Interpretable meta-learning of multi-omics data for survival analysis and pathway enrichment.

MOTIVATION: Despite the success of recent machine learning algorithms' applications to survival analysis, their black-box nature hinders interpretability, which is arguably the most important aspect. Similarly, multi-omics data integration for survival analysis is often constrained by the underlying relationships and correlations that are rarely well understood. The goal of this work is to alleviate the interpretability problem in machine learning approaches for survival analysis and also demonstrate how multi-omics data integration improves survival analysis and pathway enrichment. We use meta-learning, a machine-learning algorithm that is trained on a variety of related datasets and allows quick adaptations to new tasks, to perform survival analysis and pathway enrichment on pan-cancer datasets. In recent machine learning research, meta-learning has been effectively used for knowledge transfer among multiple related datasets. RESULTS: We use meta-learning with Cox hazard loss to show that the integration of TCGA pan-cancer data increases the performance of survival analysis. We also apply advanced model interpretability method called DeepLIFT (Deep Learning Important FeaTures) to show different sets of enriched pathways for multi-omics and transcriptomics data. Our results show that multi-omics cancer survival analysis enhances performance compared with using transcriptomics or clinical data alone. Additionally, we show a correlation between variable importance assignment from DeepLIFT and gene coenrichment, suggesting that genes with higher and similar contribution scores are more likely to be enriched together in the same enrichment sets. AVAILABILITY AND IMPLEMENTATION: https://github.com/berkuva/TCGA-omics-integration.

Association between breastfeeding and periodontitis in Korean women using Korea National Health and Nutrition Examination Survey (KNHANES): a cross-sectional study.

OBJECTIVES: The effect of breastfeeding on periodontal disease in women remains unclear. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey to explore the association between breastfeeding and periodontitis in Korean women using data from the Korean National Health and Nutrition Examination Survey (KNHANES VII). MATERIALS AND METHODS: Cross-sectional data was analyzed from the KNHANES 2016-2018. The study population included 5,587 parous women aged ≥ 30 years. The outcome variable was the presence or absence of periodontitis. The explanatory variable, period of breastfeeding, was defined as "none", "1-11 months", and "more than 12 months". Confounder variables (socio-educational, personal healthcare practice, and systemic medical characteristics) were adjusted for in the logistic regression analysis. RESULTS: Approximately 60% of the participants breastfed for ≥ 12 months. In all statistical models, the prevalence of periodontitis was approximately 60% greater in women that did not breastfeed compared to women that had breastfed for 12 months or longer. When adjusted for age, statistical significance was only present in the 50-59 years age group (adjusted odds ratio [aOR], 1.678; 95% confidence interval [CIs], 1.046-2.691). CONCLUSION: Our study shows that women that breastfed for a relatively long duration had a lower risk of periodontitis. Therefore, breastfeeding may be beneficial for women's periodontal health. These results are expected to be helpful in oral health education for pregnant women.

Embeddings of genomic region sets capture rich biological associations in lower dimensions.

MOTIVATION: Genomic region sets summarize functional genomics data and define locations of interest in the genome such as regulatory regions or transcription factor binding sites. The number of publicly available region sets has increased dramatically, leading to challenges in data analysis. RESULTS: We propose a new method to represent genomic region sets as vectors, or embeddings, using an adapted word2vec approach. We compared our approach to two simpler methods based on interval unions or term frequency-inverse document frequency and evaluated the methods in three ways: First, by classifying the cell line, antibody or tissue type of the region set; second, by assessing whether similarity among embeddings can reflect simulated random perturbations of genomic regions; and third, by testing robustness of the proposed representations to different signal thresholds for calling peaks. Our word2vec-based region set embeddings reduce dimensionality from more than a hundred thousand to 100 without significant loss in classification performance. The vector representation could identify cell line, antibody and tissue type with over 90% accuracy. We also found that the vectors could quantitatively summarize simulated random perturbations to region sets and are more robust to subsampling the data derived from different peak calling thresholds. Our evaluations demonstrate that the vectors retain useful biological information in relatively lower-dimensional spaces. We propose that vector representation of region sets is a promising approach for efficient analysis of genomic region data. AVAILABILITY AND IMPLEMENTATION: https://github.com/databio/regionset-embedding. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

S100A8 and S100A9 in saliva, blood and gingival crevicular fluid for screening established periodontitis: a cross-sectional study.

