Image analysis of immediate full-arch prosthetic rehabilitations guided by a digital workflow: assessment of the discrepancy between planning and execution

Background A dentition with adequate function and esthetics is essential for the well-being and quality of life. A full implant-retained fixed prosthetics is an ideal solution for fully edentulous arch, however requires complex planning, surgical, and prosthetic procedure. With the help of digital workflow, it becomes a predictable and fast solution for the dentists and the patients. This retrospective study analyzed the most advanced surgical approach in full-arch rehabilitation with dental implants and immediate loading using digital workflow. Methods Patient records of fully edentulous jaws treated in four clinical centers in Warsaw, Poland, were evaluated. Computer-assisted planning and surgical template fabrication were done using the planning software coDiagnostiX™, based on a pre-op cone beam computed tomography (CBCT) and scanned data of a plaster model. A post-op CBCT was acquired after the placement of four to six implants by the guided system. The influence of different surgical variables on the discrepancy between planning and execution was analyzed, together with the biomechanical indices. Results A total of nine patient records were selected of 12 edentulous jaws treated with 62 implants. The overall mean three-dimensional (3D) offset at the implant base was 1.60 mm, at the tip 1.86 mm. The mean angle of deviation was 4.89°, the mean implant stability quotient (ISQ) 70.42, and the insertion torque 35.58 Ncm. The 3D offsets were influenced by the gender of the patient, treated jaw, the diameter, and length of the implant. The angle of deviation was affected only by the treated jaw. Insertion torque was influenced by the treated jaw, the age of the patient, the length of the implant, tooth type, and the side of the jaw. Discussion Bone quality of the patient and implant preparation procedure influenced the discrepancy between the planning and the execution of the digitally guided implant placement. Dense bone—mandible, posterior area, young age, and man—and multiple preparations of the implant bed—wider and longer implant—could be suggested as risk factors. Conclusion Digital workflow successfully enabled the immediate full-arch rehabilitation with a predictable outcome by different surgeons in multiple centers

Impact of HIV Infection and Kaposi Sarcoma on Human Herpesvirus-8 Mucosal Replication and Dissemination in Uganda

Kaposi sarcoma (KS) is the leading cause of cancer in Uganda and occurs in people with and without HIV. Human herpesvirus-8 (HHV-8) replication is important both in transmission of HHV-8 and progression to KS. We characterized the sites and frequency of HHV-8 detection in Ugandans with and without HIV and KS.Participants were enrolled into one of four groups on the basis of HIV and KS status (HIV negative/KS negative, HIV positive/KS negative, HIV negative/KS positive, and HIV positive/KS positive). Participants collected oral swabs daily and clinicians collected oral swabs, anogenital swabs, and plasma samples weekly over 4 weeks. HHV-8 DNA at each site was quantified by polymerase chain reaction (PCR).78 participants collected a total of 2063 orals swabs and 358 plasma samples. Of these, 428 (21%) oral swabs and 96 (27%) plasma samples had detectable HHV-8 DNA. HHV-8 was detected more frequently in both the oropharynx of persons with KS (24 (57%) of 42 persons with KS vs. 8 (22%) of 36 persons without, p = 0.002) and the peripheral blood (30 (71%) of 42 persons with KS vs. 8 (22%) of 36 persons without, p<0.001). In a multivariate model, HHV-8 viremia was more frequent among men (IRR = 3.3, 95% CI = 1.7-6.2, p<0.001), persons with KS (IRR = 3.9, 95% CI = 1.7-9.0, p = 0.001) and persons with HIV infection (IRR = 1.7, 95% CI = 1.0-2.7, p = 0.03). Importantly, oral HHV-8 detection predicted the subsequent HHV-8 viremia. HHV-8 viremia was significantly more common when HHV-8 DNA was detected from the oropharynx during the week prior than when oral HHV-8 was not detected (RR = 3.3, 95% CI = 1.8-5.9 p<0.001). Genital HHV-8 detection was rare (9 (3%) of 272 swabs).HHV-8 detection is frequent in the oropharynx and peripheral blood of Ugandans with endemic and epidemic KS. Replication at these sites is highly correlated, and viremia is increased in men and those with HIV. The high incidence of HHV-8 replication at multiple anatomic sites may be an important factor leading to and sustaining the high prevalence of KS in Uganda

