Customized scaffolds for large bone defects using 3D‑printed modular blocks from 2D‑medical images

Additive manufacturing(AM)has revolutionized the design and manufacturing of patient-specific,three-dimensional(3D),complex porous structures known as scaffolds for tissue engineering applications.The use of advanced image acquisition techniques,image processing,and computer-aided design methods has enabled the precise design and additive manufacturing of anatomically correct and patient-specific implants and scaffolds.However,these sophisticated techniques can be timeconsuming,labor-intensive,and expensive.Moreover,the necessary imaging and manufacturing equipment may not be readily available when urgent treatment is needed for trauma patients.In this study,a novel design and AM methods are proposed for the development of modular and customizable scaffold blocks that can be adapted to fit the bone defect area of a patient.These modular scaffold blocks can be combined to quickly form any patient-specific scaffold directly from two-dimensional(2D)medical images when the surgeon lacks access to a 3D printer or cannot wait for lengthy 3D imaging,modeling,and 3D printing during surgery.The proposed method begins with developing a bone surface-modeling algorithm that reconstructs a model of the patient’s bone from 2D medical image measurements without the need for expensive 3D medical imaging or segmentation.This algorithm can generate both patient-specific and average bone models.Additionally,a biomimetic continuous path planning method is developed for the additive manufacturing of scaffolds,allowing porous scaffold blocks with the desired biomechanical properties to be manufactured directly from 2D data or images.The algorithms are implemented,and the designed scaffold blocks are 3D printed using an extrusion-based AM process.Guidelines and instructions are also provided to assist surgeons in assembling scaffold blocks for the self-repair of patient-specific large bone defects.

Corneal collagen cross-linking in patients with keratoconus from the Dresden protocol to customized solutions:theoretical basis

Keratoconus is an ectatic condition characterized by gradual corneal thinning,corneal protrusion,progressive irregular astigmatism,corneal fibrosis,and visual impairment.The therapeutic options regarding improvement of visual function include glasses or soft contact lenses correction for initial stages,gas-permeable rigid contact lenses,scleral lenses,implantation of intrastromal corneal ring or corneal transplants for most advanced stages.In keratoconus cases showing disease progression corneal collagen crosslinking(CXL)has been proven to be an effective,minimally invasive and safe procedure.CXL consists of a photochemical reaction of corneal collagen by riboflavin stimulation with ultraviolet A radiation,resulting in stromal crosslinks formation.The aim of this review is to carry out an examination of CXL methods based on theoretical basis and mathematical models,from the original Dresden protocol to the most recent developments in the technique,reporting the changes proposed in the last 15y and examining the advantages and disadvantages of the various treatment protocols.Finally,the limits of non-standardized methods and the perspectives offered by a customization of the treatment are highlighted.

A biomimetic nanoplatform for customized photothermal therapy of HNSCC evaluated on patient-derived xenograft models

Cancer cell membrane(CCM)derived nanotechnology functionalizes nanoparticles(NPs)to recognize homologous cells,exhibiting translational potential in accurate tumor therapy.However,these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts(CDX),ignoring the tumor heterogeneity and differentiation from inter-and intra-individuals and microenvironments between heterotopic-and orthotopic-tumors,limiting the therapeutic efficiency of such nanoplatforms.Herein,various biomimetic nanoplatforms(CCM-modified gold@Carbon,i.e.,Au@C-CCM)were fabricated by coating CCMs of head and neck squamous cell carcinoma(HNSCC)cell lines and patient-derived cells on the surface of Au@C NP.The generated Au@C-CCMs were evaluated on corresponding CDX,tongue orthotopic xenograft(TOX),immunecompetent primary and distant tumor models,and patient-derived xenograft(PDX)models.The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death.The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency,far above those with mismatched CCMs,resulting in distinct tumor ablation and tumor growth inhibition in all four models.This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC,can be further extended to other malignant tumors therapy.

