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At least 91 records · Page 5

Miniature Biosensor with Health Risk Assessment Feedback

Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

Hanson, Andrea↗

NASA'S Standard Measures During Bed Rest: Adaptations in the Cardiovascular System

Bed rest is a well-accepted analog of space flight that has been used extensively to investigate physiological adaptations in a larger number of subjects in a shorter amount of time than can be studied with space flight and without the confounding effects associated with normal mission operations. However, comparison across studies of different bed rest durations, between sexes, and between various countermeasure protocols have been hampered by dissimilarities in bed rest conditions, measurement protocols, and testing schedules. To address these concerns, NASA instituted standard bed rest conditions and standard measures for all physiological disciplines participating in studies conducted at the Flight Analogs Research Unit (FARU) at the University of Texas-Medical Branch. Investigators for individual studies employed their own targeted study protocols to address specific hypothesis-driven questions, but standard measures tests were conducted within these studies on a non-interference basis to maximize data availability while reducing the need to implement multiple bed rest studies to understand the effects of a specific countermeasure. When possible, bed rest standard measures protocols were similar to tests nominally used for medically-required measures or research protocols conducted before and after Space Shuttle and International Space Station missions. Specifically, bed rest standard measures for the cardiovascular system implemented before, during, and after bed rest at the FARU included plasma volume (carbon monoxide rebreathing), cardiac mass and function (2D, 3D and Doppler echocardiography), and orthostatic tolerance testing (15- or 30-minutes of 80 degree head-up tilt). Results to-date indicate that when countermeasures are not employed, plasma volume decreases and the incidence of presyncope during head-up tilt is more frequent even after short-duration bed rest while reductions in cardiac function and mass are progressive as bed rest duration increases. Additionally, while plasma volume loss can be corrected and cardiac mass can be prevented with properly applied countermeasures, orthostatic tolerance is more difficult to protect when supine exercise is the only countermeasure. Similar results have been observed after space flight. Plasma volume, cardiac chamber volume, and orthostatic tolerance recover relatively quickly with resumption of ambulation and normal activity levels after bed rest but restoration of cardiac mass is prolonged.

Lee, Stuart M. C.↗

Changes in Exercise Data Management

The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected from the treadmill, cycle ergometer, and resistance strength training hardware are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are post processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates have recently been made to how this valuable data are stored, adding an additional level of data security, increasing data accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries over the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 - current day. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the inflight data it into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratory's output time of crew reports by 67%. Expansion of the SQL database to be inclusive of additional medical requirement metrics, addition of 'app-like' tools for mobile visualization, and collaborative use (e.g. operational support teams, research groups, and International Partners) of the data system is currently being explored.

Buxton, R. E.↗

Changes in Exercise Data Management

The suite of exercise hardware aboard the International Space Station (ISS) generates an immense amount of data. The data collected, treadmill, cycle ergometer, and resistance strength training hardware, are basic exercise parameters (time, heart rate, speed, load, etc.). The raw data are processed in the laboratory and more detailed parameters are calculated from each exercise data file. Updates recently have been made to how these valuable data are stored, adding an additional level of security, increasing accessibility, and resulting in overall increased efficiency of medical report delivery. Questions regarding exercise performance or how exercise may influence other variables of crew health frequently arise within the crew health care community. Inquiries regarding the health of the exercise hardware often need quick analysis and response to ensure the exercise system is operable on a continuous basis. Consolidating all of the exercise system data in a single repository enables a quick response to both the medical and engineering communities. A SQL server database is currently in use, and provides a secure location for all of the exercise data starting at ISS Expedition 1 to current date. The database has been structured to update derived metrics automatically, making analysis and reporting available within minutes of dropping the in-flight data into the database. Commercial tools were evaluated to help aggregate and visualize data from the SQL database. The Tableau software provides manageable interface, which has improved the laboratory’s output time of crew reports by 67%. Expansion of the SQL database, to be inclusive of additional medical requirement metrics, addition of ‘app-like’ tools for mobile visualization, and collaborative use (e.g., operational support teams, research groups, and International Partners) of the data system, is currently being explored.

