Aerial drones for blood delivery

Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies

Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient's characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation.

Innovative blood transfusion strategies to address global blood deserts: a consensus statement from the Blood Delivery via Emerging Strategies for Emergency Remote Transfusion (Blood DESERT) Coalition

In rural settings worldwide, many people live in effective blood deserts without access to any blood transfusion. The traditional system of blood banking is logistically complex and expensive for many resource-restricted settings and demands innovative and multidisciplinary solutions. 17 international experts in medicine, industry, and policy participated in an exploratory process with a 2-day hybrid seminar centred on three promising innovative strategies for blood transfusions in blood deserts: civilian walking blood banks, intraoperative autotransfusion, and drone-based blood delivery. Participant working groups conducted literature reviews and interviews to develop three white papers focused on the current state and knowledge gaps of each innovation. Seminar discussion focused on defining blood deserts and developing innovation-specific implementation agendas with key research and policy priorities for future work. Moving forward, advocates should prioritise the identification of blood deserts and address the context-specific challenges for these innovations to alleviate the ongoing crisis in blood deserts.

Acceptance of medical drone technology and its determinant factors among public and healthcare personnel in a Malaysian urban environment: knowledge, attitude, and perception

Introduction

Unmanned aerial vehicles (UAVs) are used for commercial, medical, public safety, and scientific research purposes in various countries.

Methods

This study aimed to explore the acceptance of medical delivery drones among medical practitioners as well as the public community in Malaysia using a knowledge, attitude, and perception (KAP) model and statistical analysis to decrease uncertainty. Bivariate and multivariate analyses of the results were performed in SPSS.

Results

A total of 639 respondents took part in the survey, of which 557 complete responses were finally analyzed. The results showed that the overall acceptance rate for medical delivery drones was positive. The acceptance rate was significantly correlated with knowledge, attitude, and perception scores but not with sociodemographic factors.

Discussion

Raising awareness and educating the medical as well as public communities regarding the potential role and benefits of drones are therefore important in garnering support for drone usage for medical purposes.

Exploring the transformative role of drone technology in advancing healthcare delivery in Africa; a perspective

This perspective article delves into the transformative potential of drone technology in revolutionising healthcare delivery in Africa. The continent faces numerous challenges in providing timely and efficient medical services to its vast and diverse population, compounded by geographical barriers, inadequate infrastructure and limited access to medical facilities. Amidst these challenges, the integration of drone technology emerges as a promising solution, offering unprecedented opportunities to overcome longstanding obstacles and improve healthcare accessibility across Africa. Drawing from existing drone-based healthcare initiatives in Africa, the article explores various applications of drones in healthcare delivery. These encompass but are not limited to, delivering vaccines, medications, blood samples, diagnostic tools and medical personnel to remote locations in a timely and cost-effective manner. Furthermore, the paper examines the operational challenges and regulatory considerations in deploying drone technology for healthcare and the ethical implications surrounding privacy and security.

A hierarchical model for strategic and operational planning in blood transportation with drones

Blood transportation is a critical aspect of the healthcare systems, ensuring whole blood and blood products are delivered to patients in a timely and efficient manner. However, transportation of blood and other medical supplies can be challenging, especially in urban areas with limited infrastructure and heavy traffic. Drones have become increasingly important in recent years as a means of delivering medical supplies, including blood, due to their ability to provide fast, reliable, and cost-effective transportation. This study proposes two mathematical programming models in the hierarchical structure to improve decision-making for strategic and operational planning in the blood supply chain network. The limited information available in strategic planning presents risks to the blood supply chain, making it imperative to address uncertainties. To tackle this challenge, a novel approach called Scenario-based Robust Bi-objective Optimization has been proposed. The first model employs this approach to efficiently handle demand uncertainty by simultaneously maximizing the covered demand and minimizing costs. The model is subsequently solved using the augmented ε-constraint method. The second model is a routing-scheduling operational model that aims to minimize the sum of operations time, taking into account time windows for blood collection centers and hospitals. The developed hierarchical model is implemented in a three-level supply chain of Tehran province under three crisis scenarios in different parts. The findings and analysis of this implementation suggest that it is beneficial to set up drone stations in cost-effective and central locations to avoid costly network design. Furthermore, utilizing the minimum number of feasible drones enhances operational time and results in cost savings and increased efficiency. Overall, this study highlights the potential of using drones for blood transportation in urban settings, which can have significant implications for improving the quality of healthcare delivery.

