Monitoring the progression of erosive tooth wear (ETW) using BEWE index in casts and their 3D images : a retrospective longitudinal study

Objective: To determine if the Basic erosive tooth wear index (BEWE index) is able to assess and monitor ETW changes in two consecutive cast models, and detect methodological differences when using the corresponding 3D image replicas. Methods: A total of 480 pre-treatment and 2-year post-treatment orthodontic models (n = 240 cast models and n = 240 3D image replicas) from 120 adolescents treated between 2002 and 2013 at the Gent Dental Clinic, Belgium, were scored using the BEWE index. For data analysis only posterior sextants were considered, and inter-method differences were evaluated using Wilcoxon Signed Rank test, Kappa values and Me Nemar tests (p < 0.05). Correlations between methods were determined using Kendall tau correlation test. Results: Significant changes of ETW were detected between two consecutive models when BEWE index was used to score cast models or their 3D image replicas (p < 0.001). A strong significant correlation (tau b: 0.74; p < 0.001) was shown between both methods However, 3D image-BEWE index combination showed a higher probability for detecting initial surface changes, and scored significantly higher than casts (p < 0.001). Incidence and progression of ETW using 3D images was 13.3% (n = 16) and 60.9% (n = 56) respectively, with two subjects developing BEWE = 3 in at least one tooth surface. Conclusions: BEWE index is a suitable tool for the scoring of ETW lesions in 3D images and cast. The combination of both digital 3D records and index, can be used for the monitoring of ETW in a longitudinal approach. The higher sensibility of BEWE index when scoring 3D images might improve the early diagnosis of ETW lesions. Clinical significance: The BEWE index combined with digital 3D records of oral conditions might improve the practitioner performance with respect to early diagnosis, monitoring and managing ETW

The impact of a preventive and curative oral healthcare program on the prevalence and incidence of oral health problems in nursing home residents

Aims: To assess the impact of an oral healthcare program in nursing homes on the initial treatment backlog and residents' oral health stability. Materials and methods: The study is a longitudinal cohort study in nursing home residents in Flanders, Belgium, to evaluate the oral healthcare programme Gerodent. The program consisted of: (1) the introduction of an oral healthcare team, (2) oral health education, (3) the implementation of oral health guidelines and protocols, and (4) regular visits of a mobile dental team. Data were extracted from the oral health records of 381 residents from 21 nursing homes who received treatments from the mobile dental team between October 2010 and March 2014 (mean follow-up period of 22.5 months). Oral health and treatment need between baseline and follow-up were compared. Results: The mean age at baseline was 82.4 years and the mean number of consultations per resident was 3.61 during the follow-up period. The proportion of residents with an oral treatment need was reduced from 65.9% to 31.3%. Among residents with natural teeth, there was significantly lower prevalence of caries (from 70.5% at baseline to 36.5% at follow-up; p<0.001), residual roots (from 54.2% to 25.1%; p<0.001), and need for fillings (from 31.9% to 17.1%; p<0.001) or extractions (from 64.3% to 31.6%; p<0.001). In the group with partial or full dentures (n = 223), 38.1% needed a repair, rebasing or renewal of their existing dentures at baseline and the respective figure at follow-up was 9.0% (p<0.001). In terms of oral health stability, 53% of the residents had no incident restorative and prosthetic treatment need throughout the follow-up period. A lower number of natural teeth at baseline (p<0.001) and a shorter follow-up period (p = 0.002) were associated with higher chances of oral health stability. Conclusion: The oral healthcare program Gerodent significantly reduced the treatment backlog and contributed to a considerable proportion of residents being stable in terms of oral health without any incident treatment needs

Electron energy loss spectroscopy determination of Ti oxidation state at the (001) LaAlO3/SrTiO3 interface as a function of LaAlO3 growth conditions

At the (001) interface between the two band-insulators LaAlO3 and SrTiO3, a high-mobility electron gas may appear, which has been the object of numerous works over the last four years. Its origin is a subject of debate between the interface polarity and unintended doping. Here we use electron energy loss 'spectrum images', recorded in cross-section in a scanning transmission electron microscope, to analyse the Ti3+ ratio, characteristic of extra electrons. We find an interface concentration of Ti3+ that depends on growth conditions.Comment: 6 page

Tubulopathy in nephrolithiasis: Consequence rather than cause

Tubulopathy in nephrolithiasis: Consequence rather than cause. To address whether a renal tubular dysfunction is encountered in a particular patient subgroup with urolithiasis, the following parameters of tubular function were measured in urine taken in the morning from 214 stone formers after fasting: pH, excretion of lysozyme and γ-glutamyl transferase (γ-GT); fractional excretion (FE) of glucose, insulin, Mg, K, and HCO3 after an alkali loading; and the renal threshold for phosphate (TmP/GFR). The following diagnoses were made in the patient group: primary hyperparathyroidism (N = 8), medullary sponge kidneys (N = 21), hyperuricemia (N = 10), cystinuria (N = 2), struvite stone disease (N = 6), idiopathic hypercalciuria of the absorptive (N = 25), dietary (N = 69) or renal (N = 7) type, and normocalciuric idiopathic urolithiasis (N = 66). In 31% of the patients TmP/GFR was below 0.80 mmole/liter and in 13% of the patients, FE HCO3 after alkali loading was above normal. Urinary excretion of lysozyme and that of γ-GT both were elevated in 17% of the patients. FE glucose, FE insulin, FE Mg, and FE K were elevated in 8, 9, 3, and 7% of the patients, respectively. This study demonstrates that a significant number of stone formers present with signs of renal tubular dysfunction, primarily involving the proximal tubule since apparent leaks of phosphate and of bicarbonate were most frequently encountered. The defects were not specific for a given etiologic group of patients; on the other hand, occurrence was related to the presence of large stones in the pyelocaliceal system at the time data were gathered. Taken together these data suggest that the tubulopathy in nephrolithiasis is the consequence rather than the cause of the stone

