Exploration Class Missions Research Articles

Machine learning workflow for edge computed arrhythmia detection in exploration class missions

Deep-space missions require preventative care methods based on predictive models for identifying in-space pathologies. Deploying such models requires flexible edge computing, which Open Neural Network Exchange (ONNX) formats enable by optimizing inference directly on wearable edge devices. This work demonstrates an innovative approach to point-of-care machine learning model pipelines by combining this capacity with an advanced self-optimizing training scheme to classify periods of Normal Sinus Rhythm (NSR), Atrial Fibrillation (AFIB), and Atrial Flutter (AFL). 742 h of electrocardiogram (ECG) recordings were pre-processed into 30-second normalized samples where variable mode decomposition purged muscle artifacts and instrumentation noise. Seventeen heart rate variability and morphological ECG features were extracted by convoluting peak detection with Gaussian distributions and delineating QRS complexes using discrete wavelet transforms. The decision tree classifier’s features, parameters, and hyperparameters were self-optimized through stratified triple nested cross-validation ranked on F1-scoring against cardiologist labeling. The selected model achieved a macro F1-score of 0.899 with 0.993 for NSR, 0.938 for AFIB, and 0.767 for AFL. The most important features included median P-wave amplitudes, PRR20, and mean heart rates. The ONNX-translated pipeline took 9.2 s/sample. This combination of our self-optimizing scheme and deployment use case of ONNX demonstrated overall accurate operational tachycardia detection.

The Space Omics and Medical Atlas (SOMA) and international astronaut biobank

Spaceflight induces molecular, cellular and physiological shifts in astronauts and poses myriad biomedical challenges to the human body, which are becoming increasingly relevant as more humans venture into space1–6. Yet current frameworks for aerospace medicine are nascent and lag far behind advancements in precision medicine on Earth, underscoring the need for rapid development of space medicine databases, tools and protocols. Here we present the Space Omics and Medical Atlas (SOMA), an integrated data and sample repository for clinical, cellular and multi-omic research profiles from a diverse range of missions, including the NASA Twins Study7, JAXA CFE study8,9, SpaceX Inspiration4 crew10–12, Axiom and Polaris. The SOMA resource represents a more than tenfold increase in publicly available human space omics data, with matched samples available from the Cornell Aerospace Medicine Biobank. The Atlas includes extensive molecular and physiological profiles encompassing genomics, epigenomics, transcriptomics, proteomics, metabolomics and microbiome datasets, which reveal some consistent features across missions, including cytokine shifts, telomere elongation and gene expression changes, as well as mission-specific molecular responses and links to orthologous, tissue-specific mouse datasets. Leveraging the datasets, tools and resources in SOMA can help to accelerate precision aerospace medicine, bringing needed health monitoring, risk mitigation and countermeasure data for upcoming lunar, Mars and exploration-class missions.

A second space age spanning omics, platforms and medicine across orbits.

The recent acceleration of commercial, private and multi-national spaceflight has created an unprecedented level of activity in low Earth orbit, concomitant with the largest-ever number of crewed missions entering space and preparations for exploration-class (lasting longer than one year) missions. Such rapid advancement into space from many new companies, countries and space-related entities has enabled a 'second space age'. This era is also poised to leverage, for the first time, modern tools and methods of molecular biology and precision medicine, thus enabling precision aerospace medicine for the crews. The applications of these biomedical technologies and algorithms are diverse, and encompass multi-omic, single-cell and spatial biology tools to investigate human and microbial responses to spaceflight. Additionally, they extend to the development of new imaging techniques, real-time cognitive assessments, physiological monitoring and personalized risk profiles tailored for astronauts. Furthermore, these technologies enable advancements in pharmacogenomics, as well as the identification of novel spaceflight biomarkers and the development of corresponding countermeasures. In this Perspective, we highlight some of the recent biomedical research from the National Aeronautics and Space Administration, Japan Aerospace Exploration Agency, European Space Agency and other space agencies, and detail the entrance of the commercial spaceflight sector (including SpaceX, Blue Origin, Axiom and Sierra Space) into aerospace medicine and space biology, the first aerospace medicine biobank, and various upcoming missions that will utilize these tools to ensure a permanent human presence beyond low Earth orbit, venturing out to other planets and moons.

