 Hello everyone. Good morning, good afternoon or good evening depending on what you're joining us from today. Welcome to Engineering for Change or E4C for short. Today we're very pleased to present our E4C virtual salon where we deep dive into critical topics and technology for good in conversation with some key actors. Today's salon will explore open source and 3D printable medical equipment to meet global shortages. And we are so honored to have an incredible roster of panelists today, including Elizabeth Johansson, founder of Spark Health Design, Dr. Aaron Keeney, CEO, founder of Nonspec, Brian Saloka, managing director of design labs at Lehigh University, Gronwin Schmidt, assistant professor at Duff's University of Technology, and last but not least our incredible moderator, Konja Mehta, device provost of creative inquiry and director of mental health initiative at Lehigh. You'll hear more about our incredible speakers shortly. The salon you're participating in today will be archived on E4C site and our YouTube channel, both of those URLs listed on this slide. Information on upcoming webinars and salons is available on our webinar stage. E4C members will receive invitations to upcoming events directly. If you have any questions, comments, or recommendations for future topics and speakers, please contact the E4C team at webinars at engineeringforchange.org. And if you're following us on Twitter today, please join the conversation with our dedicated hashtag, hashtag E4C webinars. Now before we move on to our presenters, I'd like to tell you a bit about engineering for change. E4C is a knowledge organization, digital platform, and global community of more than one million engineers, designers, development practitioners, and social scientists who are leveraging technology to solve quality of life challenges faced by underserved communities. Some of those challenges include access to clean water and sanitation, sustainable energy, improved agriculture, medical devices, and more. We invite you to become a member. E4C membership is free and provides access to news and solviers, insights on hundreds of essential technologies in our solutions library, professional development resources, and current opportunities such as jobs, funding calls, fellowships, and more. E4C members also receive exclusive invitations to online and regional events and access to resources aligned to their interests, as well as contribution opportunities. We invite you to visit our website engineeringforchange.org to learn more and sign up. Given our focus today on medical equipment, we want to highlight an example from the E4C solutions library. This is smart PPE, a prototype aimed to improve the efficiency of personal protective equipment or PPE. The prototype is targeted towards youth and Ebola affected areas. It aims to be reusable and improve ventilation of traditional hazard mitigation equipment. So check that out. The link is available on the slide. Now, this is actually the first time we are using a Zoom webinar for the purpose of our webinars. So we want to practice with all of you on how to use the thoughts. So some housekeeping items. Please type right now into the chat window what core of the world you are joining us from. For some reason, I'm not able to see my own chat window. I know we have some of you here. Let me see if I do see it. All right. Well, I'm going to assume you are all doing an incredible job typing. Oh, there it is. It's coming up now. Just a minute. All right. We have Panama, Ohio, Boston, Cooperstown, Kolkata, I.C. Lancaster, lots and lots of participants from all over the world. Delft, New York, Connecticut. Welcome, everyone. Welcome from Netherlands and see a number of folks from the Netherlands, certainly. And hello, Portugal. It's a pleasure to have you here. Hello from Brooklyn. All right. Now, moving forward, please be sure that if you're not seeing the chat window, the icon is at the bottom on the middle of the screen. We encourage you to please use the Q&A window, which is also an icon at the bottom of your screen to present questions for our presenters so that they are able to track those and we don't get them lost in the chat. Please do use the chat for general comments. And perhaps if you have an issue, technical issues, feel free to send a private chat to our administrator. Now with that, I want to introduce the incredible panel that we have today as well as our moderator. First up, Kanjan Mehta, as I mentioned, is the Vice Provost at Lehigh University for Creative Inquiry. He champions the creation of learning environments and ecosystems where students, faculty, and external partners come together to increase their capacities for independent inquiries, take intellectual risks, learn from failure, recognize problems and opportunities, and affect constructive and sustainable change. Previously, Dr. Mehta was a founding director of the Humanitarian Engineering Social Entrepreneurship Program at Penn State University. He also serves as the Associate Editor of the IEEE Technology Society Magazine and a contributing editor here at E4C. His latest book, Solving Problems That Matter and Getting Paid for It, takes a deep dive into STEM careers and social innovation and global sustainable development. Next up, we are so thrilled to also welcome back Elizabeth Johansson, the founder of Spark Health Design. She has developed world-class medical products for as a poor as a director of the nonprofit Design That Matters and Diagnostics for All. She was a former IDO project lead driving innovation across medical devices, consumer health, and financial services for clients including Eli Lilly, Target, Pfizer, and back to Dickinson. She is currently a speaker and facilitator of who has taught design and social and for social impact to hundreds of organizations from the small social enterprises to the largest bank in the world. And she has also supported the IEEE 4C in a number of ways to the start. So we are so grateful, Elizabeth, to have you back. Next up, we have Dr. Erin Keeney, the CEO and co-founder of NonSpec, which manufactures adjustable prosthetic limbs for amputees primarily in developing countries. She is dedicated to using her background in medical device design and manufacturing to help improve people's lives. She enjoys mentoring students and entrepreneurs as well as learning with them and is heavily involved and is an immediate past chair of the Next Generation Advisory Board for the Society of Plastics Engineers, helping to connect their professionals to their industry. We are also joined today by Brian Sokol, the managing director at Design Labs at Lehigh University. He has evolved the many aspects of Lehigh University. His primary role revolves around the act of making. In addition to managing Lehigh's premiere makerspace, the Wilbur Powerhouse, he also serves as director of the Lehigh University additive manufacturing lab, and the Design Labs, which include both wood and metal shops. His passion is helping students physicalize the ideas and teaching them how to think with their hands in addition to their heads. Brian also teaches courses in design metal working, prototyping, and design builds, and serves as a faculty advisor for the technical entrepreneurship capstone program. Last but not least, we have Gurwin Smith, an assistant professor at the Biomechanical Engineering Department at Delft University of Technology. So, his research focuses on how we can design innovative, prosthetic devices using the newest technologies. Currently, he leads Project Inspiration, in which the team develops a COVID-19 emergency medical ventilator. More information about this project is described in the recently published article that you see here and will be provided on today's webinar. So, we're excited to share this with you. With that, I'm going to stop sharing my screen and turn it over to our first presenter, Dr. Elizabeth Johansson. Thank you very much, Yana, for that great introduction. Let me get the screen sharing going here. All right, great. So, it's wonderful to be with all of you today. As Yana mentioned, I'm the founder of Spark Health Design, we're a consultancy that specifically uses Human Center design for positive health outcomes. Primarily, we work with nonprofits and for-profit social enterprises who want to create medical devices, diagnostics, and digital health solutions that are more accessible