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Background Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Methods Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. Results 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. Conclusion 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost–effectiveness analysis.

Purpose To evaluate the thermal profiles of the holmium laser at different laser parameters at different locations in an in vitro anatomic pelvicalyceal collecting system (PCS) model. Laser lithotripsy is the cornerstone of treatment for urolithiasis. With the prevalence of high-powered lasers, stone ablation efficiency has become more pronounced. Patient safety remains paramount during surgery. It is well recognized that the heat generated from laser lithotripsy has the potential to cause thermal tissue damage. Methods Utilizing high-fidelity, 3D printed hydrogel models of a PCS with a synthetic BegoStone implanted in the renal pelvis, laser lithotripsy was performed with the Moses 2.0 holmium laser. At a standard power (40 W) and irrigation pressure (100 cm H 2 O), we evaluated operator duty cycle (ODC) variations with different time-on intervals at four different laser settings. Temperature was measured at two separate locations—at the stone and away from the stone. Results Temperatures were highest closest to the laser tip with a decrease away from the laser. Fluid temperatures increased with longer laser-on times and higher ODCs. Thermal doses were greater with increased ODCs and the threshold for thermal injury was reached for ODCs of 75% and 100%. Conclusion Temperature generation and thermal dose delivered are greatest closer to the tip of the laser fiber and are not dependent on power alone. Significant temperature differences were noted between four laser settings at a standardized power (40 W). Temperatures can be influenced by a variety of factors, such as laser-on time, operator duty cycle, and location in the PCS.

Background Traditional anatomy education relies on lectures, visual aids, and cadaver dissections. However, limited cadaver availability often necessitates the use of plastic models to aid 3D understanding. Virtual reality (VR) presents an immersive alternative that may enhance spatial learning without requiring cadavers. Despite its potential, few studies have directly compared VR with traditional methods in anatomy education. Objective This study aimed to compare the learning outcomes of first-year anatomy students using either VR or plastic 3D models for anatomical instruction. Methods First-year anatomy students were divided into two groups: one using VR and the other using plastic models. They participated in weekly anatomy sessions consisting of 2-hour lectures followed by 2-hour laboratory sessions covering various anatomical systems. After the lectures, students engaged in laboratory activities using either plastic models or immersive virtual reality (iVR) for 3D spatial anatomy learning, with iVR participants capturing screenshots of assigned targets for verification. Each session concluded with an online image-based multiple-choice quiz to assess anatomical identification and understanding. Results Students from the Department of Nutrition and Health Sciences (NHS) and the Department of Medical Laboratory Science and Biotechnology (MLSB) at Taipei Medical University (TMU) participated in the study. Students in the VR group initially struggled due to the time required to adapt to the system, which was reflected in their significantly lower scores in week 2 for both NHS (80.35 ± 2.04 vs. 88.82 ± 1.64, p  < 0.0019) and MLSB (72.23 ± 1.81 vs. 88.55 ± 1.67, p  < 0.0001). However, in subsequent weeks, while iVR scores were slightly lower, the differences were not statistically significant, and by the later weeks, there was no significant difference in quiz performance between the two groups, with comparable scores observed in weeks 8 and 10 for NHS. Conclusions VR provides a viable alternative to plastic models for anatomy education. Although students require an adaptation period, their performance eventually matches that of students using traditional plastic models. This study is the first to quantitatively compare VR and plastic models in anatomy instruction.

