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At least 145 records · Page 8

Health care delivery system for long duration manned space operations

Specific requirements for medical support of a long-duration manned facility in a low earth orbit derive from inflight medical experience, projected medical scenarios, mission related spacecraft and environmental hazards, health maintenance, and preventive medicine. A sequential buildup of medical capabilities tailored to increasing mission complexity is proposed. The space station health maintenance facility must provide preventive, diagnostic, and therapeutic medical support as immediate rescue capability may not exist.

Logan, J. S.↗

Knowledge Based Systems: A Critical Survey of Major Concepts, Issues, and Techniques

This Working Paper Series entry presents a detailed survey of knowledge based systems. After being in a relatively dormant state for many years, only recently is Artificial Intelligence (AI) - that branch of computer science that attempts to have machines emulate intelligent behavior - accomplishing practical results. Most of these results can be attributed to the design and use of Knowledge-Based Systems, KBSs (or ecpert systems) - problem solving computer programs that can reach a level of performance comparable to that of a human expert in some specialized problem domain. These systems can act as a consultant for various requirements like medical diagnosis, military threat analysis, project risk assessment, etc. These systems possess knowledge to enable them to make intelligent desisions. They are, however, not meant to replace the human specialists in any particular domain. A critical survey of recent work in interactive KBSs is reported. A case study (MYCIN) of a KBS, a list of existing KBSs, and an introduction to the Japanese Fifth Generation Computer Project are provided as appendices. Finally, an extensive set of KBS-related references is provided at the end of the report.

Dominick, Wayne D.↗

Gender and Decompression Sickness: A Critical Review and Analysis

The author addressed the following questions: are women at greater risk of decompression sickness and venous gas emboli at certain times in their reproductive cycle, is risk modified by the use of birth control pills (BCP), and is there a difference in overall risk between men and women under the same decompression dose? The summary considers information from the few abstracts and reports that were available. Except for the observation of more Type II DCS in women, particularly in women who fly after diving, there was no compelling evidence of a difference in DCS risk between men and women SCUBA divers. Many women that presented with DCS symptoms seemed to be in or near menses, with statistically fewer cases reported as time increased from menses. There was no compelling evidence that the use of BCP in SCUBA divers increases the risk of DCS. There were insufficient data about VGE from SCUBA diving to make any conclusion about the incidence of VGE and gender. In contrast, there were ample data about VGE from research in altitude chambers. Women produced less VGE and less Grade IV VGE compared to men under the same decompression dose, certainly when resting oxygen prebreathe (PB) was performed prior to ascent to altitude. Dual-cycle ergometry exercise during PB tends to reduce the differences in VGE between men and women. There was no compelling evidence that the risk of altitude DCS was different between men and women. However, a large number of DCS cases were associated with menses, and the use of BCP did seem to put women at a slightly greater risk than those that did not use BCP. There were substantial observations that women comprised a larger number of difficult cases that required complicated medical management.

Source record↗

Medical Updates Number 5 to the International Space Station Probability Risk Assessment (PRA) Model Using the Integrated Medical Model

The Integrated Medical Model (IMM) Project has been developing a probabilistic risk assessment tool, the IMM, to help evaluate in-flight crew health needs and impacts to the mission due to medical events. This package is a follow-up to a data package provided in June 2009. The IMM currently represents 83 medical conditions and associated ISS resources required to mitigate medical events. IMM end state forecasts relevant to the ISS PRA model include evacuation (EVAC) and loss of crew life (LOCL). The current version of the IMM provides the basis for the operational version of IMM expected in the January 2011 timeframe. The objectives of this data package are: 1. To provide a preliminary understanding of medical risk data used to update the ISS PRA Model. The IMM has had limited validation and an initial characterization of maturity has been completed using NASA STD 7009 Standard for Models and Simulation. The IMM has been internally validated by IMM personnel but has not been validated by an independent body external to the IMM Project. 2. To support a continued dialogue between the ISS PRA and IMM teams. To ensure accurate data interpretation, and that IMM output format and content meets the needs of the ISS Risk Management Office and ISS PRA Model, periodic discussions are anticipated between the risk teams. 3. To help assess the differences between the current ISS PRA and IMM medical risk forecasts of EVAC and LOCL. Follow-on activities are anticipated based on the differences between the current ISS PRA medical risk data and the latest medical risk data produced by IMM.

