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Open-Source Medical Devices Hack Chat

Tarek Loubani

Wednesday, January 29, 2020 12:00 pm PST Local time zone:
Hack Chat
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Tarek Loubani will host the Hack Chat on Wednesday, January 29, 2020 at noon Pacific Time.

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Join Hack ChatIn most of the developed world, when people go to see a doctor, they're used to seeing the latest instruments and devices used. Most exam rooms have fancy blood pressure cuffs, trays of shiny stainless steel instruments, and a comfortable exam table covered by a fresh piece of crisp, white paper. Exams and procedures are conducted in clean, quiet places, with results recorded on a dedicated PC or tablet.

Such genteel medical experiences are far from universal, though. Many clinics around the world are located in whatever building is available, if they're indoors at all. Supplies may be in chronically short supply, and to the extent that the practitioners have the instruments they need to care for patients, they'll likely be older, lower-quality versions.

Tarek Loubani is well-versed in the practice of medicine under conditions like these, as well as far worse situations. As an emergency physician and researcher in Canada, he's accustomed to well-appointed facilities and ample supplies. But he's also involved in humanitarian relief, taking his medical skills and limited supplies to places like Gaza. He has seen first-hand how lack of the correct tools can lead to poor outcomes for patients, and chose to fight back by designing a range of medical devices and instruments that can be 3D-printed. His Glia Project has free plans for a high-quality stethoscope that can be built for a couple of dollars, otoscopes and pulse oximeters, and a range of surgical tooling to make the practice of medicine under austere conditions a little easier.

Join us as we talk to Dr. Loubani about his open-source medical efforts. We'll chat about how he got interested in building devices, how he decides what's worth building, and what's in store for the future of the Glia Project specifically and open-source medicine in general.

[Image source: Lawson Health Research Institute]

  • Hack Chat Transcript, Part 3

    Lutetium01/29/2020 at 21:06 0 comments

    Tarek Loubani12:37 PM
    It took me almost a year just to ship in dummies for training. And we had to claim they were non-medical tools for displaying clothes or some oddity

    Tarek Loubani12:37 PM
    @Tammo Heeren : This was already happening. BUT, we got derailed by having to make tourniquets over the past two years.

    Tarek Loubani12:38 PM

    https://hackaday.com/2018/06/28/3d-printed-tourniquets-are-not-a-cinch/

    HACKADAY BRIAN MCEVOY

    3D Printed Tourniquets Are Not A Cinch

    Saying that something is a cinch is a way of saying that it is easy. Modeling a thin handle with a hole through the middle seems like it would be a simple task accomplishable in a single afternoon and that includes the time to print a copy or two.

    Read this on Hackaday

    Thomas Shaddack12:38 PM
    can the egypt-side smuggling be leveraged? (disclaimer: my knowledge is based mostly on smuggling german computers through the iron curtain.)

    Dr. Clint LeClair12:38 PM
    @Tarek Loubani do u have an inventory of what you've got there? We print consumables for the low and high fidelty dummies

    Tarek Loubani12:38 PM
    That has a link in there to an article that I wrote explaining some of the challenges of a tourniquet in that scenario

    Atom Atom12:38 PM
    You can get 3D printer in Gaza but not Stethoscope?

    Jim12:38 PM
    The great thing about 3D printing is that it localizes production and distribution. It seems like this would improve the adoption of these devices. Have you seen investment it this technology and can business be made from this in LMICs

    Jim12:39 PM
    Or are these funded through a different mechanism

    Tarek Loubani12:39 PM
    @Thomas Shaddack : I've already been in jail in Egypt once, and not keen to make that happen again. The Egyptians are an essential part of the blockade, and they are not neglected. They shut down all the tunnel routes, and so right now the cost of tunnel smuggling is much, much higher than local production.

    Tarek Loubani12:39 PM
    @Atom Atom : We make Prusa i3 clones there.

    Ryan Nibouar12:40 PM
    @Tarek Loubani In places such as Gaza is there a need for telemedicine consultations?

    Tammo Heeren12:40 PM
    @Tarek Loubani Why not ship parts and assemble in Gaza?

    Tarek Loubani12:40 PM
    It's hard to get extruders and stepper drivers. otherwise, things are available there from other parts.

    Tarek Loubani12:40 PM
    @Tammo Heeren : What parts?

    How are you getting supplies like filament in? Seems like that would be banned too.

    Tarek Loubani12:41 PM
    @Jim: That's a great question. I think Glia is proving that a business can revolve around local production for a poor market.

    Tammo Heeren12:41 PM
    @Tarek Loubani Parts of the Stethoskope.

    Thomas Shaddack12:41 PM
    the printing resins are basically just acrylate oligomers with reactive diluents and photoinitiators. i saw some (reportedly pretty lousy) material based on acrylated epoxidized vegetable oil. also saw mention of use of curcumin as a photoinitiator.

