Use of drones in clinical microbiology and infectious diseases: current status, challenges and barriers

Closing the air gap: the use of drones for studying wildlife ecophysiology

Techniques for non-invasive sampling of ecophysiological data in wild animals have been developed in response to challenges associated with studying captive animals or using invasive methods. Of these, drones, also known as Unoccupied Aerial Vehicles (UAVs), and their associated sensors, have emerged as a promising tool in the ecophysiology toolkit. In this review, we synthesise research in a scoping review on the use of drones for studying wildlife ecophysiology using the PRISMA-SCr checklist and identify where efforts have been focused and where knowledge gaps remain. We use these results to explore current best practices and challenges and provide recommendations for future use. In 136 studies published since 2010, drones aided studies on wild animal body condition and morphometrics, kinematics and biomechanics, bioenergetics, and wildlife health (e.g. microbiomes, endocrinology, and disease) in both aquatic and terrestrial environments. Focal taxa are biased towards marine mammals, particularly cetaceans. While conducted globally, research is primarily led by institutions based in North America, Oceania, and Europe. The use of drones to obtain body condition and morphometric data through standard colour sensors and single camera photogrammetry predominates. Techniques such as video tracking and thermal imaging have also allowed insights into other aspects of wildlife ecophysiology, particularly when combined with external sampling techniques such as biologgers. While most studies have used commercially available multirotor platforms and standard colour sensors, the modification of drones to collect samples, and integration with external sampling techniques, have allowed multidisciplinary studies to integrate a suite of remote sensing methods more fully. We outline how technological advances for drones will play a key role in the delivery of both novel and improved wildlife ecophysiological data. We recommend that researchers prepare for the influx of drone-assisted advancements in wildlife ecophysiology through multidisciplinary and cross-institutional collaborations. We describe best practices to diversify across species and environments and use current data sources and technologies for more comprehensive results.

Assessing the Feasibility of Drone-Mediated Vaccine Delivery: An Exploratory Study

Background and Aims

In the past decade, unmanned aerial systems (UASs), commonly known as drones, have found applications not only in military and agriculture but also in the transportation of medical supplies.

Purpose

The present study was conducted to assess the practicality of utilizing drones as a mode for the delivery of vaccines to combat the challenges.

Study Design

An exploratory study.

Methodology

Due to the COVID-19 pandemic restrictions and paucity of availability of rules and regulations related to drones in India in 2021, this study was conducted as a exploratory study for which number of regulatory approvals are obtained and it involves five drone missions within the premises of the Indian Institute of Technology (IIT), Kanpur, India on a confined airstrip of 3 km2 to transport simulated vaccine vials using a multi-rotor top-load UAS in the normal weather conditions in daylight where dummy vaccine vials (COVID-19) were packed with cool packs to maintain the temperature. Study was conducted to explore feasibility to carry vaccines through drones and any environmental impact on the vaccine vials while its transportation.

Results

The drones demonstrated a maximum flight endurance of 31 min while carrying a payload of up to 4.5 Kg, covering an aerial distance of 17 km at an average speed ranging at 12 m per second. Notably, the vaccine carrier box was able to maintain a recommended temperature of 3°C-4°C throughout the transportation process, and there is no impact of vibration on the physical integrity and leakage of the vaccine vials during flight.

Conclusions

These findings signify the potential for the drone-based medical supply deliveries across confined and controlled environment conditions. This study provides the insights that there is no environmental impact such as humidity, temperature, wind etc on the drone and no impact on vibrations on the physical integrity and leakage of the dummy vaccine vials. There were few regulatory barriers that required special approvals from concerned authorities. The study was not designed to assess for cost-effectiveness, also it was conducted in defined geography so all sorties were VLOS. Study has various limitations such as using simulated vaccine vials, regulatory barriers, operational barriers etc. Conducting the study in a controlled environment at IIT Kanpur limits generalizability. In spite of these limitations this study provides valuable insights and may explore a diverse environment that can help in strengthening health services especially in difficult terrains.

Operational lessons learned from simulating an elimination response to a transboundary animal disease in wild animals

Transboundary animal disease (TAD) introductions can have myriad economic, ecological, and societal impacts. When TADs are introduced into wild species, rapid and intense control efforts to reduce wild animal host populations are sometimes needed to eliminate the disease and prevent endemicity and spillover to domestic animal populations. Yet, such intensive efforts are non-trivial, and the rarity of TAD introductions means that personnel rarely have direct experience with these types of operations. Thus, explicit assessments of operational challenges for these kinds of efforts can provide direction to build emergency response preparedness capacity. Here, we simulated a TAD control effort in response to initial detection of a hypothetical index case of a TAD in wild pigs (Sus scrofa) (e.g., African swine fever; ASF). We used three removal methods (aerial control, trapping, and an experimental toxic bait). Then, we conducted an after-action assessment to identify operational challenges for rapidly reducing a population of invasive wild pigs within a simulated outbreak zone. We also simulated carcass recoveries of dispatched pigs, similar to what might be conducted during a response to a TAD with carcass-based transmission (e.g., ASF virus). Here, we describe operational challenges identified during our effort, alongside technological development solutions and a priori strategy needs to improve TAD response operation outcomes.