Butler, Doug↗

Technology Development to Support Human Health and Performance in Exploration Beyond Low Earth Orbit

In the course of defining the level of risks and mitigating the risks for exploration missions beyond low Earth orbit, NASA s Human Research Program (HRP) has identified the need for technology development in several areas. Long duration missions increase the risk of serious medical conditions due to limited options for return to Earth; no resupply; highly limited mass, power, volume; and communication delays. New space flight compatible medical capabilities required include: diagnostic imaging, oxygen concentrator, ventilator, laboratory analysis (saliva, blood, urine), kidney stone diagnosis & treatment, IV solution preparation and delivery. Maintenance of behavioral health in such an isolated, confined and extreme environment requires new sensory stimulation (e.g., virtual reality) technology. Unobtrusive monitoring of behavioral health and treatment methods are also required. Prolonged exposure to weightlessness deconditions bone, muscle, and the cardiovascular system. Novel exercise equipment or artificial gravity are necessary to prevent deconditioning. Monitoring of the degree of deconditioning is required to ensure that countermeasures are effective. New technologies are required in all the habitable volumes (e.g., suit, capsule, habitat, exploration vehicle, lander) to provide an adequate food system, and to meet human environmental standards for air, water, and surface contamination. Communication delays require the crew to be more autonomous. Onboard decision support tools that assist crew with real-time detection and diagnosis of vehicle and habitat operational anomalies will enable greater autonomy. Multi-use shield systems are required to provide shielding from solar particle events. The HRP is pursuing the development of these technologies in laboratories, flight analog environments and the ISS so that the human health and performance risks will be acceptable with the available resources.

Kundrot, C.E.↗

Arusha Rover Deployable Medical Workstation

The NSBE Arusha rover concept offers a means of human transport and habitation during long-term exploration missions on the moon. This conceptual rover calls for the availability of medical supplies and equipment for crew members in order to aid in mission success. This paper addresses the need for a dedicated medical work station aboard the Arusha rover. The project team investigated multiple options for implementing a feasible deployable station to address both the medical and workstation layout needs of the rover and crew. Based on layout specifications and medical workstation requirements, the team has proposed a deployable workstation concept that can be accommodated within the volumetric constraints of the Arusha rover spacecraft

Rover↗

Capabilities, Calibration, and Impact of the ISS-RAD Fast Neutron Detector

In the current NASA crew radiation health risk assessment framework, estimates for the neutron contributions to crew radiation exposure largely rely on simulated data with sizeable uncertainties due to the lack of experimental measurements inside the ISS. Integrated in the ISS-RAD instrument, the ISS-RAD Fast Neutron Detector (FND) will deploy to the ISS on one of the next cargo supply missions. Together with the ISS-RAD Charged Particle Detector, the FND will perform, for the first time, routine and precise direct neutron measurements inside the ISS between 0.5 and 80 MeV. The measurements will close the NASA Medical Operations Requirement to monitor neutrons inside the ISS and impact crew radiation health risk assessments by reducing uncertainties on the neutron contribution to crew exposure, enabling more efficient mission planning. The presentation will focus on the FND detection mechanism, calibration results and expectations about the FND's interaction with the mixed radiation field inside the ISS.

Leitgab, Martin↗

Exploration Medical System Technical Development

The Exploration Medical Capability (ExMC) Element systems engineering goals include defining the technical system needed to implement exploration medical capabilities for Mars. This past year, scenarios captured in the medical system concept of operations laid the foundation for systems engineering technical development work. The systems engineering team analyzed scenario content to identify interactions between the medical system, crewmembers, the exploration vehicle, and the ground system. This enabled the definition of functions the medical system must provide and interfaces to crewmembers and other systems. These analyses additionally lead to the development of a conceptual medical system architecture. The work supports the ExMC community-wide understanding of the functional exploration needs to be met by the medical system, the subsequent development of medical system requirements, and the system verification and validation approach utilizing terrestrial analogs and precursor exploration missions.

