WEBVTT

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All right, welcome to the open hardware dev room for this afternoon.

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Thank you for joining us.

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Our next presentation is going to be an amazing presentation on the open flexure microscope

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as you're well, I'm sure you're aware of this project already, or you probably wouldn't

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be here.

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Julian Sterling and Joe Napper, please give them a warm welcome.

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That's about as good as I'm going to get, so I might just leave now.

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So yeah, so we've titled the presentation, my cross-copy for everyone, so just a quick introduction

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to the open flexure microscope, so I don't know if you've seen us over in the stand.

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If you haven't, we've got them scanning, but it's a motorized digital laboratory-grade microscope.

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The stage is 3D printed, almost entirely as one piece.

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In fact, we've printed one out-fossed them, which I think is the first microscope manufacturing

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to ever actually happen out-fossed them.

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The design, it's optimized for plastic, it's not just a cheap imitation of a metal microscope,

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it's actually an optimized 3D printed microscope.

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Anyone could reproduce the design, it's entirely open.

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The focus is on medical research, as well as research medical use, educational use, and so when

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you say with 3D printing a microscope, people always say, well, how do you get the tolerances

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right?

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And you think about 3D printing, you think you don't have the surface roughness, you don't have

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the tolerance to build a traditional dovetail like you'd have in a microscope, but actually

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plastic bends quite well.

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If you've burned flexure joints, you don't get all the slipstick motion, you don't worry

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so much about the tolerances, and you can actually print it in one single piece, and so

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you've got this sort of parallelogram, each of the red dots there is acting as a hinge,

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we've got a screw going through, and we can actuate and flex the stage hence open flexure

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to produce our motion.

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So once you do that, you add some step-of-motors onto it, and we can get about

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100 nanometer precision in the motion, which if you're focusing with a times 100 objective,

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you really need sub-micron motion to actually get things into focus.

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Then we 3D print our things to hold off the shelf optics, we use Raspberry Pi camera,

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this is a high resolution version where we've got a microscope objective and a lens,

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put another lens on top with an LED, and now you've got a microscope.

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So, I started the talk with microscopy for everyone.

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Now, a lot of people, maybe not this room, we've got quite a lot of nerds here, but a lot of people

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look at me and go, do I need a microscope?

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And the answer there is, no, you probably do not need a microscope,

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but you really better hope your doctor has a microscope, and you'll notice we didn't say

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microscopes for everyone, we said microscopy.

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So, this here is a cervical smear, so if you're diagnosing cervical cancer,

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you need microscopy images.

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This here is a scan of red blood cells, so you look at red blood cells to look for parasites

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from malaria. So, about half a million people still die every year from malaria.

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The predominately that is children under the age of five in sub-Saharan Africa,

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the gold standard for malaria diagnosis is looking for parasites inside red blood cells.

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Even if you do the fast tests, sort of like the COVID test, we've got the lateral flow,

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every single case needs to be confirmed, and I think you have to look at the species as well,

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with a microscope. So, microscopes are really, really important, even if you

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don't actually want a microscope yourself. So, here is Joram in a clinic in Tanzania,

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with microscopes that you can make in Tanzania from malaria diagnosis.

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So, some people say, why build another microscope when we could just get a commercial microscope

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sent it there, how much does it cost? And maybe one that automatically scans like open

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flexure in my cost, 30,000, 40,000 euros. But then what people don't consider,

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what's the parts cost, and most important, what's the maintenance cost? The maintenance cost,

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big part is engineered travel. So, let's say, you've got a microscope from ZICE. They didn't

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necessarily expect that you were going to have such high humidity, they didn't necessarily expect

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that you were going to have air conditioning, and you've got a bit of rust on something.

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So, you say, I want a spare part. ZICE don't want to send you a spare part, they want to send

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you a service engineer. Then they say, well, we don't actually have a service engineer in your

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continent, but we can ship one over, only cost one business class flight, and then suddenly to

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get one piece replaced, that's another 15,000 euros. And how long before you need the next piece

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replaced? So, actually, the largest cost of keeping a microscope running is the long term

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maintenance cost. And so, if you can make a microscope locally, then you can mend a microscope locally.

