This study describes a protocol for the direct manufacturing of a customized titanium mesh using CAD-CAM procedures and rapid prototyping to augment maxillary bone and minimize surgery when severe atrophy or post-oncological deformities are present. Titanium mesh and particulate autogenous plus bovine demineralised bone were planned for patient rehabilitation. Bone augmentation planning was performed using the pre-op CT data set in relation to the prosthetic demands, minimizing the bone volume to augment at the minimum necessary for implants. The containment mesh design was used to prototype the 0.6 mm thickness customized titanium mesh, by direct metal laser sintering. The levels of regenerated bone were calculated using the post-op CT data set, through comparison with the pre-op CT data set. The mean vertical height difference of the crestal bone was 2.57 mm, while the mean buccal-palatal dimension of thickness difference was 3.41 mm. All planned implants were positioned after an 8 month healing period using two-step implant surgery, and finally restored with a partial fixed prosthesis. We present a viable and reproducible method to determine the correct bone augmentation prior to implant placement and CAD-CAM to produce a customized direct laser-sintered titanium mesh that can be used for bone regeneration.

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Variations in alpha rhythm have a significant role in perception and attention. Recently, alpha decrease has been associated with externally directed attention, especially in the visual domain, whereas alpha increase has been related to internal processing such as mental arithmetic. However, the role of alpha oscillations and how the different components of a task (processing of external stimuli, internal manipulation/representation, and task demand) interact to affect alpha power are still unclear. Here, we investigate how alpha power is differently modulated by attentional tasks depending both on task difficulty (less/more demanding task) and direction of attention (internal/external). To this aim, we designed two experiments that differently manipulated these aspects. Experiment 1, outside Virtual Reality (VR), involved two tasks both requiring internal and external attentional components (intake of visual items for their internal manipulation) but with different internal task demands (arithmetic vs. reading). Experiment 2 took advantage of the VR (mimicking an aircraft cabin interior) to manipulate attention direction: it included a condition of VR immersion only, characterized by visual external attention, and a condition of a purely mental arithmetic task during VR immersion, requiring neglect of sensory stimuli. Results show that: (1) In line with previous studies, visual external attention caused a significant alpha decrease, especially in parieto-occipital regions; (2) Alpha decrease was significantly larger during the more demanding arithmetic task, when the task was driven by external visual stimuli; (3) Alpha dramatically increased during the purely mental task in VR immersion, whereby the external stimuli had no relation with the task. Our results suggest that alpha power is crucial to isolate a subject from the environment, and move attention from external to internal cues. Moreover, they emphasize that the emerging use of VR associated with EEG may have important implications to study brain rhythms and support the design of artificial systems.

If you would like to write for this, or any other Emerald publication, then please use our Emerald for Authors service information about how to choose which publication to write for and submission guidelines are available for all. Please visit www.emeraldinsight.com/authors for more information. About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. AbstractPurpose -The purpose of this paper is to describe the method of virtually and physically reconstructing the missing part of a badly damaged medieval skull by means of reverse engineering, computer-aided design (CAD) and rapid prototyping (RP) techniques. Design/methodology/approach -Laser scanning data were used to create the 3D model of the damaged skull. Starting from this digital model, a virtual reconstruction of the missing part of the skull, based on the ideal symmetry with respect to the mid-sagittal plane, was achieved in a CAD environment. Finally, the custom-designed model was directly fabricated by means of the RP process. Findings -The result shows that the designed missing part of the skull fits very well with the existing skeletal remains. The final physical assembly of the prototyped element on the damaged skull was tested, restoring it to its whole original shape.Research limitations/implications -The entire process was time-consuming and may be applied just to the most representative skeletal remains. Practical implications -The method allows accurate fabrication of the missing part of the skull to be joined with the original skeletal remains. The advantage of using this technique is that the joining operation can be carried out without any need of supplementary connecting material, such as glue or plaster, to fix together the two parts. Originality/value -The reversible and non-invasive method improves the restoration process, reduces the risk of damage to the skeletal structure and allows reversion to the original repair as it was before.

Ear defects in patients affected by Treacher Collins syndrome necessitate the replacement of the existing anatomic residuals of the ears with custom-made prostheses. This paper describes a multidisciplinary protocol involving both medicine and computer-aided design/computer-aided manufacturing for manufacturing ear prostheses. Using innovative prototyping technologies together with conventional silicone processing procedures, a step-by-step procedure is presented. The complete workflow includes laser scanning of the defective regions of a patient's face, the use of 3D anatomic models from an ear digital library and rapid prototyping of both substructures for bar anchoring and moulds for silicone processing.

In regenerative medicine, 3D scaffolds are used to sustain the regeneration of tissues in removed or damaged parts of the human body. As such practices are being widely experimented in clinical applications, the design, the materials and the manufacturing process to obtain efficient 3D biocompatible lattices are being significantly investigated. Nevertheless, most of the proposed designs are based on regular 3D shapes obtained from the repetition of unit cells disposed in a three-dimensional array. This approach does not exploit the whole potential of Computer Aided Design tools coupled with manufacturing capabilities for freeform shapes. In this paper, we propose a method to model biomimetic lattices controlling the porosity and the pores size of scaffolds to be integrated with the anatomical shape of the defect. The method has been implemented in bone tissue case study and implements a Generative Design approach based on Voronoi diagrams.

Increasing the level of automation in air traffic management is seen as a measure to increase the performance of the service to satisfy the predicted future demand. This is expected to result in new roles for the human operator: he will mainly monitor highly automated systems and seldom intervene. Therefore, air traffic controllers (ATCos) would often work in a supervisory or control mode rather than in a direct operating mode. However, it has been demonstrated how human operators in such a role are affected by human performance issues, known as Out-Of-The-Loop (OOTL) phenomenon, consisting in lack of attention, loss of situational awareness and de-skilling. A countermeasure to this phenomenon has been identified in the adaptive automation (AA), i.e., a system able to allocate the operative tasks to the machine or to the operator depending on their needs. In this context, psychophysiological measures have been highlighted as powerful tool to provide a reliable, unobtrusive and real-time assessment of the ATCo’s mental state to be used as control logic for AA-based systems. In this paper, it is presented the so-called “Vigilance and Attention Controller”, a system based on electroencephalography (EEG) and eye-tracking (ET) techniques, aimed to assess in real time the vigilance level of an ATCo dealing with a highly automated human–machine interface and to use this measure to adapt the level of automation of the interface itself. The system has been tested on 14 professional ATCos performing two highly realistic scenarios, one with the system disabled and one with the system enabled. The results confirmed that (i) long high automated tasks induce vigilance decreasing and OOTL-related phenomena; (ii) EEG measures are sensitive to these kinds of mental impairments; and (iii) AA was able to counteract this negative effect by keeping the ATCo more involved within the operative task. The results were confirmed by EEG and ET measures as well as by performance and subjective ones, providing a clear example of potential applications and related benefits of AA.