3D Printing in COVID-19: Productivity Estimation of the Most Promising Open Source Solutions in Emergency Situations

Optimization of 3D printing supply chain in the era of live streaming e-commerce

This study examines the effects of the rising live streaming e-commerce on the 3DP supply chain, employing system dynamics to develop separate models for pure polymer and polymer-metal mixed printing. The analysis focuses on optimizing the 3DP supply chain configuration. Results indicate that, based solely on printing time, cost, and quality metrics, Corporate-live-3DP services are optimal for live commerce scenarios. However, despite this, Private-live-3DP maintains a substantial consumer base in practice, as evidenced by literature data and case studies. Both models pose significant challenges to conventional supply chains, necessitating adaptation. For Corporate-live-3DP, optimization strategies may include technology advancements, digital transformation, agile manufacturing, global network optimization, innovative management, collaborative R&D, fine-tuned inventory control, quality system upgrades, talent development, and organizational restructuring. Conversely, Private-live-3DP can be optimized through consolidation of private 3D printing resources, demand prediction and order optimization, supply chain collaboration platforms, quality management extensions, inventory strategy adjustments, increased transparency, regulatory compliance, and risk mitigation measures.

Three-Dimensional Printed Laryngoscopes as Allies Against COVID-19

The COVID-19 pandemic has caused an overload on the health care system on a global scale. Because the disease affects the respiratory system, patients may require ventilator equipment for breathing, and consequently, numerous tracheal intubations have been performed. The video laryngoscope is a medical device that aids this procedure. It is used by anesthesiologists to visualize the anatomical structures of the larynx during tube insertion. Unfortunately, many hospitals worldwide are unable to afford sufficient units of this medical device. To satisfy the high demand, low-cost alternatives employing three-dimensional (3D) printing techniques have been developed for health care professional's use. With the intention of ensuring the efficiency, reproducibility, and security of the 3D-printed laryngoscope, this article presents a novel model with versions for pediatric and adult use, which was developed under the supervision of a medical team. The mechanical performance of 3D-printed prototypes (of the proposed models) was evaluated using mechanical assays, and the results indicated a satisfactory safety factor.

Engineering Materials and Devices for the Prevention, Diagnosis, and Treatment of COVID-19 and Infectious Diseases

Following the global spread of COVID-19, scientists and engineers have adapted technologies and developed new tools to aid in the fight against COVID-19. This review discusses various approaches to engineering biomaterials, devices, and therapeutics, especially at micro and nano levels, for the prevention, diagnosis, and treatment of infectious diseases, such as COVID-19, serving as a resource for scientists to identify specific tools that can be applicable for infectious-disease-related research, technology development, and treatment. From the design and production of equipment critical to first responders and patients using three-dimensional (3D) printing technology to point-of-care devices for rapid diagnosis, these technologies and tools have been essential to address current global needs for the prevention and detection of diseases. Moreover, advancements in organ-on-a-chip platforms provide a valuable platform to not only study infections and disease development in humans but also allow for the screening of more effective therapeutics. In addition, vaccines, the repurposing of approved drugs, biomaterials, drug delivery, and cell therapy are promising approaches for the prevention and treatment of infectious diseases. Following a comprehensive review of all these topics, we discuss unsolved problems and future directions.

The COVID-19 pandemic and supply chain: international cooperation patterns and influence mechanism

Purpose

The aim of this study is to undertake a systematic analysis of the supply chain literature to uncover the changes and patterns of international cooperation in the context of the COVID-19 pandemic.

Design/methodology/approach

In this study, the information on supply chain-related publications in the Web of Science (WOS) database is analyzed using statistical techniques and visual approaches. The focus is on the five countries with the highest number of supply chain publications, accounting for approximately 70% of global publications. This in-depth analysis aims to provide a clearer understanding of the cooperation patterns and their impact on the supply chain during the COVID-19 pandemic.

Findings

The results of the study reveal that the growth rate of international cooperation in supply chain research during the COVID-19 pandemic is higher compared to the 5-year and 10-year periods before the pandemic. This suggests that the pandemic has not hindered international cooperation in the field, but instead has increased collaboration. In terms of international cooperation patterns, the findings indicate that China and the USA have a strong partnership, with China being the largest partner for the USA and vice versa. The UK's largest partner is China, India's largest partner is the UK and Italy's largest partner is also the UK. This implies that trade, rather than the pandemic, is a determining factor in supply chain research.

Research limitations/implications

This study examines the patterns of international cooperation in supply chain research during the COVID-19 pandemic, providing insights into the changes and mechanisms of international cooperation in this field. Moreover, the results of this study may offer practical benefits for supply chain operators and managers. By providing a deeper understanding of the international cooperation patterns in the field, this research could contribute to the recovery and growth of the global supply chain.

Social implications

This study's analysis of the impact of crisis events, such as the COVID-19 pandemic, on international cooperation in supply chain research contributes to the theoretical development of the field. Additionally, by examining how academia responds to emergencies, it provides valuable insights for operations and supply chain managers in their pursuit of more effective supply chain management.