    Thomas Shaddack12:42 PM
    methyl methacrylate can be obtained by dry distillation of plexiglas.

    Tarek Loubani12:42 PM
    @Dan Maloney : Virgin plastic is banned. Gaza has a nearly 100% recycle rate of plastic. We get ABS and pull our own filament. We add as much virgin plastic as we can get through the local market, usually smuggled by somebody along the line.

    Tarek Loubani12:42 PM

    http://www.soliforum.com/topic/16711/thank-you-to-the-filastruder-team/

    SOLIFORUM

    Thank you to the Filastruder team

    Hello friends, I want to sincerely thank the Filastruder team for their help and kindness in getting our lonely filastruder up and working in Gaza. In short, it is impossible to get pre-made filament here, though ground / recycled ABS is relatively plentiful and the occasional virgin bag of plastic can be had when the southern border with Egypt permits it.

    Read this on Soliforum

    Thomas Shaddack12:43 PM
    but it needs a polyfunctional network former. MAY be possible to transesterify on the methacrylate.

    Tarek Loubani12:43 PM
    We used a filastruder for a while....

    Read more »

  • Hack Chat Transcript, Part 2

    Lutetium01/29/2020 at 21:05 0 comments

    @riley.august sorry, (enter to send was selected) anyways there are bluetooth stethoscopes, but as stated they are expensive, of course there must be a way to make them more accessible

    Tarek Loubani12:16 PM
    If you scroll up, I answered a similar question

    brian dolge12:16 PM
    When I made the stethoscope I had to buy rubber things for the earpeices. Have you considered modeling some in flex filament? They were not cheap.

    Tammo Heeren12:16 PM
    3D printing is challenging, as it's not cheap in quantity and of quite variable quality

    Dr. Clint LeClair12:16 PM
    ok guys, I went through your github...help me find the printable files...where are they?

    I did an article on "smart stethoscopes" a while back:


    https://hackaday.com/2019/02/25/stethoscopes-electronics-and-artificial-intelligence/

    HACKADAY DAN MALONEY

    Stethoscopes, Electronics, And Artificial Intelligence

    For all the advances in medical diagnostics made over the last two centuries of modern medicine, from the ability to peer deep inside the body with the help of superconducting magnets to harnessing the power of molecular biology, it seems strange that the enduring symbol of the medical profession is something as simple as the stethoscope.

    Read this on Hackaday

    Elias Jaffa12:16 PM
    I'm also fellowship trained in emergency ultrasound, and have done some work with Glia related to an open-source solution for live-streaming ultrasound images: https://github.com/jaffamd/streambox

    Elias Jaffa12:17 PM
    @Dan Maloney Thanks for that . link, excited to take a look!

    Tarek Loubani12:17 PM
    @Tammo Heeren : I disagree that 'something is better than nothing'. Glia's goal is clinical equivalence. The third world is full of shitty handmedowns. We don't need to compromise the quality to reduce the cost on a 200 year old device!

    But doesn't realyy seem suitable for austere conditions

    Don Randolph12:17 PM
    Do you find that cost is the major problem or delivery of the equipment to the desired location? Looking at the areas you mentioned, it would seem that the technology is there (we use a lot of medical equipment from Israel here), but the method used to get it to the patients might be difficult. I am a nurse anesthetist and we use electronic stethoscopes, but I have found that analog versions are just as good.

    Israel Rosas12:17 PM
    @Dan Maloney i'll be sure to check it out, thanks for the link

    Thomas Shaddack12:17 PM
    resin 3d printing, from uv-cured materials, can be much more accurate/precise. my recent experiments achieved 0.5mm pitch M12 thread (camera lens thread) holding well without need to chase it with a tap.

    Tarek Loubani12:18 PM
    @brian dolge: We thought about modeling and injecting the ear pieces. In the end, we aren't looking to make it 100% 3d printed. just accessible. So we opted to use headphone ear tips

    Matteo Borri12:18 PM
    makes sense they're easily findable

    morgan12:18 PM
    nice creative reuse

    Tarek Loubani12:18 PM
    @Thomas Shaddack : We're looking at how to incorporate SLA / mSLA, but the reality is that a rocket is easier to get into Gaza than a tub of resin would be. It'll be a while before that's a use case for us there.. We've been trying to figure it out.

    Thomas Shaddack12:18 PM
    what about silicone casting into 3d-printed moulds? this could be a low-cost way performing economical distributed manufacture down to one-off lot sizes.

    Dr. Clint LeClair12:19 PM
    to be candid, I print medical devices for our med ed sessions...the sterility was always an issue...fixed by fdm printing first, then lightly-brushing on resin and curing with UV to get a smooth, cleanable surface

    Tammo Heeren12:19 PM
    @Tarek Loubani Agreed. I was not talking about shitty hand-me-downs. Usually to achieve the last 5% costs a lot of time and money. This might not be necessary.

