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DOE OSTI2022

Update on the Investigation of Commercial Drying Cycles Using the Advanced Drying Cycle Simulator

The purpose of this report is to document updates on the apparatus to simulate commercial vacuum drying procedures at the Nuclear Energy Work Complex at Sandia National Laboratories. Validation of the extent of water removal in a dry spent nuclear fuel storage system based on drying procedures used at nuclear power plants is needed to close existing technical gaps. Operational conditions leading to incomplete drying may have potential impacts on the fuel, cladding, and other components in the system during subsequent storage and disposal. A general lack of data suitable for model validation of commercial nuclear canister drying processes necessitates well-designed investigations of drying process efficacy and water retention. Scaled tests that incorporate relevant physics and well-controlled boundary conditions are essential to provide insight and guidance to the simulation of prototypic systems undergoing drying processes. This report documents a new test apparatus, the Advanced Drying Cycle Simulator (ADCS). This apparatus was built to simulate commercial drying procedures and quantify the amount of residual water remaining in a pressurized water reactor (PWR) fuel assembly after drying. The ADCS was constructed with a prototypic 17×17 PWR fuel skeleton and waterproof heater rods to simulate decay heat. These waterproof heaters are the next generation design to heater rods developed and tested at Sandia National Laboratories in FY20. This report describes the ADCS vessel build that was completed late in FY22, including the receipt of the prototypic length waterproof heater rods and construction of the fuel basket and the pressure vessel components. In addition, installations of thermocouples, emissivity coupons, pressure and vacuum lines, pressure transducers, and electrical connections were completed. Preliminary power functionality testing was conducted to demonstrate the capabilities of the ADCS. In FY23, a test plan for the ADCS will be developed to implement a drying procedure based on measurements from the process used for the High Burnup Demonstration Project. While applying power to the simulated fuel rods, this procedure is expected to consist of filling the ADCS vessel with water, draining the water with applied pressure and multiple helium blowdowns, evacuating additional water with a vacuum drying sequence at successively lower pressures, and backfilling the vessel with helium. Additional investigations are expected to feature failed fuel rod simulators with engineered cladding defects and guide tubes with obstructed dashpots to challenge the drying system with multiple water retention sites.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

NASA NTRS1991

The National Disaster Medical System

The Emergency Mobilization Preparedness Board developed plans for improved national preparedness in case of major catastrophic domestic disaster or the possibility of an overseas conventional conflict. Within the health and medical arena, the working group on health developed the concept and system design for the National Disaster Medical System (NDMS). A description of NDMS is presented including the purpose, key components, medical response, patient evacuation, definitive medical care, NDMS activation and operations, and summary and benefits.

Reutershan, Thomas P.↗

NASA NTRS1994

Emergency medical services

When NASA was established in 1958, it was known that space flight would require efforts beyond those of NASA to ensure the health and safety of our astronauts. On 10 Aug. 1958, a Secretary of Defense memorandum was signed that assigned the first Department of Defense (DOD) Manager to provide support to NASA for Project Mercury. This established a chain of command through the Joint Chiefs of Staff to the Secretary of Defense. The current charter is dated 19 Mar. 1986 and assigns the DOD Manager responsibilities to the Commander and Chief, US Space Command. The DOD Managers charter has many support areas and among them are recovery of astronauts and medical support. Today these efforts support the Space Shuttle and Space Station Programs. Briefly, the program works with each organization tasking the other through a requirements document. Level of care, communications, and recovery requirements are established; NASA and the DOD provide the capability to meet them. NASA is also responsible for the specialized training and equipment needed to meet these requirements. A Shuttle launch a KSC requires an Emergency Medical Services (EMS) coordinator on console to facilitate communications, ensure proper coverage, and coordinate with area hospitals. A contingent of NASA medical personnel are assembled to provide triage and medical support capabilities. The DOD provides medical evacuation (MEDEVAC) helicopters with surgeons and pararescue specialists (PJ's) or emergency medical technicians (EMT's). Each helicopter is equipped with at least one doctor and one PJ/EMT per astronaut crew member. Transoceanic abort landing (TAL) sites and end of mission (EOM) sites have similar structures, with TAL sites utilizing fixed wingg aircraft for MEDEVAC. The DOD also supports contingency planning for the support and return of crew members from the Space Station Freedom. Much of this support has been directed at the recovery of crew members following the landing of an Assured Crew Return Vehicle.