to people worldwide. Today, I'm going to focus on a recent project that we did around COVID-19, in this case, a face shield. So, Spark Health Design partnered with another nonprofit, Design That Matters, and we used a lot of our experience in design for global health and low resource settings, usually outside of the US, and learned and kind of built on many of those lessons to design something that could work well in the COVID-19 pandemic here in the US. So, first, I wanted to talk a little bit more about the background in global health design, because I think there's some interesting and important parallels between what's going on in the US and Europe right now, within the COVID-19 pandemic, and what a lot of our friends and fellow colleagues work with every day all around the world in what we call majority world settings. So, most of the world where many of the hospitals are under-equipped. So, this is a little bit of a scattershot of some of the projects that I've worked with in the past to give you an example. I used to actually be a director at Design That Matters before partnering with them on the face shield project in forming Spark Health Design. Together, we worked on a jaundice treatment light called Firefly Phototherapy, which is now used in over 25 low-middle income countries to treat newborns with jaundice. I was also a director at Diagnostics for All in the Past, and we worked on diagnostics for settings in majority world settings. In this case, I led a project around an on-farm diagnostic for dairy cows, and since forming Spark Health Design, I've been working with a non-profit life box on surgical lighting, as well as the for-profit, JonnaCare, on more affordable diagnostics to help people in monitoring and managing diabetes and cardiac care. So, it gives you a little bit an example of the range of what Spark Health Design does, but really our inspiration is somewhat encapsulated in this photo. This is actually a photo that Stephen Rudy from Grading Health Systems took in Malawi. This is a classic medical equipment junkyard that you'll see in most low-middle income countries, somewhere close to the hospital. Sometimes, it's inside of a storage cabinet, inside the hospital, sometimes it's outside. And what was shocking to me as a person who hadn't always worked in the field of global health is that most of the devices that we design when we're working in the U.S. or for a European market, most of those devices, when they go abroad to a low-resource environment, three-quarters are never even turned on. They don't function at all in that new setting, and they remain unused. And so, for myself, as a with a background in engineering and also human-centered design, and had, you know, some work previously with a lot of Fortune 500 companies and so forth, it was shocking to me to realize that these devices that we designed, in theory, to the highest standards with FDA approval and so forth, actually don't function well and aren't necessarily even safe or effective when they go to a low-resource setting. Some of the reasons are a lack of just assessment in low-middle income countries of what is the context and what is the need for that device, leading to a lot of designs just being inappropriate. Aspects like clean water and electricity are often assumed. Many of these devices are plugged in and the first power surge that comes along blows a fuse and you can't use it anymore. There's also not much information about maintenance and not a lot of resources for maintaining these pieces of equipment. Many of the healthcare staff may have different training, either more or less than the US or the European context. There's also a lot fewer staff to address so many patients, so all of those alarms that are ringing all the time, there aren't as many people to attend to those, and then especially one of the pieces I wanted to highlight that I think is really relevant also to the COVID response just worldwide is that a lot of these devices rely on consumables or disposables, which are either too expensive for facilities to maintain or there's a broken supply chain where even if they have the money they can't buy it, and so many folks are left with trying to reuse something that's meant to be disposable. So three examples of that from Lifebox. One of the wonderful projects that they have done in the past is around a pulse oximeter and the way these are currently used before the Lifebox pulse oximeter came to market is that usually these probes that you have to wrap around someone's finger are made of some kind of a sticky bandage material and as that works in a low-middle income setting, because each probe tends to be 30 to 40 dollars and you're supposed to use only one per patient, most people try and reuse it. So we visited many hospitals with Design that Matters and also Spark Health Design where people are sort of trying to wipe down the sticky bandaid and then reapply this probe. So Lifebox came up with a wonderful solution as a non-profit focused on LMICs that has this reusable panelist for pulse oximetry. Another example is a great social enterprise called MTTS in Vietnam. Design that Matters has worked with them to commercialize the Firefly Phototherapy device. They also have a device called a CPAP which is for newborns with respiratory distress. One of the things they saw is that the tubing that's used for that respiratory therapy is often reused and that can propose some kind of a cross-infection risk. One of the elements they included in their product is an ability to reuse and clean those tubes. And then the last example is something near and dear to my heart. When I was at Design that Matters, I mentioned that we designed the Firefly Phototherapy device. One of the aspects we had to think through very carefully is the bedding. So we saw in many hospitals initially with our field research Human Center Design in Vietnam newborns were laying on shared beds with often with bedding or sheets that weren't necessarily changed and infants were often given for breastfeeding and brought back to maybe a different bed. So there's a lot of sharing and potential for cross-continuation with just the bedding itself. So even thinking about how would we design a better phototherapy device for a low resource setting where there's not a lot of opportunity for laundry and it's a low staff to patient ratio, this particular bed is completely smooth and the idea is around making something really wipeable and cleanable. So I wanted to show you these three examples of sort of global health technology and how it's being adapted to a low resource setting because I think these apply very much to the COVID-19 pandemic and PPE. And something Design that matters in Spark Health Design saw pretty early on in March is a number of news articles talking about people around the world needing to reuse masks, reuse face shields, sometimes even gloves, if you look in some of the low resource settings. And so we realized, wow, suddenly a lot of the design work we've done in the past for low resource settings, which were usually outside of now applies inside the US as well. So what can we do to help? Well, the amazing maker community worldwide had already started on this and we believe face shields could be one way to help because there's a big potential for them to be easily reusable and cleanable and quite safe. So we actually started with this design from Prusa, which has made it around the world and really impressive work that they did to get this out there very quickly. I think many, many thousands of these have been printed around the world. So starting with the design that already exists and has already had some clinical vetting is one of the great pieces also benefits of open source design. And some of the, one of the elements I think I wanted to highlight about the Prusa design that works so well is they developed this really great universal strap peg and that really allows a flexibility when you're looking at an issue around supply chains being broken. Even looking at the strap for a face shield, you'd have to consider that different makers in different places may have access to different materials. So this particular universal strap peg, which works so well on the Prusa device, we kept for the future design, which I can tell you a little more about. And it connects to buttonhole elastic or, you know, coban, etc. But looking at