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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↗

Countermeasures for Mitigation of Sensorimotor Decrements Following Head-Down Bed Rest

BACKGROUND Astronauts experience postflight disturbances in postural and locomotor control due to sensorimotor adaptations during spaceflight. These alterations may have adverse consequences if a rapid egress is required after landing. Although exercise is partially effective for mitigating cardiovascular and muscular deconditioning, additional countermeasures are needed to further preserve sensorimotor function for exploration missions. We have identified proprioceptive training and electrical muscle stimulation (EMS) as promising in-flight countermeasures. Since prolonged head down bed rest (HDBR) is a spaceflight analog for body unloading and causes postural and locomotor control decrements that parallel those observed after spaceflight, it can be used to facilitate the development of these countermeasures. METHODS This study will determine the effects of proprioceptive training and EMS on functional task performance and sensorimotor function following 60 days of 6° HDBR. Subjects will be randomly assigned to one of four groups: 1)an EMS arm, 2) a proprioceptive training arm, 3) an exercise plus proprioceptive training arm, and 4) a control arm. The EMS countermeasure will include daily bilateral stimulation of selected bilateral lower extremity muscles (30 minutes per session). Proprioceptive training will be performed three days per week (20 minutes per session) consisting of body-loaded postural tasks in the horizontal position on an air bearing sled. Exercise training will mimic current protocols used on the International Space Station, but treadmill aerobic exercise will be replaced with additional cycling aerobic exercise. Primary outcome measures will include pre and post HDBR functional tests that are representative of high priority exploration mission tasks and require high demand for dynamic control of postural stability. Additional measures will be used to identify the key physiological factors contributing to countermeasure benefits. Given the constrained samples size, a Bayesian modelling approach will be used to quantify the probability that there is an effect of a given magnitude. HARDWARE AND PROTOCOL DEVELOPMENT Proprioceptive countermeasure design enhancements continued as part of the Mars Campaign Office (MCO) Crew Health and Performance (CHP) Crew Health Countermeasures (CHC). The primary goals of this work were to assemble a portable version of the countermeasure system that can be used at the :envihab facility, expand the software feedback system’s capabilities, and develop an actuator loading system that mimics what could be used on the International Space Station. In addition, one major piece of exercise hardware used in previous HDBR studies, the Horizontal Squat Device, was reassembled and restored to full functionality. Human-in-the-loop pilot testing is ongoing, prior to shipping both devices to the :envihab HDBR facility. Evaluations are also underway for the best EMS device technologies and specific methods. Finally, assessment techniques are being translated for administration in the horizontal position (e.g., leg dexterity and foot sole skin sensitivity). Our current goals are to refine the countermeasure training and assessment techniques and integrate protocols across multiple modalities. RELEVANCE The deliverable from this project will be proof-of-concept sensorimotor countermeasure designs for functional task performance with full assessment of efficacy in a spaceflight analog. If one or more countermeasures are effective, they will be translated for validation with the suite of operationally implemented in-flight countermeasures. ACKNOWLEDGEMENT This work is supported by NASA’s Human Research Program Human Health Countermeasures Element and by the Canadian Space Agency (L. Bent).

T R Macaulay↗

Alignment of NASA’s Human System Risks with Technological Capability Gaps to Enable Integrated Research and Technology Development Strategic Planning

BACKGROUND: Radiation, reduced gravity, distance from earth, isolation and confinement, and habitation within artificially created and controlled life support environments are hazards that present risk to human space explorers. NASA’s Human System Risk Board (HSRB) maintains a set of twenty-nine different Human System Risks with subject matter experts from across the agency providing regular updates to the estimated likelihood and consequence associated with each risk. The Human Research Program (HRP) has historically used these risk classifications as a primary basis for identifying and prioritizing human research investments aimed at characterizing and/or mitigating the respective human system risks. In many cases, technology development is required to mature and validate risk mitigation strategies, however, NASA’s primary technology development programs have not typically used Human System Risks as a basis for strategic planning. A primary function of the Environmental Control and Life Support Systems (ECLSS) – Crew Health and Performance (CHP) System Capability Leadership Team (SCLT) is to continually identify, review, and update technological capability gaps and to establish and oversee multiyear strategic roadmaps aimed at guiding NASA’s technology development priorities in these areas. These roadmaps are intended to be agency-wide and independent of any program, directorate, or other organization within NASA. DESCRIPTION: The SCLT and HRP collaborated to establish a set of Human System Capability Gaps, which establish a formal linkage between the capability gaps used to prioritize investments across much of NASA, and the Human System Risks that are primarily used to inform and prioritize human research. This set of twenty-eight gaps was developed by subject matter experts, and each gap mapped to the primary associated Human System Risks. The gaps and risk mapping were then reviewed and approved via the HSRB, thereby formally aligning the research-focused Human System Risks with the technology-focused capability gaps. DISCUSSION: This effort has enabled development of integrated roadmaps and budget coordination with research and technology development activities that are formally linked to agency-recognized capability gaps and Human System Risks. Close and ongoing coordination between the SCLT, HRP, Mars Campaign Office, and the Health & Medical Technical Authority (HMTA) is essential to ensure alignment and prioritization of CHP-related research and technology development to enable NASA’s future exploration missions.

