Arresting rampant dental caries with silver diamine fluoride in a young teenager suffering from chronic oral graft versus host disease post-bone marrow transplantation: a case report

BACKGROUND: Rampant caries is an advanced and severe dental disease that affects multiple teeth. This case describes the management of rampant caries in a young teenager suffering from chronic oral graft versus host disease after allogeneic bone marrow transplantation. CASE PRESENTATION: A 14-year-old Chinese boy suffering from β–thalassemia major was referred to the dental clinic for the management of rampant dental caries. An oral examination revealed pale conjunctiva, bruising of lips, and depapillation of tongue indicating an underlying condition of anemia. The poor oral condition due to topical and systemic immunosuppressants was seriously aggravated, and rampant caries developed rapidly, affecting all newly erupted, permanent teeth. The teeth were hypersensitive and halitosis was apparent. Strategies for oral health education and diet modification were given to the patient. Xylitol chewing gum was used to stimulate saliva flow to promote remineralization of teeth. Silver diamine fluoride was topically applied to arrest rampant caries and to relieve pain from hypersensitivity. Carious teeth with pulpal involvement were endodontically treated. Stainless steel crowns were provided on molars to restore chewing function, and polycarbonate crowns were placed on premolars, upper canines and incisors. CONCLUSION: This case report demonstrates success in treating a young teenager with severe rampant dental decay by contemporary caries control and preventive strategy

Online platform for applying space–time scan statistics for prospectively detecting emerging hot spots of dengue fever

Abstract Background Cases of dengue fever have increased in areas of Southeast Asia in recent years. Taiwan hit a record-high 42,856 cases in 2015, with the majority in southern Tainan and Kaohsiung Cities. Leveraging spatial statistics and geo-visualization techniques, we aim to design an online analytical tool for local public health workers to prospectively identify ongoing hot spots of dengue fever weekly at the village level. Methods A total of 57,516 confirmed cases of dengue fever in 2014 and 2015 were obtained from the Taiwan Centers for Disease Control (TCDC). Incorporating demographic information as covariates with cumulative cases (365 days) in a discrete Poisson model, we iteratively applied space–time scan statistics by SaTScan software to detect the currently active cluster of dengue fever (reported as relative risk) in each village of Tainan and Kaohsiung every week. A village with a relative risk >1 and p value <0.05 was identified as a dengue-epidemic area. Assuming an ongoing transmission might continuously spread for two consecutive weeks, we estimated the sensitivity and specificity for detecting outbreaks by comparing the scan-based classification (dengue-epidemic vs. dengue-free village) with the true cumulative case numbers from the TCDC’s surveillance statistics. Results Among the 1648 villages in Tainan and Kaohsiung, the overall sensitivity for detecting outbreaks increases as case numbers grow in a total of 92 weekly simulations. The specificity for detecting outbreaks behaves inversely, compared to the sensitivity. On average, the mean sensitivity and specificity of 2-week hot spot detection were 0.615 and 0.891 respectively (p value <0.001) for the covariate adjustment model, as the maximum spatial and temporal windows were specified as 50% of the total population at risk and 28 days. Dengue-epidemic villages were visualized and explored in an interactive map. Conclusions We designed an online analytical tool for front-line public health workers to prospectively detect ongoing dengue fever transmission on a weekly basis at the village level by using the routine surveillance data

Relationship between cortical thickness and neuropsychological performance in normal older adults and those with mild cognitive impairment

