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Three-dimensional (3D) printing is highly dependent on printing process parameters for achieving high mechanical strength. It is a time-consuming and expensive operation to experiment with different printing settings. The current study aims to propose a regression-based machine learning model to predict the mechanical behavior of ulna bone plates.

The bone plates were formed using fused deposition modeling (FDM) technique, with printing attributes being varied. The machine learning models such as linear regression, AdaBoost regression, gradient boosting regression (GBR), random forest, decision trees and k-nearest neighbors were trained for predicting tensile strength and flexural strength. Model performance was assessed using root mean square error (RMSE), coefficient of determination (R²) and mean absolute error (MAE).

Traditional experimentation with various settings is both time-consuming and expensive, emphasizing the need for alternative approaches. Among the models tested, GBR model demonstrated the best performance in predicting both tensile and flexural strength and achieved the lowest RMSE, highest R2 and lowest MAE, which are 1.4778 ± 0.4336 MPa, 0.9213 ± 0.0589 and 1.2555 ± 0.3799 MPa, respectively, and 3.0337 ± 0.3725 MPa, 0.9269 ± 0.0293 and 2.3815 ± 0.2915 MPa, respectively. The findings open up opportunities for doctors and surgeons to use GBR as a reliable tool for fabricating patient-specific bone plates, without the need for extensive trial experiments.

The current study is limited to the usage of a few models. Other machine learning-based models can be used for prediction-based study.

This study uses machine learning to predict the mechanical properties of FDM-based distal ulna bone plate, replacing traditional design of experiments methods with machine learning to streamline the production of orthopedic implants. It helps medical professionals, such as physicians and surgeons, make informed decisions when fabricating customized bone plates for their patients while reducing the need for time-consuming experimentation, thereby addressing a common limitation of 3D printing medical implants.

This study intends to improve the quality of venous thromboembolism (VTE) prophylaxis practices including proper VTE risk assessment and the appropriate prophylaxis measures for surgical urology patients.

The authors applied the Six-Sigma define, measure, analyze, improve and control (DMAIC) improvement methodology in a pre–post interventional study that involved all adult patients above 18 years old indicated and scheduled for urology surgical interventions including endoscopic urological surgeries in a urology specialized 60-bed hospital. The pre-intervention sample included all patients meeting the inclusion criteria over a period of six months. Post-intervention sample included all patients meeting the inclusion criteria over a period of six months. The improvement areas included both the VTE risk assessment as well as the VTE prophylaxis prescription.

DMAIC methodology has achieved a substantial sustained improvement in surgical urology VTE prophylaxis practices with an average of 70% on both levels; VTE risk assessment practices and VTE prophylaxis prescribing practices were statistically significant. The post-intervention results also showed a statistically controlled process with no special cause variations. Based on the study results, the Six-Sigma DMAIC methodology can be considered of high value when applied in healthcare clinical practice improvement projects.

The project study includes some pitfalls that can be addressed as follows: 1. The lack of VTE rate incidence tracking. This limitation can be partly refuted when the authors conduct a literature review and explore that the VTE prophylaxis effectiveness had been proven with sufficient evidence to an extent that pushed several scientific societies to develop their own guidelines to support VTE prophylaxis. (Algattas et al., 2018). 2. Another limitation of this study can be that it handled only surgical patients and more specifically surgical urology patients. Of course, VTE prophylaxis is a crucial life-threatening problem not only for the surgical admitted patients but also for all the medical admitted patients either in hospital wards or ICUs. However, the prediction that surgical patients especially surgical urology patients are more prone to VTE development risk as they have -in several cases-two or three main additive risk factors which are age, procedure duration and malignancy in elderly men. (Tikkinen et al., 2014). So, the authors consider the study project to be a prototype that hopefully can be utilized for future study projects that will manage both other surgical specialty patients and medical patients on the national level and can track accurately and effectively report the VTE incidence rates.

