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808 records · Page 45

Integrated Medical Model Overview

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.

Spae Adaptation Syndrome↗

Practical Application of PRA as an Integrated Design Tool for Space Systems

This paper presents the application of the first comprehensive Probabilistic Risk Assessment (PRA) during the design phase of a joint NASA/NOAA weather satellite program, Geostationary Operational Environmental Satellite Series R (GOES-R). GOES-R is the next generation weather satellite primarily to help understand the weather and help save human lives. PRA has been used at NASA for Human Space Flight for many years. PRA was initially adopted and implemented in the operational phase of manned space flight programs and more recently for the next generation human space systems. Since its first use at NASA, PRA has become recognized throughout the Agency as a method of assessing complex mission risks as part of an overall approach to assuring safety and mission success throughout project lifecycles. PRA is now included as a requirement during the design phase of both NASA next generation manned space vehicles as well as for high priority robotic missions. The influence of PRA on GOES-R design and operation concepts are discussed in detail. The GOES-R PRA is unique at NASA for its early implementation. It also represents a pioneering effort to integrate risks from both Spacecraft (SC) and Ground Segment (GS) to fully assess the probability of achieving mission objectives. PRA analysts were actively involved in system engineering and design engineering to ensure that a comprehensive set of technical risks were correctly identified and properly understood from a design and operations perspective. The analysis included an assessment of SC hardware and software, SC fault management system, GS hardware and software, common cause failures, human error, natural hazards, solar weather and infrastructure (such as network and telecommunications failures, fire). PRA findings directly resulted in design changes to reduce SC risk from micro-meteoroids. PRA results also led to design changes in several SC subsystems, e.g. propulsion, guidance, navigation and control (GNC), communications, mechanisms, and command and data handling (C&DH). The fault tree approach assisted in the development of the fault management system design. Human error analysis, which examined human response to failure, indicated areas where automation could reduce the overall probability of gaps in operation by half. In addition, the PRA brought to light many potential root causes of system disruptions, including earthquakes, inclement weather, solar storms, blackouts and other extreme conditions not considered in the typical reliability and availability analyses. Ultimately the PRA served to identify potential failures that, when mitigated, resulted in a more robust design, as well as to influence the program's concept of operations. The early and active integration of PRA with system and design engineering provided a well-managed approach for risk assessment that increased reliability and availability, optimized lifecyc1e costs, and unified the SC and GS developments.

Kalia, Prince↗

Reliability Analysis of Complex NASA Systems with Model Based Engineering

The emergence of model-based engineering, with Model- Based Systems Engineering (MBSE) leading the way, is transforming design and analysis methodologies. The recognized benefits to systems development include moving from document-centric information systems and document-centric project communication to a model-centric environment in which control of design changes in the life cycles is facilitated. In addition, a “single source of truth” about the system, that is up-to-date in all respects of the design, becomes the authoritative source of data and information about the system. This promotes consistency and efficiency in regard to integration of the system elements as the design emerges and thereby may further optimize the design. Therefore Reliability Engineers (REs) supporting NASA missions must be integrated into model-based engineering to ensure the outputs of their analyses are relevant and value-needed to the design, development, and operational processes for failure risks assessment and communication.

Reliability prediction↗

Uncertainty Considerations for Ballistic Limit Equations

The overall risk for any spacecraft system is typically determined using a Probabilistic Risk Assessment (PRA). A PRA attempts to determine the overall risk associated with a particular mission by factoring in all known risks (and their corresponding uncertainties, if known) to the spacecraft during its mission. The threat to mission and human life posed by the mircro-meteoroid & orbital debris (MMOD) environment is one of the risks. NASA uses the BUMPER II program to provide point estimate predictions of MMOD risk for the Space Shuttle and the International Space Station. However, BUMPER II does not provide uncertainty bounds or confidence intervals for its predictions. With so many uncertainties believed to be present in the models used within BUMPER II, providing uncertainty bounds with BUMPER II results would appear to be essential to properly evaluating its predictions of MMOD risk. The uncertainties in BUMPER II come primarily from three areas: damage prediction/ballistic limit equations, environment models, and failure criteria definitions. In order to quantify the overall uncertainty bounds on MMOD risk predictions, the uncertainties in these three areas must be identified. In this paper, possible approaches through which uncertainty bounds can be developed for the various damage prediction and ballistic limit equations encoded within the shuttle and station versions of BUMPER II are presented and discussed. We begin the paper with a review of the current approaches used by NASA to perform a PRA for the Space Shuttle and the International Space Station, followed by a review of the results of a recent sensitivity analysis performed by NASA using the shuttle version of the BUMPER II code. Following a discussion of the various equations that are encoded in BUMPER II, we propose several possible approaches for establishing uncertainty bounds for the equations within BUMPER II. We conclude with an evaluation of these approaches and present a recommendation regarding which of them would be the most appropriate to follow.