Mild cognitive impairment (MCI) has been extensively investigated in recent decades to identify groups with a high risk of dementia and to establish effective prevention methods during this period. Neuropsychological performance and cortical thickness are two important biomarkers used to predict progression from MCI to dementia. This study compares the cortical thickness and neuropsychological performance in people with MCI and cognitively healthy older adults. We further focus on the relationship between cortical thickness and neuropsychological performance in these two groups. Forty-nine participants with MCI and 40 cognitively healthy older adults were recruited. Cortical thickness was analysed with semiautomatic software, Freesurfer. The analysis reveals that the cortical thickness in the left caudal anterior cingulate (p=0.041), lateral occipital (p=0.009) and right superior temporal (p=0.047) areas were significantly thinner in the MCI group after adjustment for age and education. Almost all neuropsychological test results (with the exception of forward digit span) were significantly correlated to cortical thickness in the MCI group after adjustment for age, gender and education. In contrast, only the score on the Category Verbal Fluency Test and the forward digit span were found to have significant inverse correlations to cortical thickness in the control group of cognitively healthy older adults. The study results suggest that cortical thinning in the temporal region reflects the global change in cognition in subjects with MCI and may be useful to predict progression of MCI to Alzheimer's disease. The different pattern in the correlation of cortical thickness to the neuropsychological performance of patients with MCI from the healthy control subjects may be explained by the hypothesis of MCI as a disconnection syndrome

Matching Reviewers to Customers: The Role of Demographics and Preferences in Hotel Online Booking

Travelers can easily refer to online reviews as a source of advice before booking a hotel; however, online reviews are not structured which make gathering useful information uneasy. What if online review sites can prioritize and direct the reviews that are most relevant to the customers and save them a lot of time? The value and usefulness of reviews are affected by the reviewers’ background. This study investigated whether customers tend to value the reviews written by similar people more than those written by dissimilar people. The first experiment showed that positive reviews increased consumers’ intention to book a hotel, negative reviews decreased bookings, and consumers were more affected by the reviews written by similar people. When demographics about reviewers are not available, customers will focus on other traits of the reviewer, such as preferences. The second experiment added shared preference between consumers and reviewers as another basis of similarity. Customers relied on reviewers’ preferences a clue of similarity when demographic similarity was not presented, and vice versa. Online reviews offer a good chance for managers to know their customers. Online review sites should use this information to form better strategies. The researchers showed that more relevant reviews can be displayed to customers by matching people’s demographics or preferences

Viral Replication in the Nasopharynx Is Associated with Diarrhea in Patients with Severe Acute Respiratory Syndrome

The role of severe acute respiratory syndrome (SARS) coronavirus as an enteric pathogen was investigated in a cohort of 142 patients with SARS who were treated with a standard treatment protocol. Data from daily hematological, biochemical, radiological, and microbiological investigations were prospectively collected, and the correlation of these findings with diarrhea was retrospectively analyzed. Sixty-nine patients (48.6%) developed diarrhea at a mean (± standard deviation [SD]) of 7.6 ± 2.6 days after the onset of symptoms. The diarrhea was most severe at a mean (± SD) of 8.8 ± 2.4 days after onset, with a maximum frequency of 24 episodes per day (median, 5 episodes; range, 3-24 episodes). A higher mean virus load in nasopharyngeal specimens obtained on day 10 after the onset of symptoms was significantly associated with the occurrence of diarrhea (3.1 log 10 vs. 1.8 log 10 copies/mL; P = .01) and mortality (6.2 vs. 1.7 log 10 copies/mL; P<.01). However, diarrhea was not associated with mortality. The lung and the gastrointestinal tract may react differently to SARS coronavirus infection. Additional investigation of the role of SARS coronavirus in the pathogenesis of diarrhea in patients with SARS should be conducted.published_or_final_versio

Treatment Outcome Prediction for Intracerebral Hemorrhage via Generative Prognostic Model with Imaging and Tabular Data

Intracerebral hemorrhage (ICH) is the second most common and deadliest form of stroke. Despite medical advances, predicting treat ment outcomes for ICH remains a challenge. This paper proposes a novel prognostic model that utilizes both imaging and tabular data to predict treatment outcome for ICH. Our model is trained on observational data collected from non-randomized controlled trials, providing reliable predictions of treatment success. Specifically, we propose to employ a variational autoencoder model to generate a low-dimensional prognostic score, which can effectively address the selection bias resulting from the non-randomized controlled trials. Importantly, we develop a variational distributions combination module that combines the information from imaging data, non-imaging clinical data, and treatment assignment to accurately generate the prognostic score. We conducted extensive experiments on a real-world clinical dataset of intracerebral hemorrhage. Our proposed method demonstrates a substantial improvement in treatment outcome prediction compared to existing state-of-the-art approaches. Code is available at https://github.com/med-air/TOP-GP

