Rheological and Curing Behavior of Acrylate-Based Suspensions for the DLP 3D Printing of Complex Zirconia Parts

The present study demonstrates the possibility of fabricating zirconia parts with a complex shape and internal architecture using a low-cost stereolithography-based technique. One of the critical steps in ceramics stereolithography is the preparation of a photo-curable slurry with properties that fulfill specific requirements, such as having a low viscosity, high solids loading and appropriate curing characteristics. Slurries with different acrylic monomers and ceramic fillers were studied concerning their rheological and curing behavior. New formulations based on mono- and tri-functional acrylic monomers revealed the following excellent rheological properties: The viscosity of the mono-/tri-acrylate-based slurry with 75 wt.% of zirconia was 1.6 Pa·s at 30 s−1. Zirconia stabilized with 3 mol.% yttria was found to be more favorable than zirconia with 8 mol.% yttria for slurry preparation, because of its lower surface area and higher tapped density. It was shown that the cure depth of the suspensions was suitable for printing objects with a 50 µm layer thickness, good interlayers connection and surface finishing

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)