{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:21:14Z","timestamp":1788366074967,"version":"build-2803163510"},"reference-count":31,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Performance of medical procedures in spaceflight beyond low Earth orbit (LEO) requires novel solutions to replace real-time ground support, which is hampered by growing communication latencies as distance from Earth increases. The Autonomous Medical Officer Support (AMOS) Software Technology Demonstrations on the International Space Station (ISS) trialed a novel software tool that shifts the emphasis from pre-flight training and real-time remote guidance (current ISS paradigm) to a new standard of multidimensional in-flight just-in-time instruction. The AMOS platform is a skill management tool for all mission phases and currently features comprehensive training and guidance modules for urinary bladder and renal ultrasound examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Using the AMOS software, two ISS crewmembers performed in-flight bladder and kidney ultrasound examinations with no guidance from the ground and with no pre-flight exposure to the software (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 2 sessions). Images were graded for clinical quality using a strict evaluation rubric. Software use patterns were recorded, and participants provided both structured and free response feedback.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Clinically adequate images were obtained for all but one of the attempted views. Participants rated AMOS as highly useable and primarily used linear navigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Variability in subject anatomy, operator experience, and operator receptiveness to instruction during autonomous examinations is a persistent but manageable limitation. Despite these challenges, here we report the first successful demonstrations of autonomous imaging activities in the operational setting of spaceflight, validating this autonomous guidance proof-of-concept.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15305627261422798","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:02:03Z","timestamp":1773226923000},"page":"608-616","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Autonomous Medical Officer Support Software Technology Demonstrations on the International Space Station"],"prefix":"10.1177","volume":"32","author":[{"given":"Douglas","family":"Ebert","sequence":"first","affiliation":[{"name":"KBR, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlei","family":"Walton","sequence":"additional","affiliation":[{"name":"NASA-Johnson Space Center, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky E.","family":"Byrne","sequence":"additional","affiliation":[{"name":"KBR, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana M.","family":"Nelson","sequence":"additional","affiliation":[{"name":"University of California Irvine School of Medicine, Irvine, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashot","family":"Sargsyan","sequence":"additional","affiliation":[{"name":"KBR, Houston, Texas, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.1.1998.4.19"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-197901000-00005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000145083.47032.78"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2019.0177"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/app12030958"},{"key":"e_1_3_4_7_2","doi-asserted-by":"crossref","unstructured":"Parisi M Panontin T Wu S-C et al. 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