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NASA NTRS2000

Critical Questions for Space Human Factors

Traditional human factors contributions to NASA's crewed space programs have been rooted in the classic approaches to quantifying human physical and cognitive capabilities and limitations in the environment of interest, and producing recommendations and standards for the selection or design of mission equipment. Crews then evaluate the interfaces, displays, or equipment, and with the assistance of human factors experts, improvements are made as funds, time, control documentation, and weight allow. We have come a long way from the early spaceflight days, where men with the ' right stuff were the solution to operating whatever equipment was given to them. The large and diverse Shuttle astronaut corps has impacted mission designs to accommodate a wide range of human capabilities and preferences. Yet with existing long duration experience, we have seen the need to address a different set of dynamics when designing for optimal crew performance: critical equipment and mission situations degrade, and human function changes with mission environment, situation, and duration. Strategies for quantifying the critical nature of human factors requirements are being worked by NASA. Any exploration-class mission will place new responsibilities on mission designers to provide the crew with the information and resources to accomplish the mission. The current duties of a Mission Control Center to monitor system status, detect degradation or malfunction, and provide a proven solution, will need to be incorporated into on-board systems to allow the crew autonomous decision-making. The current option to resupply and replace mission systems and resources, including both vehicle equipment and human operators, will be removed, so considerations of maintenance, onboard training, and proficiency assessment are critical to providing a self-sufficient crew. As we 'move in' to the International Space Station, there are tremendous opportunities to investigate our ability to design for autonomous crews. Yet prioritizing the research that can and should be done by NASA will be based on the critical nature of the issues, and the impact of the individual research questions on mission design. The risks to crew health and safety associated with answering critical human factors issues must be properly included and communicated in order to support the Agency's decisions regarding future space programs.

Woolford, Barbara↗

NASA NTRS2004

Multipurpose Crew Restraints for Long Duration Space Flights

With permanent human presence onboard the International Space Station (ISS), a crew will be living and working in microgravity, interfacing with their physical environment. Without optimum restraints and mobility aids (R&MA' s), the crewmembers may be handicapped for perfonning some of the on-orbit tasks. In addition to weightlessness, the confined nature of a spacecraft environment results in ergonomic challenges such as limited visibility and access to the activity area and may cause prolonged periods of unnatural postures. Thus, determining the right set of human factors requirements and providing an ergonomically designed environment are crucial to astronauts' well-being and productivity. The purpose of this project is to develop requirements and guidelines, and conceptual designs, for an ergonomically designed multi-purpose crew restraint. In order to achieve this goal, the project would involve development of functional and human factors requirements, design concept prototype development, analytical and computer modeling evaluations of concepts, two sets of micro gravity evaluations and preparation of an implementation plan. It is anticipated that developing functional and design requirements for a multi-purpose restraint would facilitate development of ergonomically designed restraints to accommodate the off-nominal but repetitive tasks, and minimize the performance degradation due to lack of optimum setup for onboard task performance. In addition, development of an ergonomically designed restraint concept prototype would allow verification and validation of the requirements defined. To date, we have identified "unique" tasks and areas of need, determine characteristics of "ideal" restraints, and solicit ideas for restraint and mobility aid concepts. Focus group meetings with representatives from training, safety, crew, human factors, engineering, payload developers, and analog environment representatives were key to assist in the development of a restraint concept based on previous flight experiences, the needs of future tasks, and crewmembers' preferences. Also, a catalog with existing IVA/EVA restraint and mobility aids has been developed. Other efforts included the ISS crew debrief data on restraints, compilation of data from MIR, Skylab and ISS on restraints, and investigating possibility of an in-flight evaluation of current restraint systems. Preliminary restraint concepts were developed and presented to long duration crewmembers and focus groups for feedback. Currently, a selection criterion is being refined for prioritizing the candidate concepts. Next steps include analytical and computer modeling evaluations of the selected candidate concepts, prototype development, and microgravity evaluations.

