Special Issue "Personalized Medical Devices"

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (30 April 2021).

Special Issue Editors

Prof. Dr. Lapo Governi
E-Mail Website
Guest Editor
Dipartimento di Ingegneria Industriale, Università di Firenze, Via di Santa Marta, 3 - 50139 Firenze, Italy
Interests: reverse engineering; 3D digital modeling; computational geometry; computer-aided design; additive manufacturing; biomedical applications of additive manufacturing; biomedical applications of reverse engineering
Special Issues and Collections in MDPI journals
Dr. Francesco Buonamici
E-Mail Website
Guest Editor
Dipartimento di Ingegneria Industriale, Università di Firenze, Via di Santa Marta, 3 - 50139 Firenze, Italy
Interests: CAD; personalized medicine; additive manufacturing; 3D scanning; prototyping; reverse engineering; topology optimization; CAD modeling; CAD reconstruction; computer vision
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

Recent developments in digital technologies have caused significant changes in the tools, devices, and procedures used by modern medicine. The introduction of tailored treatments has unlocked new frontiers for the achievement of a higher quality of treatment for patients, thanks to the consideration of the patient’s specific needs. Specifically, the design of custom-made medical devices and the development of patient-specific procedures were fostered by the introduction of 3D scanning and additive manufacturing technologies in the medical sector. The revolution triggered by these techniques has recently transformed itself into a mature and large medical reality which needs to be well documented.

Accordingly, this Issue focuses on the recent development of personalized medical devices. The Issue welcomes contributions dealing with every scientific aspect involved in the design and fabrication of personalized medical devices. Papers may be focused on, but are not limited to, the following topics related to personalized medical devices: design, manufacturing, study of software design tools, human–computer interfaces, biometrics, 3D scanning, biomechanical evaluations, simulation of surgery and other medical procedures, and the design of patient-specific implants and surgical instruments.

Prof. Dr. Lapo Governi
Dr. Francesco Buonamici
Guest Editors

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Keywords

  • personalized medical devices
  • medical devices for training
  • patient-specific implants
  • software tools for personalized medicine
  • personalized orthopedic devices
  • patient-specific simulation
  • additive manufacturing and personalized medicine
  • reverse engineering and personalized medicine
  • robotic applications for personalized medicine
  • 3D scanning and personalized medicine
  • human–computer interaction
  • simulation of surgical operations

Published Papers (16 papers)

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Research

Article
Numerical and Experimental Assessment of a Novel Anchored for Intramedullary Telescopic Nails Used in Osteogenesis Imperfecta Fractures
Appl. Sci. 2021, 11(12), 5422; https://doi.org/10.3390/app11125422 - 11 Jun 2021
Viewed by 335
Abstract
Osteogenesis Imperfecta (IO) is a bone disease mainly characterized by the low bone density that produces common fractures in children around 0–7 years. The use of metal implants is a typical treatment of this disease. The intramedullary telescopic nail (ITN) was inspired by [...] Read more.
Osteogenesis Imperfecta (IO) is a bone disease mainly characterized by the low bone density that produces common fractures in children around 0–7 years. The use of metal implants is a typical treatment of this disease. The intramedullary telescopic nail (ITN) was inspired by the progressive growth in the long bones such as the femur or humerus during children’s aging. This work shows an experimental assessment of the ITN’s, focusing on their fixation; the proposed improvements in the design of the intramedullary nail studied include the separation of the element into two parts for telescopic enlargement, minimal invasive fixation through the distal anchorage, and the double auto-drilled end for fixation on the distal and proximal section of the bone. The samples were manufactured in 316 L steel and mounted on specialized jaws to replicate the implants’ boundary conditions. The experimental test was repeated three times to report the intramedullary telescopic nail’s behavior at three lengths. The results show that the device supports only 79.06 N when not at extension length. However, if the device is extended 150% it will support 46.87 N which suggests that intramedullary telescopic nails can only increase by 25% of their original length before they fail. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
A Wearable System for the Estimation of Performance-Related Metrics during Running and Jumping Tasks
Appl. Sci. 2021, 11(11), 5258; https://doi.org/10.3390/app11115258 - 05 Jun 2021
Viewed by 429
Abstract
Athletic performance, technique assessment, and injury prevention are all important aspects in sports for both professional and amateur athletes. Wearable technology is attracting the research community’s interest because of its capability to provide real-time biofeedback to coaches and athletes when on the field [...] Read more.