McGuire, K.↗

Derivation of Capabilities and Resources for Treating Medical Conditions in Deep Space

BACKGROUND: Medical care in spaceflight requires the adaptation of terrestrial standards to the constraints of the space environment. However, there is often conflict between the ideal resources required for treatment and diagnosis of a medical condition, and the constraints on their mass, volume, data needs, etc. This optimization of trades between medical risk and resources will be a significant challenge for deep space medical system design. METHODS: A team of physicians with a broad range of expertise reviewed the 120 medical conditions on the condition list for NASA’s Informing Mission Planning via analysis of Complex Tradespaces Medical Database (IMPACT-MD). Each team member was assigned a subset of conditions based on their experience and training. The assigned physician generated a proposed list of capabilities, definitions, and resources required to treat each condition based on terrestrial practice guidelines, medical literature, and subject matter expertise. Additional specialists were consulted for conditions where expertise was not present within the main group. The proposed list was then reviewed by the broader team and modified as needed to achieve consensus. Each capability and resource was then assigned parameters to define quantity required per medical event, necessity, training level required, and primacy order of any alternative resources. These capabilities and resources were placed into condition specific tables and delivered to a team of engineers who added mass and volume data for each specific resource and converted the table into a database for use as input to a computational model to simulate spaceflight (IMPACT) DISCUSSION: This process ensures that a minimum of three subject matter experts review and agree upon the scope of practice, medical diagnostic tools, and treatment modalities that would be necessary to address emergent and non-emergent conditions that may arise during spaceflight to inform requirements during the vehicle design phase. The method is scalable to any design reference mission and permits modification of the existing database as information, conditions or experience are added. By including specialists, generalists, and those with subject matter expertise in the spaceflight environment on the team, we ensure that the included capabilities represent a realistic and actionable foundation for planning deep space missions.

D R Levin↗

Intravenous Fluid Generation Mini (IVGEN Mini) Summary and Related Research

This paper assists the ongoing effort to support NASA Glenn’s mission and its Human Research Program (HRP) core competency by investigating a technology demonstration to mitigate human health and performance risks during space exploration. Crew health and performance are critical to successful human exploration beyond low Earth orbit. Four hundred forty-two medical conditions have been identified and may present and require treatment during long-duration space exploration missions. One hundred fifteen out of four hundred forty-two identified medical conditions would require medical fluid treatment, generating a need for an on-demand or continuous supply of medical fluid. Intravenous Fluid Generation Mini (IVGEN Mini) is a technology demonstration designed to demonstrate a water purification and pharmaceutical mixing system that can make intravenous (IV) fluid in microgravity and builds on the success of the original Intravenous Fluid Generation for Exploration Missions (IVGEN) experiment, which flew on the ISS in March 2010. IVGEN Mini seeks to increase the Technology Readiness Level (TRL) and the overall function of the original IVGEN experiment to reduce the dependence of a needed medical consumable and streamline the size of the device and process to generate IV fluid IVGEN Mini is funded by the Advanced Exploration Systems (AES) directorate via the Exploration Medical Integrated Product Team (XMIPT) as a part of their mission to advance exploration medical technologies to benefit the overall health and safety of crews for beyond low Earth orbit space missions. This paper discusses a collection of related research topics such as microgravity fluid mixing and studying past efforts of IV fluid usage in extreme environments to aid IVGEN Mini project scientists in developing the IVGEN Mini technology.

iv generation↗

Developing a Medical System Concept of Operations for Level of Care IV: Long-Duration Lunar Orbital and Surface Operations

A 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 a mission with lunar orbital and long duration surface operations. The medical system concept of operations (ConOps) is the starting point of creating a foundation for a medical system that meets Level of Care IV requirements, as defined by NASA’s space flight human-system standards. This ConOps illustrates how NASA can provide a Level of Care IV medical system for crews within the various cis-lunar orbit and lunar surface habitat environments. The use case scenarios included in this 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. This discussion will focus on how this concept of operations was constructed – by utilizing the lessons learned from ExMC’s existing Short-Duration Lunar Orbit Medical System Concept of Operations, by employing Model-Based Systems Engineering, and by collaborating with stakeholders in order to ensure the necessary assumptions were made.