BACKGROUND: Periodontitis is one of major oral diseases, which has no consensus on early screening tool. This study aimed to compare the association and screening ability of S100A8 and S100A9 in saliva, blood and gingival crevicular fluid (GCF) for periodontitis status. METHODS: We recruited 149 community Korean adults, 50 no or initial periodontitis (NIPERIO) and 99 established periodontitis (PERIO). Using clinical attachment loss and a panoramic radiograph, stage II-IV of new classification of periodontitis proposed at 2018 was considered cases as PERIO. Enzyme linked immunosorbent assay kit was used to quantify S100A8 and S100A9. T-test, analysis of covariance, Mann-Whitney test and correlation analysis were applied to compare the relationship of S100A8 and S100A9 in saliva, blood, and GCF for periodontitis. Receiver operating characteristic curve was applied for screening ability. RESULTS: Among S100A8 and S100A9 in saliva, blood and GCF, S100A8 in saliva was significantly higher in PERIO than in NIPERIO (p < 0.05). However, S100A8 and S100A9 in GCF were higher in NIPERIO (p < 0.05). The screening ability of salivary S100A8 was 75% for PERIO, while that of GCF S100A8 was 74% for NIPERIO. Salivary S100A8 was positively correlated to blood S100A8 (p < 0.05). CONCLUSION: Salivary S100A8 could be a potential diagnostic marker for established periodontitis and be useful for screening established periodontitis.

Diagnostic and Prognostic ability of salivary MMP-9 and S100A8 for periodontitis.

OBJECTIVES: Salivary diagnostic using matrix metalloproteinase (MMP) and S100 for periodontitis is a promising issue. However, its prognostic effect is still unclear. This study aimed to evaluate the prognostic ability of salivary MMP-9 and S100A8 for periodontitis through non-surgical periodontitis treatment clinical trial. MATERIALS AND METHODS: Total 149 participants, 99 periodontitis and 50 healthy, were recruited. Among 99 non-surgical periodontitis treatment participants, 74 participants were revisited after three months. Periodontitis was classified as stage II-IV of new classification of periodontitis proposed at 2018. Enzyme-linked immunosorbent assay kit was used to quantify salivary MMP-9 and S100A8. Receiver operating characteristic curve was applied for diagnostic ability. Paired t test was applied for prognostic ability evaluating changes in salivary markers between pre- and post-treatment. RESULTS: Salivary MMP-9 and S100A8 were associated with periodontitis (p < .05). The screening ability of algorithm using salivary MMP-9 and S100A8 for periodontitis was 0.86 (p < .05). After treatment, reduction rate of salivary S100A8 and MMP-9 was 83.7% and 23.5%, respectively, (p < .05): only salivary S100A8 was superior compared to clinical parameters. CONCLUSION: Algorithm using salivary MMP-9 and S100A8 showed high diagnostic power for periodontitis. Both salivary S100A8 and MMP-9 showed prognostic ability for periodontitis, but S100A8 was better.

Diagnostic ability of salivary matrix metalloproteinase-9 lateral flow test point-of-care test for periodontitis.

AIM: This cross-sectional study aimed to examine the diagnostic ability of salivary matrix metalloproteinase (MMP)-9 lateral flow test (LFT) point-of-care (POC) kit and develop an algorithm for diagnosis of periodontitis. MATERIALS AND METHODS: Through Seoul National Dental Hospital, 137 participants (46 LFT negatives, 91 LFT positives) were recruited. For salivary diagnostics, 150 µl of the unstimulated saliva was applied to LFT-POC kit. To make a diagnosis of periodontitis, stage II-IV in modified new international classification system was used. Covariates encompassing age, sex, smoking and obesity were evaluated through face-to-face interview. Enzyme-linked immunosorbent assay was used for quantification of salivary MMP-9. To develop a diagnostic algorithm, multivariable logistic regression analysis was used. Receiver operating characteristic curve was applied for evaluating diagnostic ability. RESULTS: Diagnostic ability of salivary MMP-9 LFT-POC test was 0.82 (sensitivity of 0.92, specificity of 0.72) in total participants. Diagnostic algorithm using POC test resulted in a response equation, that is algorithm score = -3.675 + 2.877*LFT + 0.034*age + 0.121*sex + 0.372*smoking + 0.192*obesity. Diagnostic ability of the algorithm was 0.88 (sensitivity of 0.92, specificity of 0.85) with cut-off score of 0.589. CONCLUSIONS: Salivary MMP-9 LFT-POC kit showed appropriate diagnostic ability for periodontitis and would be an efficient tool for screening of periodontitis.

