Adverse Childhood Experience-Related Conditions and Substance Use in Adolescents: A Secondary Analysis of Cross-Sectional Survey Data.

BACKGROUND: Adverse childhood experiences (ACEs) cluster within children. In addition to standardized ACE measures, there exist "ACE-related" measures that are either directly or indirectly related to the standardized ACE constructs. This study aimed to identify ACE-related latent classes of adolescents and describe past-month substance use in each class by sex and race/ethnicity. METHODS: Data from the 2018 Indiana Youth Survey (N = 70,703), which is a repeated self-administered, cross-sectional survey, were used. Latent class analysis was conducted using ACE-related family (parent incarceration, insulting/yelling within family, inability to discuss personal problems) and school (hate being in school, feeling unsafe, inability to talk to teachers one-on-one) items. Dependent variable combined past 30-day use-frequency of 17 substances. Two-way analysis of variances examined ACE by sex and race/ethnicity interaction. RESULTS: Four ACE-related classes emerged: "Family-Only" (11.2%), "School-Only" (16.5%), "Family-School" (8.0%), and "No-ACE" (64.3%). Substance use was highest in "Family-School" (mean = 0.67); lowest in "No-ACE" (mean = 0.21). Significant race/ethnicity (F = 27.06; p < .0001), ACE * sex interaction (F = 12.13; p < .0001) and ACE * race/ethnicity interaction (F = 4.57; p < .0001) effects emerged. Within each ACE-related class, substance use was lowest for Asians and highest for Hispanics. CONCLUSIONS: Adverse childhood experience-related items cluster within children across school and family environments and clustering differs by race/ethnicity, but not by sex. Incorporating ACE-related items into school surveys enhances the ability to implement interventions that target relationships between ACEs and substance use.

Knowledge Evaluation of Oral Diseases and Perception of Cooperation with Dental Experts for Oral Care of Nurses in Intensive Care Units in Korea: A Preliminary Study.

The aim of this study was to identify the status of education and knowledge concerning oral diseases for oral care as they relate to intensive care unit (ICU) nurses, as well as to investigate the perception of oral care education and practice, as led by dental experts. This study conducted a self-report survey consisting of 33 questions on education and knowledge about oral diseases, as well as perception of dental expert-led education and practice, targeting 240 nurses in the ICU. Finally, 227 questionnaires were analyzed, and 75.3% of the participants were staff nurses, and 41.4% were in the medical ICU. In the area of education and knowledge of major oral diseases, more than 50% of the respondents treating gingivitis, periodontitis, and dental caries did not complete dental education, and it was found that more than half of the respondents were unable to distinguish diseases of the mouth. It was recognized that more than half of nurses required dental expert-led education and practice. In this study, the education and knowledge of oral diseases of ICU nurses were found to be insufficient, and the need for the cooperation of dental experts was high. Therefore, collaboration to improve oral care practical guidelines for realistically applicable ICU patients will be needed.

Factors Affecting Body Image Distortion in Adolescents.

Body image distortion is an important problem in physical and psychological health in adolescents. This study examined the factors affecting body image distortion in Korean adolescents. A Rao−Scott χ2 test and a complex samples logistic regression was conducted using the statistics from the 17th (2021) Korea Youth Risk Behavior Web-based Survey. The study sample included 41,124 middle and high school students. There was a difference in the presence or absence of body image distortion according to the subject's gender, school grade, school achievement, and economic status (p < 0.001). Approximately 49.5% of subjects with body image distortion had tried to lose weight, but there were few cases where they attempted to lose weight through physical activities, such as moderate physical activity (22.8%), vigorous physical activity (23.3%), and muscle physical activity (23.9%) (p < 0.001). The group with body image distortion was 1.77 times more likely to sit for more than four hours a day on average (p < 0.001). To prevent various factors influencing the distortion of the adolescent's body image, the development of a systematic intervention program for forming no distortion of adolescents' body image is required.

Oral Care Practice, Perception, and Attitude of Nurses in Intensive Care Units in Korea: A Questionnaire Survey.