Background Terrible triad of the elbow (TTE) is a complex dislocation associating radial head (RH) and coronoid process (CP) fractures. There is at present no reproducible anatomic model for TTE, and pathophysiology is unclear. The main aim of the present study was to create and validate an anatomic model of TTE. Secondary objectives were to assess breaking forces and relative forearm rotation with respect to the humerus before dislocation. Methods An experimental comparative study was conducted on 5 fresh human specimens aged 87.4 ± 8.6 years, testing 10 upper limbs. After dissection conserving the medial and lateral ligaments, interosseous membrane and joint capsule, elbows were reproducibly positioned in maximal pronation and 15° flexion, for axial compression on a rapid (100 mm/min) or slow (10 mm/min) protocol, applied by randomization between the two elbows of a given cadaver, measuring breaking forces and relative forearm rotation with respect to the humerus before dislocation. Results The rapid protocol reproduced 4 posterolateral and 1 divergent anteroposterior TTE, and the slow protocol 5 posterolateral TTE. Mean breaking forces were 3,126 ± 1,066 N for the lateral collateral ligament (LCL), 3,026 ± 1,308 N for the RH and 2,613 ± 1,120 N for the CP. Comparing mean breaking forces for all injured structures in a given elbow on the rapid protocol found a p-value of 0.033. Comparison of difference in breaking forces in the three structures (LCL, RH and CP) between the slow and rapid protocols found a mean difference of -4%. Mean relative forearm rotation with respect to the humerus before dislocation was 1.6 ± 1.2° in external rotation. Conclusions We create and validate an anatomic model of TTE by exerting axial compression on an elbow in 15° flexion and maximal pronation at speeds of 100 and 10 mm/min.

Purpose Intranasal deposition of aerosols is often studied using in vitro nasal cavity models. However, the relevance of these models to predict in vivo human deposition has not been validated. This study compared in vivo nasal aerosol deposition and in vitro deposition in a human plastinated head model (NC1) and its replica constructed from CT-scan (NC2). Methods Two nebulizers (Atomisor Sonique® and Easynose®) were used to administer a 5.6 μm aerosol of 99m Tc-DTPA to seven healthy volunteers and to the nasal models. Aerosol deposition was quantified by γ -scintigraphy in the nasal, upper nasal cavity and maxillary sinus (MS) regions. The distribution of aerosol deposition was determined along three nasal cavity axes (x, y and z). Results There was no significant difference regarding aerosol deposition between the volunteers and NC1. Aerosol deposition was significantly lower in NC2 than in volunteers regarding nasal region ( p  < 0.05) but was similar for the upper nasal cavity and MS regions. Mean aerosol distribution for NC1 came within the standard deviation (SD) of in vivo distribution, whereas that of NC2 was outside the in vivo SD for x and y axes. Conclusions In conclusion, nasal models can be used to predict aerosol deposition produced by nebulizers, but their performance depends on their design.

Background Evidence suggests that Mental Practice (MP) could be used to finesse surgical skills. However, MP is cognitively demanding and may be dependent on the ability of individuals to produce mental images. In this study, we hypothesised that the provision of interactive 3D visual aids during MP could facilitate surgical skill performance. Methods 20 surgical trainees were case-matched to one of three different preparation methods prior to performing a simulated Laparoscopic Cholecystectomy (LC). Two intervention groups underwent a 25-minute MP session; one with interactive 3D visual aids depicting the relevant surgical anatomy (3D-MP group, n = 5) and one without (MP-Only, n = 5). A control group (n = 10) watched a didactic video of a real LC. Scores relating to technical performance and safety were recorded by a surgical simulator. Results The Control group took longer to complete the procedure relative to the 3D&MP condition (p = .002). The number of movements was also statistically different across groups (p = .001), with the 3D&MP group making fewer movements relative to controls (p = .001). Likewise, the control group moved further in comparison to the 3D&MP condition and the MP-Only condition ( p  = .004). No reliable differences were observed for safety metrics. Conclusion These data provide evidence for the potential value of MP in improving performance. Furthermore, they suggest that 3D interactive visual aids during MP could potentially enhance performance, beyond the benefits of MP alone. These findings pave the way for future RCTs on surgical preparation and performance.

The Human Connectome Project consortium led by Washington University, University of Minnesota, and Oxford University is undertaking a systematic effort to map macroscopic human brain circuits and their relationship to behavior in a large population of healthy adults. This overview article focuses on progress made during the first half of the 5-year project in refining the methods for data acquisition and analysis. Preliminary analyses based on a finalized set of acquisition and preprocessing protocols demonstrate the exceptionally high quality of the data from each modality. The first quarterly release of imaging and behavioral data via the ConnectomeDB database demonstrates the commitment to making HCP datasets freely accessible. Altogether, the progress to date provides grounds for optimism that the HCP datasets and associated methods and software will become increasingly valuable resources for characterizing human brain connectivity and function, their relationship to behavior, and their heritability and genetic underpinnings. •The Human Connectome Project (HCP) will study brain connectivity in healthy adults.•Data acquisition: multiple imaging modalities, plus behavioral, and genetic data.•Imaging modalities: diffusion MRI, resting-fMRI, task-fMRI, and MEG/EEG.•Extensive refinement and optimization efforts are currently underway.•Data will be made freely available and will enable flexible data mining.

