Development of a Simulation Software Algorithm for High-End Mechanical Ventilators with Functionalities to attend COVID-19 Patients.

More than 500 millions of people were affected by the COVID-19 pandemic and in Peru there is an increasing the high numbers of cumulative cases; as well as the hospitalized people, where more than 20 % require mechanical ventilation. This condition with other respiratory diseases cause patients to remain connected to a mechanical ventilator until they regain the ability to perform this vital function on their own. Some prototypes with characteristics equivalent to a high-end mechanical ventilator have been developed. And therefore, this paper presents the design and simulation of an algorithm for the pressure-controlled pulmonary ventilation mode of the mechanical ventilator. The functional design of the algorithm uses the linear multi compartment mathematical model to simulate the respiratory system. Finally the results respond adequately under multiple scenarios, including variations of the ventilator and pulmonary parameters, where the algorithm presents encouraging results in the mechanical ventilator simulation. Clinical relevance - The algorithm presented in this study will allow to have better knowledge for a treatment and eventual clinical diagnosis in health centers, especially in eventual variants and outbreaks of COVID-19.

Design and Simulation of a Soft Robotic Device for Muscle Rehabilitation and Blood Flow Stimulation Therapy.

Previous works have shown the efficacy of mechanical stimulation by applying pressure and vibration on muscle rehabilitation. Additionally, a temperature increase can improve both muscle performance and blood circulation during therapies. These modalities of treatment are commonly applied separately in patients with moderate disuse-induced muscle atrophy. In this paper, we propose the design of a novel medical device that synergistically integrates the function of i) elastomeric pneumatic actuators to apply focused orthogonal pressure, ii) vibratory motors to generate localized vibration and iii) carbon fibre heaters for a temperature increase. In particular, computational simulations were performed to characterize the mechanical behaviour of different pneumatic actuator geometries and their predicted advantages in comparison to previous designs. The integration of the three functionalities of the device and preliminary simulations results showcase its potential for improving therapy efficacy, while also being compact, lightweight, and comfortable, which would ease its implementation in rehabilitation programs.Clinical relevance- Disuse-induced muscle atrophy and related cardiovascular problems can lead to physical impairment and significantly affect patient independence. The surge in the number of hospitalized and bedridden patients related to the coronavirus disease (COVID-19) brings about a predicted increase in the incidence of myopathies and muscle weakness. To attend the growing demand, technological aids for more efficient physical therapies will need to be developed.

Medicina humana espacial: Performance fisiológico y contramedidas para mejorar la salud del astronauta / Human Space Medicine: Physiological Performance And Countermeasures To Improve The Astronaut's Health

Se presenta este artículo de revisión con base en la evidencia científica actual sobre medicina espacial enfocada en fisiología humana y sus contramedidas. Por lo cual se realizó una búsqueda bibliográfica no sistemática de artículos científicos y libros de investigación en inglés-español de los últimos 7 años, que detallan su aplicación en seres humanos, modelos murinos y experimentos in vitro. Se tomaron en cuenta las condiciones del ambiente espacial como microgravedad y radiación que producen considerables cambios fisiológicos en el sistema cardiovascular (redistribución de líquidos, remodelación cardiovascular, arritmias); nervioso (sensitivomotores, neurosensoriales, neurovestibulares); respiratorio (cambios de volúmenes y capacidades); renal (litiasis); musculoesquelético (atrofia muscular, osteoporosis); hematológico (anemia); inmunológico (desregulación inmune) y digestivo (alteración de la microbiota intestinal). Además, existen procesos biológicos, moleculares y genéticos aún por explorar, para conocer y mitigar los mecanismos inciertos desencadenados en ambientes extremos y peligrosos. Por lo tanto, es una prioridad desarrollar e implementar contramedidas para reducir los efectos nocivos en la salud, con el objetivo de garantizar la adaptación, seguridad y performance del astronauta durante futuros viajes espaciales.

This Review Article is presented based on current scientific evidence on space medicine focused on human physiology and its countermeasures. Therefore, a non-systematic bibliographic search of scientific articles and research books in English-Spanish of the last 7 years was carried out, detailing their application in humans, murine models and in vitro experiments. The conditions of the space environment such as microgravity and radiation that produce considerable physiological changes in the cardiovascular system (redistribution of fluids, cardiovascular remodeling, arrhythmias) were taken into account; nervous (sensorimotor, neurosensory, neurovestibular); respiratory (volume and capacity changes); renal (lithiasis); musculoskeletal (muscular atrophy, osteoporosis); hematological (anemia); immunological (immune dysregulation) and digestive (intestinal microbiota disorder). In addition, there are biological, molecular and genetic processes still to be explored, in order to know and mitigate the uncertain mechanisms triggered in extreme and dangerous environments. Therefore, it is a priority to develop and implement countermeasures to reduce the harmful effects on health, with the aim of guaranteeing the astronaut's adaptation, safety and performance during future space flights.