Ternary representation of N (N = 1 or 2)-input and 1-output algorithmic self-assembly demonstrated by DNA.

Deoxyribonucleic acid (DNA) is effective for molecular computation because of its high energy efficiency, high information density, and parallel-computing capability. Although logic implementation using DNA molecules is well established in binary systems (base value of 2) via decoration of hairpin structures on DNA duplexes, systems with base values of >2 (e.g. 3, corresponding to a ternary system) are rarely discussed owing to the complexity of the design and the experimental difficulties with DNA. In this study, DNA rule tiles that participate to form algorithmic DNA crystals exhibiting the ternary representation of an N (N = 1 or 2)-input and 1-output algorithmic assembly are conceived. The number of possible algorithmic patterns is [Formula: see text] in the ternary N-input and 1-output logic gate. Thus, the number of possible rules is 27 (=33) for a 1-input and 1-output algorithmic logic gate and 19 638 (=39) for a 2-input and 1-output algorithmic logic gate. Ternary bit information (i.e. 0-, 1-, and 2-bit) is encoded on rule tiles without hairpins and with short and long hairpins. We construct converged, line-like, alternating, and commutative patterns by implementing specific rules (TR00, TR05, TR07, and TR15, respectively) for the 1-input and 1-output gate and an ascending line-like pattern (with the rule of TR3785) for the 2-input and 1-output gate. Specific patterns generated on ternary-representing rule-embedded algorithmic DNA crystals are visualized via atomic force microscopy, and the errors during the growth of the crystals are analyzed (average error rates obtained for all experimental data are <4%). Our method can easily be extended to a system having base values of >3.

Chronic periodontitis and community-acquired pneumonia: a population-based cohort study.

BACKGROUND: This study aimed to determine the association between chronic periodontitis (CP) and community-acquired pneumonia (CAP) according to CP severity in the Korean population based on the National Health Insurance Service database. METHODS: Data from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS), conducted from 2002 to 2013, were analyzed. A total of 363,541 participants were enrolled in this retrospective cohort study. Data on socio-demographic characteristics and CAP-related variables were collected. Participants were divided into 4 groups according to CP severity. Cox proportional hazards regression was performed after adjusting for sociodemographic and related covariates. RESULTS: A total of 363,541 participants were included in the analysis. The number of CAP cases in the index period was 14,838 (4.1%). Among the 4 groups, the mean age was significantly higher in the severe CP group. The incidence rates of severe and non-severe CP were 5.68 and 4.99, respectively (per 103 person-years). The hazard ratio for CAP was not significant in any of the models regardless of the presence or absence of CP. On stratification analysis by sex, smoking and Charlson comorbidity index, there were no significant differences between CAP and CP in any of the models. CONCLUSION: The results of this study show that CP may not be a potential risk factor for CAP.

Characteristics of Local Delivery Agents for Treating Peri-Implantitis on Dental Implant Surfaces: A Preclinical Study.

Local delivery agents (LDAs) are widely used in peri-implantitis treatments. The aim of this study was to identify LDAs remaining on the dental implant surfaces and to analyze the components of these residues after applying various cleaning methods. Implants were prepared with a sand-blasted, large-grit, acid-etched surface. Four kinds of LDAs were applied on the implant surfaces: chlorhexidine gel (group 2), tetracycline solution (group 3), and 2 kinds of minocycline hydrochloride agents (groups 4 and 5). Group 1 received normal saline as a control. Two cleaning methods were applied for different durations as follows: (1) running distilled water for 10 seconds (subgroup A), 5 minutes (subgroup B), and 15 minutes (subgroup C); and (2) water spray of a dental-unit chair for 10 seconds (subgroup D) and 5 minutes (subgroup E). Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to analyze the surface morphology and residue components for all implants. The amount of LDA removed from the implant surfaces in groups 1, 2, 3, and 5 increased with the cleaning duration and pressure. However, Minocline remained coated on the implant surfaces in group 4 under all cleaning conditions. Minocline could not be cleaned off well by water due to its hydrophobicity. Therefore, directly using this agent on implant surfaces with peri-implantitis should be carefully considered. The presence of LDA residues without drug efficacies on implant surfaces might interfere with reosseointegration and act as a reservoir of microorganisms.