Originality/value

This study provides a preliminary examination of the international cooperation patterns of supply chain research in the context of the COVID-19 pandemic, representing a novel and early contribution to the existing literature, helping to expand upon current understanding in the field and provide a more comprehensive perspective. Furthermore, this study offers a practical analysis strategy for future supply chain research, fostering progress and growth in the field.

Identifying resilience strategies for disruption management in the healthcare supply chain during COVID-19 by digital innovations: A systematic literature review

The worldwide spread of the COVID-19 disease has had a catastrophic effect on healthcare supply chains. The current manuscript systematically analyzes existing studies mitigating strategies for disruption management in the healthcare supply chain during COVID-19. Using a systematic approach, we recognized 35 related papers. Artificial intelligence (AI), block chain, big data analytics, and simulation are the most important technologies employed in supply chain management in healthcare. The findings reveal that the published research has concentrated mainly on generating resilience plans for the management of COVID-19 impacts. Furthermore, the vulnerability of healthcare supply chains and the necessity of establishing better resilience methods are emphasized in most of the research. However, the practical application of these emerging tools for managing disturbance and warranting resilience in the supply chain has been examined only rarely. This article provides directions for additional research, which can guide researchers to develop and conduct impressive studies related to the healthcare supply chain for different disasters.

Translational design for limited resource settings as demonstrated by Vent-Lock, a 3D-printed ventilator multiplexer

Background

Mechanical ventilators are essential to patients who become critically ill with acute respiratory distress syndrome (ARDS), and shortages have been reported due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

We utilized 3D printing (3DP) technology to rapidly prototype and test critical components for a novel ventilator multiplexer system, Vent-Lock, to split one ventilator or anesthesia gas machine between two patients. FloRest, a novel 3DP flow restrictor, provides clinicians control of tidal volumes and positive end expiratory pressure (PEEP), using the 3DP manometer adaptor to monitor pressures. We tested the ventilator splitter circuit in simulation centers between artificial lungs and used an anesthesia gas machine to successfully ventilate two swine.

Results

As one of the first studies to demonstrate splitting one anesthesia gas machine between two swine, we present proof-of-concept of a de novo, closed, multiplexing system, with flow restriction for potential individualized patient therapy.

Conclusions

While possible, due to the complexity, need for experienced operators, and associated risks, ventilator multiplexing should only be reserved for urgent situations with no other alternatives. Our report underscores the initial design and engineering considerations required for rapid medical device prototyping via 3D printing in limited resource environments, including considerations for design, material selection, production, and distribution. We note that optimization of engineering may minimize 3D printing production risks but may not address the inherent risks of the device or change its indications. Thus, our case report provides insights to inform future rapid prototyping of medical devices.

3D Printing, Intellectual Property Rights and Medical Emergencies: In Search of New Flexibilities

The COVID-19 pandemic has exponentially accelerated the use of 3D printing (3DP) technologies in healthcare. Surprisingly, though, we have seen hardly any public intellectual property right (IPR) disputes concerning the 3D-printed medical equipment produced to cope with this crisis. Yet it can be assumed that a great variety of IPRs could potentially have been enforced against the use of various items of equipment printed out without express consent from IP holders. Many reasons might have motivated IP owners not to enforce their rights during the pandemic, such as the fear of acquiring a bad reputation during a declared situation of national emergency. There is no internationally recognised general exception to IPR enforcement for health emergencies, while several − sometimes ineffective − tools, like compulsory licensing, voluntary licensing arrangements and potential TRIPS waivers, have been considered or used to facilitate access to and the distribution of innovations in critical situations. During the COVID-19 emergency, this has meant that the 3DP community has been operating in a state of relative uncertainty including with regard to the risks of IP infringement. This study contextualises these issues for pandemic-relevant 3DP. Building upon experience gathered during the COVID-19 pandemic, we look to the future to see what novel mechanisms within the IPR system could provide the additional flexibility required for dealing more smoothly, with the help and support of digital technologies, with situations such as global health emergencies.

Workforce and supply chain disruption as a digital and technological innovation opportunity for resilient manufacturing systems in the COVID-19 pandemic

During the SARS-CoV-2 pandemic (also known as COVID-19), workforce downsizing needs, safety requirements, supply chain breaks and inventory shortages affected manufacturing systems' and supply chain's responsiveness and resilience. Companies wandered in a disrupted scenario because recommended actions/strategies to survive - and thrive - were not available an improvised actions to keep their operations up and running. This paper analyzes the COVID-19 impacts on the workforce and supply resilience in a holistic manner. The following research questions are discussed: (i) how can manufacturing firms cope with urgent staff deficiencies while sustaining at the same time a healthy and safe workforce in the perspective of socially sustainable and human-centric cyber-physical production systems?; (ii) is remote working (cf. smart working) applicable to shop-floor workers?; (iii) is it possible to overcome supply chain breaks without stopping production? In the first part, we propose three Industry 4.0-driven solutions that would increase the workforce resilience, namely: (i) the Plug-and-Play worker; (ii) the Remote Operator 4.0; (iii) the Predictive Health of the Operational Staff. In the second part, the concepts of (i) Digital & Unconventional Sourcing, i.e. Additive Manufacturing, and (ii) Product/Process Innovation are investigated from a novel business continuity and integration perspective. We ultimately argue that forward-looking manufacturing companies should turn a disruptive event like a pandemic in an opportunity for digital and technological innovation of the workplace inspired by the principles of harmonic digital innovation (that places the human well-being at the center). These aspects are discussed with use cases, system prototypes and results from research projects carried out by the authors and real-world examples arising lessons learned and insights useful for scientists, researchers and managers.