An Augmented Reality Hand-Eye Sensorimotor Impairment Assessment for Spaceflight Operations.

INTRODUCTION: Following a transition from microgravity to a gravity-rich environment (e.g., Earth, Moon, or Mars), astronauts experience sensorimotor impairment, primarily from a reinterpretation of vestibular cues, which can impact their ability to perform mission-critical tasks. To enable future exploration-class missions, the development of lightweight, space-conscious assessments for astronauts transitioning between gravity environments without expert assistance is needed.METHODS: We examined differences in performance during a two-dimensional (2D) hand-eye multidirectional tapping task, implemented in augmented reality in subjects (N = 20) with and without the presence of a vestibular-dominated sensorimotor impairment paradigm: the binaural bipolar application of a pseudorandom galvanic vestibular stimulation (GVS) signal. Metrics associated with both the impairment paradigm and task performance were assessed.RESULTS: Medial-lateral sway during balance on an anterior-posterior sway-referenced platform with eyes closed was most affected by GVS (effect size: 1.2), in addition to anterior-posterior sway (effect size: 0.63) and the vestibular index (effect size: 0.65). During the augmented reality task, an increase in time to completion (effect size: 0.63), number of misses (effect size: 0.52), and head linear accelerations (effect size: 0.30) were found in the presence of the selected GVS waveform.DISCUSSION: Findings indicate that this multidirectional tapping task may detect emergent vestibular-dominated impairment (near landing day performance) in astronauts. Decrements in speed and accuracy indicate this impairment may hinder crews' ability to acquire known target locations while in a static standing posture. The ability to track these decrements can support mission operations decisions.Allred AR, Weiss H, Clark TK, Stirling L. An augmented reality hand-eye sensorimotor impairment assessment for spaceflight operations. Aerosp Med Hum Perform. 2024; 95(2):69-78.

Human and artificial intelligence considerations for long duration space travel – A human factors perspective

Real-time communications with ground support are fundamental to ensuring crew safety in space. However, there will be long delays in communication as space missions travel further away from Earth. During a time- and life-critical situation, the crew will need on-board Artificial Intelligence (AI) driven technology to support anomaly mitigation decision-making and response. This paper discusses human factors considerations to help crew problem-solving, reduce errors, and enhance safety on exploration class missions.

Towards semi-automated pleural cavity access for pneumothorax in austere environments

Astronauts are at risk for pneumothorax, a condition where injury or disease introduces air between the chest wall and the lungs (i.e., the pleural cavity). In a worst-case scenario, it can rapidly lead to a fatality if left unmanaged and will require prompt treatment in situ if developed during spaceflight. Chest tube insertion is the definitive treatment for pneumothorax, but it requires a high level of skill and frequent practice for safe use. Physician astronauts may struggle to maintain this skill on medium- and long-duration exploration-class missions, and it is inappropriate for pure just-in-time learning or skill refreshment paradigms. This paper proposes semi-automating tool insertion to reduce the risk of complications in austere environments and describes preliminary experiments providing initial validation of an intelligent prototype system. Specifically, we showcase and analyse motion and force recordings from a sensorized percutaneous access needle inserted repeatedly into an ex vivo tissue phantom, along with relevant physiological data simultaneously recorded from the operator. When coupled with minimal just-in-time training and/or augmented reality guidance, the proposed system may enable non-expert operators to safely perform emergency chest tube insertion without the use of ground resources.

Space exploration as a catalyst for medical innovations.