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It's much better to get a guy on a scooter, drive over, fix your microscope right there. So,

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a lot of the focus of what we're doing is making sure we can build microscopes in a country. So,

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can we decide a microscope that is understandable by many? One, it's an open source project,

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we want people to contribute, we want it to be understandable. But if you're going to go through

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medical device regulations, you need to be able to explain exactly why you did something,

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and you need to be understandable to a regulator, not just all of your community. We want the

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community to still suggest changes. This is an open source project. We want different variations

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depending on, you know, if you're a hobbyist, if you're trying to build it in a school,

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you may be don't want to be going through all the processes that you're going through if you're

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building it for medical use. But then we still want to actually be able to use it as a medical

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device throughout the world, even if the community has suggested changes, which is fine,

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but medical device regulations say you've got to have really clear version control. You have to

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know what goes into the design, you have to risk assess the problems that you have to be clear

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concise with all of your technical documentation, keeping them up to date. Be very traceable of

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what decisions you made when it went in. Now if you say that to a lot of people, they go, how would you

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do that? Now we all know how we do that, but you just get, and actually let's say we have it on

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GitLab, we can put a proof, we stop people pushing to master, we can put a merge of approvals on,

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and so generally in the CAD world use product lifecycle management systems, which are

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ridiculously expensive on a level of tens of thousands of pounds per seat per year.

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And so it's not really easy to get the open source community involved with that, hey,

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you want to contribute to our project, just pay 10,000 euros a year just to get a license to be

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up, not working. So as I said, we can use Git, this was my attempt to try and explain Git to

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our hardware engineers, and so you know it looks a bit like a Git tree, but look, we've got different

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companies with different stages of manufacturing, but I'm going to assume this room is fairly

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of a fair with Git and move on, but actually in the hardware world you don't normally have

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sort of all of the benefits of DevOps that we've so used to now in software. So you can do all

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of your planning with your issue management, you've got your virtual control, you pipe it into

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CI Optimizer, you know, CI Automation, then offline, the actual hardware, we're going to do our

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production, do our testing, and we can feed that back into the system. And so we can actually start

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doing the DevOps workflow with hardware, and automation here really, really helps. So every time

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we push a commit to open SCAD, so this is all designed in open SCAD, open SCAD creates all of

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the STLs automatically for the new proposed changes. We create all of the renders for the new

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proposed changes, we put them through a program that we wrote called Git Building for documentation,

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all of the bills and materials will update, and we can do that independently for different

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variations, we can pipe all off to the website. If you're automating it, we're talking about

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quality control for medical devices, we've got Git Hashes, we know exactly what the code looks like,

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but we're developing it, we're actually building the STLs on the server, so why not stamp the

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Git Hash into the 3D printed model, and then any single time you pick up a microscope and go,

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when was that printed? You can just look up the Hash and you know exactly what code went into that.

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Not only that, we're just running in CI, so we can pipe out of open SCAD into Inkscape and

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annotate all of our renders, so we can have annotated renders, we can put the bill of materials for

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what's used in that specific page in, and then one of the most confusing things and a lot of

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people's documentation, if you take photos, you're not going to update every photo and something

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changes. The color changes, this changes, that is, especially if you're doing the same step,

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do you want to take the same step for four different variations of the same design? And we're

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basically doing the same thing, you take the thing I told you to build, you're hook it up with a

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screw and then you screw it in, but it's kind of confusing if you have to explain it in a whole

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bunch of text. Yes, I know your thing does not look like this in this case, but can you put it in

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anyway a bit like this one? So we can actually, for any variation of the microscope, make sure that

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always the documentation is exactly what you're doing. And if you have clear instructions that

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allow really good replication and modification, that's the only way in hardware your community

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can actually start building it and producing it around the world. So, always very jealous of the maps

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that open software projects put out there, but anyone just have to click download.