Andrew F J Abercromby↗

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, reduce risk, and support safe, productive human space missions. Through the powerful emerging computer science approaches of artificial intelligence (AI) and machine learning (ML), a paradigm shift has begun in biomedical science and engineered astronaut health systems, to enable Earth-independence and autonomy of mission operations. We present a decadal view of AI/ML architecture to support deep space mission goals, developed in concert with leaders in the field. We describe current AI/ML methods to support 1) fundamental biology, 2) in situ analytics, 3) high performance computing hardware, 4) automated science, 5) self-driving labs, 6) remote data management, 7) integrated real-time mission biomonitoring, and 8) a Precision Space Health system. Cutting-edge 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 field to address key challenges of small sample n, high feature count, heterogeneity, and sparse data. These include 1) connecting omics data to phenotypic data using an ensemble model to infer causality of spaceflight rodent liver health disruption, 2) usage of explainable ML to interrogate the muscular underpinnings of spaceflight muscle atrophy, 3) ML models analyzing and determining directed acyclic graphs of human space 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 interaction networks, and 5) a suite of benchmarked open science datasets (spaceflight mouse liver; radiation DNA damage) enabling programmers to identify the best ML algorithms to answer space biological science questions.

space biology↗

ECLSS Evolution

Environmental Control and Life Support Systems (ECLSS) Evolution is comprised of a large portfolio of projects funded by the Mars Campaign Office (MCO) and is focused on the following: - Utilize ISS as a testbed to determine and refine ECLSS gaps - Develop technologies to close ECLSS gaps - Improve performance and reliability of ECLS systems - Prove out integrated system in relevant environment for long duration - Test representative system on ground to increase overall data set

ECLSS↗

Exploration Atmosphere Demonstration of A Multi-Functional Integrated Medical Device (Tempus Pro)

INTRODUCTION The Exploration Medical Capability (ExMC) element within the Human Research Program and the Exploration Medical Integrated Product Team (XMIPT) within the Mars Campaign Office seek to advance medical system design and risk-informed decision-making for exploration missions. This includes assessment of candidate devices and their compatibility within a variety of increasingly Earth-independent medical scenarios. The Tempus Pro (Remote Diagnostic Technologies, Ltd., Philips Corp., Farnborough, UK) is a commercial-off-the-shelf (COTS), multi-functional integrated medical device capable of vital signs monitoring, with built-in procedure support (iAssist), patient record and telemedicine communication features, and medical imaging (e.g., camera, laryngoscope, ultrasound) that meets multiple exploration medical capability needs. One of several hypobaric atmospheres being considered for exploration vehicles is 8.2 psi with 34% oxygen. To assess the useability of the Tempus Pro in such environments by individuals without formal medical training, the unit was tested in May and June of 2023 at the Johnson Space Center 20-Foot Exploration Atmosphere Chamber in conjunction with the Exploration Atmospheres-2 (EA-2) study. TECHNOLOGY DEMONSTRATION Eight subjects in the EA-2 study were assigned roles as the caregiver or patient – or both in the case of a self-exam – and caregivers were asked to place sensors for 3-Lead ECG, non-invasive blood pressure (NIBP), pulse oximetry (SpO2), and temperature using Tempus Pro’s iAssist. Depending on the procedure, additional tasks included an oropharyngeal exam of the throat with the laryngoscope and capturing ultrasound images of a cardiac subxiphoid view or of the user’s choice from a pre-specified list. Scenarios ranged from remote-guided to fully autonomous operations and surveyed the effectiveness of support, amount of support desired, and importance of support by type (e.g., written crew procedures, iAssist and device guidance, remote console guidance, etc.). Feedback from the subjects and the support personnel was also gathered to inform future designs for training and support and to determine what operations are plausible given different levels of each. An unweighted NASA task load index (TLX) was used to profile the demands of using the device, however the sample size does not support statistics. The research was exploratory in nature and qualitative information was the main goal. Calibration checks on the Tempus Pro were conducted before and after chamber testing to ensure the device was in useable condition. RESULTS All subjects performed their tasks successfully and found the Tempus Pro easy to use with the support provided. The calibration checks outside the chamber showed that the Tempus Pro remained unchanged and measurements inside the chamber were within normal values. Caregivers taking the NASA TLX reported mean scores ≤ 41/100 showing the tasks to be undemanding and less demanding with repeated use (~20/100). Novice users were able to easily connect sensors and take vital signs with the guidance from Tempus Pro’s iAssist feature. For more complex tasks, such as the oropharyngeal exam and ultrasound image acquisition, guidance beyond iAssist was needed, primarily from a supporting physician. Feedback on the importance of support types varied by person and scenario but greater than 50% of the support used by each was non-native to the device. Overall opinions were positive, but the ultrasound users expressed a lack of confidence in their results and 3 out of 4 desired more time, training, or support. Subjects found the sensors to be comfortable and comparable to prior experiences with such devices, except for the blood pressure cuff, which squeezed too tightly for uncomfortably long periods. Many observations provoked discussion, especially regarding ultrasound, that will aide decisions about future demonstrations.

