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Torsional deformities of the lower limb are common in children with cerebral palsy (CP)-determining gait problems. The mechanisms underlying transverse plane gait deviations arise from a combination of dynamic and static factors. The dynamic elements may be due to spasticity, contractures and muscle imbalances, while the static ones may result from excessive femoral anteversion, which decreases the efficiency of the hip abductors by reducing the muscular lever arms. A therapeutic approach has been identified in multi-level functional surgery for the lower limb. Treating the malalignments of the lower limb with femoral or tibial derotation provides optimal results, especially when supported by adequate biomechanical planning. This planning requires an integrated static-dynamic approach of morphological and functional evaluation, based on radiological measurements, physical examination and gait analysis. Instrumented gait analysis has been confirmed as essential in the evaluation and surgical decision making process for children affected by CP with transverse plane deformities. Computational simulations based on musculoskeletal models that integrate patient-specific CT morphological data into gait analysis can be used for the implementation of a surgical simulation system in pre-operative planning to test the possible effects of the different surgical treatment options on the torsional defects of the lower limbs. Recently, a computer-aided simulation process has been implemented in the preoperative planning of complex osteotomies for limb deformities in children. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software. The aim of this study is to integrate the patient-specific CT musculoskeletal model with morphological data and gait analysis data, with the personalized calculation of kinematic and kinetic parameters, which allow us to generate an “avatar” of the patient for a more in-depth evaluation of the gait abnormalities. The computational simulation platform proposed provides a realistic movable musculoskeletal model in a virtual environment, with the possibility of planning and monitoring the effects of virtual three-dimensional surgical corrections.

Improvements in software for image analysis have enabled advances in both medical and engineering industries, including the use of medical analysis tools to recreate internal parts of the human body accurately. A research analysis found that FDM-sourced elements have shown viability for a customized and reliable approach in the orthopedics field. Three-dimensional printing has allowed enhanced accuracy of preoperative planning, leading to reduced surgery times, fewer unnecessary tissue perforations, and fewer healing complications. Furthermore, using custom tools chosen for each procedure has shown the best results. Bone correction-related surgeries require customized cutting guides for a greater outcome. This study aims to assess the biopolymer-based tools for surgical operations and their ability to sustain a regular heat-sterilization cycle without compromising the geometry and fit characteristics for a proper procedure. To achieve this, a DICOM and FDM methodology is proposed for fast prototyping of the cutting guide by means of 3D engineering. A sterilization test was performed on HTPLA, PLA, and nylon polymers. As a result, the unique characteristics within the regular autoclave sterilization process allowed regular supplied PLA to show there were no significant deformations, whilst annealed HTPLA proved this material’s capability of sustaining repeated heat cycles due to its crystallization properties. Both of these proved that the sterilization procedures do not compromise the reliability of the part, nor the safety of the procedure. Therefore, prototypes made with a similar process as this proposal could be safely used in actual surgery practices, while nylon performed poorly because of its hygroscopic properties.

The design of an E segment, executive, midsize sedan car was chosen to fill a gap in the market of the Ford brand and to achieve the goal of innovation looking towards the future. Ford has not owned an E-segment flagship sports sedan for years, since the historic 1960s Falcon. Starting from the latter assumption and considering that the major car manufacturers are currently investing heavily in E-segment cars, it is important to design a new model, which has been called the Eagle. This model proposed here is to fill the gap between Ford and other companies that are already producing sport cars for the electric sector and to complete Ford’s proposal. The presented methodology is based on SDE, on which many design tools are implemented, such as Quality Function Deployment (QFD), Benchmarking (BM), and Top Flop Analysis (TPA). A market analysis follows in order to identify the major competitors and their key characteristics considering style and technology. The results are used to design an innovative car. Based on the most developed stylistic trends, the vehicle is first sketched and then drawn in the 2D and 3D environments for prototyping. This result leads to the possibility of 3D printing the actual model as a maquette using the Fused Deposition Modelling (FDM) technology and testing it in different configurations in Augmented Reality (AR). These two final applications unveil the possibilities of Industry 4.0 as enrichment for SDE and in general rapid prototyping.

Three-dimensional printed custom cutting guides (CCGs) are becoming more and more investigated in medical literature, as a patient-specific approach is often desired and very much needed in today’s surgical practice. Three-dimensional printing applications and computer-aided surgical simulations (CASS) allow for meticulous preoperatory planning and substantial reductions of operating time and risk of human error. However, several limitations seem to slow the large-scale adoption of 3D printed CCGs. CAD designing and 3D printing skills are inevitably needed to develop workflow and address the study; therefore, hospitals are pushed to include third-party collaboration, from highly specialized medical centers to industrial engineering companies, thus increasing the time and cost of labor. The aim of this study was to move towards the feasibility of an in-house, low-cost CCG 3D printing methodology for pediatric orthopedic (PO) surgery. The prototype of a femoral cutting guide was developed for its application at the IOR—Rizzoli Orthopedic Institute of Bologna. The element was printed with an entry-level 3D printer with a high-temperature PLA fiber, whose thermomechanical properties can withstand common steam heat sterilization without bending or losing the original geometry. This methodology allowed for extensive preoperatory planning that would likewise reduce the overall surgery time, whilst reducing the risks related to the intervention.