Whitmore, Mihriban↗

NASA NTRSDate not supplied

Biological Research and Space Health Enabled by Machine Learning to Support Deep Space Missions

A key science goal of the NASA “Moon to Mars” campaign is to understand how biology responds to the Lunar, Martian, and deep space environments in order to advance fundamental knowledge and support human space missions. Through artificial intelligence (AI) and machine learning (ML), a paradigm shift has begun in space biosciences and engineered astronaut health systems, to enable Earth-independence and mission operations autonomy. We describe current AI/ML methods to support 1) fundamental biology, 2) in situ analytics, 3) high performance computing, 4) automated science, 5) self-driving labs, 6) remote data management, 7) integrated mission biomonitoring, and 8) a Precision Space Health system. AI/ML approaches that can be integrated to support these domains include active learning, explainable AI, adaptive learning, causal inference, knowledge graphs, federated learning, transfer learning, and large language models. Finally, we present results from several current ML projects that are underway in the space biology field to address key challenges of small sample n, high feature count, heterogeneity, and sparse data. These include 1) connecting omics to phenotypic data using an ensemble model to infer causality of rodent liver health disruption, 2) usage of explainable ML to interrogate muscular underpinnings of muscle atrophy, 3) ML models analyzing and determining directed acyclic graphs of human health risk leveraging rodent bone datasets, 4) usage of large pre-trained models connecting biomedical knowledgebases with small spaceflight datasets to understand gene-to-gene interactions, and 5) a suite of benchmarked open science datasets enabling programmers to identify best algorithms to answer space biology questions.

space biology↗

NASA NTRS2010

World, We Have Problems: Simulation for Large Complex, Risky Projects, and Events

Prior to a spacewalk during the NASA STS/129 mission in November 2009, Columbia Broadcasting System (CBS) correspondent William Harwood reported astronauts, "were awakened again", as they had been the day previously. Fearing something not properly connected was causing a leak, the crew, both on the ground and in space, stopped and checked everything. The alarm proved false. The crew did complete its work ahead of schedule, but the incident reminds us that correctly connecting hundreds and thousands of entities, subsystems and systems, finding leaks, loosening stuck valves, and adding replacements to very large complex systems over time does not occur magically. Everywhere major projects present similar pressures. Lives are at - risk. Responsibility is heavy. Large natural and human-created disasters introduce parallel difficulties as people work across boundaries their countries, disciplines, languages, and cultures with known immediate dangers as well as the unexpected. NASA has long accepted that when humans have to go where humans cannot go that simulation is the sole solution. The Agency uses simulation to achieve consensus, reduce ambiguity and uncertainty, understand problems, make decisions, support design, do planning and troubleshooting, as well as for operations, training, testing, and evaluation. Simulation is at the heart of all such complex systems, products, projects, programs, and events. Difficult, hazardous short and, especially, long-term activities have a persistent need for simulation from the first insight into a possibly workable idea or answer until the final report perhaps beyond our lifetime is put in the archive. With simulation we create a common mental model, try-out breakdowns of machinery or teamwork, and find opportunity for improvement. Lifecycle simulation proves to be increasingly important as risks and consequences intensify. Across the world, disasters are increasing. We anticipate more of them, as the results of global warming prove more and more ominous-glaciers melting in Bolivia, floods in Saudi Arabia, the Maldives sinking and salt rising along the Nile. Fear grows about potential asteroid crashes and nightly television images raise awareness of victims of floods, hurricanes, cyclones and typhoons, fire, tornado, tsunami, bombings, landslides, and cross-boundary criminality. The Red Cross says that disasters impact 250 million people each year. That means that 700,000 people are having a very bad day today. Modeling and simulation is and must be part of the solution.

