A Simplified Technique for Implant-Abutment Level Impression After Soft Tissue Adaptation Around Provisional Restoration

Impression techniques for implant restorations can be implant level or abutment level impressions with open tray or closed tray techniques. Conventional implant-abutment level impression techniques are predictable for maximizing esthetic outcomes. Restoration of the implant traditionally requires the use of the metal or plastic impression copings, analogs, and laboratory components. Simplifying the dental implant restoration by reducing armamentarium through incorporating conventional techniques used daily for crowns and bridges will allow more general dentists to restore implants in their practices. The demonstrated technique is useful when modifications to implant abutments are required to correct the angulation of malpositioned implants. This technique utilizes conventional crown and bridge impression techniques. As an added benefit, it reduces costs by utilizing techniques used daily for crowns and bridges. The aim of this report is to describe a simplified conventional impression technique for custom abutments and modified prefabricated solid abutments for definitive restorations

Precipitation Variability and Probabilities of Extreme Events in the Eastern Mediterranean Region (Latakia Governorate-Syria as a Case Study)

This study aimed at analysis of the general-index change for the mean annual and seasonal precipitation in six stations in Latakia Governorate (Syria). The data of precipitation were collected for 40 consecutive years (1970–2010) in order to figure out the extent of the changes and variability in precipitation rates and the impact of this change on changes in the potential density that might cause extremely high or low precipitation rates according to Gumbel distribution of the extreme precipitation rates. Results revealed a decrease of the annual precipitation rates in all stations, the reduction in precipitation ranged from 46 to 210 mm during the whole period of the study. Spring, however, recorded the highest and statistically significant reduction, which reached 46–210 mm, while winter precipitation increased by 21–82 mm. Spring also has witnessed a decrease of about 3–9% of the total annual precipitation as compared to winter precipitation which increased by 5–8% of the total. The potential density of extremely high winter precipitation rates increased in all stations as indicated from Gumbel distribution in winter, and a greater increase took place in the probabilities of occurrence of the extremely low spring precipitation rates. This shows significant probability of occurrence of drought during spring season. By contrast, probabilities of winter precipitation rates increased more, thus winter is relatively more humid than before and spring is relatively drier than before

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Country- and sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Country- and sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies

Self-Reflections in a Personal Space: Investigating the Process of Self-Portrait Painting by Academic Research

The purpose of this practice-based paper is to investigate the artistic reflections and self-aesthetics into the process of artwork making. Every stage of this process represents a particular significance from the initial stage to the finishing stage. Furthermore, this exploration aims to develop the employment of practical research in the field of Visual Arts on personal, communal and institutional levels. In this exploration, the methodology is the vehicle that transforms the research into reality. Making the artwork itself is the methodology, and this process is the primary reference of the present research. Therefore, the author presents the synthesis of the artwork making rather than the analysis of its aftermath, the focus in this context is the construction of the artwork. This is the result of this research, the artwork itself. Regarding the employability aspects of this approach, it involves the practitioners and researchers in the fields of the visual arts toward further realizations of the actual creative process. This employability takes place into the signs of progress on different levels through academic and artistic practices in schools, universities as well as higher learning and teaching institutions. The present practical paper is significant because it investigates reflections of the cultural identity as well as the narratives of personal memory into academic research. In the multicultural present temporality, research-oriented artists highlight the diversity of their societies and represent significantly personal aesthetics as themes in their artworks. This approach would elevate the mutual understanding among people from different aesthetical backgrounds; people's trends enhance multicultural perceptions, harmony, and coexistence. In addition, artists in this regard illustrate such an approach in their visual art when they compose practice and research with the symbolic content, which reflects social motives. Artists practice such art to critique the violent content in communication media and educate people that media may fake reality to create more audience and viewers. This study focused on the significance of subjective representations in contemporary arts, and the impact of such representations on the mutual understanding among people of multicultural societies. Keywords: Contemporary Art Practice, Studio-Based Methodology, Practice-Based Research, Hybrid Painting Techniques, Multimedia, Mixed media, Photography. DOI: 10.7176/JEP/11-12-18 Publication date: April 30th 202

People’s Reflections in the City: Exploring the Painting Practices of Figurative Expressionism by Academic Research

This paper is a practical outcome of a multidisciplinary research project conducted by the authors on the contemporary and modern practices of the Improvisation in Arts. All the authors are research-oriented practitioners in the fields of visual arts, performance arts, multimedia, Information and communication technologies as well as vocational training. Furthermore, the drawings, paintings, and sketches are all made by the correspondent author Assistant Professor Dr. Mohammed Baker Mohammed Al-Abbas as part of his research-oriented artistic practice through the hybrid painting techniques. Abstract The present studio-based paper aims to explore the creative reflections of the aesthetics of otherness within the practical phases of the painting production. This paper represents an experimental endeavor to create a two-dimensional artwork, which is a hybrid painting technique on canvas with mixed media and acrylic paints. Within such a specific practice-based context, each phase of this practical approach outlines a critical significance from the first phase of creating that painting to the completing phase. The practical methodology is the tool that converts the researcher's/artist's vision into creative academic production. The process of creating the painting on the canvas is the methodology; such manner turns to be a primary reference for the present exploration. There is a significant paradigm in this approach, which focuses on the artwork as a morphological creature being created by the researcher/artist rather than a consequent result that only exists as a finished/complete/polished outcome. The outcome of this research is the record of the artwork production itself. This record presents visual references of the artwork progress as well as a textual reflective narrative to describe this process with written words. This research-oriented artistic attempt introduces the artists and researchers in the domains of the Fine Arts to integrate the process of art-making into the methodologies of academic research. It is an academic text, reflective text as well as sequential images recording the artwork making. This studio-based experimentation is significant because it examines the aesthetics of the otherness into the expressive figurative abstraction in painting. Furthermore, the impact of such a studio-based approach manifests on advancing applications of the artistic oriented research in the field of Fine Arts globally on curatorial and academic levels. Keywords: Contemporary Art Practice, Studio-Based Methodology, Practice-Based Research, Hybrid Painting Techniques, Multimedia, Mixed media, Photography DOI: 10.7176/JEP/11-10-08 Publication date: April 30th 202

