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  1. Article: 3D-printed activated charcoal inlet filters for oxygen concentrators: A circular economy approach.

    Williams, Ellis / Piaggio, Davide / Andellini, Martina / Pecchia, Leandro

    Development engineering

    2022  Volume 7, Page(s) 100094

    Abstract: As of May 2021, the current COVID-19 pandemic is still plaguing the world, challenging all the countries and their health systems, globally. In this context, conditions typical of low-resource settings surfaced also in high-resource ones (e.g., the lack ... ...

    Abstract As of May 2021, the current COVID-19 pandemic is still plaguing the world, challenging all the countries and their health systems, globally. In this context, conditions typical of low-resource settings surfaced also in high-resource ones (e.g., the lack of essential medical equipment, of resources etc.), while exacerbating in the already resource-scarce settings, because of COVID-19. This is the case of oxygen concentrators that are one of the first-line medical devices for treating COVID-19 patients. Since the beginning of 2020, their demand has been rapidly growing worldwide, aggravating the situation for low-resource settings, where the availability of devices providing oxygen-enriched air was already scarce. In fact, due to their delicacy, the lack of spare parts and of an appropriate health technology management system, oxygen concentrators can often be found broken or not working properly in these settings. The underlying problems have deep roots. The current regulatory frameworks and standards, which are set by high-income countries, are too stringent, and do not take into account the limited resources of poorer settings. Thus, they are often inapplicable in such settings. One of the main issues affecting the oxygen concentrators, is that related to the filters, which are designed to filter out dust, particles, bacteria, and to be used in medical locations complying with international standards (e.g., the air filtration level in a surgical theatre in Italy is at 99.97%). When used in low-resource settings, which do not comply with these standards and face several challenges (e.g., dust), these filters have a much-reduced lifespan. For these reasons, this paper aims to present the redesign of the inlet filter of an oxygen concentrator, which is used to prevent gross particles to enter the device. The redesign is based on a reverse engineering approach, and on the use of 3D-printing along with activated charcoal. After testing the filtration efficiency with a particle counter, the filter design has been refined through several iterations. The final prototype performs particularly well when filtering particles above 1 μm (with a filtration efficiency of 64.2%), and still has a satisfactory performance with any particle size over 0.3 μm (with a filtration efficiency of 38.8%). Following the United Nations Sustainable Development Goals, this project aims to empower local communities, and start a positive trend of self-sustained supply chain of simple spare parts for medical devices, leveraging on frugal engineering, 3D-printing, locally produced activated charcoal, and circular economy.
    Language English
    Publishing date 2022-01-19
    Publishing country England
    Document type Journal Article
    ISSN 2352-7285
    ISSN 2352-7285
    DOI 10.1016/j.deveng.2022.100094
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Conversations with the Editors: Artificial Intelligence-Based Technologies Leading the Innovation in Surgical Care.

    Ravera, Luciano / Scheeren, Thomas W L / Piaggio, Davide / Federici, Carlo

    Clinical therapeutics

    2022  Volume 44, Issue 6, Page(s) 828–834

    MeSH term(s) Artificial Intelligence ; Communication ; Humans
    Language English
    Publishing date 2022-05-27
    Publishing country United States
    Document type Editorial
    ZDB-ID 603113-4
    ISSN 1879-114X ; 0149-2918
    ISSN (online) 1879-114X
    ISSN 0149-2918
    DOI 10.1016/j.clinthera.2022.05.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: COVID-19 preparedness and social dynamics in a Sub-Saharan Africa country, Benin.

    Maccaro, Alessia / Piaggio, Davide / Vignigbé, Marius / Stingl, Alexander / Pecchia, Leandro

    Health promotion international

    2022  Volume 37, Issue 4

    Abstract: This project aims to assess and analyse the perception and impact of the COVID-19 pandemic in Benin. The applied research methodology was interdisciplinary and combined field studies that used ethnographic and social research methods with coding and data ...