Buxton, R. E.↗

Preparing for Human Missions to Mars: The role of ISS and Artemis as Analogs for Research and Technology Testing

The hazards of spaceflight to the human system are present in in varying degrees on different spaceflight platforms: altered gravity, isolation and confinement, distance from Earth, radiation, and hostile closed environments. A strategic view of the fidelity of hazards experienced on different platforms can shape the testing plans for human research and technology demonstration related to crew health and performance. Working across the international partnership, the International Space Station (ISS) is planning periods of modified operations to improve the fidelity of Mars simulations. To understand transit durations as an independent variable, a series of 1-year, 6-month and 30-45 day missions are being planned on ISS. Standard measurements across ISS missions of different durations, lunar missions and ground analogs offers the opportunity to distinguish different hazards and their effects in the context of the relevance to future mission concepts. The ISS partnership is planning for additional test cases that are aligned with Mars mission plans. (1) Evaluating crew performance capabilities when transitioning to gravity after long durations in microgravity representative of a Mars transit. (2) Simulating crew medical care under Mars-like autonomous operations. (3) Identification and testing of operations under communications delay and autonomy expected for Mars missions and the linked effects on behavioral health and performance of the crew. Artemis missions serve as a valuable analogs for Mars surface operations, with partial gravity and deep space radiation hazards, but with crewmembers that are probably more physically capable than their counterparts would be after a Mars transit. Getting unobtrusive data from early Artemis missions, and knowledge gained from operational experience as Artemis operations develop can improve engineering design, medical requirements and countermeasures, and ultimately ensure mission success on Mars. Linking Mars architectures with the plans and capabilities for ISS and Artemis allows us to plan to most operationally relevant tests of crew health and performance on current spaceflight missions to inform planning for future missions to Mars. By using human spaceflight platforms as well as ground simulation in an integrated way, the international community can improve exploration readiness, develop countermeasures and reduce risks of future human space missions.

International Space Station↗

Implementation of a SysML Model-Based Concept of Operations for Level of Care IV: Long-Duration Lunar Orbital and Surface Operations

One goal of the Human Research Program (HRP) Exploration Medical Capability (ExMC) Element Systems Engineering (SE) team is to define the technical system needed to support crew medical system capabilities for future exploration missions, including orbital and surface operations for long duration lunar missions. This is accomplished through the development of a Medical System Foundation, which communicates medical system requirements, capabilities, conditions, and resources that define a starting point for a medical system that meets the specification for design reference missions and associated Levels of Care (as defined by NASA-STD-3001). The starting point for creating this Medical System Foundation Model is the development of a Concept of Operations (ConOps) that describes the operation of the system from the point of view of the users. It includes a comprehensive and thoroughly vetted list of the users, their specific needs, the goals of the system, key assumptions about the system, and definitions of the system’s operational environments. The use case scenarios included in the ConOps illustrate required medical system capabilities for Level of Care IV and enable the ExMC SE team to develop integrated medical system requirements and identify capabilities required to meet those requirements. For this “Long Duration” Medical System Foundation development effort, ExMC replaced the traditional document-based ConOps with a model-based ConOps using model-based systems engineering. This approach has several advantages, including the facilitation of more efficient understanding of the material through information-dense images with less opportunity for misinterpretation than text alone, the roll-out of changes to the ConOps to stakeholders in real-time as they are approved, and the consolidation of all salient information into one centralized location. This discussion will focus on both how the model represents the ConOps content and how the SE team utilized lessons learned in an agile environment to improve the way this information was created and presented to stakeholders.

M Kaetzer↗

Implementation of a SysML Model-Based Concept of Operations for Level of Care IV: Long-Duration Lunar Orbital and Surface Operations

One goal of the Human Research Program (HRP) Exploration Medical Capability (ExMC) Element Systems Engineering (SE) team is to define the technical system needed to support crew medical system capabilities for future exploration missions, including orbital and surface operations for long duration lunar missions. This is accomplished through the development of a Medical System Foundation, which communicates medical system requirements, capabilities, conditions, and resources that define a starting point for a medical system that meets the specification for design reference missions and associated Levels of Care (as defined by NASA-STD-3001). The starting point for creating this Medical System Foundation Model is the development of a Concept of Operations (ConOps) that describes the operation of the system from the point of view of the users. It includes a comprehensive and thoroughly vetted list of the users, their specific needs, the goals of the system, key assumptions about the system, and definitions of the system’s operational environments. The use case scenarios included in the ConOps illustrate required medical system capabilities for Level of Care IV and enable the ExMC SE team to develop integrated medical system requirements and identify capabilities required to meet those requirements. For this “Long Duration” Medical System Foundation development effort, ExMC replaced the traditional document-based ConOps with a model-based ConOps using model-based systems engineering. This approach has several advantages, including the facilitation of more efficient understanding of the material through information-dense images with less opportunity for misinterpretation than text alone, the roll-out of changes to the ConOps to stakeholders in real-time as they are approved, and the consolidation of all salient information into one centralized location. This discussion will focus on both how the model represents the ConOps content and how the SE team utilized lessons learned in an agile environment to improve the way this information was created and presented to stakeholders.

