Current classifications of midshaft clavicle fractures are based on radiography. The aim of the study was to evaluate the fracture pattern of clavicle fractures using 3-dimensional computed tomography (3D CT). A retrospective analysis was performed on CT scans of 65 acute clavicle fractures. Using quantitative 3D CT reconstruction techniques, the fracture of the clavicle was virtually reduced. Based on these reconstructions, a group-based fracture heat map and small fragment heat map, and the location of the most common fracture line were determined. Also, the direction and amount of displacement were evaluated. Three fracture patterns could be distinguished. The primary fracture line in type 1 is going from posteromedial to anterolateral and located between 50% and 68% of the clavicle’s length. In type 2, a transverse fracture line is located around 55%, and in type 3, a superolateral to inferomedial line is located between 47% and 56%. Wedged fracture fragments can be seen in types 1 and 2 and are mainly situated inferiorly. The displacement is similar in all types, but the main direction of displacement is specific for the different types (posterior, anterior, inferior). We can conclude that several fracture patterns can be seen in clavicle fractures. Most fractures are located laterally at the midshaft of the clavicle. Wedged segments are mainly located inferiorly, and at the posterior part of the clavicle, no comminution is ever seen. The direction of displacement depends on the fracture pattern.@en

Most digital models of the equine distal limb that are available in the community are static and/or subject specific; hence, they have limited applications in veterinary research. In this paper, we present an articulatable model of the entire equine distal limb based on statistical shape modeling. The model describes the inter-subject variability in bone geometry while maintaining proper jointspace distances to support model articulation toward different poses. Shape variation modes are explained in terms of common biometrics in order to ease model interpretation from a veterinary point of view. The model is publicly available through a graphical user interface (https://github.com/jvhoutte/equisim) in order to facilitate future digitalization in veterinary research, such as computer-aided designs, three-dimensional printing of bone implants, bone fracture risk assessment through finite element methods, and data registration and segmentation problems for clinical practices.

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In times of online shopping, it is a challenge to select the right size of the desired clothing without fitting it before ordering. Therefore, this study describes three techniques to predict 3D upper body dimensions. The first method used basic personal parameters (gender, age, weight and length), the second technique used also the shoulder width and the last method used a 3D Styku scan to add extra input parameters. The accuracy of the three prediction methods was compared against hand measurements for 17 upper body dimensions of 37 subjects. The Intraclass Correlation Coefficient increases with 11.2% for the Styku method compared to the other methods. For chest, hip and waist measurements, the basic method is reliable to predict 3D body dimensions and indicate the right size from an existing collection. For more accurate upper body dimensions as needed for producing custom made clothing, a 3D Styku scan can supply the desired input.

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In this paper, we investigate the heating function of the nasal cavity qualitatively, using a high-quality, large-scale statistical shape model. This model consists of a symmetrical and an asymmetrical part and provides a new and unique way of examining changes in nasal heating function resulting from natural variations in nasal shape (as obtained from 100 clinical CT scans). Data collected from patients suffering from different nasal or sinus-related complaints are included. Parameterized models allow us to investigate the effect of continuous deviations in shape from the mean nasal cavity. This approach also enables us to avoid many of the compounded effects on flow and heat exchange, which one would encounter when comparing different patient-specific models. The effects of global size, size-related features, and turbinate size are investigated using the symmetrical shape model. The asymmetrical model is used to investigate different types of septal deviation using Mladina's classification. The qualitative results are discussed and compared with findings from the existing literature.@en