R. S. Miller↗

Investigation of Hardware and Instrumentation to Measure Hand Grasp Activity with the Spacesuit Gloves

Introduction: During the 2022 suited injury summit, it was hypothesized that there will be concerns for hand and glove injuries for future exploration space missions, especially given the fact that the “total number of Extravehicular activity (EVA) hours and frequency” for lunar surface missions is expected to vastly increase [1]. It has been reported that the hands experienced the greatest “absolute numbers” of reported injuries and far exceeds other injuries during EVA [1, 2]. It was reported that the most fatiguing part of the surface EVA was the repetitive gripping tasks [3]. It was recommended that a “glove sub-team” be created to look at possible injury mechanism and mitigation strategies. Some of the recommendations that were suggested [1] are as follows: examine hand fatigue, utilize motion capture, examine the duration and frequency of hand movements, and identify frequent hand motions. We started assessing hardware and instrumentation to measure hand grasp activity in the pressurized glove environment. The purpose of this test was to perform a hardware evaluation for motion capture (MoCap) gloves obtained from StretchSense (Auckland, New Zealand). The specific gloves used were the Pro Fidelity and SuperSplay to determine the repeatability, reliability, feasibility, and useability inside of a pressurized gloved environment. Methods: The MoCap gloves were customized (e.g., battery/Bluetooth pack relocated to upper arm) to better suit the pressurized testing environment and protect the subject from unintentional injury (Fig. 1). Fourteen total subjects from different demographics (i.e., gender and pressurized glove experience level) participated in this test series. Testing included one session each of a baseline data collection (NASA Johnson Space Center (JSC) building 21) and a spacesuit glove box (Fig. 2 at JSC building 7 room 2027) data collection (under vacuum down to 4.3 psid), where each session lasted 3-5 hours. Controlled and reproducible tasks to systematically evaluate the repeatability and reliability of the hardware were performed during baseline data collection. Additionally, subjects performed simulated EVA-like tasks in a pressurized gloved environment. For all sessions, MoCap gloves were placed on each of the subjects’ hands and the signal from it, or the raw capacitance (Fig. 3), was analysed. The raw capacitance was used to estimate the open and closed hand states between the testing conditions and allow us to provide an offset caused by the pressurized environment. Results & Discussion: Initial observation with the bare hands (baseline) condition showed that the MoCap gloves appeared to track grasping and releasing of the fingers (opening and closing fist) with both high- and low-speed conditions, while adduction and abduction of the fingers were not relatively tracked. A hardware evaluation was done outside of the glove box to assess the reliability and repeatability of the MoCap glove. In one task, a point force was applied to various locations on the back of the hand. When the point force was applied to the space between the 1st digit and the pointer finger, there was a noticeable distortion to the MoCap data. Another task examining an increasing force from a 10 lb. sandbag applied to the back of the hand while lying flat on a table, showed a constant flat line with only a distortion when the weight was increased or added to the back of the hand. Fig. 3 shows an object relocation task where you can see when each individual finger “opened” and “closed” (changed position) when picking up and setting down the dumbbell. When the fingers were stationary, the signal remained relatively flat compared to the peaks and valleys that can be observed in Fig. 3. This study showed promising results and imperative input into an attempt to discriminate between hand states across various functional tasks and should be evaluated with context to the repeatability and reliability outcomes. Depending on the task done inside of the pressurized glove box environment and outside, the results appear to be affected by many different factors (i.e., drift, pressure, hand size, etc.). Significance: If this hardware proves to be reliable and repeatable in determining the open and closed hand states then this may provide critical insight into assisting in the characterization of the pressurized gloved environment and the effect on crew member exertion level. Ultimately, this tool will provide useful data for quantifying the repetitive nature of EVA training and tasks. Acknowledgments: The authors would like to acknowledge the NASA Mars Campaign Office for providing funding for this research. Lastly, thanks to all the engineers and technicians at NASA JSC who helped with this data collection. References: [1] Reiber, et al. (2022), NASA/TM-20220007605; [2] Scheuring, et al. (2009), Av., Sp., and Envir. Med. 80(2). [3] Scheuring, et al. (2007), NASA/TM–2007–214755.