Aerospace research has a long history of developing technologies with industry-changing applications and recent history is no exception. The expansion of commercial spaceflight and the upcoming exploration-class missions to the Moon and Mars are expected to accelerate this process even more. The resulting portable, wearable, contactless, and regenerable medical technologies are not only the future of healthcare in deep space but also the future of healthcare here on Earth. These multi-dimensional and integrative technologies are non-invasive, easily-deployable, low-footprint devices that have the ability to facilitate rapid detection, diagnosis, monitoring, and treatment of a variety of conditions, and to provide decision-making and performance support. Therefore, they are primed for applications in low-resource and remote environments, facilitating the extension of quality care delivery to all patients in all communities and empowering non-specialists to intervene early and safely in order to optimize patient-centered outcomes. Additionally, these technologies have the potential to advance care delivery in tertiary care centers by improving transitions of care, providing holistic patient data, and supporting clinician wellness and performance. The requirements of space exploration have created a number of paradigm-altering medical technologies that are primed to revitalize and elevate our standard of care here on Earth.

Selecting Medical Conditions Relevant to Exploration Spaceflight to Create the IMPACT 1.0 Medical Condition List.

INTRODUCTION: Medical conditions occurring in spaceflight pose risks to the crew and the mission and these risks will be exacerbated during exploration-class missions. Probabilistic risk assessment is a method used at NASA to quantify this risk for low-Earth orbit operations. Informing Mission Planning via Analysis of Complex Tradespaces (IMPACT) is a next-generation tool suite that will perform these assessments for exploration-class missions. It will require a robust list of medical conditions of significant likelihood and/or consequence to exploration-class missions to accurately inform the tool suite.METHODS: The IMPACT 1.0 Medical Condition List (ICL 1.0) contains 120 conditions selected in the context of a 210-d cis-lunar, Mars analog design reference mission. The conditions were selected via a systematic process that preserved institutional knowledge from nine prior condition lists. Conditions were prioritized for inclusion in the ICL 1.0 based on history of occurrence in spaceflight, concurrence among the nine source lists, and concurrence among subject matter experts.DISCUSSION: The ICL 1.0 has notable advantages over its predecessor lists in that it is more specific to exploration-class missions, contains a greater number, breadth, and depth of conditions, and was derived via consensus across multiple medical specialties.Kreykes AJ, Suresh R, Levin D, Hilmers DC. Selecting medical conditions relevant to exploration spaceflight to create the IMPACT 1.0 Medical Condition List. Aerosp Med Hum Perform. 2023; 94(7):550-557.

Incidence and Progression of Chorioretinal Folds During Long-Duration Spaceflight

The primary contributing factor for development of chorioretinal folds during spaceflight is unknown. Characterizing fold types that develop and tracking their progression may provide insight into the pathophysiology of spaceflight-associated neuro-ocular syndrome and elucidate the risk of fold progression for future exploration-class missions exceeding 12 months in duration. To determine the incidence and presentation of chorioretinal folds in long-duration International Space Station crew members and objectively quantify the progression of choroidal folds during spaceflight. In this retrospective cohort study, optical coherence tomography scans of the optic nerve head and macula of crew members completing long-duration spaceflight missions were obtained on Earth prior to spaceflight and during flight. A panel of experts examined the scans for the qualitative presence of chorioretinal folds. Peripapillary total retinal thickness was calculated to identify eyes with optic disc edema, and choroidal folds were quantified based on surface roughness within macular and peripapillary regions of interest. Spaceflight missions ranging 6 to 12 months. Incidence of peripapillary wrinkles, retinal folds, and choroidal folds; peripapillary total retinal thickness; and Bruch membrane surface roughness. A total of 36 crew members were analyzed (mean [SD] age, 46 [6] years; 7 [19%] female). Chorioretinal folds were observed in 12 of 72 eyes (17%; 6 crew members). In eyes with early signs of disc edema, 10 of 42 (24%) had choroidal folds, 4 of 42 (10%) had inner retinal folds, and 2 of 42 (5%) had peripapillary wrinkles. Choroidal folds were observed in all eyes with retinal folds and peripapillary wrinkles. Macular choroidal folds developed in 7 of 12 eyes (4 of 6 crew members) with folds and progressed with mission duration; these folds extended into the fovea in 6 eyes. Circumpapillary choroidal folds developed predominantly superior, nasal, and inferior to the optic nerve head and increased in prevalence and severity with mission duration. Choroidal folds were the most common fold type to develop during spaceflight; this differs from reports in idiopathic intracranial hypertension, suggesting differences in the mechanisms underlying fold formation. Quantitative measures demonstrate the development and progression of choroidal folds during weightlessness, and these metrics may help to assess the efficacy of spaceflight-associated neuro-ocular syndrome countermeasures.