The use of an interdental brush mitigates periodontal health inequalities: the Korean National Health and nutrition examination survey (KNHANES).

BACKGROUND: The purpose of this study was to evaluate the mitigating effect of the use of interdental brushes on periodontal health inequality. METHODS: This study was based on the data acquired in the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI; 2013-2015). A total of 17,583 participants (7,633 males and 9,950 females)) aged 19 years or older completed the KNHANES VI between 2013 and 2015. Multivariable logistic regression analysis was performed using socioeconomic characteristics (sex, age, level of education, individual income), personal health practice (smoking, toothbrushing, dental flossing, interdental brushing, dental clinic visiting), systematic medical factors (diabetes mellitus, hypercholesterolemia, hypertension, obesity) and the community periodontal index. We confirmed differences in the prevalence of periodontal disease with the use of an interdental brushes stratified according to individual income. RESULTS: Three logistic regression models adjusted for covariates hierarchically. In all models, individuals who used an interdental brush were not significantly different from individuals who did not use an interdental brush. The adjusted odds ratio (OR) for interdental brushing was 0.918 with a 95% confidence intervals (CIs) of 0.797-1.057. When periodontal disease was the outcome of the model, the lowest income group had 1.266 (95% CIs 1.066 to 1.502) times the odds of having periodontal disease than the highest income group. In interdental brush nonusers, the lowest income group had 1.276 (95% CI 1.061-1.533) times the odds of having periodontal diseases than the highest income group. However, in the interdental brush users, there were no significant differences in periodontal disease prevalence among income groups. CONCLUSIONS: The results suggest that the use of interdental brushes could alleviate periodontal health inequality.

Importance of Real-Time Assays To Distinguish Multidrug Efflux Pump-Inhibiting and Outer Membrane-Destabilizing Activities in Escherichia coli.

UNLABELLED: The constitutively expressed AcrAB multidrug efflux system of Escherichia coli shows a high degree of homology with the normally silent AcrEF system. Exposure of a strain with acrAB deleted to antibiotic selection pressure frequently leads to the insertion sequence-mediated activation of the homologous AcrEF system. In this study, we used strains constitutively expressing either AcrAB or AcrEF from their normal chromosomal locations to resolve a controversy about whether phenylalanylarginine ß-naphthylamide (PAßN) inhibits the activities of AcrAB and AcrEF and/or acts synergistically with antibiotics by destabilizing the outer membrane permeability barrier. Real-time efflux assays allowed a clear distinction between the efflux pump-inhibiting activity of PAßN and the outer membrane-destabilizing action of polymyxin B nonapeptide (PMXBN). When added in equal amounts, PAßN, but not PMXBN, strongly inhibited the efflux activities of both AcrAB and AcrEF pumps. In contrast, when outer membrane destabilization was assessed by the nitrocefin hydrolysis assay, PMXBN exerted a much greater damaging effect than PAßN. Strong action of PAßN in inhibiting efflux activity compared to its weak action in destabilizing the outer membrane permeability barrier suggests that PAßN acts mainly by inhibiting efflux pumps. We concluded that at low concentrations, PAßN acts specifically as an inhibitor of both AcrAB and AcrEF efflux pumps; however, at high concentrations, PAßN in the efflux-proficient background not only inhibits efflux pump activity but also destabilizes the membrane. The effects of PAßN on membrane integrity are compounded in cells unable to extrude PAßN. IMPORTANCE: The increase in multidrug-resistant bacterial pathogens at an alarming rate has accelerated the need for implementation of better antimicrobial stewardship, discovery of new antibiotics, and deeper understanding of the mechanism of drug resistance. The work carried out in this study highlights the importance of employing real-time fluorescence-based assays in differentiating multidrug efflux-inhibitory and outer membrane-destabilizing activities of antibacterial compounds.

