All right, welcome to the open hardware dev room for this afternoon.
Thank you for joining us.
Our next presentation is going to be an amazing presentation on the open flexure microscope
as you're well, I'm sure you're aware of this project already, or you probably wouldn't
be here.
Julian Sterling and Joe Napper, please give them a warm welcome.
That's about as good as I'm going to get, so I might just leave now.
So yeah, so we've titled the presentation, my cross-copy for everyone, so just a quick introduction
to the open flexure microscope, so I don't know if you've seen us over in the stand.
If you haven't, we've got them scanning, but it's a motorized digital laboratory-grade microscope.
The stage is 3D printed, almost entirely as one piece.
In fact, we've printed one out-fossed them, which I think is the first microscope manufacturing
to ever actually happen out-fossed them.
The design, it's optimized for plastic, it's not just a cheap imitation of a metal microscope,
it's actually an optimized 3D printed microscope.
Anyone could reproduce the design, it's entirely open.
The focus is on medical research, as well as research medical use, educational use, and so when
you say with 3D printing a microscope, people always say, well, how do you get the tolerances
right?
And you think about 3D printing, you think you don't have the surface roughness, you don't have
the tolerance to build a traditional dovetail like you'd have in a microscope, but actually
plastic bends quite well.
If you've burned flexure joints, you don't get all the slipstick motion, you don't worry
so much about the tolerances, and you can actually print it in one single piece, and so
you've got this sort of parallelogram, each of the red dots there is acting as a hinge,
we've got a screw going through, and we can actuate and flex the stage hence open flexure
to produce our motion.
So once you do that, you add some step-of-motors onto it, and we can get about
100 nanometer precision in the motion, which if you're focusing with a times 100 objective,
you really need sub-micron motion to actually get things into focus.
Then we 3D print our things to hold off the shelf optics, we use Raspberry Pi camera,
this is a high resolution version where we've got a microscope objective and a lens,
put another lens on top with an LED, and now you've got a microscope.
So, I started the talk with microscopy for everyone.
Now, a lot of people, maybe not this room, we've got quite a lot of nerds here, but a lot of people
look at me and go, do I need a microscope?
And the answer there is, no, you probably do not need a microscope,
but you really better hope your doctor has a microscope, and you'll notice we didn't say
microscopes for everyone, we said microscopy.
So, this here is a cervical smear, so if you're diagnosing cervical cancer,
you need microscopy images.
This here is a scan of red blood cells, so you look at red blood cells to look for parasites
from malaria. So, about half a million people still die every year from malaria.
The predominately that is children under the age of five in sub-Saharan Africa,
the gold standard for malaria diagnosis is looking for parasites inside red blood cells.
Even if you do the fast tests, sort of like the COVID test, we've got the lateral flow,
every single case needs to be confirmed, and I think you have to look at the species as well,
with a microscope. So, microscopes are really, really important, even if you
don't actually want a microscope yourself. So, here is Joram in a clinic in Tanzania,
with microscopes that you can make in Tanzania from malaria diagnosis.
So, some people say, why build another microscope when we could just get a commercial microscope
sent it there, how much does it cost? And maybe one that automatically scans like open
flexure in my cost, 30,000, 40,000 euros. But then what people don't consider,
what's the parts cost, and most important, what's the maintenance cost? The maintenance cost,
big part is engineered travel. So, let's say, you've got a microscope from ZICE. They didn't
necessarily expect that you were going to have such high humidity, they didn't necessarily expect
that you were going to have air conditioning, and you've got a bit of rust on something.
So, you say, I want a spare part. ZICE don't want to send you a spare part, they want to send
you a service engineer. Then they say, well, we don't actually have a service engineer in your
continent, but we can ship one over, only cost one business class flight, and then suddenly to
get one piece replaced, that's another 15,000 euros. And how long before you need the next piece
replaced? So, actually, the largest cost of keeping a microscope running is the long term
maintenance cost. And so, if you can make a microscope locally, then you can mend a microscope locally.