Investigating the barriers to drone implementation in sustainable agriculture: A hybrid fuzzy-DEMATEL-MMDE-ISM-based approach

Drone integration in sustainable agriculture has emerged as a transformative technological advancement, enabling farmers to achieve accurate crop health monitoring, soil analysis, weed mapping, precise spraying, and livestock monitoring. It facilitates many sustainable measures, such as conserving freshwater resources, reducing soil erosion and pesticide overuse, minimizing agriculture waste, and enhancing productivity and resilience. Despite its benefits, drone adoption faces several barriers, highlighting the requirement of well-structured mitigation strategies to overcome these challenges and ensure successful implementation. We propose a hybrid fuzzy-DEMATEL-MMDE-ISM-based approach for analysing the barriers to drone implementation in sustainable agriculture. We obtain a list of 15 potential barriers by exploring the relevant literature and finalizing the 13 critical barriers based on the experts' opinions. We adopt the fuzzy-Decision Making Trial and Evaluation Laboratory (fuzzy-DEMATEL) technique to segregate casual and effect barriers. Then, we apply the Maximum Mean De-Entropy (MMDE) method to determine the threshold value for the Interpretive Structural Modelling (ISM) method for constructing the three-level hierarchical structure of the barriers. The insights signify that the most crucial barriers are stability and reliability, drone sensor quality, and drone payload capacity. Flight duration, high initial cost, and maintenance infrastructure serve as linkage barriers between crucial barriers and public perception and psychological barrier. We also find some barriers with minimal or no interdependence on other barriers that should be handled separately. We suggest mitigation strategies to address the underlying challenges of drone implementation in sustainable agriculture. We can extend this study by incorporating additional barriers and applying different methods in other countries to examine the variations in the model.

Using drones to improve care for HIV-exposed children in Conakry, Republic of Guinea: Anthropological perspectives

In Conakry, Guinea, like many other African capitals, traffic congestion is a major obstacle to transporting blood samples from peripheral health centres to laboratories where tests are centralised. This situation complicates early HIV testing of HIV-exposed children (i.e., born to HIV-positive mothers), even though the World Health Organization recommends treating HIV-positive children before the age of two months to reduce mortality. The use of drones, which has proved effective in many countries for rapidly transporting healthcare products and reaching isolated areas, could help to resolve these difficulties and improve early detection. A pilot study was conducted from 2020-2021 to assess the feasibility, cost-effectiveness and acceptability of such a strategy. The pilot study had an anthropological component and this article presents the results on the acceptability and perception of using drones to optimise the transport of blood samples in Conakry. Interviews and observations were conducted across six health facilities in Conakry and in various national and international institutions, with 62 people: mothers living with HIV, health professionals and community workers, the local population, health authorities and development workers. The theoretical framework is based on the concepts of innovation and acceptability from an anthropological perspective. The analyses focus on perceptions and conditions of acceptance of a technological innovation such as drones in the healthcare sector. The results show that perceptions of drones are generally positive, despite concerns about their potential misuse. However, this consensus is fragile, knowledge on the subject is sometimes limited and public opinion can vary depending on policy changes in the political and health contexts. Future drone programmes will need to be adapted to the priority health needs identified by local stakeholders, to meet the technical and ethical challenges of this emerging technology and to develop appropriate communication to ensure an optimum level of public support.

Risks of Drone Use in Light of Literature Studies

This article aims to present the results of a bibliometric analysis of relevant literature and discuss the main research streams related to the topic of risks in drone applications. The methodology of the conducted research consisted of five procedural steps, including the planning of the research, conducting a systematic review of the literature, proposing a classification framework corresponding to contemporary research trends related to the risk of drone applications, and compiling the characteristics of the publications assigned to each of the highlighted thematic groups. This systematic literature review used the PRISMA method. A total of 257 documents comprising articles and conference proceedings were analysed. On this basis, eight thematic categories related to the use of drones and the risks associated with their operation were distinguished. Due to the high content within two of these categories, a further division into subcategories was proposed to illustrate the research topics better. The conducted investigation made it possible to identify the current research trends related to the risk of drone use and pointed out the existing research gaps, both in the area of risk assessment methodology and in its application areas. The results obtained from the analysis can provide interesting material for both industry and academia.

Drone a technological leap in health care delivery in distant and remote inaccessible areas: A narrative review

In developing countries, last-mile delivery of medical products is a challenge, especially in hilly and rural areas where there is no road connectivity. As helicopters or other air services are not affordable all the time, drones can be used for the supply of medical products. They are cost-effective as compared to other air or road transport. However, the carrying capacity of drone is less, it is not able to carry heavier payloads. Also, operating drones requires trained operators, and it is a new venture in a developing country so possibilities of confusion and lack of clarity on operating procedures are there. Drones are becoming increasingly reliable for the health care delivery. This narrative review explores the use of drones in healthcare delivery globally.