Billica, Roger↗

NASA NTRSDate not supplied

Overlapping Conditions in IMPACT

Introduction The IMPACT 1.0 model assumes independence of 119 different medical conditions. That is, it is assumed that one medical event maps to a single medical condition. However, it is often the case that a single medical event may lead to several different concurrent conditions (e.g., a single accident resulting in multiple fractures, chest/abdominal trauma, and sepsis). There is a significant overlap between many of the conditions in ICL 1.0. For example, depression and anxiety are two separate conditions but often co-exist. This overlap may lead to an overestimation in the incidence calculation. In future iterations of the model, we plan to address progression of medical conditions. Methods There are two possible methods to approach progression of a medical condition. The first is to take any medical condition in ICL, calculate its incidence and determine its outcomes no matter what sequelae occur. For example, calculate the incidence of prostatitis and determine its metrics (e.g., loss of crew life, risk of medical evacuation or task time affected) no matter what the sequelae might be (sepsis, hydronephrosis, renal failure, etc.). The second approach is to take any medical condition in the ICL and calculate the outcomes based on transitions to any other condition. For example, calculate the incidence of nephrolithiasis and determine the incidence of each possible transition (e.g., hydronephrosis, renal failure, UTI, pyelonephritis, sepsis) and then determine its metrics. With perfectly informative evidence, the answers should be the same using either method. The question is which approach best reduces the opportunity for overlapping. Results The team identified 31 conditions that were the most likely to transition to a secondary condition such as sepsis and respiratory failure. It was felt that the first approach, as described above, would be the easiest to implement and would have the greatest reduction in overlapping conditions. The identified conditions were primarily infectious conditions, like UTI and pneumonia (which could lead to both respiratory failure and sepsis), toxic inhalations, cardiac arrest, seizures, and trauma. Once these conditions were identified, the conditions were divided between the four clinicians on the team to identify those that were not consistent with the others in way they were approached. There were 13 conditions that were found to be problematic. Some condition definitions needed to be changed to eliminate references to transitions or to update them in cases where the definitions were out of date. Some conditions required new evidence to correct the loss of crew life, and one condition was felt to have so much overlap that it was recommended for elimination. A second effort required modification of the sepsis incidence calculation to prevent double counting of the conditions, such as prostatitis, that could progress to sepsis. Conclusion The team made significant progress in clarifying the method for dealing with transitions from one medical condition to another. In addition, errors were found and corrected in definitions, incidence, and loss of crew life as well as a condition in which reference was made to a CLiFF that was no longer included. These modifications will provide greater fidelity in the IMPACT model and reduce overlap.

Arian Anderson↗

DOE OSTI2026

Quantitative Evaluation of Potassium Iodide Implementation Strategies for Emergency Preparedness and Response

This study evaluates the effectiveness of potassium iodide (KI) distribution strategies in mitigating exposure to radioiodine during severe nuclear power plant accidents. This analysis quantitatively compares various KI distribution methods (pre-distributed versus stockpiles), including scenarios with and without KI administration. The results indicate that differences in distribution strategies impact the projected thyroid dose by at least an order of magnitude. The results also indicate that the timing of KI administration is critical, as expected. For scenarios involving delayed releases of significant quantities of radionuclides, evacuation is the most effective protection strategy regardless of KI distribution method. For scenarios involving rapid releases, retrieving KI from stockpiles can have a detrimental effect. Pre-distributed KI is potentially the most effective approach when used as a supplement to evacuation and sheltering. However, these model results are based on idealized conditions for KI distribution and administration; the actual benefits of KI prophylaxis are likely to be less than estimated in this report due to many variables. The results highlight the importance of considering the cost and rigor of different distribution programs and public compliance with emergency instructions. This report includes suggested research to explore KI distribution plans for advanced reactors.