Collagen is the primary component of the extracellular matrix in the human body. It has proved challenging to fabricate collagen scaffolds capable of replicating the structure and function of tissues and organs.We present a method to 3D-bioprint collagen using freeform reversible embedding of suspended hydrogels (FRESH) to engineer components of the human heart at various scales, from capillaries to the full organ. Control of pH-driven gelation provides 20-micrometer filament resolution, a porous microstructure that enables rapid cellular infiltration and microvascularization, and mechanical strength for fabrication and perfusion of multiscale vasculature and tri-leaflet valves. We found that FRESH 3D-bioprinted hearts accurately reproduce patient-specific anatomical structure as determined by micro–computed tomography. Cardiac ventricles printed with human cardiomyocytes showed synchronized contractions, directional action potential propagation, and wall thickening up to 14% during peak systole.

Understanding the amazingly complex human cerebral cortex requires a map (or parcellation) of its major subdivisions, known as cortical areas. Making an accurate areal map has been a century-old objective in neuroscience. Using multi-modal magnetic resonance images from the Human Connectome Project (HCP) and an objective semi-automated neuroanatomical approach, we delineated 180 areas per hemisphere bounded by sharp changes in cortical architecture, function, connectivity, and/or topography in a precisely aligned group average of 210 healthy young adults. We characterized 97 new areas and 83 areas previously reported using post-mortem microscopy or other specialized study-specific approaches. To enable automated delineation and identification of these areas in new HCP subjects and in future studies, we trained a machine-learning classifier to recognize the multi-modal ‘fingerprint’ of each cortical area. This classifier detected the presence of 96.6% of the cortical areas in new subjects, replicated the group parcellation, and could correctly locate areas in individuals with atypical parcellations. The freely available parcellation and classifier will enable substantially improved neuroanatomical precision for studies of the structural and functional organization of human cerebral cortex and its variation across individuals and in development, aging, and disease. A detailed parcellation (map) of the human cerebral cortex has been obtained by integrating multi-modal imaging data, including functional magnetic resonance imaging (fMRI), and the resulting freely available resources will enable detailed comparative studies of the human brain in health, ageing and disease. A modern map of the brain For more than a century, neuroscientists have sought to subdivide the human cerebral cortex into a patchwork of anatomically and functionally distinct areas. Until now such maps have relied largely on only a single property such as micro-architecture or functional imaging, have been based on a relatively small number of individuals, and have usually been blurry due to misalignment of brain areas from person to person. Matthew Glasser, David Van Essen and colleagues have tackled these deficiencies in a new more 'universal' map of the human cerebral cortex by integrating multi-modal imaging data obtained from 210 healthy subjects and validated on 210 other individuals. The authors propose a total of 180 areas per cerebral hemisphere (97 of them previously unknown) and apply a machine-learning classifier to automatically identify these areas in new subjects, even in individuals with atypical parcellations. This freely available resource will enhance the anatomical accuracy and interpretability of future structural and functional studies of the human brain in health and disease.

Transformative technologies are enabling the construction of three-dimensional maps of tissues with unprecedented spatial and molecular resolution. Over the next seven years, the NIH Common Fund Human Biomolecular Atlas Program (HuBMAP) intends to develop a widely accessible framework for comprehensively mapping the human body at single-cell resolution by supporting technology development, data acquisition, and detailed spatial mapping. HuBMAP will integrate its efforts with other funding agencies, programs, consortia, and the biomedical research community at large towards the shared vision of a comprehensive, accessible three-dimensional molecular and cellular atlas of the human body, in health and under various disease conditions. HuBMAP supports technology development, data acquisition, and spatial analyses to generate comprehensive molecular and cellular three-dimensional tissue maps.