COVID-19 Detection Based on 6-Layered Explainable Customized Convolutional Neural Network

This paper presents a 6-layer customized convolutional neural network model(6L-CNN)to rapidly screen out patients with COVID-19 infection in chest CT images.This model can effectively detect whether the target CT image contains images of pneumonia lesions.In this method,6L-CNN was trained as a binary classifier using the dataset containing CT images of the lung with and without pneumonia as a sample.The results show that the model improves the accuracy of screening out COVID-19 patients.Compared to othermethods,the performance is better.In addition,the method can be extended to other similar clinical conditions.

“New Regulations”born regarding the pilot customized cosmetics

On April 10th,2023,Shanghai Medical Products Administration released a notice on publicly asking for opinions about Rules for the On-site Personalized Service Examination of Ordinary Cosmetics of Shanghai Pudong New Area(Trial)(exposure draft).This notice mainly explained the targeted group,purpose of release,condition of applying for filing,rules which organizations and relevant people should obey,quality administration system of personalized cosmetics.

Comparison of high order aberration after conventional and customized ablation in myopic LASIK in different eyes of the same patient

Purpose: To verify whether there exists any difference in higher order aberrations after undergoing myopic LASIK (laser in situ keratomileusis) with conventional ablation and customized ablation in different eyes of the same patient. Methods: This was a prospective randomized study of 54 myopic eyes (27 patients) that underwent LASIK using the Nidek EC-5000 ex-cimer laser system (Nidek, Gamagori, Japan). Topography-guided customized aspheric treatment zone (CATz) was used in the first eye of the patient (study group) and the other eye of the same patient was operated on with conventional ablation (control group). Higher order aberrations [root-mean-square (RMS) in the 5-mm zone] of both groups were observed with the Nidek OPD-Scan aberrometer before and 3 months after LASIK. Preoperative mean refractive error was similar between two eyes of the same patient (t=?0.577, P>0.05). Results: Preoperatively, higher order aberrations (RMS in the 5-mm zone) in the CATz ablation and conventional groups were (0.3600±0.0341) μm and (0.2680±0.1421) μm, respectively. This difference was not statistically significant (t=1.292, P>0.05). Three months after LASIK, higher order aberrations (RMS in 5-mm zone) in the CATz ablation and conventional groups were (0.3627±0.1510) μm and (0.3991±0.1582) μm, respectively. No statistically significant difference was noted between pre- and postoperative higher order aberrations in the CATz group (t=?0.047, P>0.05). However, a statistically significant increase in higher order aberrations was observed after conventional ablation (t=?5.261, P<0.05). A statistically sig-nificant difference was noted in the increase of higher order aberrations after LASIK between groups (t=?2.050, P=0.045). Con-clusion: LASIK with conventional ablation and topography-guided CATz ablation resulted in the same BSCVA (best specta-cle-corrected visual acuity) 3 month after LASIK. Higher order aberrations were increased, but the increase of higher order ab-errations after customized ablation treatment was less than that after conventional ablation.

Customized reconstructive prosthesis design based on topological optimization to treat severe proximal tibia defect

A novel reconstructive prosthesis was designed with topological optimization(TO)and a lattice structure to enhance biomechanical and biological properties in the proximal tibia.The biomechanical performance was validated through finite element analysis(FEA)and biomechanical tests.The tibia with inhomogeneous material properties was reconstructed according to computed tomography images,and different components were designed to simulate the operation.Minimum compliance TO subject to a volume fraction constraint combined with a graded lattice structure was utilized to redesign the prosthesis.FEA was performed to evaluate the mechanical performances of the tibia and implants after optimization,including stress,micromotion,and strain energy.The results were analyzed by paired-samples t tests,and p<0.05 was considered significant.Biomechanical testing was used to verify the tibial stresses.Compared to the original group(OG),the TO group(TOG)exhibited lower stress on the stem,and the maximum von Mises stresses were 87.2 and 53.1 MPa,respectively,a 39.1%reduction(p<0.05).Conversely,the stress and strain energy on the tibia increased in the TOG.The maximum von Mises stress values were 16.4 MPa in the OG and 22.9 MPa in the TOG with a 39.6%increase(p<0.05),and the maximum SED value was 0.026 MPa in the OG and 0.042 MPa in the TOG,corresponding to an increase of 61.5%(p<0.05).The maximum micromotions in the distal end of the stem were 135μm in the OG and 68μm in the TOG,almost a 50%reduction.The stress curves of the biomechanical test coincided well with the FEA results.The TO approach can effectively reduce the whole weight of the prosthesis and improve the biomechanical environment of the tibia.It could also pave the way for next-generation applications in orthopedics surgery.