Elfrey, Priscilla↗

NASA NTRS2006

Progress Toward a Format Standard for Flight Dynamics Models

In the beginning, there was FORTRAN, and it was... not so good. But it was universal, and all flight simulator equations of motion were coded with it. Then came ACSL, C, Ada, C++, C#, Java, FORTRAN-90, Matlab/Simulink, and a number of other programming languages. Since the halcyon punch card days of 1968, models of aircraft flight dynamics have proliferated in training devices, desktop engineering and development computers, and control design textbooks. With the rise of industry teaming and increased reliance on simulation for procurement decisions, aircraft and missile simulation models are created, updated, and exchanged with increasing frequency. However, there is no real lingua franca to facilitate the exchange of models from one simulation user to another. The current state-of-the-art is such that several staff-months if not staff-years are required to 'rehost' each release of a flight dynamics model from one simulation environment to another one. If a standard data package or exchange format were to be universally adopted, the cost and time of sharing and updating aerodynamics, control laws, mass and inertia, and other flight dynamic components of the equations of motion of an aircraft or spacecraft simulation could be drastically reduced. A 2002 paper estimated over $ 6 million in savings could be realized for one military aircraft type alone. This paper describes the efforts of the American Institute of Aeronautics and Astronautics (AIAA) to develop a standard flight dynamic model exchange standard based on XML and HDF-5 data formats.

Jackson, E. Bruce↗

NASA NTRS2017

Understanding the International Space Station Crew Perspective following Long-Duration Missions through Data Analytics & Visualization of Crew Feedback

The International Space Station (ISS) first became a home and research laboratory for NASA and International Partner crewmembers over 16 years ago. Each ISS mission lasts approximately 6 months and consists of three to six crewmembers. After returning to Earth, most crewmembers participate in an extensive series of 30+ debriefs intended to further understand life onboard ISS and allow crews to reflect on their experiences. Examples of debrief data collected include ISS crew feedback about sleep, dining, payload science, scheduling and time planning, health & safety, and maintenance. The Flight Crew Integration (FCI) Operational Habitability (OpsHab) team, based at Johnson Space Center (JSC), is a small group of Human Factors engineers and one stenographer that has worked collaboratively with the NASA Astronaut office and ISS Program to collect, maintain, disseminate and analyze this data. The database provides an exceptional and unique resource for understanding the "crew perspective" on long duration space missions. Data is formatted and categorized to allow for ease of search, reporting, and ultimately trending, in order to understand lessons learned, recurring issues and efficiencies gained over time. Recently, the FCI OpsHab team began collaborating with the NASA JSC Knowledge Management team to provide analytical analysis and visualization of these over 75,000 crew comments in order to better ascertain the crew's perspective on long duration spaceflight and gain insight on changes over time. In this initial phase of study, a text mining framework was used to cluster similar comments and develop measures of similarity useful for identifying relevant topics affecting crew health or performance, locating similar comments when a particular issue or item of operational interest is identified, and providing search capabilities to identify information pertinent to future spaceflight systems and processes for things like procedure development and training. In addition, the comments were scored for sentiment using a polarity scoring algorithm to identify both positive and negative comments for particular groups and clusters, allowing the team to make analytically informed decisions regarding future hardware and operating procedures. The use of polarity scoring with time series analysis was used to provide insight into how crew health and habitability is changing throughout various spaceflight increments or the station lifecycle as a whole. Finally, a visualization framework was developed to address the needs of the end users to search for and analyze comments by user, category or mission. This paper will discuss how the use of an analytical framework in conjunction with the current human interface, improved the understanding of crew perspective and shortened the time for analysis allowing for more informed decisions and rapid development of improvements. These methods are significantly optimizing the way that this valuable data can be assessed and applied to current and future spaceflight design and development. This collaboration allows the FCI OpsHab team to effectively analyze and share data in a more automated and timely fashion. Trends are no longer derived manually and can be illustrated effectively and accurately with these evolving techniques to an ever growing group of human spaceflight end users.