Survey on Path Planning for UAVs in Healthcare Missions

This article presents a comprehensive review of the state-of-the-art applications and methodologies related to the use of unmanned aerial vehicles (UAVs) in the healthcare sector, with a particular focus on path planning. UAVs have gained remarkable attention in healthcare during the outbreak of COVID-19, and this study explores their potential as a viable option for medical transportation. The survey categorizes existing studies by mission type, challenges addressed, and performance metrics to provide a clearer picture of the path planning problems and potential directions for future research. It highlights the importance of addressing the path planning problem and the challenges that UAVs may face during their missions, including the UAV delivery range limitation, and discusses recent solutions in this field. The study concludes by encouraging researchers to conduct their studies in a realistic environment to reveal UAVs' real potential, usability, and feasibility in the healthcare domain.

Interfacility Transport of Critically Ill Patients

OBJECTIVES

To assess recent advances in interfacility critical care transport.

DATA SOURCES

PubMed English language publications plus chapters and professional organization publications.

STUDY SELECTION

Manuscripts including practice manuals and standard (1990-2021) focused on interfacility transport of critically ill patients.

DATA EXTRACTION

Review of society guidelines, legislative requirements, objective measures of outcomes, and transport practice standards occurred in work groups assessing definitions and foundations of interfacility transport, transport team composition, and transport specific considerations. Qualitative analysis was performed to characterize current science regarding interfacility transport.

DATA SYNTHESIS

The Task Force conducted an integrative review of 496 manuscripts combined with 120 from the authors' collections including nonpeer reviewed publications. After title and abstract screening, 40 underwent full-text review, of which 21 remained for qualitative synthesis.

CONCLUSIONS

Since 2004, there have been numerous advances in critical care interfacility transport. Clinical deterioration may be mitigated by appropriate patient selection, pretransport optimization, and transport by a well-resourced team and vehicle. There remains a dearth of high-quality controlled studies, but notable advances in monitoring, en route management, transport modality (air vs ground), as well as team composition and training serve as foundations for future inquiry. Guidance from professional organizations remains uncoupled from enforceable regulations, impeding standardization of transport program quality assessment and verification.

A bi-objective optimization model for the medical supplies' simultaneous pickup and delivery with drones

In the COVID-19 pandemic, it is essential to transport medical supplies to specific locations accurately, safely, and promptly on time. The application of drones for medical supplies delivery can break ground traffic restrictions, shorten delivery time, and achieve the goal of contactless delivery to reduce the likelihood of contacting COVID-19 patients. However, the existing optimization model for drone delivery is cannot meet the requirements of medical supplies delivery in public health emergencies. Therefore, this paper proposes a bi-objective mixed integer programming model for the multi-trip drone location routing problem, which allows simultaneous pick-up and delivery, and shorten the time to deliver medical supplies in the right place. Then, a modified NSGA-II (Non-dominated Sorting Genetic Algorithm II) which includes double-layer coding, is designed to solve the model. This paper also conducts multiple sets of data experiments to verify the performance of modified NSGA-II. Comparing with separate pickup and delivery modes, this study demonstrates that the proposed optimization model with simultaneous pickup and delivery mode achieves a shorter time, is safer, and saves more resources. Finally, the sensitivity analysis is conducted by changing some parameters, and providing some reference suggestions for medical supplies delivery management via drones.