Rachel L Thompson↗

ISS Technology Demonstrations for Future Spaceflight Medical Systems

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

Astronaut health and performance↗

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, reduce risk, and support safe, productive human space missions. Through the powerful emerging approaches of artificial intelligence (AI) and machine learning (ML), a paradigm shift has begun in biomedical science and engineered astronaut health systems, to enable Earth independence and autonomy of mission operations. Here we present an overview of AI/ML architecture to support deep space mission goals, developed with leaders in the field. First, we focus on the fundamental biological research that supports our understanding of physiological responses to spaceflight, and we describe current efforts to support AI/ML research including data standardization and data engineering through maximally open and FAIR (findable, accessible, interoperable, reusable) databases and the generation of AI-ready datasets for reuse and analysis. We also discuss remote data management frameworks for research data as well as environmental and health data that are generated during deep space missions. We highlight several research projects that leverage data standardization and management for fundamental biological discovery to uncover the complex effects of space travel on living systems. Next, we provide an overview of cutting-edge AI/ML approaches that can be integrated to support remote monitoring and analysis during deep space missions, including generative models and large language models to learn the underlying biomedical patterns and predict outcomes or answer questions during off world medical scenarios. We also describe current AI/ML methods to support this research and monitoring through automated cloud-based labs which enable limited human intervention and closed-loop experimentation in remote settings. These labs could support mission autonomy by analyzing environmental data streams, and would be facilitated through in situ analytics capabilities to avoid sending large raw data files through low bandwidth communications. Finally, in the context of deep space missions with limited communications or access to medical advice from Earth, we describe a solution for integrated, real-time mission biomonitoring across hierarchical levels from continuous environmental monitoring, to wearables and point-of-care devices, to molecular and physiological monitoring. We introduce a precision space health system that will ensure that the future of space health is predictive, preventative, participatory and personalized.