that, we were curious, we wanted to kind of combine the best of our medical device design background to kind of lead that into what to do for a face shield. Part of it is the clinician engagement, which I think Prusa had a lot going on there. We also do a lot on kind of background research. So what's been shown about how aerosols spread, infectious aerosols. What's, what also, what standards are there out there for face shields? So we did a major research project as well. And one of the things we discovered is in this image at the bottom, a really important paper by Chan at all 2018. They mapped how aerosols spread during a cough or during an aerosolization, aerosolizing procedure. And we realized that a lot of these aerosols could go up and then come back down. And then one of the things we did notice with a lot of the designs out there is that there's an open top. So though you're getting some good coverage from the front, there wasn't as much up at the top. So we said upon saying, okay, how do we build on this great open source design and add some coverage from the top? And you can see a number of our iterations here. Like maybe we can add an extra transparency on the top. Maybe we can just completely enclose the top. And a really amazing volunteer, David Pakman from Microsoft suggested that we could do this sort of backward visor idea. And so we quickly took many of these ideas in the tradition of human center design to a variety of clinicians. You're only seeing a really small subset of who we spoke with, both at MGH and then especially at the Harborview Medical Center in Washington, to understand what works in a facial, what doesn't. And ultimately, the backward visor design went one out. We realized that it provides some coverage on top, but it doesn't completely enclose it. So you can still have ventilation to not induce too much fogging. It's also wipeable, like many of these designs, but unlike the classic disposable face shields that people had been using traditionally before with the kind of foam piece on top, which isn't as clean and full, still allows venting, also allows rapid assembly, unlike some of the flop pack versions. And one of the greatest things we realized we could do with this design is that in the U.S., people use three hole punches. And we realized you could use office supplies in the three hole punch to be able to replace that front shield. So not only could makers around the world provide this to healthcare providers, but in addition, if those healthcare providers ran out of a shield or got scratched, they had multiple avenues with which they could replace that themselves and just keep on going. So this particular 3D printable face shield design was the first to be recommended by the National Institutes of Health in a novel mechanism for reviewing 3D printed PPE. And many people have been printing it around the world, including many colleges in fact. So I also teach a class that's an Olin and Babson Joint College, but many other folks besides have been putting their printers to task on printing some of these and getting them to their essential workers. But also as part of this open source effort, we were able to engage a number of volunteers early in the design process and that included a materials expert from Boeing. And the great thing is he was able to then go back to Boeing and say, hey, we've got a great design here, it's NIH recommended. So Boeing tasks their 12 centers around the U.S. in printing probably over 10,000 of these face shields for FEMA. So sorry. Let's see if we can get this back. We cannot. Sorry for the technical difficulty here. And then the designs that we created and posted to the NIH website have also influenced the community of face shield designers in terms of this sort of backward visor idea and especially leading in terms of how do we provide good protection to our healthcare providers and especially adding that level of protection on top. So this idea in kind of the spirit of open source voodoo manufacturing is building on some of that idea. Amazon themselves have made a new version that they're going to print in manufacturing high volume as well as many others. And a lot of that was due to sharing some of our research. So not only is the design up there, but the research around what are some of the standards that apply, what are some of these research articles and so forth. We shared that very early with the open source medical device community through some of these various routes. And then the last piece of our project is that we realized high volume manufacturing could help as well. So we worked with a group called Global Tech Plastics who's been amazing that they've been willing to design it for injection moldings with some slight changes that actually improve the design. And they're now building tools and producing hundreds of thousands for the state of Washington. So all in all, many, many people came together in order to do this. And I think there's a model here around, you know, the wonderfulness of open source collaboration around technology and what can be provided quickly to a community when people get together and, you know, see that end in mind. And I think there's maybe a call to action for all of you in the audience. You know, I love this quote from Margaret Mead. There's never doubt that a small group of thoughtful committed citizens can change the world. And indeed, it's the only thing that ever has. And I think, you know, for us, we've been really humbled by being part of this larger maker community in addressing the PPE shortages. And I will also post an article from E4C, which has connections. So if you're a person who wants to print a face shield, you'll be able to get information there. And if you want to manufacture this at scale, there's a fully open source FDA emergency use authorization package you can access as well. Thank you. Thank you so much, Elizabeth. Now we are going to turn it over to Dr. Erin Keeney. Oh, you are on mute, Erin. Hello, I hope you're all doing well. I'm Erin Keeney, the COO and co-founder of Nonspec. We make affordable orthotics and prosthetics devices for developing countries primarily, but globally. Our first initial product was the adjustable prosthetic limb. It is a scalable product that we currently make in-house. We machine all of the components and have designed it all to be scaled to our injection molding and extrusion so that we can reach a really high volume as needed for the population of amputees worldwide. The thing that we've spent a lot of time on this design is ensuring that it is affordable to over 80% of the world's amputees and that it meets world standards, so it meets FDA and ISO, which is required to be sold globally. We have primarily been working in India and Rwanda and our product has been very highly sought after from amputees because it allows for a much higher level of activity than the current low-cost options in these areas. So as you can see here, we have someone who goes out right away as soon as he put on our limb and starts playing soccer, so we're really empowering people to get back to the things that they love. So when we were back in January, we actually were in Europe talking with a company that is one of the largest prosthetics providers in the world about a partnership and potentially exit to allow us to really serve a much larger population and help them to achieve the low-income patients as customers. And what happened was when the shutdown occurred, it was in various levels across the world, but really getting amputees fit is an elective procedure, so it was really challenging to continue moving forward on our initial task that we had set out for the last couple of months. And unfortunately, the amputee population has a lot of pre-conditions that make them very susceptible in this time. So we spent a lot of time reaching out to our customers and amputees who spent lots of time on the ground with making sure that we're making a product that works for them, making sure that they're safe and educated about how they can stay safe during these times. Along the lines of what Elizabeth was talking about, mid to late March, we started thinking about how we can use our resources to start helping in the Get Me PPE around the world that was needed. So we actually were able to use our manufacturing capabilities in-house and our design team in order to make the mold that you