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It has been repeatedly acknowledged that age-at-death estimation based on dentalcementum represents a partial and time-consuming method that hinders adoptionof this histological approach. User-friendly micrograph analysis represents a grow-ing request of cementochronology. This article evaluates the feasibility of using amodule to accurately quantify cementum deposits and compares the module's per-formance to that of a human expert. On a dental collection (n=200) of known-ageindividuals, precision and accuracy of estimates performed by a developed pro-gram (101 count/tooth;n=20,200 counts) were compared to counts performedmanually (5 counts/tooth;n=975 counts). Reliability of the software and agree-ment between the two approaches were assessed byintraclass correlation coeffi-cient and Bland Altman analysis. The automated module produced reliable andreproducible counts with a higher global precision than the human expert. Althoughthe software is slightly more precise, it shows higher sensitivity to taphonomic dam-ages and does not avoid the trajectory effect described for age-at-death estimationin adults. Likewise, for human counts, global accuracy is acceptable, but underestima-tions increase with age. The quantification of the agreement between the twoapproaches shows a minor bias, and 94% of individuals fall within the intervals ofagreement. Automation gives an impression of objectivity even though the region ofinterest, profile position and parameters are defined manually. The automated systemmay represent a time-saving module that can allow an increase in sample size, whichis particularly stimulating for population-based studies. info:eu-repo/semantics/publishedVersion

International audience; To compare the image quality of cranial post-mortem computed tomography (CT) obtained with and without projection-based single-energy metal artifact reduction (SEMAR) in cadavers with intracranial metallic ballistic projectiles. Materials and methods: From January 2017 to January 2018, cadavers with ballistic projectile head wounds with metal fragments and without massive head destruction were investigated using post-mortem CT. All subjects underwent CT using a conventional iterative reconstruction (IR) and SEMAR. To evaluate the impact of metallic artifacts, the total intracranial area (TA), non-interpretable zone (NIZ), disturbed interpretation zone (DZ), and artifact total surface (ATS) were delineated. Two independent readers identified extra-axial hemorrhage (EAH) and subarachnoid hemorrhage (SAH). Autopsy reports were used as the standard of reference. Results: Eleven corpses (10 males, 1 female; mean age, 62.8 ± 17.9 [SD] years) were evaluated. SEMAR showed a significant decrease in the ATS ratio with respect to conventional IR (72.1 ± 26.1 [SD] % [range: 26.8-99.1] vs. 86.4 ± 17.8 [SD] % [range: 37.2-100]; P < 0.001) and NIZ/TA ratios (11.6 ± 8.26% [range: 0.95-33.4] versus 42.5 ± 30.5% [range: 3.86-100]; P < 0.001). The interobserver reproducibility in diagnosing EAH and SAH was excellent with conventional IR (0.82) and good with SEMAR (0.75). SEMAR reduced uncertain diagnoses of EAH in 7 subjects for Reader 1 and in 6 for Reader 2, but did not influence the diagnosis of SAH for either reader. Conclusion: SEMAR reduces the influence of metallic artifacts and increases the confidence with which the diagnosis of EAH can be made on post-mortem CT.

International audience; Age estimation of living individuals aged less than 13, 18 or 21 years, which are some relevant legal ages in most European countries, is currently problematic in the forensic context. Thus, numerous methods are available for legal authorities, although their efficiency can be discussed. For those reasons, we aimed to propose a new method, based on the biometric analysis of hand bones. 451 hand radiographs of French individuals under the age of 21 were retrospectively analyzed. This total sample was divided into three subgroups bounded by the relevant legal ages previously mentioned: 0–13, 13–18 and 18–21 years. On these radiographs, we numerically applied the osteometric board method used in anthropology, by including each metacarpal and proximal phalange of the five hand rays in the smallest rectangle possible. In that we can access their length and width information thanks to a measurement protocol developed precisely for our treatment with the ORS Visual 1 software. Then, a statistical analysis was performed from these biometric data: a Linear Discriminant Analysis (LDA) evaluated the probability for an individual to belong to one of the age group (0–13, 13–18 or 18–21); and several multivariate regression models were tested for the establishment of age estimation formulas for each of these age groups. The mean Correlation Coefficient between chronological age and both lengths and widths of hand bones is equal to 0.90 for the total sample. Repeatability and reproducibility were assessed. The LDA could more easily predict the belonging to the 0–13 age group. Age can be estimated with a mean standard error which never exceeds 1 year for the 95% confidence interval. Finally, compared to the literature, we can conclude that estimating an age from the biometric information of metacarpals and proximal phalanges is promising.

International audience; Age estimation is commonly of interest in a judicial context. In adults, it is less documented than in children. The aim of this study was to evaluate age estimation in adults using CT images of the sternal plastron with volume rendering technique (VRT). The evaluation criteria are derived from known methods used for age estimation and are applicable in living or dead subjects. The VRT images of 456 patients were analyzed. Two radiologists performed age estimation independently from an anterior view of the plastron. Interobserver agreement and correlation coefficients between each reader's classification and real age were calculated. The interobserver agreement was 0.86, and the correlation coefficients between readers classifications and real age classes were 0.60 and 0.65. Spearman correlation coefficients were, respectively, 0.89, 0.67, and 0.71. Analysis of the plastron using VRT allows age estimation in vivo quickly and with results similar than methods such as Iscan, Suchey-Brooks, and radiographs used to estimate the age of death.