It's much better to get a guy on a scooter, drive over, fix your microscope right there. So,
a lot of the focus of what we're doing is making sure we can build microscopes in a country. So,
can we decide a microscope that is understandable by many? One, it's an open source project,
we want people to contribute, we want it to be understandable. But if you're going to go through
medical device regulations, you need to be able to explain exactly why you did something,
and you need to be understandable to a regulator, not just all of your community. We want the
community to still suggest changes. This is an open source project. We want different variations
depending on, you know, if you're a hobbyist, if you're trying to build it in a school,
you may be don't want to be going through all the processes that you're going through if you're
building it for medical use. But then we still want to actually be able to use it as a medical
device throughout the world, even if the community has suggested changes, which is fine,
but medical device regulations say you've got to have really clear version control. You have to
know what goes into the design, you have to risk assess the problems that you have to be clear
concise with all of your technical documentation, keeping them up to date. Be very traceable of
what decisions you made when it went in. Now if you say that to a lot of people, they go, how would you
do that? Now we all know how we do that, but you just get, and actually let's say we have it on
GitLab, we can put a proof, we stop people pushing to master, we can put a merge of approvals on,
and so generally in the CAD world use product lifecycle management systems, which are
ridiculously expensive on a level of tens of thousands of pounds per seat per year.
And so it's not really easy to get the open source community involved with that, hey,
you want to contribute to our project, just pay 10,000 euros a year just to get a license to be
up, not working. So as I said, we can use Git, this was my attempt to try and explain Git to
our hardware engineers, and so you know it looks a bit like a Git tree, but look, we've got different
companies with different stages of manufacturing, but I'm going to assume this room is fairly
of a fair with Git and move on, but actually in the hardware world you don't normally have
sort of all of the benefits of DevOps that we've so used to now in software. So you can do all
of your planning with your issue management, you've got your virtual control, you pipe it into
CI Optimizer, you know, CI Automation, then offline, the actual hardware, we're going to do our
production, do our testing, and we can feed that back into the system. And so we can actually start
doing the DevOps workflow with hardware, and automation here really, really helps. So every time
we push a commit to open SCAD, so this is all designed in open SCAD, open SCAD creates all of
the STLs automatically for the new proposed changes. We create all of the renders for the new
proposed changes, we put them through a program that we wrote called Git Building for documentation,
all of the bills and materials will update, and we can do that independently for different
variations, we can pipe all off to the website. If you're automating it, we're talking about
quality control for medical devices, we've got Git Hashes, we know exactly what the code looks like,
but we're developing it, we're actually building the STLs on the server, so why not stamp the
Git Hash into the 3D printed model, and then any single time you pick up a microscope and go,
when was that printed? You can just look up the Hash and you know exactly what code went into that.
Not only that, we're just running in CI, so we can pipe out of open SCAD into Inkscape and
annotate all of our renders, so we can have annotated renders, we can put the bill of materials for
what's used in that specific page in, and then one of the most confusing things and a lot of
people's documentation, if you take photos, you're not going to update every photo and something
changes. The color changes, this changes, that is, especially if you're doing the same step,
do you want to take the same step for four different variations of the same design? And we're
basically doing the same thing, you take the thing I told you to build, you're hook it up with a
screw and then you screw it in, but it's kind of confusing if you have to explain it in a whole
bunch of text. Yes, I know your thing does not look like this in this case, but can you put it in
anyway a bit like this one? So we can actually, for any variation of the microscope, make sure that
always the documentation is exactly what you're doing. And if you have clear instructions that
allow really good replication and modification, that's the only way in hardware your community
can actually start building it and producing it around the world. So, always very jealous of the maps
that open software projects put out there, but anyone just have to click download.
