Preceded by: 23 Mar 2020 sci.engr.biomed:14721
26 Mar 2020 sci.engr.biomed:14722

First of all, the design has to be extremely simple and robust so anyone can manufacture or repair it. Think easy to fix Lada vs better Traband, or
the development economist calling for "appropriate technology". Time cannot
be wasted waiting for a specialist. Also see HBR article ca 1987 about the
IBM Chapel Hill the printer design being simplified for robot so it became easier to make by hand.

Off pump CABG and asceptic milk came about because power is not relaible in most of the world. Plus in emergency, power may not be reliable even
here. So diesel seems preferable but a room full of MASH diesel repsirators would kill faster than COVID. So I'm thinking you have to generate motion (pneumatically, mechanically) outside the building and transmit it
inside. Also it should be at the opposite end of the building from oxygen concentrators or electrolytic generators, for smoke and fire reasons. One
idea was a pump, with a big bellows, like induction, powering smaller
bellows. Practitioners seem to prefer pistons. Hadjiangelis and the Columbia engineering hackathon have spurred DIY ventilators with Ambu-Bags. The other would be like a car transmittion shaft running through the building.
Manhattan and other old industrial cities still have public steam power.
Design specs: Cooney 1976 v2 p347,413, 12 breath/min, 284 ml/min O2 104 mm
Hg, 227 ml/min CO2 40 mm Hg. You would been to adjust volume flow and pulse rate by patient, and you need some random sigh to assure the lungs work right (Bronzino ch 11). In the bellows case, ie pneumatic control, I thought maybe to convolute the pipes into some turbulence for sighs, which might however release projectives, blocked by the inductive discontinuity. Mechanical
control might also be amendable to mechanical tuning. Maybe the pumps should only move the lungs and keep them inflated, and to be sure, better to do the gas exchange through the blood via canula like dialysis. Or a
perfluorocarbon artificial blood though a gut catheter. Perfluorocarbin is
the only artificial blood approved for internal use, but there are other artifical bloods for ex vivo devide testing use which may be safe for the
gut. I cringe at the thought of some third world kid having to manually pump his granma's lungs but also wonder why it wasn't done in China and Italy to those who were triaged against respirators because of supply. If this goes
to the third world manual ventilators need to be considered. Musk might well provide wonderful batteries but when I was a teen my uncle-in-law was responsible for the batteries of Greek subs and had nightmares of them exploding (All stored energy, carbon, electrical, nuclear explodes); of
course, they too, might be kept at a distance from patients.

Exacerbating pre-existing medical conditions should also be treated pharmacologically to minimise respirator time. I was blown away a few weeks
ago at grand rounds that they use colchicine to reduce heart compression from TB. I've used it for gout and it is brutal, but it really works. Maybe it can reduce lung inflamation. Fibrotic lungs could be treated with relaxin, a pregnancy antifibrotic hormone which, however, could cause aneurisms.
Further, asma could be treated by rapamycin analogs (DL001 and SAR943).

COVID survives nine yeards before degrading because of its lipid capsid membrane. So I was thinking what type of benign, non-toxic environment could degrade it faster in essential public spaces. A friend was working on salt therapy. YOu could be walking around a fine particulate salt cloud, but then you need to sweep it up. Air ionisers and ozone may work. UV may work but at some point it will be hazardous. Maybe it can be pulsed, flash every five minutes, say in a subway or supermarket. In a way anything that kills this thing will also kill us but we need to play with intensity, frequency and quanity.

I think Compassionate Use will work for a month or so more, unless we turn really bad, in which case the FDA will need to further unknot its Clin trials are one of the costliest components of our med system. And other coutries
ride free at our expence. Twenty years go there were attempts to use moderm software like Macsyma and Wolfram to do Adaptive Maximum Likelihood integrals for every sample instead of wait for the trial to end and do it all. But then Vioxx hit and all bets were off. Bob Cailif, who came up with Compassionate
use (terminal patients try anything; enhanced by Trump as Right to Try) while he was Obama FDA chief is now at Google Verily trying to use the entire
Google universe as a trial sample. Already, In Australia, they are allowing health care workers to try a TB vaccine. In this case, a doctors is like an accredited investor. If they want to try a drug on themselves, why
not. Jenner tired the smallpox vaccine on himself.