The high prevalence of foot pain, and its relation to foot shape, indicates the need for an expert system to identify foot shape abnormalities. Yet, to date, no such expert system exists that examines the full 3D foot shape and produces an intuitive explanation of why a foot is abnormal. In this work, we present the first such expert system that satisfies those goals. The system is based on the concept of model-based outlier detection: a statistical shape model (SSM) is generated from 186 3D optical foot scans of healthy feet. This model acts as a knowledge base which is then parameterized by one's demographic characteristics (e.g., age, weight, height, shoe size) through a multivariate regression. This regression introduces model flexibility as it allows the model to be fine tuned to a specific individual. This fine tuned model is then used as a baseline to which the individual's 3D foot scan can be compared using standard statistical tests (e.g. t-tests). These statistical tests are performed at each vertex along the foot surface to identify the degree and location of shape outliers. Our expert system was validated on foot scans from patients with hallux valgus and abnormal foot arches. As expected, our results varied per patient, confirming that feet with the same clinical classification still show high shape variability. Additionally, the foot shape abnormalities identified by our system not only agreed with the expected location and severity of the tested foot deformities, but our analysis of the full 3D foot shape was able to completely characterize the extent of those abnormalities for the first time. These results show that the combination of statistical shape modelling, multivariate regression, and statistical testing is powerful enough to perform outlier detection for 3D foot shapes. The resulting insights provided by this system could prove useful in both shoe design and clinical diagnosis.@en

Quantitative analyses of plantar pressure images typically occur at the group level and under the assumption that individuals within each group display homogeneous pressure patterns. When this assumption does not hold, a personalized analysis technique is required. Yet, existing personalized plantar pressure analysis techniques work at the image level, leading to results that can be unintuitive and difficult to interpret. To address these limitations, we introduce PAPPI: the Personalized Analysis of Plantar Pressure Images. PAPPI is built around the statistical modelling of the relationship between plantar pressures in healthy controls and their demographic characteristics. This statistical model then serves as the healthy baseline to which an individual’s real plantar pressures are compared using statistical parametric mapping. As a proof-of-concept, we evaluated PAPPI on a cohort of 50 hallux valgus patients. PAPPI showed that plantar pressures from hallux valgus patients did not have a single, homogeneous pattern, but instead, 5 abnormal pressure patterns were observed in sections of this population. When comparing these patterns to foot pain scores (i.e. Foot Function Index, Manchester-Oxford Foot Questionnaire) and radiographic hallux angle measurements, we observed that patients with increased pressure under metatarsal 1 reported less foot pain than other patients in the cohort, while patients with abnormal pressures in the heel showed more severe hallux valgus angles and more foot pain. Also, incidences of pes planus were higher in our hallux valgus cohort compared to the modelled healthy controls. PAPPI helped to clarify recent discrepancies in group-level plantar pressure studies and showed its unique ability to produce quantitative, interpretable, and personalized analyses for plantar pressure images.@en

While dynamic plantar pressure measurements are commonly used for clinical evaluation of gait-related problems, computational analysis techniques for these datasets are few and farbetween. To address this issue, we introduce an open-access database of plantar pressure videos for researchers to develop algorithms around.@en

The nose is a complex and important organ with a multitude of functions. Computational fluid dynamics (CFD) has been shown to be a valuable tool to obtain a better understanding of the functioning of the nose. CFD simulations require a surface geometry, which is constructed from tomographic data. This can be a very time-consuming task when one chooses to exclude the sinuses from the simulation domain, which in general keeps the size of the CFD model more manageable. In this work, an approach for the semi-automatic construction of the human nasal cavity is presented. In the first part, limited manual interaction is needed to create a coarse surface model. In the next part, this result is further refined based on the combination of active shape modeling with elastic surface deformation. The different steps are bundled in a Matlab toolbox with a graphical interface which guides the user. This interface allows easy manipulation of the data during intermediate steps, and also allows manual adjustments of the reconstructed nasal surface at the end. Two results are shown, and the approach and its precision are discussed. These results demonstrated that the followed approach can be used for the semi-automatic segmentation of a human nasal cavity from tomographic data, substantially reducing the amount of operator time.@en

Statistical body shape modeling (SBSM) is a well-known technique to map out the variability of body shapes and is commonly used in 3D anthropometric analyses. In this paper, a new approach to integrate movement acquired by a motion capture system with a body shape is proposed. This was done by selecting landmarks on a body shape model, and predicting a body shape based on features. Then, a virtual skeleton was generated relative to those landmarks. This skeleton was parented to a body shape, allowing to modify its pose and to add pre-recorded motion to different body shapes in a realistic way.@en

