3D printing of face shields to meet the immediate need for PPE in an anesthesiology department during the COVID-19 pandemic

Personalized 3D Printed Eye Gear for Microscopic Surgeons Amidst and beyond COVID-19

The COVID-19 pandemic underscored the need for enhanced protective measures for healthcare workers, particularly surgeons, who face a heightened risk of exposure to infectious aerosols. However, conventional eye protection equipment such as face shields, goggles, or glasses often leads to ergonomic discomfort and a reduced field of view (FOV), impeding surgeons' ability to perform microsurgical procedures with precision and ease. To address these limitations, this study aimed to develop personalized 3D-printed eye gear for microscopic surgeons based on facial anthropometry data. 3D scanning was employed to obtain facial data from ten neurosurgery residents. Utilizing computer-aided designing, eye gears tailored to the unique facial features of each participant were developed. Finite element analysis-based contact simulation was used to assess the pressure exerted by the eye gear. Multi-material 3D printing was employed to fabricate the personalized eye gear. Participants, while donning the eye gear, engaged in simulation-based micro suturing tasks at various magnifications of the operating microscope, and marked the FOV range. They provided feedback scores (1-10) on the effectiveness of the eye gear through a Likert scale questionnaire (Q1-Q8). Finite element analysis demonstrated uniform strain distribution on the face, indicating that the edges of the customized eye gear fit exactly to the user's face. The average scores for the questionnaire Q1 to Q8 ranged from 6.8 to 8.5, with an overall mean score of 7.6. This indicates that the developed eye gear was simple to use and did not cause any discomfort. Additionally, the average reduction in the FOV was only 10.93% across the different operating microscope magnifications. These findings highlight eye gear's potential to alleviate discomfort and enhance precision in microscopic surgeries. Consequently, personalized 3D-printed eye gear offers a promising solution for providing surgeons with a safe environment while preserving the benefits of the operating microscope.

Design and fabrication of a biodegradable face shield by using cleaner technologies for the protection of direct splash and airborne pathogens during the COVID-19 pandemic

Due to global supply chain disruptions and high demand for personal protective equipment (PPE), the rapidly expanding COVID-19 crisis left millions of front-line fighters unprotected. The disposal of PPE in the environment caused significant environmental pollution. Hence, indigenous initiatives have been taken to fabricate antiviral and biodegradable face shields with the help of neoteric and cleaner technologies. This paper describes a novel endeavor to design, manufacture, and performance analysis of a face shield made by plastic injection molding and LASER Cutting. Because of the requirement of permanent wear, the face shield's ergonomic design is considered low weight and easy head fixation, alongside high production ability. Here, face shield frames are made with lightweight, biodegradable plastic called Poly Lactic Acid (PLA), whereas an optical grade PLA sheet is used as the visor for better clarity. Visors PLA Sheet is coated with Nano-Silver disinfectant spray to incorporate antiviral properties to the Faceshield. Partially circumferential adjustable elastic straps are used for comfortable head fixation. To evaluate the product, clinical fit tests along with statistical survey were conducted, and the feedback from the end-users on comfort (41% Excellent, 30% Good, 26% Average and 3% Poor), clear view (33% Excellent, 38% Good, 24% Average, and 5% Poor), design features (43% Excellent, 35% Good, and 22% Average), simplicity of installation and disassembly (29% Excellent, 33% Good, and 38% Average), and ease of wearing/removing (45% Excellent, 40% Good, and 15%Average) are encouraging.