Just-in-time Training with Remote Guidance for Ultrasound-Guided Percutaneous Intervention

BACKGROUND: Management of surgical emergencies in spaceflight will pose a challenge as the era of exploration class missions dawns, requiring increased crew autonomy at a time when training and supplies will be limited. Ultrasound-guided percutaneous intervention would allow for the management of a variety of pathologies with largely shared equipment and training. This proof-of-concept work attempts to determine the feasibility of "just-in-time" remote teaching and guidance of a sample procedure of this type.METHODS: Subjects naïve to ultrasound-guided intervention were instructed via a short video regarding the technique for placement of a percutaneous drain into a simulated abscess within a gel phantom. Subjects were then guided through the performance of the procedure via two-way audiovisual communication with an experienced remote assistant. Technical success was determined by the successful aspiration or expression of fluid from the simulated abscess following drain placement. This was then performed by and compared with staff experienced with such procedures. Time to completion and number of needle redirections required were also measured.RESULTS: All 29 subjects naïve to interventional work and the 4 experienced control subjects achieved technical success. There was a statistically significant difference in the time to completion between the two groups, with the experienced subjects averaging 2 min to completion and the inexperienced 5.8 min. There was no statistically significant difference in the number of redirections.DISCUSSION: This proof-of-concept work demonstrates high rates of technical success of percutaneous ultrasound-guided intervention in previously inexperienced personnel when provided with brief just-in-time training and live two-way audiovisual guidance.Lerner DJ, Pohlen MS, Apland RC, Parivash SN. Just-in-time training with remote guidance for ultrasound-guided percutaneous intervention. Aerosp Med Hum Perform. 2022; 93(12):882-886.

MIRECLE: Science Yield for a Mid-infrared Explorer-class Mission to Study Nontransiting Rocky Planets Orbiting the Nearest M Stars Using Planetary Infrared Excess

Recent investigations have demonstrated the potential for utilizing a new observational and data-analysis technique for studying the atmospheres of nontransiting exoplanets with combined light that relies on acquiring simultaneous, broad-wavelength spectra and resolving planetary infrared emission from the stellar spectrum through simultaneous fitting of the stellar and planetary spectral signatures. This new data-analysis technique, called planetary infrared excess (PIE), holds the potential to open up the opportunity for measuring mid-infrared (MIR) phase curves of nontransiting rocky planets around the nearest stars with a relatively modest telescope aperture. We present simulations of the performance and science yield for a mission and instrument concept that we call the MIR Exoplanet CLimate Explorer, a concept for a moderately sized cryogenic telescope with broad wavelength coverage (1–18 μm) and a low-resolution (R ∼ 50) spectrograph designed for the simultaneous wavelength coverage and extreme flux measurement precision necessary to detect the emission from cool rocky planets with PIE. We present exploratory simulations of the potential science yield for PIE measurements of the nearby planet Proxima Centauri b, showing the potential to measure the composition and structure of an Earth-like atmosphere with a relatively modest observing time. We also present overall science yields for several mission architecture and performance metrics, and discuss the technical performance requirements and potential telescope and instrument technologies that could meet these requirements.

Evolving radiological protection guidelines for exploration-class missions

International Space Station partner nations have yet to agree on career radiation dose constraints. This is of increasing concern for collaborative mission planning beyond low-Earth orbit, since it is likely that one or two long-duration missions will expose crew to a cumulative dose that approaches or exceeds their current respective limits. As with radiological effects, the cumulative health impact of the numerous other injuries and illnesses documented during spaceflight is inherently heightened with longer and farther missions, say to the Moon and Mars. This paper summarizes the origin of existing radiological constraints employed by the Canadian Space Agency and explores how to build upon these protection practices to address the challenges associated with beyond low-Earth orbit missions. The discussion then leads into a review of conventional risk metrics currently under evaluation by space-faring nations to quantify risk of radiation-induced cancer mortality. This paper concludes with a proposal for the application of an existing burden of disease model termed the Disability Adjusted Life Year, to space exploration. This model can accommodate the many health hazards of spaceflight, including ionizing radiation, on a common scale. It has the potential to serve as an intuitive communication tool for informing on the impact of spaceflight on crew health.