see here to injection mold face shield visors. And we were able first to 3D print these devices so that we took them to doctors and nurses in healthcare facilities to make sure it was the design that they needed. And the great thing about moving to scale is that at very early April, we had this in production. And we actually looking at the head cowl is what we call it part, we were able to do that in the lower cost material of the PET. So the film actually comes up and protects the head without having to use more of the plastic that you've seen in the 3D printed models. We also started with the Prusa design, but as was mentioned, it's not scalable for mass manufacturing. So we were able to tweak that and improve on the design. And then four days after we started in production, we had this out donated to local healthcare providers in our area. And we got feedback coming in saying these are so much lighter than the riot gear options that they had been asked to use prior to our donation. And they were really excited to get more. And that was the big request. So in order to get more, we started working with groups locally to see how we could scale this up even further. We open sourced our design both the 3D printed option as well as the mold cavity so that this could be scaled internationally. So the empowering people network has this in their folder. So when they actually did an awesome article about this, so people can reach out to them and receive these files in order to move forward. We partnered with the local university, UMass Lowell near us in order to use the injection molding facility that helped us start production. And we worked with other local manufacturers who weren't necessarily in the healthcare space initially, but thought how can we use our capacity in a time where we have one or two projects that were considered essential and were open, but we have a lot more capacity. So they were looking for ways that they could help. We also started working internationally. So we had groups in India that we had come across during our normal work who were looking for ways to help. So we had a packaging company with the flat pack design you see on the bottom left here. And we stepped in as someone whose experience in the healthcare space with the right connections in order to get that distributed so that they could make higher impact. And coming at this, I'm a plastics engineer. So it's been very interesting to look at the supplier side. I've been keeping tabs on how plastic is being perceived in the world and how all of this disposable and reusable plastic PPE is going to start impacting what people are thinking about the benefits of plastic. The costs have also been fluctuating and things like PET, your plastic water bottles are all of a sudden the demand for that material got a lot higher. And that's what everyone was after to make the shields. So it's been interesting to watch those dynamics. Also, a lot of companies who have not touched medical before, especially with the FDA, sort of lowering their standards to get stuff out there just to help if it's not a huge safety concern to the population, has been a very interesting dynamic. So we've seen, as I said, packaging companies coming out of the woodwork, auto manufacturers being like, how can we do this too? So in that short window that it took us to launch, we kind of had maybe a month before we had lots of other really large companies you've heard about the efforts with GE and Nike and New Balance, all of them coming out with PPE technology. So what I'm looking at is how is this going to be affecting healthcare long term? Are any of these companies planning on being permanent providers of PPE in hospitals and or to consumers? And the number of nonprofits that have come up just sort of support this effort, it will be interesting to see where they continue and how they pivot as we move forward. The key challenges that my company has come across during this, as usual being a very small company, we have a team of three in the US and a team of two in India and a handful of people globally who are working with us. But we have to start small, we don't have a lot of money overhead to start this scale up. So we relied on a lot of donations and in kind services to allow us to make the donations. But it was a lot harder for us to kind of make that jump to start sales in the PPE space. The material costs were fluctuating as we went through this and the demand all of a sudden we would be fine getting material and all of a sudden it wouldn't be there anymore. So trying to understand how the markets are playing into this and also the customer acquisition costs. A lot of companies who were not in the medical space came to us saying, well, we're having hospitals asking for donations because they want to see what the options are and then they get really distracted and busy doing other things and it doesn't necessarily result in a sale or even feedback or discussion towards how they can get more PPE. And we've seen the same with governments as well. It's kind of, they have call pages but someone higher up can make a decision to go to a big company and kind of, it can get lost. That also left our team in disarray. We're kind of in different stages of shutdown during the last couple of months and trying to make sure that we have a good branding story about what we were able to do during this time and even though it might not allow us to have met some of the goals that we really wanted to achieve, how we could pivot and the ones that we did achieve and how important they are. So the impact that we actually were able to have over this time is we personally made and distributed about a thousand face shields to local care facilities and healthcare. We worked with Make It Labs in Nashua and they actually got a donation of PET from Coca-Cola and we're chunking it out and distributing it to groups who were 3D printing and otherwise making face shields. So that was a wonderful partnership that we were able to engage in and as I mentioned we used the manufacturing facility at UMass Lowell. Our design also enabled the manufacturer to make a dual cavity mold for the visor piece and that allows them to make over 10,000 shields per day. So that's an exciting thing that's being done in Massachusetts and we were able to provide this globally as well. So it started our design help start production in Sri Lanka for face shields and again we've also been able to enable people who are not in healthcare industry to start kind of getting involved in the health and safety of their customers on a different level and I'd be happy to answer any questions about this at the end. Thank you. Thank you so much Erin. All right moving on. Hi everybody. Hi in Europe. Hi everybody. Ryan's looking from Lehigh University here. I'm just honored and privileged to be part of this webinar. I'm going to be talking a little bit about Lehigh's COVID response and you'll see some I think similar themes to what the other two presenters have talked about. So you know much like the rest of the world when COVID hit we watched it sort of head on over across through China and across Europe and we're sort of waiting for it to hit the shores of the US which it did pretty quickly and while this was happening I was trying to determine what can we do to help. It was clear that people were getting overwhelmed and very early on we started to look at where are the areas where the design labs, Lehigh's resources can be leveraged to help the situation. We looked very quickly into like N95 masks. Can we start to 3D print those? The research was pretty compelling that that's not the way to go. That it kind of gives you a false sense of security and you can't really do a great job with filtration. Started looking at you know are we going to be overrun and need a lot of ventilators? Can we start to 3D print ventilators? What does that look like? And so you know I've been doing some research looking at what was available what other people in especially Italy were trying to deal with and what they were trying to make. And then kind of the answer the question got answered for us on March 20th when the email started to pour in from local hospitals. So we were originally looking like oh New York is getting this this huge surge and can we start to help out and and here we needed that to help right in our own backyard in the Lehigh Valley in