Analysis of changes in gingiva-occlusal parameters as perceived by three Middle-East population.

Purpose. This study aims to compare the effect of various smile parameters (buccal corridor, gummy smile, midline to face discrepancy, with and without upper lip filling) on the perception of smile attractiveness by applying the digital modification of images judged by laypersons from different Middle East populations. Materials and Methods. One hundred and eighty participants are divided into 3 groups (n=60: 30 men and 30 women): Lebanese, Syrian, and Egyptian laypersons. A frontal photo of a woman\u27s smile is manipulated with Photoshop to modify each smile parameter gradually into 3 grades. The total number of smiles assessed is 18. In addition, each evaluator must indicate which feature she or he finds most attractive in a face. Analysis of repeated measures variances followed by univariate analyses and multiple comparisons of Bonferroni are performed. Results: Eyes and smile are the most attractive elements in the face. For midline to face discrepancy, only Lebanese laypeople and Egyptian women prefer the coincidence of the midline to face compared with other positions with significant difference (p value 0.05). Concerning the buccal corridor, its size does not influence smile attractive (p value\u3e 0.05). Upper lip filling affected the perception of smile aesthetics for the midline (for Syrians and Egyptians). Conclusion: Sex and culture affect the perception of the smile attractiveness for certain parameters. Alteration of the buccal corridor does not seem to influence the smile attractiveness. Upper lip filling may be advantageous in some cases and unfavorable in others. Clinical significance: Dentists should take into consideration cultural differences when restoring smile aesthetics

Emergency Online Learning in Low-Resource Settings: Effective Student Engagement Strategies

We aim to identify the engagement strategies that higher education students, engaging in emergency online learning in low-resource settings, perceive to be effective. We conducted a sequential mixed-methods study based on Moore’s interaction framework for distance education. We administered a questionnaire to 313 students engaging in emergency online learning in low-resource settings to examine their perceptions of different engagement strategies. Our results showed that student–content engagement strategies, e.g., screen sharing, summaries, and class recordings, are perceived as the most effective, closely followed by student–teacher strategies, e.g., Q and A sessions and reminders. Student–student strategies, e.g., group chat and collaborative work, are perceived as the least effective. The perceived effectiveness of engagement strategies varies based on the students’ gender and technology access. To support instructors, instructional designers, and researchers, we propose a 10-level guide for engaging students during emergency online classes in low-resource settings

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Emergency remote teaching in low-resource contexts: How did teachers adapt?

28th International Conference on Computers in Education, 23-27 November 2020, Web conference.The COVID-19 pandemic forced students and teachers to engage in emergency remote learning. Remote learning is particularly challenging for students and teachers in lowresource contexts. We aim to analyze the adaptation process of teachers who engaged in remote emergency teaching in low-resource contexts. We conduct ten interviews with teachers who provided emergency online teaching in Lebanon. We show that there was a decrease in synchronous student-teacher, student-content, and student-student interactions due to the scarcity of resources. We also show how the teachers adapted their practice to cope with these challenges, and how their adaptation process increased asynchronous student-teacher and student-content interactions

Rapprochement de l'image complexe et de l'image induite : le cas d’une ville touristique libanaise

International audienceLa présente recherche étudie l'image d'une destination touristique libanaise, la ville de Tyr. Afin de comparer les différences existantes entre l'image complexe par les visiteurs de la destination et l'image voulue par la municipalité de la ville, deux études complémentaires ont été effectuées. Les résultats obtenus ont montré l'existence d'une divergence significative entre des composantes essentielles de l'image perçue et celles de l'image désirée de la ville, et par le fait même la nécessité d'un apport d'améliorations au niveau opérationnel et commercial pour garantir une satisfaction des touristes et susciter l'intérêt des touristes potentiels pour cette ville

Formulation de mortiers imprimables incorporant des matériaux recyclés

International audienceLa fabrication additive appliquée au domaine de la construction ouvre des perspectives inédites pour la réalisation d’ouvrages ou d’éléments d’ouvrages de formes complexes. De plus, cette méthode de mise en oeuvre permet d’optimiser la forme et le remplissage des éléments imprimés réduisant ainsi les quantités de matériaux et le poids des pièces fabriquées. Cependant, pour pouvoir tirer le meilleur parti de ce nouveau procédé de construction, les cordons déposés par les imprimantes 3D sont généralement étroits et le matériau extrudé doit posséder une granulométrie suffisamment fine pour éviter les blocages. Ainsi, les matériaux imprimables sont généralement des mortiers voire même des pâtes et ils nécessitent des quantités de ciment nettement plus élevées que les bétons traditionnels, ce qui pénalise lourdement le bilan carbone du procédé. A l’inverse, l’utilisation de fractions fines dans les matériaux imprimables ouvre des perspectives intéressantes pour la valorisation de certains déchets ou sous-produits de granulométrie fine et dont la valorisation est souvent délicate pour les techniques classiques de construction

Emergency Online Learning in Low-Resource Settings: Effective Student Engagement Strategies

We aim to identify the engagement strategies that higher education students, engaging in emergency online learning in low-resource settings, perceive to be effective. We conducted a sequential mixed-methods study based on Moore’s interaction framework for distance education. We administered a questionnaire to 313 students engaging in emergency online learning in low-resource settings to examine their perceptions of different engagement strategies. Our results showed that student–content engagement strategies, e.g., screen sharing, summaries, and class recordings, are perceived as the most effective, closely followed by student–teacher strategies, e.g., Q and A sessions and reminders. Student–student strategies, e.g., group chat and collaborative work, are perceived as the least effective. The perceived effectiveness of engagement strategies varies based on the students’ gender and technology access. To support instructors, instructional designers, and researchers, we propose a 10-level guide for engaging students during emergency online classes in low-resource settings

Crystalline orientation in the polymer matrix of micro-composite resulting from both nucleating platelet fillers and strain field

International audienc