Athletic performance, technique assessment, and injury prevention are all important aspects in sports for both professional and amateur athletes. Wearable technology is attracting the research community’s interest because of its capability to provide real-time biofeedback to coaches and athletes when on the field and outside of more restrictive laboratory conditions. In this paper, a novel wearable motion sensor-based system has been designed and developed for athletic performance assessment during running and jumping tasks. The system consists of a number of components involving embedded systems (hardware and software), back-end analytics, information and communications technology (ICT) platforms, and a graphical user interface for data visualization by the coach. The system is able to provide automatic activity recognition, estimation of running and jumping metrics, as well as vertical ground reaction force (GRF) predictions, with sufficient accuracy to provide valuable information as regards training outcomes. The developed system is low-power, sufficiently small for real-world scenarios, easy to use, and achieves the specified communication range. The system’s high sampling rate, levels of accuracy and performance enables it as a performance evaluation tool able to support coaches and athletes in their real-world practice. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Stochastic PCA-Based Bone Models from Inverse Transform Sampling: Proof of Concept for Mandibles and Proximal Femurs
Appl. Sci. 2021, 11(11), 5204; https://doi.org/10.3390/app11115204 - 03 Jun 2021
Viewed by 369
Abstract
Principal components analysis is a powerful technique which can be used to reduce data dimensionality. With reference to three-dimensional bone shape models, it can be used to generate an unlimited number of models, defined by thousands of nodes, from a limited (less than [...] Read more.
Principal components analysis is a powerful technique which can be used to reduce data dimensionality. With reference to three-dimensional bone shape models, it can be used to generate an unlimited number of models, defined by thousands of nodes, from a limited (less than twenty) number of scalars. The full procedure has been here described in detail and tested. Two databases were used as input data: the first database comprised 40 mandibles, while the second one comprised 98 proximal femurs. The “average shape” and principal components that were required to cover at least 90% of the whole variance were identified for both bones, as well as the statistical distributions of the respective principal components weights. Fifteen principal components sufficed to describe the mandibular shape, while nine components sufficed to describe the proximal femur morphology. A routine has been set up to generate any number of mandible or proximal femur geometries, according to the actual statistical shape distributions. The set-up procedure can be generalized to any bone shape given a sufficiently large database of the respective 3D shapes. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Additive Manufacturing and Reverse Engineering in Cranioplasty: A Personalized Approach to Minimize Skin Flap Complications
Appl. Sci. 2021, 11(11), 4926; https://doi.org/10.3390/app11114926 - 27 May 2021
Viewed by 237
Abstract
Cranioplasty is a procedure performed to repair defects in the human skull bone by surgically reconstructing the shape and function of the cranium. Several complications, both intraoperative and postoperative, can affect the procedure’s outcome (e.g., inaccuracies of the reconstructed shape, infections, ulcer, necrosis). [...] Read more.
