[Morsicatio related white lesions of the tongue borders and lower lip: a case report]. / Witte veranderingen van de onderlip en de tongranden als gevolg van morsicatio.

A 28-year-old woman was referred by her dentist to an oral and maxillofacial surgeon for white lesions of the lower lip and lateral tongue borders on both sides. The diagnoss morsicatio labiorum and linguarum was made. Cheek, tongue, and lip biting occurs with some regularity and often patients are unaware of this habit. The diagnosis of morsicatio is based on clinical appearance and additional diagnostics are unnecessary. The condition belongs to a subcategory of obsessive-compulsive disorders. Treatment is not always necessary, but may consist of making the patient aware of the cause, possibly combined with symptomatic and/or causal therapy, for instance with an occlusal splint or cognitive behavioral therapy.

Which score most likely represents pain on the observational PAINAD pain scale for patients with dementia?

OBJECTIVES: We sought to determine a cutoff score for the observational Pain Assessment in Advanced Dementia (PAINAD), to adequately assess pain in clinical nursing home practice and research. DESIGN AND SETTING: We used data from multiple sources. We performed a literature review on PAINAD, performed secondary data analysis of a study examining psychometric properties of PAINAD in nursing home patients with dementia, and performed another study in nursing home patients with dementia specifically aimed at determining a cutoff score for PAINAD. PARTICIPANTS: Patients with dementia in long term care facilities. MEASUREMENTS: We related PAINAD scores (range 0 to 10) to (1) self-reported and proxy-reported pain by global clinical judgment and (2) scores on another pain assessment instrument (DOLOPLUS-2), and (3) we compared scores between painful and supposedly less painful conditions. RESULTS: Findings from this study showed that a cutoff value of 2 should serve as a trigger for a trial with pain treatment. Although the majority of patients scoring 1 or 0 were not in pain, pain could be ruled out. CONCLUSION: Based on the findings of multiple available data sources, we recommend that a PAINAD score of 2 or more can be used as an indicator of probable pain. A score of 1 is a sign to be attentive to possible pain. Future work may focus on cutoff scores for the presence of pain and severe pain in other frequently used pain tools, and on further development of methodology to assess cutoff scores.

A fast feedforward training algorithm using a modified form of the standard backpropagation algorithm.

In this letter, a new approach for the learning process of multilayer feedforward neural network is introduced. This approach minimizes a modified form of the criterion used in the standard backpropagation algorithm. This criterion is based on the sum of the linear and the nonlinear quadratic errors of the output neuron. The quadratic linear error signal is appropriately weighted. The choice of the weighted design parameter is evaluated via rank convergence series analysis and asymptotic constant error values. The new proposed modified standard backpropagation algorithm (MBP) is first derived on a single neuron-based net and then extended to a general feedforward neural network. Simulation results of the 4-b parity checker and the circle in the square problem confirm that the performance of the MBP algorithm exceed the standard backpropagation (SBP) in the reduction of the total number of iterations and in the learning time.

Two-dimensional joint process lattice for adaptive restoration of images.

The two dimensional (2D) joint process lattice (TDJPL) and its implementations for image restoration applications are examined. A 2D adaptive lattice algorithm (TDAL) is first developed. Convergence properties of the algorithm are covered for the 2D adaptive lattice least mean squares (TDAL-LMS) case. The complexity of the normalized algorithm is slightly more than that of the TDAL-LMS, but it is a faster-converging algorithm. Implementations of the proposed TDJPL estimator as a 2D adaptive lattice noise canceler and as a 2D adaptive lattice line enhancer are then considered. The performance of both schemes is evaluated using artificially degraded image data at different signal-to-noise ratios (SNRs). The results show that substantial noise reduction has been achieved, and the high improvement in the mean square error, even at very low input SNR, is ensured. The results obtained consistently demonstrate the efficacy of the proposed TDJPL implementations, and illustrate the success in its use for adaptive restoration of images.