Validation of 3D-Printed Swabs for Sampling in SARS-CoV-2 Detection: A Pilot Study

In this pilot study, we characterize and evaluate 3D-printed swabs for the collection of nasopharyngeal and oropharyngeal secretion samples for the SARS-CoV-2 detection. Swabs are made with the fused deposition modeling technique using the biopolymer polylactic acid (PLA) which is a medical-grade, biodegradable and low-cost material. We evaluated six swabs with mechanical tests in a laboratory and in an Adult Human Simulator performed by healthcare professionals. We proved the adequacy of the PLA swab to be used in the gold standard reverse transcriptase-polymerase chain reaction (qRT-PCR) for viral RNA detection. Then, we did in vitro validation for cell collection using the 3D-printed swabs and RNA extraction for samples from 10 healthy volunteers. The 3D-printed swabs showed good flexibility and maneuverability for sampling and at the same time robustness to pass into the posterior nasopharynx. The PLA did not interfere with the RNA extraction process and qRT-PCR test. When we evaluated the expression of the reference gene (RNase P) used in the SARS-CoV-2 detection, the 3D-printed swabs showed good reproducibility in the threshold cycle values (Ct = 23.5, range 19-26) that is comparable to control swabs (Ct = 24.7, range 20.8-32.6) with p value = 0.47. The 3D-printed swabs demonstrated to be a reliable, and an economical alternative for mass use in the detection of SARS-CoV-2.

Lessons from COVID-19 for future disasters: an opinion paper

A "Pandemic/Disaster Law" is needed to condense and organize the current dispersed and multiple legislation. The State must exercise a single power and command appropriate to each situation, with national validity. The production of plans for the use of land and real estate as potential centers for health care, shelter or refuge is recommended. There should be specific disaster plans at least for Primary Health Care, Hospitals and Socio-sanitary Centers. The guarantee of the maintenance of communication and supply routes is essential, as well as the guarantee of the autochthonous production of basic goods. The pandemic has highlighted the need to redefine the training plans for physicians who, in their different specialties, have to undertake reforms that allow a more versatile and transversal training. National research must have plans to be able to respond quickly to questions posed by the various crises, using all the nation's resources and in particular, all the data and capabilities of the health sector. Contingency plans must consider ethical aspects, and meet the needs of patients and families with a humanized approach. In circumstances of catastrophe, conflicts increase and require a bioethical response that allows the best decisions to be made, with the utmost respect for people's values. Rapid, efficient and truthful communication systems must be contained in a special project for this sector in critic circumstances. Finally, we believe that the creation of National Coordination Centers for major disasters and Public Health can contribute to better face the crises of the future.

Mohan D, Karganroudi SS. The Unprecedented Role of 3D Printing Technology in Fighting the COVID-19 Pandemic: A Comprehensive Review

The coronavirus disease 2019 (COVID-19) rapidly spread to over 180 countries and abruptly disrupted production rates and supply chains worldwide. Since then, 3D printing, also recognized as additive manufacturing (AM) and known to be a novel technique that uses layer-by-layer deposition of material to produce intricate 3D geometry, has been engaged in reducing the distress caused by the outbreak. During the early stages of this pandemic, shortages of personal protective equipment (PPE), including facemasks, shields, respirators, and other medical gear, were significantly answered by remotely 3D printing them. Amidst the growing testing requirements, 3D printing emerged as a potential and fast solution as a manufacturing process to meet production needs due to its flexibility, reliability, and rapid response capabilities. In the recent past, some other medical applications that have gained prominence in the scientific community include 3D-printed ventilator splitters, device components, and patient-specific products. Regarding non-medical applications, researchers have successfully developed contact-free devices to address the sanitary crisis in public places. This work aims to systematically review the applications of 3D printing or AM techniques that have been involved in producing various critical products essential to limit this deadly pandemic's progression.

Smart face shield for the monitoring of COVID-19 physiological parameters: Personal protective equipment (PPE) for health-care workers (HCW’s) and COVID-19 patients