Cranioplasty is a procedure performed to repair defects in the human skull bone by surgically reconstructing the shape and function of the cranium. Several complications, both intraoperative and postoperative, can affect the procedure’s outcome (e.g., inaccuracies of the reconstructed shape, infections, ulcer, necrosis). Although the design of additive manufactured implants in a preoperative stage has improved the general quality of cranioplasties, potential complications remain significant, especially in the presence of critical skin tissue conditions. In this paper, an innovative procedure to improve the chances of a positive outcome when facing critical conditions in a cranioplasty is described. The proposed approach relies on a structured planning phase articulated in a series of digital analyses and physical simulations performed on personalized medical devices that guide the surgeon in defining surgical cuts and designing the implant. The ultimate goal is to improve the chances of a positive outcome and a fast recovery for the patient. The procedure, described in extenso in the paper, was positively tested on a cranioplasty case study, which presented high risk factors. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
A Novel Earwax Self-Sampling Device: A Feasibility Study
Appl. Sci. 2021, 11(11), 4882; https://doi.org/10.3390/app11114882 - 26 May 2021
Viewed by 420
Abstract
(1) Background: Earwax might provide the long-term concentration of substances that are altered in chronic diseases. Standardised earwax extraction has to be exclusively performed by clinicians. We investigated the safety, reliability, and tolerance of a novel self-sampling earwax device in comparison with a [...] Read more.
(1) Background: Earwax might provide the long-term concentration of substances that are altered in chronic diseases. Standardised earwax extraction has to be exclusively performed by clinicians. We investigated the safety, reliability, and tolerance of a novel self-sampling earwax device in comparison with a clinical method; (2) Methods: We compared the reliability between both methods in a longitudinal study. We first cleaned both ears at baseline in 37 controls. Secondly, we obtained a sample a month after by extracting earwax from the right ear with a novel self-sampling device, and from the left ear by using the clinical method. Reliability of both methods was measured by coefficients of variation; (3) Results: The weight of the baseline samples was not significantly different between ear sides. The reliability of the two methods was not significantly different. The self-extraction method removed eight times more earwax than the clinical method. The new method proved to be well tolerated; (4) Conclusions: The novel device was as reliable as the clinical method in sampling earwax. In view of its practicality, safety, tolerability and efficiency, the new method may have clinical applications at a reduced cost. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Concept, Design, Initial Tests and Prototype of Customized Upper Limb Prosthesis
Appl. Sci. 2021, 11(7), 3077; https://doi.org/10.3390/app11073077 - 30 Mar 2021
Viewed by 399
Abstract
This paper presents aspects of the concept and design of prostheses for the upper limb. The objective of this research is that of prototyping a customized prosthesis, with EMG signals that initiate the motion. The prosthesis’ fingers’ motions (as well as that of [...] Read more.
This paper presents aspects of the concept and design of prostheses for the upper limb. The objective of this research is that of prototyping a customized prosthesis, with EMG signals that initiate the motion. The prosthesis’ fingers’ motions (as well as that of its hand and forearm parts) are driven by micro-motors, and assisted by the individualized command and control system. The software and hardware tandem concept of this mechatronic system enables complex motion (in the horizontal and vertical plane) with accurate trajectory and different set rules (gripping pressure, object temperature, acceleration towards the object). One important idea is regarding customization via reverse engineering techniques. Due to this, the dimensions and appearance (geometric characteristics) of the prosthesis would look like the human hand itself. The trajectories and motions of the fingers, thumbs, and joints have been studied by kinematic analysis with the matrix–vector method aided by Matlab. The concept and design of the mechanical parts allow for complex finger motion—rotational motion in two planes. The command and control system is embedded, and data received from the sensors are processed by a micro-controller for managing micro-motor control. Preliminary testing of the sensors and micro-motors on a small platform, Arduino, was performed. Prototyping of the mechanical components has been a challenge because of the high accuracy needed for the geometric precision of the parts. Several techniques of rapid prototyping were considered, but only DLP (digital light processing) proved to be the right one. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Development of Femtosecond Laser-Engineered β-Tricalcium Phosphate (β-TCP) Biomimetic Templates for Orthopaedic Tissue Engineering
Appl. Sci. 2021, 11(6), 2565; https://doi.org/10.3390/app11062565 - 12 Mar 2021
Viewed by 365
Abstract
Reconstruction of bone tissue defects is a problematic area of the modern world. Temporary “platforms” of various materials for improving cell adhesion and proliferation have been extensively researched in recent decades. β-tricalcium phosphate (β-TCP) is a suitable biocompatible, biodegradable material used for bone [...] Read more.
