Search

Elizabeth Abu-Haydar,1 David Katuntu2 ,†James Bauer,1 Alec Wollen,1 Mike Eisenstein,1 Jill Sherman-Konkle,1 Anthony Roche,3 Michael Ruffo1 1PATH, Programs and Innovation Division, Medical Devices and Health Technologies, Seattle, WA, USA; 2PATH, Uganda Country Program, Kampala, Uganda; 3Department of Global Health, University of Washington, Seattle, WA, USA†David Katuntu passed away on September 1, 2020.Correspondence: Elizabeth Abu-HaydarPATH, Programs and Innovation Division, Medical Devices and Health Technologies, 2201 Westlake Ave, Seattle, WA, 98121, USATel +1 206 285-3500Email eabuhaydar@path.orgPurpose: Infusion pumps are the preferred method for intravenous delivery of drugs and fluids, and an essential tool in health facilities. Their high cost, complexity and reliance on electricity pose serious challenges to wide-spread use, availability and access in low- and middle-income countries. PATH developed the RELI Delivery System (RELI), a low cost, non-electric infusion pump to address these challenges. Input collected from fifty-nine newborn and maternal care providers and from seven national level decision makers in Uganda was used to guide product development, further informing product design requirements, and optimal design features to best serve their needs.Methods: A formative evaluation following a mixed methods approach including focus group discussions (FGDs), stakeholder interviews, and observations was used to collect data from end users.Results: Stakeholders provided critical input on the RELI prototype design features, safety criteria, and contexts of use of infusion pumps, as well as recommendations for design refinements. Infusion systems are greatly needed but not readily available and their use is limited to well-resourced higher level facilities, even though the need is high in non-tertiary care hospital where patient volume is high, resources are scarce, power is inconsistent, and facilities are understaffed and overcrowded. Users expressed a need for an affordable and simple device with an intuitive user interface, clear instructions for use, and basic safety features.Conclusion: The study provided important guidance for further design refinements based on input from respondents and confirmed the need for robust, affordable, infusion pumps that meet the requirements for use in low-resource settings.Keywords: infusion pumps, low- and middle-income countries, user-centered design, product development, Uganda

To lower vehicle greenhouse gas emissions, many automotive companies are exploring fuel cell technologies, which combine hydrogen and oxygen to produce electricity and water. While hydrogen storage and infrastructure remain issues, Renault and Nuvera Fuel Cells are developing an onboard fuel processor, which can convert a variety of fuels into hydrogen to power these fuel cell vehicles. The fuel processor is now small enough and powerful enough for use on a vehicle. The catalysts and heat exchangers occupy 80 l and can be packaged with balance of plant controls components in a 150-l volume designed to fit under the vehicle. Recent systems can operate on gasoline, ethanol, and methanol with fuel inputs up to 200 kWth and hydrogen efficiencies above 77%. The startup time is now less than 4 min to lower the CO in the hydrogen stream to the target value for the fuel cell.

Nuvera's state-of-the-art on-board fuel processor is a very compact system with catalyst and heat exchanger volume of 80 liters, with a maximum power input of 215 kWth, and with hydrogen efficiencies capabilities above 77%. For our fuel processor we use four distinct reaction zones, ATR-HTS-LTS- PrOx. The entire fuel processor, with balance of plant controls components, can be packaged in a volume of 150-liter designed to fit in the floor of a vehicle.The on-board fuel processor design is quite flexible; it can operate on a number of fuels including gasoline, diesel, ethanol, methanol and gas fuels, and the fuel processor can be either scaled up or scaled down for other applications, for example, APU systems. Also, the on- board fuel processors were integrated successfully with Nuvera's automotive PEM fuel cell stacks. A fuel processor start-up time of less than 4 minutes was achieved to the target value for the fuel cell.

An ongoing program has made further technology advances in onboard fuel processors for use with PEM fuel cells. These systems are being explored as an option for reducing vehicle CO 2 emissions and for other benefits such as fuel-flexibility that would allow vehicles to operate on a range of bio-fuels, conventional fuels, and synthetic fuels to support diversification and/or “greening” of the fuel supply.