented challenge of independently responding to anomalies that have historically been handled by a team 20 times their size. Another important resource upon which the ground heavily relies to support procedure execution and anomaly response is data. The amount of telemetry data that each flight controller monitors is extensive. In addition, as the ground team works to further assess impacts, trouble shoot, identify workarounds, and oversee procedure execution, it accesses and synthesizes engineering and procedure information, as well as system build, test, and configuration documentation. It is not feasible nor useful to put all these data onboard as crews become more Earth independent. Each member of a small Mars mission small crew will have multiple roles beyond monitoring telemetry and data gathering, and multiple roles within anomaly resolution processes, thereby limiting their capacity for copious amounts of information. Moreover, while access is necessary, it alone is insufficient. Information will need to be compiled, refined, and represented appropriately to support the crew’s reduced attention and expertise. This work seeks to understand the content and representation of information needed to support time-constrained problem solving and decision making by the crew without real-time ground support. To build this understanding, we first surveyed the literature, focusing on how expert problem solvers construct and manipulate their mental models. Next, we interviewed expert problem solvers in spaceflight and analogous domains and surveyed industry solutions for data presentation. Finally, we analyzed current spaceflight operations by investigating flight controller anomaly resolution processes during ISS training simulations and real operational events. These methods led to creating a problem-solving framework that details common themes and features of attending to, assessing, analyzing, and acting on problems in complex, time-constrained domains. Using this framework and the results of our analysis, we identified conceptual data representations needed for crew-led problem-solving. Preliminary onboard user interface concepts to meet identified needs will be presented.

anomaly response↗
NASA NTRS2025

Innovative Drug Selection, Storage, and Shelf-Life Strategies for Exploration Spaceflight

Medications have been a part of space travel dating back to the Apollo missions. A safe and effective medication formulary is essential to maintaining crew health and performance during long-duration spaceflight outside of low Earth orbit (LEO). Distance from Earth creates four key operational changes that increase medical risks, including communication, resupply, crewmember health, and evacuation. The current spaceflight pharmaceutical formulary consists of medications indicated to treat a variety of anticipated medical events and healthcare needs during spaceflight, but depends on a robust consumables resupply chain, which may be strained for a Lunar, and possibly non-existent for a Mars mission. The specific medications selections for the formulary may change to optimally align with the mission, crew compliment, and spacecraft design. Medical support at long-duration exploration missions will differ from LEO missions due to mission duration, lack of consumables resupply, prolonged exposure to space radiation, and the absence of emergency medical return capability. Loss of medication resupply limits or removes the ability to replace medications that have been exhausted or degraded, potentially exacerbating the medical risk posture. To address these anticipated risks, long-duration missions must consider use of novel medical technologies, treatment modalities, and smart medical systems that offer greater crew autonomy, such as physiologically based pharmacokinetic modeling, drug repurposing, on demand drug synthesis, or wearable drug delivery / monitoring devices. Once an ideal formulary for exploration space is determined, it is essential to establish the chemical and physical stability of each medication compound, as well as its safety by identifying its degradation profiles and products. Although few studies have been conducted to provide evidence on the physicochemical stability of pharmaceuticals during space missions, the data suggests that the spaceflight environment may promote degradation in some pharmaceuticals. Formulary drug purity and efficacy should be verified by pharmaceutical stability assessments, and can be realized non-destructively, and accessed in remote environments. Non-destructive pharmaceutical analysis and statistical modelling techniques could optimize exploration spaceflight medical care by enabling early detection of suboptimal therapeutics. Likewise, novel packaging, storage strategies, and dosage form innovations are promising countermeasures to optimize pharmaceutical shelf life, purity, and quality of exploration spaceflight medications. As we prepare for more distant exploration missions, risk management planning for astronaut healthcare should include the assembly of a medication formulary that is comprehensive enough to prevent or treat anticipated medical events, remains safe and chemically stable, and retains sufficient potency to last for the duration of the mission. Following extensive review of the literature, we will present innovative formulary optimization strategies, pharmaceutical stability assessment techniques, and storage and packaging solutions that could enhance drug safety and efficacy for future exploration spaceflight missions.

Vernie R Daniels↗
NASA NTRS2026

Outgassing Characterization of Common Trash Items for Disposal By Nanoracks Airlock on the International Space Station

The arrival of the Nanoracks Airlock to the International Space Station (ISS) has provided the ISS program the capability to dispose of common trash items. The concept of operations involved the crew bagging up those items into a trash bag and then utilizing the robotic arm and the airlock to jettison the trash bag. Because of the unknown thermal vacuum stability of some of the items, a molecular contamination concern was raised by the ISS program as the trash is exposed to vacuum upon the evacuation of air from the airlock and the robotic arm moving the airlock to its jettison location. In order to characterize the representative outgassing rates for ISS trash, thermal vacuum testing was performed at White Sands Test Facility. Trash was sorted into a “lower” outgassing bag and a “mixed” bag. The “mixed” trash bag contained more items that were suspected to be not vacuum stable. Load cells were chosen as the primary means for measuring mass loss. A sharp decay in the outgassing rate was observed in the first 30 minutes followed by a slower decay. As expected, the “mixed” bag lost more mass. While Quartz Crystal Microbalances (QCMs) are often utilized to measure long term outgassing rates and the sticking coefficients of contaminants at different operating temperatures for vacuum stable materials, these measurements proved difficult due to the amount and the inclusion of materials with suspect thermal vacuum stability. Because of high rates of material outgassing, the facility was unable to maintain the CQCM temperature setpoint of 80 K QCMs.. The QCMs operating at the warmer temperatures also saturated on occasion due to high levels of condensed matter. Though testing was able to confirm high risk of outgassing contamination for the program, true sticking coefficients could not be determined, available measurements are provided herein.

Alvin Y Huang↗