Background: This cross-sectional study investigated the factors influencing oral care in patients in intensive care units (ICUs) by identifying the current oral care practice status, perceptions, and attitudes of ICU nurses in Korea. Methods: This study surveyed 240 nurses with work experience in the ICU using a self-report questionnaire consisting of 22 items on the status, perception, and attitude towards oral care in the ICU. Results: A total of 227 questionnaires were analyzed. The average age of the participants was 29.79 ± 5.92 years, and the medical ICU was the most type of ICU. The factors affecting the attitude towards oral care and its importance in ICU patients were the experience of working as a nurse (r = 0.336, p < 0.01), ICU work experience (r = 0.218, p < 0.01), and oral care practice frequency (r = 0.167 p < 0.05); these were found to be statistically significant. Conclusions: In this study, the interest of the nurses in oral care practice and education was high, but professional education and the regular implementation of oral care practices were insufficient. To address these problems, it will be necessary to improve oral care practices through dental intervention and education about oral care methods focused on ICU patients.

Relationship between Risk Factors Related to Eating Disorders and Subjective Health and Oral Health.

This study examined the factors related to eating disorders (ED) and the relationship between ED and subjective health or subjective oral health in adolescents. The 46,146 adolescents (age 12-18 years) who participated in the Korea Youth Risk Behavior Web-based Survey were selected, including those who had attempted to lose weight within the past 30 days during the survey period. The variables included were eating behavior, BMI, body image subjective health, and subjective oral health. The weight-loss method was divided into two groups (regular exercise, RE, and eating disorder, ED). The data were analyzed using the Rao-Scott χ2 test and logistic regression analysis. The adolescents with an obese body image had a lower risk of ED (OR = 0.75, 95% CI 0.38-1.49) than adolescents with a very thin body image. Adolescents with ED had a higher risk of a poor subjective health assessment (OR = 2.32, 95% CI 1.85-2.91). On the other hand, they had a lower risk of a poor subjective oral health assessment (OR = 0.89, 95% CI 0.71-1.12). ED is closely associated with eating behavior, BMI, body image, oral health behavior, subjective health, and subjective oral health in Korean adolescents.

Exploration of pharmacist comfort with harm reduction behaviors: Cross-sectional latent class analysis.

BACKGROUND: Pharmacists are positioned to play important roles in implementing evidence-based prevention and harm reduction approaches for opioid misuse and related health care outcomes such as human immunodeficiency virus (HIV) and hepatitis C. More research is needed to understand how best to facilitate harm reduction practices among pharmacists. OBJECTIVES: This hypothesis-generating study investigated (1) whether subgroups (latent classes) were observable among pharmacists based on self-reported comfort with specific harm reduction behaviors, (2) whether having reported expertise in key content areas was associated with any latent classes that might be identified, and (3) whether comfort and training were associated with actually having dispensed syringes for likely nonprescription drug use. METHODS: This was a statewide census of community managing pharmacists in Arizona conducted from December 2018 to May 2019. Participants reported their degree of comfort with 10 harm reduction behaviors, their expertise (e.g., recent continuing pharmacy education or specialization) in selected content areas, and their syringe dispensing behavior. Additional sociodemographic information was also collected. Subgroups related to harm reduction were computed using latent class analysis, and associations between study variables were assessed using the Fisher's exact tests. RESULTS: Data suggested the existence of 4 latent, comfort-based harm reduction classes: high comfort, moderate comfort, and clinical comfort, and opioid prevention only. Reported expertise in pre-exposure prophylaxis for HIV was likely associated with harm reduction class. However, class membership was not associated with reporting having dispensed nonprescription syringes, although the single comfort item for syringe dispensing, by itself, was associated therewith. CONCLUSION: Comfort with harm reduction likely clusters, so pharmacists may be broadly comfortable with topics or methods of harm reduction; however, comfort with a specific harm reduction pharmacy practice may be a better predictor of engaging in that behavior than harm reduction comfort class. In contrast, strategies to improve comfort, such as intervention development, might successfully be informed by pharmacists' latent class.

Evaluation of the Erosive and Cariogenic Potential of Over-the-Counter Pediatric Liquid Analgesics and Antipyretics.

