Our lab, has been very active in responding to request of help and support for COVID-19. In particular three members of our Lab, Dr Leandro Pecchia (Reader), Dr Silvio Pagliara (PDRA) and Mr Davide Piaggio (PhD student) are proactively taking part in a volunteer-based response to the COVID19 pandemic.

As the world is plagued by the recent outbreak, the healthcare settings of all the countries (independently from the level of income and resources) are being challenged. The truth behind this haunting nightmare is the fact that no country was ever perfectly prepared to tackle such a pandemic. Already Italy, which has one of the best healthcare systems in the world , is struggling to keep up with the ever-increasing number of patients who need hospital care or intensive care. The number of available beds is plunging along with the number of healthcare personnel (who is getting infected too) and of the available personal protective equipment.

To this purpose, the effort of the healthcare staff (including retired workers and freshly graduates who made themselves available to help in this collective effort), incessantly working overtime despite the health-related risks, is assisted by clinical and biomedical engineers, who, despite having a more “hidden” role in this fight, are another vital engine of the response. Clinical and biomedical engineers, in fact, are normally in charge of verifying that all the medical devices and medical equipment are compliant with international standards. Only a strict compliance with such standards guarantees the efficiency of medical devices and the safety of their users.

On the one hand, a positive role in this critical situation is being played by international and local manufacturers (e.g., JLR, Dyson, Ferrari etc.), who are converting their usual production line in order to produce hand sanitizers, ventilators, respirators and face shields. On the other hand, a negative role is being played by all the self-proclaimed “Archimedes”, who suggest creative alternatives to tackle some of the above-mentioned problems using their social media coverage. We are not far from a MacGyver’s episode, in which the protagonist creates gadgets with whatever he has available. The innumerable solutions one can come across on the internet span from using baking paper to reproduce a face mask to 3D printing respirators using cotton filters, claiming that they are effective in filtering the virus.

Although many of these “Archimedes” may be doing this bona fide, the scientific community has to make clear the fact that the only approved solutions are the ones that have obtained a CE mark. The roads to the CE marks are different and depend on the risk-category which the device is part of. The common denominator among these different paths is that there are a series of tests that need to be performed, depending on the type of device and equipment.

The ABSPIE Lab has been dealing with international standards for a long time, as one of its research streams deals with the design of medical devices resilient to low-resource settings, one of the questions being: “to which extent can international standards be stretched and still be effective?” Strengthened by their field experiences in Africa, Leandro, Silvio and Davide are incessantly working with the International Federation of Medical and Biological Engineering (IFMBE) and the World Health Organization (WHO) in order to supply guidelines for helping who wants to help in this world crisis. The ABSPIE Lab is also backing up many university-led responses and companies who are revolutionizing their production line as a response to these urgent needs.

Beyond its support on this matter, the ABSPIE Lab has also supported a telemedicine company in adapting their platforms for COVID monitoring of patients and self-isolated citizens. This system is now serving hundreds of self-isolated patients and citizens in the Rome Region for three local National Health Service (NHS) Trusts, and discussion is going on to open the same platform to UK NHS Trusts for high-risk populations (e.g., cancer patients).

Lastly, as the scientific community has stated, SARS-CoV-2 is not a transient problem. Therefore, we will need to coexist with this virus forever, hoping that new cost-effective vaccines and therapies will come and will mitigate the risks. While vaccines and therapies are under development, we also need to be ready to early detect COVID19 from symptoms. This is actually the challenge for next winter. In response to this need, the ABSPIE Lab is trying to develop an AI system to detect pneumonia from symptoms (e.g., coughing, pain…) based on non-COVID specific data collected in Bosnia-Herzegovina.

Overall, there are many non-trivial challenges related to this pandemic, which should be left to people who have the right competences. The way forward in this collective response needs to be led by responsible thinking, responsible action and also responsible silence, when we do not have specific competences.

Our recent study on hypoglycaemia detention via AI and ECG waveform from few heartbeats is having a significant circulation among media.

According to Nature, our paper is in the 99^th percentile, ranked 764^th of the 232,496 tracked articles of a similar age in all journals (i.e., top 3 per thousand!), per media interest. Most important, a number of patients and patient associations are approaching our team to ask for more information, expressing satisfaction and encouragement for us to go on.

While we still confirm that those are only preliminary results coming from a small pilot (8 in the paper published in Scientific Reports and 25 in a second paper now under revision), and more research and validation will be required before considering to move this promising technology into the clinical practice, we thing that this interest is inspiring and we will continue with all our determination our work in this area.

Here some articles recalling our work:

• The Times, AI heart monitor alerts diabetics to low blood sugar
• Science Daily, AI can detect low-glucose levels via ECG without fingerprick test
• Diabetes.co.uk, AI and ECG could provide an alternative to finger prick tests

Can an #AI deep neural network be trained to diagnose low blood sugar from the ECG signal?https://t.co/X6f8gvtLoK
I wouldn't have guessed this was possible, but here it is, by @PecchiaLeandro @WarwickEngineer and team@SciReports #openaccess pic.twitter.com/YwHkRvrxgT

— Eric Topol (@EricTopol) January 13, 2020

Three members of the lab, are in Benin, Africa, to perform two field studies.

Davide Piaggio and Busola Oronti are two PhD student with a background in biomedical engineering and medical devices. Both are IFMBE Clinical Engineering Division collaborators. In this field study Davide and Busola are testing medical devices considering international standards and regulations for electric safety.

In fact, it is know that medical devices in Africa struggle to work as in Europe, but there is no evidence of the real reasons why this is. The aim of this study is to produce evidence on reasons why medical devices fail to work safely and effectively. This will inform the design of more resilient medical devices.

Meanwhile Alessia Maccaro, Philosopher with a PhD in bioethics, is investigates the implications of adopting EU regulations in Africa. Our hypothesis is that the uncritical adoption of international regulations can result in risky and unethical working conditions.

Alessia Maccaro, WIRL COFUND of the Institute of Advanced Study of the University of Warwick, member of the Applied Biomedical and Signal Processing Intelligent E-Lab directed by professor Leandro Pecchia is just arrived in Bénin (Sub-saharan Africa) were she'll do her field study. Some surveys about ethical perceptions of medical devices according to local culture have already done with the poorest women of the villages of the southern part of Benin. Help others is not only give, but also try to understand their real needs and look for new possibilities that could be compatibles and acceptable by their own culture.