artificial intelligence↗

Evaluation of Markerless Motion Capture for Monitoring Sensorimotor Performance

BACKGROUND Astronauts returning from long-duration exposure to microgravity frequently exhibit alterations in sensorimotor function leading to postural imbalance, impaired locomotion, and operational challenges to manual control. Mission duration and individual responses often influence both the severity of performance decrements and the variability in adaptation timelines. Postflight disruptions during functional tasks are often detected through body-worn inertial measurement unit (IMU) devices. While IMU sensors are relatively compact, the long-term wear may lead to discomfort, displacement of the sensors on the body, and restrictions in movement or crew behavior. Although IMU data offers valuable insights from a research standpoint, interpreting changes in pre- and post-flight measures can be difficult for crew support personnel beyond the research domain, which can hinder the application for medical assessments and rehabilitation. Finally, the availability of inertial sensors in-flight is limited. There is a need for unobtrusive monitoring tools to improve our ability to monitor adaptation following gravitational transitions in various postflight evaluations and rehabilitation settings. Markerless motion capture (MMC) is an evolving unobtrusive technology that builds upon decades of research with marker-based motion capture systems to provide 3D human pose estimation from multiple synchronized 2D camera views using deep learning algorithms. Markerless technology can revolutionize how data is captured pre- and post-flight and potentially in-flight during intravehicular activity by enabling pose estimation of multiple crew members from onboard camera hardware. METHODS The following presents the initial evaluation of a state-of-the-art commercial-off-the-shelf MMC system, Theia Markerless, compared to IMU devices during various ground-based functional tasks and environmental conditions. The featured functional tasks include assessments from Human Research Program (HRP) funded studies such as Sensorimotor Standard Measures and Sensorimotor Assessments. Synchronous data collected using both motion capture and IMUs are analyzed for six male and female subjects of varying anthropometry. The analysis includes limited assessments of clothing, capture volume configurations, and the tool's sensitivity to detecting performance changes after a spaceflight analog centrifuge exposure. The development of visualization tools to enhance the application of the pose estimation output is also presented. RESULTS Initial results demonstrate comparable root mean square error (RMSE) to existing literature evaluating markerless and marker-based motion capture systems. Considering the relative functional range of motion of the cervical spine, normalized error values for the markerless system’s accuracy of the head was 0.032 in pitch, 0.025 in roll, and 0.018 in yaw plane of motion across a subset of functional tasks. The raw RMSE values were 3.49, 2.25, and 2.81 degrees respectively. For the torso, results suggest normalized errors of 0.469 in pitch, 0.191 in roll, and 0.307 in yaw planes of motion and raw RMSE values of 3.52, 1.53, and 3.07 degrees respectively. The data suggests the functional demands of a particular task influences the estimation accuracy of the MMC system where more dynamic motion and cases where subjects are not upright may introduce diminished tracking accuracy. DISCUSSION The following work lays the foundation for future implementations leveraging markerless motion capture to assess the time course of recovery and provide insight for rehabilitation protocols to enhance crew readiness for the resumption of daily activities. These tools offer effective methods for anonymizing sensitive crew data, facilitating numerous applications across research, medical, and rehabilitation groups. Collaborations with the Anthropometry and Biomechanics Facility will provide further comparisons of the Markerless system to a marker-based system. ACKNOWLEDGEMENT</ This work is supported by NASA’s Exploration Systems Development Mission Directorate Mars Campaign Office Crew Health Countermeasures.

Hannah M. Weiss↗

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

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

C A Haddix↗

Radiation-Tolerant Displays

The Radiation Tolerant Displays project aims to develop a reference design for a display system that can withstand and mitigate the effects of radiation in deep space. Radiation Tolerant Displays seeks to deliver on this goal through a collaboration across industry and agency and by building upon the Mars Campaign Office’s (MCO) Project Polaris Radiation Tolerant Displays effort.

Geraldo Cisneros↗

Custom Integration of Multiple Medical Functionalities

INTRODUCTION: Previous spaceflight experience and results from probabilistic risk assessment of spaceflight medical risk have highlighted the need for vital sign measurements, medical scopes, and clinical imaging tools for managing medical conditions during spaceflight. The Human Research Program’s Exploration Medical Capability (ExMC) Element and the Mars Campaign Office’s Exploration Medical Integrated Product Team (XMIPT) have performed ground-based evaluations of two Commercial-off-the-Shelf (COTS) Multi-functional Integrated Medical (MIM) devices, which integrate various medical capabilities together in one device. The key findings from these evaluations are presented in a complementary presentation, leaving this presentation to focus on forward recommendations for customized integration of multiple medical functionalities. KEY COMPONENTS: The key features of a custom integration of multiple medical functionalities includes devices and capabilities that optimally reduce medical risk. The COTS MIM devices incorporated functionality for best supporting Earth-based, emergency, pre-hospital care. Our custom integration will use probabilistic risk assessment tools, such as the Medical Extensible Dynamic Probabilistic Risk Assessment Tool (MEDPRAT), to determine the optimal functionality to include based on medical risk minimization. An additional feature of custom integration includes the ability to adapt to different requirements within different vehicles and/or missions. The COTS MIM devices store data in patient specific records, however, the format of the records is not modifiable, and data are not easily transferred from the MIM device to a central data architecture outside of the manufacturer’s established system. Our concept for custom integration will use devices that have an open application programming interface, which can easily connect to independent data architectures and third-party visualization software. The ultrasound capabilities included within the COTS MIM devices did not satisfy many of the Artemis Research and Operations Working Group’s ultrasound functional needs, and therefore, incorporation of higher quality ultrasound capabilities within a customized integration will be beneficial. The COTS MIM devices included minimal procedural guidance and clinical decision support tools. Supplemental tools of this type would need to be supplied along with the COTS MIM devices if they were to be used operationally, so another advantage of customization is the ability to integrate these support tools along with the medical functionality, for a more streamlined user experience. CONCLUSION: Investigation of a customized integration of medical functionality provides a method for further understanding the needs of a long-term exploration spaceflight medical system. The crew members of these exploration missions will need to operate more and more independently from Earth-based ground support. Therefore, having an optimized, streamlined medical system, which contains the functionality and supporting information needed, while remaining within mission and vehicle constraints, will help to maintain crew health and performance, which is necessary for achieving high levels of mission success.

