Background Surgical, anaesthetic, and obstetric (SAO) health-care system strengthening is needed to address the emergency and essential surgical care that approximately 5 billion individuals lack globally. To our knowledge, a complete, non-modelled national situational analysis based on the Lancet Commission on Global Surgery surgical indicators has not been done. We aimed to undertake a complete situation analysis of SAO system preparedness, service delivery, and financial risk protection using the core surgical indicators proposed by the Commission in Colombia, an upper-middle-income country.Methods Data to inform the six core surgical system indicators were abstracted from the Colombian national health information system and the most recent national health survey done in 2007. Geographical access to a Bellwether hospital (defined as a hospital capable of providing essential and emergency surgery) within 2 h was assessed by determining 2 h drive time boundaries around Bellwether facilities and the population within and outside these boundaries. Physical 2 h access to a Bellwether was determined by the presence of a motor vehicle suitable for individual transportation. The Department Administrativo Nacional de Estadística population projection for 2016 and 2018 was used to calculate the SAO provider density. Total operative volume was calculated for 2016 and expressed nationally per 100 000 population. The total number of postoperative deaths that occurred within 30 days of a procedure was divided by the total operative volume to calculate the all-cause, non-risk-adjusted postoperative mortality. The proportion of the population subject to impoverishing costs was calculated by subtracting the baseline number of impoverished individuals from those who fell below the poverty line once out-of-pocket payments were accounted for. Individuals who incurred out-of-pocket payments that were more than 10% of their annual household income were considered to have experienced catastrophic expenditure. Using GIS mapping, SAO system preparedness, service delivery, and cost protection were also contextualised by socioeconomic status. FindingsIn 2016, at least 7•1 million people (15•1% of the population) in Colombia did not have geographical access to SAO services within a 2 h driving distance. SAO provider density falls short of the Commission's minimum target of 20 providers per 100 000 population, at an estimated density of 13•7 essential SAO health-care providers per 100 000 population in 2018. Lower socioeconomic status of a municipality, as indicated by proportion of people enrolled in the subsidised insurance regime, was associated with a smaller proportion of the population in the municipality being within 2 h of a Bellwether facility, and the most socioeconomically disadvantaged municipalities often had no SAO providers. Furthermore, Colombian providers appear to be working at or beyond capacity, doing 2690-3090 procedures per 100 000 population annually, but they have maintained a relatively low median postoperative mo...

The ability to use Food Layered Manufacturing (FLM) to fabricate attractive food presentations and incorporate additives that can alter texture, nutrition, color, and flavor have made it widely investigated for combatting various issues in the food industry. For a food item to be FLM compatible, it must possess suitable rheological properties to allow for its extrusion and to keep its 3D printed structure. Here, we present a rheological analysis of two commercially available breakfast spreads, Vegemite and Marmite, and show their compatibility with FLM in producing 3D structures onto bread substrates. Furthermore, we demonstrated that these materials can be used to fabricate attractive food designs that can be used for educational activities. The inherent conductivity of the breakfast spreads was used to print edible circuits onto a "breadboard.". Abstract 9The ability to use Food Layered Manufacturing (FLM) to fabricate attractive food 10 presentations and incorporate additives that can alter texture, nutrition, color, and flavor have 11 made it widely investigated for combatting various issues in the food industry. For a food 12 item to be FLM compatible, it must possess suitable rheological properties to allow for its 13 extrusion and to keep its 3D printed structure. Here, we present a rheological analysis of two 14 commercially available breakfast spreads, Vegemite and Marmite, and show their 15 compatibility with FLM in producing 3D structures onto bread substrates. Furthermore, we 16 demonstrated that these materials can be used to fabricate attractive food designs that can be 17 used for educational activities. The inherent conductivity of the breakfast spreads was used to 18 print edible circuits onto a "breadboard." 19

We present a star copolypeptide-based hydrogel ink capable of structural microfabrication using 3D extrusion printing. The material comprises an amphiphilic block copolymer structure of poly(benzyl-l-glutamate)- b-oligo(l-valine), which spontaneously forms hydrogels through hydrophobic interactions. The chemical design allows the bulk phase of the hydrogel to remain intact after application of shear due to its self-recovery behavior. It is demonstrated that the composition of the materials is ideally suited for 3D printing with scaffolds capable of maintaining structural cohesion after extrusion. Post extrusion UV-triggered fixation of the printed structures is carried out, resulting in stable hydrogel constructs. The constructs were found to be degradable, exhibited favorable release of encapsulated molecular cargo, and do not appear to affect the metabolic health of the commonly used fibroblastic cell line Balb/3T3 in the absence of the reactive diluent N, N'-methylenebis(acrylamide). The star copolypeptide inks allow for rapid prototyping enabling the fabrication of defined intricate microstructures, providing a platform for complex scaffold development that would otherwise be unattainable with other processing techniques such as molding or casting.