Extraterrestrial Gynecology: Could Spaceflight Increase the Risk of Developing Cancer in Female Astronauts? An Updated Review.

Outer space is an extremely hostile environment for human life, with ionizing radiation from galactic cosmic rays and microgravity posing the most significant hazards to the health of astronauts. Spaceflight has also been shown to have an impact on established cancer hallmarks, possibly increasing carcinogenic risk. Terrestrially, women have a higher incidence of radiation-induced cancers, largely driven by lung, thyroid, breast, and ovarian cancers, and therefore, historically, they have been permitted to spend significantly less time in space than men. In the present review, we focus on the effects of microgravity and radiation on the female reproductive system, particularly gynecological cancer. The aim is to provide a summary of the research that has been carried out related to the risk of gynecological cancer, highlighting what further studies are needed to pave the way for safer exploration class missions, as well as postflight screening and management of women astronauts following long-duration spaceflight.

Immersive Extended Reality use in Medical Education with Implications for Remote and Space Medicine Training

Objective: Medical education continually adapts and evolves as evidence-based practice expands our knowledge. Ease of access and reduced cost of novel technology has revolutionized delivery of medical education. Immersive extended reality (iXR) technology may play an invaluable role in improving delivery and quality of medical education in rural and extra-planetary settings.
 Methods: An extensive literature review was conducted for using MeSH terms specific to iXR technology related to medical education. Relevant manuscripts were accessed from database searches and filtered based on pre-specified inclusion and exclusion criteria. Extraction of data and thematic qualitative analysis was conducted in relation to relevance to remote medical training with an emphasis on potential for deep-space exploration class missions.
 Results: From a total of 4005 search results, 35 final papers met inclusion criteria for this study. Current applications of virtual, augmented and mixed reality technology in medical education were explored, and themes from each modality of iXR technology were defined.
 Conclusions: Themes determined from the results were applied to a discussion regarding the application of iXR technology in two distinct areas: remote and rural medical training and space medicine. Relative strengths and weaknesses of each modality of iXR were explored and applied to the unique factors impacting medical education delivery in these two domains.

PRELIMINARY MULTICRITERION ANALYSIS OF THE STRUCTURE OF A PHYSICAL-CHEMICAL LIFE SUPPORT SYSTEM FOR A REMOTE SPACE MISSION VEHICLE

Preliminary structural analysis of a physical-chemical life support system (LSS) was made for a 1000-day mission of 4 crew members from Earth's orbit to Mars orbit and back using the next 5 criteria: robustness, total equivalent mass, insertion mass and volume, and combined expenses on R&D and reliability testing. Analyzed were structures of 4 LSS designs including supply-relied, hybrid, semi-closed and two options of nearly closed LSS by the criterion of failure classifications: all failures are independent and common cause failures are probable. An adequate level of robustness must be first reached using an integral approach that is inclusion of supplies, finalizing the system design and production, and inherent cold redundancy of critical regeneration subsystems. This must be followed by informal analysis of alternative LSS designs with rational values of the other 4 Q-factors. It was concluded that simple, reliable and cheap supply-based LSS as well as hybrid LSS are uneconomic for exploration class missions, as their insertion masses exceed the acceptable level in 5 times and twice, respectively. Nearly closed LSS is also unacceptable for the reason of very high R&D costs. Therefore, we give preference to partly closed LSS, provided the requirement to increase the LSS specific weight from 0.15 to 0.28 is satisfied.

Space Radiation Protection Countermeasures in Microgravity and Planetary Exploration.