Augmented Reality (AR) is worldwide recognized as one of the leading technologies of the 21st century and one of the pillars of the new industrial revolution envisaged by the Industry 4.0 international program. Several papers describe, in detail, specific applications of Augmented Reality developed to test its potentiality in a variety of fields. However, there is a lack of sources detailing the current limits of this technology in the event of its introduction in a real working environment where everyday tasks could be carried out by operators using an AR-based approach. A literature analysis to detect AR strength and weakness has been carried out, and a set of case studies has been implemented by authors to find the limits of current AR technologies in industrial applications outside the laboratory-protected environment. The outcome of this paper is that, even though Augmented Reality is a well-consolidated computer graphic technique in research applications, several improvements both from a software and hardware point of view should be introduced before its introduction in industrial operations. The originality of this paper lies in the detection of guidelines to improve the Augmented Reality potentialities in factories and industries.

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

Annulus pipe conveying fluids have many practical applications, such as hydraulic control lines and aircraft fuel lines. In some applications, these tubes are exposed to high speeds. Normally, this leads to a vibration effect which may be of a catastrophic nature. The phenomenon is not only driven by the centrifugal forces, but an important role is played also by the Coriolis forces. Many theoretical approaches exist for a simple configuration or a complex three-dimensional configuration. Finite element models are tested. This paper provides a numerical technique for solving the dynamics of annulus pipe conveying fluid by means of the mono-dimensional Finite Element Method (FEM). In particular, this paper presents a numerical solution to the equations governing a fluid conveying pipeline segment, where a Coriolis force effect is taken into consideration both for fix and hinge constraint.

This work aims to present an in-house low-cost computer-aided simulation (CASS) process that was recently implemented in the preoperative planning of complex osteotomies for limb deformities in children. Five patients admitted to the Unit of Paediatric Orthopaedics and Traumatology from April 2018 to December 2019, for correcting congenital or post-traumatic limb deformities were included in the study. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software, and the surgery was planned and simulated starting from the 3D digital model. 3D printed sterilizable models were fabricated using a low-cost 3D printer, and animations of the operation were generated with the aim to accurately explain the operation to parents. All procedures were successfully planned using our CASS method and the 3D printed models were used during the operation, improving the understanding of the severely abnormal bony anatomy. The surgery was precisely reproduced according to CASS and the deformities were successfully corrected in four cases, while in one case, the intraoperative intentional undersizing of the bone osteotomy produced an incomplete correction of a congenital forearm deformity. Our study describes the application of a safe, effective, user-friendly, and low-cost CASS process in paediatric orthopaedics (PO) surgery. We are convinced that our study will stimulate the widespread adoption of this technological innovation in routine clinical practice for the treatment of rare congenital and post-traumatic limb deformities during childhood.

This work describes a Mixed Reality application useful to modify and cut virtual objects. A digital simulation of surgical operations is presented. Following this approach, surgeons can test all the designed solutions of the preoperative stage in a Mixed Reality environment. High precision in surgery applications can be achieved thanks to the new methodology. The presented solution is hands free and does not need the use of a mouse or computer’s keyboard: it is based on HoloLens, Leap Motion device and Unity. A new cutting algorithm has been developed in order to handle multiple objects and speed up the cut with complex meshes and preserve geometry quality. A case study presents the cut of several bones in order to simulate surgeon’s operations. A reduction in cut time compared to the original method is noticed, together with a high flexibility of the tool and a good fidelity of the geometry. Moreover, all the object fragments generated from the algorithm are available for manipulation and new cuts.

In this paper, we present a solution for the photorealistic ambient light render of holograms into dynamic real scenes, in augmented reality applications. Based on Microsoft HoloLens, we achieved this result with an Image Base Lighting (IBL) approach. The real-time image capturing that has been designed is able to automatically locate and position directional lights providing the right illumination to the holograms. We also implemented a negative “shadow drawing” shader that contributes to the final photorealistic and immersive effect of holograms in real life. The main focus of this research was to achieve a superior photorealism through the combination of real-time lights placement and negative “shadow drawing” shader. The solution was evaluated in various Augmented Reality case studies, from classical ones (using Vuforia Toolkit) to innovative applications (using HoloLens).

This paper presents the application of a low-cost 3D printing technology in pre-operative planning and intra-operative decision-making. Starting from Computed Tomography (CT) scans, we were able to reconstruct a 3D model of the area of interest with a very simple and rapid workflow, using open-source software and an entry level 3D printer. The use of High Temperature Poly-Lactic Acid (HTPLA) by ProtoPasta allowed fabricating sterilizable models, which could be used within the surgical field. We believe that our method is an appealing alternative to high-end commercial products, being superior for cost and speed of production. It could be advantageous especially for small and less affluent hospitals that could produce customized sterilizable tools with little investment and high versatility.