DARDN: A Deep-Learning Approach for CTCF Binding Sequence Classification and Oncogenic Regulatory Feature Discovery.

Characterization of gene regulatory mechanisms in cancer is a key task in cancer genomics. CCCTC-binding factor (CTCF), a DNA binding protein, exhibits specific binding patterns in the genome of cancer cells and has a non-canonical function to facilitate oncogenic transcription programs by cooperating with transcription factors bound at flanking distal regions. Identification of DNA sequence features from a broad genomic region that distinguish cancer-specific CTCF binding sites from regular CTCF binding sites can help find oncogenic transcription factors in a cancer type. However, the presence of long DNA sequences without localization information makes it difficult to perform conventional motif analysis. Here, we present DNAResDualNet (DARDN), a computational method that utilizes convolutional neural networks (CNNs) for predicting cancer-specific CTCF binding sites from long DNA sequences and employs DeepLIFT, a method for interpretability of deep learning models that explains the model's output in terms of the contributions of its input features. The method is used for identifying DNA sequence features associated with cancer-specific CTCF binding. Evaluation on DNA sequences associated with CTCF binding sites in T-cell acute lymphoblastic leukemia (T-ALL) and other cancer types demonstrates DARDN's ability in classifying DNA sequences surrounding cancer-specific CTCF binding from control constitutive CTCF binding and identifying sequence motifs for transcription factors potentially active in each specific cancer type. We identify potential oncogenic transcription factors in T-ALL, acute myeloid leukemia (AML), breast cancer (BRCA), colorectal cancer (CRC), lung adenocarcinoma (LUAD), and prostate cancer (PRAD). Our work demonstrates the power of advanced machine learning and feature discovery approach in finding biologically meaningful information from complex high-throughput sequencing data.

Inequality in dental flossing behavior among Korean adults based on household income levels.

Objectives: The aim of this study was to estimate the association between household income and dental flossing. Methods: This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices. Results: In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27-2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86-7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05-2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07-2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24-2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23-2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10-2.44). Conclusion: The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.

Radiologically derived 3D virtual models for neurosurgical planning.

Three dimensional (3D) virtual models for neurosurgery have demonstrated substantial clinical utility, especially for neuro-oncological cases. Computer-aided design (CAD) modelling of radiological images can provide realistic and high-quality 3D models which neurosurgeons may use pre-operatively for surgical planning. 3D virtual models are useful as they are the basis for other models that build off this design. 3D virtual models are quick to segment but can also be easily added to normal neurosurgical and radiological workflow without disruption. Three anatomically complex neuro-oncology cases that were referred from a single institution by three different neurosurgeons were segmented and 3D virtual models were created for pre-operative surgical planning. A face-to-face interview was performed with the surgeons after the models were delivered to gauge the usefulness of the model in pre-surgical planning. All three neurosurgeons found that the 3D virtual model was useful for presurgical planning. Specifically, the virtual model helped in planning operative positioning, understanding spatial relationship between lesion and surrounding critical anatomy and identifying anatomy that will be encountered intra-operatively in a sequential manner. It provided benefit in Multidisciplinary team (MDT) meetings and patient education for shared decision making.3D virtual models are beneficial for pre-surgical planning and patient education for shared decision making for neurosurgical neuro-oncology cases. We believe this could be further expanded to other surgical specialties. The integration of 3D virtual models into normal workflow as the initial step will provide an easier transition into modalities that build off the virtual models such as printed, virtual, augmented and mixed reality models.

Computed tomography Scan Size Analysis of stapedius and tensor tympani muscles in middle ear myoclonic tinnitus.