M. Kaetzer↗

To develop a spectral analyzer for physiological and medical use

Scientific requirements necessary to develop a spectral analyzer for monitoring mammalian subjects, are discussed. The analyzer measures dynamic or time dependent data as a measure of the subjects operating status. Measurable data include metabolic rate, body temperature, and blood constituents like glucose, oxygen, and carbon dioxide, and lactic acid. Metabolic cycles were found with periodicities in the range of minutes and hours; longer cycles in body weight (3 1/2 days and 60 days), indicative of metabolic processes, were also found.

Iberall, A.↗

An Automated Medical Inventory System (AMIS) to Enable Earth-Independent Medical Operations

BACKGROUND: Inventory of medical consumables and durables (medications, treatment aids, diagnostic equipment, etc.) aboard the International Space Station is a manual process whereby crewmembers reach out to their flight surgeon to relay when items are used. Performing a full medical system inventory is time intensive. However, as exploration progresses to long duration missions with little to no resupply or evacuation capabilities, maintaining an accurate account of inventory and location for medical systems across the mission will become increasingly critical. A new system must be developed for future exploration missions to meet the need for a crew-facing, real time method of managing medical inventory. OVERVIEW: NASA’s Exploration Medical Integrated Product Team (XMIPT) is funding the AMIS project to mature the technology readiness level and to conduct a flight demonstration of a medical inventory capability. AMIS will leverage lessons learned from a Medical Consumables Tracking project previously demonstrated aboard the ISS in 2016 and 2017. Key components of AMIS include a database, supporting hardware and software, and interfaces to power, communications, or other vehicle or medical systems. Some medical inventory capability may be provided by the vehicle inventory management system which relies upon RFID-based technology and can track larger items such as medical kits or medical hardware. AMIS will augment these capabilities to enable tracking of individual medical kit contents. Efforts are underway to characterize the optimal solution trade space by comparing system specifications (e.g. mass and volume, etc.) across maintenance and operational use cases (e.g. crew time saved, total inventory automated, etc). DISCUSSION: The contents of a Mars Medical System have not been fully defined which poses challenges to defining an inventory system and requires assumptions regarding medical kit contents and medical system design. Other important considerations include minimizing crew time required, avoiding access restrictions to medical inventory in the event of an emergency, and ensuring that data is accessible to other medical system elements to enable crew autonomy in provision of medical care.

Automated Medical Inventory System↗

Multi-Objective Optimization of Uranium Target Assembly–3: A Comparison of Genetic and Traditional Methods

Commonly produced as a byproduct of uranium fission, 99 Mo is a key medical isotope that is in high demand in the United States. An international goal is to switch from medical isotope production technologies that require highly enriched uranium to medical isotope production technologies that require only low-enriched uranium. Niowave Inc. is contributing to this goal by developing an accelerator-driven subcritical assembly called the Uranium Target Assembly (UTA). This work compares the performance of Dakota’s Multi-Objective Genetic Algorithm (MOGA) against traditional sensitivity analysis in the neutronic optimization of the UTA-3 system. The design objectives are k-eigenvalue (k eff ) and natural uranium fission power, which are directly correlated with the amount of 99 Mo produced. Dakota:MOGA did not perform as well as human engineering ingenuity in optimization studies with high numbers of input parameters, such as fuel rod type selection and fuel rod placement. However, Dakota:MOGA did outperform traditional sensitivity analysis in optimization studies with fewer than 20 parameters and revealed the degree to which each parameter influences the optimal design space for k eff and natural uranium fission power (to a lesser extent). As the design model became more complex in the final stage of design, the computational resources required to calculate the design objective values in the Monte Carlo N-Particle transport code from selected input parameter combinations limited Dakota:MOGA’s performance, and, unfortunately, human intervention was required to discern the optimal design space. In conclusion, future work will attempt to reduce computational resource constraints by incorporating areduced-order neutronics model into the optimization cycle.