Background: Space radiation is one of the principal environmental factors limiting the human tolerance for space travel, and therefore a primary risk in need of mitigation strategies to enable crewed exploration of the solar system. Methods: We summarize the current state of knowledge regarding potential means to reduce the biological effects of space radiation. New countermeasure strategies for exploration-class missions are proposed, based on recent advances in nutrition, pharmacologic, and immune science. Results: Radiation protection can be categorized into (1) exposure-limiting: shielding and mission duration; (2) countermeasures: radioprotectors, radiomodulators, radiomitigators, and immune-modulation, and; (3) treatment and supportive care for the effects of radiation. Vehicle and mission design can augment the overall exposure. Testing in terrestrial laboratories and earth-based exposure facilities, as well as on the International Space Station (ISS), has demonstrated that dietary and pharmacologic countermeasures can be safe and effective. Immune system modulators are less robustly tested but show promise. Therapies for radiation prodromal syndrome may include pharmacologic agents; and autologous marrow for acute radiation syndrome (ARS). Conclusions: Current radiation protection technology is not yet optimized, but nevertheless offers substantial protection to crews based on Lunar or Mars design reference missions. With additional research and human testing, the space radiation risk can be further mitigated to allow for long-duration exploration of the solar system.

Space radiation electrostatic shielding scaling laws: Beam-like and isotropic angular distributions

Passive radiation shielding alone cannot provide adequate protection for astronauts on long-term, deep-space missions. High atomic number and energy (HZE) ions, and/or their secondaries, can penetrate any realistic mass shielding for long-term deep-space missions and cause damage to cells via direct energy deposition and/or through the production of secondary particles and fragmented nuclei. Active shielding, or the use of electromagnetic fields to deflect or stop incoming ions before reaching the spacecraft, has gained substantial attention over the last decade as a way to augment passive shielding. Recently, a mathematical relationship between a dimensionless scaling parameter characterizing the active shield and the incoming ion and a protected area formed on a downstream detector due to the deflection of HZE ions by the applied field was validated in Earth-based laboratory conditions. In the present work, the mathematical formulation is extended to relate electrostatic shielding efficacy with the ability to deflect positively charged ions with parameters relevant to space applications. Additionally, a modified scaling parameter is formulated to characterize the shielding efficacy of a “family” of electrostatic active shielding configurations for reducing flux density for a space-relevant isotropic source of energetic protons. The results of this study demonstrate a strong correlation among dimensionless scaling parameters and shielding efficacy metrics for space radiation-relevant HZE ions in beam and isotropic angular distributions. Furthermore, it establishes a framework for optimizing design of three-dimensional electrostatic shielding configurations to improve space radiation protection for astronauts on exploration-class missions.

Asteroid Observations from the Transiting Exoplanet Survey Satellite: Detection Processing Pipeline and Results from Primary Mission Data

The Transiting Exoplanet Survey Satellite (TESS) is a NASA Explorer-class mission designed for finding exoplanets around nearby stars. TESS image data can also serve as a valuable resource for asteroid and comet detection, including near-Earth objects (NEOs). In order to exploit the TESS image data for moving object detection and potential object discovery, our team has developed an image processing pipeline as part of the Lincoln Near-Earth Asteroid Research (LINEAR) program, sponsored by the NASA NEO Observations Program. The LINEAR-TESS pipeline is currently in operation and reporting asteroid observations to the Minor Planet Center. In this paper we discuss the algorithms and methodology utilized to push the limits of the astrometric accuracy and photometric sensitivity of the TESS instrument for asteroid detection without a priori information on the ephemerides of the objects, and report on observation statistics from the first two years of TESS mission data.

Medical Education for Exploration Class Missions: NASA Aerospace Medicine Elective at the Kennedy Space Centre

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Multidisciplinary Expertise for Exploration Medical System Design

The design of exploration class missions that send crews beyond low-Earth orbit has uncovered challenging crew health and performance (CHP) needs not previously faced in human spacef light. The engineers who design and build the medical systems integrated into a habitat and the clinicians who ultimately use those systems to provide care to astronauts must work together with a common language and design processes to effectively address such needs. This article proposes adapting systems engineering tools to provide a streamlined, thorough, and efficient method for communicating between clinical and engineering disciplines to advance human health and performance in space.