    Abstract This project aims to assess and analyse the perception and impact of the COVID-19 pandemic in Benin. The applied research methodology was interdisciplinary and combined field studies that used ethnographic and social research methods with coding and data analysis, leading to theoretical dilemmas, which were analysed from the viewpoint of bioethical reflection. Furthermore, biomedical engineering approaches were used to assess the preparedness to COVID-19. Despite the preparedness to COVID-19 due to the promoted governmental measures, a peculiar management of the pandemic emerged. The latter, although noteworthy, did not overcome the typical challenges of medical locations in low-resource settings. This, together with the controversial spread of information and local beliefs, caused significant economic and social consequences, exceeding the benefits related to the containment of the virus. This research highlights how the emotion of fear, in this specific situation, was herald of dramatic consequences, rather than having a heuristic and empowering effect.
    MeSH term(s) Africa South of the Sahara ; Benin/epidemiology ; COVID-19/prevention & control ; Humans ; Pandemics
    Language English
    Publishing date 2022-08-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 1027448-0
    ISSN 1460-2245 ; 0957-4824
    ISSN (online) 1460-2245
    ISSN 0957-4824
    DOI 10.1093/heapro/daac105
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: A robotic arm for safe and accurate control of biomedical equipment during COVID-19.

    Iadanza, Ernesto / Pasqua, Giammarco / Piaggio, Davide / Caputo, Corrado / Gherardelli, Monica / Pecchia, Leandro

    Health and technology

    2023  Volume 13, Issue 2, Page(s) 285–300

    Abstract: Purpose: Hospital facilities and social life, along with the global economy, have been severely challenged by COVID-19 since the World Health Organization (WHO) declared it a pandemic in March 2020. Since then, countless ordinary citizens, as well as ... ...

    Abstract Purpose: Hospital facilities and social life, along with the global economy, have been severely challenged by COVID-19 since the World Health Organization (WHO) declared it a pandemic in March 2020. Since then, countless ordinary citizens, as well as healthcare workers, have contracted the virus by just coming into contact with infected surfaces. In order to minimise the risk of getting infected by contact with such surfaces, our study aims to design, prototype, and test a new device able to connect users, such as common citizens, doctors or paramedics, with either common-use interfaces (e.g., lift and snack machine keyboards, traffic light push-buttons) or medical-use interfaces (e.g., any medical equipment keypad).
    Method: To this purpose, the device was designed with the help of Unified Modelling Language (UML) schemes, and was informed by a risk analysis, that highlighted some of its essential requirements and specifications. Consequently, the chosen constructive solution of the robotic system, i.e., a robotic-arm structure, was designed and manufactured using computer-aided design and 3D printing.
    Result: The final prototype included a properly programmed micro-controller, linked via Bluetooth to a multi-platform mobile phone app, which represents the user interface. The system was then successfully tested on different physical keypads and touch screens. Better performance of the system can be foreseen by introducing improvements in the industrial production phase.
    Conclusion: This first prototype paves the way for further research in this area, allowing for better management and preparedness of next pandemic emergencies.
    Language English
    Publishing date 2023-01-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2581463-1
    ISSN 2190-7196 ; 2190-7188
    ISSN (online) 2190-7196
    ISSN 2190-7188
    DOI 10.1007/s12553-022-00715-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: The role of ethics in science: a systematic literature review from the first wave of COVID-19.

    Maccaro, Alessia / Piaggio, Davide / Pagliara, Silvio / Pecchia, Leandro

    Health and technology

    2021  Volume 11, Issue 5, Page(s) 1063–1071

    Abstract: This paper proposes a systematic literature review on ethics and CoviD-19, aiming to understand the impact and the perception of the pandemic during the first wave (January-June 2020) and the consequences one year later. PubMed was systematically ... ...

    Abstract This paper proposes a systematic literature review on ethics and CoviD-19, aiming to understand the impact and the perception of the pandemic during the first wave (January-June 2020) and the consequences one year later. PubMed was systematically searched up May 2020 to identify studies that took into consideration various ethical issues that have been arising from the Covid-19 outbreak. The eligibility of the papers was determined by two authors, who screened the results mediated by a third author. In order to facilitate the screening, the titles were divided into five sub-thematic macro-areas, namely
    Supplementary information: The online version contains supplementary material available at 10.1007/s12553-021-00570-6.
    Language English
    Publishing date 2021-06-03
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 2581463-1
    ISSN 2190-7196 ; 2190-7188
    ISSN (online) 2190-7196
    ISSN 2190-7188
    DOI 10.1007/s12553-021-00570-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The use of smart environments and robots for infection prevention control: A systematic literature review.

    Piaggio, Davide / Zarro, Marianna / Pagliara, Silvio / Andellini, Martina / Almuhini, Abdulaziz / Maccaro, Alessia / Pecchia, Leandro

    American journal of infection control

    2023  Volume 51, Issue 10, Page(s) 1175–1181

    Abstract: Background: Infection prevention and control (IPC) is essential to prevent nosocomial infections. This manuscript aims at investigating the current use and role of robots and smart environments on IPC systems in nosocomial settings METHODS: The ... ...