An improved electroporator with continuous liquid flow and double-exponential waveform for liquid food pasteurization

Pulsed electric field (PEF) pasteurisation keeps treated liquid food fresh and nutritious compared to traditional thermal pasteurisation. However, PEF adoption is still limited on an industrial scale due to a lack of practical systems. As a result, a great deal of research has gone into overcoming the limitations of the existing systems. Keeping this in mind, the current study contributes to the improvement of the electroporator. The heterogeneous electric field's distribution raises the temperature of the treated food samples. Liquid laminar flow is a reason for heterogeneous electric field's distribution in continuous treatment. Hotspots may also be created by using an inefficient high-voltage waveform in addition to the heterogeneous electric field distribution. This study rectifies the heterogeneous distribution by proposing an improved coaxial treatment chamber and double-exponential waveform to replace the exponential-decaying waveform. A static mixer provides an increased mixing, i.e. disrupting the laminar flow, inside the treatment zone. COMSOL based computational model was developed to study flow behaviour and corresponding temperature distribution in the proposed coaxial treatment chamber with sieves. Based on the model, it has been concluded that coaxial electrodes with sieves provide more homogeneous flow properties inside the treatment chamber. The effectiveness of the double-exponential (DE) waveform was validated using MATLAB. A three-stage Marx generator giving the DE waveform was designed and constructed. The performance of the improved treatment chamber together with the DE waveform, known as the electroporator, was studied using chemical and microbial analysis. Untreated, PEF treated, and thermal treated orange samples were stored at 4°C for 9 days before being examined. The lowest microbial growth was observed in both the PEF treated with sieves and thermally treated food samples than the untreated sample. However, treated juices' visual and chemical colour analysis showed that the PEF-treated sample acquired a brighter appearance than a thermally processed sample. Thus, this study provides significant findings in developing and utilising an electroporator to inactivate microorganisms

Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021

Background Previous global analyses, with known underdiagnosis and single cause per death attribution systems, provide only a small insight into the suspected high population health effect of sickle cell disease. Completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, this study delivers a comprehensive global assessment of prevalence of sickle cell disease and mortality burden by age and sex for 204 countries and territories from 2000 to 2021. Methods We estimated cause-specific sickle cell disease mortality using standardised GBD approaches, in which each death is assigned to a single underlying cause, to estimate mortality rates from the International Classification of Diseases (ICD)-coded vital registration, surveillance, and verbal autopsy data. In parallel, our goal was to estimate a more accurate account of sickle cell disease health burden using four types of epidemiological data on sickle cell disease: birth incidence, age-specific prevalence, with-condition mortality (total deaths), and excess mortality (excess deaths). Systematic reviews, supplemented with ICD-coded hospital discharge and insurance claims data, informed this modelling approach. We employed DisMod-MR 2.1 to triangulate between these measures—borrowing strength from predictive covariates and across age, time, and geography—and generated internally consistent estimates of incidence, prevalence, and mortality for three distinct genotypes of sickle cell disease: homozygous sickle cell disease and severe sickle cell β-thalassaemia, sickle-haemoglobin C disease, and mild sickle cell β-thalassaemia. Summing the three models yielded final estimates of incidence at birth, prevalence by age and sex, and total sickle cell disease mortality, the latter of which was compared directly against cause-specific mortality estimates to evaluate differences in mortality burden assessment and implications for the Sustainable Development Goals (SDGs). Findings Between 2000 and 2021, national incidence rates of sickle cell disease were relatively stable, but total births of babies with sickle cell disease increased globally by 13·7% (95% uncertainty interval 11·1–16·5), to 515 000 (425 000–614 000), primarily due to population growth in the Caribbean and western and central sub-Saharan Africa. The number of people living with sickle cell disease globally increased by 41·4% (38·3–44·9), from 5·46 million (4·62–6·45) in 2000 to 7·74 million (6·51–9·2) in 2021. We estimated 34 400 (25 000–45 200) cause-specific all-age deaths globally in 2021, but total sickle cell disease mortality burden was nearly 11-times higher at 376 000 (303 000–467 000). In children younger than 5 years, there were 81 100 (58 800–108 000) deaths, ranking total sickle cell disease mortality as 12th (compared to 40th for cause-specific sickle cell disease mortality) across all causes estimated by the GBD in 2021. Interpretation Our findings show a strikingly high contribution of sickle cell disease to all-cause mortality that is not apparent when each death is assigned to only a single cause. Sickle cell disease mortality burden is highest in children, especially in countries with the greatest under-5 mortality rates. Without comprehensive strategies to address morbidity and mortality associated with sickle cell disease, attainment of SDG 3.1, 3.2, and 3.4 is uncertain. Widespread data gaps and correspondingly high uncertainty in the estimates highlight the urgent need for routine and sustained surveillance efforts, further research to assess the contribution of conditions associated with sickle cell disease, and widespread deployment of evidence-based prevention and treatment for those with sickle cell disease.publishedVersio

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London