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Cobotized intra-oral digitization: a preliminary study
No full textNational audienceThis article investigates the potential of using a collaborative robot (cobot) to perform intra-oral scanning for dental applications. In a field where intra-oral scanners (IOS) have revolutionized dental restorations by offering enhanced digital accuracy and patient comfort, manual operation remains highly dependent on the operator's skill. This dependency can lead to inconsistencies in scan quality and may increase the risk of musculoskeletal disorders due to repetitive movements and awkward postures. This study thus explores whether a cobotized approach could reduce operator bias, improve repeatability, and ultimately serve as a valuable teaching tool in dental training.The experimental setup involves a standardized mandibular model based on a 3D-printed anatomical reference. The model is fixed in an articulator simulating an average 45 mm mouth opening to mimic in-vivo conditions. A Dexis IS3800 wireless IOS, chosen for its compact design and ease of use, is mounted on a UR5e cobot fitted with an adaptive gripper. Two scanning trajectories are tested. The first, called the OVL (occlusal-vestibular-lingual) pathway, entails a continuous movement where the scanner first covers the occlusal surface, then the vestibular side, and finally the lingual side of the mandible. The second, the S-shape pathway, involves scanning the three surfaces for each tooth sequentially before moving to the next. To optimize the scanning process and ensure smooth trajectories, a virtual twin of the experimental setup is created using RoboDK. This digital simulation aids in adjusting the scanner's position and orientation while preventing collisions and identifying any non-visible areas that require further attention.For comparison, an experienced practitioner performed manual scans using the OVL pathway under identical experimental conditions. The resulting STL files from both cobotized and manual scans were then analyzed with Zeiss Inspect optical 3D software. The evaluation focused on metrics such as the number of vertices, facets, and the total digitized surface area. In addition, the study introduced two quantitative criteria: the ratio (Rmesh) of the valid scanned area to the nominal mesh and the weighted normalized distance (wND), which measures the volumetric deviation between the scanned and nominal meshes. Although the manual scans produced a slightly larger digitized surface?attributed to the operator's real-time feedback?the cobotized scans exhibited higher point density and lower variability. In terms of accuracy, manual scanning demonstrated marginally better results, but the difference in wND between the two methods was less than 10 µm, a discrepancy deemed clinically acceptable.Overall, the study suggests that while manual scanning may benefit from immediate corrective actions, the cobotized approach offers superior consistency and repeatability. With further optimization in scanner positioning and pathway refinement, cobotized intra-oral digitization shows promise for reducing operator-related errors and fatigue in dental practices, as well as enhancing dental education
Care pathways for critically ill children aged 0–5 years arriving at district hospitals in Burkina Faso, Guinea, Mali, and Niger (2022): a cross-sectional study
No full textInternational audienceAbstract Background Under-five mortality remains high in West Africa, where sick children are expected to first attend the primary health care before being referred to a hospital if necessary. However, little is known about how families navigate between home and higher levels of care to meet their children’s health needs, despite multiple known barriers (including social, financial, and geographical accessibility). We analysed the care pathways of children aged 0–5 years before they presented to the district hospital with a serious illness and the determinants of these care pathways in four West African countries. Methods From May to August 2022, we conducted a cross-sectional study over a one-month data collection in seven district hospitals participating in the AIRE project aimed to introduce pulse oximetry at primary health care level in Burkina Faso, Guinea, Mali, and Niger. All children aged 0–5 years, classified as severe or priority cases by clinicians at referral district hospitals were included after parental consent. Data about care pathways since the onset of their disease were collected from caregivers, and the Levesque framework was used to analyse the accessibility issues. Results A total of 861 severely ill children were included, with 33% being neonates: 20.3% in Burkina Faso, 9.2% in Guinea, 9.5% in Mali, and 61% in Niger. In Burkina Faso and Niger, most children followed the recommended care pathway and first visited a primary health centre before arriving at the hospital, with 81.1% and 73.3% of children, respectively. However, they were only 51.2% in Mali and 13.9% in Guinea. Using alternative pathways was common, particularly in Guinea, where 30.4% of children first consulted a pharmacist, and Mali, where 25.6% consulted a traditional medicine practitioner. Overall, primary care was perceived to be more geographically accessible and less expensive, but parents were much less convinced that it could improve their child's health compared to hospital care. Conclusion The recommended pathway is largely adhered to, yet parallel pathways require attention, notably in Guinea and Mali. A better understanding of healthcare-seeking behaviours can help remove barriers to care, improving the likelihood that a sick child will receive optimal care