    Abstract Background: Infection prevention and control (IPC) is essential to prevent nosocomial infections. This manuscript aims at investigating the current use and role of robots and smart environments on IPC systems in nosocomial settings METHODS: The systematic literature review was performed following the PRISMA statement. Literature was searched for articles published in the period January 2016 to October 2022. Two authors determined the eligibility of the papers, with conflicting decisions being mitigated by a third. Relevant data was then extracted using an ad-hoc extraction table to facilitate the analysis and narrative synthesis.
    Results: The search strategy returned 1520 citations and 17 papers were included. This review identified 3 main areas of interest: hand hygiene and personal protective equipment compliance, automatic infection cluster detection and environments cleaning (ie, air quality control, sterilization). This review demonstrates that IPC practices within hospitals mostly do not rely on automation and robotic technology, and few advancements have been made in this field.
    Conclusions: Increasing the awareness of healthcare workers on these technologies, through training and involving them in the design process, is essential to accomplish the Health 4.0 transformation. Research priorities should also be considering how to implement similar or more contextualized alternatives for low-income countries.
    MeSH term(s) Humans ; Robotics ; Infection Control ; Cross Infection/prevention & control ; Health Personnel ; Delivery of Health Care
    Language English
    Publishing date 2023-03-15
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2023.03.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Pandemic Preparedness: A Scoping Review of Best and Worst Practices from COVID-19.

    Maccaro, Alessia / Audia, Camilla / Stokes, Katy / Masud, Haleema / Sekalala, Sharifah / Pecchia, Leandro / Piaggio, Davide

    Healthcare (Basel, Switzerland)

    2023  Volume 11, Issue 18

    Abstract: The COVID-19 pandemic highlighted the scale of global unpreparedness to deal with the fast-arising needs of global health threats. This problem was coupled with a crisis of governance and presented in the context of globally hitting climate crisis and ... ...

    Abstract The COVID-19 pandemic highlighted the scale of global unpreparedness to deal with the fast-arising needs of global health threats. This problem was coupled with a crisis of governance and presented in the context of globally hitting climate crisis and disasters. Although such a pandemic was predictable due to the known effects of human intervention on the surrounding environment and its devastating secondary effects, such as climate change and increased zoonoses, most countries were unprepared to deal with the scale and scope of the pandemic. In this context, such as that of the climate crisis, the Global North and Global South faced several common challenges, including, first and foremost, the scarcity of resources required for health, policy, wellbeing and socioeconomic wellness. In this paper, we review the most recent evidence available in the literature related to pandemic preparedness and governance, focusing on principles and practices used during the COVID-19 pandemic, and we place it in the context of a European Parliament Interest Group meeting (this event took place on 21 March 2023 during the "European Health Tech Summit") to ground it within ongoing discussions and narratives of policy and praxis. The review identified key practices and principles required to better face future health threats and emergencies. Beyond health practices relying on technology and innovation, it is useful to mention the importance of contextualising responses and linking them to clear goals, improving the agreement between science and policymaking, thus building trust and enabling transparent communication with the general public based on clear ethical frameworks.
    Language English
    Publishing date 2023-09-18
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare11182572
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Biomedical engineering and ethics: reflections on medical devices and PPE during the first wave of COVID-19.

    Maccaro, Alessia / Piaggio, Davide / Dodaro, Concetta Anna / Pecchia, Leandro

    BMC medical ethics

    2021  Volume 22, Issue 1, Page(s) 130

    Abstract: In March 2019, the World Health Organization (WHO) declared that humanity was entering a global pandemic phase. This unforeseen situation caught everyone unprepared and had a major impact on several professional categories that found themselves facing ... ...

    Abstract In March 2019, the World Health Organization (WHO) declared that humanity was entering a global pandemic phase. This unforeseen situation caught everyone unprepared and had a major impact on several professional categories that found themselves facing important ethical dilemmas. The article revolves around the category of biomedical and clinical engineers, which were among those most involved in dealing with and finding solutions to the pandemic. In hindsight, the major issues brought to the attention of biomedical engineers have raised important ethical implications, such as the allocation of resources, the responsibilities of science and the inadequacy and non-universality of the norms and regulations on biomedical devices and personal protective equipment. These issues, analyzed one year after the first wave of the pandemic, come together in the appeal for responsibility for thought, action and, sometimes, even silence. This highlights the importance of interdisciplinarity and the definitive collapse of the Cartesian fragmentation of knowledge, calling for the creation of more fora, where this kind of discussions can be promoted.
    MeSH term(s) Biomedical Engineering ; COVID-19 ; Humanities ; Humans ; Personal Protective Equipment ; SARS-CoV-2
    Language English
    Publishing date 2021-09-25
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041552-7
    ISSN 1472-6939 ; 1472-6939
    ISSN (online) 1472-6939
    ISSN 1472-6939
    DOI 10.1186/s12910-021-00697-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Towards a common European ethical and legal framework for conducting clinical research: the GATEKEEPER experience.