For product developers that design near-body products, virtual mannequins that represent realistic body shapes, are valuable tools. With statistical shape modelling, the variability of such body shapes can be described. Shape variation captured by statistical shape models (SSMs) is often polluted by posture variations, leading to less compact models. In this paper, we propose a framework that has low computational complexity to build a posture invariant SSM, by capturing and correcting the posture of an instance. The posture-normalised SSM is shown to be substantially more compact than the non-posture-normalised SSM. Practitioner summary: Statistical shape modelling is a technique to map out the variability of (body) shapes. This variability is often polluted by variations in posture. In this paper, we propose a framework to build a posture invariant statistical shape model. Abbreviations: SSM: statistical shape model; 1D: one-dimensional; 3D: three-dimensional; DHM: digital human model; LBS: linear blend skinning; PCA: princial component analysis; PC: principal component; TTR: thumb tip reach.

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Multi-post-labeling-delay pseudo-continuous arterial spin labeling (multi-PLD PCASL) allows for absolute quantification of the cerebral blood flow (CBF) as well as the arterial transit time (ATT). Estimating these perfusion parameters from multi-PLD PCASL data is a non-linear inverse problem, which is commonly tackled by fitting the single-compartment model (SCM) for PCASL, with CBF and ATT as free parameters. The longitudinal relaxation time of tissue T1t is an important parameter in this model, as it governs the decay of the perfusion signal entirely upon entry in the imaging voxel. Conventionally, T1t is fixed to a population average. This approach can cause CBF quantification errors, as T1t can vary significantly inter- and intra-subject. This study compares the impact on CBF quantification, in terms of accuracy and precision, of either fixing T1t, the conventional approach, or estimating it alongside CBF and ATT. It is shown that the conventional approach can cause a significant bias in CBF. Indeed, simulation experiments reveal that if T1t is fixed to a value that is 10% off its true value, this may already result in a bias of 15% in CBF. On the other hand, as is shown by both simulation and real data experiments, estimating T1t along with CBF and ATT results in a loss of CBF precision of the same order, even if the experiment design is optimized for the latter estimation problem. Simulation experiments suggest that an optimal balance between accuracy and precision of CBF estimation from multi-PLD PCASL data can be expected when using the two-parameter estimator with a fixed T1t value between population averages of T1t and the longitudinal relaxation time of blood T1b.@en

Data reduction techniques are commonly applied to dynamic plantar pressure measurements, often prior to the measurement's analysis. In performing these data reductions, information is discarded from the measurement before it can be evaluated, leading to unkonwn consequences. In this study, we aim to provide the first assessment of what impact data reduction techniques have on plantar pressure measurements. Specifically, we quantify the extent to which information of any kind is discarded when performing common data reductions. Plantar pressure measurements were collected from 33 healthy controls, 8 Hallux Valgus patients, and 10 Metatarsalgia patients. Eleven common data reductions were then applied to the measurements, and the resulting datasets were compared to the original measurement in three ways. First, information theory was used to estimate the information content present in the original and reduced datasets. Second, principal component analysis was used to estimate the number of intrinsic dimensions present. Finally, a permutational multivariate ANOVA was performed to evaluate the significance of group differences between the healthy controls, Hallux Valgus, and Metatarsalgia groups. The evaluated data reductions showed a minimum of 99.1% loss in information content and losses of dimensionality between 20.8% and 83.3%. Significant group differences were also lost after each of the 11 data reductions (α=0.05), but these results may differ for other patient groups (especially those with highly-deformed footprints) or other region of interest definitions. Nevertheless, the existence of these results suggest that the diagnostic content of dynamic plantar pressure measurements is yet to be fully exploited.