International audience; ObjectivesIn France, medical students regularly complain about the shortcomings of their theoretical training and the necessity of its adaptation to better fit the needs of students. The goal was to evaluate the theoretical teaching practices in postgraduate medical studies by: 1) collecting data from medical students in different medical faculties in France; 2) comparing this data with expected practices when it is possible; 3) and proposing several lines of improvement.MethodsA survey of theoretical practices in the 3rd cycle of medical studies was conducted by self-administered questionnaires which were free of charge, anonymous, and administered electronically from July 3 to October 31, 2013 to all medical students in France.ResultsNational, inter-regional, regional and field internship educational content was absent in respectively 50.5%, 42.8%, 26.0% and 30.2% of cases. Medical students follow complementary training due to insufficient DES and/or DESC 2 training in 43.7% of cases or as part of a professional project in 54.9% of cases. The knowledge sought by medical students concerns the following crosscutting topics: career development (58.9%), practice management (50.7%), medical English (50.4%) and their specialty organization (49.9%). Fifty-four point one percent would like to be evaluated on their theoretical training on an annual basis.ConclusionThe results of this first national survey give insights into the theoretical teaching conditions in postgraduate medical education in France and the aspirations of medical students.; ProposLe troisième cycle des études médicales (TCEM) constitue la base de la formation spécialisée des médecins en France. L’objectif a été d’évaluer les pratiques d’enseignement théorique au cours du troisième cycle des études médicales en : 1) recueillant des données auprès des internes en médecine dans les différentes facultés de France ; 2) comparant ces données aux pratiques opposables quand cela était possible ; 3) et en proposant des mesures d’amélioration.MéthodesUne enquête sur les pratiques d’enseignement théorique en TCEM a été réalisée par auto-questionnaire, libre et anonyme, administré par voie électronique du 3 juillet au 31 octobre 2013 à l’ensemble des étudiants en TCEM de France.RésultatsLes enseignements nationaux, inter-régionaux, régionaux et sur le terrain de stage n’existent pas dans respectivement 50,5 %, 42,8 %, 26,0 % et 30,2 % des cas. Les internes ont recours à des formations complémentaires en raison d’une formation de DES et/ou DESC 2 jugée insuffisante (43,7 %) ou dans le cadre d’un projet professionnel (54,9 %). Les thématiques transversales à développer étaient le développement de carrière (58,9 %), la gestion d’un cabinet ou d’un service (50,7 %), l’anglais médical (50,4 %) et l’organisation de leur spécialité (49,9 %). Ils souhaiteraient pour 54,1 % d’entre eux être évalués annuellement sur le plan théorique.ConclusionIl s’agit de la première évaluation nationale du TCEM en France sur le versant de l’enseignement théorique. Complétée par le versant pratique, elle pourrait permettre de proposer une réforme du TCEM capable d’accroître l’efficience de la formation, sans allongement de sa durée.

International audience; Lamendin and colleagues (1992) proposed to assess age-at-death from root translucency and periodontosis. Several teeth from the same individual were included in their study. In our work, we evaluate the reliability of their formulas without introducing this bias. Our sample was constituted of 214 individuals (114 males and 100 women) selected from the Terry collection (U.S.A.). The R2 between age and both indicators is equal to 0.33 and 0.08 (p < 0.001). Based on linear regression, the mean of standard error for individual age prediction was equal to 13.67 years, and the mean interval length is equal to 53.89 years. Multinomial logistic regression and Bayesian approach failed to give satisfactory results whenclassifying the individuals in age categories. Therefore, the use of root translucency and periodontosis may lead to incorrect age-at-death assessment, and it is thus necessary to complement this approach with other techniques to assess age-at-death.

International audience; INTRODUCTION: Biobanks may play a pivotal role in lung cancer patients' management, research, and health policy. The Nancy "Centre of Biologic Resources" analyzed the evolving profiles of operated lung cancer patients and their management over 20 years. METHODS: A total of 1259 consecutive patients operated upon from 1988 till 2007 were included. Survival rates were statistically compared before and after 1997. The parameters associated with a significant improvement of survival were determined. RESULTS: After 1997, lung cancer was diagnosed at an earlier stage. For Squamous Cell Lung Cancer (SQCLC), stages IA increased from 5.4 to 19.5% and for Adenocarcinoma (ADC), stage IA increased from 9.9 to 24.7%. More women with stage I ADC were operated upon after 1997 (p = 0.01). More patients with Large Cell Lung Cancer were diagnosed recently. Recent patients received more adjuvant or neo-adjuvant chemotherapy (p < 0.001) and less radiotherapy (stage I SQCLC: p = 0.019, stage I ADC: p < 0.001). A longer overall patients' survival was observed after 1997 (chi test for SQLC and ADC independently p < or = 0.002). Among SQCLC long survivors, those at stage I-II, below 50 years, were more numerous. A longer survival was associated with early stage in ADC patients. Stage was the single constant factor for overall outcome. CONCLUSION: Overall and stage-adjusted survival of operated lung cancer patients has been improved in the last decade due mainly to earlier diagnosis. The generalized use of computed tomography scan, chemotherapy, and a collegial management improved patients' survival.