Reconstruction of bone tissue defects is a problematic area of the modern world. Temporary “platforms” of various materials for improving cell adhesion and proliferation have been extensively researched in recent decades. β-tricalcium phosphate (β-TCP) is a suitable biocompatible, biodegradable material used for bone regeneration. The creation of scaffolds with specifically designed surface structures will enable bone engineering applications that require navigated cell proliferation on a substrate with pre-set geometric limits. In this study, an innovative laser-based technique for surface modification was applied to improve the morphological properties of the surface of β-TCP pellets for proper cell surface environment creation. The obtained topographies with diverse processing parameters were compared. Homogenous microgroove structures, less than 100 µm, without the onset of melting and crack formation, were produced. The contribution from the accumulation effect of a diverse number of laser pulses (N = 1–100) on the final structure dimensions was examined. The microstructured scaffolds were investigated by confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Fourier-transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD) analyses. We studied the effect of the patterned surface of the material on the mouse calvaria osteoblast (MC3T3) cells’ viability and cytotoxicity from 1 to 7 days. The results indicated that cell behavior was affected by microscale dimensions of the surface. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Design of a Modular Plantar Orthosis System through the Application of TRIZ Methodology Tools
Appl. Sci. 2021, 11(5), 2051; https://doi.org/10.3390/app11052051 - 25 Feb 2021
Cited by 1 | Viewed by 462
Abstract
Innovations within the medical device sector are constantly and rapidly emerging due to increasing demand, especially for orthosis systems, which usually constitute built rigids with low comfort, due mainly to the standardized production process. This article reports the design process of a plantar [...] Read more.
Innovations within the medical device sector are constantly and rapidly emerging due to increasing demand, especially for orthosis systems, which usually constitute built rigids with low comfort, due mainly to the standardized production process. This article reports the design process of a plantar orthosis system from the application of Theory of Inventive Problem Solving (TRIZ) tools, known as generic parameters, matrix of contradictions, and inventive principles. The final orthosis is integrated by four modules or components (1 central and 3 movables) and customers can buy only the required ones, reducing cost in unnecessary parts. The plantar orthosis was defined based on three engineering parameters that delimited the design work by developing a customizable system that is capable of performing simultaneous functions and whose manufacture could be standardized. We identified the existence of a technical contradiction between the engineering parameters, customization, and standardization, which was solved by the inventive principles of segmentation, inversion, transition to a new dimension, and porous materials. A modular design with four components was accomplished, molds are built for each component in a machining center and injected using granulated ethylene vinyl acetate copolymer. The positions of the movable components are configured through a bolt-hole assembly mechanism to the central component, which is a flat perforated plantar base. The novelty in the design here presented is elated to supports that constitute the orthosis, which are interchangeable and adjustable to the pathological and morphological needs of each patient. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Handheld Optical System for Pectus Excavatum Assessment
Appl. Sci. 2021, 11(4), 1726; https://doi.org/10.3390/app11041726 - 15 Feb 2021
Cited by 1 | Viewed by 422
Abstract
Disruptive 3D technologies, such as reverse engineering (RE) and additive manufacturing (AM), when applied in the medical field enable the development of new methods for personalized and non-invasive treatments. When referring to the monitoring of pectus excavatum, one of the most common thoracic [...] Read more.
