3D Topological Scanning and Multi-material Additive Manufacturing for Facial Prosthesis Development

Prosthetic-based rehabilitation is an alternative to and offers several advantages over surgical intervention. Prosthetic devices are commonly handmade, requiring significant amounts of skilled labour and subjective manufacturing techniques. This chapter discusses the use of industrial optical scanning methods to capture the surface topology from a volunteer’s facial anatomy. This data was then used to generate a 3D CAD model, which was further used to design a patient-specific prosthesis. Amongst the many advantages over the existing techniques are that data collection is non-intrusive, quick to collect and provides anatomically precise information. The use of 3D CAD models provides greater flexibility when developing and evaluating design iterations and further allows for the creation of ‘part libraries’ for use where patients have no initial reference anatomy. Such patient data can also be kept on record should it be required for future use. The final prosthesis is realised through high-resolution, multi-material additive manufacturing, providing precise model reproduction and adding functionality such as mimicry of soft and hard tissues. This approach provides an optimised, low-cost method for streamlining similar prosthesis production

Longitudinal follow‐up study: effect of psychological co‐morbidity on the prognosis of inflammatory bowel disease

Background Psychological co-morbidity is more common in patients with inflammatory bowel disease (IBD), compared with the general population, but little is known about the cumulative effect of increasing psychological burden on disease behaviour. Aims To examine the effect of psychological co-morbidity on inflammatory bowel disease in a longitudinal follow-up study. Methods We collected complete demographic, symptom and psychological co-morbidity data (anxiety, depression and somatisation scores) at baseline from adults with IBD in biochemical remission (faecal calprotectin <250 µg/g). Objective markers of disease activity, including glucocorticosteroid prescription or flare of disease activity, escalation of therapy, hospitalisation or intestinal resection, were reviewed ≥2 years of follow-up. We performed multivariate Cox regression, controlling for patient characteristics and follow-up duration, to examine cumulative effect of psychological co-morbidities on subsequent IBD behaviour. Results Among 218 participants, 48 (22.0%) had one, 13 (6.0%) two and nine (4.1%) three psychological co-morbidities at baseline. Following multivariate Cox regression analysis, glucocorticosteroid prescription or flare, and escalation of medical therapy were significantly higher among those with two (hazard ratio [HR] = 3.18; 95% confidence interval [CI] 1.44-7.02, and HR = 2.48; 95% CI 1.03-5.93, respectively) or three (HR = 3.53; 95% CI 1.26-9.92, and HR = 8.19; 95% CI 2.88-23.23, respectively) psychological co-morbidities. Occurrence of at least one endpoint of interest was significantly higher with increasing psychological co-morbidity (HR = 1.74; 95% CI 1.07-2.82 for one, HR = 2.47; 95% CI 1.12-5.46 for two and HR = 4.93; 95% CI 1.84-13.17 for three psychological co-morbidities). Conclusions Individuals with IBD in biochemical remission experienced a worse disease course with increasing psychological co-morbidity at baseline