Providing Customized Security Based on Network Function Composition and Reconfiguration

Real-time multimedia sharing in Consumer-centric Multimedia Network(CMN) requires usability anywhere, anytime and from any device. However, CMNs are usually located or implemented on application layer, which makes CMNs subjected to their fixed substrate security framework. A fundamental diversifying attribute for the customized security experiences of CMNs is pressing. This paper proposes a programmable network structure which is named Service Processing Chain(SPC) based on network function combination. The SPC is established by the ordinal combination of network functions in substrate switches dynamically, and therefore constructs a special channel for each CMN with required security. The construction and reconfiguration algorithms of SPC are also discussed in this paper. Evaluations and implementation show that above approaches are effective in providing multilevel security with flexibility and expansibility. It is believed that the SPC could provide customized security service and drive participative real-time multimedia sharing for CMNs.

Service Customized Space-Air-Ground Integrated Network for Immersive Media: Architecture, Key Technologies, and Prospects

The space-air-ground integrated network(SAGIN) is regarded as the key approach to realize global coverage in future network and it reaches broad access for various services. Being the new paradigm of service, immersive media(IM) has attracted users’ attention for its virtualization, but it poses challenges to network performance, e.g. bandwidth, rate, latency. However, the SAGIN has limitations in supporting IM services, such as 4 K/8 K video, virtual reality, and interactive games. In this paper, a novel service customized SAGIN architecture for IM applications(SAG-IM) is proposed, which achieves content interactive and real-time communication among terminal users. State-of-the-art research is investigated in detail to facilitate the combination of SAGIN and service customized technology, which provides endto-end differentiated services for users. Besides, the functional components of SAG-IM contain the infrastructure layer, perception layer, intelligence layer, and application layer, reaching the capabilities of intelligent management of the network. Moreover, to provide IM content with ultra-high-definition and high frame rate for the optimal user experience, the promising key technologies on intelligent routing and delivery are discussed. The performance evaluation shows the superiority of SAG-IM in supporting IM service.Finally, the prospects in practical application are high-lighted.

Multi-objective quality control method for cold-rolled products oriented to customized requirements

To deal with the increasing demand for low-volume customization of the mechanical properties of cold-rolled products, a two-way control method based on mechanical property prediction and process parameter optimization(PPO) has become an effective solution. Aiming at the multi-objective quality control problem of a company's cold-rolled products, based on industrial production data, we proposed a process parameter design and optimization method that combined multi-objective quality prediction and PPO. This method used the multi-output support vector regression(MSVR) method to simultaneously predict multiple quality indices. The MSVR prediction model was used as the effect verification model of the PPO results. It performed multi-process parameter collaborative design and realized the optimization of production process parameters for customized multi-objective quality requirements. The experimental results showed that, compared with the traditional single-objective quality prediction model based on support vector regression(SVR), the multi-objective prediction model could better take into account the coupling effect between process parameters and quality index, the MSVR model prediction accuracy was higher than that of the SVR, and the optimized process parameters were more capable and reflected the influence of metallurgical mechanism on the quality index,which were more in line with actual production process requirements.