Schonberg, W. P.↗

Reliability Analysis of Complex NASA Systems with Model-Based Engineering

The emergence of model-based engineering, with Model- Based Systems Engineering (MBSE) leading the way, is transforming design and analysis methodologies. The recognized benefits to systems development include moving from document-centric information systems and document-centric project communication to a model-centric environment in which control of design changes in the life cycles is facilitated. In addition, a “single source of truth” about the system, that is up-to-date in all respects of the design, becomes the authoritative source of data and information about the system. This promotes consistency and efficiency in regard to integration of the system elements as the design emerges and thereby may further optimize the design. Therefore Reliability Engineers (REs) supporting NASA missions must be integrated into model-based engineering to ensure the outputs of their analyses are relevant and value-needed to the design, development, and operational processes for failure risks assessment and communication.

FMEA/FMECA↗

Integration of Evidence Base into a Probabilistic Risk Assessment

INTRODUCTION: A probabilistic decision support model such as the Integrated Medical Model (IMM) utilizes an immense amount of input data that necessitates a systematic, integrated approach for data collection, and management. As a result of this approach, IMM is able to forecasts medical events, resource utilization and crew health during space flight. METHODS: Inflight data is the most desirable input for the Integrated Medical Model. Non-attributable inflight data is collected from the Lifetime Surveillance for Astronaut Health study as well as the engineers, flight surgeons, and astronauts themselves. When inflight data is unavailable cohort studies, other models and Bayesian analyses are used, in addition to subject matters experts input on occasion. To determine the quality of evidence of a medical condition, the data source is categorized and assigned a level of evidence from 1-5; the highest level is one. The collected data reside and are managed in a relational SQL database with a web-based interface for data entry and review. The database is also capable of interfacing with outside applications which expands capabilities within the database itself. Via the public interface, customers can access a formatted Clinical Findings Form (CLiFF) that outlines the model input and evidence base for each medical condition. Changes to the database are tracked using a documented Configuration Management process. DISSCUSSION: This strategic approach provides a comprehensive data management plan for IMM. The IMM Database s structure and architecture has proven to support additional usages. As seen by the resources utilization across medical conditions analysis. In addition, the IMM Database s web-based interface provides a user-friendly format for customers to browse and download the clinical information for medical conditions. It is this type of functionality that will provide Exploratory Medicine Capabilities the evidence base for their medical condition list. CONCLUSION: The IMM Database in junction with the IMM is helping NASA aerospace program improve the health care and reduce risk for the astronauts crew. Both the database and model will continue to expand to meet customer needs through its multi-disciplinary evidence based approach to managing data. Future expansion could serve as a platform for a Space Medicine Wiki of medical conditions.

Saile, Lyn↗

Eccentric loading of microtensile specimens

Ceramic materials have a lower density than most metals and are capable of performing at extremely high temperatures. The utility of these materials is obvious; however, the fracture strength of brittle materials is not easily predicted and often varies greatly. Characteristically, brittle materials lack ductility and do not yield as other materials. Ceramics materials are naturally populated with microscopic cracks due to fabrication techniques. Upon application of a load, stress concentration occurs at the root of these cracks and fracture will eventually occur at some not easily predicted strength. In order to use ceramics in any application some design methodology must exist from which a component can be placed into service. This design methodology is CARES/LIFE (Ceramics Analysis and Reliability Evaluation of Structures) which has been developed and refined at NASA over the last several decades. The CARES/LIFE computer program predicts the probability of failure of a ceramic component over its service life. CARES combines finite element results from a commercial FE (finite element) package such as ANSYS and experimental results to compute the abovementioned probability of failure. Over the course of several tests CARES has had great success in predicting the life of various ceramic components and has been used throughout industry. The latest challenge is to verify that CARES is valid for MEMS (Micro-Electro Mechanical Systems). To investigate a series of microtensile specimens were fractured in the laboratory. From this data, material parameters were determined and used to predict a distribution of strength for other specimens that exhibit a known stress concentration. If the prediction matches the experimental results then these parameters can be applied to a desired component outside of the laboratory. During testing nearly half of the tensile Specimens fractured at a location that was not expected and hence not captured in the FE model. It has been my duty to investigate the nature of this phenomenon in hopes of finding a better correlation between theory and empirical results. To investigate I built complete FE models of all of the tensile specimens using ANSYS. It is suspected that some misalignment naturally occurs during testing and thus additional bending stresses are present in the specimens. I modeled this eccentric loading and ran several FE trials using ANSYS/PDS (a probabilistic design system in ANSYS). My objective this summer has been familiarize myself with the CARES/LIFE program in hopes of using it in conjunction with ANSYS to help verify that CARES is applicable to MEMS-scale (greater that 1 micron, less than 1 millimeter) components.

