The study aim is to estimate the cost-benefit of two dental programs for children with age of 5 years or less and the school children from first-grade elementary. Within dental programs, children were used with or without fluoride gel and treated with or without fissure sealant respectively. The two cohorts were based on dental claims data from Taiwan National Health Insurance Research Database. The first cohort was from children at aged<=5 years from year 2004 to 2006, comparing the incremental benefit and cost between fluoride gel used and never-used children. The second cohort was from first-grade elementary children from year 2013 to 2016, comparing the incremental benefit and cost between sealant treated children and never-treated children. The main benefit measurements were the costs of outpatient service utilization such as dental caries, pulpitis and total dental services utilization. In the study, the Propensity Score Matching method was applied to reduce the selection bias between groups. The Difference in Difference approach was conducted to estimate the effect of service utilization and costs. The average cost of fluoride gel was NT$285. The fluoride gel used group compared to never-used group, the net benefit of dental caries had decreased by NT$74 and pulpitis had decreased by NT$770. As a result, cost-beneficial ratio were 0.26 and 2.70. As for sealant strategy, the average cost of fissure sealant for dental care was NT$660. The sealant treated group compared to never- treated group, the net benefit of dental caries had decreased by NT$240 and pulpitis had decreased by NT$297. As a result, cost-beneficial ratio were 0.36 and 0.45. The fluorine strategy was only cost- effective in reducing the medical costs of dental caries while sealant strategy was a worthy-investment to both dental caries and pulpitis. Although sealant was costlier, it receives an overall positive effect subsequently.

Acute fatty liver during pregnancy (AFLP) is an emergency and potentially fatal condition occurring during the peripartum period. It is characterized by fatty microvascular infiltration of hepatocytes and has an incidence rate of approximately one in 7,000 to one in 20,000 pregnancies. It may induce profound liver failure and can be accompanied by renal failure, polydipsia/polyuria, disseminated intravascular coagulation, hypoglycemia, and encephalopathy. Emergency delivery at the appropriate time is crucial to control the development of AFLP. Gestational diabetes insipidus (GDI) is another rare disorder characterized by polyuria, polydipsia, and dehydration. It has an incidence rate of 2-4 cases/100,000 pregnancies and develops during the third trimester. Here the authors present the case of a patient with AFLP and transient GDI complicated with non-reassuring fetal status. The conditions were resolved after delivery and multidisciplinary intensive care.

We have study the effect of Mg doping on structural, magnetic, electric and magnetocapacitive properties of nanocrystalline Ga1-xMgxFeO3 (GMFO, 0 <= x <= 0.10) prepared by a modified Pechini method. The presence of a single crystalline phase identified as the orthorhombic structure with Pc21(n) space in all the GMFO samples. Magnetization measurements reveal that with increasing Mg-content up to 0.10, the ferrimagnetic transition temperature (T-C) increases from 302 to 325 K. It is also found that the Mg-doped GaFeO3 (GFO) samples exhibit the characteristics of ferroelectricity at room temperature. Furthermore, Mg substitution in GFO brings in the balance of structural distortion, cation distribution, and magnetic exchange interaction, which affects both ferrimagnetism and ferroelectricity. The simultaneous enhancement of magnetization, electric polarization and magnetocapacitance of Mg-doped GFO samples are prominent candidates for the applications of multiferroic devices. (C) 2016 Elsevier B.V. All rights reserved.

We have prepared a series of GaFe1−xCoxO3 (GFCO, 0 ≤ x ≤ 0.10) nanoparticles and study the effect of Co-doping on their structural and magnetic properties. It is found that with increasing Co-content up to 0.10, the ferrimagnetic transition temperature (TC) increases from 325 to 360 K. Magnetic hysteresis loops measured below TC exhibit two-phase-like magnetic behavior consisting of hard and soft magnetic phases. These results could be explained in terms of site-disorder in GFCO. Furthermore, magnetic irreversibility is observed in temperature-dependent magnetizations of all the nanoparticles, which are ascribed to the inherent magnetic anisotropy.

GaFeO3 (GFO) nanoparticles with different grain sizes (16–152 nm) have been synthesized by a modified Pechini method. The magnetic characterization indicates that with decreasing grain size, the ferrimagnetic transition temperature (TC) increases from 275 to 325 K. The magnetic hysteresis curves measured below TC exhibit two-phase-like magnetic behavior consisting of soft and hard magnetic phases. The results could be explained by the site-disorder of the cations in GFO. Furthermore, thermo-magnetic irreversibility and cusp in zero-field cooled magnetization are observed for all the GFO nanoparticles, which are attributed to the inherent magnetic anisotropy.