Application of Customized Navigated Template for Percutaneous Radiofrequency Thermocoagulation Treatment of Primary Trigeminal Neuralgia

Objective: To investigate the successful rate and accuracy of percutaneous radiofrequency thermocoagulation (PRT) for treatment of primary trigeminal neuralgia (PTN) with customized navigated template via three dimensional (3D) printing technique. Methods: 65 patients with PTN were recruited from January 2014 to March 2015 and randomly divided into two groups: template group (n = 28) and traditional group (n = 37). The patients in traditional group received PRT under guidance of C-arm fluoroscopy, while the ones in template group were treated with customized navigated templates. The data of time, depth and accuracy rate of puncture, the average effective dose equivalent of radiation, complications after operation were collected and analyzed. Results: No intra-operative failures occurred in the template group: the pain was alleviated immediately after operation. Accuracy rate of the template group was 100% while 96% was achieved in traditional group. However, the average time of puncture by the template was significantly reduced compared with traditional group (2.37 ± 0.64 minutes and 24.2 ± 6.55 minutes, respectively;P 0.05). No complications were observed in template group while several complications such as blooding, leakage of cerebrospinal fluid and dizziness were observed in traditional group. Conclusion: The application of customized template is advocated for improving the accuracy of PRT.

Customized Foot Orthosis Development by 3D Reconstruction of the CT Images

Clinicians can provide a means to better distribute the pressure around the foot, and can also correct the biomechanics of the foot by using a customized shoe insole. If detected early enough, orthopedic insoles can correct or prevent further complications. In this study the 3 Dimensional (D) model of the foot was used to fabricate a customized orthosis. The Computed Tomography (CT) images of patient’s foot having no muscle weakness and joint restriction were acquired. The gray intensities corresponding to the bones of the foot from the CT images were 3 dimensionally reconstructed. The 3D model of the foot was then imported into the CAD Software. Boolean operations were carried out in between the 3D foot model and a solid rectangular surface to create a customized foot orthosis. The exact contours and shape of the subject’s foot was acquired using the computerized method of fabricating an orthosis. The novel idea described in this study support, automating the process of designing a customized orthosis with the impression got from the 3 dimensionally modeled feet, thereby reducing the modeling time considerably. The simple technique used in this process will help in giving comfort and stability to the patient’s feet while walking.

The college students' response to customized information services based on Library2.0 technologies at universities in Nanjing

Through a questionnaire survey of students’ response from 6 universities in Nanjing, this paper aims to determine their varying degrees of satisfaction about the customized information service based on Library2.0 technologies. In so doing, the authors carefully examined the data collected from the returned questionnaires about such key issues as the students’ perceptions about the customized information service via a Library2.0platform, self-initiated use experience of such a mechanism, their achieved information searching results vis-à-vis their expectations, etc. In addition, the authors also made a comparative study between information providers(i.e. librarians) and information consumers(i.e. students) at Chinese and American academic libraries.

Construction of Customized Bio Incubator and Designing of Tailored Scaffolds for Bone Tissue Engineering from Laboratory Scale Up to Clinical Scale

In order to obtain larger,clinical-scale and practical-scale bone grafts,we have designed both tailored scaffolds and tailored bio incubator with optimal bio-production characteristics.Using DIC files to Simpleware Scan-IP(Simple-ware-exeter United Kingdom),we have digitally reconstructed segmental additive bone-tissue in order to perform images processing.Both hydroxyapatite and tannin composites have been used in order to get the final bone modules combined for retexturing of segmental bone defect.We have found that sectioning of bone segment deficiency reorganizations into well disk-shaped design permits one to standardize the cell culture and seeding protocol,to get better products.The present study concludes that some techniques with cultured cell in segmental bone grafts in the laboratory can be transferred and clinically used.