Pennsylvania. And so within hours I think we were contacted by by three hospitals and they all said hey we've been seeing this information about 3D printed PPE. We already know we're going to have a shortage. We know we're going to get overrun. We're looking at our stocks. We can't order anything everybody's you know nothing's available right now. Is Lehigh willing to help? What can they make? And when can you start to do this? And so you know I gathered my team at Lehigh and we started to look at this and imagine that we came across the Prusa the Prusa Shield. Now I've been following Prusa's work the the previous couple weeks and seen that they'd work with the Czech Ministry of Health to kind of validate the shield design and again you know we kind of quickly ruled out the N95 idea. So I sent an email back to the hospitals and said look I you know we can't help much with masks but if PPE is is the area that you're you're most concerned about you know what do you think about face shields and they said sounds great what can you provide. And so very quickly we we you know just used the initial Prusa design printed out a couple and got them to local hospitals for some validation from clinical doctors and clinicians and they gave us kind of this feedback. One the shield that was provided with the Prusa design wasn't wide enough it didn't wrap the face far enough around they were worried about droplets coming in from the side and we're asking for a wider face shield and then as the two other presenters have already talked about with and Aaron mentioned earlier that the forehead the space between the forehead band and the front of the shield provides an area for droplets to come in so it's really nice to see that we've got some great research showing that that can in fact happen and that also that forehead interface over a period of time started to become really uncomfortable. The other issue that they had with it was the elastic band on the back that held the the face shield around the head was hard to clean and slightly hard to adjust and they were hoping for materials that they could use to make these more usable reusable I should say and not sort of single use. And so we sort of took all of these concerns to to heart worked with my own team at the same time a group from Noel manufacturing which makes furniture reached out to us and said hey you know we're shut down making furniture but you know we're thinking about making face shields are you guys working on this and we said yes and so we got their design team and our design team together and I sort of shared this information from the local hospitals with them and and we put our heads together and tried to solve some of these problems. What we did was we sort of looked at our available resources so at Lehigh I have about 30 some filament 3d printers that are all kind of ganged together as a printer farm so we knew we had a decent amount of 3d printing capability but we also have other things like laser cutters and water jets and so we thought about how we could leverage the sort of maker tools traditional maker tools in a more full-scale manufacturing operation to make these face shields. And so what we came up with was using neoprene in two areas so we used essentially wetsuit material which is relatively inexpensive and you can get in huge rolls at pretty discount prices for both kind of a roof a cover over that over between the front of the forehead and the front of the face shield in the same way that you kind of saw in the first design that 3d printed roof and also as the backstrap and the hospitals liked the neoprene because it was it was pretty easily cleanable they could take it off and wash it and sanitize it. And it also kind of served double duty as a membrane between the forehead and the actual plastic so it provided some cushioning for the clinicians. So you know we looked into 3d printing kind of that that backward shield design and what we found on our end was if we kept a very similar version of the original Prusa design we could stack that and we could really maximize our 3d print time so it's what we arrived at is we can stack about 10 of those shields on a print tray and it takes about 24 hours for that to print and so that was a great way for us to kind of maximize our manufacturing capability but that wasn't possible and it really did increase the the print time if we opted for that that backward-facing shield design so that's why we opted because we have such such great laser cutting capacity to move to the neoprene design and so we did this newer version we got it to the hospitals they said man this roof it works great it seals out all potential droplets from the side the doctors and nurses are saying how much more comfortable these are than even the commercially available versions and then their first question to us was you know when can we get more how soon can you start to go into manufacturing with this and so that really you know from a from an institutional perspective we we had to kind of run it up to the upper administration can we use lehigh resources how do we fund this you know lehigh as an institution responded very quickly and got us funding the necessary funding to go ahead and proceed and make this happen and so essentially the final design is five pieces it's the clear face shield which is which again is pet and laser cut and then you have the neoprene band for the back the kind of roof section and then the two 3d printed components one goes at the forehead and the other one goes at the base to kind of just wrap the shield a little bit more around the chin area again that was a that was part of the original proofs of design with our current capabilities we were able to manufacture about 500 of these a week the 3d printing was being that was the limiting factor for us we could we could laser cut you know 1500 components at least a week of the other things but but the 3d printing was definitely the limiting factor but that's what we started to do we released the design to other local universities and colleges in the area because it had already been vetted by the three local hospitals and they were very very happy with this design so again supply chain like erin mentioned really started to become a concern where can we get the materials we needed to do this how many can we start to make and how do we manufacture efficiently so again that's where we started to come with those the stack design trying to eliminate all of the support material and 3d printing as much as possible and then buying bulk materials and trying to get them in the door thankfully we had a local source for pet that got us kind of over our initial hump and while that was happening our our institutions sort of reached out to a lot of our corporate partners and just like erin mentioned coca-cola came through for them du pont chemical came through for us they had huge rolls of pet just sitting around and they said hey you know what size do you need this we'll cut it down for you and get it sent over so you know we had a thousand foot roll of pet from du pont chemical within a couple days so like i said between april 10th and today we've produced about 2,500 face shields and they've been distributed to local hospitals we have three local hospitals which were we're distributing to and what we came to realize actually thinking that the hospitals were were clearly the place that needed these that we were overlooking kind of a huge demographic and that was first responders who don't work for hospitals they work for communities and nursing homes which also don't work for hospitals and other sort of police fire rescue and and so we started to look for avenues where we could start to get some of these face shields to them and what we found is our local emergency management agencies were the kind of best distribution channel and so we started to split our uh manufacturing capabilities between sharing between the hospitals and uh two local emas or emergency management agencies um with the with the amount of face shields we've done we've also again we shared this design with others and i think there's probably about another 2,000 face shields of this design that have been printed from local universities to get this out all of the success from this actually led us to a kind of another project about two weeks into our face shield production i got a call from uh lehigh valley hospital