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Goal : Lessons learned from decades of human spaceflight have helped advance the delivery of healthcare in rural and remote areas of the globe. Inclusion of the public in spaceflights is not yet accompanied by technology capable of monitoring their physical and mental health, managing clinical conditions, and rapidly identifying medical emergencies. Telepharmacy is a practice prioritizing pharmacotherapeutic guidance and monitoring to help improve patient quality of life, and can potentially expand the field of space medicine. We seek to advance pharmaceutical care through telepharmacy by developing a digital platform. Objective: This study focuses on the development of a digital platform for teleassistance and pharmaceutical teleconsulting services that builds on lessons learned in delivering space medicine. Methods: The platform contains evidence-based information on various drugs grouped by medical specialty, and also records and saves patient appointments. It has specific service protocols for service standardization, including artificial intelligence, to allow agility in services and escalation. All data is protected by privacy and professional ethics guidelines. Results: The telepharmacy platform is ready and currently undergoing testing for ground applications through validation studies in hospitals or medical clinics. Conclusions: Although developed for use on Earth, this telepharmacy platform provides a good example of how terrestrial healthcare knowledge and technology can be transferred to space missions., (© 2023 The Authors.)

Three-dimensional printing (3DP) has recently gained importance in the medical industry, especially in surgical specialties. It uses different techniques and materials based on patients' needs, which allows bioprofessionals to design and develop unique pieces using medical imaging provided by computed tomography (CT) and magnetic resonance imaging (MRI). Therefore, the Department of Biology and Medicine and the Department of Physics and Engineering, at the Bioastronautics and Space Mechatronics Research Group, have managed and supervised an international cooperation study, in order to present a general review of the innovative surgical applications, focused on anatomical systems, such as the nervous and craniofacial system, cardiovascular system, digestive system, genitourinary system, and musculoskeletal system. Finally, the integration with augmented, mixed, virtual reality is analyzed to show the advantages of personalized treatments, taking into account the improvements for preoperative, intraoperative planning, and medical training. Also, this article explores the creation of devices and tools for space surgery to get better outcomes under changing gravity conditions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 José Cornejo et al.)

The aim was to investigate mechanical and functional failure of diffuse axonal injury (DAI) in nerve bundles following frontal head impacts, by finite element simulations. Anatomical changes following traumatic brain injury are simulated at the macroscale by using a 3D head model. Frontal head impacts at speeds of 2.5-7.5 m/s induce mild-to-moderate DAI in the white matter of the brain. Investigation of the changes in induced electromechanical responses at the cellular level is carried out in two scaled nerve bundle models, one with myelinated nerve fibres, the other with unmyelinated nerve fibres. DAI occurrence is simulated by using a real-time fully coupled electromechanical framework, which combines a modulated threshold for spiking activation and independent alteration of the electrical properties for each three-layer fibre in the nerve bundle models. The magnitudes of simulated strains in the white matter of the brain model are used to determine the displacement boundary conditions in elongation simulations using the 3D nerve bundle models. At high impact speed, mechanical failure occurs at lower strain values in large unmyelinated bundles than in myelinated bundles or small unmyelinated bundles; signal propagation continues in large myelinated bundles during and after loading, although there is a large shift in baseline voltage during loading; a linear relationship is observed between the generated plastic strain in the nerve bundle models and the impact speed and nominal strains of the head model. The myelin layer protects the fibre from mechanical damage, preserving its functionalities.

Objective: We confirm that alteration of a neuron structure can induce abnormalities in signal propagation for nervous systems, as observed in brain damage. Here, we investigate the effects of geometrical changes and damage of a neuron structure in 2 scaled nerve bundle models, made of myelinated nerve fibers or unmyelinated nerve fibers., Methods: We propose a 3D finite element model of nerve bundles, combining a real-time full electromechanical coupling, a modulated threshold for spiking activation, and independent alteration of the electrical properties for each fiber. With the inclusion of plasticity, we then simulate mechanical compression and tension to induce damage at the membrane of a nerve bundle made of 4 fibers. We examine the resulting changes in strain and neural activity by considering in turn the cases of intact and traumatized nerve membranes., Results: Our results show lower strain and lower electrophysiological impairments in unmyelinated fibers than in myelinated fibers, higher deformation levels in larger bundles, and higher electrophysiological impairments in smaller bundles., Conclusion: We conclude that the insulation sheath of myelin constricts the membrane deformation and scatters plastic strains within the bundle, that larger bundles deform more than small bundles, and that small fibers tolerate a higher level of elongation before mechanical failure., (© 2018 John Wiley & Sons, Ltd.)