Same with, you know, circuit boards, I get the feeling it's a bit easier to send it
off to the fab and get it somewhere, but once you've got something 3D printed, microscope designed
the barrier to entries quite high. And so we try and lower the barrier to entry with making it
easy to get every single STL, easy to good build and materials. And we, you know, we're not
doing telemetry and say, oh, we just found somebody using it. We're just waiting for people to
pop up on the forum and say, hey, I've got one in Thailand, and then we color it pink. So so far,
this is where we know people have built or used a microscope, including on the Antarctic
CIS, you know, quite a few countries in Africa, most of Latin America. We were talking some
people earlier, leave a space, haven't built one in Greece yet. So, they need to get on it,
anyone in any of these countries that agree, please build a microscope and go to the forum and
tell us that you've, and tell us that you've built a microscope. Maybe you're going on holiday
to one of these countries. You can make a microscope on holiday. And also, if you've got good
replication instructions, people can actually modify it in the research community. So we start
looking through the research literature, and we found somebody in Japan had built an optical
sectioning microscope, built our far microscope, a different group in Scotland had built a super
resolution microscope, built using our microscope. And finally, education and educational use is
something we really want to support. So this is a print farm in Nairobi, Kenya. What they are doing
is they are printing a modified version of the microscope for schools. So good for education,
if you're going to actually see an image and point it to it, rather than asking somebody to look
down a microscope and saying, do you see that kind of blue thing next to the sort of pink thing?
Yeah, I don't, maybe. So educational use is so good. The thing that's so cool in this print
farm in Kenya is they were actually getting on pushbikes, going round to local cafes,
collecting the disarney water bottles, taking the labels off, cleaning them, turning it through
their own homemade machine into filament, putting it through their home homemade printers that
they made from e-waste. And from the e-waste printer and from the waste bottles they made
microscopes. And if that's not upcycling, I don't know what anything is. So I'm going to pass it over to Joe.
It doesn't have a beard for the beard, Mike, but, uh,
okay, can you hear me okay? So thanks to you all in for the introduction, you've only
ruined the supplies on two of my slides. So thanks to that, the obvious question after talking
a bit about what goes into it behind the scenes, what's happened at the core development team is,
what does this look like in practice out in the world? And there's two answers to that and one
of them is easy and one of them is interesting. So we're going to go with both. So what's it
what I can practice? Well, here is our software running on this microscope, run off a power bank
and to prove it's live. And I didn't pre-record that in case anyone's very paranoid.
So we've got a microscope that we've built, we've flown with, it's gone to airport security,
they've done the usual thing of picking up the flight case and going, what is this?
And I get to say, well, it was a microscope, but now who knows? That's what was in Norway.
So, so what's this? So microscope. Oh, what kind of microscope? What answer wouldn't let me
on the plane? So that is now live, I can scan around and I can go into this tab and start a scan.
First rule of engineering never do live demos. So I'm going to the tab out of that.
That's going to scan around just taking the feed from the pie camera, taking each image,
auto-focusing on it and then building up a composite large area scan.
But the other aspect of what this looks like in practice is what does this look like out in the world.
And so I'm just going to put a spotlight on some of the people who have got in touch saying,
I've built this, I've modified this, I've sold this. We've already heard about the use case
from malaria, incredibly important. The gold standard from malaria diagnosis is manual white microscopy.
It's called the gold standard because we know how to treat malaria if it's diagnosed early
and we know that diagnostic test very well. But it's the access to equipment to medical supplies
where COVID estimates are at least 50% of medical equipment in sub-Saharan Africa is currently in landfill.
Over 50% a lot of the time it's donated as end of life equipment from Europe or parts of North America
with the best intentions but no one to plan for how they can be supported.
Instead, in the World Health Organization recent compendium,
we've been recommended as one of the innovative emerging technologies that could make a huge
difference. And if you turn to page 71 of why they recommend us, there's a big green tick next to open source and access.
Thank you very much.
Although from Chile, Paula was using this for tracking beaver populations.
Taking some of the most spectacular pictures with the open flagship microscope in the foreground
and huge values and rivers in the background. Across Africa, organizations like Africa,
Russia and Wambian are running microscope workshops, building these locally and then running workshops
in whatever the attendees are interested in. It can be used as a platform for talking about engineering,
got computer science or biology or medicine, but also about entrepreneurship and how you could set up
a business selling these modifying these and keeping the control in the community where they needed.
Dr Daniel Rosen, a professor of pathology at the Baylor College of Medicine in Texas,
he is part of the global health team and has used our microscope in a few different countries,
building them, maintaining them and explaining that this brings more control when more
independent to the communities where they're most needed. So quiz time, while I take a break,
these are two identical microscopes and almost every way, almost.