Regenron's spike-protein antibody cocktail will go on trials in September; Safer than plasma which might carry other diseases. Maybe FDA will unkot knichers as was trying to do before vioxx blowup. Things that scare me most (please NO!): 1. The common cold from which covid derives mutates so fast we can't vaccinate against it. 2. If two pet dogs in Hong Kong, three zoo tigers and three zoo lions got it in NYC, how long until small mammalian vermin get and transmit it? Italy is trying ionisers for public spaces. Greece trials
with colchicine (common for TB heart compression) may also prevent
inflammation of secondary organs. Now that we got enough ventilators in NYC, there is a dialysis crisis. Is blood clotting and organ failure because of inflammation or directly from the virus?

https://en.wikipedia.org/wiki/Medical_ventilator https://accessmedicine.mhmedical.com/content.aspx?bookid=520&sectionid=41692239%20
https://hackaday.com/2020/03/12/ultimate-medical-hackathon-how-fast-can-we-design-and-deploy-an-open-source-ventilator/
https://engineering.columbia.edu/covid-tech-innovation https://www.ny.gov/programs/new-york-state-covid-19-technology-swat-team


- = -
Vasos Panagiotopoulos, Columbia'81+, Reagan, Mozart, Pindus
blog: panix.com/~vjp2/ruminatn.htm - = - web: panix.com/~vjp2/vasos.htm
facebook.com/vasjpan2 - linkedin.com/in/vasjpan02 - biostrategist.com
---{Nothing herein constitutes advice. Everything fully disclaimed.}---

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

Subject: COVID Ventilator Design Hackathon, esp third world

Preceded by: 23 Mar 2020 sci.engr.biomed:14721
26 Mar 2020 sci.engr.biomed:14722
17 Mar 2020 and onwards private emails

First of all, the design has to be extremely simple and robust so anyone can manufacture or repair it. Think easy to fix Lada vs better Traband, or
the development economist calling for "appropriate technology". Time cannot
be wasted waiting for a specialist. Also see HBR article ca 1987 about the
IBM Chapel Hill the printer design being simplified for robot so it became easier to make by hand.

Off pump CABG and asceptic milk came about because power is not relaible in most of the world. Plus in emergency, power may not be reliable even
here. So diesel seems preferable but a room full of MASH diesel repsirators would kill faster than COVID. So I'm thinking you have to generate motion (pneumatically, mechanically) outside the building and transmit it
inside. Also it should be at the opposite end of the building from oxygen concentrators or electrolytic generators, for smoke and fire reasons. One
idea was a pump, with a big bellows, like induction, powering smaller
bellows. Practitioners seem to prefer pistons. Hadjiangelis and the Columbia engineering hackathon have spurred DIY ventilators with Ambu-Bags. The other would be like a car transmittion shaft running through the building.
Manhattan and other old industrial cities still have public steam power.
Design specs: Cooney 1976 v2 p347,413, 12 breath/min, 284 ml/min O2 104 mm
Hg, 227 ml/min CO2 40 mm Hg. You would been to adjust volume flow and pulse rate by patient, and you need some random sigh to assure the lungs work right (Bronzino ch 11). In the bellows case, ie pneumatic control, I thought maybe to convolute the pipes into some turbulence for sighs, which might however release projectives, blocked by the inductive discontinuity. Mechanical
control might also be amendable to mechanical tuning. Maybe the pumps should only move the lungs and keep them inflated, and to be sure, better to do the gas exchange through the blood via canula like dialysis. Or a
perfluorocarbon artificial blood though a gut catheter. Perfluorocarbin is
the only artificial blood approved for internal use, but there are other artifical bloods for ex vivo devide testing use which may be safe for the
gut. I cringe at the thought of some third world kid having to manually pump his granma's lungs but also wonder why it wasn't done in China and Italy to those who were triaged against respirators because of supply. If this goes
to the third world manual ventilators need to be considered. Musk might well provide wonderful batteries but when I was a teen my uncle-in-law was responsible for the batteries of Greek subs and had nightmares of them exploding (All stored energy, carbon, electrical, nuclear explodes); of
course, they too, might be kept at a distance from patients.

Exacerbating pre-existing medical conditions should also be treated pharmacologically to minimise respirator time. I was blown away a few weeks
ago at grand rounds that they use colchicine to reduce heart compression from TB. I've used it for gout and it is brutal, but it really works. Maybe it can reduce lung inflamation. Fibrotic lungs could be treated with relaxin, a pregnancy antifibrotic hormone which, however, could cause aneurisms.
Further, asma could be treated by rapamycin analogs (DL001 and SAR943).

COVID survives nine yeards before degrading because of its lipid capsid membrane. So I was thinking what type of benign, non-toxic environment could degrade it faster in essential public spaces. A friend was working on salt therapy. YOu could be walking around a fine particulate salt cloud, but then you need to sweep it up. Air ionisers and ozone may work. UV may work but at some point it will be hazardous. Maybe it can be pulsed, flash every five minutes, say in a subway or supermarket. In a way anything that kills this thing will also kill us but we need to play with intensity, frequency and quanity.