59 BASIC BIOLOGICAL SCIENCES↗

NASA NTRSDate not supplied

IMPACT-ing Exploration Spaceflight Risk Prediction and Medical System Design

Human exploration spaceflight missions to the Moon and Mars present unprecedented challenges for in-mission medical care. Compared with the ISS, the greater distance from Earth will mean increased mission durations, communication delays, limited to no resupply opportunities, and significant limitations on the evacuation of ill or injured crew. Spacecraft mass, volume, and power will be curtailed while higher demands will be placed on the crew’s knowledge, skills, and abilities. In this higher risk environment, it is important to: a) quantitatively estimate human system risk attributable to medical conditions, a process known as Probabilistic Risk Analysis, and b) use these estimates to inform medical system design. IMPACT (Informing Mission Planning via Analysis of Complex Tradespaces) is a PRA and medical trade space analysis tool developed by NASA to advance exploration mission medical system design. IMPACT improves upon and will soon replace NASA’s existing tool, the Integrated Medical Model, with: a novel evidence base baselined to exploration environments; an expanded list of 120 medical conditions; a significant increase in the number of medical resources that can be utilized and in the flexibility of their use; and the modelling of time lost performing mission-specific tasks due to medical conditions. IMPACT provides evidence-based, mission-specific PRA estimates of in-flight medical risk and an initial list of clinical capabilities and medical resources/hardware to be considered. In addition, sophisticated trade space capabilities estimate how human system risk varies with changes to the mission architecture or medical capability set (e.g., if the system mass constraint decreases by 10% or ultrasound is removed). This panel will provide an overview of IMPACT, its intended use cases, and future development plans. The panel will be the first public presentation of IMPACT results, including medical risk estimates for extended duration Artemis missions, the medical conditions most influencing medical risk metrics, and the clinical capabilities that have the largest effect on medical risk.

Ben Easter↗

DOE OSTI2023

Advanced Drying Cycle Simulator Thermal Response to Commercial Drying Conditions

The purpose of this report is to document updates on testing of the apparatus built to simulate commercial drying procedures for spent nuclear fuel at the Nuclear Energy Work Complex at Sandia National Laboratories. Validation of the extent of water removal in a dry spent nuclear fuel storage system based on drying procedures used at nuclear power plants is needed to close existing technical gaps. Operational conditions leading to incomplete drying may have potential impacts on the fuel, cladding, and other components in the system during subsequent storage and disposal. A general lack of data suitable for model validation of commercial nuclear canister drying processes necessitates well-designed investigations of drying process efficacy and water retention that incorporate relevant physics and well-controlled boundary conditions. This report documents testing updates for the Advanced Drying Cycle Simulator (ADCS). This apparatus was built to simulate commercial drying procedures and quantify the amount of residual water remaining in a pressurized water reactor (PWR) fuel assembly after drying. The ADCS was constructed with a prototypic 17×17 PWR fuel skeleton and waterproof heater rods to simulate decay heat. These waterproof heaters are the next generation design to heater rods developed and tested at Sandia National Laboratories in FY20. This report describes preliminary testing of the ADCS through measurement and analysis of the thermal response of the system to a subset of commercial drying conditions that exclude the introduction of water, namely simulated decay heats and pressures relevant to commercial drying. This test series, referred to as a “dry” test series in this report, spans three uniform waterproof heater rod powers (representing spent fuel decay heats), four helium fill pressures, and six vacuum levels. This test series was conducted to cover the range of expected ADCS testing conditions for upcoming “wet” testing, where water will be introduced and a simulated commercial drying cycle will be performed. The dry test conditions were derived from the commercial drying conditions seen in the High Burnup Demonstration and the vacuum drying conditions chosen for a smaller scale Dashpot Drying Apparatus tested at Sandia National Laboratories in FY22. For a given uniform power and pressure/vacuum level, the ADCS was operated at constant power and pressure and allowed to reach steady state conditions. The thermal data obtained from these tests were analyzed, and the results can inform computational models built to simulate commercial drying processes by providing baseline thermal data prior to the introduction of water. Following the preliminary dry tests, a test plan for the ADCS will be developed to implement a drying procedure that begins with the introduction of water to the system and is based on measurements from the drying process used for the High Burnup Demonstration Project. While applying power to the simulated fuel rods, this procedure is expected to consist of filling the ADCS vessel with water, draining the water with applied pressure and multiple helium blowdowns, evacuating additional water with a vacuum drying sequence at successively lower pressures, and backfilling the vessel with helium. Additional investigations are expected to feature failed fuel rod simulators with engineered cladding defects and guide tubes with obstructed dashpots to challenge the drying system with multiple water retention sites. The data from these investigations is expected to inform the efficacy of commercial drying operations through the quantification of residual water in a prototypic-length dry storage canister.