To evaluate the cariogenic and erosive potentials of over-the-counter pediatric oral liquid antipyretics and analgesics, we tested nine over-the-counter pediatric oral liquid medications classified as antipyretic or analgesic medicines available in Korea. For each substance, we measured the pH with a pH meter and the sugar content with a sugar content meter. We determined the titratable acidity (TA) levels based on the volumes of NaOH solution that had to be added to reach a pH of 7.0. We also evaluated the dental erosion potentials with an International Organization for Standardization method based on observing changes in the pH of a CaPO4 solution upon introducing a small volume of the solution to be tested. The oral liquid medications had pH values of 3.40-5.68. In the TA assessments, several oral liquid medications required greater volumes of NaOH solution to reach a pH of 7.0. The dental erosion potentials varied but correlated strongly with the NaOH volumes needed to reach a neutral pH (r = 0.84; p < 0.0001). Many oral liquid antipyretics and analgesics have features that can promote dental erosion. A correct understanding of pediatric antipyretics and analgesics is required in dentistry for children's oral health.

Relationship between an Oral Health Risk Assessment Using a Salivary Multi-Test System and Woman's Subjective Oral Health Symptoms and Sleep Disorder.

Saliva is used as a diagnosis and monitoring tool for various diseases because it can maintain the balance of the oral ecosystem and reflect the physiological and pathological state of the body. Because women suffer more fatigue than men because of physiological, psychological, and social factors, individual management strategies are needed to evaluate mental health and oral diseases. Therefore, this study examined the oral health risk level from seven saliva factors using a saliva multi-test system for adult women to confirm the possibility of screening for sleep disorders. The saliva of 83 adult female participants was surveyed along with a self-reported questionnaire consisting of seven subjective oral health symptoms and three questions about sleep disorders. Seven saliva factors were evaluated using the saliva multi-test system (SiLL-Ha ST-4910) to assess the oral health risk levels. In the tooth health risk groups, the acidity was high, while the buffering capacity was low (p < 0.001). The periodontal health risk groups showed significant differences in acidity, occult blood, leukocytes, proteins, and ammonia (p < 0.05). The oral malodor risk group had higher levels of cariogenic bacteria, occult blood, leukocytes, and ammonia (p < 0.05). In groups with 'irregular sleep times' and 'insomnia', the acidity was high, and the buffering capacity was low (p < 0.001). This study confirmed the relevance of saliva factors and sleep disorder. Therefore, an evaluation using saliva was confirmed for oral health risk assessments and as an early screening tool for sleep disorders.

Hospital Dentistry for Intensive Care Unit Patients: A Comprehensive Review.

This study aimed to review the oral hygiene status, oral care guidelines, and outcomes of oral care in intensive care unit (ICU) patients from a dental perspective for effective oral care. A literature search using the keywords "Hospital dentistry" OR "Oral care" OR "Intensive care unit" OR "Hospital inpatient" OR "Hospitalization" OR "Emergency service" AND "Oral health" OR "Oral hygiene" OR "Dental plaque" was conducted in PubMed, Medline, and Google Scholar to identify publications reporting on the oral care of the patients admitted to ICUs. A total of 17,400 articles were initially identified. Of these, 58 were selected and classified into three categories for critical review. Seven of these studies evaluated the oral status of ICU patients, and most of the studies indicated that ICU patients had poor oral hygiene or required active dental treatment. Thirty-three of these studies evaluated oral care methods for ICU patients, and in general, oral care methods using chlorhexidine as adjuncts along with tooth brushing were recommended. However, there were insufficient studies to evaluate oral hygiene through effective assessment tools from a dental perspective. In 36 studies on the outcomes of oral care in ICU patients, interventions by dental professionals showed effective results in preventing hospital-acquired infection. This review highlights the importance of establishing guidelines for the evaluation of oral status in ICU patients and summarizes data that may be useful for future studies. Further studies on maintaining good oral hygiene among ICU patients are needed.

Influence of General and Local Anesthesia on Postoperative Pain after Impacted Third Molar Surgery.