Curvature radius measurement by optical profiler and determination of the residual stress in thin films

The Stoney formula, based on the measurement of the substrate curvature, is often used for the determination of the thin films' residual stress. In this study, titanium nitride coatings were deposited by DC reactive magnetron sputtering on silicon substrates. An optical profiler was used to determine the curvature of the surface before and after coating. Two radii were then obtained, along the principal perpendicular directions of the surface curvature. A simple and efficient method to determine the experimental error on the stress calculation was developed taking into account the film thickness dispersion and the radii dispersion. Using constant deposition parameters, some samples' characteristics were tested: film and substrate thickness, size, shape and crystallographic orientations of the substrates. With the help of the developed error method, we analyzed what can be conclude about the influence of these characteristics on the calculated stress values, obtained from the experimental measurements

Pourquoi questionner les partenariats à Médecins du Monde ?

Dans un monde globalisé, multipolaire et médiatisé, les interactions d’une ONG comme Médecins du Monde (MDM) avec les institutions et organisations avec lesquelles elle agit la définissent tout autant que le contenu de ses programmes. Poussés par la double exigence de nos valeurs et de l’évolution des contextes, nous questionnons en permanence notre relation à nos partenaires de la société civile au même titre que nos pratiques médicales, financières, de communication ou nos relations avec les gouvernements ou les forces armées en présence. Surtout, questionner nos partenariats, c’est, au-delà de nos actions, réinterroger notre perception de l’altérité

The acoustical and perceptual features of snore-related sounds in patients with obstructive sleep apnea sleeping with the dynamic mandibular advancement system MATRx plus®

Purpose: The effect of snoring on the bed partner can be studied through the evaluation of in situ sound records by the bed partner or unspecialized raters as a proxy of real-life snoring perception. The aim was to characterize perceptual snore events through acoustical features in patients with obstructive sleep apnea (OSA) with an advanced mandibular position. Methods: Thirty-minute sound samples of 29 patients with OSA were retrieved from overnight, in-home recordings of a study to validate the MATRx plus® dynamic mandibular advancement system. Three unspecialized raters identified sound events and classified them as noise, snore, or breathing. The raters provided ratings for classification certainty and annoyance. Data were analyzed with respect to respiratory phases, and annoyance. Results: When subdividing perceptual events based on respiratory phase, the logarithm-transformed Mean Power, Spectral Centroid, and Snore Factor differed significantly between event types, although not substantially for the spectral centroid. The variability within event type was high and distributions suggested the presence of subpopulations. The general linear model (GLM) showed a significant patient effect. Inspiration segments occurred in 65% of snore events, expiration segments in 54%. The annoyance correlated with the logarithm of mean power (r = 0.48) and the Snore Factor (0.46). Conclusion: Perceptual sound events identified by non-experts contain a non-negligible mixture of expiration and inspiration phases making the characterization through acoustical features complex. The present study reveals that subpopulations may exist, and patient-specific features need to be introduced

Pourquoi questionner les partenariats à Médecins du Monde ?

Dans un monde globalisé, multipolaire et médiatisé, les interactions d’une ONG comme Médecins du Monde (MDM) avec les institutions et organisations avec lesquelles elle agit la définissent tout autant que le contenu de ses programmes. Poussés par la double exigence de nos valeurs et de l’évolution des contextes, nous questionnons en permanence notre relation à nos partenaires de la société civile au même titre que nos pratiques médicales, financières, de communication ou nos relations avec les gouvernements ou les forces armées en présence. Surtout, questionner nos partenariats, c’est, au-delà de nos actions, réinterroger notre perception de l’altérité

Perceptual snoring as a basis for a psychoacoustical modeling and clinical patient profiling

Purpose The perceptual burden and social nuisance for mainly the co-sleeper can affect the relationship between snorer and bedpartner. Mandibular advancement devices (MAD) are commonly recommended to treat sleep-related breathing such as snoring or sleep apnea. There is no consensus about the definition of snoring particularly with MAD, which is essential for assessing the effectiveness of treatment. We aimed to stablish a notion of perceptual snoring with MAD in place. Methods Sound samples, each 30 min long, were recorded during in-home, overnight, automatic mandibular repositioning titration studies in a population of 29 patients with obstructive sleep apnea syndrome (OSAS) from a clinical trial carried out to validate the MATRx plus. Three unspecialized and calibrated raters identified sound events and classified them as noise, snore, or breathing as well as providing scores for classification certainty and annoyance. Data were analyzed with respect to expiration-inspiration, duration, annoyance, and classification certainty. Results A Fleiss' kappa (>0.80) and correlation duration of events (>0.90) between raters were observed. Prevalence of all breath sounds: snore 55.6% (N = 6398), breathing sounds 31.7% (N = 3652), and noise 9.3% (N = 1072). Inspiration occurs in 88.3% of events, 96.8% contained at least on expiration phase. Snore and breath events had similar duration, respectively 2.58s (sd 1.43) and 2.41s (sd 1.22). Annoyance is lowest for breathing events (8.00 sd 0.98) and highest for snore events (4.90 sd 1.92) on a VAS from zero to ten. Conclusion Perceptual sound events can be a basis for analysis in a psychosocial context. Perceived snoring occurs during both expiration as well as inspiration. Substantial amount of snoring remains despite repositioning of the mandible aimed at the reduction of AHI-ODI