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Same with, you know, circuit boards, I get the feeling it's a bit easier to send it

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off to the fab and get it somewhere, but once you've got something 3D printed, microscope designed

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the barrier to entries quite high. And so we try and lower the barrier to entry with making it

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easy to get every single STL, easy to good build and materials. And we, you know, we're not

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doing telemetry and say, oh, we just found somebody using it. We're just waiting for people to

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pop up on the forum and say, hey, I've got one in Thailand, and then we color it pink. So so far,

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this is where we know people have built or used a microscope, including on the Antarctic

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CIS, you know, quite a few countries in Africa, most of Latin America. We were talking some

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people earlier, leave a space, haven't built one in Greece yet. So, they need to get on it,

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anyone in any of these countries that agree, please build a microscope and go to the forum and

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tell us that you've, and tell us that you've built a microscope. Maybe you're going on holiday

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to one of these countries. You can make a microscope on holiday. And also, if you've got good

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replication instructions, people can actually modify it in the research community. So we start

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looking through the research literature, and we found somebody in Japan had built an optical

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sectioning microscope, built our far microscope, a different group in Scotland had built a super

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resolution microscope, built using our microscope. And finally, education and educational use is

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something we really want to support. So this is a print farm in Nairobi, Kenya. What they are doing

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is they are printing a modified version of the microscope for schools. So good for education,

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if you're going to actually see an image and point it to it, rather than asking somebody to look

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down a microscope and saying, do you see that kind of blue thing next to the sort of pink thing?

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Yeah, I don't, maybe. So educational use is so good. The thing that's so cool in this print

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farm in Kenya is they were actually getting on pushbikes, going round to local cafes,

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collecting the disarney water bottles, taking the labels off, cleaning them, turning it through

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their own homemade machine into filament, putting it through their home homemade printers that

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they made from e-waste. And from the e-waste printer and from the waste bottles they made

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microscopes. And if that's not upcycling, I don't know what anything is. So I'm going to pass it over to Joe.

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It doesn't have a beard for the beard, Mike, but, uh,

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okay, can you hear me okay? So thanks to you all in for the introduction, you've only

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ruined the supplies on two of my slides. So thanks to that, the obvious question after talking

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a bit about what goes into it behind the scenes, what's happened at the core development team is,

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what does this look like in practice out in the world? And there's two answers to that and one

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of them is easy and one of them is interesting. So we're going to go with both. So what's it

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what I can practice? Well, here is our software running on this microscope, run off a power bank

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and to prove it's live. And I didn't pre-record that in case anyone's very paranoid.

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So we've got a microscope that we've built, we've flown with, it's gone to airport security,

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they've done the usual thing of picking up the flight case and going, what is this?

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And I get to say, well, it was a microscope, but now who knows? That's what was in Norway.

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So, so what's this? So microscope. Oh, what kind of microscope? What answer wouldn't let me

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on the plane? So that is now live, I can scan around and I can go into this tab and start a scan.

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First rule of engineering never do live demos. So I'm going to the tab out of that.

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That's going to scan around just taking the feed from the pie camera, taking each image,

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auto-focusing on it and then building up a composite large area scan.

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But the other aspect of what this looks like in practice is what does this look like out in the world.

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And so I'm just going to put a spotlight on some of the people who have got in touch saying,

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I've built this, I've modified this, I've sold this. We've already heard about the use case

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from malaria, incredibly important. The gold standard from malaria diagnosis is manual white microscopy.

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It's called the gold standard because we know how to treat malaria if it's diagnosed early

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and we know that diagnostic test very well. But it's the access to equipment to medical supplies

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where COVID estimates are at least 50% of medical equipment in sub-Saharan Africa is currently in landfill.

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Over 50% a lot of the time it's donated as end of life equipment from Europe or parts of North America

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with the best intentions but no one to plan for how they can be supported.

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Instead, in the World Health Organization recent compendium,

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we've been recommended as one of the innovative emerging technologies that could make a huge

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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.

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Thank you very much.

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Although from Chile, Paula was using this for tracking beaver populations.

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Taking some of the most spectacular pictures with the open flagship microscope in the foreground

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and huge values and rivers in the background. Across Africa, organizations like Africa,

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Russia and Wambian are running microscope workshops, building these locally and then running workshops

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in whatever the attendees are interested in. It can be used as a platform for talking about engineering,

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got computer science or biology or medicine, but also about entrepreneurship and how you could set up

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a business selling these modifying these and keeping the control in the community where they needed.

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Dr Daniel Rosen, a professor of pathology at the Baylor College of Medicine in Texas,

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he is part of the global health team and has used our microscope in a few different countries,

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building them, maintaining them and explaining that this brings more control when more

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independent to the communities where they're most needed. So quiz time, while I take a break,

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these are two identical microscopes and almost every way, almost.