11 NUCLEAR FUEL CYCLE AND FUEL MATERIALS↗

NASA NTRS2011

Exploration Medical System Demonstration Project

A near-Earth Asteroid (NEA) mission will present significant new challenges including hazards to crew health created by exploring a beyond low earth orbit destination, traversing the terrain of asteroid surfaces, and the effects of variable gravity environments. Limited communications with ground-based personnel for diagnosis and consultation of medical events require increased crew autonomy when diagnosing conditions, creating treatment plans, and executing procedures. Scope: The Exploration Medical System Demonstration (EMSD) project will be a test bed on the International Space Station (ISS) to show an end-to-end medical system assisting the Crew Medical Officers (CMO) in optimizing medical care delivery and medical data management during a mission. NEA medical care challenges include resource and resupply constraints limiting the extent to which medical conditions can be treated, inability to evacuate to Earth during many mission phases, and rendering of medical care by a non-clinician. The system demonstrates the integration of medical technologies and medical informatics tools for managing evidence and decision making. Project Objectives: The objectives of the EMSD project are to: a) Reduce and possibly eliminate the time required for a crewmember and ground personnel to manage medical data from one application to another. b) Demonstrate crewmember's ability to access medical data/information via a software solution to assist/aid in the treatment of a medical condition. c) Develop a common data management architecture that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all crew health and life sciences activities. d) Develop a common data management architecture that allows for scalability, extensibility, and interoperability of data sources and data users. e) Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management f) Provide better crew health via the reduction in crew errors, crew time, and ground time.

Chin, D. A.↗

NASA NTRS2009

The Integrated Medical Model: A Risk Assessment and Decision Support Tool for Space Flight Medical Systems

The Integrated Medical Model (IMM) is a decision support tool that is useful to mission planners and medical system designers in assessing risks and designing medical systems for space flight missions. The IMM provides an evidence based approach for optimizing medical resources and minimizing risks within space flight operational constraints. The mathematical relationships among mission and crew profiles, medical condition incidence data, in-flight medical resources, potential crew functional impairments, and clinical end-states are established to determine probable mission outcomes. Stochastic computational methods are used to forecast probability distributions of crew health and medical resource utilization, as well as estimates of medical evacuation and loss of crew life. The IMM has been used in support of the International Space Station (ISS) medical kit redesign, the medical component of the ISS Probabilistic Risk Assessment, and the development of the Constellation Medical Conditions List. The IMM also will be used to refine medical requirements for the Constellation program. The IMM outputs for ISS and Constellation design reference missions will be presented to demonstrate the potential of the IMM in assessing risks, planning missions, and designing medical systems. The implementation of the IMM verification and validation plan will be reviewed. Additional planned capabilities of the IMM, including optimization techniques and the inclusion of a mission timeline, will be discussed. Given the space flight constraints of mass, volume, and crew medical training, the IMM is a valuable risk assessment and decision support tool for medical system design and mission planning.