The COVID-19 pandemic has triggered instabilities in various aspects of daily life. This includes economic, social, financial, and health crisis. In addition, the COVID-19 pandemic with the evolution of different virus strains such as delta and omicron has led to frequent global lockdowns. These lockdowns have caused disruption of trade activities that in turn have led to the shortage of medical supplies, especially personal protective equipment’s (PPE’s). Health-care workers (HCW’s) have been at the forefront of the fight against this pandemic and are responsible for saving millions of lives worldwide. However, the PPE’s available to HCW’s in the form of face shields and face masks only provide face and eye protection without encapsulating the ability to continuously monitor vital COVID-19 parameters including body temperature, heart rate, and SpO2. Hence, in this study, we propose the design and utilization of a PPE in the form of smart face shield. The device has been integrated with the MAX30102 sensor for measuring the heart rate and oxygen saturation (SpO2) and the DS18B20 body temperature measuring sensor. The readings of these sensors are analyzed by a NodeMCU ESP8266 and measurements are displayed on a laptop screen. Also, the Wi-Fi module of NodeMCU ESP8266 enables compatibility with the ThingSpeak mobile application and permits HCW’s and patients recovering from COVID-19 to keep a track of their physiological parameters. Overall, this PPE has been observed to provide reliable readings and the results indicate that the designed prototype can be used for monitoring COVID-19 essential parameters.

Innovation Environment’s Role in Supporting Industry 4.0 Technology Adoption to Address Effects of COVID-19

Health systems were severely strained at the start of the COVID-19 pandemic, where the demand for personal protection equipment (PPE) could not be met. The challenge faced by many countries was how to innovate quickly to create PPE and other needed solutions. The subsequent research gap identified was a lack of practical insights on how to support such novel technology adoption, particularly those that stem from Industry 4.0 (I4.0) within a developing world context. To address this previous literature on I4.0 technology, the role of innovation environments and theoretical principles of technology adoption was reviewed. A practical case from an academic makerspace based in a South African university was then assessed. It was selected due to its direct role in rapid solutions development of PPE using additive manufacturing (AM) until such a time that manufacturers could set up production on a larger scale. It was found that AM and other novel technologies have facilitated innovative solutions to address the significant impacts of the pandemic. Key to which were practices identified of an innovation environment that supported early-stage adoption of AM to achieve this even in a developing country context. The findings imply that innovation environments offer an agile platform to leverage innovation by streamlining certain critical success factors of I4.0 technology adoption, which is presented in a model. However, individual skills developed by such environments to enhance innovation capabilities within this paradigm require further research.

Customized protective visors enabled by closed loop controlled 4D printing

The COVID-19 pandemic makes protective visors important for protecting people in close contacts. However, the production of visors cannot be increased greatly in a short time, especially at the beginning of the pandemic. The 3D printing community contributed largely in fabricating the visor frames using the rapid and adaptive manufacturing ability. While there are many open source designs of face visors for affordable 3D printers, all these designs fabricate mono-sized frames without considering diverse users’ dimensions. Here, a new method of visor post-processing technology enabled by closed loop controlled 4D printing is proposed. The new process can further deform the printed visor to any customized size for a more comfortable user experience. FEM analysis of the customized visor also shows consistent wearing experience in different circumstances compared with the old visor design. The fabrication precision and time cost of the method is studied experimentally. A case study regarding the reducing, reusing and recycling (3R) of customized visors in classrooms is proposed to enable the customized visors manufactured in a more sustainable way.

The feasibility of masks and face shields designed by 3D printing makers; some considerations of their use against the COVID-19

The use of mask and face shield has been established as one of the main preventive measures for the control of COVID 19 spread. In Mexico, as well as in other regions of the world, 3D printing has been employed for the design and production of masks and face shields as personal protective equipment (PPE). These models have been fabricated mainly by the makers, industries, and university communities; therefore, it is necessary to analyze the feasibility of the 3D printed PPE to understand its advantages and limitations. In this work, some characteristics of masks and face shields fabricated by additive manufacturing were studied to explore their viability as protection against flow fluids similar to human sneeze. In the present paper, the PPE was designed, and 3D printed utilizing three types of polylactic acid (PLA) as base material. The morphology and the surface elemental analyses of sectioned samples were analyzed by scanning electron microscopy (SEM) and energy dispersion x-ray spectroscopy (EDS). Showing spacing between printed layers, porous areas, and dispersed copper particles. On the other hand, a computational fluid dynamics (CFD) simulation was carried out, the results demonstrated the importance of using PPE for protection of a possible exposure to a “contaminated” aerosol and human sneeze. Based on the abovementioned results, it is possible to consider the commercial PLA as suitable material for the manufacturing of PPE due to its capability to be disinfected employing isopropanol, ethanol, or commercial disinfectants.

