EYESPIRATOR- A novel do-it-yourself suction device

Surgery, by nature, involves blood loss. Thus, suction plays an important role in ensuring a clean operating view and ease of access. In ophthalmology, there is a void for an efficient and flexible suction apparatus that is yet to be filled. Our innovation, the Eyespirator, is made using recycled or inexpensive parts, is easy to assemble, and can serve as a cost-effective alternative to the current apparatus under use. It helps to overcome the difficulties caused by large instruments and non-pliable suction tips, unregulated generation of vacuum, and high pressures generated causing trauma to the delicate structures, and can prove to be of immense use in fields such as ophthalmology where the small surgical field is a big challenge. It creates a vacuum by using a simple water pump and is regulated by a foot pedal. This can be deployed even in rural settings, and small modifications can allow its usage in a wide variety of surgical fields.

Do It Yourself (DIY) Radiolucent Drill Guide Using a 10 ml Syringe for Freehand Distal Interlocking in Intra-medullary Nailing: A Surgical Technique

Distal interlocking during intramedullary femoral, tibial, and humeral nailing is frequently challenging. In the traditional image intensifier (II) 'bull's eye' technique, the implant's interlocking screw hole can be obscured by the radio-opaque chuck, necessitating multi-planar checks by tilting the drill bit before drilling. This manoeuvre can adversely alter the drill trajectory, compromise fixation, or damage the implant. We introduce a surgical technique that uses a 10 ml syringe to overcome this difficulty.

A Do-It-Yourself Hyperspectral Imager Brought to Practice with Open-Source Python

Commercial hyperspectral imagers (HSIs) are expensive and thus unobtainable for large audiences or research groups with low funding. In this study, we used an existing do-it-yourself push-broom HSI design for which we provide software to correct for spectral smile aberration without using an optical laboratory. The software also corrects an aberration which we call tilt. The tilt is specific for the particular imager design used, but correcting it may be beneficial for other similar devices. The tilt and spectral smile were reduced to zero in terms of used metrics. The software artifact is available as an open-source Github repository. We also present improved casing for the imager design, and, for those readers interested in building their own HSI, we provide print-ready and modifiable versions of the 3D-models required in manufacturing the imager. To our best knowledge, solving the spectral smile correction problem without an optical laboratory has not been previously reported. This study re-solved the problem with simpler and cheaper tools than those commonly utilized. We hope that this study will promote easier access to hyperspectral imaging for all audiences regardless of their financial status and availability of an optical laboratory.

Do-It-Yourself Automated Insulin Delivery: A Leading Example of the Democratization of Medicine

Digital innovations have led to an explosion of data in healthcare, driving processes of democratization and foreshadowing the end of the paternalistic era of medicine and the inception of a new epoch characterized by patient-centered care. We illustrate that the "do it yourself" (DIY) automated insulin delivery (AID) innovation of diabetes is a leading example of democratization of medicine as evidenced by its application to the three pillars of democratization in healthcare (intelligent computing; sharing of information; and privacy, security, and safety) outlined by Stanford but also within a broader context of democratization. The heuristic algorithms integral to DIY AID have been developed and refined by human intelligence and demonstrate intelligent computing. We deliver examples of research in artificial pancreas technology which actively pursues the use of machine learning representative of artificial intelligence (AI) and also explore alternate approaches to AI within the DIY AID example. Sharing of information symbolizes the core philosophy behind the success of the DIY AID evolution. We examine data sharing for algorithm development and refinement, for sharing of the open-source algorithm codes online, for peer to peer support, and sharing with medical and scientific communities. Do it yourself AID systems have no regulatory approval raising safety concerns as well as medico-legal and ethical implications for healthcare professionals. Other privacy and security factors are also discussed. Democratization of healthcare promises better health access for all and we recognize the limitations of DIY AID as it exists presently, however, we believe it has great potential.

Real-World Use of Do-It-Yourself Artificial Pancreas Systems in Children and Adolescents With Type 1 Diabetes: Online Survey and Analysis of Self-Reported Clinical Outcomes

Background

Patient-driven initiatives have made uptake of Do-it-Yourself Artificial Pancreas Systems (DIYAPS) increasingly popular among people with diabetes of all ages. Observational studies have shown improvements in glycemic control and quality of life among adults with diabetes. However, there is a lack of research examining outcomes of children and adolescents with DIYAPS in everyday life and their social context.

Objective

This survey assesses the self-reported clinical outcomes of a pediatric population using DIYAPS in the real world.

Methods

An online survey was distributed to caregivers to assess the hemoglobin A_1c levels and time in range (TIR) before and after DIYAPS initiation and problems during DIYAPS use.

Results

A total of 209 caregivers of children from 21 countries responded to the survey. Of the children, 47.4% were female, with a median age of 10 years, and 99.4% had type 1 diabetes, with a median duration of 4.3 years (SD 3.9). The median duration of DIYAPS use was 7.5 (SD 10.0) months. Clinical outcomes improved significantly, including the hemoglobin A_1c levels (from 6.91% [SD 0.88%] to 6.27% [SD 0.67]; P<.001) and TIR (from 64.2% [SD 15.94] to 80.68% [SD 9.26]; P<.001).

Conclusions

Improved glycemic outcomes were found across all pediatric age groups, including adolescents and very young children. These findings are in line with clinical trial results from commercially developed closed-loop systems.

Open Source Closed-Loop Insulin Delivery Systems: A Clash of Cultures or Merging of Diverse Approaches?

Biomedical outcomes for people with diabetes remain suboptimal for many. Psychosocial care in diabetes does not fare any better. "Artificial pancreas" (also known as "closed-loop" and "automated insulin delivery") systems present a promising therapeutic option for people with diabetes (PWD)-simultaneously improving glycemic outcomes, reducing the burden of self-management, and improving health-related quality of life. In recent years there has emerged a growing movement of PWD innovators rallying behind the mantra #WeAreNotWaiting, developing "do-it-yourself artificial pancreas systems (DIY APS)." Self-reported results by DIY APS users show improved metabolic outcomes such as impressive stability of glucose profiles, significant reduction of A1c, and more time within their glycemic target range. However, the benefits remain unclear for the broader population of PWD beyond these highly engaged, highly tech-savvy users willing and able to engage in the demands of building and maintaining their DIY APS. We discuss the challenges faced by key stakeholder groups in terms of potential collaboration and open debate of these challenges.