B E Lewandowski↗

Exploration Medical Integrated Product Team Clinical Decision Support Market Survey

NASA’s Exploration Medical Integrated Product Team (XMIPT) has identified Clinical Decision Support (CDS) technology as a critical need for future human space exploration. Such technology will support real time diagnosis, monitoring, and treatment of spaceflight medical conditions. The need for such tools and support systems is critical for in-mission clinical decision-making, especially when Earth-based support is unavailable due to communication delays or blackouts. Supporting technologies may or may not involve Artificial Intelligence (AI), and would support astronaut crew with minimal clinical training, or even those with advanced training if they are, for example, in need of a refresher, experiencing multiple stressors, or temporarily overloaded with tasking. This need traces to the Development of Earth Independent Operations Technologies for NASA’s Mars Campaign Office. The CDS Market Survey purpose, methods, outcomes thus far, and near-term steps will be discussed.

Decision support↗

Improvement of Odor Control for the UWMS Hard-Sided Fecal Canister and the Alternate Fecal Canister

On longer range exploration missions, the mass and volume of critical hardware and consumables required to support crew will pose a big stowage challenge. This includes the hardware for the collection and storage of human metabolic solid waste. The amount of stowage needed for this hardware both before (empty) and after (full) use will be a significant burden on the overall spacecraft habitable volume, layout, and design. To help with this challenge, the National Aeronautics and Space Administration (NASA) Mars Campaign Office (MCO) Logistics Reduction (LR) Portfolio has developed a collapsible canister for the collection and containment of fecal deposits. The Alternate Fecal Canister (AFC) is a collapsible alternative to the exploration toilet Hard-sided Fecal Canister (HFC). The AFC in its empty state has a volumetric benefit to smaller vehicles on longer missions. The current designs for HFC and AFC were tested with human fecal material for odor containment at White Sands Test Facility (WSTF) where the tests on both were unsuccessful. The source of the lack of containment was isolated to a gasket used on both HFC and AFC. The gasket used was found to be open cell in design. This paper provides a summary of the materials selection and testing process to identify a replacement gasket material with the intention to replace the gaskets on both existing units as well as incorporate it into the designs going forward for future builds for exploration. Details will be provided on the design of the canisters interface with the odor bacteria lid which led to the selection of the thickness of the desired replacement. Finally, the paper will provide an update on the testing in advance of a return to WSTF for final testing and detail plans to complete testing and perform a demonstration on ISS with UWMS.

ECLSS↗

Improvement of Odor Control for the UWMS Hard-Sided Fecal Canister and the Alternate Fecal Canister

On longer range exploration missions, the mass and volume of critical hardware and consumables required to support crew will pose a big stowage challenge. This includes the hardware for the collection and storage of human metabolic solid waste. The amount of stowage needed for this hardware both before (empty) and after (full) use will be a significant burden on the overall spacecraft habitable volume, layout, and design. To help with this challenge, the National Aeronautics and Space Administration (NASA) Mars Campaign Office (MCO) Logistics Reduction (LR) Portfolio has developed a collapsible canister for the collection and containment of fecal deposits. The Alternate Fecal Canister (AFC) is a collapsible alternative to the exploration toilet Hard-sided Fecal Canister (HFC). The AFC in its empty state has a volumetric benefit to smaller vehicles on longer missions. The current designs for HFC and AFC were tested with human fecal material for odor containment at White Sands Test Facility (WSTF) where the tests on both were unsuccessful. The source of the lack of containment was isolated to a gasket used on both HFC and AFC. The gasket used was found to be open cell in design. This paper provides a summary of the materials selection and testing process to identify a replacement gasket material with the intention to replace the gaskets on both existing units as well as incorporate it into the designs going forward for future builds for exploration. Details will be provided on the design of the canisters interface with the odor bacteria lid which led to the selection of the thickness of the desired replacement. Finally, the paper will provide an update on the testing in advance of a return to WSTF for final testing and detail plans to complete testing and perform a demonstration on ISS with UWMS.

Toilet↗