Digital Innovation, Data Analytics, and Supply Chain Resiliency: A Bibliometric-based Systematic Literature Review

In recent times, the literature has seen considerable growth in research at the intersection of digital innovation, data analytics, and supply chain resilience. While the number of studies on the topic has been burgeoning, due to the absence of a comprehensive literature review, it remains unclear what aspects of the subject have already been investigated and what are the avenues for impactful future research. Integrating bibliometric analysis with a systematic review approach, this paper offers the review of 262 articles at the nexus of innovative technologies, data analytics, and supply chain resiliency. The analysis uncovers the critical research clusters, the evolution of research over time, knowledge trajectories and methodological development in the area. Our thorough analysis enriches contemporary knowledge on the subject by consolidating the dispersed literature on the significance of innovative technologies, data analytics and supply chain resilience thereby recognizing major research clusters or domains and fruitful paths for future research. The review also helps improve practitioners' awareness of the recent research on the topic by recapping key findings of a large amount of literature in one place.

Additive Manufacturing Technology for Spare Parts Application: A Systematic Review on Supply Chain Management

Additive manufacturing (AM) is gaining interest among researchers and practitioners in the field of manufacturing. One major potential area of AM application is the manufacturing of spare parts, which affects the availability of the operation and supply chain. The data show that the application and adoption of AM has contributed to a reduction in lead times and inventory, which also contributes to a reduction in holding costs. This paper provides a review of recent work on the application of AM technology specifically for spare parts. The review shows that there are supply chain opportunities and challenges to the adoption of AM in spare parts within various application sectors. Our research reviews both the quantitative and qualitative models used for analysis to meet the emerging needs of the industry. The review also shows that the development of technology and its application is still emerging; therefore, there will be further opportunities to develop better spare parts supply chains to support AM applications. This paper concludes with future research directions.

Overcoming supply disruptions during pandemics by utilizing found hardware for open source gentle ventilation

This article details the design of an open source emergency gentle ventilator (gentle-vent) framework that can be used in periods of scarcity. Although it is not a medical device, the system utilizes a wide range of commonly-available components that are combined using basic electronics skills to achieve the desired performance. The main function of the gentle-vent is to generate a calibrated pressure wave at the pump to provide support to the patient's breathing. Each gentle-vent permutation was tested using a DIY manometer as it would be utilized in the field in low-resource settings and validated with an open source VentMon. The most rudimentary implementation costs less than $40.

Digital technologies, healthcare and Covid-19: insights from developing and emerging nations

COVID-19 pandemic created a global health crisis affecting every nation. The essential smart medical devices/accessories, quarantine facilities, surveillance systems, and related digital technologies are in huge demand. Healthcare, manufacturing industries, and educational institutions need technologies that allow working from a safe location. Digital technologies and Industry 4.0 tools have the potential to fulfil these customized requirements during and post COVID-19 crisis. The purpose of this research is to provide understanding to healthcare professionals, government policymakers, researchers, industry professionals, academics, and students/learners of the paradigm of different Digital technologies, Industry 4.0 tools, and their applications during the COVID-19 pandemic. Digital technologies, Industry 4.0 tools and their current and potential applications have been reviewed. The use of different Digital technologies and Industry 4.0 tools is identified. Digital technologies and Industry 4.0 tools (3D Printing, Artificial Intelligence, Cloud Computing, Autonomous Robot, Biosensor, Telemedicine service, Internet of Things (IoT), Virtual reality, and holography) offer opportunities for effective delivery of healthcare service(s), online education, and Work from Home (WFH) environment. The article emphasises the usefulness, most recent development, and implementation of Digital technologies, Industry 4.0 techniques, and tools in fighting the COVID-19 pandemic worldwide.

Opportunities for the Application of 3D Printing in the Critical Infrastructure System

The present article presents an analysis of the potential application of 3D printing in the critical infrastructure system. An attempt has been made to develop case studies for selected critical infrastructure areas, particularly with reference to the area of energy supply. The need for 3D printing applications is identified based on expert research in the energy industry. It identifies the application schemes determined by the technical and logistical possibilities associated with 3D printing in its broadest sense. A review of additive technologies with a view to their application in selected phases of critical infrastructure operation, including in crisis situations, is also carried out. Furthermore, a methodology for incorporating 3D printing into the existing critical infrastructure system is proposed. As a result, the following research hypothesis is adopted: the use of 3D printing can be an important part of measures to ensure the full functionality and efficiency of critical infrastructures, particularly in crisis situations.