Trapp, Mark A.↗

Sensorimotor Application of Proposed Methods to Combine the Effects of Multiple Countermeasures for PRisM

Risk associated with human systems is challenging to quantify but is critical for the mission planning and decision making required to enable future Lunar and Martian missions. To address this gap, the Crew Health and Performance-Probabilistic Risk Assessment (CHP-PRA) project is developing an integrated computational model for CHP mission risk. Much like how MEDPRAT is designed to allow medical resource trades informed by medical risk, CHP-PRA will enable analogous trades in human system risks across multiple CHP functions and capabilities. Human performance is one component of the risk intended to be captured by CHP-PRA through the Performance Risk Model (PRisM). The sensorimotor risk area provides a good frame of reference for investigating the structure of a performance model because most tasks that astronauts are expected to perform require input from the sensory system and/or movement/motor control. Additionally, sensorimotor countermeasures are an area of particular concern for NASA’s Human Research Program because of the increased sensorimotor risk associated with surface operations in Lunar and Martian missions. Thus, a tool that can quickly compare risk reductions of potential countermeasures would be beneficial in guiding research and development of effective countermeasures. In this proof of concept, we present a systematic way to combine multiple performance data sets for humans subjected to different countermeasures such that we can predict the countermeasure(s) that optimize astronaut performance on relevant tasks. PRisM assumes that both the tests that are used to measure countermeasure effectiveness (input data) and the tasks we use to represent astronaut performance, can be broken down and represented as a function/vector of the human systems required to perform that test/task. Through mathematical combination, test data are used to predict performance on astronaut tasks that use similar systems. We propose that when combining countermeasures evaluated using the same test, that only one value should be used to represent their combined effectiveness. We start our analysis with the assumption that two countermeasures together will perform better than each countermeasure individually. Our initial implementation of this framework compares various space motion sickness countermeasures and the most up to date analysis will be demonstrated at the IWS.

Caroline R Austin↗

Risk of Bone Fracture due to Spaceflight-induced Changes to Bone

The Human Research Program (HRP) is taking a biomechanical approach to assessing subsequent fracture risk in active astronauts as a consequence of spaceflight exposure. Triennial testing of active and retired astronauts continues as Space Medicine monitors for a premature diagnosis of primary osteoporosis, which is associated with age-related bone loss and skeletal fragility. This updated 2023 Fracture Evidence Report has expanded the description of skeletal changes to capture the full effects of spaceflight on bone: • Recent analysis of fractures from health records of the full astronaut cohort, suggests an increased incidence rate of hip and spine fractures in astronauts following longer spaceflight duration flights compared to incident rates found in shorter duration flights. • Routine preflight-to-postflight surveillance by DXA (dual-energy x-ray absorptiometry) does not provide the full detection of loss and recovery in the long-duration (LD) astronaut nor the full recovery of hip trabecular bone. • The inclusion of hip quantitative computed tomography (QCT) in flight studies delineates effects of spaceflight, of countermeasures, and of post-flight recovery on cortical and trabecular bone parameters—some of which are verified predictors of hip fracture in the aged. • QCT detects and compares the distinct countermeasure effects of the pharmaceutical alendronate and of resistive exercise (on the Advanced Resistive Exercise Device, ARED) in specific cortical and trabecular bone sub-regions during spaceflight. • A published comparison of QCT-determined loss rates of hip trabecular bone in LD astronauts compared to terrestrial cohorts suggest that accelerated loss rates in trabecular volumetric BMD (vBMD) during spaceflight might be analogous to skeletal effects of accelerated loss rates in females due to menopause, potentially leading to disruptions in trabecular microarchitecture. • A dataset of finite element (FE) estimates of hip bone strength in aging terrestrial cohorts (spanning astronaut age-range) provides comparative context for changes in the FE of hip bone strength in LD astronauts, including comparison (force unit of newton) to percentiles (50th, 75th, and 100th) of sex-matched aged humans with hip fractures. • Risk of fracture, due to the mechanical overloading of bones, is being updated with IMPACT, the next-generation tool suite for probabilistic risk assessment (PRA) for exploration missions being created by the Exploration and Medical Capability Element (ExMC) at NASA. IMPACT is currently in development and will not be included in this 2024 update. The risk for fracture necessitates understanding the relationship between applied loads to bone and the biomechanical competence of bone. The Risk for Early Onset Osteoporosis focuses on the weakened condition of bone (including development of new technologies, measurements of novel skeletal attributes, translation of multiple measures to an index of bone fragility, and interpretations of data used to reflect a weakened bone), while the Risk for Fracture assesses factors that influence the probability an astronaut would encounter applied loads exceeding the biomechanical competence of bones, resulting in fracture. This Evidence Report combines the research gaps and tasks associated with both risks.