Several recommendations can be extracted from the research project that is summarized in the following points: Paying focused attention to continuous healthcare quality improvement initiatives and projects as a main approach for healthcare improvement especially for the public health-related problems. This might be achieved through periodic region-specific or specialty-specific focus groups from which public health problems could be addressed and prioritized to be considered as a part of country healthcare campaigns regarding cost-utility and feasibility studies. The adoption of a system thinking approach in dealing with the improvement strategies; all efforts and resources are to be employed to achieve a common objective. This includes the generation of a national-wide electronic health information system that can aid in healthcare resource allocation and direct the healthcare efforts towards the most important, high-priority public health problems. Electronic national-wide health record is really an effort, and resources consuming activity, but actually, it's worth exerting efforts, and its valuable outcomes may be seen several years later. 3. Development of unified national specialized VTE prophylaxis pathways to standardize the patient-specific VTE prophylaxis plans. Standardization of healthcare pathways enables healthcare professionals to follow an evidence-based practice which will be reflected on the improvement of healthcare quality level, cost-effectiveness enhancement, and timely patient care on all levels especially in high critical areas like ER and ICU. 4. Incorporation of VTE prophylaxis costs in the universal health insurance diagnosis-related group (DRG) insurance packages and service pricing. Universal health insurance is a nationwide strategy that is aiming to cover all Egypt residents by the year 2030. Universal health insurance is being following the DRG reimbursement policy that is thought to control all the healthcare-associated costs so, the VTE prophylaxis costs shall be added as the main cost item to encourage all healthcare facilities to follow an evidence-based VTE prophylaxis pathway taking into consideration the high-risk patient categories who will definitely represent a high-cost burden on the long run if they suffer a VTE event.

DMAIC improvement methodology applications in healthcare are still relatively limited, especially on the clinical level. The study can be considered one of a kind in Egypt dealing with a comprehensive DMAIC methodology application on the clinical level.

The development of new advanced materials, such as photopolymerizable resins for use in stereolithography (SLA) and Ti6Al4V manufacture via selective laser melting (SLM) processes, have gained significant attention in recent years. Their accuracy, multi-material capability and application in novel fields, such as implantology, biomedical, aviation and energy industries, underscore the growing importance of these materials. The purpose of this study is oriented toward the application of new advanced materials in stent manufacturing realized by 3D printing technologies.

The methodology for designing personalized medical devices, implies computed tomography (CT) or magnetic resonance (MR) techniques. By realizing segmentation, reverse engineering and deriving a 3D model of a blood vessel, a subsequent stent design is achieved. The tessellation process and 3D printing methods can then be used to produce these parts. In this context, the SLA technology, in close correlation with the new types of developed resins, has brought significant evolution, as demonstrated through the analyses that are realized in the research presented in this study. This study undertakes a comprehensive approach, establishing experimentally the characteristics of two new types of photopolymerizable resins (both undoped and doped with micro-ceramic powders), remarking their great accuracy for 3D modeling in die-casting techniques, especially in the production process of customized stents.

A series of analyses were conducted, including scanning electron microscopy, energy-dispersive X-ray spectroscopy, mapping and roughness tests. Additionally, the structural integrity and molecular bonding of these resins were assessed by Fourier-transform infrared spectroscopy–attenuated total reflectance analysis. The research also explored the possibilities of using metallic alloys for producing the stents, comparing the direct manufacturing methods of stents’ struts by SLM technology using Ti6Al4V with stent models made from photopolymerizable resins using SLA. Furthermore, computer-aided engineering (CAE) simulations for two different stent struts were carried out, providing insights into the potential of using these materials and methods for realizing the production of stents.

This study covers advancements in materials and additive manufacturing methods but also approaches the use of CAE analysis, introducing in this way novel elements to the domain of customized stent manufacturing. The emerging applications of these resins, along with metallic alloys and 3D printing technologies, have brought significant contributions to the biomedical domain, as emphasized in this study. This study concludes by highlighting the current challenges and future research directions in the use of photopolymerizable resins and biocompatible metallic alloys, while also emphasizing the integration of artificial intelligence in the design process of customized stents by taking into consideration the 3D printing technologies that are used for producing these stents.