The specs of these are identical. One of these is what we consider to be a medical version of
our microscope and one of these we consider to be more fun research things like that. So I'll give
you a few seconds to make your choice. Hands up for the one on the left being medical. Hands up for
the one on the right. Okay, interesting. The food that we got, these are medical colors.
These are serious. It's blue. It's black. It's white. This one's fun. I can't have that.
So Daniel, once talk one of our microscopes to diagnose a soft material cancer in Brazil
and thought it'd be a nice touch to print the parts in the colours of the Brazilian flag.
Show that with a microscope that was bright green and blue in yellow, happily pondered down on their
table and the medic said we're not touching that. There's the important point there about it's
not enough to make something open and then just fire information at people. We could sit there
all day telling them about the resolution and the contrast of the speed and the range of motion.
But that's not what interests them and that's not what generates trust in a device
and it's the trust that we've been working on for years now.
Over in Ukraine, Toloca are driving around in vans with 3D printers in the back, building whatever
they think they can design and build to support the efforts over there. They've got in touch
to let us know that some of our microscopes have been used still in education there during one
of the most challenging times in the country's history. Professor Matsui, firm Japan,
sent us a very polite email a few years ago to say hi, we found your designs. We modified them
a bit. It's now doing super resolution microscopy. We're publishing a paper. Here's the DIY.
We hope you don't mind. Now, now, over in Argentina, using it to look at the soil health
for local agriculture purposes, making sure that people can see right in front of their eyes,
this sample being tested live in front of them, making it real for people,
rather than science happening at some remote lab far away. Julian. Julian took one of our microscopes out
to Panama and was running it on samples, and the microscope's quite light. He didn't want to take
a mouse and keyboard with him. He's controlling that with a SNES controller. Dr. Homo Kelsey
is a specialist in women's health, who is also part of the global health team over in America,
and as Julian mentioned, we have worked on building up this huge wide area scans that
a single image from one. May what like this? The scans were doing what more like this.
All automated running on the Raspberry Pi, able to get dive nurses and places that traditionally
would rely on manual techniques. Kelsey set up this work we did in Rwanda last January,
setting up the microscopes there so that doctors can get second opinions and online
consults. Previously at Shashubay, there was a manual microscope. If they couldn't diagnose
your condition, it was most likely that they would put you on a bus to the north of the country
seven hours away. Now instead we run regular sessions for training where they can look at samples,
they found challenging on about microscope and have discussions with other pathologists in other areas.
That means that not only are they getting that training on that sample, but also they're
up scaling and learning more about the cases that they're going to be facing.
So this is our world map, and as Julian mentioned, it works more like this. But also,
like you said, we don't track, and so we've got this forum where people get in touch,
sometimes they tell us where, sometimes they value their privacy and that's fine.
But on part of the University of Glasgow, and there's an academic, I feel like I'm constantly fighting
against particularly the phrase, data available on reasonable request, or waiting for someone to
email asking for a lab tool, or letting you know that we'll see you at a conference.
And when people wait for things like that, they miss out on some of the things that people have
come to our forum and said about soil microscopy, knife sharpening, we're some students that want to
do microscopy at home during a pandemic. Can you translate the instructions into French?
I'd like to make this with my children. Can you build a telescope with this?
Open flagship con where we've got a load of us together in a room to talk about the
direction for the project. I'd like to build this on a date with my girlfriend.
We never heard back from them.
Motion dice.
Thank you.
Yeah, it's all open source. Some vendors have got in touch with us saying that they are selling it,
some of them funds the project back, others contribute to the code base, so we've got to keep
the lights on. So I'm so pleased by a t-shirt. Open flagship voice control, and then an email
can I send the open flagship to space? Go and ask any conventional microscopy academic,
how long they would have to wait to get an email like that for the proprietary system.
And so this is the end of the talk where what we're supposed to do is talk about the future
of the project. And there's things that we're working on where we're writing the underlying
software. We've got two other projects, the block stage and the delta stage. We
desperately working towards medical certification in Tanzania or in Rwanda.