Mary Susan Kaetzer↗

Medical and technology requirements for human solar system exploration missions

Measures that need to be taken to cope with the health problems posed by zero gravity and radiation in manned solar system exploration missions are discussed. The particular systems that will be used aboard Space Station Freedom are addressed, and relevant human factors problems are examined. The development of a controlled ecological life support system is addressed.

Nicogossian, Arnauld↗

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

Niederhaus, Charles E.↗

Identifying and Closing Medical Capability Gaps for Human Spaceflight Missions Beyond Low Earth Orbit

BACKGROUND: Features of human space missions beyond low Earth orbit such as increasing distance from Earth, lack of real-time communication, and limited or no evacuation or resupply capability are expected to drive an increase in medical risk and require crews to operate in an increasingly autonomous fashion. A diverse set of stakeholders at NASA are seeking to fund the development of concepts of operations, medical requirements, and medical capabilities for such missions. However, a systematic approach to identification of current medical capability gaps and a strategic framework to gap closure is needed. OVERVIEW: The Exploration Medical Integrated Product Team (XMIPT) has developed a list of nine high-level medical capability gaps and associated activities required for gap closure. The list was derived based on inputs from subject matter experts at NASA including flight surgeons, other clinical providers, as well as operational and research communities regarding medical capabilities required to support human missions to the Moon and the Mars surface. Responses were reviewed and distilled to identify common themes across capabilities. To ensure alignment with established human system risks, the gap list was further refined based on inputs from NASA’s Human System Risk Board. Relevant medical gap closure activities outside of those funded by the XMIPT were identified through solicitation of inputs from Elements of NASA’s Human Research Program (particularly Exploration Medical Capability), the broader medical operations community, and other stakeholders. This medical capability gap list is reviewed and updated regularly as new information becomes available or new stakeholders are identified. DISCUSSION: The medical capability gap list has matured to include a large group of NASA stakeholders and development activities. This has enabled articulation of priorities to funding entities and programmatic stakeholders, while serving as an accessible resource summarizing gap closure activities, relevant programmatic infusion points, and opportunities for collaboration between stakeholders. This presentation will provide an overview of the nine NASA medical capability gaps and their associated gap closure activities.

Moriah Thompson↗

OSHA medical and workplace surveillance requirements and NIOSH recommendations (for employees exposed to toxic substances and other work hazards)

Both OSHA medical and work place surveillance requirements and NIOSH recommendations were prepared as a desk reference to help occupational health professionals to perform their duties. The medical surveillance information focuses on frequency of physical examinations, specific problems that may arise as a result of exposure (e.g., decreased immunocompetence, weight loss, ets.), conditions that intensify the harmful effects of exposure (e.g., medication an exposed employee may be taking, cigarette smoking, etc.), the areas that should be scrutinized in medical and work histories and during the physical exam, and specific clinical tests that should be conducted. Recordkeeping requirements are also specified. The workplace surveillance information consists of monitoring requirements, personal protective equipment requirements, and recordkeeping requirements. Such details as the sampling devices that should be used, the type of respirators that should be worn, and the frequency of inspections are included. This document does not specify the training, labeling and posting, and safe work practice requirements and recommendations due to space considerations.

Cooper, L. P.↗

Artificial Gravity as a Multi-System Countermeasure to Bed Rest Deconditioning: Pilot Study Overview

Efficient, effective, multi-system countermeasures will likely be required to protect the health, safety, and performance of crews aboard planned exploration-class space flight missions to Mars and beyond. To that end, NASA, DLR, and IMBP initiated a multi-center international project to begin systematically exploring the utility of artificial gravity (AG) as a multi-system countermeasure in ground based venues using test subjects deconditioned by bed rest. The goal of this project is to explore the efficacy of short-radius, intermittent AG as a countermeasure to bone, muscle, cardiovascular, and sensory-motor adaptations to hypogravity. This session reports the results from a pilot study commissioned to validate a standardized protocol to be used by all centers involved in the project. Subject selection criteria, medical monitoring requirements, medical care procedures, experiment control procedures, and standardized dependent measures were established jointly. Testing was performed on 15 rigorously screened male volunteers subjected to 21 days of 6deg HDT bed rest. (All provided written consent to volunteer after the nature of the study and its hazards were clearly explained to them.) Eight were treated with daily 1hr AG exposures (2.5g at the feet decreasing to 1.0g at the heart) aboard a short radius (3m) centrifuge, while the other seven served as controls. Multiple tests of multiple dependent measures were made in each of the primary physiological systems of interest during a 10 day acclimatization period prior to HDT bed rest and again during an 8 day recovery period after the bed rest period was complete. Analyses of these data (presented in other papers in this session) suggest the AG prescription had salutary effects on aspects of the bone, muscle, and cardiovascular systems, with no untoward effects on the vestibular system, the immune system, or cognitive function. Furthermore, treatment subjects were able to tolerate 153/160 centrifuge sessions over the 21 day deconditioning protocol, suggesting that tolerance was unaffected by deconditioning. These positive results set the stage for full implementation of the planned multi-center international AG project. Future work will be devoted to developing optimization techniques for AG prescriptions (likely supplemented by exercise) to provide maximum physiological protection across all systems subject to space flight deconditioning in both men and women with minimum time and/or side effects. While a continuous AG solution (rotating vehicle) would likely be more efficient, this study suggests that intermittent AG could be an effective multi-system countermeasure.