U-Space and UTM Deployment as an Opportunity for More Complex UAV Operations Including UAV Medical Transport

Unmanned Aerial Vehicles (UAVs) or Unmanned Aircraft Systems (UASs) commonly called drones are relatively new entrants to the airspace. The regulatory agencies, numerous States and entities are involved in creation of the safe integration with manned aviation. The so-called U-space concept announced by the European Commission is one of the approaches to achieve that goal. There is also known concept of Unmanned Traffic Management (UTM) – a tool which would enable the services needed for safe conduct of UAV flights in generally accessible airspace. There are quite a few European projects which focuses on testing UTM capabilities in order to find a solution which could enable the market and ensure safe UAV operations. One of those systems is PansaUTM – which was developed in order to coordinate drone flights in different types of airspace in Poland. The first part of the paper will present an example of the implementation of this system as a foundation for new possible applications of drones and increasing number of operations. The conclusion of the first part of the article is that, in line rapid growth of UAS flights and different applications of drone services, the European drone ecosystem should evolve even further to deploy very complex drone operations in scalable manner. In order to accommodate unmanned air taxi operations, cargo flights, medical cargo flights, automatic surveillance flights, etc. Europe is preparing towards deployment of Advanced Air Mobility (AAM).

The second part of the text indicate the possibility of extensive use of drones in medical logistics as well as minimizing the epidemiological risk as a result of the use of this mean of transport. At the same time, it should be stressed out that the medical transport using drones can be used in urgent situations, where the main variable that has an impact on the success of life and health saving is the breaking of barriers to reaching difficult-to-reach places. In addition, the development of transport using drones can have a lasting impact on improving the quality of life of chronically ill patients who experience severe disease recurrence and thus on the need to implement emergency prevention or treatment measures.

The second part of the article focuses as well on the U-space concept as an opportunity for UAVs to be widely used in the field of day-to-day supplies as well as health-related supplies. In the context of the spread of SARS-CoV-2 virus, drones may be used to provide diagnostic screening tests, medicinal products and septic materials, transport of samples of biological material, as well as an information campaign on how to deal with an epidemic, quarantine or isolation at home. The use of UAV for medical supplies is economically and legally justified. The U-space environment from the operational and regulatory side is a multidisciplinary approach that requires the interaction of aviation, law, medicine, robotics, mechatronics and engineering experts. The legal framework for the development of U-space should be taken into account, as well as sector-specific regulations taking into account the principles of the use of drones in strictly defined areas, including in the process of medical supply, and liability for damage caused by UAV medical supply or AI-controlled intelligent machines.

A Conceptual Approach to Time Savings and Cost Competitiveness Assessments for Drone Transport of Biologic Samples with Unmanned Aerial Systems (Drones)

Unmanned aerial vehicles (UAVs, drones) are expected to save transport time and improve service reliability for transport of biologic samples, but few studies have evaluated the potential time savings of such services. The total transport time defined as time from sample ready for transport until arrival at the laboratory was used to assess the absolute and relative time savings of drones compared with ground transport, using ground distances from 4–7 km (urban model) to 179–262 km (rural district routes) with one to eight daily scheduled trips. Costs of existing ground transport were allocated to drone flight times as a proxy for drone cost competitiveness. Time savings were less than 20–30% in the urban model but 65–74% in the rural routes using drone speeds of 100 km/h, but the time between trips (route frequencies) and drone speeds influenced the relative time savings substantially. Cost of time gains per number of samples was less favorable using drones in the rural models due to lower transport volumes. This research concludes that drone solutions provide marginal gains for short-distance transports, whereas time savings are more promising in long transport models with appropriate scheduling and sufficiently high drone speeds.