THORplan is a treatment planning system developed at Tsing Hua University, Taiwan, for boron neutron capture therapy (BNCT) purpose. It is recently developed with user-friendly interface using Interactive Data Language. In this article the accuracy of THORplan is verified by comparing results of Snyder phantom calculation with the analytical model results of MCNP. Neutron source from THOR epithermal neutron beam is used as the source for the calculation. The thermal neutron flux calculated by THORplan is very close to the reference results. SERA overestimates thermal neutron flux by 2–5%. NCTPlan underestimates thermal neutron flux by 4–9% in most locations. The total weighted dose calculated by THORplan is accurate to within 3% except at the tissue interface. SERA overestimates the total weighted dose at depth >1.5cm by 2–5%. NCTPlan underestimates the total weighted dose by ∼10% at depth >1cm.

OBJECTIVE:To evaluate changes in (1) motor control characteristics of the hemiparetic hand during the performance of a functional reach-to-grasp task and (2) functional performance of daily activities in patients with stroke treated with modified constraint-induced movement therapy.DESIGN:Two-group randomized controlled trial with pretreatment and posttreatment measures.SETTING:Rehabilitation clinics.SUBJECTS:Thirty-two chronic stroke patients (21 men, 11 women; mean age=57.9 years, range=43-81 years) 13-26 months (mean 16.3 months) after onset of a first-ever cerebrovascular accident.INTERVENTION:Thirty-two patients were randomized to receive modified constraint-induced movement therapy (restraint of the unaffected limb combined with intensive training of the affected limb) or traditional rehabilitation for three weeks.MAIN MEASURES:Kinematic analysis was used to assess motor control characteristics as patients reached to grasp a beverage can. Functional outcomes were evaluated using the Motor Activity Log and Functional Independence Measure.RESULTS:There were moderate and significant effects of modified constraint-induced movement therapy on some aspects of motor control of reach-to-grasp and on functional ability. The modified constraint-induced movement therapy group preplanned reaching and grasping (P=0.018) more efficiently and depended more on the feedforward control of reaching (P=0.046) than did the traditional rehabilitation group. The modified constraint-induced movement therapy group also showed significantly improved functional performance on the Motor Activity Log (P<0.0001) and the Functional Independence Measure (P=0.016).CONCLUSIONS:In addition to improving functional use of the affected arm and daily functioning, modified constraint-induced movement therapy improved motor control strategy during goal-directed reaching, a possible mechanism for the improved movement performance of stroke patients undergoing this therapy.

Background. Obesity is a risk factor for gallbladder disease. The authors retrospectively analyse the prevalence and risk factors of gallbladder disease using logistic regression and artificial neural networks among obese patients in Taiwan.Methods. Artificial neural networks is a popular technique, which can detect complex patterns within data. They have not been applied to risk of gallbladder disease in obese population. We studied the risk factors associated with gallstones in 117 obese patients who were undergoing bariatric surgery between February 1999 and October 2005. Artificial neural networks, constructed with three-layered back-propagation algorithm, were trained to predict the risk of gallbladder disease. Thirty input variables including clinical data (gender, age, body mass index and associated diseases), laboratory evaluation and histopathologic findings of gallbladder were obtained from the patient records. The result was compared with a logistic regression model developed from the same database.Results. Artificial neural networks demonstrated better average classification rate and lower Type II errors than those of logistic regression. The risk factors from both data mining techniques were diastolic blood pressure, inflammatory condition, abnormal glucose metabolism and cholesterolosis. The biological significance of inflammatory condition in obese population requires further investigation.Conclusion. Artificial neural networks might be a useful tool to predict the risk factors and prevalence of gallbladder disease and gallstone development in obese patients on the basis of multiple variables related to laboratory and pathological features. The performance of artificial neural networks was better than traditional modeling techniques. (c) 2007 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Variceal hemorrhage confers a significant threat for cirrhotic patients. The balloon tamponade still acts as life-saving procedure, especially when endoscopic hemostasis is unavailable or unsuccessful. Impaction is a rare complication of balloon tamponade, which may need surgery to remove the tube. We report a patient with severe esophageal variceal hemorrhage, which was complicated with an impacted Sengstaken-Blakemore tube. The undeflatable gastric balloon was finally resolved by the puncture of a large-gauge aspiration needle, after repeated trials of other through-the-scope instruments. Literatures are reviewed for investigating the mechanisms of balloon impaction as well as various endoscopic maneuvers for deflation.