I think Compassionate Use will work for a month or so more, unless we turn really bad, in which case the FDA will need to further unknot its
knickers. Clin trials are one of the costliest components of our med
system. And other coutries ride free at our expence. As confidence level is
a function of error over the square root of sample size, you can reduce your sample if you reduce your error. Twenty years ago there were attempts to use moderm software like Macsyma and Wolfram to do Adaptive Maximum Likelihood integrals for every sample instead of wait for the trial to end and do it
all. But then Vioxx blew up and all bets were off. Bob Cailif, who came up
with Compassionate use (terminal patients try anything; enhanced by Trump as Right to Try) while he was Obama FDA chief is now at Google Verily trying to use the entire Google universe as a trial sample. Already, In Australia, they are allowing health care workers to try a TB vaccine. In this case, a doctors is like an accredited investor. If they want to try a drug on themselves, why not. Jenner tired the smallpox vaccine on himself.

Regenron's spike-protein antibody cocktail will go on trials in September; Safer than plasma which might carry other diseases. Maybe FDA will unkot knichers as was trying to do before vioxx blowup. Things that scare me most (please NO!): 1. The common cold from which covid derives mutates so fast we can't vaccinate against it. 2. If two pet dogs in Hong Kong, three zoo tigers and three zoo lions got it in NYC, how long until small mammalian vermin get and transmit it? Italy is trying ionisers for public spaces. Greece trials
with colchicine (common for TB heart compression) may also prevent
inflammation of secondary organs. Now that we got enough ventilators in NYC, there is a dialysis crisis. Is blood clotting and organ failure because of inflammation or directly from the virus?

https://en.wikipedia.org/wiki/Medical_ventilator https://accessmedicine.mhmedical.com/content.aspx?bookid=520&sectionid=41692239%20
https://hackaday.com/2020/03/12/ultimate-medical-hackathon-how-fast-can-we-design-and-deploy-an-open-source-ventilator/
https://engineering.columbia.edu/covid-tech-innovation https://www.ny.gov/programs/new-york-state-covid-19-technology-swat-team


- = -
Vasos Panagiotopoulos, Columbia'81+, Reagan, Mozart, Pindus
blog: panix.com/~vjp2/ruminatn.htm - = - web: panix.com/~vjp2/vasos.htm
facebook.com/vasjpan2 - linkedin.com/in/vasjpan02 - biostrategist.com
---{Nothing herein constitutes advice. Everything fully disclaimed.}---

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)

Preceded by: 23 Mar 2020 sci.engr.biomed:14721
26 Mar 2020 sci.engr.biomed:14722
17 Mar 2020 and onwards private emails

VENTILATORS

First of all, the design has to be extremely simple and robust so anyone can manufacture or repair it. Think easy to fix Lada vs better Traband, or
the development economist calling for "appropriate technology". Time cannot
be wasted waiting for a specialist. Also see HBR article ca 1987 about the
IBM Chapel Hill the printer design being simplified for robot so it became easier to make by hand.

Off pump CABG and asceptic milk came about because power is not relaible in most of the world. Plus in emergency, power may not be reliable even
here. So diesel seems preferable but a room full of MASH diesel repsirators would kill faster than COVID. So I'm thinking you have to generate motion (pneumatically, mechanically) outside the building and transmit it
inside. Also it should be at the opposite end of the building from oxygen concentrators or electrolytic generators, for smoke and fire reasons. One
idea was a pump, with a big bellows, like induction, powering smaller
bellows. Practitioners seem to prefer pistons. Hadjiangelis and the Columbia engineering hackathon have spurred DIY ventilators with Ambu-Bags. The other would be like a car transmittion shaft running through the building.
Manhattan and other old industrial cities still have public steam power.
Design specs: Cooney 1976 v2 p347,413, 12 breath/min, 284 ml/min O2 104 mm
Hg, 227 ml/min CO2 40 mm Hg. You would been to adjust volume flow and pulse rate by patient, and you need some random sigh to assure the lungs work right (Bronzino ch 11). In the bellows case, ie pneumatic control, I thought maybe to convolute the pipes into some turbulence for sighs, which might however release projectives, blocked by the inductive discontinuity. Mechanical
control might also be amendable to mechanical tuning. Maybe the pumps should only move the lungs and keep them inflated, and to be sure, better to do the gas exchange through the blood via canula like dialysis. Or a
perfluorocarbon artificial blood though a gut catheter. Perfluorocarbin is
the only artificial blood approved for internal use, but there are other artifical bloods for ex vivo devide testing use which may be safe for the
gut. I cringe at the thought of some third world kid having to manually pump his granma's lungs but also wonder why it wasn't done in China and Italy to those who were triaged against respirators because of supply. If this goes
to the third world manual ventilators need to be considered. Musk might well provide wonderful batteries but when I was a teen my uncle-in-law was responsible for the batteries of Greek subs and had nightmares of them exploding (All stored energy, carbon, electrical, nuclear explodes); of
course, they too, might be kept at a distance from patients.