Disparities in obstetric hemorrhage outcomes

Both the maternal and fetal outcomes of pregnancy vary greatly according to a pregnant woman’s community and her condition. The most devastating outcome is the death of a mother. In 2017, there were ≈295,000 maternal deaths globally with dramatic differences in maternal mortality based on geographic region, country, and women’s underlying conditions. Worldwide, the leading cause of maternal death is hemorrhage, comprising 94% of maternal deaths, with most cases occurring in low‐ or middle‐income countries. Whether a hemorrhage originates from inside the uterus (80%‐90%), from lacerations or incisions (10%‐20%), or from an underlying coagulopathy (<1%), an acute acquired coagulopathy will evolve unless the hemorrhage is controlled. In low‐ or middle‐income countries, the full range of resources to control hemorrhage is not available, but besides the usual obstetric measures, blood availability, hemostatic medication, and hematologic expertise are necessary to save mothers’ lives. Hemostasis and thrombosis experts can address the disparities in obstetric hemorrhage outcomes not only as providers but as consultants, researchers, and advocates.

A Socio-Analytical Approach to the Integration of Drones into Health Care Systems

The integration of drones into health care as a supplement to existing logistics methods may generate a need for cooperation and involvement across multiple resource areas. It is currently not well understood whether such integrations would merely represent a technical implementation or if they would cause more significant changes to laboratory services. By choosing socio-technical theory as the theoretical lens, this paper intends to harvest knowledge from the literature on various organizational concepts and examine possible synergies between such theories to determine optimal strategies for introducing the use of drones in a health care context. Our particular interest is to examine whether the insights generated from the multi-level perspective (MLP) may have the potential to create dynamic spin-offs related to the organizational transitions associated with the implementation of drones in health services. We built our study on a scoping literature review of topics associated with the MLP and socio-technical studies from differing arenas, supplemented with studies harvested on a broader basis. The scoping review is based on 25 articles that were selected for analysis. As a way of organizing the literature, the niche, regime, and landscape levels of the MLP are translated to the corresponding health care-related terms, i.e., clinic, institution, and health care system. Furthermore, subcategories emerged inductively during the process of analysis. The MLP provides essential knowledge regarding the context for innovation and how the interaction between the different levels can accelerate the diffusion of innovations. Several authors have put both ethical topics and public acceptance into a socio-technological perspective. Although a socio-technical approach is not needed to operate drones, it may help in the long run to invest in a culture that is open to innovation and change.

Assessing the practicalities of joint snakebite and dog rabies control programs: Commonalities and potential pitfalls

Both rabies and snakebite primarily affect underserved and impoverished communities globally, with an estimated 200,000 people dying from these diseases annually, and the greatest burden being in Africa and Asia. Both diseases have been neglected and have thus been denied appropriate prioritization, support, and interventions, and face many of the challenges common to all neglected tropical diseases (NTDs). In line with the call for integrated approaches between NTDs in the recent NTD Roadmap, we sought to build upon previous conceptualizations for an integrated approach by identifying the commonalities between snakebite and rabies to explore the feasibility of an integrated approach. While multiple areas for potential integration are identified, we highlight the potential pitfalls to integrating rabies and snakebite programs, considering the nuances that make each disease and its intervention program unique. We conclude that health system strengthening, and capacity building should be the focus of any integrated approach among NTDs, and that by strengthening overall health systems, both rabies and snakebite can advocate for further support from governments and stakeholders.

A Smart Capsule Equipped with Artificial Intelligence for Autonomous Delivery of Medical Material through Drones