saying hey you were amazing to do that you think you could help us with something else they had uh they they had plenty of n95 masks but what they were finding was even the small n95s didn't fit petite doctors and nurses uh to the degree that they would provide them the appropriate protection and so they were looking for alternatives to that and they said hey we have lots of uh you can see the thing um on the left of your screen which are anesthesia masks and we have literally thousands of these noise uh 100 respirator respirator cartridges but we have no way to connect them um can you help can you make something that that we can use to do this uh and so you know 24 hour turnaround in our part it doesn't this is not some huge glamorous mechanical engineering project um it looks like something you could buy on the shelf of Lowe's but it's a tapered fit inside with some threads that mash up match up to the respirator on the outside and it allows you in a very short distance to connect these two things um this was taken to the hospital uh literally a day after we got this project um they did some test fits uh with some of the the doctors that needed this and they've been able to successfully implement this in the field to provide protection uh to the doctors and nurses so uh with that you know here's uh the the feedback we've gotten from the face shields again has been amazing the nurses are kind of fighting for hours because they're more comfortable than the commercially available ones um and it's a huge team that has brought this all together including um uh my colleagues at Lehigh the local hospitals the EMAs Dupont and Noel so that's all I have thank you so much thank you so much Brian all right and uh last but not least Gerwin can you kindly share your screen and please every uh to our attendees please do continue putting your any questions you may have into the Q&A uh we've gotten quite a few already not seeing this yet Gerwin oh there we go okay uh yes well I will tell a little bit about our project called project inspiration in which we uh designed a developed medical ventilator and well uh well we had um it started the project started at uh March 20th 20th March already uh well so many weeks ago at that time in the Netherlands the uh the uh the number of cases of cases and hospitalizations was rapidly rising so you see that here can you see my arrow uh can you see it or when I point with my mouse yes yes you can see it okay so um and uh at that time everybody was fearing that I would be as short as a ventilator in the Netherlands um well um and some of my colleagues uh there were already two projects working on a on a ventilator and uh colleagues asked me whether I would want to join um and then I thought that uh I I looked at the words and I realized that there were two very big problems and it was one was that the supply chain was disrupted and it would be very hard to get uh a lot of parts that we needed and the other thing was um that we that we um well if you if you develop a new device especially one with some electronics inside you need to test test that and the electronics and the software and there is very little time to test so I thought that well we need something something uh with a proven track record and I thought back of uh several years ago I visited uh uh Cape Town the hospital a grote grote schuur hospital in Cape Town and in 1968 um Professor Barnhart did the first surgery uh heart transplant heart transplantation there so at that time they already had uh well they could do complicated things but they did not have so much electronics and especially not software so I thought okay but in that time uh what kind of ventilators did they use and I did some searching and I found uh several options and I found the uh east red cliff ventilator and well you can read an interesting blog about this on the uh by Mike Yeats the link is in the corner uh at the right bottom um and well then I thought okay well we need we need such a ventilator so we can it would be nice if we could could copy that ventilator um or be or develop a new ventilator based on the design so so we would need a design uh to to look at but where can I find such a design and then I thought okay in the Netherlands there's only one place um and that's the science that's a science museum if you if you once visited the Netherlands I would recommend to go to the Rijksmuseum Boerhaave and that's a science and medical museum and I found in their online repository that they had uh that they had an east red cliff ventilator in a well in the in their collection so I asked some medical doctors and I said would would this would this ventilator be sufficient uh and helpful to treat COVID patients and and well they said they looked at the specification and I said yeah well it's a basic design but it will uh it can do everything that's needed so uh so and they they said to me okay call call the uh call the museum and ask them if you can can take it to the university well and then I thought okay but perhaps they are not willing to do so so I I called them and I said okay can I can I borrow this ventilator bring it to the university and take it entirely apart uh so well they needed to think a little bit about that because well normally they only touch this with uh white white gloves on so but they said well give me the the situation come come buy and take it so so I sent some people there and they they gently put a ventilator in the in the trunk of a car and they drove to the university um and then well we uh it was already I think they stored it in the 80s so they they stored this in the basement of the museum so we started try to start it and actually turn out the work and here you see the running using the main cam is driving the you see actually there are two motors one one for the like the main supply and one with a 12 volt backup and then we started taking it apart part for part and taking a lot of pictures to document everything so that we would make sure that everything would fit together later later on and well my colleague was how some of my colleagues started helping me and later on we got students who volunteered and and over the weeks we the team grow grow from like two persons in the beginning to like about 40 people of staff and students and we found out a lot of nice things when you open the ventilator there are some parts that you do not expect in the medical advice like for example here you see a gear hub then that was used for the transmission to to let the ventilator run at different speeds and I was surprised by that but first thought it did not make so much sense but later on I thought that okay it is a smart solution because these things are very reliable and they are abundantly available there's also the humidifier the artificial nose and that one is made out of well if you look carefully you could already recognize that it is made out of a pressure cooker just a household pressure cooker so this is how it works the air comes in here there is a one-way valve and air enters into a bellow that one is driven up and down by a can there's a weight you can add weight or the space weight to increase the pressure then the air goes through the humidifier where it's made warm and humid it goes to the inlet valve to the patient it goes to the outlet valve and then it it goes out of the patient and out of the machine and there's a peep regulator to to keep a positive and exploratory pressure we made drawings of the original ventilator I had a team of students making an entire drawing of that and but we made a simplified version so here you see it running for the first time so we were very excited and we started doing a lot of measurements so here you see the first one and then we made the second one out of sheet steel largely made with laser cutting and also some some some machining metal machining but all all can be done in a regular workshop so here we you see the simplified design without Casey you see the valves and the main bellow and here you see that and then all we have to do is turn turn on and off and if we want to turn out make the machine run faster we just turn and well if we want it to go faster that is to increase the frequency of the breaths we can do it by adjusting or make it go slower as you see we replaced the gear hub with a speed controller just a motor controller but that's actually the only electronics to keep