Fracture↗

Long-Term Health Metric Development Effort

INTRODUCTION Probabilistic Risk Assessment (PRA) is a methodology applied when high-stakes decisions need to be made about complex systems. PRA often uses risk minimization to aid decision making, such as when establishing vehicle requirements or resource allocations. The NASA Human System Risk Board (HSRB) maintains the human spaceflight risk postures, many of which have in-mission medical outcomes, but the full risk set also includes performance and Long-Term Health (LTH) outcomes. An effort is underway to determine the dependencies between LTH risk outcomes and mission characteristics and to identify metrics for quantifying LTH outcomes. The LTH metrics will be incorporated into future PRA tools currently under development to support crew health and performance decision making. LONG-TERM HEALTH (LTH) RISK LTH risk encompasses the timeframe from immediately post-flight, through the rest of an astronaut’s career, through retirement, and until death. LTH outcomes include the time and interventions needed for the astronaut to return to preflight physiological states after experiencing spaceflight hazards and recovery from any in-mission medical events that persist into the post-flight timeframe. It includes chronic complications that may arise due to experiencing in-flight medical conditions or injuries and medical conditions that occur later in life with a higher probability of occurrence or with more severity because of their spaceflight exposure. Finally, LTH outcomes can also include a reduction in life expectancy due to spaceflight exposures. Eighteen of the HSRB risks contain an LTH component, each with a unique incidence rate and consequence severity. ON-GOING LTH METRIC DEVELOPMENT EFFORTS Based on guidance from a stakeholder workshop held on June 1, 2023, only LTH outcomes with causes tied to spaceflight experience that are significantly different from normal healthy aging and which can be affected by changes in in-mission resources are targeted for inclusion within the PRA modeling efforts. Current on-going efforts include a sensitivity analysis of potential in-flight medical conditions to determine which conditions may persist into post-flight and how the consequences may be affected by in-mission medical resources. Also underway is determination of differences in the time for a return to preflight physiological baselines when in-flight countermeasures are available versus when they are not. Analyses performed with publicly available astronaut data and collaborations with the Lifetime Surveillance of Astronaut Health team are being designed to understand which LTH outcomes differ significantly from natural healthy aging. Information exchanges are also occurring with LTH risk custodians to understand how they quantify outcomes. FUTURE PLANS Risk characteristics will be determined for each LTH risk that meets our inclusion criteria and the dependencies of their outcomes to in-mission resources and mission characteristics will be established. The individual risks will be integrated together into one or more high level LTH metrics for inclusion in the PRA tool, so that LTH risks can be considered along with in-mission risks during crew health and performance system decision support trade studies.