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The specs of these are identical. One of these is what we consider to be a medical version of

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our microscope and one of these we consider to be more fun research things like that. So I'll give

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you a few seconds to make your choice. Hands up for the one on the left being medical. Hands up for

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the one on the right. Okay, interesting. The food that we got, these are medical colors.

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These are serious. It's blue. It's black. It's white. This one's fun. I can't have that.

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So Daniel, once talk one of our microscopes to diagnose a soft material cancer in Brazil

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and thought it'd be a nice touch to print the parts in the colours of the Brazilian flag.

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Show that with a microscope that was bright green and blue in yellow, happily pondered down on their

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table and the medic said we're not touching that. There's the important point there about it's

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not enough to make something open and then just fire information at people. We could sit there

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all day telling them about the resolution and the contrast of the speed and the range of motion.

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But that's not what interests them and that's not what generates trust in a device

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and it's the trust that we've been working on for years now.

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Over in Ukraine, Toloca are driving around in vans with 3D printers in the back, building whatever

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they think they can design and build to support the efforts over there. They've got in touch

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to let us know that some of our microscopes have been used still in education there during one

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of the most challenging times in the country's history. Professor Matsui, firm Japan,

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sent us a very polite email a few years ago to say hi, we found your designs. We modified them

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a bit. It's now doing super resolution microscopy. We're publishing a paper. Here's the DIY.

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We hope you don't mind. Now, now, over in Argentina, using it to look at the soil health

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for local agriculture purposes, making sure that people can see right in front of their eyes,

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this sample being tested live in front of them, making it real for people,

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rather than science happening at some remote lab far away. Julian. Julian took one of our microscopes out

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to Panama and was running it on samples, and the microscope's quite light. He didn't want to take

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a mouse and keyboard with him. He's controlling that with a SNES controller. Dr. Homo Kelsey

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is a specialist in women's health, who is also part of the global health team over in America,

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and as Julian mentioned, we have worked on building up this huge wide area scans that

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a single image from one. May what like this? The scans were doing what more like this.

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All automated running on the Raspberry Pi, able to get dive nurses and places that traditionally

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would rely on manual techniques. Kelsey set up this work we did in Rwanda last January,

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setting up the microscopes there so that doctors can get second opinions and online

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consults. Previously at Shashubay, there was a manual microscope. If they couldn't diagnose

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your condition, it was most likely that they would put you on a bus to the north of the country

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seven hours away. Now instead we run regular sessions for training where they can look at samples,

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they found challenging on about microscope and have discussions with other pathologists in other areas.

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That means that not only are they getting that training on that sample, but also they're

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up scaling and learning more about the cases that they're going to be facing.

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So this is our world map, and as Julian mentioned, it works more like this. But also,

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like you said, we don't track, and so we've got this forum where people get in touch,

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sometimes they tell us where, sometimes they value their privacy and that's fine.

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But on part of the University of Glasgow, and there's an academic, I feel like I'm constantly fighting

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against particularly the phrase, data available on reasonable request, or waiting for someone to

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email asking for a lab tool, or letting you know that we'll see you at a conference.

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And when people wait for things like that, they miss out on some of the things that people have

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come to our forum and said about soil microscopy, knife sharpening, we're some students that want to

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do microscopy at home during a pandemic. Can you translate the instructions into French?

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I'd like to make this with my children. Can you build a telescope with this?

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Open flagship con where we've got a load of us together in a room to talk about the

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direction for the project. I'd like to build this on a date with my girlfriend.

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We never heard back from them.

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Motion dice.

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Thank you.

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Yeah, it's all open source. Some vendors have got in touch with us saying that they are selling it,

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some of them funds the project back, others contribute to the code base, so we've got to keep

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the lights on. So I'm so pleased by a t-shirt. Open flagship voice control, and then an email

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can I send the open flagship to space? Go and ask any conventional microscopy academic,

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how long they would have to wait to get an email like that for the proprietary system.

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And so this is the end of the talk where what we're supposed to do is talk about the future

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of the project. And there's things that we're working on where we're writing the underlying

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software. We've got two other projects, the block stage and the delta stage. We

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desperately working towards medical certification in Tanzania or in Rwanda.