the system running so there are no no really critical components so the machine keeps running and actually we once we made the device we turned it on and we had we made multiple versions multiple samples and one sample we turned it on running and I think it has been running now for like seven or six weeks something like that and this is another picture of the device we added also a monitoring system with sensors so you can read out all the values and it also gives alarms when the values are exceeded we turned we made a casing for for the to protect the device and then we then we we made a press release and we got a lot of media attention because we were at that time the the curve was going down in the Netherlands but we thought okay it would be good to make this available outside the Netherlands and we got got attention from also international press so we got a lot of we got a lot of interest so we started making we started making samples that we shipped to countries that were interested to build their own device and we shipped one to Ukraine and one to Guatemala and this initiative Respirat Guatemala is now building their own device in Ukraine they are building a device and they are going to to test it and make a large number for local production also we supplied one to the to the Mexican embassy which will be tested in Mexico city and we made all the drawings of available on github so you can make your own device locally and we are now finishing up the electronics we have we just making a revision of the current version and we are well we have a crowdfunding running on our website so you can support us we believe that everybody should have access to to a ventilator and in some parts of the world that's difficult now if you want to contact us this is these are a lot of details and you can visit our website to find more information about open source files or about the crowdfunding well that wasn't in short thank you very much thank you so much Gervin that's really excellent I'm going to turn over the microphone now to our intrepid moderator right Elizabeth, Erin, Gervin and Brian thank you so much for your excellent presentations we've had a stream of questions come in some of which have been answered but I'll do a really a real quick recap so the first question was about from Naman Pushp and he asked if the design is open source and could we send the link for it and I saw that Elizabeth has already sent the link over and we will also make sure that we append it to the youtube video that ultimately goes on the channel so that you can access it easily the next question was from Rishi Rajatard and he asked if this was a write down to create a website or portal for the community exclusively for open source engineering designs and speedy plans for healthcare and again Elizabeth pointed out that there is actually a website that is hosted by NIH and there are specific page for the COVID response as well so we will make sure that those exist and here's a great question from Caroline Rohas and the question was about standards what standards have you followed for facial designs at E4C you're doing research of standards that apply for different technologies using the COVID-19 context we have not been able to find much information about standards that apply to face shields so I think this was a really important topic and although Elizabeth has responded I would love to request her to explain how we are approaching standards when it comes to PPE yeah absolutely so early on we did a you know a bit of background research on any standards that do apply or processes for regulatory approval amidst COVID and so forth face shields as they had been before COVID were actually in kind of a weird regulatory space in terms of standards and regulatory so there are a couple voluntary standards out there that are listed in this document that you'll all get the link to but some of those didn't really address necessarily infectious a facial use for preventing cross-contamination or infection and so a lot of it was like for welders or carpenters and so forth so some hospitals have still been looking at that standard as a way to screen different face shields and figure out which ones to move forward with because they do have some testing around you know making sure it stays secure on the head and some other things that are applicable in general but other than that previously face shields were only regulated for use in surgery and but then something that happened early in April is that FDA issued a letter regarding face shields which is also in this background document and they essentially said okay for now face shields under emergency use authorization for all medical purposes you need to abide by these couple simple regulations that are in the letter and it's essentially says have instructions for use and indicate what you can clean it with because cleaning and disinfection you know these were originally single use disposables so it talks about making sure people have a really good idea of how to do that and making sure you include instructions with your face shield and then the other two components are to keep an inventory of where you sent your face shields in case someone has an issue and you need to contact them and if there are any complaints there's a website at the FDA where people can provide a complaint around a face shield so it's not too onerous and it's it's all in that background research document. I'd like to jump in here also that internationally people will ask you for standards even if they don't exist so what we've been seeing as sort of the standard is having a one pager that calls out the pieces of that which Elizabeth just mentioned making sure that people understand how to clean and use your device but also from a design standpoint it's important a lot of groups have been really wanted to put their logo into the visor section so that you get undercuts and things that are really hard to clean so you want to make sure that you're actually minimizing those spaces where germs and viruses can can stay so that's a good consideration just for those open source designs. Can I build on this whole thread a little bit further? Just this morning I saw a post from one of my colleagues on Facebook and she's a psychologist and she said after watching how some people wear their masks I understand my contraception fails and I can totally see us designing the best mask the best PPE that actually works lives up to some quality standards that might not exist but that's a different issue but let's talk a little bit about the usability aspects you know how do you design PPE that actually proactively mitigates that human error and ignorance and how do we educate people to use PPE right and what can we as engineers do about it? That's certainly the big reason my company focused on face shields because we we heard that in hospitals people were using homemade masks even and this the face shield is the next best way to make sure that they're staying safe because it it's an extra layer on top of that but it really comes down to education it it surprises me that in my area there's a $300 fine if you're caught with not wearing a mask in a public location but there I don't believe there's any description on that whether it's not that you're wearing it properly so it's really needs to be the thing that everyone sees on Facebook rather than all the hypotheses that people are making up. Yeah and I think you know like to Aaron's point the whole the the beauty of the face shield is it's a little bit more difficult to wear incorrectly right it's almost idiot-proof in a lot of ways so once you put it on the forehead and you wrap it around it's gonna it's gonna give you a level of protection whether you're wearing a mask or not and so you know it is almost the first line of defense for those droplets coming toward the doctors or medical care practitioners clearly they should probably know how to wear their face masks correctly but it does give you an extra level of protection and that was you know like in our design we kept that prusa thing on the bottom that helped to make it go around the chin more because it really it makes it a little bit more idiot-proof and it provides an additional layer of protection around that mask. Great thank you. Gerbin do you want to jump on to this you know I would hate to be on a ventilator and if I was on one and I saw a