The International Space Medicine Summit II sought to identify mature data with significant clinical implications for Terrestrial populations. This work aims at identifying space medical technology which has been translated for use by private costumers, those in remote locations on Earth and areas affected by natural disasters., Methods: Following PRISMA Guidelines, we sought to review the published literature and NASA technical resources (from 2012 to 2017). Search terms used included "Medical AND Technology AND Diagnosis AND Monitor"., Results: 23 applications were identified of medical technology arisen from the Space industry. Of these, 5 were treatment based; 6 diagnostic; 10 medical measurement devices., Discussion: The Aerospace industry has provided a significant transfer in knowledge and technology which can improve our management of patients on Earth., Significance: Highlighting the use and benefits of Aerospace medical research for terrestrial medical care.

The International Space Medicine Summit II sought to identify mature data with significant clinical implications for Terrestrial populations. This work aims at identifying innovation in biomedical engineering (BE), involving space medicine and translation., Methods: Following PRISMA Guidelines, we sought to review the published literature and NASA technical resources (from 2012 to 2017) to identify space medical technology which has been translated for use by private costumers., Results: The analysis focuses on technical and medical requirements, human health and Terrestrial implication., Discussion: Innovation in BE arises from matching space medical requirements for developing autonomous medical systems., Significance: Highlighting the use and benefits of aerospace medical research for Terrestrial medical care.

Objective: We propose a novel approach for modelling the interdependence of electrical and mechanical phenomena in nervous cells, by using electrothermal equivalences in finite element (FE) analysis so that existing thermomechanical tools can be applied., Methods: First, the equivalence between electrical and thermal properties of the nerve materials is established, and results of a pure heat conduction analysis performed in Abaqus CAE Software 6.13-3 are validated with analytical solutions for a range of steady and transient conditions. This validation includes the definition of equivalent active membrane properties that enable prediction of the action potential. Then, as a step toward fully coupled models, electromechanical coupling is implemented through the definition of equivalent piezoelectric properties of the nerve membrane using the thermal expansion coefficient, enabling prediction of the mechanical response of the nerve to the action potential., Results: Results of the coupled electromechanical model are validated with previously published experimental results of deformation for squid giant axon, crab nerve fibre, and garfish olfactory nerve fibre., Conclusion: A simplified coupled electromechanical modelling approach is established through an electrothermal equivalent FE model of a nervous cell for biomedical applications., Significance: One of the key findings is the mechanical characterization of the neural activity in a coupled electromechanical domain, which provides insights into the electromechanical behaviour of nervous cells, such as thinning of the membrane. This is a first step toward modelling three-dimensional electromechanical alteration induced by trauma at nerve bundle, tissue, and organ levels.

Axonal damage is one of the most common pathological features of traumatic brain injury, leading to abnormalities in signal propagation for nervous systems. We present a 3D fully coupled electro-mechanical model of a nerve bundle, made with the finite element software Abaqus 6.13-3. The model includes a real-time coupling, modulated threshold for spiking activation and independent alteration of the electrical properties for each 3-layer fibre within the bundle. Compression and tension are simulated to induce damage at the nerve membrane. Changes in strain, stress distribution and neural activity are investigated for myelinated and unmyelinated nerve fibres, by considering the cases of an intact and of a traumatized nerve membrane. Results show greater changes in transmitting action potential in the myelinated fibre.

Equivalence is one of most popular techniques to simulate the behavior of systems governed by the same type of differential equation. In this case, a thermo-electrical equivalence is considered as a method for modelling the inter-dependence of electrical and mechanical phenomena in biological tissue. We seek to assess this approach for multi-scale models (from micro-structure to tissue scale) of biological media, such as nerve cells and cardiac tissue, in which the electrical charge distribution is modelled as a heat distribution in an equivalent thermal system. This procedure allows for the reduction in problem complexity and it facilitates the coupling of electrical and mechanical phenomena in an efficient and practical way. Although the findings of this analysis are mainly addressed towards the electro-mechanics of tissue within the biomedical domain, the same approach could be used in other studies in which a coupled finite element analysis is required.