 So, I'm very happy to dine. We have two speakers here, Zeph and Dagie, and they are somehow, I think they'll explain it later, connected to CODOS, and they are building medical apparatus. Let's say it like this. And the name of the talk is Remobo, Robus and Reparable Vital Sign Monitoring for Mobile Hospital Boxes. Medical devices for all, and please give them a big applause. Thanks. Good evening. I'm happy to be here, and I'm also happy to give the talk in German. I'm really happy that we can give the talk, because we already gave, we already talked about this project last year, and this is like one year after the project actually launched. And I want to explain where we actually come from, and the setting. So, an obvious fact is that the developments in the world are getting worse. We have climate change, we have armed conflicts, and we have migrations as a consequence of this. But also, again, armed conflicts are getting more, and it is really like a global catastrophe. And we have so many armed conflicts that are being waged asynchronously. And on the one side you have something like the government, and on the other side you have like some other fight. And then in between you have the humanitarian workers that are caught in the crossfire. And traditionally, humanitarian help is usually done by governmental organizations, and you have large committees like the Red Cross. But even these big organizations have the problem that in war times also civil targets like hospitals are being destroyed or affected by collateral damage. You could talk about Afghanistan, you could talk about Mali, there are so many examples where different sides of the same conflict where directly there were direct attacks on medical supply institutions in these conflicts. So we, and when I mean we, I'm talking about our organization. So we have been founded in 2014 and like many small NGOs, we have less bureaucracy because we're smaller. And also because, which is kind of strange maybe, is we actually have the courage to do more, we actually have to take, we're actually willing to take more risks than maybe bigger organizations. And I mean, other maybe bigger organizations can go into a country, try to help, but after a while they leave again. And we are much, much more flexible, and we can respond better to local needs. And this is actually what we are doing. So we were in Iraq, Iraq this year, and there are no big NGOs anymore. But and we still try to stay there even when the media has left the country already. Because, you know, the general public back in the western world has already seen enough, they don't want to see anymore. So the media is not there. But the problems still exist in these countries. However, there are some problems. So as small NGOs, we have less infrastructure to rely on. And especially because we have less media attention on us, there are of course less financial aids coming our way. And this project was initially created on top of the example mobile hospital project. And we thought about, okay, what is actually needed to have such a mobile hospital? And the mobile, we really thought about this. And we said, okay, the mobility is really central. So that we have a mobile front, a mobile medical front, a mobile supportive front that can help in these conflicts and in these areas. So we have created this hospital, so this mobile hospital, and it's actually registered as a regular hospital. And of course, if you ask about the equipment in the hospital, it's special. And of course, you could have different strategies. You could either say, okay, we're going for the cheap options. And or you could say, okay, we could support ourselves with donations to finance ourselves. The idea is that these hospitals have written off the devices so they can maybe donate them and get a tax write off, or we can try to get new stuff. But basically, the thing is we're going to a place where it's even worse than here in Germany. We need more technology, better stuff, but we take our off casts. So how and why? And of course, the situation as far as repair goes, it's worse there. If you have software problems in the middle of Syria, then yeah. And if you can't repair the devices, they're going to die after two or three months. The other idea is you can buy new devices. So this is one for monitoring vital parameters. It's blood pressure, ECG, and not a big one, but just to lead. It can measure SPO2. You need that to see if a patient is critical or not, and to monitor a critical patient. Are they feeling better? Are they feeling worse? Do we have to intervene again? Can I leave him? The problem is the price. This thing costs a lot more than 1000 euros, even though you can't actually treat with it. There's no defibrillator in it. But for our place, for Germany here, with the price of one or two thousand euro, it's so cheap that it's not worth repairing it. It breaks, you throw it away. So if you have a station hospital with 20 bands and have to buy this, you're at 40k. That's a lot. Another thing is proprietary connectors. Every manufacturer has their own cables, so you can't use devices from other manufacturers or even from different generations. So here, if the SPO2 sensor's cable breaks, then you can throw the whole thing away. That was our concept