The purpose of this study is to describe the design and validation of a three-dimensional (3D)-printed phantom of a uterus to support the development of uterine balloon tamponade devices conceived to stop post-partum haemorrhages (PPHs).

The phantom 3D model is generated by analysing the main requirements for validating uterine balloon tamponade devices. A modular approach is implemented to guarantee that the phantom allows testing these devices under multiple working conditions. Once finalised the design, the phantom effectiveness is validated experimentally.

The modular phantom allows performing the required measurements for testing the performance of devices designed to stop PPH.

PPH is the leading obstetric cause of maternal death worldwide, mainly in low- and middle-income countries. The proposed phantom could speed up and optimise the design and validation of devices for PPH treatment, reducing the maternal mortality ratio.

To the best of the authors’ knowledge, the 3D-printed phantom represents the first example of a modular, flexible and transparent uterus model. It can be used to validate and perform usability tests of medical devices.

Left atrial appendage occlusion (LAAO) is a structural interventional cardiology procedure that offers several possibilities for the application of additive manufacturing technologies. The literature shows a growing interest in the use of 3D-printed models for LAAO procedure planning and occlusion device choice. This study aims to describe a full workflow to create a 3D-printed LAA model for LAAO procedure planning.

The workflow starts with the patient’s computed tomography diagnostic image selection. Segmentation in a commercial software provides initial geometrical models in standard tessellation language (STL) format that are then preprocessed for print in dedicated software. Models are printed using a commercial stereolithography machine and postprocessing is performed.

Models produced with the described workflow have been used at the Careggi Hospital of Florence as LAAO auxiliary planning tool in 10 cases of interest, demonstrating a good correlation with state-of-the-art software for device selection and improving the surgeon’s understanding of patient anatomy and device positioning.

3D-printed models for the LAAO planning are already described in the literature. The novelty of the article lies in the detailed description of a robust workflow for the creation of these models. The robustness of the method is demonstrated by the coherent results obtained for the 10 different cases studied.

Polymethyl methacrylate (PMMA) is a remarkable biocompatible material for bone cement and regeneration. It is also considered 3D printable but requires in-depth process–structure–properties studies. This study aims to elucidate the mechanistic effects of processing parameters and sterilization on PMMA-based implants.

The approach comprised manufacturing samples with different raster angle orientations to capitalize on the influence of the filament alignment with the loading direction. One sample set was sterilized using an autoclave, while another was kept as a reference. The samples underwent a comprehensive characterization regimen of mechanical tension, compression and flexural testing. Thermal and microscale mechanical properties were also analyzed to explore the extent of the appreciated modifications as a function of processing conditions.

Thermal and microscale mechanical properties remained almost unaltered, whereas the mesoscale mechanical behavior varied from the as-printed to the after-autoclaving specimens. Although the mechanical behavior reported a pronounced dependence on the printing orientation, sterilization had minimal effects on the properties of 3D printed PMMA structures. Nonetheless, notable changes in appearance were attributed, and heat reversed as a response to thermally driven conformational rearrangements of the molecules.

This research further deepens the viability of 3D printed PMMA for biomedical applications, contributing to the overall comprehension of the polymer and the thermal processes associated with its implementation in biomedical applications, including personalized implants.

Biofeedback is used for regulating vestibular adaptation and balance by providing real-time stimulus to the individual during physical activities. This study aimed at (1) developing a wearable device, which tracks balance, counts the number and the direction of balance losses and provides haptic biofeedback through real-time vibration stimulus (2) investigating device efficacy on an adolescent medulloblastoma patient during static and dynamic tasks.

A 16-year-old medulloblastoma patient used the device during 10-m walking and single-leg stance tests. The knee joint kinematics and the number and direction of balance losses were recorded for “with” and “without” biofeedback conditions.