In the last few years, many examples of blood and medicine delivery drones have been demonstrated worldwide, which mainly rely on aeronautical experience that is not common in the medical world. Speaking about drone delivery, attention should focus on the most important thing: the transported lifesaving good. Traditional boxes that monitor temperature are not usually in real time, and are not suitable for drone transportation because they are heavy and bulky. This means that the biomedical characteristics of delivery are of primary importance. A Smart Capsule, equipped with artificial intelligence (AI), is the first system ever proposed to provide a fully autonomous drone delivery service for perishable and high-value medical products, integrating real-time quality monitoring and control. It consists in a smart casing that is able to guide any autonomous aerial vehicle attached to it, specifically designed for transporting blood, organs, tissues, test samples and drugs, among others. The system monitors the conditions of the product (e.g., temperature, agitation and humidity) and adjusts them when needed by exploiting, for instance, vibrations to maintain the required agitation, ensuring that goods are ready to be used as soon as they are delivered. The Smart Capsule also leverages external temperature to reduce energy uptake from the drone, thus improving the drone’s battery life and flight range. The system replaces the need for specialized drivers and traditional road-bound transportation means, while guaranteeing compliance with all applicable safety regulations. A series of 16 experimental tests was performed to demonstrate the possibility of using the smart capsule to manage the flight and internal good delivery. Eighty-one missions were carried out for a total of 364 min of flight. The Smart Capsule greatly improves emergency response and efficiency of healthcare systems by reducing delivery times by up to 80% and costs by at least 28%. The Smart Capsule and its enabling technology based on AI for drone deliveries are discussed in this paper. The aim of this work is to show the possibility of managing drone delivery with an AI-based device.

Optimising antimicrobial use in humans - review of current evidence and an interdisciplinary consensus on key priorities for research

Addressing the silent pandemic of antimicrobial resistance (AMR) is a focus of the 2021 G7 meeting. A major driver of AMR and poor clinical outcomes is suboptimal antimicrobial use. Current research in AMR is inequitably focused on new drug development. To achieve antimicrobial security we need to balance AMR research efforts between development of new agents and strategies to preserve the efficacy and maximise effectiveness of existing agents. Combining a review of current evidence and multistage engagement with diverse international stakeholders (including those in healthcare, public health, research, patient advocacy and policy) we identified research priorities for optimising antimicrobial use in humans across four broad themes: policy and strategic planning; medicines management and prescribing systems; technology to optimise prescribing; and context, culture and behaviours. Sustainable progress depends on: developing economic and contextually appropriate interventions; facilitating better use of data and prescribing systems across healthcare settings; supporting appropriate and scalable technological innovation. Implementing this strategy for AMR research on the optimisation of antimicrobial use in humans could contribute to equitable global health security.

The effect of drone transport on the stability of biochemical, coagulation and hematological parameters in healthy individuals

Objectives

Transport of blood tubes is mainly by car or pneumatic transport. The transportation of blood tubes by drones is a novel approach for rapid transportation of blood tubes over long distances. However, limited data on the stability of biochemical, coagulation and hematological parameters is available after transport of blood tubes by drone.

Methods

To investigate the effect of drone transport on the stability of blood parameters, four test flights were performed. Blood was drawn from 20 healthy individuals and 39 of the most frequently measured blood parameters were compared between 4 groups; immediate measurement (control), late measurement, transport by car and transport by drone. Total Allowable Error (TAE) of the EFLM Biological Variation Database was used to determine the clinical relevance of significant differences.

Results

The majority of blood parameters were not affected by drone transport. Eight of the measured parameters showed significant differences between all the groups; glucose, phosphate, potassium, chloride, hemoglobin, platelet count, APTT and Lactate dehydrogenase (LD). A clinically relevant increase for LD after transport and a decrease for glucose values in time and after transport compared with the control group was shown.

Conclusions

Transportation of blood tubes from healthy individuals by drones has a limited clinically relevant effect. From the 39 investigated blood parameters only LD and glucose showed a clinically relevant effect.

A Drone Logistic Model for Transporting the Complete Analytic Volume of a Large-Scale University Laboratory