Disruptive 3D technologies, such as reverse engineering (RE) and additive manufacturing (AM), when applied in the medical field enable the development of new methods for personalized and non-invasive treatments. When referring to the monitoring of pectus excavatum, one of the most common thoracic malformations, 3D acquisition of the patient chest proved to be a straightforward method for assessing and measuring chest deformation. Unfortunately, such systems are usually available in a dedicated facility, can be operated only by specialized doctors with the support of engineers and can be used only with patients on site. It is therefore impossible to perform any routine check-up when the patient is unable to reach the outpatient clinic. The COVID19 pandemic situation has placed even greater restrictions on patient mobility, worsening this problem. To deal with this issue, a new low-cost portable optical scanner for monitoring pectus excavatum is proposed in this work. The scanner, named Thor 2.0, allows a remote diagnostic approach, offering the possibility to perform routine check-ups telematically. Usability tests confirmed the user-friendly nature of the devised system. The instrument was used at the Meyer Children’s Hospital (Florence, Italy) chest-malformations center to treat PE patients. The performed measurements proved to be in line with the current state of the art. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Are Suprapectineal Quadrilateral Surface Buttressing Plates Performances Superior to Traditional Fixation? A Finite Element Analysis
Appl. Sci. 2021, 11(2), 858; https://doi.org/10.3390/app11020858 - 18 Jan 2021
Viewed by 1011
Abstract
Acetabular fractures have a high impact on patient’s quality of life, and because acetabular fractures are high energy injuries, they often co-occur with other pathologies such as damage to cartilage that could increase related morbidity; thus, it appears of primary importance developing reliable [...] Read more.
Acetabular fractures have a high impact on patient’s quality of life, and because acetabular fractures are high energy injuries, they often co-occur with other pathologies such as damage to cartilage that could increase related morbidity; thus, it appears of primary importance developing reliable treatments for this disease. This work aims at the evaluation of the biomechanical performances of non-conservative treatments of acetabular fractures through a finite element approach. Two pelvic plates models (the standard suprapectineal plate—SPP, and a suprapectineal quadrilateral surface buttressing plate—SQBP) were analyzed when implanted on transverse or T-shaped fractures. The plates geometries were adapted to the specific hemipelvis, mimicking the bending action that the surgeon performs on the plate intraoperatively. Implemented models were tested in a single leg stance condition. The obtained results show that using the SQBP plate in transverse and T-shaped acetabular fractures generates lower bone stress if compared to the SPP plate. Interfragmentary movement analysis shows that the SQBP plate guarantees greater stability in transverse fractures. In conclusion, the SQBP plate seems worthy of further clinical analysis, having resulted as a promising option in the treatment of transverse and T-shaped acetabular fractures, able to reduce bone stress values and to get performances comparable, and in some cases superior, to traditional fixation. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Biofunctional Surfaces for Smart Entrapment of Polysomes
Appl. Sci. 2021, 11(2), 776; https://doi.org/10.3390/app11020776 - 15 Jan 2021
Viewed by 345
Abstract
Protein synthesis is a central process in all cells, crucial for cell development and maintenance. Translational dysregulation, in fact, is associated with cancer or neurodegenerative diseases. Active protein synthesis occurs on a supramolecular complex, named polyribosome or polysome, formed by a mRNA associated [...] Read more.
Protein synthesis is a central process in all cells, crucial for cell development and maintenance. Translational dysregulation, in fact, is associated with cancer or neurodegenerative diseases. Active protein synthesis occurs on a supramolecular complex, named polyribosome or polysome, formed by a mRNA associated with multiple ribosomes. Polysomes therefore can be considered as a privileged molecular platform to obtain information about the physiological or pathological state in cells. The classical methods for purifying the mRNAs associated with polysomes mainly rely on ultracentrifugation in sucrose gradient followed by standard RNA extraction. This method present several drawbacks, among all it is a time-consuming procedure, which requires a fairly large amounts of starting material. New methods offering an efficient, rapid and user-friendly alternative to standard methods are therefore highly desirable. Here, a panel of surfaces and surface functionalizations were screened for their ability to entrap polysomes with the ultimate aim to set up smart biofunctional surfaces for the purification of nonlabelled polysomes and their associated mRNAs. As a proof-of-concept, prepurified ribosomes and polysomes were incubated on multiple functional surfaces and characterized by atomic force microscopy to assess number and morphology of entrapped polysomes. Surfaces able to efficiently capture polysomes were then included in a microdevice with promising results, opening the future perspective of developing protocols and devices based on biofunctional surfaces. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Self-Powered, Hybrid, Multifunctional Sensor for a Human Biomechanical Monitoring Device
Appl. Sci. 2021, 11(2), 519; https://doi.org/10.3390/app11020519 - 07 Jan 2021
Viewed by 495
Abstract
For personal and daily activities, it is highly desirable to collect energy from multiple sources, not only for charging personal electronics but also for charging devices that may in the future sense and transmit information for healthcare and biomedical applications. In particular, hybridization [...] Read more.