Bryant, Cody↗

NASA NTRS2003

SpaceDock: A Performance Task Platform for Spaceflight Operations

Preliminary evidence during both short- and long-duration spaceflight indicates that perceptual-motor coordination changes occur and persist in-flight. However, there is presently no in-flight method for evaluating astronaut performance on mission-critical tasks such as docking. We present a portable platform we have developed for attempting and evaluating docking, and describe the results of a pilot study wherein flight novices learned the docking task. Methods: A dual-joystick, six degrees of freedom platform-called SpaceDock-was developed to enable portable, adaptable performance testing in a spaceflight operations setting. Upon this platform, a simplified docking task was created, involving a constant rate of approach towards a docking target and requiring the user to correct translation in two dimensions and attitude orientation along one dimension (either pitch or roll). Ten flight naive subjects performed the task over a 45 min period and all joystick inputs and timings were collected, from which we could successfully reconstruct travel paths, input profiles and relative target displacements. Results: Subjects exhibited significant improvements in docking over the course of the experiment. Learning to compensate for roll-alterations was robust, whereas compensation for pitch-alterations was not in evidence in this population and relatively short training period. Conclusion: The SpaceDock platform can provide a novel method for training and testing subjects, on a spaceflight-relevant task, and can be used to examine behavioral learning, strategy use, and has been adapted for use in brain imaging experiments.

Marshburn, Thomas H.↗

NASA NTRS1999

Functional Performance Evaluation

The Extended Duration Orbiter Medical Project (EDOMP) was established to address specific issues associated with optimizing the ability of crews to complete mission tasks deemed essential to entry, landing, and egress for spaceflights lasting up to 16 days. The main objectives of this functional performance evaluation were to investigate the physiological effects of long-duration spaceflight on skeletal muscle strength and endurance, as well as aerobic capacity and orthostatic function. Long-duration exposure to a microgravity environment may produce physiological alterations that affect crew ability to complete critical tasks such as extravehicular activity (EVA), intravehicular activity (IVA), and nominal or emergency egress. Ultimately, this information will be used to develop and verify countermeasures. The answers to three specific functional performance questions were sought: (1) What are the performance decrements resulting from missions of varying durations? (2) What are the physical requirements for successful entry, landing, and emergency egress from the Shuttle? and (3) What combination of preflight fitness training and in-flight countermeasures will minimize in-flight muscle performance decrements? To answer these questions, the Exercise Countermeasures Project looked at physiological changes associated with muscle degradation as well as orthostatic intolerance. A means of ensuring motor coordination was necessary to maintain proficiency in piloting skills, EVA, and IVA tasks. In addition, it was necessary to maintain musculoskeletal strength and function to meet the rigors associated with moderate altitude bailout and with nominal or emergency egress from the landed Orbiter. Eight investigations, referred to as Detailed Supplementary Objectives (DSOs) 475, 476, 477, 606, 608, 617, 618, and 624, were conducted to study muscle degradation and the effects of exercise on exercise capacity and orthostatic function (Table 3-1). This chapter is divided into three parts. Part 1 describes specific findings from studies of muscle strength, endurance, fiber size, and volume. Part 2 describes results from studies of how in-flight exercise affects postflight exercise capacity and orthostatic function. Part 3 focuses on the development of new noninvasive methods for assessing body composition in astronauts and how those methods can be used to correlate measures of exercise performance and changes in body composition.

Greenisen, Michael C.↗

NASA NTRS2016

Human Error and the International Space Station: Challenges and Triumphs in Science Operations

Any system with a human component is inherently risky. Studies in human factors and psychology have repeatedly shown that human operators will inevitably make errors, regardless of how well they are trained. Onboard the International Space Station (ISS) where crew time is arguably the most valuable resource, errors by the crew or ground operators can be costly to critical science objectives. Operations experts at the ISS Payload Operations Integration Center (POIC), located at NASA's Marshall Space Flight Center in Huntsville, Alabama, have learned that from payload concept development through execution, there are countless opportunities to introduce errors that can potentially result in costly losses of crew time and science. To effectively address this challenge, we must approach the design, testing, and operation processes with two specific goals in mind. First, a systematic approach to error and human centered design methodology should be implemented to minimize opportunities for user error. Second, we must assume that human errors will be made and enable rapid identification and recoverability when they occur. While a systematic approach and human centered development process can go a long way toward eliminating error, the complete exclusion of operator error is not a reasonable expectation. The ISS environment in particular poses challenging conditions, especially for flight controllers and astronauts. Operating a scientific laboratory 250 miles above the Earth is a complicated and dangerous task with high stakes and a steep learning curve. While human error is a reality that may never be fully eliminated, smart implementation of carefully chosen tools and techniques can go a long way toward minimizing risk and increasing the efficiency of NASA's space science operations.