This study examined the effects of general anesthesia on the postoperative pain level after third molar extractions compared to local anesthesia. This retrospective study included patients who underwent four simultaneous third molar extractions under general or local anesthesia and had records of their postoperative pain levels (visual analog scale, VAS). The pain level was determined in the early (Postoperative day; POD < #3) and late (POD #3-7) periods. The operation time and recently modified difficulty index were analyzed to validate the homogenous condition of the extraction. Of the 227 male inpatients (aged 20.9 ± 1.3 years), 172 and 55 patients underwent third molar extractions under local and general anesthesia, respectively. The age and difficulty index were distributed equally, but the operation time was longer in general anesthesia than in local anesthesia (p < 0.001). The early and late periods featured similar pain outcomes. The operation time correlated with the total periods with a correlation coefficient of 0.271 (p < 0.001). In conclusion, the postoperative pain following whole third molar extraction was related to the operation time rather than the anesthetic methods.

Dentin-Derived-Barrier Membrane in Guided Bone Regeneration: A Case Report.

An autogenous, demineralized, dentin matrix is a well-known osteo-inductive bone substitute that is mostly composed of type I collagen and is widely used in implant dentistry. This single case report describes a successful outcome in guided bone regeneration and dental implantation with a novel human-derived collagen membrane. The authors fabricated a dentin-derived-barrier membrane from a block-type autogenous demineralized dentin matrix to overcome the mechanical instability of the collagen membrane. The dentin-derived-barrier acted as an osteo-inductive collagen membrane with mechanical and clot stabilities, and it replaced the osteo-genetic function of the periosteum. Further research involving large numbers of patients should be conducted to evaluate bone forming capacity in comparison with other collagen membranes.

Developing and Validating a Novel Anonymous Method for Matching Longitudinal School-Based Data.

Prospective longitudinal data collection is an important way for researchers and evaluators to assess change. In school-based settings, for low-risk and/or likely-beneficial interventions or surveys, data quality and ethical standards are both arguably stronger when using a waiver of parental consent-but doing so often requires the use of anonymous data collection methods. The standard solution to this problem has been the use of a self-generated identification code. However, such codes often incorporate personalized elements (e.g., birth month, middle initial) that, even when meeting the technical standard for anonymity, may raise concerns among both youth participants and their parents, potentially altering willingness to participate, response quality, or generating outrage. There may be value, therefore, in developing a self-generated identification code and matching approach that not only is technically anonymous but also appears anonymous to a research-naive individual. This article provides a proof of concept for a novel matching approach for school-based longitudinal data collection that potentially accomplishes this goal.

Statistical and Machine Learning Methods Applied to the Prediction of Different Tropical Rainfall Types.

Predicting rain from large-scale environmental variables remains a challenging problem for climate models and it is unclear how well numerical methods can predict the true characteristics of rainfall without smaller (storm) scale information. This study explores the ability of three statistical and machine learning methods to predict 3-hourly rain occurrence and intensity at 0.5° resolution over the tropical Pacific Ocean using rain observations the Global Precipitation Measurement (GPM) satellite radar and large-scale environmental profiles of temperature and moisture from the MERRA-2 reanalysis. We also separated the rain into different types (deep convective, stratiform, and shallow convective) because of their varying kinematic and thermodynamic structures that might respond to the large-scale environment in different ways. Our expectation was that the popular machine learning methods (i.e., the neural network and random forest) would outperform a standard statistical method (a generalized linear model) because of their more flexible structures, especially in predicting the highly skewed distribution of rain rates for each rain type. However, none of the methods obviously distinguish themselves from one another and each method still has issues with predicting rain too often and not fully capturing the high end of the rain rate distributions, both of which are common problems in climate models. One implication of this study is that machine learning tools must be carefully assessed and are not necessarily applicable to solving all big data problems. Another implication is that traditional climate model approaches are not sufficient to predict extreme rain events and that other avenues need to be pursued.

Effects of ACT Out! Social Issue Theater on Social-Emotional Competence and Bullying in Youth and Adolescents: Cluster Randomized Controlled Trial.