Molecular point-of-care devices for the diagnosis of infectious diseases in resource-limited settings - A review of the current landscape, technical challenges, and clinical impact

Molecular point-of-care (POC) tests offer high sensitivity, rapid turnaround times, relative ease of use, and the convenience of laboratory-grade testing in the absence of formal laboratory spaces and equipment, making them appealing options for infectious disease diagnosis in resource-limited settings. In this review, we discuss the role and potential of molecular POC tests in resource-limited settings and their associated logistical challenges. We discuss U.S. Food and Drug Administration approval, Clinical Laboratory Improvement Amendments complexity levels, and the REASSURED criteria as a starting point for assessing options currently available inside and outside of the United States. We then present POC tests currently in research and development phases that have potential for commercialization and implementation in limited-resource settings. Finally, we review published studies that have assessed the clinical impact of molecular POC testing in limited- and moderate-resource settings.

Acceptance of medical drone technology and its determinant factors among public and healthcare personnel in a Malaysian urban environment: knowledge, attitude, and perception

Introduction

Unmanned aerial vehicles (UAVs) are used for commercial, medical, public safety, and scientific research purposes in various countries.

Methods

This study aimed to explore the acceptance of medical delivery drones among medical practitioners as well as the public community in Malaysia using a knowledge, attitude, and perception (KAP) model and statistical analysis to decrease uncertainty. Bivariate and multivariate analyses of the results were performed in SPSS.

Results

A total of 639 respondents took part in the survey, of which 557 complete responses were finally analyzed. The results showed that the overall acceptance rate for medical delivery drones was positive. The acceptance rate was significantly correlated with knowledge, attitude, and perception scores but not with sociodemographic factors.

Discussion

Raising awareness and educating the medical as well as public communities regarding the potential role and benefits of drones are therefore important in garnering support for drone usage for medical purposes.

Exploring the transformative role of drone technology in advancing healthcare delivery in Africa; a perspective

This perspective article delves into the transformative potential of drone technology in revolutionising healthcare delivery in Africa. The continent faces numerous challenges in providing timely and efficient medical services to its vast and diverse population, compounded by geographical barriers, inadequate infrastructure and limited access to medical facilities. Amidst these challenges, the integration of drone technology emerges as a promising solution, offering unprecedented opportunities to overcome longstanding obstacles and improve healthcare accessibility across Africa. Drawing from existing drone-based healthcare initiatives in Africa, the article explores various applications of drones in healthcare delivery. These encompass but are not limited to, delivering vaccines, medications, blood samples, diagnostic tools and medical personnel to remote locations in a timely and cost-effective manner. Furthermore, the paper examines the operational challenges and regulatory considerations in deploying drone technology for healthcare and the ethical implications surrounding privacy and security.

Sensitive poliovirus detection using nested PCR and nanopore sequencing: a prospective validation study

Timely detection of outbreaks is needed for poliovirus eradication, but gold standard detection in the Democratic Republic of the Congo takes 30 days (median). Direct molecular detection and nanopore sequencing (DDNS) of poliovirus in stool samples is a promising fast method. Here we report prospective testing of stool samples from suspected polio cases, and their contacts, in the Democratic Republic of the Congo between 10 August 2021 and 4 February 2022. DDNS detected polioviruses in 62/2,339 (2.7%) of samples, while gold standard combination of cell culture, quantitative PCR and Sanger sequencing detected polioviruses in 51/2,339 (2.2%) of the same samples. DDNS provided case confirmation in 7 days (median) in routine surveillance conditions. DDNS enabled confirmation of three serotype 2 circulating vaccine-derived poliovirus outbreaks 23 days (mean) earlier (range 6-30 days) than the gold standard method. The mean sequence similarity between sequences obtained by the two methods was 99.98%. Our data confirm the feasibility of implementing DDNS in a national poliovirus laboratory.

Survey on Path Planning for UAVs in Healthcare Missions

This article presents a comprehensive review of the state-of-the-art applications and methodologies related to the use of unmanned aerial vehicles (UAVs) in the healthcare sector, with a particular focus on path planning. UAVs have gained remarkable attention in healthcare during the outbreak of COVID-19, and this study explores their potential as a viable option for medical transportation. The survey categorizes existing studies by mission type, challenges addressed, and performance metrics to provide a clearer picture of the path planning problems and potential directions for future research. It highlights the importance of addressing the path planning problem and the challenges that UAVs may face during their missions, including the UAV delivery range limitation, and discusses recent solutions in this field. The study concludes by encouraging researchers to conduct their studies in a realistic environment to reveal UAVs' real potential, usability, and feasibility in the healthcare domain.

Unmanned aerial vehicles for surveillance and control of vectors of malaria and other vector-borne diseases

The use of Unmanned Aerial Vehicles (UAVs) has expanded rapidly in ecological conservation and agriculture, with a growing literature describing their potential applications in global health efforts including vector control. Vector-borne diseases carry severe public health and economic impacts to over half of the global population yet conventional approaches to the surveillance and treatment of vector habitats is typically laborious and slow. The high mobility of UAVs allows them to reach remote areas that might otherwise be inaccessible to ground-based teams. Given the rapidly expanding examples of these tools in vector control programmes, there is a need to establish the current knowledge base of applications for UAVs in this context and assess the strengths and challenges compared to conventional methodologies. This review aims to summarize the currently available knowledge on the capabilities of UAVs in both malaria control and in vector control more broadly in cases where the technology could be readily adapted to malaria vectors. This review will cover the current use of UAVs in vector habitat surveillance and deployment of control payloads, in comparison with their existing conventional approaches. Finally, this review will highlight the logistical and regulatory challenges in scaling up the use of UAVs in malaria control programmes and highlight potential future developments.

