Effects of Steam Heat and Dry Heat Sterilization Processes on 3D Printed Commercial Polymers Printed by Fused Deposition Modeling.

Fused deposition modeling (FDM), the most widely used additive manufacturing (AM) technology, is gaining considerable interest in the surgical sector for the production of single-use surgical devices that can be tailor-made according to specific requirements (e.g., type of patient surgery, specific shapes, etc.) due to its low cost, ease of access to materials (3D-printing filament), and the relatively low complexity. However, surgical 3D-printing parts should resist sterilization treatments without losing structural, mechanical, and dimensional accuracy. Thus, in this work, 3D-filaments based on poly(lactic acid) (PLA), poly(ethylene glycol-co-1,4-cyclohexanedimethanol terephthalate) (PETG), and a modified PETG material (CPE) were used to produce 3D-printed parts and further subjected to moist heat (MH) and dry heat (DH) sterilization processes as affordable and widely used sterilization processes in the medical field. The effect of MH and DH was evaluated by performing a complete mechanical, structural, thermal, and morphological characterization before and after both treatments. In general, the moist heat treatment produced a higher degradation of the polymeric matrix of PETG and CPE due to hydrolytic and thermal degradation, particularly affecting the tensile test and flexural properties. For instance, the linear coefficient of thermal expansion (LCTE) before glass transition temperature (Tg) increased 47% and 31% in PETG samples due to the MH and DH, respectively, while it increased 31% in CPE due to MH and was mainly maintained after the DH process. Nevertheless, in PLA, the MH produced an increase of 20% in LCTE value and the DH showed an increase of 33%. Dry heat treatment resulted in being more suitable for medical applications in which dimensional accuracy is not a key factor and there are no great mechanical demands (e.g., surgical guides).

Mechanical, Dynamic-Mechanical, Thermal and Decomposition Behavior of 3D-Printed PLA Reinforced with CaCO3 Fillers from Natural Resources.

This study evaluates the effect of CaCO3 fillers extracted from waste eggshells on 3D-printed PLA performance. Samples of neat PLA and PLA reinforced with CaCO3 fillers embedded with different wt.% were prepared using an FDM (fused deposition modeling) technology. The samples were examined using mechanical, dynamic mechanical, thermal, and thermal decomposition analyses. The results revealed increasing elastic moduli, tensile strength, and flexure as the filler content increased. The rheological results from the MFR tests showed that the filler content did not influence the PLA-based samples' processability. Further, the thermal degradation of neat and various CaCO3-wt.%-reinforced PLA specimens revealed relatively small discrepancies in their exposure to the temperature increase, mainly concerning the eggshell organic components and volatile components, from their processability up to 300 °C. By contrast, the increased filler content positively shifted the peaks along the temperature scale at the maximum degradation rate. Additionally, the weight content of the natural reinforcement strongly influenced the surface wettability and appearance of the samples. Further, the SEM analysis featured both the presence of interlayer disturbances and the interfacial compatibility the PLA with the selected fillers.

New Materials for 3D-Printing Based on Polycaprolactone with Gum Rosin and Beeswax as Additives.

In this work, different materials for three-dimensional (3D)-printing were studied, which based on polycaprolactone with two natural additives, gum rosin, and beeswax. During the 3D-printing process, the bed and extrusion temperatures of each formulation were established. After, the obtained materials were characterized by mechanical, thermal, and structural properties. The results showed that the formulation with containing polycaprolactone with a mixture of gum rosin and beeswax as additive behaved better during the 3D-printing process. Moreover, the miscibility and compatibility between the additives and the matrix were concluded through the thermal assessment. The mechanical characterization established that the addition of the mixture of gum rosin and beeswax provides greater tensile strength than those additives separately, facilitating 3D-printing. In contrast, the addition of beeswax increased the ductility of the material, which makes the 3D-printing processing difficult. Despite the fact that both natural additives had a plasticizing effect, the formulations containing gum rosin showed greater elongation at break. Finally, Fourier-Transform Infrared Spectroscopy assessment deduced that polycaprolactone interacts with the functional groups of the additives.

International perspectives on emergency department crowding.

The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes.

Professeur Debry, su personalidad y su entorno / No disponible

El autor describe sus primeros pasos en Nancy comoalumno del profesor Gerard Debry, con quien cursó laDiplomatura en Biología de la Nutrición en la primeramitad de la década de los 70. Describe al profesor Debrycomo un señor serio, afable, sencillo, discreto y muyhumano. Ensalza el alto nivel técnico-científico de loscursos realizados. El autor rememora el recuerdo entrañable de su paso por Nancy y el privilegio de participar en un servicio puntero en la materia

The author describes his early steps as a student in Nancyat the Department of professor Gerard Debry. He followedthe University Diploma in Biology of Human Nutrition inthe early 70s. Describes professor Debry as grave, friendly, easy, discrete and above all, a close human being. He highlights the high scientific and technical level of the courses. The author remembers memories of his stay in Nancy and the privilege of being able to participate in first line service at that time (AU)