green balloon go up and go on and off that would that might scare me just a little bit so how do you kind of you know build a confidence amongst your patients that your device actually works? Okay yeah thank you well the green balloon was actually that was simulating the lung yeah so that would be the place where the patient is attached. Well I think well I think what is good about the ventilator that our team designed is that it is based on on a design with a proven track record. The east red cliff ventilator was originally designed during the polio epidemic in the 60s and it has been used in the 60s and the 70s in many European hospitals and then in the 80s when they got newer devices many of them were exported to all around the world where they have been used in low-resort settings for many more decades and they could do local maintenance by themselves. The design is so simple that well you don't need a degree in electronics you can just well smart car repairment can just repair the thing and there have been patients who have been paralyzed patients who have been on this ventilator for more than one or two years and well our design now of course is not the identical copy of this design so it needs to be well we did a lot of measurements all we could measure we did measure and now it's up to independent people to also verify this and then go into a trajectory to approve this for for a local application. We were in a trajectory of doing this in the Netherlands. The government opened a special trajectory for emergency ventilators but then the number of cases dropped due to all the the COVID cases dropped because of all the measurements we had and then they closed this special problem so we cannot certify it anymore in the Netherlands only for normal certification which would cost us like nine months but that's not feasible or not really practical so now people will do it locally and now the people in Guatemala are building they almost have finished two prototypes once we have finished our improved electronics we will send them the electronics monitoring system and then they will put that on their system and they will prepare it for for local testing and they collaborate with local hospital and the local government we ask everybody to all teams who want to have contact with us and make it to have contact with at least a major hospital and and with their local government great thank you so let's zoom out a little bit from all these products to the systems level and we had a question come in about from likely an academic who said my institution was paralyzed by this uh sorry was paralyzed by this crisis and obviously the speakers today were not in my situation and able to do incredible things despite the challenges and any thoughts on how to be proactive when your administration is not in a proactive frame of mind and i would like to build on this further because we do have a million members a million engineers set apart of this engineering for change community we have a special interest group in humanitarian technology that has chapters all over the world we have all these volunteers that want to do good how can they be proactive what can they do and they might not have all those 3d printers and pressure cookers lying around maybe the pressure cookers anybody want to pick that up just say collaboration is key i think that was highlighted in all of our discussions making sure that you can connect to people with the resources that you have so if you have a skill bring it up so that people can leverage that it that might might sound harder than it than it is and obviously each of the networks that we just described are very different and aren't working together necessarily but it's always my goal to start connecting those people so that we can make the largest impact yeah and i'm just going to follow up on what erin said you know for us it it was that collaboration that was kind of um our secondary outlet uh you know we we got together with no and they were in a position where they could pull the trigger and mass manufacturers so when we were doing the design for the face shield we were making sure that everything could be injection moldable and everything could be die cut um not using 3d printers and laser cutters that you know we were just trying to like hold the line as as long as we could and that was even before i permission from the institution to move forward with mass production so um we kind of had a backup plan um we knew it would take them a couple weeks to get off the ground with mass production but um you know making sure that you have those partnerships that you can leverage i think is is really critical i can add to that i think there's an individual aspect and an institutional aspect so for us as spark health design and design that matters we're small nimble organizations so it was you know easy on the institutional level to to get going on something but we certainly engaged with big folks like bowing and global tech plastics and so forth and i think from our perspective it was being able to be really public with that we wanted to do an initiative and sort of inviting people who wanted to show up and be part of it um just say yes please be part of it and let's find a way to do it so if you're an individual or an institution and you see something out there already going on and you want to join you know reaching out and offering that help you know definitely helps and i think the other piece we worked with being a person who's also adjunct faculty at a university i worked with a number of folks at universities who were trying to get initiatives going around ppe printing or other ways that they could help the community and there definitely were some struggles in terms of you know who's who's doing what and which initiative there are many things we could do and and then convincing the institution itself that it would be safe you know that they wouldn't be engaging in something that left people worse off than they would have been before and at least from the perspective of the face shield project being able to provide some information about these sort of what are the regulations or lack thereof and how do we comply with that and so providing more of a package not just the CAD files but also instructions for use and other things wrapped around that regulatory information you know helped with some of the institutional folks who decided to take on printing the face shield so i think we are pretty much running out of time now it's spell 15 and i think this might be a good note to end the webinar on so i mean here's what i'm thinking you know as an engineer educator as a concerned citizen and yes i agree with margaret me that it's all about concerned citizens like us it's been wonderful to see and hear about these different all kinds of organizations coming together to you know to bring different resources and expertise together and address this challenge but what can we what should we do now what can we do now to keep this momentum going to sustain this momentum and to build on these relationships so that you know at some point we will hopefully get get back to a new normal it might not be the world that the way it looks right now but maybe we'll have a vaccine we'll go back to normal and put this pandemic behind us only to wait for the next pandemic only to wait for the next such disaster right so what should we be doing now to keep building those relationships and it is all about those relationships so that's a good thought and i hope that you guys reach out to the local site chapters local engineers with our board this chapter is what have you people that really care about these issues and keep collaborating and erin bryan gervin and ellisabeth thank you so much for for sharing your expertise and excellent work keep going and yana thank yana yana thanks for hosting this and thanks for having us i'll turn it back to yana thank you so much calm down thank you to all the speakers and presenters thank you to our attendees for joining us today in terms of which you just said calm down we are here to help facilitate these connections to continue to provide platforms for the conversation i know we are over time so i want to be respectful of everybody's time i know everyone's quite busy thank you all enjoy the rest of your day morning or evening and be sure to wear your masks correctly and then take care everyone bye