Research on the benefits of 3D printing in a trauma hospital
3D printing is seeing increasingly widespread adoption in the medical field, with numerous examples of applications that help surgeons accurately plan cosmetic surgery. Now, the potential of 3D printing is being examined by hospitals treating patients who are fighting for their life.
The ETZ (Elisabeth-TweeSteden Ziekenhuis) is one of 11 trauma centres in the Netherlands. As the only centre in the country with trauma surgeons on location 24 hours a day, it serves as the main location for emergency patients in North Brabant. 3D printing has already been used to visualise bone fractures, but pioneering researchers believe it can also be used to help treat trauma patients.
Mike Bemelman, MD, trauma surgeon at the ETZ, had already seen the potential of 3D printing back in 2016. Together with Lars Brouwers, MD, PhD-candidate, and Koen Lansink, MD, trauma surgeon, they have started conducting research into the benefits and effectiveness of 3D printing, compared to traditional and other new technologies. Their idea is to 3D print scanned bone fractures in order to give both surgeons and patients a clear understanding of each situation, before operating.
Before 3D printing
In order to prepare for an operation, surgeons will analyse CT scans of the patient. Getting an exact idea of each situation is challenging, even for an experienced surgeon. CT scans are converted into a 3D reconstruction, enabling surgeons to examine it virtually on a computer screen. While this has improved the ease of understanding each situation, it has limitations: surgeons sometimes find it difficult to orient the model, and 3D reconstructions are viewed on a 2D screen, lacking a realistic sense of depth.
3D printing fractured bones
Lars started using the Ultimaker to print fractured bone structures, allowing surgeons to analyse a fracture not only by looking at it, but also touching and rotating it, which gives important added value to the operation planning process.
Using water-soluble PVA support material, complex, organic geometries can be accurately reproduced with small cavities and important details included.
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Adopting 3D printing to the process
One challenge of adopting 3D printing was finding a simple and efficient way to convert DICOM files—the proprietary file format of CT scans—into 3D printable STL files. Using Philips IntelliSpace Portal, Lars is able to directly export a 3D model of the scan, which he can prepare in Ultimaker Cura, and send to the Ultimaker 3.
Benefits for the patient
After the patient is in a stable condition, a CT scan is produced so that doctors can make a diagnosis. CT scan information is immediately available to Lars in the 3D print studio, where he can begin printing the fractured bone structure of the patient. The 3D print will be ready within a day and is used by surgeons to plan the operation and explain the process to the patient before it happens.
Our goal was to investigate if 3D printing can be of added value in classifying acetabular fractures. The most important conclusion of our research is that 3D printing is of added value.
Results of Lars’ research
When a patient has a fracture, doctors will analyse the x-rays or 2DCT scans and decide on an appropriate treatment. The better the understanding of the situation, the more accurately the right procedure can be determined. Surgeons will reach a solution using an agreement scoring system, known as the kappa score. On average, surgeons with little experience have a kappa score around 0.2, using traditional 2DCT images. Surgeons with more years of experience have a kappa score around 0.4.
Lars researched the agreement score when surgeons used other techniques such as 3DCT, 3D printing and VR visualization. Using a 3D printed model, both new and experienced surgeons scored a kappa of between 0.6 up to 0.7, which is the highest score of all methods.
The increased kappa score demonstrates the added value of 3D printing to the decision-making process. By conducting this research, Lars hopes to prove that 3D printing can be of added value to patient satisfaction, surgical satisfaction, operation time, and health-related quality of life for the patient.
Disclaimer: Ultimaker 3D printers are designed and built for Fused Filament Fabrication with Ultimaker engineering thermoplastics within a commercial/business environment. The mixture of precision and speed makes the Ultimaker 3D printers the perfect machine for concept models, functional prototypes and the production of small series. Although we achieved a very high standard in the reproduction of 3D models with the usage of Ultimaker Cura, the user remains responsible to qualify and validate the application of the printed object for its intended use, especially critical for applications in strictly regulated areas like medical devices and aeronautics.
Peloton vulnerable to cyber attacks, McAfee research finds
Peloton, the popular exercise bikes, were found to be vulnerable to cyber attacks in the latest research from McAfee.
Peloton is a brand of electric bikes that combines high end exercise equipment with cutting-edge technology. Its products use wi fi to connect to a large tablet that interfaces with the components of the exercise device, and provides an easy way for physical activity enthusiasts to attend virtual workout classes over the internet several times a week.
Peloton has garnered attention recently around the privacy and security of its products. So McAfee decided to take a look for themselves and purchased a Peloton Bike+.
Researchers looked at the Android devices and uncovered a vulnerability that could allow an attacker with either physical access to the Bike+ or access during any point in the supply chain to gain to hack into the bike’s tablet, including the camera, microphone and personal data.
For the person using it there would be no indication the Bike+ has been tampered with, potentially putting Peloton’s 16.7 million users at risk.
The flaw was found in the Android Verified Boot (AVB) process. McAfee researchers were able to bypass the Android Verified Boot process, which normally verifies all code and data before booting. They were then able to get the device to boot bypassing this step.
This could potentially lead to the Android OS being compromised by an attacker who is physically present. Even worse, the attacker could boot up the Peloton with a modified credential to gain privileges, granting them access to the bike remotely.
As the attacker never has to unlock the device to boot it up, there would be no trace of their access on the device. This type of attack could also happen at any point from construction to warehouse to delivery, by installing a backdoor into the Android tablet without the user ever knowing.
Given the simplicity and criticality of the flaw, McAfee informed Peloton while auditing was ongoing. The vendor was sent full details, and shortly after, Peloton confirmed the issue and released a fix for it.
Further conversations between McAfee and Peloton confirmed that this vulnerability had also been present on the Peloton Tread exercise equipment.
Peloton’s Head of Global Information Security Adrian Stone, commented on the research: “This vulnerability reported by McAfee would require direct, physical access to a Peloton Bike+ or Tread. Like with any connected device in the home, if an attacker is able to gain physical access to it, additional physical controls and safeguards become increasingly important.
"To keep our members safe, we acted quickly and in coordination with McAfee. We pushed a mandatory update in early June and every device with the update installed is protected from this issue.”