"Of course, drones delivering urgent medicines are necessary. But I would not use them until…" Insights from a qualitative study on users' needs and requirements regarding the use of medical drones

BACKGROUND

The current COVID-19 pandemic, demographic trends, and the increasing shortage of skilled workers pose major challenges for the care of people with and without care needs. The potential of drones as unmanned aerial vehicles in health care is being discussed as an effective innovative way of delivering much-needed medicines, especially in rural areas. Although the advantages are well known, the needs of the users have not yet been taken into account.

METHODS

Online-based focus groups (via WebEx) were conducted with participants from different disciplines: nursing, pharmacy, physicians. Focus groups with COVID-19 patients were conducted face-to-face. The focus was primarily on potential problems and requirements of the users regarding the use of drones. Structured and contrastive snowball sampling has been deployed. The focus groups were audio recorded, transcribed by a transcription-company, and coded with the help of the program "f4analyse 2" for content (Elo et al. 2008).

RESULTS

Especially during the pandemic situation, delays, and restrictions in the delivery of medicines have been noticed. All interview partners (patients, pharmacists, physicians, and nurses; n = 36 participants) see drones as useful in cases of limited mobility, time-critical medicines (rapid availability), emergencies, and disasters (e.g., floods), but also for the delivery of regular medicines in rural areas (e.g., for the treatment of chronic diseases). Moreover, only 16.7% of the participants have experiences with drones.

DISCUSSION

Drone deliveries do not play a role in the health system yet despite their great importance, which is perceived as particularly evident in the pandemic situation. The results lead to the conclusion that this is mainly due to knowledge and application deficits, so that educational and advisory work is absolutely necessary. There is also a need for further studies that go beyond the scope of acceptance research to describing and evaluating concrete scenarios of drone delivery on the basis of a user-centered approach.

Using drones to transport suspected COVID-19 samples; experiences from the second largest testing centre in Ghana, West Africa

BACKGROUND

The declaration of COVID-19 as a pandemic on March 11 2020, by the World Health Organisation prompted the need for a sustained and a rapid international response. In a swift response, the Government of Ghana, in partnership with Zipline company, launched the use of Unmanned Automated Vehicles (UAV) to transport suspected samples from selected districts to two foremost testing centres in the country. Here, we present the experiences of employing this technology and its impact on the transport time to the second largest testing centre, the Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR) in Kumasi, Ghana.

METHODS

Swab samples collected from suspected COVID-19 patients were transported to the Zipline office by health workers. Information on the samples were sent to laboratory personnel located at KCCR through a WhatsApp platform to get them ready to receive the suspected COVID-19 samples while Zipline repackaged samples and transported them via drone. Time of take-off was reported as well as time of drop-off.

RESULTS

A total of 2537 COVID-19 suspected samples were received via drone transport from 10 districts between April 2020 to June 2021 in 440 deliveries. Ejura-Sekyedumase District Health Directorate delivered the highest number of samples (765; 30%). The farthest district to use the drone was Pru East, located 270 km away from KCCR in Kumasi and 173 km to the Zipline office in Mampong. Here, significantly, it took on the average 39 minutes for drones to deliver samples compared to 117 minutes spent in transporting samples by road (p<0.001).

CONCLUSION

The use of drones for sample transport during the COVID-19 pandemic significantly reduced the travel time taken for samples to be transported by road to the testing site. This has enhanced innovative measures to fight the pandemic using technology.

Smartphone-Based Multiplexed Biosensing Tools for Health Monitoring

Many emerging technologies have the potential to improve health care by providing more personalized approaches or early diagnostic methods. In this review, we cover smartphone-based multiplexed sensors as affordable and portable sensing platforms for point-of-care devices. Multiplexing has been gaining attention recently for clinical diagnosis considering certain diseases require analysis of complex biological networks instead of single-marker analysis. Smartphones offer tremendous possibilities for on-site detection analysis due to their portability, high accessibility, fast sample processing, and robust imaging capabilities. Straightforward digital analysis and convenient user interfaces support networked health care systems and individualized health monitoring. Detailed biomarker profiling provides fast and accurate analysis for disease diagnosis for limited sample volume collection. Here, multiplexed smartphone-based assays with optical and electrochemical components are covered. Possible wireless or wired communication actuators and portable and wearable sensing integration for various sensing applications are discussed. The crucial features and the weaknesses of these devices are critically evaluated.