Technological scouting of bi-material face masks: simulation of adherence using 3D Facial Norms

During the COVID-19 pandemic started in March 2020, the need for personal protective equipment rapidly grew as it became mandatory. The availability of a set of faces can be of great utility in designing a face mask with proper adherence and comfortability in wearing and breathing. A 3D geometry of a face with user-defined anthropometric measures was generated with Blender, a powerful development tool for creating 3D images. Using 3D Facial Norms, a free online database, it was possible to compute the mean anthropometric measures for the age groups of 17-20, 20-30, and 30-40 years old and then generate the respective faces for both genders. The adherence of an innovative face mask was then simulated with the reverse engineering software considering both the face mask and the faces rigid.

Technological scouting of bi-material face masks: experimental analysis on real faces

The need for personal protective equipment rapidly grew during the COVID-19. Companies had to face problems related to their products' sustainability, adherence, and comfortability. Designing a face mask with proper adherence and comfortability in wearing and breathing became a matter of great importance. In this work, the adherence of an innovative face mask and its comfortability were experimentally tested with real faces, considering the deformation of the mask and the soft facial tissues. A stereophotogrammetric acquisition was made of the face with the face mask during these tests. A comparison between the geometries of the face and the mask, undeformed and deformed, gave the respective deformations. The force applied by the mask to the face was calculated, measuring the elastic strain of the mask bands during wearing and the deformation.

A critical review of an additive manufacturing role in Covid-19 epidemic

In 2019, a massive and deadly coronavirus pandemic known as the COVID-19 pandemic has swept through more than 180 nations, causing a massive strain on already overtaxed health systems around the globe. Global demand for medical equipment has put a strain on traditional manufacturing methods, resulting in the need for an efficient, low-cost, and speedy mode of production. Additive manufacturing, or 3D printing, has been used by manufacturers to bridge the gap and enhance the production of medical products. Some designs that had been previously or conventionally fabricated have been revised to meet the 3D printing requirement for combating COVID-19. A variety of designs were created, and they are now in use in hospitals by patients and healthcare professionals. However, because some gadgets must adhere to rigorous standards, it is possible that some items will not meet these requirements. As a result, in order to protect the health of the user, it is necessary to understand each gadget, its usage, and industry standards. An investigation of the usage of additive manufacturing during the COVID-19 epidemic is presented in this paper. It brings together the manufacturers of a variety of 3D-printed products, including face shields, face masks, valves, nasopharyngeal swabs, and others, to debate their application and regulatory concerns in the medical field. The primary shortcoming of technology, discussed in reference to the next pandemic, is addressed here. It also looks at some of the ways that additive manufacturing could be used in the future during an emergency.

Adaptive Manufacturing for Healthcare During the COVID-19 Emergency and Beyond

During the COVID-19 pandemic, global health services have faced unprecedented demands. Many key workers in health and social care have experienced crippling shortages of personal protective equipment, and clinical engineers in hospitals have been severely stretched due to insufficient supplies of medical devices and equipment. Many engineers who normally work in other sectors have been redeployed to address the crisis, and they have rapidly improvised solutions to some of the challenges that emerged, using a combination of low-tech and cutting-edge methods. Much publicity has been given to efforts to design new ventilator systems and the production of 3D-printed face shields, but many other devices and systems have been developed or explored. This paper presents a description of efforts to reverse engineer or redesign critical parts, specifically a manifold for an anaesthesia station, a leak port, plasticware for COVID-19 testing, and a syringe pump lock box. The insights obtained from these projects were used to develop a product lifecycle management system based on Aras Innovator, which could with further work be deployed to facilitate future rapid response manufacturing of bespoke hardware for healthcare. The lessons learned could inform plans to exploit distributed manufacturing to secure back-up supply chains for future emergency situations. If applied generally, the concept of distributed manufacturing could give rise to "21st century cottage industries" or "nanofactories," where high-tech goods are produced locally in small batches.

Community-driven PPE production using additive manufacturing during the COVID-19 pandemic: Survey and lessons learned

This study presents a detailed analysis of the production efforts for personal protective equipment in makerspaces and informal production spaces (i.e., community-driven efforts) in response to the COVID-19 pandemic in the United States. The focus of this study is on additive manufacturing (also known as 3D printing), which was the dominant manufacturing method employed in these production efforts. Production details from a variety of informal production efforts were systematically analyzed to quantify the scale and efficiency of different efforts. Data for this analysis was primarily drawn from detailed survey data from 74 individuals who participated in these different production efforts, as well as from a systematic review of 145 publicly available news stories. This rich dataset enables a comprehensive summary of the community-driven production efforts, with detailed and quantitative comparisons of different efforts. In this study, factors that influenced production efficiency and success were investigated, including choice of PPE designs, production logistics, and additive manufacturing processes employed by makerspaces and universities. From this investigation, several themes emerged including challenges associated with matching production rates to demand, production methods with vastly different production rates, inefficient production due to slow build times and high scrap rates, and difficulty obtaining necessary feedstocks. Despite these challenges, nearly every maker involved in these production efforts categorized their response as successful. Lessons learned and themes derived from this systematic study of these results are compiled and presented to help inform better practices for future community-driven use of additive manufacturing, especially in response to emergencies.