Kerstman, Eric↗

NASA NTRS2015

Integrated Medical Model Project - Overview and Summary of Historical Application

Introduction: The Integrated Medical Model (IMM) Project represents one aspect of NASA's Human Research Program (HRP) to quantitatively assess medical risks to astronauts for existing operational missions as well as missions associated with future exploration and commercial space flight ventures. The IMM takes a probabilistic approach to assessing the likelihood and specific outcomes of one hundred medical conditions within the envelope of accepted space flight standards of care over a selectable range of mission capabilities. A specially developed Integrated Medical Evidence Database (iMED) maintains evidence-based, organizational knowledge across a variety of data sources. Since becoming operational in 2011, version 3.0 of the IMM, the supporting iMED, and the expertise of the IMM project team have contributed to a wide range of decision and informational processes for the space medical and human research community. This presentation provides an overview of the IMM conceptual architecture and range of application through examples of actual space flight community questions posed to the IMM project. Methods: Figure 1 [see document] illustrates the IMM modeling system and scenario process. As illustrated, the IMM computational architecture is based on Probabilistic Risk Assessment techniques. Nineteen assumptions and limitations define the IMM application domain. Scenario definitions include crew medical attributes and mission specific details. The IMM forecasts probabilities of loss of crew life (LOCL), evacuation (EVAC), quality time lost during the mission, number of medical resources utilized and the number and type of medical events by combining scenario information with in-flight, analog, and terrestrial medical information stored in the iMED. In addition, the metrics provide the integrated information necessary to estimate optimized in-flight medical kit contents under constraints of mass and volume or acceptable level of mission risk. Results and Conclusions: Historically, IMM simulations support Science and Technology planning, Exploration mission planning, and ISS program operations by supplying simulation support, iMED data information, and subject matter expertise to Crew Health and Safety and the HRP. Upcoming release of IMM version 4.0 seeks to provide enhanced functionality to increase the quality of risk decisions made using the IMM through a more accurate representation of the real world system.

Myers, J.↗

NASA NTRS1990

Biomedical program at Space Biospheres Ventures

There are many similarities and some important differences between potential health problems of Biosphere 2 and those of which might be anticipated for a space station or a major outpost on Mars. The demands of time, expense, and equipment would not readily allow medical evacuation from deep space for a serious illness or major trauma, whereas personnel can easily be evacuated from Biosphere 2 if necessary. Treatment facilities can be somewhat less inclusive, since distance would not compel the undertaking of heroic measures or highly complicated surgical procedures on site, and with personnel not fully trained for these procedures. The similarities are given between medical requirements of Biosphere 2 and the complex closed ecological systems of biospheres in space or on Mars. The major problems common to all these would seem to be trauma, infection, and toxicity. It is planned that minor and moderate degrees of trauma, including debridement and suturing of wounds, x ray study of fractures, will be done within Biosphere 2. Bacteriologic and fungal infections, and possibly allergies to pollen or spores are expected to be the commonest medical problem within Biosphere 2.