Harris, Samantha S.↗

NASA NTRS1993

Hubble Space Telescope EVA Power Ratchet Tool redesign

The Power Ratchet Tool (PRT) is a self contained, power-driven, 3/8 inch drive ratchet wrench which will be used by astronauts during Extravehicular Activities (EVA). This battery-powered tool is controlled by a dedicated electonic controller. The PRT was flown during the Hubble Space Telescope (HST) Deployment Mission STS-31 to deploy the solar arrays if the automatic mechanisms failed. The PRT is currently intended for use during the first HST Servicing Mission STS-61 as a general purpose power tool. The PRT consists of three major components; the wrench, the controller, and the battery module. Fourteen discrete combinations of torque, turns, and speed may be programmed into the controller before the EVA. The crewmember selects the desired parameter profile by a switch mounted on the controller. The tool may also be used in the manual mode as a non-powered ratchet wrench. The power is provided by a silver-zinc battery module, which fits into the controller and is replaceable during an EVA. The original PRT did not meet the design specification of torque output and hours of operation. To increase efficiency and reliability the PRT underwent a redesign effort. The majority of this effort focused on the wrench. The original PRT drive train consisted of a low torque, high speed brushless DC motor, a face gear set, and a planocentric gear assembly. The total gear reduction was 300:1. The new PRT wrench consists of a low speed, high torque brushless DC motor, two planetary gear sets and a bevel gear set. The total gear reduction is now 75:1. A spline clutch has also been added to disengage the drive train in the manual mode. The design changes to the controller will consist of only those modifications necessary to accomodate the redesigned wrench. The battery design will be unaffected.

Richards, Paul W.↗

NASA NTRS2010

Reliability and Validity of Ultrasound Cross Sectional Area Measurements for Long-Duration Spaceflight

Limb muscle atrophy and the accompanying decline in function can adversely affect the performance of astronauts during mission-related activities and upon re-ambulation in a gravitational environment. Previous characterization of space flight-induced muscle atrophy has been performed using pre and post flight magnetic resonance imaging (MRI). In addition to being costly and time consuming, MRI is an impractical methodology for assessing in-flight changes in muscle size. Given the mobility of ultrasound (US) equipment, it may be more feasible to evaluate changes in muscle size using this technique. PURPOSE: To examine the reliability and validity of using a customized template to acquire panoramic ultrasound (US) images for determining quadriceps and gastrocnemius anatomical cross sectional area (CSA). METHODS: Vastus lateralis (VL), rectus femoris (RF), medial gastrocnemius (MG), and lateral gastrocnemius (LG) CSA were assessed in 10 healthy individuals (36+/-2 yrs) using US and MRI. Panoramic US images were acquired by 2 sonographers using a customized template placed on the thigh and calf and analyzed by the same 2 sonographers (CX50 Philips). MRI images of the leg were acquired while subjects were supine in a 1.5T scanner (Signa Horizon LX, General Electric) and were analyzed by 3 trained investigators. The average of the 2 US and 3 MRI values were used for validity analysis. RESULTS: High inter-experimenter reliability was found for both the US template and MRI analysis as coefficients of variation across muscles ranged from 2.4 to 4.1% and 2.8 to 3.8%, respectively. Significant correlations were found between US and MRI CSA measures (VL, r = 0.85; RF, r = 0.60; MG, r = 0.86; LG, r = 0.73; p < 0.05). Furthermore, the standard error of measurement between US and MRI ranged from 0.91 to 2.09 sq cm with high limits of agreement analyzed by Bland-Altman plots. However, there were significant differences between absolute values of MRI and US for all muscles. CONCLUSION: The present results indicate that utilizing a customized US template provides reliable measures of leg muscle CSA, and thus could be used to characterize changes in muscle CSA both in flight and on the ground.