BACKGROUND: Schools increasingly prioritize social-emotional competence and bullying and cyberbullying prevention, so the development of novel, low-cost, and high-yield programs addressing these topics is important. Further, rigorous assessment of interventions prior to widespread dissemination is crucial. OBJECTIVE: This study assesses the effectiveness and implementation fidelity of the ACT Out! Social Issue Theater program, a 1-hour psychodramatic intervention by professional actors; it also measures students' receptiveness to the intervention. METHODS: This study is a 2-arm cluster randomized control trial with 1:1 allocation that randomized either to the ACT Out! intervention or control (treatment as usual) at the classroom level (n=76 classrooms in 12 schools across 5 counties in Indiana, comprised of 1571 students at pretest in fourth, seventh, and tenth grades). The primary outcomes were self-reported social-emotional competence, bullying perpetration, and bullying victimization; the secondary outcomes were receptiveness to the intervention, implementation fidelity (independent observer observation), and prespecified subanalyses of social-emotional competence for seventh- and tenth-grade students. All outcomes were collected at baseline and 2-week posttest, with planned 3-months posttest data collection prevented due to the COVID-19 pandemic. RESULTS: Intervention fidelity was uniformly excellent (>96% adherence), and students were highly receptive to the program. However, trial results did not support the hypothesis that the intervention would increase participants' social-emotional competence. The intervention's impact on bullying was complicated to interpret and included some evidence of small interaction effects (reduced cyberbullying victimization and increased physical bullying perpetration). Additionally, pooled within-group reductions were also observed and discussed but were not appropriate for causal attribution. CONCLUSIONS: This study found no superiority for a 1-hour ACT Out! intervention compared to treatment as usual for social-emotional competence or offline bullying, but some evidence of a small effect for cyberbullying. On the basis of these results and the within-group effects, as a next step, we encourage research into whether the ACT Out! intervention may engender a bystander effect not amenable to randomization by classroom. Therefore, we recommend a larger trial of the ACT Out! intervention that focuses specifically on cyberbullying, measures bystander behavior, is randomized by school, and is controlled for extant bullying prevention efforts at each school. TRIAL REGISTRATION: Clinicaltrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/17900.

Temporal and spatial analysis of per and polyfluoroalkyl substances in surface waters of Houston ship channel following a large-scale industrial fire incident.

Firefighting foams contain per- and polyfluoroalkyl substances (PFAS) - a class of compounds widely used as surfactants. PFAS are persistent organic pollutants that have been reported in waterways and drinking water systems across the United States. These substances are of interest to both regulatory agencies and the general public because of their persistence in the environment and association with adverse health effects. PFAS can be released in large quantities during industrial incidents because they are present in most firefighting foams used to suppress chemical fires; however, little is known about persistence of PFAS in public waterways after such events. In response to large-scale fires at Intercontinental Terminal Company (ITC) in Houston, Texas in March 2019, almost 5 million liters of class B firefighting foams were used. Much of this material flowed into the Houston Ship Channel and Galveston Bay (HSC/GB) and concerns were raised about the levels of PFAS in these water bodies that have commercial and recreational uses. To evaluate the impact of the ITC incident response on PFAS levels in HSC/GB, we collected 52 surface water samples from 12 locations over a 6-month period after the incident. Samples were analyzed using liquid chromatography-mass spectrometry to evaluate 27 PFAS, including perfluorocarboxylic acids, perfluorosulfonates and fluorotelomers. Among PFAS that were evaluated, 6:2 FTS and PFOS were detected at highest concentrations. Temporal and spatial profiles of PFAS were established; we found a major peak in the level of many PFAS in the days and weeks after the incident and a gradual decline over several months with patterns consistent with the tide- and wave-associated water movements. This work documents the impact of a large-scale industrial fire, on the environmental levels of PFAS, establishes a baseline concentration of PFAS in HSC/GB, and highlights the critical need for development of PFAS water quality standards.