Exacerbating pre-existing medical conditions should also be treated pharmacologically to minimise respirator time. I was blown away a few weeks
ago at grand rounds that they use colchicine to reduce heart compression from TB. I've used it for gout and it is brutal, but it really works. Maybe it can reduce lung inflamation. Fibrotic lungs could be treated with relaxin, a pregnancy antifibrotic hormone which, however, could cause aneurisms.
Further, asma could be treated by rapamycin analogs (DL001 and SAR943).

ENVIRONMENT

COVID survives nine yeards before degrading because of its lipid capsid membrane. So I was thinking what type of benign, non-toxic environment could degrade it faster in essential public spaces. A friend was working on salt therapy. You could be walking around a fine particulate salt cloud, but then you need to sweep it up. Air ionisers and ozone may work (.1ppm daily
average) but could burn lungs, especially damaged ones. UV (253.7 nm) may
work but at some point it will be hazardous; you would have to at least
protect as for sunburn with sunglasses and long limb coverings. Maybe it can be pulsed, flash every five minutes, say in a subway or supermarket. In a
way anything that kills this thing will also kill us but we need to play with intensity, frequency, quanity and modulation.

FDA

I think Compassionate Use will work for a month or so more, unless we turn really bad, in which case the FDA will need to further unknot its
knickers. Clin trials are one of the costliest components of our med
system. And other coutries ride free at our expence. As confidence level is
a function of error over the square root of sample size, you can reduce your sample if you reduce your error. Twenty years ago there were attempts to use moderm software like Macsyma and Wolfram to do Adaptive Maximum Likelihood integrals for every sample instead of wait for the trial to end and do it
all. But then Vioxx blew up and all bets were off. Bob Cailif, who came up
with Compassionate use (terminal patients try anything; enhanced by Trump as Right to Try) while he was Obama FDA chief is now at Google Verily trying to use the entire Google universe as a trial sample. Already, In Australia, they are allowing health care workers to try a TB vaccine. In this case, a doctors is like an accredited investor. If they want to try a drug on themselves, why not. Jenner tired the smallpox vaccine on himself. See the ACCT
trial. Remdesevir, which was used on the first USA patient in Seattle, was approved under such adaptive trials.

GENERALITIES

Regenron's spike-protein antibody cocktail will go on trials in September; Safer than plasma which might carry other diseases. Maybe FDA will unkot knichers as was trying to do before vioxx blowup. Things that scare me most (please NO!): 1. The common cold from which covid derives mutates so fast we can't vaccinate against it. 2. If two pet dogs in Hong Kong, three zoo tigers and three zoo lions got it in NYC, how long until small mammalian vermin get and transmit it? Italy is trying ionisers for public spaces. Greece trials
with colchicine (common for TB heart compression) may also prevent
inflammation of secondary organs. Now that we got enough ventilators in NYC, there is a dialysis crisis. I wonder if they can't attach ions (I,Cu,Ag) to the spike protein antibodies to blow holes in the membrane and maybe even attach the vaccine so that it will attack the exposed RNA. I susepct the reason folks staying at home are so susceptible is they don't excercise their lungs which can be done by walking up and down indoor stairs or dancing.

INFLAMATION

Instead of pursuing millions with the virus, maybe we should treat the thousands who have the inflammatory (cytokine storm, auto-immune, almost allergic) reaction. Rx: Olumiant, ibudilast, Cortisone, Colchicine (see grecco-19 and colcorona on gov clin trials site). Searching medlineplus.gov
for <virus clot> shows antiphospholipid syndrome causes clots against virii
and bacteria.



https://en.wikipedia.org/wiki/Medical_ventilator https://accessmedicine.mhmedical.com/content.aspx?bookid=520&sectionid=41692239%20
https://hackaday.com/2020/03/12/ultimate-medical-hackathon-how-fast-can-we-design-and-deploy-an-open-source-ventilator/
https://engineering.columbia.edu/covid-tech-innovation https://www.ny.gov/programs/new-york-state-covid-19-technology-swat-team


- = -
Vasos Panagiotopoulos, Columbia'81+, Reagan, Mozart, Pindus
blog: panix.com/~vjp2/ruminatn.htm - = - web: panix.com/~vjp2/vasos.htm
facebook.com/vasjpan2 - linkedin.com/in/vasjpan02 - biostrategist.com
---{Nothing herein constitutes advice. Everything fully disclaimed.}---

--- SoupGate-Win32 v1.05
* Origin: fsxNet Usenet Gateway (21:1/5)