Telemedicine System Applicability Using Drones in Pandemic Emergency Medical Situations

Drones have evolved significantly in recent years, acquiring greater autonomy and carrier capacity. Therefore, drones can play a substantial role in civil medicine, especially in emergency situations or for the detection and monitoring of disease spread, such as during the COVID-19 pandemic. The aim of this paper is to present the real possibilities of using drones in field rescue operations, as well as in nonsegregated airspace, in order to obtain solutions for monitoring activities and aerial work in support of the public health system in crisis situations. The particularity of our conceptual system is the use of a “swarm” of fast drones for aerial reconnaissance that operate in conjunction, thus optimizing both the search and identification time while also increasing the information area and the operability of the system. We also included a drone with an RF relay, which was connected to a hub drone. If needed, a carrier drone with medical supplies or portable devices can be integrated, which can also offer two-way audio and video communication capabilities. All of these are controlled from a mobile command center, in real time, connected also to the national dispatch center to shorten the travel time to the patient, provide support with basic but life-saving equipment, and offer the opportunity to access remote or difficult-to-reach places. In conclusion, the use of drones for medical purposes brings many advantages, such as quick help, shortened travel time to the patient, support with basic but life-saving equipment, and the opportunity to access remote or difficult-to-reach places.

The Intersection of Telemedicine and Wilderness Care: Past, Present, and Future

Wilderness medicine and telemedicine seemingly exist at opposite ends of the clinical continuum. However, these 2 specialties share a common history and the literature abounds with examples of successful deployment of telemedicine to resource limited settings. The recent widespread adoption of telemedicine has important ramifications for wilderness providers. Telemedicine is inherently reliant on some sort of technology. There is a wide spectrum of complexity involved, but in general these systems rely on a hardware component, a software component, and a network system to transmit information from place to place. Today, connectivity is nearly ubiquitous through access to cellular networks, Wi-Fi, or communication satellites. However, bandwidth, defined as the amount of data which can be transmitted through a given connection over time, remains a limiting factor for many austere settings. Telemedicine services are typically organized into 4 categories: 1) live/interactive; 2) store and forward; 3) remote patient monitoring; and 4) mHealth. Each of these categories has an applicable wilderness medicine use case which will be reviewed in this paper. Though the regulatory environment remains complex, there is enormous potential for telemedicine to enhance the practice of wilderness medicine. Drones are likely to transform wilderness medicine supply chains by facilitating delivery of food, shelter, and medicines and are able to enhance search and rescue efforts. Remote consultations can be paired with remote patient monitoring technology to deliver highly specialized care to austere environments. Early feasibility studies are promising, but further prospective data will be required to define future best practices for wilderness telemedicine.

Human drone interaction in delivery of medical supplies: A scoping review of experimental studies

BACKGROUND

The COVID-19 pandemic, ageing populations and the increasing shortage of skilled workers pose great challenges for the delivery of supplies for people with and without care needs. The potential of drones, as unmanned air vehicles, in healthcare are huge and are discussed as an effective new way to delivery urgent medicines and medical devices, especially in rural areas. Although the advantages are obvious, perspectives of users are important particularly in the development process. Investigating human drone interaction could potentially increase usefulness and usability. The present study aims to perform a systematic scoping review on experimental studies examining the human drone interaction in deliveries of drugs and defibrillators.

METHODS

Two databases (MEDLINE and CINAHL) and references of identified publications were searched without narrowing the year of publication or language. Studies that investigated the human drone interaction or medical delivery with drones in an experimental manner were included (research articles). All studies that only simulated the delivery process were excluded.

RESULTS

The search revealed 83 publications with four studies being included. These studies investigated the user experience of drone delivered defibrillators, but no study was identified that investigated the human drone interaction in the delivery of drugs. Three categories of human drone interaction were identified: landing, handover, and communications. Regarding landing and handover, the most important issue was the direct physical contact with the drone while regarding communications users need clearer instructions about drone´s direction, sound and look like.

DISCUSSION

The identified studies used technology-driven approaches by investigating human drone interaction in already existing technologies. Users must become integral part of the whole development process of medical drone services to reduce concerns, and to improve security, usability and usefulness of the system. Human drone interaction should be developed according to the identified categories of human drone interaction by using demand- and technology-driven approaches.

A Socio-Analytical Approach to the Integration of Drones into Health Care Systems

The integration of drones into health care as a supplement to existing logistics methods may generate a need for cooperation and involvement across multiple resource areas. It is currently not well understood whether such integrations would merely represent a technical implementation or if they would cause more significant changes to laboratory services. By choosing socio-technical theory as the theoretical lens, this paper intends to harvest knowledge from the literature on various organizational concepts and examine possible synergies between such theories to determine optimal strategies for introducing the use of drones in a health care context. Our particular interest is to examine whether the insights generated from the multi-level perspective (MLP) may have the potential to create dynamic spin-offs related to the organizational transitions associated with the implementation of drones in health services. We built our study on a scoping literature review of topics associated with the MLP and socio-technical studies from differing arenas, supplemented with studies harvested on a broader basis. The scoping review is based on 25 articles that were selected for analysis. As a way of organizing the literature, the niche, regime, and landscape levels of the MLP are translated to the corresponding health care-related terms, i.e., clinic, institution, and health care system. Furthermore, subcategories emerged inductively during the process of analysis. The MLP provides essential knowledge regarding the context for innovation and how the interaction between the different levels can accelerate the diffusion of innovations. Several authors have put both ethical topics and public acceptance into a socio-technological perspective. Although a socio-technical approach is not needed to operate drones, it may help in the long run to invest in a culture that is open to innovation and change.