B. E. Lewandowski↗

Analysis of Alternative Architectures for Cargo Lunar Landers

NASA’s Human Landing System (HLS) program has been working with commercial partners to develop human-class lunar landers to return the first American woman and next American man to the lunar surface in the mid 2020’s. In an effort to expand human presence beyond low Earth orbit, NASA’s Artemis program aims to facilitate a sustainable, long-term human presence in cis-lunar space. A component of this will require significant infrastructure to be delivered to the lunar surface. Delivering this infrastructure will require a significant lander capability that has yet to be developed. A thorough understanding of cargo lunar lander architectures is required such that select alternatives can be identified that best support the Artemis program’s objective of sustainability. The goal of this study is to aid NASA and its partners in the understanding of the cargo lunar lander trades space, as well as identify potential robust alternatives. The results will support NASA as it moves forward with key activities such as requirements formulation, agency strategic planning, and potential cargo lunar lander procurements. The study builds off of recent work performed by the Human Landing System program’s Architecture and Systems Analysis group to encompass a broad trade space of cargo lunar lander architecture alternatives. The current trade space as depicted by the morphological matrix and mission graph in Fig. 1 and Fig. 2, respectively, includes key alternative options that have become highly relevant due to current HLS activities and include on-orbit refueling, active cryogenic fluid management, Earth orbit aggregation, and global lunar access. The authors believe that there is also a statistically relevant impact of lander-payload configuration on the primary structure of the vehicle that could greatly impact alternative selection. Because of this, several conceptual lander-payload configurations will be evaluated to determine the level of impact. The current set of conceptual configurations are shown in Fig. 3 and Fig. 4. To aid the conceptual evaluation of these configurations, a catalogue of notional payloads has been developed that represent a wide range of masses and volumes that are expected to be delivered in support of a sustained human lunar presence, including pressurized and unpressurized rovers, surface habitats, power systems, and other support infrastructure. In order to execute this study in a timely fashion, a similar approach to that utilized in a similar 2019 study focused on 2024 human lunar sorties will be employed [1]. The team utilized a novel architecture synthesis framework currently being developed by NASA/MSFC to evaluate over 600,000 lunar lander architectures over a two month time frame [2]. From this large data set, varying ground rules and assumptions were applied as filters to explore the trade space to identify alternatives which exhibited robustness, as measured by launch vehicle payload margin, to absorb the natural growth that occurs during design maturation. The set of Earth-Moon system Delta-Vs assumed from the 2019 study, shown in Fig. 5, will be repurposed to accelerate model formulation for this effort. Additionally, current efforts in collaboration with the Georgia Institute of Technology’s Aerospace System Design Lab will be integrated to provide probabilistic modeling of the cargo lunar lander architectures to aid in identifying robust design alternatives [3]. The approach will help minimize potential impacts due to large levels of uncertainty inherent to pre phase-A conceptual design. By leveraging these past and present studies and partnerships, a highly detailed set of data can be generated in a short time period to aid NASA in the coming years to support the goal of a sustained human lunar presence.

Architectures↗

Probabilistic 21st and 22nd Century Sea-Level Projections at a Global Network of Tide-Gauge Sites

Sea-level rise due to both climate change and non-climatic factors threatens coastal settlements, infrastructure, and ecosystems. Projections of mean global sea-level (GSL) rise provide insufficient information to plan adaptive responses; local decisions require local projections that accommodate different risk tolerances and time frames and that can be linked to storm surge projections. Here we present a global set of local sea-level (LSL) projections to inform decisions on timescales ranging from the coming decades through the 22nd century. We provide complete probability distributions, informed by a combination of expert community assessment, expert elicitation, and process modeling. Between the years 2000 and 2100, we project a very likely (90% probability) GSL rise of 0.5–1.2 m under representative concentration pathway (RCP) 8.5, 0.4–0.9 m under RCP 4.5, and 0.3–0.8 m under RCP 2.6. Site-to-site differences in LSL projections are due to varying non-climatic background uplift or subsidence, oceanographic effects, and spatially variable responses of the geoid and the lithosphere to shrinking land ice. The Antarctic ice sheet (AIS) constitutes a growing share of variance in GSL and LSL projections. In the global average and at many locations, it is the dominant source of variance in late 21st century projections, though at some sites oceanographic processes contribute the largest share throughout the century. LSL rise dramatically reshapes flood risk, greatly increasing the expected number of “1-in-10” and “1-in-100” year events.