3D-Printing to Mitigate COVID-19 Pandemic

3D-printing technology provided numerous contributions to the health sector during the recent Coronavirus disease 2019 (COVID-19) pandemic. Several of the 3D-printed medical devices like personal protection equipment (PPE), ventilators, specimen collectors, safety accessories, and isolation wards/ chambers were printed in a short time as demands for these were rising significantly. The review discusses some of these contributions of 3D-printing that helped to protect several lives during this health emergency. By enlisting some of the significant benefits of using the 3D-printing technique during an emergency over other conventional methods, this review claims that the former opens enormous possibilities in times of serious shortage of supply and exceeding demands. This review acknowledges the collaborative approaches adopted by individuals, entrepreneurs, academicians, and companies that helped in forming a global network for delivering 3D-printed medical/non-medical components, when other supply chains were disrupted. The collaboration of the 3D-printing technology with the global health community unfolds new and significant opportunities in the future.

Retrospective and prospective application of robots and artificial intelligence in global pandemic and epidemic diseases

About 4.25% of people have lost their lives due to COVID-19 disease, among SARS-CoV-2 infected patients. In an unforeseen situation, approximately 25,000 frontline healthcare workers have also been infected by this disease while providing treatment to the infected patients. In this devastating scenario, without any drug or vaccine available for the treatment, frontline healthcare workers are highly prone to viral infection. However, some countries are drastically facing a shortage of healthcare workers in hospitals.

METHODS

The literature search was conducted in ScienceDirect and ResearchGate, using words "Medical Robots", and "AI in Covid-19" as descriptors. To identify and evaluate the articles that create the impact of robots and artificial intelligence in pandemic diseases. Eligible articles were included publications and laboratory studies before and after covid-19 and also the prospective and retrospective of application of Robots and AI.

CONCLUSION

In this pandemic situation, robots were employed in some countries during the COVID-19 outbreak, which are medical robots, UV-disinfectant robots, social robots, drones, and COBOTS. Implementation of these robots was found effective in successful disease management, treatment, most importantly ensures the safety of healthcare workers. Mainly, the Disposal of deceased bodies and the location and transportation of infected patients to hospitals and hospitals were tough tasks and risk of infection. These tasks will be performed by employing mobile robots and automated guided robots respectively. Therefore, in the future, advanced automated robots would be a promising choice in hospitals and healthcare centers to minimize the risk of frontline healthcare workers.

Rapid Prototyping of Pneumatic Directional Control Valves

The main objective of the study was to design a pneumatic directional control valve for controlling pneumatic drives and produce it using a rapid prototyping technique. As the basic design assumption was to achieve high performance through a high flow rate and a low pressure drop, it was necessary to determine two flow parameters: the sonic conductance and the critical pressure ratio. The flow rate of compressed air and the diameters of the pneumatic conduits and fittings are important as they affect the rate of travel of the pneumatic cylinder piston. The 3D solid model of the directional control valve, developed in a CAD program, was used to simulate and optimize the flow rate. The analysis was performed by means of ANSYS CFX, a computational flow dynamics program. The main elements of the valve, i.e., the spool and the body, were produced using the PolyJet Matrix technology. The prototype was tested experimentally to determine the nominal flow-rate, calculate the flow parameters in accordance with the ISO 6358-1989 standard and compare them with the CFD simulation data. The simulation results showed very good agreement with the measurement data. The CFD analysis of the 3D solid model enabled us to optimize the flow of compressed air through the valve. The rapid prototyping method was found to be suitable to produce a fully functional directional control valve, which was confirmed through measurements at a test stand. The attempt to combine rapid prototyping used to fabricate pneumatic directional control valves with CFD used to simulate their operation was successful. The study shows that it is possible to design and construct a fully functional directional control valve characterized by high efficiency, high performance and a small pressure loss in a very short time and at a very low cost, which makes rapid prototyping superior to conventional methods of prototype making.