at the time. We had a mixed concept. We would buy some devices. We would have some donated, but we weren't happy with the whole thing. Then we talked to the professor Dr. Dr. Makrefting and asked her, what can we do about this? Now it's her turn. Okay, actually there was one slide here for you. There are robust devices that are used in Syria, for example or could be used there. They're used by the large NGO or State organizations and by the military. They're very robust, but they can't be repaired. And they're, of course, very expensive. This one costs 40K. So that's not really possible for a small NGO. So we thought, hey, this is stupid. It has to be possible to have medical devices or build them that fit the design criteria you need for a mobile hospital like this. So they have to be robust. Standard medical devices are developed for a hospital environment. Temperature-controlled, stationary. In Syria, you have temperatures over 50 degrees Celsius. You have a lot of dust. And when you transport it with a mobile hospital, then with the roads, you have a lot of shock-loading. So those are criteria, as far as robustness goes, that these devices simply don't fulfill. Plus, if the thing is bouncing around in Syria somewhere and it breaks, then we can't just call the technician from the company. They're not going to buy me a replacement. So it has to be possible to repair the devices. And the repair has to be possible for people that are not trained as a medical technician or anything. And it has to be able to be done with the tools that I have with me. It has to be affordable. It has to be affordable. And more or less anyone, like a small NGO, like in Kyrgyzstan, they have pretty bad infrastructure. They get a lot of donated medical devices. And they just stand around broken, unrepairable. Best case, they don't harm anyone. Worst case, when you use it wrong, you can actually hurt people with it. So we want to build devices that can be fixed and where people really know what they're doing with them. We have started with monitoring of vital parameters because it's useful for the first contact with the patient, like in a mobile hospital. We here have a gigantic flood of technologies, imaging and everything. But monitoring of vital parameters is one of the most basic medical devices. This is really no rocket science. These are all old and established procedures that are easy to use. So the EKG is older than 100 years. And because they are so old, there are no patterns. And it's easy to just reconstruct these. And in addition, it's also a good template for working on further projects. So I have some sensors. I have some input. I have some blood drug. And I can measure blood pressure or oxygen satisfaction. And I have an analog digital converter. And I can visualize the signals and I see which kind of thresholds are being passed for the patients. So if they have some critical condition or some critical measurements. So we applied for public funding to start the project. And this is at the HTA Berlin. And there are some people from NGOs and some engineers part of the team. And it's definitely not something that we just do on our own. And it's a good team that we basically brought together. The first critical thing was to investigate robustness to see. So we had different tests in a climate chamber to see how much we can ramp up the temperature until the devices fail. And we did the same thing for humidity. And we just let the devices run. And we saw that things worked. So we didn't test it indefinitely, but because we didn't have super much time. But overall, it was very promising. And we also tested for resilience tests. So there's actually something called test dust. Or something, yeah, conceptually test dust. And we also used old dust from different. Yeah, so a lot of electrical devices don't deal with dust so well, because they have all these tiny slots where dust can creep in and where the dust can really harm the devices. And another question was the hardware. So you don't have to read. You don't have to be able to read what is shown here on the slides. But we have devices for measuring oxygen content and the pulse and all of this open source. And we also have EKG and, of course, those people in the medical field, they all know these procedures. And they can work with these devices. Temperature is actually very easy to realize. There are sensors that you can just buy as a spare part or you could just assemble it yourself with separate components. Unfortunately, you missed it. At our booth, we actually have these devices. Unfortunately, they are all already given out. But maybe in the next sorting session, we can create more of these. So you see, it's actually not that big. And on the right, we have the circuit schema. And I have, for the sensor hardware, I have the mechanical pump that measures blood pressure. And once I have the pump, I have a mechanical part. And I also have to drag in air so that it can pressure the veins and arteries of the patient. So blood pressure can also be measured via pulse transit time, or at least we're working on that. Blood pressure checks, of course, important. It's the blood pressure dropping, rising in some unhealthy way. This is our prototype that you see here. There are different colors that's