    Maccaro, Alessia / Tsiompanidou, Vasiliki / Piaggio, Davide / Gallego Montejo, Alba M / Cea Sánchez, Gloria / de Batlle, Jordi / Quesada Rodriguez, Adrian / Fico, Giuseppe / Pecchia, Leandro

    NPJ digital medicine

    2024  Volume 7, Issue 1, Page(s) 95

    Abstract: This paper examines the ethical and legal challenges encountered during the GATEKEEPER Project and how these challenges informed the development of a comprehensive framework for future Large-Scale Pilot (LSP) projects. GATEKEEPER is a LSP Project with 48 ...

    Abstract This paper examines the ethical and legal challenges encountered during the GATEKEEPER Project and how these challenges informed the development of a comprehensive framework for future Large-Scale Pilot (LSP) projects. GATEKEEPER is a LSP Project with 48 partners conducting 30 implementation studies across Europe with 50,000 target participants grouped into 9 Reference Use Cases. The project underscored the complexity of obtaining ethical approval across various jurisdictions with divergent regulations and procedures. Through a detailed analysis of the issues faced and the strategies employed to navigate these challenges, this study proposes an ethical and legal framework. This framework, derived from a comparative analysis of ethical application forms and regulations, aims to streamline the ethical approval process for future LSP research projects. By addressing the hurdles encountered in GATEKEEPER, the proposed framework offers a roadmap for more efficient and effective project management, ensuring smoother implementation of similar projects in the future.
    Language English
    Publishing date 2024-04-13
    Publishing country England
    Document type Journal Article
    ISSN 2398-6352
    ISSN (online) 2398-6352
    DOI 10.1038/s41746-024-01092-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: The Inadequacy of Regulatory Frameworks in Time of Crisis and in Low-Resource Settings: Personal Protective Equipment and COVID-19.

    Pecchia, Leandro / Piaggio, Davide / Maccaro, Alessia / Formisano, Claudio / Iadanza, Ernesto

    Health and technology

    2020  Volume 10, Issue 6, Page(s) 1375–1383

    Abstract: COVID-19 pandemic is plaguing the world and representing the most significant stress test for many national healthcare systems and services, since their foundation. The supply-chain disruption and the unprecedented request for intensive care unit (ICU) ... ...

    Abstract COVID-19 pandemic is plaguing the world and representing the most significant stress test for many national healthcare systems and services, since their foundation. The supply-chain disruption and the unprecedented request for intensive care unit (ICU) beds have created in Europe conditions typical of low-resources settings. This generated a remarkable race to find solutions for the prevention, treatment and management of this disease which is involving a large amount of people. Every day, new Do-It-Yourself (DIY) solutions regarding personal protective equipment and medical devices populate social media feeds. Many companies (e.g., automotive or textile) are converting their traditional production to manufacture the most needed equipment (e.g., respirators, face shields, ventilators etc.). In this chaotic scenario, policy makers, international and national standards bodies, along with the World Health Organization (WHO) and scientific societies are making a joint effort to increase global awareness and knowledge about the importance of respecting the relevant requirements to guarantee appropriate quality and safety for patients and healthcare workers. Nonetheless, ordinary procedures for testing and certification are currently questioned and empowered with fast-track pathways in order to speed-up the deployment of new solutions for COVID-19. This paper shares critical reflections on the current regulatory framework for the certification of personal protective equipment. We hope that these reflections may help readers in navigating the framework of regulations, norms and international standards relevant for key personal protective equipment, sharing a subset of tests that should be deemed essential even in a period of crisis.
    Keywords covid19
    Language English
    Publishing date 2020-05-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2581463-1
    ISSN 2190-7196 ; 2190-7188
    ISSN (online) 2190-7196
    ISSN 2190-7188
    DOI 10.1007/s12553-020-00429-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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