Impact of Using Drones in Emergency Medicine: What Does the Future Hold?

The use of unmanned aerial vehicles or "drones" has expanded in the last decade, as their technology has become more sophisticated, and costs have decreased. They are now used routinely in farming, environmental surveillance, public safety, commercial product delivery, recreation, and other applications. Health-related applications are only recently becoming more widely explored and accepted. The use of drone technology in emergency medicine is especially promising given the need for a rapid response to enhance patient outcomes. The purpose of this paper is to describe some of the main current and expanding applications of drone technology in emergency medicine and to describe challenges and future opportunities. Current applications being studied include delivery of defibrillators in response to out-of-hospital cardiac arrest, blood and blood products in response to trauma, and rescue medications. Drones are also being studied and actively used in emergency response to search and rescue operations as well as disaster and mass casualty events. Current challenges to expanding their use in emergency medicine and emergency medical system (EMS) include regulation, safety, flying conditions, concerns about privacy, consent, and confidentiality, and details surrounding the development, operation, and maintenance of a medical drone network. Future research is needed to better understand end user perceptions and acceptance. Continued technical advances are needed to increase payload capacities, increase flying distances, and integrate drone networks into existing 9-1-1 and EMS systems. Drones are a promising technology for improving patient survival, outcomes, and quality of life, particularly for those in areas that are remote or that lack funds or infrastructure. Their cost savings compared with ground transportation alone, speed, and convenience make them particularly applicable in the field of emergency medicine. Research to date suggests that use of drones in emergency medicine is feasible, will be accepted by the public, is cost-effective, and has broad application.

Connected healthcare: Improving patient care using digital health technologies

Now more than ever, traditional healthcare models are being overhauled with digital technologies of Healthcare 4.0 increasingly adopted. Worldwide, digital devices are improving every stage of the patient care pathway. For one, sensors are being used to monitor patient metrics 24/7, permitting swift diagnosis and interventions. At the treatment stage, 3D printers are under investigation for the concept of personalised medicine by allowing patients access to on-demand, customisable therapeutics. Robots are also being explored for treatment, by empowering precision surgery, rehabilitation, or targeted drug delivery. Within medical logistics, drones are being leveraged to deliver critical treatments to remote areas, collect samples, and even provide emergency aid. To enable seamless integration within healthcare, the Internet of Things technology is being exploited to form closed-loop systems that remotely communicate with one another. This review outlines the most promising healthcare technologies and devices, their strengths, drawbacks, and opportunities for clinical adoption.

Ethical Considerations Associated with "Humanitarian Drones": A Scoping Literature Review

The use of drones (or unmanned aerial vehicles, UVAs) in humanitarian action has emerged rapidly in the last decade and continues to expand. These so-called 'humanitarian drones' represent the first wave of robotics applied in the humanitarian and development contexts, providing critical information through mapping of crisis-affected areas and timely delivery of aid supplies to populations in need. Alongside these emergent uses of drones in the aid sector, debates have arisen about potential risks and challenges, presenting diverse perspectives on the ethical, legal, and social implications of humanitarian drones. Guided by the methodology introduced by Arksey and O'Malley, this scoping review offers an assessment of the ethical considerations discussed in the academic and gray literature based on a screening of 1,188 articles, from which we selected and analyzed 47 articles. In particular, we used a hybrid approach of qualitative content analysis, along with quantitative landscape mapping, to inductively develop a typology of ethical considerations associated with humanitarian drones. The results yielded 11 key areas of concern: (1) minimizing harm, (2) maximizing welfare, (3) substantive justice, (4) procedural justice, (5) respect for individuals, (6) respect for communities, (7) regulatory gaps, (8) regulatory dysfunction, (9) perceptions of humanitarian aid and organizations, (10) relations between humanitarian organizations and industry, and (11) the identity of humanitarian aid providers and organizations. Our findings illuminate topics that have been the focus of extensive attention (such as minimizing risks of harm and protecting privacy), traces the evolution of this discussion over time (i.e., an initial focus on mapping drones and the distinction of humanitarian from military use, toward the ethics of cargo drones carrying healthcare supplies and samples), and points to areas that have received less consideration (e.g., whether sustainability and shared benefits will be compromised if private companies' interest in humanitarian drones wanes once new markets open up). The review can thus help to situate and guide further analysis of drone use in humanitarian settings.

