0:03 All right, we’re going to have some fun. So in 2014 I flew into the jungle of Guatemala, and when I say the jungle of Guatemala I mean the jungle of Guatemala, we’re talking about mosquitoes the size of hummingbirds and just Unwritten rules that you have to do, like if you’re going to get something off that top shelf you need to remove the box, look down, make sure there’s no Critters that going to come to get you. But it was at that time in the clinic, where we started a Prosthetic Clinic in 2006 that Mo focused mainly on kids, but 2014 kind of is the year that lives in infamy for me, and that created the turning point for me to move more towards a digital solution.

0:49 You see, 2014 was when we saw the most amount of patients that we had ever seen in one Clinic before, so in six days, from start to finish, we manually made 63 devices. I was useless when I got back, in fact I had a colleague, he said, hey Brent, tell me, tell me a little bit about the Guatemala trip, how did it go, and I said, oh man, it was amazing, we did 63 new prosthetic devices, people walked for the first time, kids walked for the first time, we got kids, we had tears, it was amazing. He goes, Brent, how many people are there in the world that need something like what you’re talking about, and so that’s what took me down this Rabbit Hole.

1:38 So the World Health Organization states that 7% of Any Given population has an amputation, so this small little country that we serve in Guatemala has roughly 15 million people, so we’re talking about a population that needs our services of about a 100,000 people. And he continued that convers, he said, so Brent, you saw 63, what about the other 999,000 and such, and it was at that point, it was, it was a little bit of a kick in the gut, right, because I, I have also friends around the world that are involved in nonprofits and Nos, and just in Guatemala itself we probably only reach about 500 people a year, it’s not enough. So we say, what is scalable, and that’s how my digital Journey began.

2:30 And I will say this, I was a big fan of traditional fabrication, I really thought that anybody would, that was using digital tools were using them as a crutch and weren’t a good clinician, so I’ve made a complete 180, and so this is a little bit about that Journey. This story is not complete without a story like Veronica, so Veronica’s story is a difficult one to tell. Mass men came into to her house with machetes, took the life of her father, and she lost her arm defending herself, getting away from these men, cuts all over her body. She came to our clinic, and she, she said, I want an arm, I want to be, feel whole again, and at that point I wasn’t 3D printing much of anything, let alone an upper extremity prosthesis, but I had my old printer bot, simple extended Z, with some color Fab skin tone filament, and I said, I think I can help, had no idea what I was going to do, but I had some hand models, and so we ended up creating a prosthesis for her.

3:43 And when we put that prosthesis on, it was like we had Veronica again, it was a spark, a light, and so behind this, this picture you can see her smiling, and this is a couple Generations after, where we’re having some fun. But as our team got to know Veronica, we also knew just the emotional challenges that were faced with people that have disabilities in the developing world, and so a lot of times if you’re missing an arm or leg, we know that everybody is complete, but there you are essentially less of a person, and so she would ask questions like this, is anybody going to love me, will I be able to have a family, and what I’m excited to tell you is, and it’s not because of her prosthesis, but because of the confidence that she had, she did find somebody to love her, she did get married, and it was just so exciting to see how a prosthesis, one prosthesis, and additive manufacturing comes together and change the life of one person.

4:49 And this is where computational design, additive manufacturing really can come together, where we can create millions of stories like Veronica’s story. So I’m going to start off with just some vocabulary, very basic, about a prosthesis, I know that most people don’t assemble prostheses for a living, but y’all are smart, so I don’t know how a mountain boy from North Carolina got up here, but this is, this is just the basics of Prosthetics. So whatever it interacts with the foot, this is a special foot for running, is called the foot, there’s a little stub of metal that’s called the pylon, and then what we’re talking about today is called the socket, and there’s, there’s some components that go above it.

5:38 You see a little tube, it looks like a straw, this particular socket has a vacuum pump on it, and what it allows him to do, it not only really holds the prosthesis to him while he’s running, but it also Wicks some of the sweat away as he’s running. But as I mentioned, we did a lot of stuff with traditional fabrication, and it’s, it’s a mess. Like you use casting tape, it’s the same casting tape that you use when you have a broken arm, and so a lot of times these casts, you got to put special pants on, you got to protect the shoes, it’s just a big time mess, and then you pour it down with plaster Paris, and some of these models weigh probably 30, 40 plus pounds depending on the size, and those models just go to waste. So you talk about sustainability, not only are you using water, but you’re using plaster that you then have to throw away.

6:32 And I think you’ll appreciate this, this is how we make it. So this is in our lab in Guatemala, we have a pizza oven, and you’ll notice that the pizza oven is pushed through the wall, so the heat doesn’t get inside, we’re in the jungle, we don’t need to make it any hotter inside than what’s already there. But this is a basic way to make a prosthesis, you vacuum form molten plastic, that’s in sheet form, and it just sucks up underneath the model while it’s still hot, you take some scissors, cut it, you use power tools, get your trim lines, and off you go. It’s it’s actually a very effective way to make a prosthesis, super coste effective, it’s faster than 3D printing, but it doesn’t scale because it takes skill.