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And keeping the community engaged, organizing other events and just being ready for when people

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get in touch. But really, that's just a gas and we've got no idea where the project is going next.

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This was version one of the open flagship microscope. From there it's gone to the Antarctic

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and it's gone to Tanzania and Rwanda and the Philippines and it's gone on their parabolic flight

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for zero g. And we couldn't really have predicted any of that. So a lot of our development isn't

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about pushing it in certain directions, it's making this a platform that's ready for whatever

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is, whatever direction people being gone. And so with that, I'll say that we had no idea

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where it was going at the start. All we had was a small snapshot and we had to wait

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and let other people bring things in and it grew and grew and grew until you've got a much bigger

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idea of what's going on. That's about my entire talk with a metaphor for scanning microscopes. Thank you

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very much. We have any questions.

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Hi, an awesome project back here. I have a question about maintenance, do the

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lectures everywhere out? Yeah, so really a question. So it depends a lot on the quality of the PLA

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filament. So if you do it with a lot of moisture in the filament, if it's not new filament,

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they haven't printed well, they tend to crack. So you have to worry a lot about say humidity where

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you are, but what we were doing for a while in Tanzania was just having a microscope around a

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full edge of the travel forward backwards forwards backwards. The first thing that happened

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to the first thing that broke was we wore the metal off the lead screw. Now we had bought

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really cheap, I think some sort of Chinese cheese steel alloy. So we did have to buy better screws,

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but we managed to run them for three months forward in backwards. And I think possibly you'll get

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a year or two, you might get some degradation, but that's the thing of you could it's a cheap enough

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part that if they're built locally, you can put that in a regular maintenance schedule to switch

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out the body a year. Other than choosing the right colors, what challenges for getting medical

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certification. A lot of it's around documentation, so you really need to, there's a lot of paperwork,

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for good reason, not just to show that you've done, you've done your checks, you've thought

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through why you thought to how it could fail, but making sure you've got the processes in place.

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So when you have one that works, that is every single one that you build, going to be the same

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as the one that you tested. And so that's why it's quite hard, it's an open source project,

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you can't medically certify the open source project because if somebody builds it badly, that's

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not the same. So we're not trying to be medically certified ourselves, we're trying to provide a platform

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where manufacturers can work with us to become medically certified, then it will be their own company

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that is medically certified. So they're not relying on us because what we don't want to do is set it

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up in a way that they're continuously relying on us for certification. We want to make it in a case

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way. If me and Joe become evil and tell them that they can't do it anymore, they can go up,

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well, it's an irrevocable open license, so yes, we can. So the plan is to make sure that we're

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not in control, but that means a lot of upskilling, a lot of making sure the design is transferred

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from us to other people and that they understand it well enough that they can do all of the checks in

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place and make sure their suppliers don't give them the rubbish screws that we talked about,

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the war out before the flagships. Yeah, brilliant, I'll do the love it. Just wondering, because

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there's a talk about making it available in Tanzania and other places where no resource is

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or more expensive, options may not be the disruption. Is there a plan, before example,

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make something like up and fracture, be somewhat more standard within Europe, where we do have,

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you know, whatever fancy company with their proprietary software and hardware is available,

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but to make it more available in the marketplace and investment development countries.

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Yeah, so I've been where we're definitely talking to schools about educational use,

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but we're actually talking to university college London who are starting a trial for

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chronic UTIs, where they're hopefully going to use the open flexure as part of that. So then

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and that really builds trust that it's not, this is for you, this is for us, but the main use case for

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us has been making sure the EEs possible to build. We know it's possible to build it in England,

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that's where we're designing it. If we only designed it, waited until and went, well this is kind

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of a low cost where we are, so we assume it works in Africa, that's the worst way to do engineering

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with that, you have to engineer with Africans, there's brilliant engineers in Africa,

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we need to know, you know, what's available in different places.

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Did you, did you see they're using global shutter cameras to overcome the knock on the table problem?

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Sorry? Did you want to see they're using global shutter cameras to overcome the knock on the

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table problem? We would love to, it's basically, it's availability of components, so it comes

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back to the previous question of which are most available, so yeah, they are quite standard

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but getting them in onto the Raspberry Pi, so I know they've got a global shutter one now, so hopefully

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soon.

