Drones as mobile microbiological laboratories ESCMIDMario PoljakeLibrary Institute of Microbiology and Immunology Faculty of Medicine, University of Ljubljana, Slovenia © by author. I have no conflicts of interest to declare. ESCMID eLibrary © by author autonomous, or remotely controlled, multiuse aerial vehicles that are driven by aerodynamic forces and are capable of carrying a payload definition framed the distinction from other aerial systems like: ballistic vehicles, gliders, balloons, and cruise missiles ESCMID eLibrary © by author autonomous, or remotely controlled, multiuse aerial vehicles that are driven by aerodynamic forces and are capable of carrying a payload definition framed the distinction from other aerial systems like: ballistic vehicles, gliders, balloons, and cruise missiles Drone coined in reference to the early remotely-flown target aircraft used for practice firing of a battleship's guns the term first used with the 1920‘s Fairey Queen target aircrafts UnmannedESCMID aircraft vehicle/system eLibrary (UAV; UAS) adopted by the United States Federal Aviation Administration in 2005 © by author https://en.wikipedia.org/wiki/Drone - agricultural drone - delivery drone - micro air UAV - miniature UAV - multi-rotor - passenger drone - quadcopter - unmanned combat aerial vehicle ESCMID eLibrary © by author https://en.wikipedia.org/wiki/Drone - agricultural drone - delivery drone - micro air UAV - miniature UAV - multi-rotor - passenger drone - quadcopter - unmanned combat aerial vehicle ESCMIDmedical drone eLibrary lab-on-a-drone © by author https://en.wikipedia.org/wiki/Drone - agricultural drone - delivery drone - micro air UAV - miniature UAV - multi-rotor - passenger drone - quadcopter - unmanned combat aerial vehicle ESCMIDmedical drone eLibraryFixed wing aircrafts lab-on-a-drone UAVs resembling helicopters © by author Fixed wing aircrafts PROS: can reach high altitudes, travel great distances, relatively high speed CONS: require a preexisting runway or a launching platform ESCMID eLibrary © by author UAVs resembling helicopters PROS: have vertical take-off and landing capabilities, easier to navigate in dense, urban environments and even inside buildings CONS: shorter flying range, lower speed, relatively smaller payload capacity ESCMID eLibrary © by author non-medical use of drones general medical use of drones ESCMIDuse of drones eLibrary in CM/ID © by author ESCMID eLibrary © by author Drone a male bee, from an unfertilized egg Drone a fertile male ant ESCMID eLibrary © by author Drone a male bee, from an unfertilized egg term ”drone” coined because of the similarity of the loud and cadenced sound of old military unmanned target aircraft to that of a male bee Drone a fertile male ant ESCMID eLibrary © by author 36 eligible papers ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author Drone perception ESCMID eLibrary © by author Drones are crucial component of most prominent national militaries ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author Drone perception ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author ESCMID eLibrary © by author delivery of non-medical products by drones despite the early predictions that drones would be used to deliver fast food and other goods, the reality is rather different drone delivery service across Elliðárvogu, an inlet that divides Reykjavik from its eastern suburbs; customers can order goods using online apps and, weather permitting, select a drone delivery; drones do not use cameras or radar to navigate, but GPS; start with fixed routes that gradually become more ambitious small aid packages delivered to communities affected by major disasters: - 2010 - earthquake in Haiti - 2012 - Superstorm Sandy hurricane (US, Canada and the Caribbean) - 2015 - category 5 cyclone (Pam, islands of Vanuatu) - 2015ESCMID - earthquake in Nepal eLibrary drone supply of spare parts to ships anchored offshore in Singapore (March 2019) © by author delivery of non-medical products by drones delivery of blood, medicines, antivenom, vaccines etc. by drones ESCMID eLibrary © by author Transfusion 2017;57:582-88 six leukoreduced red blood cell (RBC) and six apheresis platelet (PLT) units units placed in a cooler, attached to the drone, and flown for up to 26.5 minutes with temperature logging after flight, the RBC parent units centrifuged and visually checked for hemolysis; PLTs checked for changes in mean PLT volumes (MPVs), pH, and PLT count no evidence of RBC hemolysis; no significant changes in PLT count, pH, or MPVs; and noESCMIDchanges in the FP24 bubbles eLibrary no adverse impact of drone transport on RBC or PLT units © by author Rwanda is the