Quantitative analysis of movement along an earthquake thrust scarp: a case study of a vertical exposure of the 1999 surface rupture of the Chelungpu fault at Wufeng, Western Taiwan

A vertical exposure across the principal thrust scarp of the 1999 Mw 7.6 earthquake allows quantification of fault slip. The exposure is located on the active Chelungpu fault near Wufeng, along the range front of the fold-and-thrust belt in western Taiwan. The 1999 surface ruptures at the Wufeng site are characterized by a west-facing 2 to 3 m high principal thrust scarp and an east-facing lesser backthrust scarp. We mapped a 15 m-long, 5 m-deep exposure across the principal thrust scarp and characterized complex deformation structures, which include a main basal thrust fault, a wedge thrust, and a pop-up anticlinal fold with two secondary opposing thrust faults. The vertical displacement across the principal thrust scarp is measured directly from the offsets of the same sedimentary horizons between the hangingwall and the footwall. The average vertical displacement is 2.2±0.1 m, and the maximum displacement is 2.5 m, at the crest of the small pop-up fold. Horizontal displacement estimates were determined using line- and area-balancing methods. With line-length methods we estimated a horizontal displacement of 3.3±0.3 m across the principal scarp for four sedimentary horizons. For area balancing, first we selected three horizontal soil/sand deposits with a total thickness of about 0.5 m. The estimate yields an average horizontal displacement of 4.8±1.0 m. Using these individual and relatively thin stratigraphic layers yielded significant standard deviations in displacement estimates as a result of thickness variations. Second, we used the 3 m-thick overbank soil/sand and the lower part of fluvial pebble/cobble to calculate a horizontal displacement of 2.6±0.2 m with the area-balancing technique. According to the geometry of the dip angle (35–40°) of the basal thrust, the line-length measurement and the 3 m-thick package area balancing both provided reasonable results of horizontal displacement. By comparing the different deposits applied to the line- and area-balancing methods, we interpret that decoupling of deformation occurred between the lower fluvial gravels and the upper overbank sand and mud deposits. Due to lesser confining pressure at the surface, additional deformation occurred in the upper 1–2 m thick overbank deposits. This additional deformation yielded further vertical uplift of 0.3–0.5 m and horizontal displacement of 0.2–0.8 m around the core of the pop-up fold. Our work suggests that determination of slip across surface thrust ruptures varies as a function of the mechanical behavior of young late Quaternary deposits

Reply to “Comment on ‘A Vertical Exposure of the 1999 Surface Rupture of the Chelungpu Fault at Wufeng, Western Taiwan: Structural and Paleoseismic Implications for an Active Thrust Fault,’ by Jian-Cheng Lee, Yue-Gau Chen, Kerry Sieh, Karl Mueller, Wen-Shan Chen, Hao-Tsu Chu, Yu-Chang Chan, Charles Rubin, and Robert Yeats,” by Yuan-Hsi Lee, Shih-Ting Lu, Tung-Sheng Shih, and Wei-Yu Wu

We welcome Y. H. Lee et al.'s interest in our article (Lee et al., 2001). We thank them for their comment, which provides a further opportunity for discussing the quantification of the slip amounts including horizontal and vertical components and the fault geometry for an earthquake thrust scarp in Wufeng, western Taiwan, during the 1999 M 7.6 earthquake. In their comment, Y. H. Lee et al. used restoration of deformed concrete fence across the 1999 scarp to estimate the slip vector of the main fault. The estimated slip amount, especially the horizontal component, is different (significantly less) from our results presented in the 2001 BSSA article. They then applied an “area-balance” technique to compare their results with ours. They showed that their area-balance method favored their estimates including the slip amounts and the fault dip angle. They concluded that their estimated slip amounts are more reasonable than ours. The fundamental questions in this issue, in our opinions, include the actual amounts of deformation (slip) and the associated deformation processes, as well as the limitation and uncertainty of the applied techniques on an earthquake-formed thrust scarp. Hereafter we attempt to answer these questions and clarify the related problems