The device helped regulate the knee joint kinematics and reduce the number of balance losses of the medulloblastoma patient. The knee joint movement pattern similarity of the control subject was highly correlated (R² = 0.997, RMSE = 1.232). Conversely, medulloblastoma patient knee joint movement pattern similarity was relatively weak (R² = 0.359, RMSE = 18.6) when “with” and “without” biofeedback conditions were compared. The number of balance losses decreased when the medulloblastoma patient was guided with biofeedback.

The major limitation of this pilot study is the lack of a large and homogeneous number of participants. The medulloblastoma patient used the device while walking after she was given enough time to get used to the tactile biological feedback, so the long-term effect of the device and biofeedback guidance were not investigated. Additionally, the potential desensitization with prolonged use of the device was not evaluated.

Biofeedback reduced the number of balance losses; additionally, the knee joint movement pattern was regulated during static and dynamic tasks. This device can be integrated into the physical therapy of patients with balance, vestibular and postural control impairments.

This is compact and has an easy-to-wear design, patients, who have balance and postural control impairments, can practically use the device during their activities of daily living.

The device promotes physical activity adaptation and regulates gait through continuous and real-time balance control. Its design makes it simple for the user to wear it beneath clothing while using the sensor.

This paper aims to explore the antecedents and consequences of service chain flexibility (SCF) in healthcare service delivery.

A structural model was developed based on a literature review. A 29-indicator questionnaire was circulated among service providers in the healthcare system across India, and 253 valid responses were received, corresponding to a response rate of 46%. The research model was assessed using a cross-sectional research design, and the data were analyzed by structural equation modeling using analysis of moment structures (AMOS) software.

Service orientation (SO), technology integration (TI), knowledge sharing (KS) and supply chain integration (SCI) were identified as antecedents of SCF, the consequence of which is responsiveness in service delivery (RSD). Furthermore, patient-centered care moderates the relationship between SCF and RSD.

This paper highlights the impact of SCF on RSD in healthcare organizations. Consideration of the four constructs of SO, TI, KS and SCI as antecedents of SCF and, in turn, RSD may be one of the limitations. Future work may identify other theoretical constructs with potential impacts on SCF and RSD. Furthermore, eight months for data collection could have resulted in early-late response bias. This study was operationalized in India and may reflect political, economic, social, technological, environmental and legal factors unique to India.

The study provides suggestions to practitioners for building RSD by leveraging SO, TI, KS and SCI in flexibility-driven service chain processes. Recognizing the relationships among these constructs can aid in the timely formulation of corrective actions and patient-centric policies.

This paper highlights how focusing on a SCF can promote RSD. This understanding may aid the design of processes that develop patient-centricity and deliver health as a social good in an effective manner.

The empirical evidence from this study can help hospitals integrate and build flexibility in their functions, thus enabling them to deliver responsiveness in care.

This paper aims to prompt ideas amongst readers (especially librarians) about how they can become active partners in knowledge dissemination amongst concerned user groups by implementing 3D printing technology under the “Makerspace.”

The paper provides a brief account of various tools and techniques used by veterinary and animal sciences institutions for information dissemination amongst the stakeholders and associated challenges with a focus on the use of 3D printing technology to overcome the bottlenecks. An overview of the 3D printing technology has been provided following the instances of use of this novel technology in veterinary and animal sciences. An initiative of the University Library, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, to harness the potential of this technology in disseminating information amongst livestock stakeholders has been discussed.

3D printing has the potential to enhance learning in veterinary and animal sciences by providing hands-on exposure to various anatomical structures, such as bones, organs and blood vessels, without the need for a cadaver. This approach enhances students’ spatial understanding and helps them better understand anatomical concepts. Libraries can enhance their visibility and can contribute actively to knowledge dissemination beyond traditional library services.

The ideas about how to harness the potential of 3D printing in knowledge dissemination amongst livestock sector stakeholders have been elaborated. This promotes creativity amongst librarians enabling them to think how they can engage in knowledge dissemination thinking out of the box.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.