In hip arthroplasty, preoperative planning is fundamental to reaching a successful surgery. Nowadays, several software tools for computed tomography (CT) image processing are available. However, research studies comparing segmentation tools for hip surgery planning for patients affected by osteoarthritic diseases or osteoporotic fractures are still lacking. The present work compares three different software from the geometric, dimensional, and usability perspectives to identify the best three-dimensional (3D) modelling tool for the reconstruction of pathological femoral heads. Syngo.via Frontier (by Siemens Healthcare) is a medical image reading and post-processing software that allows low-skilled operators to produce prototypes. Materialise (by Mimics) is a commercial medical modelling software. 3D Slicer (by slicer.org) is an open-source development platform used in medical and biomedical fields. The 3D models reconstructed starting from the in vivo CT images of the pathological femoral head are compared with the geometries obtained from the laser scan of the in vitro bony specimens. The results show that Mimics and 3D Slicer are better for dimensional and geometric accuracy in the 3D reconstruction, while syngo.via Frontier is the easiest to use in the hospital setting.

In the era of the fourth industrial revolution, human has still a central role. Manufacturing industries have to deal with human sustainability in order to guarantee workers’ health and well-being. Several studies have proved the importance of ergonomics in workplace design and the benefits related to the adoption of the human-centered approach. The enabling technologies of Industry 4.0 are changing the role of the operator and can support him from a physical and cognitive point of view. On the other hand, companies are increasingly implementing lean philosophies, such as World Class Manufacturing, to maintain their competitiveness by reducing wastes and costs. However, the need arises for a comprehensive methodology to support the design of manufacturing equipment considering human factors by integrating Industry 4.0 technologies and World Class Manufacturing elements. It aims at improving both ergonomic and efficiency aspects of the workstation. The proposed methodology allows identifying and in-depth analyzing the problem, thus finding and implementing a solution that complies with all the requirements and constraints defined. Each step of the methodology can be strengthened by Industry 4.0 technologies. The methodology has been experimented in a real case study with a global company of agriculture and industrial vehicles, leading to the design and implementation of a new equipment. Relevant benefits in terms of ergonomics, efficiency, and process standardization have been achieved.

The scientific literature highlights how Mixed Reality (MR) simulations allow obtaining several benefits in healthcare education. Simulation-based training, boosted by MR, offers an exciting and immersive learning experience that helps health professionals to acquire knowledge and skills, without exposing patients to unnecessary risks. High engagement, informational overload, and unfamiliarity with virtual elements could expose students to cognitive overload and acute stress. The implementation of effective simulation design strategies able to preserve the psychological safety of learners and the investigation of the impacts and effects of simulations are two open challenges to be faced. In this context, the present study proposes a method to design a medical simulation and evaluate its effectiveness, with the final aim to achieve the learning outcomes and do not compromise the students' psychological safety. The method has been applied in the design and development of an MR application to simulate the rachicentesis procedure for diagnostic purposes in adults. The MR application has been tested by involving twenty students of the 6^th year of Medicine and Surgery of Università Politecnica delle Marche. Multiple measurement techniques such as self-report, physiological indices, and observer ratings of performance, cognitive and emotional states of learners have been implemented to improve the rigour of the study. Also, a user-experience analysis has been accomplished to discriminate between two different devices: Vox Gear Plus® and Microsoft Hololens®. To compare the results with a reference, students performed the simulation also without using the MR application. The use of MR resulted in increased stress measured by physiological parameters without a high increase in perceived workload. It satisfies the objective to enhance the realism of the simulation without generating cognitive overload, which favours productive learning. The user experience (UX) has found greater benefits in involvement, immersion, and realism; however, it has emphasized the technological limitations of devices such as obstruction, loss of depth (Vox Gear Plus), and narrow FOV (Microsoft Hololens).

The human-centered design (HCD) approach places humans at the center of design in order to improve both products and processes, and to give users an effective, efficient and satisfying interactive experience. In industrial design and engineering, HCD is very useful in helping to achieve the novel Industry 5.0 concept, based on improving workers’ wellbeing by providing prosperity beyond jobs and growth, while respecting the production limits of the planet as recently promoted by the European Commission. In this context, the paper proposes an ergonomic assessment method based on the analysis of the workers’ workload to support the design of industrial products and processes. This allows the simultaneous analysis of the physical and cognitive workload of operators while performing their tasks during their shift. The method uses a minimum set of non-invasive wearable devices to monitor human activity and physiological parameters, in addition to questionnaires for subjective self-assessment. The method has been preliminarily tested on a real industrial case in order to demonstrate how it can help companies to support the design of optimized products and processes promoting the workers’ wellbeing.

Craniomaxillofacial surgeries are performed using custom-made physical cutting guides and resin dental splints that present several drawbacks (e.g. time and cost required for their design and production). The literature commonly provides augmented/mixed reality (AR/MR) solutions for assisting maxillofacial osteotomies and repositioning without any interactive guide. This work proposes a new MR application, useful for osteotomy and repositioning, providing interactive, fast, and intuitive feedback to the surgeon, who is then supported in performing the bone fragment resection and replacement frame by frame. The proposed application speeds up the surgery and reduces under/overshooting errors. Moreover, the idea of integrating osteotomy and repositioning assistance in the same MR application is rarely found in the literature. It is an entirely novel approach to craniomaxillofacial surgery. The MR application has been designed with a three-button menu. The “App Start” calibrates the app, the “Osteotomy Mode” visualises the holograms of the cutting lines and drilling points, and the “Repositioning Mode” visualises the step-by-step real-time feedback to precisely support the surgeon placing the osteotomised bone fragment towards the final pre-planned position. The MR app has been developed in Unity and deployed on Microsoft HoloLens V2. A laboratory test bench was realised to validate the accuracy of the proposed MR-based approach. The validation protocol consists of two tasks to test the osteotomy and repositioning modes using a 3D-printed skull phantom. For osteotomy, the accuracy is 0.89 mm (genioplasty), 1.24 mm (maxillary osteotomy), 1.33 mm (orthognathic surgery), and 2.89 mm (mandibular angle osteotomy). For repositioning, the accuracy is 0.6 mm (anteroposterior deviation), 0.7 mm (mediolateral deviation), and 0.6° (angular deviation).