Indications for accurate and appropriate use of personal protective equipment for healthcare professionals. A systematic review

BACKGROUND

The speed of the spread of coronavirus disease 2019 (COVID-19) has put enormous pressure on hospitals and other healthcare facilities. This, together with blockages in several countries, has hindered the availability and accessibility of the necessary personal protective equipment (PPE).

OBJECTIVE

To identify, systematically evaluate and summarize the available scientific evidence on the efficacy, safety, safe use and reuse of PPE for healthcare professionals, for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

DESIGN AND SETTING

Systematic review of studies analyzing products for disinfecting and enabling reuse of PPE for coronavirus within the evidence-based health program of a federal university in São Paulo (SP), Brazil.

METHODS

A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science and LILACS databases, for articles published up to November 30, 2020.

RESULTS

Ten studies were selected. These analyzed the use of N95, surgical and cotton masks, face shields, flexible enclosures with plastic covers or polycarbonate intubation boxes and plastic curtains; and also PPE disinfection using several substances.

CONCLUSION

Combined use of a face shield with a N95 mask proved to be superior to other associations for protecting healthcare workers. Some products are useful for disinfecting PPE, such as 70% ethanol, 0.1% sodium hypochlorite and a mixture of quaternary ammonium and H2O2, and hydrogen peroxide. Ultraviolet light and dry heat at 70 °C can be used to decontaminate N95 masks.

REGISTRATION NUMBER

DOI: 10.17605/OSF.IO/4V5FD at the OPENSCIENCE Framework.

3D Printing: Advancement in Biogenerative Engineering to Combat Shortage of Organs and Bioapplicable Materials

Abstract

Organ or cell transplantation is medically evaluated for end-stage failure saving or extending the lives of thousands of patients who are suffering from organ failure disorders. The unavailability of adequate organs for transplantation to meet the existing demand is a major challenge in the medical field. This led to day-day-increase in the number of patients on transplant waiting lists as well as in the number of patients dying while on the queue. Recently, technological advancements in the field of biogenerative engineering have the potential to regenerate tissues and, in some cases, create new tissues and organs. In this context, major advances and innovations are being made in the fields of tissue engineering and regenerative medicine which have a huge impact on the scientific community is three-dimensional bioprinting (3D bioprinting) of tissues and organs. Besides this, the decellularization of organs and using this as a scaffold for generating new organs through the recellularization process shows promising results. This review discussed about current approaches for tissue and organ engineering including methods of scaffold designing, recent advances in 3D bioprinting, organs regenerated successfully using 3D printing, and extended application of 3D bioprinting technique in the field of medicine. Besides this, information about commercially available 3D printers has also been included in this article.

Lay Summary

Today's need for organs for the transplantation process in order to save a patient's life or to enhance the survival rate of diseased one is the prime concern among the scientific community. Recent, advances in the field of biogenerative engineering have the potential to regenerate tissues and create organs compatible with the patient's body. In this context, major advances and innovations are being made in the fields of tissue engineering and regenerative medicine which have a huge impact on the scientific community is three-dimensional bioprinting (3D bioprinting) of tissues and organs. Besides this, the decellularization of organs and using this as a scaffold for generating new organs through the recellularization process shows promising results. This review dealt with the current approaches for tissue and organ engineering including methods of scaffold designing, recent advances in 3D bioprinting, organs regenerated successfully using 3D printing, and extended application of 3D bioprinting technique in the field of medicine. Furthermore, information about commercially available 3D printers has also been included in this article.