Scott, Jessica M.↗

NASA NTRS2014

Forecasting Sensorimotor Adaptability from Baseline Inter-Trial Correlations

One of the greatest challenges surrounding adaptation to the spaceflight environment is the large variability in symptoms, and corresponding functional impairments, from one crewmember to the next. This renders preflight training and countermeasure development difficult, as a "one-size-fits-all" approach is inappropriate. Therefore, it would be highly advantageous to know ahead of time which crewmembers might have more difficulty adjusting to the novel g-levels inherent to spaceflight. Such knowledge could guide individually customized countermeasures, which would enable more efficient use of crew time, both preflight and inflight, and provide better outcomes. The primary goal of this project is to look for a baseline performance metric that can forecast sensorimotor adaptability without exposure to an adaptive stimulus. We propose a novel hypothesis that considers baseline inter-trial correlations, the trial-to-trial fluctuations in motor performance, as a predictor of individual sensorimotor adaptive capabilities. To-date, a strong relationship has been found between baseline inter-trial correlations and adaptability in two oculomotor systems. For this project, we will explore an analogous predictive mechanism in the locomotion system. METHODS: Baseline Inter-trial Correlations: Inter-trial correlations specify the relationships among repeated trials of a given task that transpire as a consequence of correcting for previous performance errors over multiple timescales. We can quantify the strength of inter-trial correlations by measuring the decay of the autocorrelation function (ACF), which describes how rapidly information from past trials is "forgotten." Processes whose ACFs decay more slowly exhibit longer-term inter-trial correlations (longer memory processes), while processes whose ACFs decay more rapidly exhibit shorterterm inter-trial correlations (shorter memory processes). Longer-term correlations reflect low-frequency activity, which is more easily measured in the frequency domain. Therefore, we use the power spectrum (PS), which is the Fourier transform of the ACF, to describe our inter-trial correlations. The decay of the PS yields a straight line on a log-log frequency plot, which we quantify by Beta = - (slope of PS on log-log axes). Hence, Beta is a measure of the strength of inter- trial correlations in the baseline data. Larger Beta values are indicative of longer inter-trial correlations. Experimental Approach: We will begin by performing a retrospective analysis of treadmill-gait adaptation data previously collected by Dr. Bloomberg and colleagues. Specifically, we will quantify the strength of inter-trial correlations in the baseline step cadence and heart rate data and compare it to the locomotor adaptability performance results already described by these investigators. Incorporating these datasets will also allow us to explore the applicability of (and potential limitations surrounding) the use of Beta in forecasting physiological performance. We will also perform a new experiment, in which Beta will be derived from baseline data collected during over-ground (non-treadmill) walking, which will enable us to consider locomotor performance, through the parameter Beta, under the most functionallyrelevant, natural gait condition. This experiment will incorporate two baseline and five post-training over-ground locomotion tests to explore the consistency and potential adaptability of the Beta values themselves. HYPOTHESES: We hypothesize that the strength of baseline inter-trial correlations of step cadence and heart rate will relate to locomotor adaptability. Specifically, we anticipate that individuals who show weaker longer-term inter-trial correlations in baseline step cadence data will be the better adaptors, as step cadence can be modified in real-time (i.e., online corrections are an inherent property of the locomotor system; analogous to results observed in the VOR). Conversely, because heart rate is not altered mid-beat, we expect that individuals who demonstrate stronger longer-term correlations in heart rate will be the better adaptors (analogous to results observed in the saccadic system). CONCLUSIONS: At the conclusion of this project we hope to uncover a baseline predictor of locomotor adaptability. If our hypotheses hold true, our results will demonstrate that the temporal structure of baseline behavioral data contains important information that may aid in forecasting adaptive capacities. The ability to predict such adaptability in the sensorimotor system has significant implications for spaceflight, where astronauts must adjust their motor programs following a change in g-level to retain movement accuracy.