7:16 So we talk about the foundational principles, we talked about a cast, so what about a scan, people ask me all the time, well Brent, what scanner do you use, and Engineers will ask that, and I said, said, whichever one works, and that’s, people don’t like, especially Engineers, they don’t like that, and they want to hear, oh what kind of accuracy, and I go, plus or minus 1 millimeter, and they’re like, oh this isn’t rocket science, and it’s not, but it’s it’s that’s what we’re playing with. And so scanners now that fit in your pocket work very well, so this one was with a structure sensor, Circa 2015, and you can see that we have on the model with a hand measurement 375 mm, digital measurement, training, and if you know anything about marathon training that’s not going to cut it, it’s got to be more than three to four miles, okay, and he just could not get above it.

8:38 And this prus, super skilled prus, in fact if I was missing my limb I would probably go to him, but he said, hey, do you have any technology that is available that we can try, and I said, hey, I’ve got some software, I’ve, HP had released the Luol TPU, and we’re like let’s give that a shot, and so we way overdesigned this, okay, so this was iteration one, but what was wild is that he put it on and he said, I’ve never felt so comfortable in my life before. And so the the neat thing about that though is that we’re actually getting into what inputs do we need to get an output like this, maybe not like this, but something that gets us some function, and so what we found is that we can take an inner surface and a volume and create a prosthesis like this, lce structures and all, and so here is him running.

9:41 And so what I look for when people are running or walking is do they look comfortable, are they tensed up, are they symmetrical, do they look like they’re walking or running on eggshells, and we see none of that, and his name’s rich, with Richard. And so Richard then says, I’m going to build, build these miles up, so he starts hitting five miles, seven miles, 10 miles, 13 miles, 15 miles, and I get a text, Brent, I was only able to do 15 miles today, I go, oh Richard, I’m so sorry, what happened, he goes, no, I was only able to do 15 miles, like that’s as far as I could go today, not because I was hurting, I just couldn’t physically go any further. And then he built 17, 20, 22, and then in 2022 he ran that marathon, and it’s so excited, and he’s the first person that I know of ever to run a marathon in a 3D printed prosthesis.

10:46 So now we know what we can do with inputs, how do we get this so it will scale, and this is where things get a little bit interesting. We know that we need something that’s a foundation, so we need a scan input of some sort, and what we’re trying to do is we’re trying to tell our clinicians, hey, we want you to be like dentists, dentists don’t care how the crown is made in between, they’re going to evaluate and then they’re going to fit, and we feel like clinician should do the same thing, evaluate, do the things that are relevant to you, get the clinical inputs, and then we’ll get an output. So you can use a free software like mesh mixer, you can use blender, you can use like what Josh is going to be talking about with radi, those are clinically relevant options for you to input, and then let us take care of the Automation and design.

11:49 So we are working on 3 MFS, but we are so far behind as far as clinicians go, a lot of times St L is about the best we can go, so we had a file format called aop, which was based on a a circular reference, a complete disaster, so like STL is an upgrade, so I can’t imagine what’s going to happen with the 3 MFS. So with, there’s one input, clinically relevant, in the alignment that it’s supposed to go, and then what you can do is you give the clinicians some ability to do what they want to do, how thick do you want your socket, where do you want your lofts, how do you want your holes positioned, all these are slides and buttons that they can push and do, and then you have a rendering, and all this is AWS based.

12:37 If it looks kind of like shape diver, it’s not shape diver, it’s our own software, but we took a lot of inspiration from what we learned from what we were trying to do there, we were just super computationally limited by what was offered there, so we build our own. And then from there you have this rendering of what it’s going to look like, and then you run the computes function, right, run dendro, and it runs through, you get your final water type mold, I’m going to show some of these bodies taken off so you can kind of see what everything looks like, you scroll down a little bit more, you press download, and then you open it up in your favorite tool, right, Builder is getting sunsetted, but I think this was a builder file, and you get to take a look at a beautifully designed socket, consistent every time, within a matter of a minute or less, and that is what we are excited about as far as scaling for the masses, so we can keep on hearing stories like the ones that we shared about with Veronica.

13:56 So if you want know more about what I do, life enabled is our nonprofit organization, life enabled. Comom, would love to connect with you, if you’re on LinkedIn I’d love to connect with you as well, we’re actually heading to Guatemala in 10 days, and I’m actually just found out I’m going to be seeing a bunch of kids, and so I’m having a script made right now, because I didn’t have time to get feet in, so I can print feet while I’m down in Guatemala for the kids that I see, so it’s going to be another computational design script for that, but y’all were awesome, thank you so much for being here. If I get a chance to meet you I’d love to meet you as well, and if I miss something, or you like, Brent, I think I can help you even more, I’m an open book, I’d love to talk to you. Yeah, so I don’t toot the horn much on the life enabled stuff, but danan said I could, so if you go to life en.com there is a donate button if you feel so LED, so thank you.