Walford, Roy↗

NASA NTRS2014

Exploration Medical System Demonstration

BACKGROUND: Exploration class missions will present significant new challenges and hazards to the health of the astronauts. Regardless of the intended destination, beyond low Earth orbit a greater degree of crew autonomy will be required to diagnose medical conditions, develop treatment plans, and implement procedures due to limited communications with ground-based personnel. SCOPE: The Exploration Medical System Demonstration (EMSD) project will act as a test bed on the International Space Station (ISS) to demonstrate to crew and ground personnel that an end-to-end medical system can assist clinician and non-clinician crew members in optimizing medical care delivery and data management during an exploration mission. Challenges facing exploration mission medical care include limited resources, inability to evacuate to Earth during many mission phases, and potential rendering of medical care by non-clinicians. This system demonstrates the integration of medical devices and informatics tools for managing evidence and decision making and can be designed to assist crewmembers in nominal, non-emergent situations and in emergent situations when they may be suffering from performance decrements due to environmental, physiological or other factors. PROJECT OBJECTIVES: The objectives of the EMSD project are to: a. Reduce or eliminate the time required of an on-orbit crew and ground personnel to access, transfer, and manipulate medical data. b. Demonstrate that the on-orbit crew has the ability to access medical data/information via an intuitive and crew-friendly solution to aid in the treatment of a medical condition. c. Develop a common data management framework that can be ubiquitously used to automate repetitive data collection, management, and communications tasks for all activities pertaining to crew health and life sciences. d. Ensure crew access to medical data during periods of restricted ground communication. e. Develop a common data management framework that allows for scalability, extensibility, and interoperability of data sources and data users. f. Lower total cost of ownership for development and sustainment of peripheral hardware and software that use EMSD for data management. g. Provide a better standard of healthcare for crew members through reductions in the time required by crew and ground personnel to provide medical treatment and the number of crew errors experienced during treatment.

Rubin, D. A.↗

NASA NTRS2014

Mass and Volume Optimization of Space Flight Medical Kits

Resource allocation is a critical aspect of space mission planning. All resources, including medical resources, are subject to a number of mission constraints such a maximum mass and volume. However, unlike many resources, there is often limited understanding in how to optimize medical resources for a mission. The Integrated Medical Model (IMM) is a probabilistic model that estimates medical event occurrences and mission outcomes for different mission profiles. IMM simulates outcomes and describes the impact of medical events in terms of lost crew time, medical resource usage, and the potential for medically required evacuation. Previously published work describes an approach that uses the IMM to generate optimized medical kits that maximize benefit to the crew subject to mass and volume constraints. We improve upon the results obtained previously and extend our approach to minimize mass and volume while meeting some benefit threshold. METHODS We frame the medical kit optimization problem as a modified knapsack problem and implement an algorithm utilizing dynamic programming. Using this algorithm, optimized medical kits were generated for 3 mission scenarios with the goal of minimizing the medical kit mass and volume for a specified likelihood of evacuation or Crew Health Index (CHI) threshold. The algorithm was expanded to generate medical kits that maximize likelihood of evacuation or CHI subject to mass and volume constraints. RESULTS AND CONCLUSIONS In maximizing benefit to crew health subject to certain constraints, our algorithm generates medical kits that more closely resemble the unlimited-resource scenario than previous approaches which leverage medical risk information generated by the IMM. Our work here demonstrates that this algorithm provides an efficient and effective means to objectively allocate medical resources for spaceflight missions and provides an effective means of addressing tradeoffs in medical resource allocations and crew mission success parameters.