Exploring the full magneto-ionic oxidation spectrum in Pt/CoFeB/HfO2
No full textInternational audienceWe show that in Pt/CoFeB/HfO2 a wide range of oxidation levels at the ferromagnet/oxide interface can be accessed through magneto-ionic gating using ionic liquid gates. Perpendicular magnetic anisotropy (PMA) is induced at intermediate oxidation levels, while two in-plane anisotropy states with nonequivalent ionic states are induced for under-oxidized and over-oxidized interfaces. This system shows reversibility and non-volatility in the whole range of oxidation states, where oxidation levels have been monitored by x-ray absorption spectroscopy and x-ray photoelectron spectroscopy. This study shows that multistate magneto-ionic memory elements with a wider range of intermediate states can be designed by leveraging both under- and over-oxidation around the optimal oxidation state that induces PMA
Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses
No full textInternational audienceObjective: To evaluate the existing meta-analytic evidence of associations between exposure to ultra-processed foods, as defined by the Nova food classification system, and adverse health outcomes.Design: Systematic umbrella review of existing meta-analyses.Data sources: MEDLINE, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews, as well as manual searches of reference lists from 2009 to June 2023.Eligibility criteria for selecting studies: Systematic reviews and meta-analyses of cohort, case-control, and/or cross sectional study designs. To evaluate the credibility of evidence, pre-specified evidence classification criteria were applied, graded as convincing ("class I"), highly suggestive ("class II"), suggestive ("class III"), weak ("class IV"), or no evidence ("class V"). The quality of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorised as "high," "moderate," "low," or "very low" quality.Results: The search identified 45 unique pooled analyses, including 13 dose-response associations and 32 non-dose-response associations (n=9 888 373). Overall, direct associations were found between exposure to ultra-processed foods and 32 (71%) health parameters spanning mortality, cancer, and mental, respiratory, cardiovascular, gastrointestinal, and metabolic health outcomes. Based on the pre-specified evidence classification criteria, convincing evidence (class I) supported direct associations between greater ultra-processed food exposure and higher risks of incident cardiovascular disease related mortality (risk ratio 1.50, 95% confidence interval 1.37 to 1.63; GRADE=very low) and type 2 diabetes (dose-response risk ratio 1.12, 1.11 to 1.13; moderate), as well as higher risks of prevalent anxiety outcomes (odds ratio 1.48, 1.37 to 1.59; low) and combined common mental disorder outcomes (odds ratio 1.53, 1.43 to 1.63; low). Highly suggestive (class II) evidence indicated that greater exposure to ultra-processed foods was directly associated with higher risks of incident all cause mortality (risk ratio 1.21, 1.15 to 1.27; low), heart disease related mortality (hazard ratio 1.66, 1.51 to 1.84; low), type 2 diabetes (odds ratio 1.40, 1.23 to 1.59; very low), and depressive outcomes (hazard ratio 1.22, 1.16 to 1.28; low), together with higher risks of prevalent adverse sleep related outcomes (odds ratio 1.41, 1.24 to 1.61; low), wheezing (risk ratio 1.40, 1.27 to 1.55; low), and obesity (odds ratio 1.55, 1.36 to 1.77; low). Of the remaining 34 pooled analyses, 21 were graded as suggestive or weak strength (class III-IV) and 13 were graded as no evidence (class V). Overall, using the GRADE framework, 22 pooled analyses were rated as low quality, with 19 rated as very low quality and four rated as moderate quality.Conclusions: Greater exposure to ultra-processed food was associated with a higher risk of adverse health outcomes, especially cardiometabolic, common mental disorder, and mortality outcomes. These findings provide a rationale to develop and evaluate the effectiveness of using population based and public health measures to target and reduce dietary exposure to ultra-processed foods for improved human health. They also inform and provide support for urgent mechanistic research
Du Bonheur des Dames au Paradis : les spectacles du grand magasin
No full textInternational audienceLa série britannique The Paradise (Bienvenue au Paradis), diffusée en 2012 en deux saisons sur la BBC, adapte librement Au Bonheur des Dames (1883) d’Émile Zola en transposant son univers fictionnel du Paris des années 1864-1869 au Nord-Est de l’Angleterre victorienne. Que rend possible ce déplacement dans l’espace et dans le temps d’un chronotope central – le grand magasin – magistralement étudié et mis en évidence dans le roman emblématique de Zola ? L’adaptation télévisée propose une nouvelle lecture d’un récit traitant du développement du capitalisme moderne, de l’émergence d’une culture de la consommation et de la constitution d’une nouvelle catégorie socioprofessionnelle de la vendeuse, incarnation de la « misère en robe de soie », située entre le monde ouvrier d’où elle est issue et la bourgeoise qu’elle sert. La transposition spatiotemporelle opérée par la série permet d’édulcorer, par le puritanisme, le traitement parfois très cru de conditions de vie difficiles, entre précarité financière et prostitution forcée. Elle revisite également les trajectoires d’ascension sociale et propose une autre vision de la hiérarchie entre l’aristocratie qui prête ses moyens et son concours à la consolidation du magasin, et la petite bourgeoisie dont la consommation