We present a model for drone transport of the complete annual analytic volume of 6.5 million analyses—(routine and emergency) between two inner-city university laboratories at Oslo University Hospital located 1.8 km apart and with a time restriction for the analyses of no more than 60 min. The total laboratory activity was analyzed per min for the complete year of 2018. The time from the clinical ordering of tests to the loading of the drone, drone transport time, and analysis time after the sample arrived at the analyzing laboratory were assessed using the lead time of emergency analyses of C-reactive protein, troponin, and the international normalized ratio. The activity had characteristic diurnal patterns, with the most intensive traffic between 8 and 12 a.m. on weekdays and there being considerably less traffic for the rest of the day, at night and on weekends. Drone schedules with departures 15–60 min apart were simulated. A maximum of 15 min between flights was required to meet the emergency demand for the analyses being completed within 60 min. The required drone weight capacity was below 3.5 kg at all times. In multiple simulations, the drone times were appropriate, whereas variations in the clinic- and laboratory-related time intervals caused violations of the allowed time 50% of the time. Drone transport with regular schedules may potentially improve the transport time compared with traditional ground transport and allow the merging of large laboratories, even when the demand for emergency analyses restricts the maximum transport time. Comprehensive economic evaluations and robust drone technology are needed before such solutions can be ready for implementation.

Real-time breath recognition by movies from a small drone landing on victim's bodies

In local and global disaster scenes, rapid recognition of victims' breathing is vital. It is unclear whether the footage transmitted from small drones can enable medical providers to detect breathing. This study investigated the ability of small drones to evaluate breathing correctly after landing on victims' bodies and hovering over them. We enrolled 46 medical workers in this prospective, randomized, crossover study. The participants were provided with envelopes, from which they were asked to pull four notes sequentially and follow the written instructions ("breathing" and "no breathing"). After they lied on the ground in the supine position, a drone was landed on their abdomen, subsequently hovering over them. Two evaluators were asked to determine whether the participant had followed the "breathing" or "no breathing" instruction based on the real-time footage transmitted from the drone camera. The same experiment was performed while the participant was in the prone position. If both evaluators were able to determine the participant's breathing status correctly, the results were tagged as "correct." All experiments were successfully performed. Breathing was correctly determined in all 46 participants (100%) when the drone was landed on the abdomen and in 19 participants when the drone hovered over them while they were in the supine position (p < 0.01). In the prone position, breathing was correctly determined in 44 participants when the drone was landed on the abdomen and in 10 participants when it was kept hovering over them (p < 0.01). Notably, breathing status was misinterpreted as "no breathing" in 8 out of 27 (29.6%) participants lying in the supine position and 13 out of 36 (36.1%) participants lying in the prone position when the drone was kept hovering over them. The landing points seemed wider laterally when the participants were in the supine position than when they were in the prone position. Breathing status was more reliably determined when a small drone was landed on an individual's body than when it hovered over them.

A review of postpartum hemorrhage in low-income countries and implications for strengthening health systems

Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity and mortality worldwide. Disparities in PPH-associated survival between high and low-/middle-income countries reflect an imperative for low-resource countries to improve strategies for rapid diagnosis and treatment. A review of current PPH diagnosis, prevention, treatment, and access to care in low-income countries has been used to understand, extract, and report the challenges that public health systems face in trying to solve the marked global disparity in PPH outcomes. Improvement in PPH survival begins with holistic strengthening of each step along the continuum of care in health systems and should include performance feedback measures and quality-of-care research.

Improved Compact Cuckoo Search Algorithm Applied to Location of Drone Logistics Hub

Drone logistics can play an important role in logistics at the end of the supply chain and special environmental logistics. At present, drone logistics is in the initial development stage, and the location of drone logistics hubs is an important issue in the optimization of logistics systems. This paper implements a compact cuckoo search algorithm with mixed uniform sampling technology, and, for the problem of weak search ability of the algorithm, this paper combines the method of recording the key positions of the search process and increasing the number of generated solutions to achieve further improvements, as well as implements the improved compact cuckoo search algorithm. Then, this paper uses 28 test functions to verify the algorithm. Aiming at the problem of the location of drone logistics hubs in remote areas or rural areas, this paper establishes a simple model that considers the traffic around the village, the size of the village, and other factors. It is suitable for selecting the location of the logistics hub in advance, reducing the cost of drone logistics, and accelerating the large-scale application of drone logistics. This paper uses the proposed algorithm for testing, and the test results indicate that the proposed algorithm has strong competitiveness in the proposed model.