Material Extrusion-Based Additive Manufacturing of Poly(Lactic Acid) Antibacterial Filaments-A Case Study of Antimicrobial Properties

In the era of the coronavirus pandemic, one of the most demanding areas was the supply of healthcare systems in essential Personal Protection Equipment (PPE), including face-shields and hands-free door openers. This need, impossible to fill by traditional manufacturing methods, was met by implementing of such emerging technologies as additive manufacturing (AM/3D printing). In this article, Poly(lactic acid) (PLA) filaments for Fused filament fabrication (FFF) technology in the context of the antibacterial properties of finished products were analyzed. The methodology included 2D radiography and scanning electron microscopy (SEM) analysis to determine the presence of antimicrobial additives in the material and their impact on such hospital pathogens as Staphylococcus aureus, Pseudomonas aeruginosa, and Clostridium difficile. The results show that not all tested materials displayed the expected antimicrobial properties after processing in FFF technology. The results showed that in the case of specific species of bacteria, the FFF samples, produced using the declared antibacterial materials, may even stimulate the microbial growth. The novelty of the results relies on methodological approach exceeding scope of ISO 22196 standard and is based on tests with three different species of bacteria in two types of media simulating common body fluids that can be found on frequently touched, nosocomial surfaces. The data presented in this article is of pivotal meaning taking under consideration the increasing interest in application of such products in the clinical setting.

3D Printing in Eye Care

Three-dimensional printing enables precise modeling of anatomical structures and has been employed in a broad range of applications across medicine. Its earliest use in eye care included orbital models for training and surgical planning, which have subsequently enabled the design of custom-fit prostheses in oculoplastic surgery. It has evolved to include the production of surgical instruments, diagnostic tools, spectacles, and devices for delivery of drug and radiation therapy. During the COVID-19 pandemic, increased demand for personal protective equipment and supply chain shortages inspired many institutions to 3D-print their own eye protection. Cataract surgery, the most common procedure performed worldwide, may someday make use of custom-printed intraocular lenses. Perhaps its most alluring potential resides in the possibility of printing tissues at a cellular level to address unmet needs in the world of corneal and retinal diseases. Early models toward this end have shown promise for engineering tissues which, while not quite ready for transplantation, can serve as a useful model for in vitro disease and therapeutic research. As more institutions incorporate in-house or outsourced 3D printing for research models and clinical care, ethical and regulatory concerns will become a greater consideration. This report highlights the uses of 3D printing in eye care by subspecialty and clinical modality, with an aim to provide a useful entry point for anyone seeking to engage with the technology in their area of interest.

Moldable Mask: A Reusable, Hot Water Moldable, Additively Manufactured Mask to Be Used as an N95 Alternative

There has been high demand for personal protective equipment (PPE) during the COVID-19 pandemic, especially N95 respirators. Unfortunately, at the early stage of the pandemic, the supply could not meet the demand for N95 respirators, leading to a shortage and unsafe reuse of this form of PPE. We developed the Moldable Mask to ease the demand for N95 respirators by creating a 3D-printed mask that uses a piece of N95 material as a filter. A sheet of N95 material could be used or one N95 respirator to be turned into two masks. The main feature of the mask is the ability to easily mold it in hot water to create a custom fit for each user. It can also be easily assembled at home with affordable materials. The final mask design was qualitatively fit tested on 13 subjects, with all subjects showing an improvement in fit with the hot water molding technique and 10 (77%) subjects passing the fit test. This shows that the Moldable Mask is a viable option for a safe, affordable N95 alternative when N95 mask supply is strained.

A Statewide Voluntary Movement Addressing the Shortage of Medical Supplies During the COVID-19 Pandemic

During the COVID-19 pandemic, a shortage of personal protective equipment compromised efficient patient care and provider safety. Volunteers from many different backgrounds worked to meet these demands. Additive manufacturing, laser cutting, and alternative supply chains were used to produce, test, and deliver essential equipment for health care workers and first responders. Distributed equipment included ear guards, face shields, and masks. Contingent designs were created for powered air-purifying respirator hoods, filtered air pumps, intubation shields, and N95 masks.