Sustainable supply chain management towards disruption and organizational ambidexterity: A data driven analysis

Balancing sustainability and disruption of supply chains requires organizational ambidexterity. Sustainable supply chains prioritize efficiency and economies of scale and may not have sufficient redundancy to withstand disruptive events. There is a developing body of literature that attempts to reconcile these two aspects. This study gives a data-driven literature review of sustainable supply chain management trends toward ambidexterity and disruption. The critical review reveals temporal trends and geographic distribution of literature. A hybrid of data-driven analysis approach based on content and bibliometric analyses, fuzzy Delphi method, entropy weight method, and fuzzy decision-making trial and evaluation laboratory is used on 273 keywords and 22 indicators obtained based on the experts' evaluation. The most important indicators are identified as supply chain agility, supply chain coordination, supply chain finance, supply chain flexibility, supply chain resilience, and sustainability. The regions show different tendencies compared with others. Asia and Oceania, Latin America and the Caribbean, and Africa are the regions needs improvement, while Europe and North America show distinct apprehensions on supply chain network design. The main contribution of this review is the identification of the knowledge frontier, which then leads to a discussion of prospects for future studies and practical industry implementation.

Design and construction of a simplified, gas-driven, pressure-controlled emergency ventilator

INTRODUCTION

Due to the COVID-19 crisis or any other mass casualty situation it might be necessary to give artificial ventilation to many affected patients. Contrarily, the worldwide availability of emergency ventilators is still a shortage, especially in developing countries.

METHODS

Modes of artificial ventilation were compared and the most safe, easy to use, and lung protecting principle was optimized to fit all requirements of both emergency ventilation and cost-effective mass production.

RESULTS

The presented research results describe a simplified device for a pressure-controlled ventilation which works without electricity according to a known principle. Just pressurized gas and a patient connection is required. The device enables the control of basic ventilator parameters such as peak inspiratory pressure, positive end-expiratory pressure and the ventilation frequency. Further, the device is semiadaptive to the patient's lung stiffness and automatically maintains minute volume through frequency adjustment. The machine can be manufactured by turning, milling and drilling and needs purchased components with costs less than 100 USD. A sterilization and thus a reuse is possible.

DISCUSSION

The presented development does not describe a ready-to-purchase ventilator, it rather outlines a refined working principle for emergency ventilation and its easiest methods of production with a minimum of requirements. The presented research aims on providing an open-source guideline for production of an emergency ventilator using worldwide available methods and thus should inspire local researchers to do a reverse engineering and eventually to put it into operation following country-specific regulations. For long-term ventilation exceeding emergency purposes, a monitoring of alarms for disconnection and violation of desired ventilator parameters should be established. The ventilator is limited to a fixed ratio between PIP and PEEP. Moreover, the ventilation frequency depends on two parameters, which needs some training. Nevertheless, the ventilator provides basic features to enable an emergency ventilation with minimal prerequisites.

Additive Manufacturing for Localized Medical Parts Production: A Case Study

Centralized supply chains (SCs) are prone to disruption, which makes them a risky choice for medical equipment production. Additive manufacturing (AM) allows for production localization and improvements in SC resilience. However, the comparative competitiveness of a localized SC from the time and cost perspective is still unclear. In this study, we investigate the competitiveness of localized medical part AM SCs against centralized ones by analyzing the responsiveness and cost of each SC. We utilize a real-world case study in which an AM service provider supplies medical parts to university medical centers in the Netherlands to construct six scenarios. We also develop a thorough empirical cost formulation for both central and local AM of patient-specific medical parts. The results of scenario analysis show that when utilizing the currently available AM technology, localized SC configurations significantly reduce the delivery time from about 54 to 27h, but at a 4.3-fold higher cost. Hence, we illustrate that the cost difference between the localized and centralized scenarios can be reduced when state-of-the-art AM machines are utilized, demand volumes increase, and the distances between the SC network nodes expand. Moreover, our scenario analysis confirms that the cost of the measures taken to prevent dust dispersion associated with powder-bed fusion AM has a major impact on the total cost of localized AM SCs for medical parts. The results of this study contribute to the understanding of the relevant factors in deciding whether central or localized SC configurations can be used in the AM production of medical parts. Furthermore, this study provides managerial insights for decision-makers at governments and hospitals as well as AM service providers and AM equipment manufacturers.

Comparing cost and print time estimates for six commercially-available 3D printers obtained through slicing software for clinically relevant anatomical models

Background

3D printed patient-specific anatomical models have been applied clinically to orthopaedic care for surgical planning and patient education. The estimated cost and print time per model for 3D printers have not yet been compared with clinically representative models across multiple printing technologies. This study investigates six commercially-available 3D printers: Prusa i3 MK3S, Formlabs Form 2, Formlabs Form 3, LulzBot TAZ 6, Stratasys F370, and Stratasys J750 Digital Anatomy.

Methods

Seven representative orthopaedic standard tessellation models derived from CT scans were imported into the respective slicing software for each 3D printer. For each printer and corresponding print setting, the slicing software provides a print time and material use estimate. Material quantity was used to calculate estimated model cost. Print settings investigated were infill percentage, layer height, and model orientation on the print bed. The slicing software investigated are Cura LulzBot Edition 3.6.20, GrabCAD Print 1.43, PreForm 3.4.6, and PrusaSlicer 2.2.0.