compulsive permet de faire vivre et prospérer l’enseigne. Par ailleurs, d’un pays à l’autre, la dimension politique de la fiction zolienne se trouve elle aussi modifiée, réinterprétant les enjeux relatifs à la grandeur de la nation par le faste du spectacle et l’ambition du projet haussmannien. Enfin, le format sériel de l’adaptation télévisée permet de revoir l’importance et la destinée des protagonistes : des liens de rivalité, mais aussi de solidarité, se tissent autrement entre les vendeuses, autour du personnage central de Denise Baudu, renommée Denise Lovett. En comparant dans le détail le roman de Zola, son dossier préparatoire et la série de 2012, cette communication propose d’examiner la triple relecture historique, politique et narrative proposée par l’adaptation contemporaine. Du Bon Marché au « Paradis » en passant par le « Bonheur des Dames », quelles resémiotisations de ce lieu central, réel et fantasmé, qu’est le grand magasin peut-on ainsi observer ? Si Zola s’attachait à montrer que ce dernier était déjà en lui-même tout un spectacle, comment le spectacle télévisuel traduit-il à son tour cette composante majeure de la fiction littéraire ? L’analyse intégrera également les éléments créatifs de la pièce de théâtre immersive proposée en 2022 par le Bon Marché Rive Gauche in situ dans ses rayonnages, à partir du roman de Zola, en collaboration avec Crumble Production, à l’occasion des 170 ans du magasin
Development, validity and reproducibility of a semi-quantitative food frequency questionnaire for use among adult population in Reunion island
No full textInternational audienc
Le débaguage orthodontique, l'art de conclure sans abimer!
No full textNational audienceOften regarded as a mere formality marking the endof orthodontic treatment, bracket removal is in facta procedure with a high iatrogenic risk. This step,sometimes performed hastily or too quickly, can leadto irreversible damage to already weakened enamel- a paradox considering the patience required overmonths or even years of orthodontic treatment.Although data on the subject exist in the literature,a lack of information, training, or the underestimationof potential harm often results in quality beingunintentionally sacrificed in favor of speed. This articleaims to reestablish debonding as a central clinicalconcern, exploring the limitations of currentinstrumentation while opening avenues toward moreprecise, tissue-friendly tools that remain compatiblewith the time constraints of everyday clinical practice.Souvent considéré comme une simple formalité marquant la findu traitement, le débaguage orthodontique est en réalité une étapeà haut risque iatrogène. Réalisé parfois de manière « précipitée »,il peut entraîner des dommages irréversibles sur un émail fragilisé.Un paradoxe, compte tenu de la patience imposée durant desmois, voire des années de traitement. Bien que des donnéesexistent dans la littérature, le manque d’informations, de formationou la sous-estimation des dégâts potentiels conduisent à sacrifier,parfois involontairement, la qualité au profit de la rapidité. Cet articlepropose de replacer le débaguage au centre des préoccupationscliniques. Il s’intéresse aux limites des instruments actuellementdisponibles, tout en ouvrant des pistes vers une instrumentationplus précise, mieux tolérée par les tissus dentaires et compatibleavec les contraintes de temps de la pratique clinique quotidienne
Bregman Conditional Random Fields: Sequence Labeling with Parallelizable Inference Algorithms
No full textInternational audienceWe propose a novel discriminative model for sequence labeling called Bregman conditional random fields (BCRF). Contrary to standard linear-chain conditional random fields, BCRF allows fast parallelizable inference algorithms based on iterative Bregman projections. We show how such models can be learned using Fenchel-Young losses, including extension for learning from partial labels. Experimentally, our approach delivers comparable results to CRF while being faster, and achieves better results in highly constrained settings compared to mean field, another parallelizable alternative
Parenthood and all-cause mortality in older adults with schizophrenia: a multicenter 5-year prospective study
No full textInternational audienceThe large body of literature examining the association between parenthood and mortality in the general population contrasts with a lack of such studies on older adults with schizophrenia. Identifying potential protective factors of premature death in this population is important to help guide prevention measures. Here, we examined whether all-cause and cause-specific mortality rates significantly differ between older parents and non-parents with schizophrenia during a 5-year follow-up. Methods: We used data from a 5-year prospective multicenter sample of older adults with an ICD-10 diagnosis of schizophrenia (aged 55 years or more) recruited in France. We performed a forward stepwise logistic regression to examine the association between parenthood and all-cause mortality, Results: Of the 323 older adults with schizophrenia, 133 (41.2%) were parents (mean age = 67.0, SD = 6.1) and 190 were not (mean age = 67.2, SD = 6.6). Following adjustments, parenthood was significantly associated with lower all-cause mortality compared to patients without children (21.1% [n=28] vs. 35.8% [n=68]; AOR = 0.50; 95%CI 0.27-0.94; p = 0.032); the association involved Conclusion: Parenthood could be a protective factor against mortality among older patients with schizophrenia who live in France. Further research is needed to understand the specific mechanisms underlying this association