Effects of the ACT OUT! Social Issue Theater Program on Social-Emotional Competence and Bullying in Youth and Adolescents: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: Students in the United States spend a meaningful portion of their developmental lives in school. In recent years, researchers and educators have begun to focus explicitly on social and emotional learning (SEL) in the school setting. Initial evidence from meta-analyses suggests that curricula designed to promote SEL likely produce benefits in terms of social-emotional competence (SEC) and numerous related behavioral and affective outcomes. At the same time, there are often barriers to implementing such curricula as intended, and some researchers have questioned the strength of the evaluation data from SEL programs. As part of the effort to improve programming in SEL, this paper describes the protocol for a cluster randomized trial of the ACT OUT! Social Issue Theater program, a brief psychodramatic intervention to build SEC and reduce bullying behavior in students. OBJECTIVE: The objective of this trial is to examine if a short dose of interactive psychodrama can affect SEC metrics and bullying experiences in schoolchildren in either the short (2-week) or medium (6-month) term. METHODS: The ACT OUT! trial is a cluster randomized superiority trial with 2 parallel groups. The unit of measurement is the student, and the unit of randomization is the classroom. For each grade (fourth, seventh, and 10th), an even number of classrooms will be selected from each school-half will be assigned to the intervention arm and half will be assigned to the control arm. The intervention will consist of 3 moderated psychodramatic performances by trained actors, and the control condition will be the usual school day. Outcome data will be collected at baseline (preintervention), 2-week postintervention (short term), and 6-month postintervention (medium term). Outcomes will include social-emotional competency; self-reported bullying and experiences of being bullied; receptivity to the program; and school-level data on truancy, absenteeism, and referrals to school displinary action for bullying. A power analysis adjusted for clustering effect, design effect, and potential attrition yielded a need for approximately 1594 students, consisting of an estimated 80 classrooms split evenly into intervention and control arms. RESULTS: This study was funded in June 2019; approved by the Indiana University Institutional review board on September 17, 2019; began subject recruitment on November 5, 2019; and prospectively registered with ClinicalTrials.gov. CONCLUSIONS: Many states have issued recommendations for the integration of SEL into schools. The proposed study uses a rigorous methodology to determine if the ACT OUT! psychodramatic intervention is a cost-effective means of bolstering SEC and reducing bullying incidence in schools. TRIAL REGISTRATION: ClinicalTrials.gov NCT04097496; https://clinicaltrials.gov/ct2/show/NCT04097496. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/17900.

Global multivariate point pattern models for rain type occurrence.

We seek statistical methods to study the occurrence of multiple rain types observed by satellite on a global scale. The main scientific interests are to relate rainfall occurrence with various atmospheric state variables and to study the dependence between the occurrences of multiple types of rainfall (e.g. short-lived and intense versus long-lived and weak; the heights of the rain clouds are also considered). Commonly in point process model literature, the spatial domain is assumed to be a small, and thus planar domain. We consider the log-Gaussian Cox Process (LGCP) models on the surface of a sphere and take advantage of cross-covariance models for spatial processes on a global scale to model the stochastic intensity function of the LGCP models. We present analysis results for rainfall observations from the TRMM satellite and atmospheric state variables from MERRA-2 reanalysis data over the tropical Eastern and Western Pacific Ocean, as well as over the entire tropical and subtropical ocean regions. Statistical inference is done through Monte Carlo likelihood approximation for LGCP models. We employ covariance approximation to deal with massive data.

Social Media Outrage in Response to a School-Based Substance Use Survey: Qualitative Analysis.