Results

The effect of changing infill between 15% and 20% on estimated print time and material use was negligible. Orientation of the model has considerable impact on time and cost with worst-case differences being as much as 39.30% added print time and 34.56% added costs. Averaged across all investigated settings, horizontal model orientation on the print bed minimizes estimated print time for all 3D printers, while vertical model orientation minimizes cost with the exception of Stratasys J750 Digital Anatomy, in which horizontal orientation also minimized cost. Decreasing layer height for all investigated printers increased estimated print time and decreased estimated cost with the exception of Stratasys F370, in which cost increased. The difference in material cost was two orders of magnitude between the least and most-expensive printers. The difference in build rate (cm³/min) was one order of magnitude between the fastest and slowest printers.

Conclusions

All investigated 3D printers in this study have the potential for clinical utility. Print time and print cost are dependent on orientation of anatomy and the printers and settings selected. Cost-effective clinical 3D printing of anatomic models should consider an appropriate printer for the complexity of the anatomy and the experience of the printer technicians.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41205-020-00091-4.

Additive Manufacturing Processes in Medical Applications

Additive manufacturing (AM, 3D printing) is used in many fields and different industries. In the medical and dental field, every patient is unique and, therefore, AM has significant potential in personalized and customized solutions. This review explores what additive manufacturing processes and materials are utilized in medical and dental applications, especially focusing on processes that are less commonly used. The processes are categorized in ISO/ASTM process classes: powder bed fusion, material extrusion, VAT photopolymerization, material jetting, binder jetting, sheet lamination and directed energy deposition combined with classification of medical applications of AM. Based on the findings, it seems that directed energy deposition is utilized rarely only in implants and sheet lamination rarely for medical models or phantoms. Powder bed fusion, material extrusion and VAT photopolymerization are utilized in all categories. Material jetting is not used for implants and biomanufacturing, and binder jetting is not utilized for tools, instruments and parts for medical devices. The most common materials are thermoplastics, photopolymers and metals such as titanium alloys. If standard terminology of AM would be followed, this would allow a more systematic review of the utilization of different AM processes. Current development in binder jetting would allow more possibilities in the future.

Retrospective and prospective application of robots and artificial intelligence in global pandemic and epidemic diseases

About 4.25% of people have lost their lives due to COVID-19 disease, among SARS-CoV-2 infected patients. In an unforeseen situation, approximately 25,000 frontline healthcare workers have also been infected by this disease while providing treatment to the infected patients. In this devastating scenario, without any drug or vaccine available for the treatment, frontline healthcare workers are highly prone to viral infection. However, some countries are drastically facing a shortage of healthcare workers in hospitals.

Methods

The literature search was conducted in ScienceDirect and ResearchGate, using words “Medical Robots”, and “AI in Covid-19” as descriptors. To identify and evaluate the articles that create the impact of robots and artificial intelligence in pandemic diseases. Eligible articles were included publications and laboratory studies before and after covid-19 and also the prospective and retrospective of application of Robots and AI.

Conclusion

In this pandemic situation, robots were employed in some countries during the COVID-19 outbreak, which are medical robots, UV-disinfectant robots, social robots, drones, and COBOTS. Implementation of these robots was found effective in successful disease management, treatment, most importantly ensures the safety of healthcare workers. Mainly, the Disposal of deceased bodies and the location and transportation of infected patients to hospitals and hospitals were tough tasks and risk of infection. These tasks will be performed by employing mobile robots and automated guided robots respectively. Therefore, in the future, advanced automated robots would be a promising choice in hospitals and healthcare centers to minimize the risk of frontline healthcare workers.

Towards Reinforcing Healthcare 4.0: A Green Real-Time IIoT Scheduling and Nesting Architecture for COVID-19 Large-Scale 3D Printing Tasks

With declaring the highly transmissible COVID-19 as a pandemic, an unprecedented strain on healthcare infrastructures worldwide occurred. An enormous shortage in the personal protective equipment (PPE) and the spare parts (SP) for the mechanical ventilators ensued as a consequence of the failure of the centralized global supply chains. Additive manufacturing and Industrial Internet of Things (IIoT), as the pillars of Industry 4.0, arose as the robust noncentralized alternatives. When gathered and properly managed in the IIoT, 3D Printers (3DPs) can complement and support Healthcare 4.0 to face the current and future pandemics. Thus, this paper proposes a real-time green allocation and scheduling architecture designed and dedicated particularly for the large-scale distributed 3D printing tasks (3DPTs) of both PPE and SPs. Our proposed architecture comprises; a broker (B) and a cluster manager (CM). Dynamic status check for the 3DPs and admission control for 3DPTs are among the interconnected roles of CM. CM also performs task allocation and scheduling according to our proposed Online Ascending Load-Balancing Modified Best-Fit (OALMBF) allocation algorithm and Green Real-time Nesting Priority-Based Adaptive (GRNPA) scheduling algorithm. The performance of the proposed architecture was investigated under extremely high-load environments which resulted in a success ratio and a response rate of 99.9667% and 10.9665 seconds, respectively, for the 3000 3DPTs trial. These results proved the robustness and the scalability of our architecture that surpasses its state-of-the-art counterparts. Besides respecting the real-time requirements of the 3DPTs, the proposed architecture improves the utilization of the 3DPs and guarantees an even workload distribution.