Clinical Application of CAD/CAM Customized Zirconia Abutment in Maxillary Anterior Region

[Objectives]To explore the difference between the CAD/CAM customized zirconia abutment and the finished titanium abutment in the maxillary anterior region.[Methods]A total of 60 implants were selected from 60 patients who had undergone maxillary single anterior implant implantation in the Department of Oral and Maxillofacial Surgery,Affiliated Hospital of Qingdao University from July 2017 to July 2018.They were randomly divided into an observation group and a control group(30 patients/group).The observation group used CAD/CAM customized zirconia abutment and all-ceramic crown,while the control group used finished titanium abutment and all-ceramic crown.Twelve months after the crown restoration,mechanical complications,pink esthetic(another spelling of aesthetic)score(PES)and white esthetic score(WES),and patient satisfaction were used as clinical observation indicators to evaluate the restoration effect.[Results]For 12 months after crown restoration,the implant survival rate of the two groups of patients was 100%,and there was no abutment breakage,loosening,falling off,or screw loosening and breakage.The PES and WES of the observation group were significantly higher than those of the control group(P<0.05).The patient satisfaction of the observation group was significantly higher than those of the control group(P<0.05).[Conclusions]CAD/CAM customized zirconia abutment implant restoration in the maxillary anterior region can obtain good esthetic restoration effect in a short term,and has good clinical application effect.

Influence of Customized Demand Generation as a Strategy to Increase Uptake of Voluntary Counseling and Testing Services amongst Sex Workers in Mumbai and Thane

Background: To demonstrate that customized demand generation leads to increased voluntary HIV counseling and testing (VCT) among Sex Workers (SWs). Methods: FHI 360 Aastha implemented Vivek intervention among SWs in Mumbai and Thane, India using customized demand generation through outreach services for VCT. Program monitoring data and integrated counseling and testing center tracking sheets were used to assess the intervention effect. Results: Higher proportion of registered SWs tested during: 1) Vivek months than other months (17% vs. 5%, p < 0.001);2) Post-initiation non-Vivek months than pre-Vivek months (4.7%, vs. 1.5% p < 0.001). Conclusions: Customized demand generation approach is successful in increasing HIV testing.

Developing Customized Evaluation Software for Clinical Trials: An Example with Obstructive Lung Diseases

Corresponding customized software tool is usually unavailable, which increases the time and workload for evaluating the results of a clinical trial. In the present paper, we demonstrate the development process of a customized software for one clinical trial on patients with obstructive lung disease. Over hundred patients and volunteers as controlled were included in the clinical trial. They were examined by spirometry and EIT in a seated position during spontaneous tidal breathing. Subsequently, standard vital capacity maneuver and forced full expiration maneuver were performed. In order to evaluate the offline data, a customized software was developed. The requirements of the software were defined by investigators. The software was then tested on patients’ data and refined based on feedbacks of the investigators. We finalized the customized software with analysis of various disease-specific parameters and indices. Compared to the data process with device specific programs and other commercial software, the customized software is more flexible, user-friendly and extendable. As conclusion, customized software simplifies the evaluation process distinctly and helps physicians to focus on study design and result interpretation.

State Estimation over Customized Wireless Network

In this paper the state estimation techniques are investigated over customized wireless network for a continuous-time plant. It is assumed that the plant is connected to the controller over the proposed network. The feedback control over wireless networks includes limited bandwidth, time-varying and unknown delays with a high probability of data loss. Reasonably, some of these issues are deduced from the wireless networks structures. In order to deal with these problems the customized wireless network architecture is proposed for this Wireless Networked Control System (WNCS) and the problem of transmission delays and packet losses which induced by this scheme is studied. The time-varying delays of the TCP based shared network is estimated by fuzzy state estimation technique. Thereafter the kalman filtering is applied to address the problem of optimal filtering for this continuous-time plant with time-varying delays. The re-organized innovation analysis approach is applied to tackle the network induced time-varying delays. The simulation results show the applicability of the proposed approach.

DESIGN ATTRIBUTES OPTIMIZATION MODEL FOR CUSTOMIZED PRODUCT AND ITS APPLICATION

By formulating the design of customized product as a multi-objectiveoptimization problem, a method for designing customized product according to the relative importanceof customer needs is proposed. This method searches for the optimal design that maximizes customersatisfaction by establishing mapping from design attributes to the degree of customer satisfactionon-each customer need. A window product is taken as an example for case study. The result indicatesthat this method is feasible.