Artificial intelligence as a fundamental tool in management of infectious diseases and its current implementation in COVID-19 pandemic

The world has never been prepared for global pandemics like the COVID-19, currently posing an immense threat to the public and consistent pressure on the global healthcare systems to navigate optimized tools, equipments, medicines, and techno-driven approaches to retard the infection spread. The synergized outcome of artificial intelligence paradigms and human-driven control measures elicit a significant impact on screening, analysis, prediction, and tracking the currently infected individuals, and likely the future patients, with precision and accuracy, generating regular international and national data on confirmed, recovered, and death cases, as the current status of 3,820,869 infected patients worldwide. Artificial intelligence is a frontline concept, with time-saving, cost-effective, and productive access to disease management, rendering positive results in physician assistance in high workload conditions, radiology imaging, computational tomography, and database formulations, to facilitate availability of information accessible to researchers all over the globe. The review tends to elaborate the role of industry 4.0 technology, fast diagnostic procedures, and convolutional neural networks, as artificial intelligence aspects, in potentiating the COVID-19 management criteria and differentiating infection in SARS-CoV-2 positive and negative groups. Therefore, the review successfully supplements the processes of vaccine development, disease management, diagnosis, patient records, transmission inhibition, social distancing, and future pandemic predictions, with artificial intelligence revolution and smart techno processes to ensure that the human race wins this battle with COVID-19 and many more combats in the future.

Future developments in training

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the value of highly skilled and extensively trained specialists in clinical microbiology (CM) and infectious diseases (ID). Training curricula in CM and ID must constantly evolve to prepare trainees for future pandemics and to allow trainees to reach their full clinical and academic potential.

OBJECTIVES

In this narrative review, we aim to outline necessary future adaptations in CM and ID training curricula and identify current structural barriers in training with the aim of discussing possibilities to address these shortcomings.

SOURCES

We reviewed literature from PubMed and included selected books and online publications as appropriate. There was no time constraint on the included publications.

CONTENT

Drawing from the lessons learnt during the pandemic, we summarize novel digital technologies relevant to CM and ID trainees and highlight interdisciplinary teamwork and networking skills as important competencies. We centre CM and ID training within the One Health framework and discuss gender inequalities and structural racism as barriers in both CM and ID training and patient care.

IMPLICATIONS

CM and ID trainees should receive training and support developing skills in novel digital technologies, leadership, interdisciplinary teamwork and networking. Equally important is the need for equity of opportunity, with firm commitments to end gender inequality and structural racism in CM and ID. Policy-makers and CM and ID societies should ensure that trainees are better equipped to achieve their professional goals and are better prepared for the challenges awaiting in their fields.

Progress in robotics for combating infectious diseases

The world was unprepared for the COVID-19 pandemic, and recovery is likely to be a long process. Robots have long been heralded to take on dangerous, dull, and dirty jobs, often in environments that are unsuitable for humans. Could robots be used to fight future pandemics? We review the fundamental requirements for robotics for infectious disease management and outline how robotic technologies can be used in different scenarios, including disease prevention and monitoring, clinical care, laboratory automation, logistics, and maintenance of socioeconomic activities. We also address some of the open challenges for developing advanced robots that are application oriented, reliable, safe, and rapidly deployable when needed. Last, we look at the ethical use of robots and call for globally sustained efforts in order for robots to be ready for future outbreaks.

Containing the COVID-19 pandemic with drones - Feasibility of a drone enabled back-up transport system

The COVID-19 pandemic has profoundly altered common social and economic patterns as governments all over the world have been forced to take drastic measures to counter the spread of the disease. Among them, quarantine, the closure of borders, and social distancing are the ones that have affected transportation systems most severely. With the clear need to avoid all unnecessary direct human contact, an increased interest in contactless transportation and delivery modes emerged. Drones are a promising alternative in this regard, especially for the delivery of essential goods, such as COVID-19 viral tests. In this study, we therefore investigate how drones can be used to distribute viral tests to potentially infected patients. The novel approach that we propose is to use existing drone infrastructure to perform this task, where drones owned and operated by different public and private entities are retrofitted for the distribution of essential goods in the case of emergency. In a wider sense, we hence suggest the establishment of a drone enabled back-up transport system. Potential performance gains are analyzed through a mathematical time and cost model that was developed in close cooperation with the state Red Cross Organization and a utility drone manufacturer. Process design as well as parameter estimation are based on empirical investigation including, but not limited to, accompanying a COVID-19 mobile testing team in the field. The practical feasibility was verified by retrofitting drones initially assigned to other purposes. Additionally, policy recommendations, such as the establishment of public-public and public-private partnerships, were identified.

Smart technologies driven approaches to tackle COVID-19 pandemic: a review

The novel coronavirus infection (COVID-19) is not diminishing without vaccine, but it impinges on human safety and economy can be minimized by adopting smart technology to combat pandemic situation. The implementation of new innovations and novel tactics has proven to be effective in curbing the risk of COVID-19. The present study covers the role of smart technology in mitigating the spread of COVID-19 with specific focus on advancement in the field of drone, robotics, artificial intelligence (AI), mask, and sensor technology. The findings shed light on the robotics and drone technology-driven approaches that have been applied for assisting health system, surveillance, and disinfection process, etc. The AI technology strategies and framework is highlighted in terms of bulk data computing, predicting infection threats, providing medical assistance, and analyzing diagnosis results. Besides this, the technological shift in mask and sensor technology during the pandemic have been illustrated, which includes fabrication method like 3D printing and optical sensing, respectively. Furthermore, the strength, weakness, opportunities, and possible threats that have been shaped by the rigorous implementation of these technologies are also covered in detail.