first country that has sought to integrate drones into its health service with drones used to deliver blood ‘Uber for blood’ service launched in 2016 in the presence of the Rwandan President a fleet of small, battery-powered aircraft-like drones designed and built by a Silicon Valley start-up Zipline International drone service activated by local healthcare workers via text-message ordering service GPS coordinates of the intended delivery site are used to program the drones and guideESCMID them to their destination, significantly eLibrary reducing delivery times 4,100 units of blood delivered in the first year; delivery time 15-45 minutes; 40% of the blood for postpartum hemorrhaging; 40% for treatment of severe malaria © by author Tanzania launched the world's largest drone delivery network in January 2018 more than 1,000 health facilities across the Tanzania connected dlivery of blood, vaccines and malaria and HIV/AIDS drugs modified Zipline International drones flying at 100 km (62 miles) per hour; drones parachuting blood and medicines with biodegradable parachutes ESCMID eLibrary Tanzania has one of the world's worst maternal mortality rates - 556 deaths per 100,000 deliveries © by author Vaccine 2016;34:4062-7 sensitivity analyses to assess the impact of using drones for routine vaccine distribution vs. traditional multi-tiered land transport system (TMLTS) compared to the TMLTS, drones maintained cost savings in all sensitivity analyses, ranging from $0.05 to $0.21 per dose administered implementing a drone delivery could increase vaccine availability and decrease costs in a wide range of settings and circumstances if the drones are used frequently enough to overcome the capital costs of installing and maintaining theESCMIDsystem eLibrary © by author remote island of Erromango - South Pacific nation of Vanuatu about 20 % of Vanuatu’s 35,000 children under age 5 do not get all their shots many villages reachable only by “banana boats” most villages have no electricity ESCMID eLibrary © by author Drones are delivering contraceptives to hard-to-reach Ghanaian villages in a program jointly funded by the United Nations and the Bill & Melinda Gates Foundation. Deliveries to rural Ghana that once took two days now take 30 minutes by drone, and each flight costs only $15. Program expanding to six other African countries. The goal is to revolutionize women’s health and family planning in Africa. Tanzania, Rwanda, Zambia, EthiopiaESCMIDand Mozambique have expressed eLibraryan interest. © by author IEEE J Transl Eng Health Med 2018;6:4000107 six-rotor UAS used to model situations relevant to organ transportation real-time organ status monitoring using a wireless biosensor combined with an organ global positioning system 14 drone organ missions performed; temp. remained stable and low (2.5°C) biopsies of the kidney revealed no damage resulting from drone travel ESCMID eLibrary © by author delivery of non-medical products by drones delivery of blood, medicines, antivenom, vaccines etc. by drones ESCMIDdelivery of samples eLibrary to centralised laboratory by drones © by author PLoS One 2015;10:e0134020 three paired samples obtained from 56 adult volunteers; chemistry, hematology, and coagulation testing 168 samples held stationary vs. 168 samples flown in the UAS (6-38 minutes) 33 of the most common chemistry, hematology, and coagulation tests performed a mean difference of 3.2% for glucose and <1% for other analytes onlyESCMIDbicarbonate did not meet the strictest eLibraryperformance criteria. transportation of laboratory specimens via small UASs does not affect accuracy of routine chemistry, hematology, and coagulation tests results © by author ESCMID eLibrary Amukele et al. © by author PLoS One 2015;10:e0134020 Am J Clin Pathol 2017;148:427-35 stability of biological samples in prolonged drone flights paired chemistry and hematology samples from 21 adult volunteers half of the samples held stationary, other samples flown for 3 hours (258 km) in a custom active cooling box mounted on the drone 17 analytes had small or no bias glucose and potassium in flown samples showed an 8% and 6.2% bias; the changes consistentESCMIDwith the magnitude and duration eLibraryof the temperature difference between the flown and stationary samples © by author Am J Clin Pathol 2017;148:427-35 ESCMID eLibrary © by author Anal Biochem 2018;545:1-3 proper mixing for homogenous dispersion of silica particles, separator gels, clot activators or anti-coagulants is vital for optimal downstream separation of serum or plasma; controlling the level of agitation applied during mixing is important for minimizing hemolysis of red blood cells which