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In this paper, we present a new framework to integrate movement acquired by a motion capture system to a statistical body shape model using Blender. This provides a visualization of a digital human model based upon anthropometry and biomechanics of the subject. A moving statistical body shape model helps to visualize physical tasks with inter-individual variability in body shapes as well as anthropometric dimensions. This parametric modeling approach is useful for reliable prediction and simulation of the body shape movement of a specific population with a few given predictors such as stature, body mass index and age.@en

This study characterizes plantar pressure differences betweenhallux valgus patients and healthycontrols using statistical parametric mapping(SPM).The plantar pressuredifferences are minimalwhich, combinedwith previous studies, suggesthigh variability in the plantar pressures of hallux valgus patients@en

This paper presents a registration framework for the construction of a statistical shape model of the human hand in a standard pose. It brings a skeletonized reference model of an individual human hand into correspondence with optical 3D surface scans of hands by sequentially applying articulation-based registration and elastic surface registration. Registered surfaces are then fed into a statistical shape modelling algorithm based on principal component analysis. The model-building technique has been evaluated on a dataset of optical scans from 100 healthy individuals, acquired with a 3dMD scanning system. It is shown that our registration framework provides accurate geometric and anatomical alignment, and that the shape basis of the resulting statistical model provides a compact representation of the specific population. The model also provides insight into the anatomical variation of the lower arm and hand, which is useful information for the design of well-fitting products.@en

This chapter presents digital human models (DHMs) as supporting tools in user-centered design for smart clothing. Smart clothing represents the new class of design era 2.0 with interactive technologies intended to be attractive, comfortable, and fit for the purpose of the identified user (Scataglini et al., 2019). While DHMs offer the possibility to analyze or predict human posture, motion, and other functions in a high-fidelity, physics-based, three-dimensional, real-time environment, smart clothing allows for monitoring vital (heart rate, breathing rate, temperature) and emotional (heart rate variability, electrodermal activity) parameters, movements, and postures. Effectiveness of functional wear is verified on the integration of DHMs into the design of a smart clothing system. Smart clothing represents a “second skin” that has a close “intimate” relation with the human body. This relation is physiological, psychological, biomechanical, and ergonomical. Physiological, biomechanical, and ergonomic aspects represent a retro-feedback of the user’s function in the iterative co-design workflow for designing smart garments, permitting the redesign and the technological refinement of it.

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Parametric 3D human body models are valuable tools for ergonomic product design and statistical shape modelling (SSM) is a powerful technique to build realistic body models from a database of 3D scans. Like the underlying 3D scans, body models built from SSMs are typically represented with triangle meshes. Unfortunately, triangle meshes are not well supported by CAD software where spline geometry dominates. Therefore, we propose a methodology to convert databases of pre-corresponded triangle meshes into multi-patch B-spline SSMs. An evaluation on four 3D scan databases shows that our method is able to generate accurate and water-tight models while preserving inter-subject correspondences by construction. In addition, we demonstrate that such SSMs can be used to generate design manikins which can be readily used in SolidWorks for designing well conforming product parts.@en

During a transcatheter aortic valve implantation, an axisymmetric implant is placed in an irregularly shaped aortic root. Implanting an incorrect size can cause complications such as leakage of blood alongside or through the implant. The aim of this study was to construct a method that determines the optimal size of the implant based on the three-dimensional shape of the aortic root. Based on the pre-interventional computed tomography scan of 89 patients, a statistical shape model of their aortic root was constructed. The weights associated with the principal components and the volume of calcification in the aortic valve were used as parameters in a classification algorithm. The classification algorithm was trained using the patients with no or mild leakage after their intervention. Subsequently, the algorithms were applied to the patients with moderate to severe leakage. Cross validation showed that a random forest classifier assigned the same size in 65 ± 7% of the training cases, while 57 ± 8% of the patients with moderate to severe leakage were assigned a different size. This initial study showed that this semi-automatic method has the potential to correctly assign an implant size. Further research is required to assess whether the different size implants would improve the outcome of those patients.
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In this paper we present an innovative approach to design smart clothing using statistical body shape modeling (SBSM) from the CAESAR™ dataset. A combination of different digital technologies and applications are used to create a common co-design workflow for garment design. User and apparel product design and developers can get personalized prediction of cloth sizing, fitting and aesthetics.

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