mostly due to modularity. Because when one part breaks, it's a good thing to be able to use the others. So it can be repaired, but it's not robust yet. This is just a prototype. And it's to show that you really can put it together out of standard components. Then we did the whole IT system. Not very originally, we're just using a Raspberry Pi. But being original is not our point. But being original is using what the point is, is using standard off-the-shelf components. So just a little board. Yeah, why not send a second? Doesn't eat much power. And then we thought, how do we do the whole display? And we built the system in such a way that almost any mobile device can be used as a play for this system. If one of those breaks, then, yeah, you can't do anything. But Paul, who's sitting up here, thought up a beautiful, very unixie solution. You can even download our Raspberry Pi image. You can use it. And it uses Bluetooth to connect to the web browser. And our application, which is client-side JavaScript, doesn't have to talk to the server all the time. And the web app communicates with the service that does the sensing. And it can display that data on your end device. The hard part was provisioning the large amount of different signals on one side, and on the other side, dynamically adding and removing mobile devices. So the system has to be able to serve this data at all times, no matter how many devices are actually attached to it. Well, this is a really kind of beautiful solution here. We're still working on the front end. It looks a bit, yeah, it doesn't look like the real monitoring devices so early. But it's going in the right direction. All in all, we want everyone to be able to build this. It should be able to be cheap. The hardware is less than 100 bucks. The little ECG system costs 12 bucks all in. We haven't yet shrunk the others down to this format. The Raspberry Pi is about 35 bucks. If you want the official Raspberry display, that's 70 bucks. So you add around 102. Plus you need mobile devices. So all in, it's very easy to find ends. Does any one of you know the healthy Pi? That's about 300 bucks, I think. So that's the same power of 10. As far as that goes, we're quite happy. Repairability is also well on the way. You have different modules, and you can solder on anything you want. The question is, how modular do we make it? It's useless to build your own Raspberry Pi. I just send along a second one that can be swapped in. That's just, it's a balancing act. How modular, what do I send as a replacement part? But at least with the sensor boards, it should be at least in principle, solderable by anyone. The Raspberry image is on an SD card. The Raspberry image is on an SD card. That's easy to send the second one in case you have no internet. And you don't have the ability to download a new one. The JavaScript front end, same thing. We haven't had any problems with it. It worked on every mobile device we tried it on. And that's the end. How are we going to continue this product? But what you didn't talk about, it was robustness. We didn't test that much. And we're very happy for people to build our system and maybe drop it a bit. All the projects running until April next year after that financing is over. And then we're just going to do it as volunteers. So we'd be very happy to gain more volunteers who could help us test the thing. You guys know you can't do all of this yourself because you can't really test your own system too hard because you like it and think it doesn't have any problems. Talking to people at our assembly, we got a lot of feedback about the device. If you have different devices, then it would be nice to talk about it with you. And there, of course, are always other solutions. I mentioned the Healthy Pie. There are other devices or other things that you guys may have as ideas, different things you can do. And of course, we're happy about any and all ideas you may have for us. That's the end. And we're looking forward to an interesting discussion with you, what kind of ideas you might have, what kind of questions. Yeah, applause. Yeah. Yeah, applause, please. Ah, thank you. 40,000, 50,000, 60,000 Euro kostenlisten. Mm-hm. Yeah, there were maybe also my questions. You have all smartphones. For whom was the repairability actually a purchase criterion for the smartphone? Well, one, two, three. I would say about 10 to 20 percent. Yeah, you're right. But that shows you everywhere that what used to be very understandable that you can build your computer apart when something is broken and what can be replaced. And that's already a luxury today. And yeah, we live in a world where it's not that bad. I can buy a new smartphone if I want to, but that doesn't work in other regions. And I think especially with medical care, I think that's the right thing to do. It's really an ethical question, whether you really want to leave this market criterion like that. Absolutely, applause. And since that's one of the greatest projects that I've seen here in the context, you definitely have the donation address. Do you want to blend it in here or do you want to say it again? Very explicit, if we want to... kados.org. kados.org, have you heard of it? You're still there until tomorrow at 6, 18 o'clock. We're in hall