Objectives: To analyze the sizes of the stapedius and tensor tympani (TT) muscles using a temporal bone CT (TBCT) scan in patients with middle ear myoclonic tinnitus (MEMT) and investigate their value for the diagnosis of this rare cause of tinnitus. Methods: Medical records and TBCT of patients with MEMT or vascular tinnitus (VT) at Seoul St. Mary's Hospital from January 2012 to December 2022 were reviewed. The stapedius and TT muscles were analyzed. Results: Thirty-eight patients with unilateral MEMT and 39 patients with VT were included. More males were in the MEMT group compared to the VT group (MEMT: n = 24, VT: n = 8, p = .001). The mean age of the MEMT group was younger compared to the VT group (MEMT: 35 ± 12 years, VT: 44 ± 14.3 years, p = .005). The mean BMI for the MEMT group was less than the VT group (MEMT: 22.3 ± 2.5, VT: 24.8 ± 4.36, p = .010). The mean length and width of the stapedius in the MEMT group were larger than those of the VT group (Length MEMT: 1.47 ± 0.60 mm, VT: 0.98 ± 0.24 mm, p = .001; Width MEMT: 0.89 ± 0.32 mm, VT: 0.72 ± 0.19 mm, p = .009). The mean length and width of the TT in the MEMT group were larger than that of the VT group (Length MEMT: 3.10 ± 0.50 mm, VT: 2.27 ± 0.42, p = .001; Width MEMT: 2.02 ± 0.36, VT: 1.75 ± 0.26 p = .001). Conclusion: The mean length and width of the stapedius and TT muscles measured in the MEMT group were longer and wider than the VT group. This suggests the use TBCT scan as a diagnostic tool for MEMT. Further studies with a larger study group to validate the results of this study are recommended.Level of Evidence: 4.

Presence and diversity of free-living amoebae and their potential application as water quality indicators.

Free-living amoebae (FLA) are found in diverse environments, such as soils, rivers, and seas. Hence, they can be used as bioindicators to assess the water quality based solely on their presence. In this study, we determined the presence of FLA in river water by filtering water samples collected from various sites and culturing the resulting filtrates. FLA were detected in all the water samples with varying quality grades (Grades Ι-V). The significant increase in the size of the amoebae population with the deterioration in the water quality. Monoxenic cultures of the amoebae were performed, and genomic DNAs were isolated, among which 18S rDNAs were sequenced to identify the amoeba species. Of the 12 species identified, 10 belonged to the Acanthamoeba genus; of the remaining 2 species, one was identified as Vannella croatica and the other as a species of Vermamoeba. Acanthamoeba was detected in samples with Grades Ι to VI quality, whereas the Vermamoeba species was present only in Grade Ι water. V. croatica was found exclusively in water with Grade ΙΙ quality. Following morphological observations, genomic DNA was sequenced using 16S rDNA to determine whether the species of Acanthamoeba harbored endosymbionts. Most of the isolated Acanthamoeba contained endosymbionts, among which 4 species of endogenous bacteria were identified and examined using transmission electron microscopy. This study provides evidence that the distribution of amoebae other than Acanthamoeba may be associated with water quality. However, further confirmation will be required based on accurate water quality ratings and assessments using a more diverse range of FLA.

Effects of multigrain rice and white rice on periodontitis: an analysis using data from the Korea National Health and Nutrition Examination Survey 2012-2015.

OBJECTIVES: Numerous studies have investigated the efficacy of whole grains; however, research on multigrain remains limited. Grains exhibit combined positive effects against various diseases. The purpose of this study was to examine the impact of multigrain and white rice consumption on periodontitis. METHODS: We analyzed data from the Korea National Health and Nutrition Examination Survey V-3 and VI, collected between 2012 and 2015, which included 12,450 patients (4,859 male and 7,591 female) aged 19-64 years. The World Health Organization's Community Periodontal Index (CPI) was utilized to assess the presence of periodontitis, with periodontitis defined as a CPI index score of ≥3. Multivariable logistic regression analysis was performed after adjusting for potential confounding variables. RESULTS: The group that consumed only multigrain rice was less likely to have periodontitis than the group that consumed only white rice (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.69 to 0.93). When stratified by sex, the risk of periodontitis demonstrated a 24% decrease in female who consumed only multigrain rice (OR, 0.76; 95% CI, 0.62 to 0.93). A similar result was observed in the age group of 40-64 years (OR, 0.84; 95% CI, 0.71 to 0.99). In the diabetes stratification model, the normal group that consumed only multigrain rice exhibited a 25% decrease in the odds of periodontitis (OR, 0.75; 95% CI, 0.62 to 0.91). CONCLUSIONS: Our findings suggest that the prevalence of periodontitis may vary depending on the type of rice consumed.