For personal and daily activities, it is highly desirable to collect energy from multiple sources, not only for charging personal electronics but also for charging devices that may in the future sense and transmit information for healthcare and biomedical applications. In particular, hybridization of triboelectric and piezoelectric energy-harvesting generators with lightweight components and relatively simple structures have shown promise in self-powered sensors. Here, we present a self-powered multifunctional sensor (SPMS) based on hybridization with a novel design of a piezoelectrically curved spacer that functions concurrently with a zigzag shaped triboelectric harvester for a human biomechanical monitoring device. The optimized SPMS had an open-circuit voltage (VOC) of 103 V, short-circuit current (ISC) of 302 µA, load of 100 kΩ, and maximum average power output of 38 mW under the operational processes of compression/deformation/touch/release. To maximize the new sensor’s usage as a gait sensor that can detect and monitor human motion characteristics in rehabilitation circumstances, the deep learning long short-term memory (LSTM) model was developed with an accuracy of the personal sequence gait SPMS signal recognition of 81.8%. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Virtual Reality Exposure Therapy for Driving Phobia Disorder (2): System Refinement and Verification
Appl. Sci. 2021, 11(1), 347; https://doi.org/10.3390/app11010347 - 31 Dec 2020
Cited by 2 | Viewed by 559
Abstract
Driving phobia is a widespread anxiety disorder in modern society. Driving phobia disorders often cause difficulties in people’s professional and social activities. A growing trend for treating driving phobia is to apply virtual reality exposure therapy (VRET). We refined the system’s performance based [...] Read more.
Driving phobia is a widespread anxiety disorder in modern society. Driving phobia disorders often cause difficulties in people’s professional and social activities. A growing trend for treating driving phobia is to apply virtual reality exposure therapy (VRET). We refined the system’s performance based on the previous research publication and have conducted a VRET pre-test research study with treatment and control group subjects to demonstrate the effectiveness of VRET. Some systemic problems were discovered in the first published experiment. For example, the experimental process and the virtual reality (VR) driving scenarios had to be modified to reflect realistic scenarios causing the fear of driving. These issues were identified and improvements made and verified in this research. A total of 130 subjects completed the driving behavior survey. Thirty subjects were randomly drawn from the subjects with high driving fear questionnaire scores and were invited to participate in the treatment experiments. The latest research presents the refined VRET for driving phobia disorders, including the revised system framework, the main modules and integration, and the subjects’ biodata collection, management, and analysis. The experiment results provide strong evidence that the refined VRET design helps subjects overcome driving phobias. The subjects’ subjective distress and fear of driving are reduced significantly through the implementation of VRET. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Design of Personalized Devices—The Tradeoff between Individual Value and Personalization Workload
Appl. Sci. 2021, 11(1), 241; https://doi.org/10.3390/app11010241 - 29 Dec 2020
Viewed by 606
Abstract
Personalized medical devices adapted to the anatomy of the individual promise greater treatment success for patients, thus increasing the individual value of the product. In order to cater to individual adaptations, however, medical device companies need to be able to handle a wide [...] Read more.