Monte Carlo Method↗

NASA NTRSDate not supplied

Clinical Decision Support - Concepts of Operation

We are entering a new era in space exploration to return to the moon and explore Mars. These ambitious goals will require significant changes to in-flight and habitat medical care due to constraints on mass, volume, power, crew time and medical evacuation capabilities. These constraints make it absolutely necessary to develop transformative solutions using new technologies. The Exploration Medical Capability (ExMC) Element of the Human Research Program (HRP) pushes the boundary of space medical systems to advance the care of astronauts on future exploration missions beyond low Earth orbit by identifying and testing next-generation medical care and crew health maintenance technologies. The Clinical Decision Support (CDS) project addresses the gap Medical-701 within the Inflight Medical Conditions risk: Enhance medical capabilities within an exploration medical system. For long-duration, deep space missions, computational and data resources will play an important role in maintaining crew health, wellness and performance where the crew will need to be more self-reliant. The aim of the CDS project is to develop and provide recommended requirements for an in-vehicle CDSS that acts as an assistant for delivering optimal health and performance and medical care during exploration missions. The CDSS is envisioned as a software-based tool that will augment a crewmembers’ knowledge, skills and abilities to assist in decision-making and crew health and performance (CHP) management thus increasing CHP systems capabilities. The human interface will be context aware and lessen the cognitive load to assimilate and use information as well as combine large disparate data sets in such a manner that provides the crew with actionable insight to decisions related to crew medical, health and performance management. Crew autonomy will be provided through a CDS that presents knowledge and data in a context aware manner to augment a crew members’ knowledge, skills and abilities during the process of observation, orientation, decisions and action. The CDS project addresses the need for crew members to operate independently during long duration space exploration missions that require medical Levels of Care (LoC) V, the highest level specified by NASA-STD-3001 and described in more detail by the ExMC interpretation of LoC document (NASA/TM-2017-219290), where significant changes to in-flight and habitat medical care necessitate increasing crew autonomy in decision making and task performance. The CDS project will develop and test a series of iterative and increasingly more complex system prototypes. These annual demonstrations of the data system integration with the crew health and performance domain will inform exploration medical system requirements for an on-board Clinical Decision Support System (CDSS) through a series of use cases that guide CDS prototype functionality. CDS concepts are based on ExMC Concept of Operations documents (presented separately) and will highlight architecture extensibility to other more complex analyses and tests using core crew health and performance integrated data management, processing and visualization capabilities. This approach also establishes how externally developed analyses and approaches could be added to expand a clinical decision support system and thus highlight how a comprehensive system can be commercially and/or globally developed. The CDS project will build upon the concept of an integrated data management approach based on the Medical Data Architecture (MDA) project to more fully address challenges associated with in-flight and habitat medical, health and performance care due to constraints on mass, volume, power, crew time and medical evacuation capabilities required for medical LoC V. These requirements will be derived through systems engineering approaches and software prototype developments over the course of the multi-year CDS project to address crew health and performance decision-making and task performance, often autonomously executed by the crew, in a manner that is consistent with the appropriate medical level of care for the mission. This presentation will provide an overview of the vision for the CDS project and highlight the initial accomplishments in project planning, implementation and requirements identification in fiscal year 2020.

clinical decision support↗

NASA NTRSDate not supplied

Clinical Decision Support - Overview and Update

clinical decision support system↗

NASA NTRS2016

Environmental Testing of Flight Hardware in the 25 ft. Space Simulator at JPL in a Manual Mode

After receiving global admiration for the Mars Science Laboratory (MSL) Curiosity rover, the Jet Propulsion Laboratory (JPL) is planning to embark upon another mobile mission to the red planet in the year 2020. Currently, the working name given to this sophisticated next-generation rover is Mars 2020. Mars 2020 will boast a multitude of newly developed instruments to aid in the scientific study of Mars. This paper will describe the process of testing one of the Mars 2020 instruments in the 25 ft. Space Simulator. The testing was performed at Mars CO2 atmospheric pressure of 7 Torr and consisted of multiple chamber evacuations and backfills. The Programmable Logic Control (PLC) system for the chamber was in the middle of a major overhaul that resulted in utilizing the manual Hand/Off/Auto switches to operate the chamber. Accomplishing this challenging task required the meticulous development of new operating procedures and thorough training of the chamber’s operators.

Ovcharenko, Anton↗

NASA NTRS2023

The Value of a Spaceflight Clinical Decision Support System for Earth-Independent Medical Operations

As NASA prepares for crewed lunar missions over the next several years, plans are also underway to journey farther into deep space. Deep space exploration will require a paradigm shift in astronaut medical support toward progressively earth-independent medical operations (EIMO). The Exploration Medical Capability (ExMC) element of NASA’s Human Research Program (HRP) is investigating the feasibility and value of advanced capabilities to promote and enhance EIMO. Currently, astronauts rely on real-time communication with ground-based medical providers. However, as the distance from Earth increases, so do communication delays and disruptions. Moreover, resupply and evacuation will become increasingly complex, if not impossible, on deep space missions. In contrast to today’s missions in low earth orbit (LEO), where most medical expertise and decision-making are ground-based, an exploration crew will need to autonomously detect, diagnose, treat, and prevent medical events. Due to the sheer amount of pre-mission training required to execute a human spaceflight mission, there is often little time to devote exclusively to medical training. One potential solution is to augment the long duration exploration crew’s knowledge, skills, and abilities with a clinical decision support system (CDSS). An analysis of preliminary data indicates the potential benefits of a CDSS to mission outcomes when augmenting cognitive and procedural performance of an autonomous crew performing medical operations, and we provide an illustrative scenario of how such a CDSS might function.