Dental service sector and patient-reported oral health outcomes: Modification by trust in dentists.

Objective: The study aimed to examine the association between patient-reported oral health outcomes and the dental service sector and trust in dentists. The possible interaction effect of trust on this association was also explored. Methods: Randomly selected adults aged over 18 years living in South Australia were surveyed using self-administered questionnaires. The outcome variables were self-rated dental health and the evaluation outcome of the Oral Health Impact Profile. The dental service sector and the Dentist Trust Scale were included in bivariate and adjusted analyses with sociodemographic covariates. Results: Data from 4,027 respondents were analyzed. Unadjusted analysis showed that poor dental health and oral health impact were associated with sociodemographic characteristics, including lower income/education, public dental service, and lower trust in dentists (p < 0.01). Adjusted associations were similarly maintained (p < 0.05) but attenuated with the loss of statistical significance, mainly in the trust tertiles. Lower trust in dentists in the private sector had an interaction effect, with a higher prevalence ratio of oral health impact (prevalence ratio = 1.51; 95% confidence interval, 1.06-2.14; p < 0.05). Conclusion: Patient-reported oral health outcomes were associated with sociodemographic characteristics, the dental service sector, and trust in dentists. Implications for public health: The inequality of oral health outcomes between dental service sectors needs to be addressed both independently and in association with covariates including socioeconomic disadvantage.

The use of prophylactic antiepileptic medication and driving restrictions for craniotomies among Australian and New Zealand neurosurgeons.

Prophylactic antiepileptic drug (pAED) use for craniotomy surgery is currently not supported in literature [1-5] except possibly in traumatic brain injury (TBI) [6]. Post craniotomy driving restrictions using the Austroad guidelines are based upon literature on TBI and not specifically craniotomy [16-18]. This study was to review Australian and New Zealand neurosurgeons on their use of pAED and advice on driving restrictions post craniotomy surgery. A voluntary and anonymous survey link was distributed to the members of the Neurosurgical Society of Australasia (NSA) through the NSA newsletter. The survey was available on the SurveyMonkey platform in the year 2021 August to December. Questions regarding the use of pAED and duration of driving restrictions were presented to survey participants. Sixty-one (26 %) out of 231 neurosurgeons responded to the survey. Thirty-six percent of respondents stated that they prescribed pAEDs regularly whilst thirty-two percent of respondents did not routinely prescribe pAEDs for craniotomy surgery. Driving restrictions varied but the most common driving restriction post craniotomy surgery was 6 months. There were divided opinions among NSA members in regards to pAED use and driving restrictions. The rationale for pAED use and prolonged driving restrictions for craniotomy surgery needs to be re-evaluated with current literature. The significant effect this may have on the well-being and quality life of patients need to be considered before prescribing pAEDs or long driving restrictions.

Effect of interdental cleaning devices on proximal caries.

OBJECTIVES: To estimate the association between the use of interdental cleaning devices and proximal caries experience. METHODS: This study used a cross-sectional data from the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). A total of 13 525 adults aged 19-64 years who participated in both the nutrition survey and the health examination survey were included. Data on sociodemographic factors (age and sex), socioeconomic factors (level of education and household income) and personal health practices (frequency of toothbrushing, visits to dental clinic, frequency of snacking and self-rated oral health status), and number of proximal caries were collected. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were calculated using the multivariable Poisson generalized linear model according to use of dental floss or an interdental brush. The risk of proximal caries for dental floss following the stratification of participants into various subgroups related to oral health was assessed. RESULTS: While nonflossers had 1.46 times (PR 1.46, 95% CI: 1.16-1.84) higher risk for proximal caries than flossers, the use of an interdental brush was not associated with proximal caries. In the nonflossers, the association for proximal caries was the strongest in those in their 40s (PR 2.28, 95% CI: 1.29-4.03), followed by those in their 30s (PR 1.85, 95% CI: 1.18-2.90). Although nonflossers with middle-low household income had a 59% higher risk (PR 1.59, 95% CI: 1.24-2.03) for proximal caries than those with high household income, there were no significant differences in household income in flossers. CONCLUSIONS: The findings of the study suggest that flossing at home along with toothbrushing is one of the easiest ways to prevent proximal caries. Therefore, dental floss should not be excluded from oral healthcare products.