Personalized medical devices adapted to the anatomy of the individual promise greater treatment success for patients, thus increasing the individual value of the product. In order to cater to individual adaptations, however, medical device companies need to be able to handle a wide range of internal processes and components. These are here referred to collectively as the personalization workload. Consequently, support is required in order to evaluate how best to target product personalization. Since the approaches presented in the literature are not able to sufficiently meet this demand, this paper introduces a new method that can be used to define an appropriate variety level for a product family taking into account standardized, variant, and personalized attributes. The new method enables the identification and evaluation of personalizable attributes within an existing product family. The method is based on established steps and tools from the field of variant-oriented product design, and is applied using a flow diverter—an implant for the treatment of aneurysm diseases—as an example product. The personalization relevance and adaptation workload for the product characteristics that constitute the differentiating product properties were analyzed and compared in order to determine a tradeoff between customer value and personalization workload. This will consequently help companies to employ targeted, deliberate personalization when designing their product families by enabling them to factor variety-induced complexity and customer value into their thinking at an early stage, thus allowing them to critically evaluate a personalization project. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
Modified Gingival Index (MGI) Classification Using Dental Selfies
Appl. Sci. 2020, 10(24), 8923; https://doi.org/10.3390/app10248923 - 14 Dec 2020
Viewed by 452
Abstract
Background: Gum diseases are prevalent in a large proportion of the population worldwide. Unfortunately, most people do not follow a regular dental checkup schedule, and only seek treatment when experiencing acute pain. We aim to provide a system for classifying gum health status [...] Read more.
Background: Gum diseases are prevalent in a large proportion of the population worldwide. Unfortunately, most people do not follow a regular dental checkup schedule, and only seek treatment when experiencing acute pain. We aim to provide a system for classifying gum health status based on the MGI (Modified Gingival Index) score using dental selfies alone. Method: The input to our method is a manually cropped tooth image and the output is the MGI classification of gum health status. Our method consists of a cascade of two stages of robust, accurate, and highly optimized binary classifiers optimized per tooth position. Results: Dataset constructed from a pilot study of 44 participants taking dental selfies using our iGAM app. From each such dental selfie, eight single-tooth images were manually cropped, producing a total of 1520 images. The MGI score for each image was determined by a single examiner dentist. On a held-out test-set our method achieved an average AUC (Area Under the Curve) score of 95%. Conclusion: The paper presents a new method capable of accurately classifying gum health status based on the MGI score given a single dental selfie. Enabling personal monitoring of gum health—particularly useful when face-to-face consultations are not possible. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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Article
“In Vivo” Validation of 3D-Printed Innovative Surgical Template for Lumbar Spinal Arthrodesis
Appl. Sci. 2020, 10(17), 5977; https://doi.org/10.3390/app10175977 - 28 Aug 2020
Cited by 1 | Viewed by 595
Abstract
The most common type of spine instrumentation is the pedicle screw fixation. The recent literature shows how customized drilling templates help surgeons to perform the surgery better. This work aims to validate the design of a customized template for inserting lumbar pedicle screw [...] Read more.
The most common type of spine instrumentation is the pedicle screw fixation. The recent literature shows how customized drilling templates help surgeons to perform the surgery better. This work aims to validate the design of a customized template for inserting lumbar pedicle screw via a procedure based on rapid prototyping and reverse engineering techniques and to show the benefits. The novelties of this template are its low-invasive sizes, its design based on a patented algorithm, which calculates the sizes of the screws and the optimal insertion direction, the engage/disengage system, and the adaptability to every kind of surgeon’s kit. Accuracy of pedicle screw location, surgery duration, and X-ray exposition have been used to evaluate the performances of the template. Mono-centric in vivo trial was performed. Twenty patients (8 women and 12 men) were enrolled randomly corresponding to sixty vertebrae treated with spinal arthrodesis (30 with and 30 without templates). Accuracy of the screw positioning and reduction in both surgery duration and patients’ exposure to X-rays achieved excellent results because the time spent on the insertion of pedicle screws via the surgical template was cut down by about 63%, while the number of X-ray shots was reduced by about 92%. The proposed template performed better than the standard approach and could be helpful both for skilled and novice surgeons. Full article
(This article belongs to the Special Issue Personalized Medical Devices)
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