Paloski, William H.↗

Machine learning based reconstruction of intracardiac electrical behavior based on electrocardiograms

A computer-based system and process are disclosed for reconstructing the internal electrical behavior of a patient's heart based partly or wholly on the patient's electrocardiogram (ECG). The output of the process may include, for example, a cardiac activation map, and/or a representation of transmembrane potentials over time. The process advantageously does not require any medical imaging of the patient, and does not require any special medical equipment. For example, the patient's activation map and transmembrane potentials may be reconstructed based solely on a preexisting or newly-obtained 12-lead cardiac ECG of the patient. The process makes use of a machine learning model, such as a neural network based model, trained with actual and/or simulated ECGs and intracardiac electrical data (typically transmembrane potentials) of many thousands of patients. Because an insufficient quantity of such data exists for actual patients, model training may be performed using ECGs and intracardiac electrical data obtained through computer simulations.

Blake, Robert↗

Overview of Pre-Flight Physical Training, In-Flight Exercise Countermeasures and the Post-Flight Reconditioning Program for International Space Station Astronauts

International Space Station (ISS) astronauts receive supervised physical training pre-flight, utilize exercise countermeasures in-flight, and participate in a structured reconditioning program post-flight. Despite recent advances in exercise hardware and prescribed exercise countermeasures, ISS crewmembers are still found to have variable levels of deconditioning post-flight. This presentation provides an overview of the astronaut medical certification requirements, pre-flight physical training, in-flight exercise countermeasures, and the post-flight reconditioning program. Astronauts must meet medical certification requirements on selection, annually, and prior to ISS missions. In addition, extensive physical fitness testing and standardized medical assessments are performed on long duration crewmembers pre-flight. Limited physical fitness assessments and medical examinations are performed in-flight to develop exercise countermeasure prescriptions, ensure that the crewmembers are physically capable of performing mission tasks, and monitor astronaut health. Upon mission completion, long duration astronauts must re-adapt to the 1 G environment, and be certified as fit to return to space flight training and active duty. A structured, supervised postflight reconditioning program has been developed to prevent injuries, facilitate re-adaptation to the 1 G environment, and subsequently return astronauts to training and space flight. The NASA reconditioning program is implemented by the Astronaut Strength, Conditioning, and Rehabilitation (ASCR) team and supervised by NASA flight surgeons. This program has evolved over the past 10 years of the International Space Station (ISS) program and has been successful in ensuring that long duration astronauts safely re-adapt to the 1 g environment and return to active duty. Lessons learned from this approach to managing deconditioning can be applied to terrestrial medicine and future exploration space flight missions.

Kerstman, Eric↗

Medical Data Architecture Project Status

The Medical Data Architecture (MDA) project supports the Exploration Medical Capability (ExMC) risk to minimize or reduce the risk of adverse health outcomes and decrements in performance due to in-flight medical capabilities on human exploration missions. To mitigate this risk, the ExMC MDA project addresses the technical limitations identified in ExMC Gap Med 07: We do not have the capability to comprehensively process medically-relevant information to support medical operations during exploration missions. This gap identifies that the current in-flight medical data management includes a combination of data collection and distribution methods that are minimally integrated with on-board medical devices and systems. Furthermore, there are a variety of data sources and methods of data collection. For an exploration mission, the seamless management of such data will enable a more medically autonomous crew than the current paradigm. The medical system requirements are being developed in parallel with the exploration mission architecture and vehicle design. ExMC has recognized that in order to make informed decisions about a medical data architecture framework, current methods for medical data management must not only be understood, but an architecture must also be identified that provides the crew with actionable insight to medical conditions. This medical data architecture will provide the necessary functionality to address the challenges of executing a self-contained medical system that approaches crew health care delivery without assistance from ground support. Hence, the products supported by current prototype development will directly inform exploration medical system requirements.

medical data architecture↗