And keeping the community engaged, organizing other events and just being ready for when people
get in touch. But really, that's just a gas and we've got no idea where the project is going next.
This was version one of the open flagship microscope. From there it's gone to the Antarctic
and it's gone to Tanzania and Rwanda and the Philippines and it's gone on their parabolic flight
for zero g. And we couldn't really have predicted any of that. So a lot of our development isn't
about pushing it in certain directions, it's making this a platform that's ready for whatever
is, whatever direction people being gone. And so with that, I'll say that we had no idea
where it was going at the start. All we had was a small snapshot and we had to wait
and let other people bring things in and it grew and grew and grew until you've got a much bigger
idea of what's going on. That's about my entire talk with a metaphor for scanning microscopes. Thank you
very much. We have any questions.
Hi, an awesome project back here. I have a question about maintenance, do the
lectures everywhere out? Yeah, so really a question. So it depends a lot on the quality of the PLA
filament. So if you do it with a lot of moisture in the filament, if it's not new filament,
they haven't printed well, they tend to crack. So you have to worry a lot about say humidity where
you are, but what we were doing for a while in Tanzania was just having a microscope around a
full edge of the travel forward backwards forwards backwards. The first thing that happened
to the first thing that broke was we wore the metal off the lead screw. Now we had bought
really cheap, I think some sort of Chinese cheese steel alloy. So we did have to buy better screws,
but we managed to run them for three months forward in backwards. And I think possibly you'll get
a year or two, you might get some degradation, but that's the thing of you could it's a cheap enough
part that if they're built locally, you can put that in a regular maintenance schedule to switch
out the body a year. Other than choosing the right colors, what challenges for getting medical
certification. A lot of it's around documentation, so you really need to, there's a lot of paperwork,
for good reason, not just to show that you've done, you've done your checks, you've thought
through why you thought to how it could fail, but making sure you've got the processes in place.
So when you have one that works, that is every single one that you build, going to be the same
as the one that you tested. And so that's why it's quite hard, it's an open source project,
you can't medically certify the open source project because if somebody builds it badly, that's
not the same. So we're not trying to be medically certified ourselves, we're trying to provide a platform
where manufacturers can work with us to become medically certified, then it will be their own company
that is medically certified. So they're not relying on us because what we don't want to do is set it
up in a way that they're continuously relying on us for certification. We want to make it in a case
way. If me and Joe become evil and tell them that they can't do it anymore, they can go up,
well, it's an irrevocable open license, so yes, we can. So the plan is to make sure that we're
not in control, but that means a lot of upskilling, a lot of making sure the design is transferred
from us to other people and that they understand it well enough that they can do all of the checks in
place and make sure their suppliers don't give them the rubbish screws that we talked about,
the war out before the flagships. Yeah, brilliant, I'll do the love it. Just wondering, because
there's a talk about making it available in Tanzania and other places where no resource is
or more expensive, options may not be the disruption. Is there a plan, before example,
make something like up and fracture, be somewhat more standard within Europe, where we do have,
you know, whatever fancy company with their proprietary software and hardware is available,
but to make it more available in the marketplace and investment development countries.
Yeah, so I've been where we're definitely talking to schools about educational use,
but we're actually talking to university college London who are starting a trial for
chronic UTIs, where they're hopefully going to use the open flexure as part of that. So then
and that really builds trust that it's not, this is for you, this is for us, but the main use case for
us has been making sure the EEs possible to build. We know it's possible to build it in England,
that's where we're designing it. If we only designed it, waited until and went, well this is kind
of a low cost where we are, so we assume it works in Africa, that's the worst way to do engineering
with that, you have to engineer with Africans, there's brilliant engineers in Africa,
we need to know, you know, what's available in different places.
Did you, did you see they're using global shutter cameras to overcome the knock on the table problem?
Sorry? Did you want to see they're using global shutter cameras to overcome the knock on the
table problem? We would love to, it's basically, it's availability of components, so it comes
back to the previous question of which are most available, so yeah, they are quite standard
but getting them in onto the Raspberry Pi, so I know they've got a global shutter one now, so hopefully
soon.