sea level↗

Complex Dynamics of Air Traffic Flow

Air traffic in the United States has continued to grow at a steady pace since 1980, except for a dip immediately after the tragic events of September 11, 2001. There are different growth scenarios associated both with the magnitude and the composition of the future air traffic. The Terminal Area Forecast (TAF), prepared every year by the FAA, projects the growth of traffic in the United States. Both Boeing and Airbus publish market outlooks for air travel annually. Although predicting the future growth of traffic is difficult, there are two significant trends: heavily congested major airports continue to see an increase in traffic, and the emergence of regional jets and other smaller aircraft with fewer passengers operating directly between non-major airports. The interaction between air traffic demand and the ability of the system to provide the necessary airport and airspace resources can be modeled as a network. The size of the resulting network varies depending on the choice of its nodes. It would be useful to understand the properties of this network to guide future design and development. Many questions, such as the growth of delay with increasing traffic demand and impact of the en route weather on future air traffic, require a systematic understanding of the properties of the air traffic network. There has been a major advance in the understanding of the behavior of networks with a large number of components. Several theories have been advanced about the evolution of large biological and engineering networks by authors in diversified disciplines like physics, mathematics, biology and computer science. Several networks exhibit a scale-free property in the sense that the probabilistic distribution of their nodes as a function of connections decreases slower than an exponential. These networks are characterized by the fact that a small number of components have a disproportionate influence on the performance of the network. Scale-free networks are tolerant to random failure of components, but are vulnerable to selective attack on components. This paper examines two network representations for the baseline air traffic system. A network defined with the 40 major airports as nodes and with standard flight routes as links has a characteristic scale: all nodes have 60 or more links and no node has more than 460 links. Another network is defined with baseline aircraft routing structure exhibits an exponentially truncated scale-free behavior. Its degree ranges from 2 connections to 2900 connections, and 225 nodes have more than 250 connections. Furthermore, those high-degree nodes are homogeneously distributed in the airspace. A consequence of this scale-free behavior is that the random loss of a single node has little impact, but the loss of multiple high-degree nodes (such as occurs during major storms in busy airspace) can adversely impact the system. Two future scenarios of air traffic growth are used to predict the growth of air traffic in the United States. It is shown that a three-times growth in the overall traffic may result in a ten-times impact on the density of traffic in certain parts of the United States.

Scale-free Networks↗

Integrated Medical Model (IMM) 4.0 Enhanced Functionalities

The Integrated Medical Model is a probabilistic simulation model that uses input data on 100 medical conditions to simulate expected medical events, the resources required to treat, and the resulting impact to the mission for specific crew and mission characteristics. The newest development version of IMM, IMM v4.0, adds capabilities that remove some of the conservative assumptions that underlie the current operational version, IMM v3. While IMM v3 provides the framework to simulate whether a medical event occurred, IMMv4 also simulates when the event occurred during a mission timeline. This allows for more accurate estimation of mission time lost and resource utilization. In addition to the mission timeline, IMMv4.0 features two enhancements that address IMM v3 assumptions regarding medical event treatment. Medical events in IMMv3 are assigned the untreated outcome if any resource required to treat the event was unavailable. IMMv4 allows for partially treated outcomes that are proportional to the amount of required resources available, thus removing the dichotomous treatment assumption. An additional capability IMMv4 is to use an alternative medical resource when the primary resource assigned to the condition is depleted, more accurately reflecting the real-world system. The additional capabilities defining IMM v4.0the mission timeline, partial treatment, and alternate drug result in more realistic predicted mission outcomes. The primary model outcomes of IMM v4.0 for the ISS6 mission, including mission time lost, probability of evacuation, and probability of loss of crew life, are be compared to those produced by the current operational version of IMM to showcase enhanced prediction capabilities.

Spae Adaptation Syndrome↗

The Integrated Medical Model: A Probabilistic Simulation Model for Predicting In-Flight Medical Risks

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

Risk Analysis↗

The Integrated Medical Model: A Probabilistic Simulation Model Predicting In-Flight Medical Risks

The Integrated Medical Model (IMM) is a probabilistic model that uses simulation to predict mission medical risk. Given a specific mission and crew scenario, medical events are simulated using Monte Carlo methodology to provide estimates of resource utilization, probability of evacuation, probability of loss of crew, and the amount of mission time lost due to illness. Mission and crew scenarios are defined by mission length, extravehicular activity (EVA) schedule, and crew characteristics including: sex, coronary artery calcium score, contacts, dental crowns, history of abdominal surgery, and EVA eligibility. The Integrated Medical Evidence Database (iMED) houses the model inputs for one hundred medical conditions using in-flight, analog, and terrestrial medical data. Inputs include incidence, event durations, resource utilization, and crew functional impairment. Severity of conditions is addressed by defining statistical distributions on the dichotomized best and worst-case scenarios for each condition. The outcome distributions for conditions are bounded by the treatment extremes of the fully treated scenario in which all required resources are available and the untreated scenario in which no required resources are available. Upon occurrence of a simulated medical event, treatment availability is assessed, and outcomes are generated depending on the status of the affected crewmember at the time of onset, including any pre-existing functional impairments or ongoing treatment of concurrent conditions. The main IMM outcomes, including probability of evacuation and loss of crew life, time lost due to medical events, and resource utilization, are useful in informing mission planning decisions. To date, the IMM has been used to assess mission-specific risks with and without certain crewmember characteristics, to determine the impact of eliminating certain resources from the mission medical kit, and to design medical kits that maximally benefit crew health while meeting mass and volume constraints.

Risk Analysis↗