The role of 3D printing during COVID-19 pandemic: a review

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread through more than 180 countries, leading to diverse health systems overload around the world. Because of the high number of patients and the supply chain disruption, it generated a shortage of medical devices and personal protective equipment. In this context, initiatives from the additive manufacturing community emerged to fight the lack of devices. Diverse designs were produced and are currently being used in hospitals by patients and health workers. However, as some devices must follow strict standards, these products may not fulfill these standards. Therefore, to ensure the user's health, there is a need for understanding each device, their usage, and standards. This study reviews the use of additive manufacturing during COVID-19 pandemic. It gathers the source of several 3D printed devices such as face shields, face masks, valves, nasopharyngeal swabs, and others, discussing their use and regulatory issues. In this regard, the major drawbacks of the technology, addressed for the next pandemic scenario, are highlighted. Finally, some insights of the future of additive manufacturing during emergency are given and discussed.

Parametric nasopharyngeal swab for sampling COVID-19 and other respiratory viruses: Open source design, SLA 3-D printing and UV curing system

Access to nasopharyngeal swabs for sampling remain a bottleneck in some regions for COVID-19 testing. This study develops a distributed manufacturing solution using only an open source manufacturing tool chain consisting of two types of open source 3-D printing and batch UV curing, and provides a parametric fully free design of a nasopharyngeal swab. The swab was designed using parametric OpenSCAD in two components (a head with engineered break point and various handles), which has several advantages: i) minimizing print time on relatively slow SLA printers, ii) enabling the use of smaller print volume open source SLA printers, iii) reducing the amount of relatively expensive UV resin, and iv) enabling production of handle on more accessible material extrusion 3-D printers. A modular open source UV LED box was designed, fabricated for $45 and tested for batch curing. Swabs can be fabricated for $0.06-$0.12/swab. The results of the mechanical validation tests showed that the swabs could withstand greater forces than would be expected in normal clinical use. The swabs were also able to absorb a significant amounts of synthetic mucus materials and passed abrasion and handling tests. The results show the open source swab are promising candidates for clinical trials.

Partially RepRapable automated open source bag valve mask-based ventilator

This study describes the development of a simple and easy-to-build portable automated bag valve mask (BVM) compression system, which, during acute shortages and supply chain disruptions can serve as a temporary emergency ventilator. The resuscitation system is based on the Arduino controller with a real-time operating system installed on a largely RepRap 3-D printable parametric component-based structure. The cost of the materials for the system is under $170, which makes it affordable for replication by makers around the world. The device provides a controlled breathing mode with tidal volumes from 100 to 800 mL, breathing rates from 5 to 40 breaths/minute, and inspiratory-to-expiratory ratio from 1:1 to 1:4. The system is designed for reliability and scalability of measurement circuits through the use of the serial peripheral interface and has the ability to connect additional hardware due to the object-oriented algorithmic approach. Experimental results after testing on an artificial lung for peak inspiratory pressure (PIP), respiratory rate (RR), positive end-expiratory pressure (PEEP), tidal volume, proximal pressure, and lung pressure demonstrate repeatability and accuracy exceeding human capabilities in BVM-based manual ventilation. Future work is necessary to further develop and test the system to make it acceptable for deployment outside of emergencies such as with COVID-19 pandemic in clinical environments, however, the nature of the design is such that desired features are relatively easy to add using protocols and parametric design files provided.

Additively Manufactured Parametric Universal Clip-System: An Open Source Approach for Aiding Personal Exposure Measurement in the Breathing Zone

Design for additive manufacturing is adopted to help solve problems inherent to attaching active personal sampler systems to workers for monitoring their breathing zone. A novel and parametric 3D printable clip system was designed with an open source Computer-aided design (CAD) system and was additively manufactured. The concept was first tested with a simple clip design, and when it was found to be functional, the ability of the innovative and open source design to be extended to other applications was demonstrated by designing another tooling system. The clip system was tested for mechanical stress test to establish a minimum lifetime of 5000 openings, a cleaning test, and a supply chain test. The designs were also tested three times in field conditions. The design cost and functionalities of the clip system were compared to commercial systems. This study presents an innovative custom-designed clip system that can aid in attaching different tools for personal exposure measurement to a worker’s harness without hindering the operation of the worker. The customizable clip system opens new possibilities for occupational health professionals since the basic design can be altered to hold different kinds of samplers and tools. The solution is shared using an open source methodology.

Digital Technologies-Enabled Smart Manufacturing and Industry 4.0 in the Post-COVID-19 Era: Lessons Learnt from a Pandemic

The "Severe Acute Respiratory Syndrome Coronavirus Type 2" (SARS-CoV-2) has been identified as the infectious agent responsible for the generally mild but sometimes life-threatening communicable disease known as "Coronavirus Disease 2019" (COVID-19) [...].