Beaton, K. H.↗

NASA NTRS2003

Some approaches to medical support for Martian expedition

Medical support in a Martian expedition will be within the scope of crew responsibilities and maximally autonomous. Requirements to the system of diagnostics in this mission include considerable use of means and methods of visualization of the main physiological parameters, telemedicine, broad usage of biochemical analyses (including "dry" chemistry), computerized collection, measurement, analysis and storage of medical information. The countermeasure system will be based on objective methods of crew fitness and working ability evaluation, individual selection of training regimens, and intensive use of computer controlled training. Implementation of the above principles implies modernization and refinement of the countermeasures currently used by space crews of long-term missions (LTM), and increases of the assortment of active and passive training devices, among them a short-arm centrifuge. The system of medical care with the functions of prevention, clinical diagnostics and timely treatment will be autonomous, too. The general requirements to medical care during the future mission are the following: availability of conditions and means for autonomous urgent and special medical aid and treatment of the most possible states and diseases, "a hospital", and assignment to the crew of one or two doctors. To ensure independence of medical support and medical care in an expedition to Mars an automated expert system needs to be designed and constructed to control the medical situation as a whole. c2003 Published by Elsevier Science Ltd.

Mars↗

NASA NTRSDate not supplied

JETT3: A Holistic, Integrated Analog for Artemis Lunar Surface Exploration

Since 1972, NASA astronauts have performed hundreds of Extravehicular Activities (EVAs) in support of Skylab, Space Shuttle and International Space Station missions. Not since Apollo, however, have EVAs been driven by discovery-based principles of scientific exploration. Upcoming Artemis missions are challenged to build on lessons learned from Apollo, merging 50 years of EVA experience with the planetary science community’s expertise in the remote surface exploration of Mars. The highest-fidelity preparation for Artemis includes both operational and scientific underpinning to represent the complete, complex picture of lunar surface operations. The Joint EVA & Human Surface Mobility Test Team (JETT) is an interdisciplinary team providing such an environment for collaborative analog testing. JETT builds upon prior analog campaigns (e.g., [1, 2]) to provide high-fidelity environments for hardware and concept of operations development. Sponsored by the NASA EVA & Human Surface Mobility Program (EHP), JETT includes representatives from EHP, NASA Engineering, the Science Mission Directorate (SMD), Human Health & Performance, and the Flight Operations Directorate (FOD). JETT tests evaluate NASA reference designs for EVA (e.g., suits and tools), address gaps and risks for Artemis lunar surface operations, develop capabilities for EVA and science tasks, enable technology maturation, and provide training for Artemis EVA operations. JETT3, the final JETT field test of FY22, occurred Oct 3-11, 2022 in the San Francisco Volcanic Field north of Flagstaff, AZ. The test focused on developing the Artemis concept of operations and systems, including integrating an Artemis-like Science Team into a NASA Flight Control Team (FCT) to plan and execute a series of simulated lunar EVAs in an environment analogous to Artemis 3.

T. E. Caswell↗

NASA NTRSDate not supplied

JETT3: A Holistic, Integrated Analog for Artemis Lunar Surface Exploration

T. E. Caswell↗

NASA NTRS1998

Applications of telemedicine in the United States space program

Since the beginning of human space flight, NASA has been placing humans in extreme and remote environments. There are many challenges in maintaining humans in outer space, including the provision of life-support systems, radiation shielding, and countermeasures for minimizing the effect of microgravity. Because astronauts are selected for their health, among other factors, disease and illness are minimized. However, it is still of great importance to have appropriate medical care systems in place to address illness and injury should they occur. With the exception of the Apollo program, exploration of space has been limited to missions that are within several hundred miles of the surface of the Earth. At the drawn of the 21st century and the new millennium, human exploration will be focused on operation of the International Space Station (ISS) and preparation for human missions to Mars. These missions will present inherent risks to human health, and, therefore, appropriate plans must be established to address these challenges and risks. Crews of long-duration missions must become more independent from ground controllers. New systems, protocols, and procedures are currently being perfected. Application of emerging technologies in information systems and telecommunications will be critical to inflight medical care. Application of these technologies through telemedicine will provide crew members access to information, noninvasive procedures for assessing health status, and guidance through the integration of sensors, holography, decision-support systems, and virtual environments. These technologies will also serve as a basis to enhance training and medical education. The design of medical care for space flight should lead to a redesign of the practice of medicine on Earth.