two. As I said, the whole thing has been built up. We're also at the start. There's no donation box. We're happy to lead you live. No, really. I think that's really typical, totally hacker-like and still totally new. I just think it's awesome. And the crazy thing is that it's actually new. If you had the devices from the 50s and 60s, they would probably even be enough in quality. That's just what it was. So if you look at this medical technology market, the customers, so to speak, the limits for the accuracy, they're always turned higher. But they don't really have anything to do with it, what you need in such a way to determine the health condition of a person. But they really have more to do with it. Which manufacturers achieve these limits, these criteria, and which fly? Also about certain limitations. So we already have a few questions. We also have some more questions. First of all, a question. Yeah. Thank you for the question. Thank you very much for the talk. One question. Is it your plan to conform to laws about medical products and devices? Especially if you have other things repaired by let's call them non-experts, is the device then non-conforming or is there a way to prevent that? Very good question. We discussed this because there are some laws that say that only certified producers may produce these things. But for devices that are used locally, we decided that we want to publish everything, we want to open source it. Because development of these things is actually a very expensive process. And it's actually not our approach. We really want NGOs to be able to recreate the devices that we have created worldwide. And if it's not fulfilling the lawful criteria, then, well, yeah, OK, it's not so nice, but we won't strive for certification. OK, well, the thing is we said we wanted to do this all legal and now we don't adhere to German laws. But here the thing is we want to show what is possible. So what can we do? And if we have to skirt a few laws to be able to equip people in these bad places, then we'd rather do that. Though we only need the certification, Germany, if we want to market it here, which we don't want to do. But it's interesting how far other countries are maybe interested in this legally. There may be tensions there if you offer this in other countries. So it may also be that weird things like quality management and just are useful, but there's always a component there for artificially reducing the ability to go to market. I was at a bit surprised, because I the cost for this display, it was actually quite expensive. And also if it's breaking, then it's really hard to repair. And if you have a major, OK, I have to pass on this one. OK, the thing is, yes, a Pi 0 is technically enough, but as of now, we use the big one for the big prototype. Maybe the Pi might be enough, the Pi 0. With the display, we thought about a long time. And so now we build a system where anyone, even without authentication, can connect to the thing and have it show you the values. But we need to be able to operate the device. And we're not yet sure whether we're going to do a special Bluetooth connection for someone who's authorized or maybe authenticated to operate the device, because we don't want 20 people to connect to the thing via Bluetooth and just start pressing buttons all willy-nilly. So we decided to use the smartphones display read only. And the device is hooked up to a display that can be used to control the device. We're not done with that yet. I'm thinking a bit about taking it in the direction of there being one pair device that has rights to control the system. That's right now the reason why we still have a display hooked up to it. OK, signal engel, trager aus dem Internet. Signal angel, question from the internet. Oh, or not. OK, signal engel, then let's do it with the different question. One, two, thank you. My question is how realistic is the repairability? How realistic is the repairability? If you are really in a critical area, is it really realistic that you get a spare part? That's the thing I was talking about a while ago. How modular do I make it? I think Fairphone did it quite well. You don't have to solder anything. You can pull it apart. If the speaker is broken, you can add a new module. That can be done. And that's why we went with the module construction, too. It's not like you can't get anything in these countries. You can get smartphones. And as far as special chips goes, we're probably going to pack a replacement part with the device. Maybe a whole module. If you say, now that can't be done by untrained people. That's part of what we need help for. We need to try this out in the community. What can be repaired? What can't be repaired? What's easy to understand? There's a guy in front here who's making videos, like videos that explain how to do that sort of thing. But the question is, do they work? If it doesn't work, then we're just going to send a second device or whatever if there's room and sort of extend the supply chain there. I'd also like to say, as CADDIS, we're a member in the Global Innovation Gathering, which is a network of maker spaces that does this sort of thing. We often have a very wrong view of what it means to have little resources. The people down there have to work with it