Brian K. Russell↗

NASA NTRS2022

Supporting Hazard Analysis for Wildfire Response Using fmdtools and MIKA

The System Wide Safety (SWS) Safety Demonstrator (SD) Series drives development of an increasingly capable In-Time Aviation Safety Management System (IASMS) focusing on humanitarian applications, starting with wildfire response (SD-1). The goals of this report are to (1) provide an early hazard analysis and mitigation evaluation of wildfire response to support these efforts and (2) provide a demonstration of capabilities of the Fault Model Design Tools (fmdtools) and Manager for Intelligent Knowledge Access (MIKA) tools. fmdtools provides a modeling, simulation, and resiliency analysis framework in which a wildfire response model, the System Modeling and Analysis of Resiliency in Scalable Traffic Management for Emergency Response Operations (SMARt-STEReO), is built. MIKA is an intelligent knowledge manager with several capabilities, including assisting in hazard analysis by extracting and analyzing hazards from historical incident reports. The following topics are covered in the report: Understanding Wildfire Hazard Dynamics. We provide a description and simulated examples of how hazards occur in the SMARt-STEReO model of wildfire response and their effect on its outcome. This provides a common mental model and focuses the analysis presented in the remainder of the report. Wildfire Hazard Identification. MIKA identifies wildfire hazards from three relevant datasets: the ICS-209-PLUS, SAFECOM, and SAFENET. Hazards are manually organized into a taxonomy and MIKA analyzes each hazard’s effects, likelihood, severity, and risk. Evaluating Mitigation Strategies. The SMARt-STEReO wildfire response model built in fmdtools evaluates a subset of identified hazards. Specifically, we simulate the effect of communications faults and equipment faults on operator safety, the effect of changing winds and flammability, and a scenario with multiple ignition points and heavy smoke. Tool Limitations and Usage Considerations. We provide a discussion of appropriate tool use cases as well as limitations and considerations for usage. The tool findings are used to synthesize recommendations for wildfire response operations, which can be captured as part of an IASMS. Key recommendations are as follows: Hazards are identified from a broad spectrum of sources including aircraft subsystems, operational sources, and ground crew operations. Highest risk operational environment hazards identified are Evacuations. The highest risk manned aerial operations hazard categorized is Jumper Operations Mishap. Ground crew hazards that are highest risk are Burns, Cargo Operations Overhead, Dehydration, Entrapment, Falling Objects, Heart Attacks, Heat Exhaustion, Inadequate Training or Certification, Vehicle Breakdown, and Vehicle Collision. Modelled containment failures arise from a mismatch between the difficulty of the firefighting scenario and the capacity (e.g., speed, effectiveness, awareness) of the response. In firefighting scenarios where containment is possible (e.g., because the fire does not spread too quickly), these mismatches can occur because of a change in environmental conditions (e.g., wind, flammability, etc) or because of planning, equipment, or communications faults. Improvements to communications increase the capacity of the firefighting response by reducing the time needed to respond to the fire. While surveillance does not increase this capacity by itself, it increases operator safety by increasing state awareness, enabling firefighters to evade approaching fires. Increasing both has a synergistic effect. In general, these performance and resilience increases generalize over fault scenarios as well as unforeseen changes to circumstances (i.e., wind, aridity, etc.). However, these improvements need to be designed so as not to make the system prone to persistent large-scale communications outages, which can reduce performance.

Hazard analysis↗