Review, Tutorial↗

NASA NTRS2016

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploration Symposium

Surgical capabilities in human space flight, whether on a space-based platform in low Earth orbit or on a long duration planetary exploration mission, will be challenging to conduct for a variety of reasons, some of which will be ameliorated by training, technology, and pre-flight planning. Nevertheless, inherent risks and challenges remain. Early space missions did not have any surgical capability. It was not until NASA's Skylab mission that serious consideration was given to this fundamental medical care capability. Over the past 30 years, subject matter experts have been brought together for discussion on the myriad of challenges and opportunities in this endeavor. The last such meeting was held in 2005 at the NASA Johnson Space Center. As we continue to move forward with human space flight activities for the International Space Station and beyond, the capabilities of information technology, robotics, sensors and imaging have rapidly changed since the last gathering of expertise. In December 2015, through sponsorship of the National Space Biomedical Research Institute (NSBRI), a diverse group of individuals from government, academia, and industry representing three countries gathered at the NSBRI Space 4 Biomedicine facility in Houston, TX. This two day symposia included comprehensive sessions that addressed the challenges that we all face in developing, deploying, and utilizing surgical care capabilities in all human space missions, regardless of mission duration or profile. The symposium benefited from the knowledge and experience of three seasoned NASA physician astronauts, Drs. Jay Buckey, Thomas Marshburn, and Lee Morin. At the end of the first day, the assembled group heard from the crew members about their experiences and their ideas. It is clear that the discussion of surgical capabilities is part of the larger discussion of consideration of advanced healthcare, including critical care, on exploration space missions. This report represents the culmination of the symposium, capturing knowledge, experience, conceptual dialogue, and a narrative that can be used in supporting the development of future programs and potential policy. Each of the presentations that were provided by the guest speakers is included in the appendices. Those presentations that are not included were due to sensitivity of the material or at the request of the speaker. In addition, each speaker was offered an opportunity to provide comments in a 'lightning round' format. All of these comments and speaker abstracts also appear in the appendices. At the conclusion of the second day, a discussion was held that reviewed the priorities that perhaps add value to decision makers. These are also summarized. This report will serve as the final product of this symposium. Additional material may be produced for the peer-reviewed literature.

Doarn, Charles R.↗

NASA NTRS2015

Bone Loss During Spaceflight: Available Models and Counter-Measures

There is ongoing concern for human health during spaceflights. Of particular interest is the uncoupling of bone remodeling and its resultant effect on calcium metabolism and bone loss. The calculated average loss of bone mineral density (BMD) is approximately 1-1.5% per month of spaceflight. The effect of decreased BMD on associated fractures in astronauts is not known. Currently on the International Space Station (ISS), bone loss is managed through dietary supplements and modifications and resistance exercise regimen. As the duration of space flights increases, a review of the current methods available for the prevention of bone loss is warranted. The goal of this project is to review and summarize recent studies that have focused on maintaining BMD during exposure to microgravity. Interventions were divided into physical (Table 1), nutritional (Table 2), or pharmacologic (Table 3) categories. Physical modalities included resistance exercise, low level vibration, and low intensity pulsed ultrasound. Nutritional interventions included altering protein, salt, and fat intake; and vitamin D supplementation. Pharmacologic interventions included the use of bisphosphonates and beta blockers. Studies reported outcomes based on bone density determined by DXA bone scan, micro-architecture of histology and microCT, and serum and urine markers of bone turnover. The ground analog models utilized to approximate osseous physiology in microgravity included human patients previously paralyzed or subjects confined to bedrest. Ground analog animal models include paralysis, immobilization and ovariectomies. As a result of the extensive research performed there is a multi-modality approach available for the management of BMD during spaceflight that includes resistance training, nutrition and dietary supplements. However, there is a paucity of literature describing a formalized tiered protocol to guide investigators through the progression from animal models to human patient ground analogs to experiments on the ISS. With regards to testing, further evaluation to determine the association between non-invasive tests and fracture during and after spaceflight needs to be performed.

Morris, Jonathan↗