BACKGROUND: School-based alcohol, tobacco, and other drug use (ATOD) surveys are a common epidemiological means of understanding youth risk behaviors. They can be used to monitor national trends and provide data, in aggregate, to schools, communities, and states for the purposes of funding allocation, prevention programming, and other supportive infrastructure. However, such surveys sometimes are targeted by public criticism, and even legal action, often in response to a lack of perceived appropriateness. The ubiquity of social media has added the risk of potential online firestorms, or digital outrage events, to the hazards to be considered when administering such a survey. Little research has investigated the influence of online firestorms on public health survey administration, and no research has analyzed the content of such an occurrence. Analyzing this content will facilitate insights as to how practitioners can minimize the risk of generating outrage when conducting such surveys. OBJECTIVE: This study aimed to identify common themes within social media comments comprising an online firestorm that erupted in response to a school-based ATOD survey in order to inform risk-reduction strategies. METHODS: Data were collected by archiving all public comments made in response to a news study about a school-based ATOD survey that was featured on a common social networking platform. Using the general inductive approach and elements of thematic analysis, two researchers followed a multi-step protocol to clean, categorize, and consolidate data, generating codes for all 207 responses. RESULTS: In total, 133 comments were coded as oppositional to the survey and 74 were coded as supportive. Among the former, comments tended to reflect government-related concerns, conspiratorial or irrational thinking, issues of parental autonomy and privacy, fear of child protective services or police, issues with survey mechanisms, and reasoned disagreement. Among the latter, responses showed that posters perceived the ability to prevent abuse and neglect and support holistic health, surmised that opponents were hiding something, expressed reasoned support, or made factual statements about the survey. Consistent with research on moral outrage and digital firestorms, few comments (<10%) contained factual information about the survey; nearly half of the comments, both supportive and oppositional, were coded in categories that presupposed misinformation. CONCLUSIONS: The components of even a small online firestorm targeting a school-based ATOD survey are nuanced and complex. It is likely impossible to be fully insulated against the risk of outrage in response to this type of public health work; however, careful articulation of procedures, anticipating specific concerns, and two-way community-based interaction may reduce risk.

Diagnosis and management of cracked tooth by quantitative light-induced fluorescence technology.

INTRODUCTION: The aim of this case report was to describe the process of diagnosis and treatment of a cracked tooth using quantitative light-induced fluorescence (QLF). CASE REPORT: A 43-year-old male presented at our dental clinic with a complaint of cold pain in #17 tooth. A routine oral examination with radiography was performed for evaluation of the oral condition and treatment planning. Additionally, QLF image capture was performed using Qraycam and Qraypen (AIOBIO, Seoul, Republic of Korea), to collect white-light and fluorescence images. The #17 tooth was observed to have a crack line, showing red fluorescence, from the distal to mesial aspect on the occlusal surface. Even though there was no visible root fracture in the radiographic image, bone loss was observed. Therefore, we performed periodontal treatment. One month later, a root canal treatment was performed because the patient still complained of pain in the #17 tooth. During this treatment, one fluorescent image and one white light image set was captured with the Qraypen. A crack line showing red fluorescence was observed, while the line was not visible to the naked eye. After treatment, the patient has had no complaint related to this tooth for 3 years until today. CONCLUSIONS: Clinically, use of QLF confirmed the presence of a crack before and during a root canal treatment. Therefore, it is postulated that the QLF technology could objectively facilitate the diagnosis and treatment of a cracked tooth.

Predictive Statistical Representations of Observed and Simulated Rainfall Using Generalized Linear Models.

This study explores the feasibility of predicting subdaily variations and the climatological spatial patterns of rain in the tropical Pacific from atmospheric profiles using a set of generalized linear models: logistic regression for rain occurrence and gamma regression for rain amount. The prediction is separated into different rain types from TRMM satellite radar observations (stratiform, deep convective, and shallow convective) and CAM5 simulations (large-scale and convective). Environmental variables from MERRA-2 and CAM5 are used as predictors for TRMM and CAM5 rainfall, respectively. The statistical models are trained using environmental fields at 0000 UTC and rainfall from 0000 to 0600 UTC during 2003. The results are used to predict 2004 rain occurrence and rate for MERRA-2/TRMM and CAM5 separately. The first EOF profile of humidity and the second EOF profile of temperature contribute most to the prediction for both statistical models in each case. The logistic regression generally performs well for all rain types, but does better in the east Pacific compared to the west Pacific. The gamma regression produces reasonable geographical rain amount distributions but rain rate probability distributions are not predicted as well, suggesting the need for a different, higher-order model to predict rain rates. The results of this study suggest that statistical models applied to TRMM radar observations and MERRA-2 environmental parameters can predict the spatial patterns and amplitudes of tropical rainfall in the time-averaged sense. Comparing the observationally trained models to models that are trained using CAM5 simulations points to possible deficiencies in the convection parameterization used in CAM5.