Accelerator-driven systems↗

Haughton-Mars Project/NASA 2006 Lunar Medical Contingency Simulation: Equipment and Methods for Medical Evacuation of an Injured Crewmember

Introduction: Achieving NASA's Space Exploration Vision scientific objectives will require human access into cratered and uneven terrain for the purpose of sample acquisition to assess geological, and perhaps even biological features and experiments. Operational risk management is critical to safely conduct the anticipated tasks. This strategy, along with associated contingency plans, will be a driver of EVA system requirements. Therefore, a medical contingency EVA scenario was performed with the Haughton-Mars Project/NASA to develop belay and medical evacuation techniques for exploration and rescue respectively. Methods: A rescue system to allow two rescuer astronauts to evacuate one in incapacitated astronaut was evaluated. The systems main components were a hard-bottomed rescue litter, hand-operated winch, rope, ground picket anchors, and a rover-winch attachment adapter. Evaluation was performed on 15-25deg slopes of dirt with embedded rock. The winch was anchored either by adapter to the rover or by pickets hammered into the ground. The litter was pulled over the surface by rope attached to the winch. Results: The rescue system was utilized effectively to extract the injured astronaut up a slope and to a waiting rover for transport to a simulated habitat for advanced medical care, although several challenges to implementation were identified and overcome. Rotational stabilization of the winch was found to be important to get maximize mechanical advantage from the extraction system. Discussion: Further research and testing needs to be performed to be able to fully consider synergies with the other Exploration surface systems, in conducting contingency operations. Structural attachment points on the surface EVA suits may be critical to assist in incapacitated evacuation. Such attach points could be helpful in microgravity incapacitated crewmember transport as well. Wheeled utility carts or wheels that may be attachable to a litter may also aid in extraction and transport. Utilizing parts of the rover (e.g. seats) to deploy as a litter may be considered. Testing in simulated 1/6-g to determine feasibility of winch operation and anchor establishment will further reduce implementation uncertainties.

Chappell, S. P.↗

Exploration Medical Capability Medical Scenarios

Medical systems supporting exploration class missions to cislunar space, the lunar surface, and the vicinity of Mars require an evolution in medical capability beyond that available for today’s low Earth orbit centric paradigm. Progress in developing more capable medical systems will be driven by the requirements of prolonged mission duration, increasing distance from Earth, and the realities of orbital mechanics, all necessitating a concomitant need for progressively Earth independent medical decision-making capabilities. These medical systems (which include the crewmembers) are expected to be capable of evaluating, diagnosing, treating and managing a defined list of medical conditions as well as addressing unanticipated medical conditions that may arise. The prioritized medical capabilities and associated resources needed to treat these medical conditions and support anticipated inflight medical events provide robust content that informs system designers and allows for a more complete evaluation of both medical and overall mission risk. Communication of these medical capabilities to system, vehicle, and mission designers can be enhanced using scenarios that characterize the system’s operations. Carefully considered scenarios provide the context needed to explore expected human and system interfaces, roles of ground and inflight crew (including periods of interrupted or delayed communications), identify training needs, assess data needs, etc. Mission-based scenario content varies dependent upon the needs, medical capabilities, conditions and context they are intended to illustrate. This document explicitly seeks to capture and codify those scenarios that have been useful to the Exploration Medical Capability Element of the Human Research Program in defining the enhanced medical systems required for future space exploration. It is expected that this document will continue to evolve through the refinement and characterization of current and future scenarios, respectively, as our knowledge grows, and requirements increasingly focus on Earth independent spaceflight operations.

Derek M Nusbaum↗