and are image like soldering, putting things together with bits from other things, doing a bit of homebrew inventing. And I honestly don't worry that much about repairability being possible. I have heard that the internet has a question now. Did you hear of the Delia project that is developing open medical devices, so stethoscopes and other medical devices for measuring vital signs? Yes, they have endoscopes and stethoscopes. No, stethoscopes, otoscopes, and ternogies. I personally don't know it, but you have to say there's a lot of stuff going on in signal parameter monitoring. Three years ago, we had our first thoughts two years ago the project started. By the way, this is why it says compare up there. There are a lot of devices like this, and we don't necessarily want to say ours is the best ever. Because, well, we developed it, of course. But no, not really. If other people have something good, something better that fulfills our requirements or that can be extended more easily, then, of course, we're very thankful for such tips. But it's good to know that people are doing this, because, well, the endoscope was sort of our next project. Good to know that people are working on it. OK, very good. The web address is remote.hbo.h4.htw-ballin.d. And there's another question. Thank you for this nice talk. What are your next projects? So what are your plans for them? How did you do the case for the devices? Because the casing of the device was just some glass. So what is your strategy with regard to that? Well, Zepp, who is somewhere here in the audience, thought about this a lot. But right now, and we think the people have ideas too, we're very happy for help as far as that goes. People have told us about different ideas. Maybe you can say something about that project. Because there, too, you had the whole robustness part, which was important. Right now, we're transitioning from a big, un-willy prototype down to single-board modules. Now that we've got that all together, then we have to see how we can stack them. Do you have any infos? Yeah, we're very happy to hear that. Yes, we very much like some help. As far as current projects go, the professional component that's working for KARDOS is tied to the research project. KARDOS has the Berlin Crisis Response Makerspace, which is a bit more for the big stuff, like building new patient treatment places. We're working on a civilian airdrop project for getting supplies where they need to be as fast as possible. I hardly understood anything about the second half of the talk. So a dream would be imaging diagnostics, because that's stupid expensive, and you can really use it. I mean, X-ray diagnostics in the field that costs about 70K, would be a dream if we could find another university or school that would work with us on this. So we're still going to stay friends, but the professional thing is going to end. The plan was doing multiple of these projects at the same time. But we have the problem that we work in the field, too, so that we have to provide personnel for both. And we have to see how can we finish this project successfully and usable in the field, and our patients we are working on in the field. And yet, doing a research proposal for that isn't exactly easy. And we also have to add that. We... There were more groups participating in this project that were helping out with both work and expertise. And... So the next challenge would indeed be imaging... It's really difficult, so you really have to watch out, because, especially if you consider old X-ray equipment, these things are, well, problematic. But maybe we could do ultrasound or some other optic procedure in the future. Well, we have to look around, see what is available, and then work with that. For instance, an operation lamp, so that when you do surgery, you basically have better lights during the operation. Something we could do. There was actually a lot of different things and there was actually a group at the university that was looking into this. Yeah, but just as a community project, this is really difficult to tackle on our own. Okay, there is one more question, and after that we're going to be done. The last one, let's go. Oh, this is a really interesting topic. Sure question about the complexity of the software. So if I have my modules, etc., how does it look as far as diagnosis goes? Does the operator see who the blue modules busted? Can I switch this? What's that something you thought about? Yes, you need some method to figure out which part is actually broken. And we thought about this and we're still working on this, how to make it possible for people to diagnose problems of the device. It could be something like the device isn't actually broken, but has some sort of weird grounding problem. And the operator just sees the signal and can say, yeah, no, that's not right. Yes, we will basically give the devices to medical personnel and see how they will use it, and then we will use this as feedback to optimize our devices for usage. So if there is noise, then we can say, okay, this is most likely this and that problem. Okay, thank you very much. For all of you, support, applause, donate, katas.org. Thank you too, Dagi and Zeb. And here we're going to have the next talk at 2210. Surveillance for everyone.