Evaluation of 3D-printer settings for producing personal protective equipment

Aim: COVID-19 resulted in a shortage of personal protective equipment. Community members united to 3D-print face shield headbands to support local healthcare workers. This study examined factors altering print time and strength. Materials & methods: Combinations of infill density (50%, 100%), shell thickness (0.8, 1.2 mm), line width (0.2 mm, 0.4 mm), and layer height (0.1 mm, 0.2 mm) were evaluated through tensile testing, finite element analysis, and printing time. Results: Strength increased with increased infill (p < 0.001) and shell thickness (p < 0.001). Layer height had no effect on strength. Increasing line width increased strength (p < 0.001). Discussion: Increasing layer height and line width decreased print time by 50 and 39%, respectively. Increased shell thickness did not alter print time. These changes are recommended for printing.

Role of additive manufacturing in medical application COVID-19 scenario: India case study

This paper reviews how the Additive Manufacturing (AM) industry played a key role in stopping the spread of the Coronavirus by providing customized parts on-demand quickly and locally, reducing waste and eliminating the need for an extensive manufacturer. The AM technology uses digital files for the production of crucial medical parts, which has been proven essential during the COVID-19 crisis. Going ahead, the 3D printable clinical model resources described here will probably be extended in various centralized model storehouses with new inventive open-source models. Government agencies, individuals, corporations and universities are working together to quickly development of various 3D-printed products especially when established supply chains are under distress, and supply cannot keep up with demand.

The role of 3D printing in the fight against COVID-19 outbreak

Along with the COVID-19 pandemic, urgent needs for medical and specialized products, especially personal protective equipment, has been overwhelming. The conventional production line of medical devices has been challenged by excessive global demand, and the need for an easy, low-cost and rapid fabrication method is felt more than ever. In a scramble to address this shortfall, manufacturers referred to additive manufacturing or 3D printing to fill the gap and increase the production line of medical devices. Various previously/conventionally fabricated designs have been modified and redesigned to suit the 3D printing requirement to fight against COVID-19. In this perspective, various designs accommodated for the current worldwide outbreak of COVID-19 are discussed and how 3D printing could help the global community against the current and future conditions has been explored.

Manufacturing Zero-Waste COVID-19 Personal Protection Equipment: a Case Study of Utilizing 3D Printing While Employing Waste Material Recycling

COVID-19 pandemic outbreak dictated the extensive use of personal protective equipment (PPE) by the majority of the population and mostly by frontline professionals. This need triggered a sudden demand that led to a global shortage of available PPEs threatening to have an immense contribution to the virus contamination spread. In these conditions, the need for a local, flexible, and rapid manufacturing method that would be able to cope with the increased demand for PPE fabrication arose. 3D printing proved to be such a manufacturing technique since its working principles make it an ideal technology for local, decentralized production of PPEs meeting the local demands. While considered to be more environmentally friendly than conventional fabrication techniques and aligning well with the principles of sustainability and circular economy, 3D printing can produce waste as the result of potential failed prints and material used for the fabrication of support structures. This paper describes the case of utilizing pre-existing FDM 3D printing equipment in an academic facility for the production of PPEs (face shields) and their distribution according to local demands. The plastic wastes produced were forwarded to a recycling process that led to their conversion to 3D filament that would be returned to the academic facility as raw material for future 3D printing operations. The followed procedure minimized 3D printing waste and led to a zero-waste fabrication case that was initiated in a pandemic for a greater-good cause (production of COVID-19 fighting PPEs) while assimilating the values of sustainability and circular economy.

COVID-19: The Use of 3D Printing to Address PPE Shortage during a Pandemic-A Safety Perspective

The COVID-19 pandemic created a global health crisis that impacted the supply of personal protective equipment and created a shortage of much-needed face shields and masks for essential workers. During this time, a community of manufacturers, academic institutes, and hobbyists came together and tried to address the supply shortage by providing 3D-printed face shields and masks. Although the Secretary of U.S. Department of Human and Health Services and the Food and Drug Administration relaxed some of the liability and product regulations regarding 3D-printed medical supplies during the pandemic, the safety of 3D-printed face shields and masks is still a concern. In this Review, we have highlighted some of the safety concerns related to printing materials, design consideration, waste generation and disposal, intellectual property and manufacturing regulations, and the sanitization of 3D-printed personal protective equipment.