    Jim12:19 PM
    Just a note on electronic stethoscope, an ECM or MEMS device "hears" differently than the ear, so I believe some transform is required in order to have the electronic stethoscope sound like a conventional...

    Read more »

  • Hack Chat Transcript, Part 1

    Lutetium01/29/2020 at 21:04 0 comments

    Tarek Loubani10:28 AM
    You might remember Christoph from such hackaday articles as https://hackaday.com/2017/06/30/3d-printed-halbach-motor-part-deux-tuning-testing/ and https://hackaday.com/2014/05/24/the-hour-of-the-3d-printed-clock-draws-nigh/

    Tarek Loubani10:28 AM
    You wrote that first one, Dan.

    Right, Christophe - knew it looked familiar. Honestly looks like it could snap that PCB in half with a few twists of the wrist

    Tarek Loubani10:29 AM
    ahaha. Will not seek to confirm.

    Tarek Loubani10:30 AM
    p.s., here's the thingiverse link, though have patience as the site still sucks: https://www.thingiverse.com/thing:2064269

    Tarek Loubani10:43 AM
    While I'm here with the world's best hackers, maybe another question: Is it possible to correctly assess these capacitors without desoldering them the board?

    Chinna11:19 AM
    Hi Tarek, great innovations. I read your papers and it's an amazing work

    Tarek Loubani11:19 AM
    Thank you so much, Chinna!

    Chinna11:22 AM
    I suspect you might be working on a electronic stethoscope as well?

    Tarek Loubani11:25 AM
    Not really. We thought about the idea and let it go for three main reasons: The first is that the electronic stethoscope is a significant step backward with current technology in terms of usability and quality. Any health care provider who's used both can testify to that. They are primarily an advantage for people with hearing issues, and for teaching. The second is that they are largely covered by patents still. And lastly, our project is trying to approach the basics of each piece of equipment. After we get them out there, maybe we'll circle back to upgrade things.

    Chinna11:30 AM
    Thanks for the reply. It's good to know these reasons from an expert.

    Chinna11:31 AM
    I mean from you

    Tarek Loubani11:32 AM
    Thank you for the vote of confidence. Our team is trying to make the best decisions based on the situation as we perceive it, so the decisions are always more discussions and priority-setting than final say

    Chinna11:32 AM
    I am working on ophthalascope attachment for a smartphone

    Matteo Borri11:33 AM
    I'm working on a printer for synthetic skin, but I got nothing to show for it yet, am here to learn :)

    Chinna11:34 AM
    I found that the lenses are pretty costly

    Tarek Loubani11:34 AM
    @Chinna and @Matteo: That's great. Please let me know how things progress and hwo we can help

    Tarek Loubani11:34 AM
    @Matteo Borri ^^

    Tarek Loubani11:35 AM
    @Chinna: The lenses are indeed expensive. It's one of the reasons we started with an otoscope (look in ears). https://github.com/GliaX/Otoscope

    Tarek Loubani11:36 AM
    I've been occasionally kicking in my mind how we could accomplish an ophthalmoscope in a way that's reliable and sustainable. Haven't quite figured it out yet...

    Israel Rosas joined  the room.11:37 AM

    Chinna11:38 AM
    Yep, I saw your otoscope. It's great. I made one of my own as well, but it's with rechargeable batteries.

    Tarek Loubani11:39 AM
    What do you mean by rechargeable batteries? I use mine with some rechargeable AA batteries. Would that count?

    Tarek Loubani11:39 AM
    Also, would be amazing to see your design.

    Chinna11:41 AM

    Tarek Loubani11:41 AM
    Oh!! phone-based!

    Tarek Loubani11:41 AM
    Cool idea with re-using a stock holder.

    Chinna11:41 AM
    Yep, but can be used without the phone as well

    Chinna11:42 AM
    Yep

    Matteo Borri11:42 AM
    cool!

    Tarek Loubani11:43 AM
    An amazing hacker named Kliment Yanev made a phone-mounted for us that we could never really get to work. I ended up deprecating it in our otoscope repo: https://github.com/GliaX/Otoscope/tree/phone_mounted

    twoxe joined  the room.11:43 AM

    Tarek Loubani11:45 AM
    @Chinna : Is it FLOSS?

    Tarek Loubani11:45 AM
    It would be great to link to it at least from our rep

    Tarek Loubani11:45 AM
    repo

    Chinna11:46 AM
    I yet to document my design

    Chinna11:46 AM

    Chinna11:46 AM
    This is the opthalscope

    Chinna11:47 AM
    But the lens I ordered was a fake one, so didn't work as expected

    Tarek Loubani11:47 AM
    That's a real shame, @Chinna. We've...

    Read more »

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fluffymastodons wrote 01/28/2020 at 20:08 point

how do hackaday discussions work?

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Dan Maloney wrote 01/29/2020 at 17:36 point

Just log onto the Hack Chat public chat at https://hackaday.io/messages/room/2369. We meet at noon Pacific every Wednesday.

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