Status of the Republic of Somaliland under international law

Celem niniejszej pracy jest próba określenia statusu Republiki Somalilandu w świetle prawa międzynarodowego - obszaru, który 18 maja 1991 r. ogłosił jednostronnie secesję od Republiki Somalii. Od tego czasu funkcjonuje on w praktyce jako niezależny byt. Pomimo nieustannych starań Somaliland nie jest nadal uznawany przez żadne państwo świata. Sam Somaliland uznaje się za niepodległe państwo, jednak z perspektywy prawa międzynarodowego ustalenie czy tak jest w istocie, czy może Somaliland jest nadal częścią Somalii lub jeszcze czymś innym nie jest takie proste. Pierwszy rozdział pracy poświęcony jest problematyce państw oraz innych podmiotów terytorialnych w prawie międzynarodowym. Następuje próba zdefiniowania czym jest państwo w świetle prawa międzynarodowego. Przedstawione zostają cechy, które dany podmiot musi spełniać, aby móc mienić się państwem. Poruszona zostanie również kwestia uznania międzynarodowego, które odgrywa bardzo ważną rolę, a według części doktryny jest nawet konieczne by móc mówić o państwie. Rozdział drugi poświęcony zostanie omówieniu problematyki powstawania i upadku państw. Szczególna uwaga jest poświęcona pojęciu secesji, które odgrywa główną rolę w badaniu sytuacji prawno-międzynarodowej Somalilandu. Rozdział trzeci w całości jest poświęcony historii państwowości Somalilandu i Somalii. Przedstawione są najważniejsze wydarzenia, które miały wpływ na kształt obecnej sytuacji w regionie. Ostatni rozdział jest rozdziałem podsumowującym, w którym zdarzenia związane z Somalilandem poddane zostają analizie prawnej opartej o wcześniejsze rozważania. Ocenie prawnej poddane zostały m.in. powstanie Republiki Somalii i secesja Somalilandu. Ostatnim elementem pracy jest próba określenia czym Somaliland jest: niepodległym państwem, reżimem de facto czy może po prostu częścią Republiki Somalii.The purpose of this thesis is to attempt to determine the status of Somaliland under international law - an area that unilaterally declared secession from the Republic of Somalia on 18 May 1991. Since then, it has functioned in practice as an independent entity. Despite sustained efforts, Somaliland is still not recognised by any state in the world. Somaliland itself recognises itself as an independent state, but from the perspective of international law, determining whether this is in fact the case, or whether Somaliland is still part of Somalia or something else is not so simple. The first chapter of the thesis is devoted to the issue of states and other territorial entities in international law. There follows an attempt to define what a state is in the light of international law. The characteristics that an entity must fulfil in order to be called a state are presented. It also addresses the issue of international recognition, which plays a very important role and, according to some doctrine, is even necessary to be able to speak of a state. The second chapter will be devoted to discussing the issue of state formation and collapse. Particular attention is given to the concept of secession, which plays a central role in the study of Somaliland's legal and international situation. Chapter three is entirely devoted to the history of Somaliland and Somali statehood. The major events that have shaped the current situation in the region are presented. The final chapter is a concluding chapter in which events related to Somaliland are subjected to a legal analysis based on previous considerations. Amongst others, the establishment of the Republic of Somalia and the secession of Somaliland are assessed in legal terms. The final element of the thesis is an attempt to define what Somaliland is: an independent state, a de facto regime or perhaps simply part of the Republic of Somalia

Experimental investigation of the ecological hybrid refrigeration cycle

The requirements for environmentally friendly refrigerants promote application of CO2 and water as working fluids. However there are two problems related to that, namely high temperature limit for CO2 in condenser due to the low critical temperature, and low temperature limit for water being the result of high triple point temperature. This can be avoided by application of the hybrid adsorption-compression system, where water is the working fluid in the adsorption high temperature cycle used to cool down the CO2 compression cycle condenser. The adsorption process is powered with a low temperature renewable heat source as solar collectors or other waste heat source. The refrigeration system integrating adsorption and compression system has been designed and constructed in the Laboratory of Thermodynamics and Thermal Machine Measurements of Cracow University of Technology. The heat source for adsorption system consists of 16 tube tulbular collectors. The CO2 compression low temperature cycle is based on two parallel compressors with frequency inverter. Energy efficiency and TEWI of this hybrid system is quite promising in comparison with the compression only systems