Restructured society and environment: A review on potential technological strategies to control the COVID-19 pandemic

The emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in China at December 2019 had led to a global outbreak of coronavirus disease 2019 (COVID-19) and the disease started to spread all over the world and became an international public health issue. The entire humanity has to fight in this war against the unexpected and each and every individual role is important. Healthcare system is doing exceptional work and the government is taking various measures that help the society to control the spread. Public, on the other hand, coordinates with the policies and act accordingly in most state of affairs. But the role of technologies in assisting different social bodies to fight against the pandemic remains hidden. The intention of our study is to uncover the hidden roles of technologies that ultimately help for controlling the pandemic. On investigating, it is found that the strategies utilizing potential technologies would yield better benefits and these technological strategies can be framed either to control the pandemic or to support the confinement of the society during pandemic which in turn aids in controlling the spreading of infection. This study enlightens the various implemented technologies that assists the healthcare systems, government and public in diverse aspects for fighting against COVID-19. Furthermore, the technological swift that happened during the pandemic and their influence in the environment and society is discussed. Besides the implemented technologies, this work also deals with untapped potential technologies that have prospective applications in controlling the pandemic circumstances. Alongside the various discussion, our suggested solution for certain situational issues is also presented.

Do drones have a realistic place in a pandemic fight for delivering medical supplies in healthcare systems problems?

The advancement of Unmanned Aerial Vehicle (UAV) technology in terms of industrial processes and communication and networking technologies has led to an increase in their use in civil, business, and social applications. Global rules in most countries had previously limited the use of drones to military applications due to their deployment in the open air, drones are likely to be lost, destroyed, or physically hijacked. However, more recently, the presence of COVID-19 has forced the world to present new implementing measures which will also widen the use of drones in civil and commercial and social applications, especially now in the delivery of medicines for medical home care. In the period of required public isolation as a consequence of the SARS-COV-2 pandemic, this knowledge has become one of the principal partners in the fight against the coronavirus. This paper offers a summary of the medical drone manufacturing, with a specific emphasis on its approval by the pharmaceutical sector to solve logistical problems in healthcare during times of sensitive need. We also discuss the numerous challenges to be met in the integration of drones to save our lives and suggest future research directions. The question that arises for this problem, how to optimize delivery medical supplies times in-home health care made up of drones? We conducted a synthesis literature review devoted to the use of UAVs in healthcare with their different aspects. A total of different research made are given to describe the role of UAV in Home healthcare with the presence of SARS-COV-2. We conclude that the drones will be able to optimize the way of eliminating contamination with a very high percentage (through the reduction of human contact) with the increase of the flexibility of the flight (reaching the less accessible regions every hour of the day).

Creeping Through the Backdoor: Disruption in Medicine and Health

Can disruption happen when no one notices? Disruptive technologies and processes are fundamentally starting to up-end how medicines and health systems benefit patients but the question is whether health systems are ready for them. This paper will briefly review the business strategy and management literature on topics such as disruption and “black swan” theories of change, before turning to discuss some of the areas where change is affecting medicine and healthcare. Such areas include the emergence of cell and gene therapies, the economics of cures, digital technologies, mobile apps, social media, supply chain technologies such as drones and online distribution, universal health coverage and funding, and consumerisation of healthcare. The question to be asked is whether these sorts of changes are “disruptive” or whether they were coming for a long time and it is just that health systems are slow to change. It could be argued that while perhaps unexpected by day-to-day practitioners in healthcare, in fact, many of the changes now starting to affect the health and medicines sector have been affecting other sectors such as technology, finance and communications for decades.

Consolidation of Clinical Microbiology Laboratories and Introduction of Transformative Technologies

Clinical microbiology is experiencing revolutionary advances in the deployment of molecular, genome sequencing-based, and mass spectrometry-driven detection, identification, and characterization assays. Laboratory automation and the linkage of information systems for big(ger) data management, including artificial intelligence (AI) approaches, also are being introduced. The initial optimism associated with these developments has now entered a more reality-driven phase of reflection on the significant challenges, complexities, and health care benefits posed by these innovations. With this in mind, the ongoing process of clinical laboratory consolidation, covering large geographical regions, represents an opportunity for the efficient and cost-effective introduction of new laboratory technologies and improvements in translational research and development. This will further define and generate the mandatory infrastructure used in validation and implementation of newer high-throughput diagnostic approaches. Effective, structured access to large numbers of well-documented biobanked biological materials from networked laboratories will release countless opportunities for clinical and scientific infectious disease research and will generate positive health care impacts. We describe why consolidation of clinical microbiology laboratories will generate quality benefits for many, if not most, aspects of the services separate institutions already provided individually. We also define the important role of innovative and large-scale diagnostic platforms. Such platforms lend themselves particularly well to computational (AI)-driven genomics and bioinformatics applications. These and other diagnostic innovations will allow for better infectious disease detection, surveillance, and prevention with novel translational research and optimized (diagnostic) product and service development opportunities as key results.