Process Chain for the Fabrication of a Custom 3D Barrier for Guided Bone Regeneration

Guided Bone Regeneration (GBR) is a surgical procedure that consists in the use of barrier membranes to cover bone defects caused by trauma, periodontal disease and other pathologies. These barriers allow the proliferation of bone cells, and prevent the invasion of the defect by non-osteogenic cells (connective and epithelium) in patients with a lack of horizontal and/or vertical bone. This process is essential for the successful dental implant placement. Additive manufacturing (AM) is emerging as an important tool for biomedical applications, especially for regenerative medicine and tissue engineering. This paper proposes a process chain for the fabrication of a custom barrier from cone beam computed tomography (CBCT) as Digital Imaging and Communication in Medicine (DICOM) files obtained from a patient with vertical bone resorption of the anterior maxilla.DICOM files have been processed with Invesalius 3.0 to obtain the tridimensional (3D) anatomy of the region of interest. This 3D model was cleaned, fixed, and smoothed. The prototyped model of the patient’s bone defect was further processed in Rhinoceros to offer a 3D architecture for cell growth. To obtain information of the thermal and mechanical properties a finite element method (FEM) was assessed. The prototype obtained was produced with fused deposition modeling (FDM) an additive manufacturing technology

Biodiversidad 2017. Estado y tendencias de la biodiversidad continental de Colombia

En la cuarta versión del Reporte, que corresponde al año 2017, es una obligación preguntarnos cuál ha sido y es el papel de esta publicación y si ha abarcado la diversidad de formas y conceptos que definen el estado y el futuro de la biodiversidad colombiana. Las temáticas que constituyen la columna vertebral de cada uno de los reportes anuales responden a temas de pertinencia, nivel de incidencia y actualidad desde cada uno de los diferentes niveles de organización de la biodiversidad y buscan responder las siguientes preguntas fundamentales: 1) ¿Cómo se encuentra la biodiversidad del país? 2)¿Qué factores, en dónde y en qué medida está siendo afectada? 3)¿Cuáles son las iniciativas que desde la sociedad civil o a nivel de políticas públicas buscan evitar esa pérdida? 4)¿Cuáles son las grandes oportunidades para mejorar su gestión y manejo? Si bien evaluar la incidencia que puede tener el Reporte sobre acciones de gestión no es tarea fácil, se debe reconocer la buena acogida que han tenido los textos, las ilustraciones y la cifras entre los distintos tipos de lectores y el papel fundamental que ha jugado el Reporte en comunicar información de altísima calidad sobre la biodiversidad colombiana en diferentes momentos coyunturales. En ese sentido esta publicación es cada vez más una herramienta de consulta y referencia que está abierta al público tanto en formato impreso como digital, y de la misma manera busca fortalecerse para continuar brindando información relevante para la toma de decisiones en materia ambiental.BogotáSubdirección de Investigacione

Biodiversidad 2018. Reporte de estado y tendencias de la biodiversidad continental de Colombia

Las cifras y temáticas contenidos en el presente Reporte, aunque no son el panorama completo del estado del conocimiento de la biodiversidad en Colombia, son un compendio seleccionado de los temas que, desde el Instituto Humboldt, consideramos son relevantes y merecen ser discutidos por el público general. En muchos de los casos, las cifras no son esperanzadoras u son un llamado urgente a la acción. En otro casos son la evidencia de que se requieren acciones a nivel nacional, y más allá de esto, son muchas las iniciativas que están germinando desde los territorios, cada vez desde una mayor variedad de actores.Bogotá, D. C., Colombi

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)