Sleep and periodontal health.

Sleep is fundamental for health and well-being. An adequate amount and quality of sleep is a cardinal component of a healthy lifestyle at the basis of the prevention of many non-communicable chronic diseases. Recent evidence suggests that sleep disorders, particularly obstructive sleep apnea, represent an emerging risk factor for periodontal health. This review article provides a critical appraisal of the existing literature concerning the association between sleep duration, sleep quality, sleep disorders in general, and obstructive sleep apnea with periodontal diseases, including gingivitis and periodontitis. The putative mechanisms underlying these associations are described as well as the potential clinical implications for diagnosis and treatment.

Age and healthy lifestyle behavior's disparities and similarities on knowledge of myocardial infarction symptoms and risk factors among public and outpatients in a resource-limited setting, cross-sectional study in greater Gaborone, Botswana.

OBJECTIVES: In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors. METHOD: Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n = 525) and the public (n = 2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities). RESULTS: The valid response rate was 97.9% comprising 97.8% for the public (n = 2199) and 98.1% for outpatients (n = 515). Public respondents (35.2 ± 12.3 years) were younger than outpatients (38.5 ± 12.6 years). The public comprised 56.9% females while outpatients 54.6%. In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores ± SD of 3.49 ± 2.84 vs 2.80 ± 2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33 ± 3.22 vs 3.82 ± 3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35-49 years. Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours. CONCLUSION: Results call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior.

The impacts of cancer treatment on lifestyle habits and mental health in Vietnamese women: an exploratory qualitative study.

AIMS: This qualitative study explores the experiences of women after cancer treatment in terms of habit changes and mental health impact. METHOD: The study involved 10 women who had undergone cancer treatment, recruited from three major hospitals in Hanoi, Vietnam. Data were collected through semi-structured interviews, which were transcribed and analyzed using thematic analysis. RESULTS: The findings of the study shed light on the various factors influencing lifestyle behavior and mental health changes among women after cancer treatment. Ten participants, aged 39 to 64 years, shared experiences including dietary changes, sleep disruptions, and reliance on non-scientific sources for health decisions. Initially shocked by their diagnosis, many transitioned to acceptance, adopting a "giving-in" attitude. Cultural beliefs, word-of-mouth sharing, and social support networks played significant roles in shaping post-treatment lifestyle changes, coping mechanisms, information-seeking behaviors, and mental health. CONCLUSION: The study highlights the need for accessible and scientifically verified information for women after cancer treatment to make informed decisions about their health. It emphasizes the importance of addressing traditional beliefs and promoting evidence-based practices. Moreover, the study underscores the importance of social support and relationships in coping with the challenges of post-cancer experiences.

Reference gene catalog and metagenome-assembled genomes from the gut microbiome reveal the microbial composition, antibiotic resistome, and adaptability of a lignocellulose diet in the giant panda.

The giant panda, a strict herbivore that feeds on bamboo, still retains a typical carnivorous digestive system. Reference catalogs of microbial genes and genomes are lacking, largely limiting the antibiotic resistome and functional exploration of the giant panda gut microbiome. Here, we integrated 177 fecal metagenomes of captive and wild giant pandas to construct a giant panda integrated gene catalog (GPIGC) comprised of approximately 4.5 million non-redundant genes and reconstruct 393 metagenome-assembled genomes (MAGs). Taxonomic and functional characterization of genes revealed that the captivity of the giant panda significantly changed the core microbial composition and the distribution of microbial genes. Higher abundance and prevalence of antibiotic resistance genes (ARGs) were detected in the guts of captive giant pandas, and ARG distribution was influenced by geography, for both captive and wild individuals. Escherichia, as the prevalent genus in the guts of captive giant pandas, was the main carrier of ARGs, meaning there is a high risk of ARG transmission by Escherichia. We also found that multiple mcr gene variants, conferring plasmid-mediated mobile colistin resistance, were widespread in the guts of captive and wild giant pandas. There were low proportions of carbohydrate-active enzyme (CAZyme) genes in GPIGC and MAGs compared with several omnivorous and herbivorous mammals. Many members of Clostridium MAGs were significantly enriched in the guts of adult, old and wild giant pandas. The genomes of isolates and MAGs of Clostridiaceae harbored key genes or enzymes in complete pathways for degrading lignocellulose and producing short-chain fatty acids (SCFAs), indicating the potential of these bacteria to utilize the low-nutrient bamboo diet. Overall, our data presented an exhaustive reference gene catalog and MAGs in giant panda gut and provided a comprehensive understanding of the antibiotic resistome and microbial adaptability for a high-lignocellulose diet.

A biobehavioral observational study to understand the multilevel determinants of cardiovascular health in Black women: the BLOOM Study protocol.

BACKGROUND: The racial/ethnic and gender disparities in cardiovascular disease (CVD) morbidity and mortality in the United States are evident. Across nearly every metric, non-Hispanic Black women have poorer overall cardiovascular health. Emerging evidence shows a disproportionately high burden of increased CVD risk factors in Black women of childbearing age, which has a far-reaching impact on both maternal and child outcomes, resulting in premature onset of CVD and further widens the racial disparities in CVD. There is growing recognition that the fundamental driver of persistent racial/ethnic disparities in CVD, as well as disparities in behavioral risk factors such as physical activity and sleep, is structural racism. Further, the lived personal experience of racial discrimination not only has a negative impact on health behaviors, but also links to various physiological pathways to CVD risks, such as internalized stress resulting in a pro-inflammatory state. Limited research, however, has examined the interaction between daily experience and health behaviors, which are influenced by upstream social determinants of health, and the downstream effect on biological/physiological indicators of cardiovascular health in non-pregnant Black women of childbearing age. METHODS/DESIGN: The BLOOM Study is an observational study that combines real-time ambulatory assessments over a 10-day monitoring period with in-depth cross-sectional lab-based physiological and biological assessments. We will use a wrist-worn actigraphy device to capture 24-h movement behaviors and electronic ecological momentary assessment to capture perceived discrimination, microaggression, and stress. Blood pressure will be captured continuously through a wristband. Saliva samples will be self-collected to assess cortisol level as a biomarker of psychological stress. Lab assessments include a fasting venous blood sample, and assessment of various indices of peripheral and cerebral vascular function/health. Participants' address or primary residence will be used to obtain neighborhood-level built environmental and social environmental characteristics. We plan to enroll 80 healthy Black women who are between 18 and 49 years old for this study. DISCUSSION: Results from this study will inform the development of multilevel (i.e., individual, interpersonal, and social-environmental levels) lifestyle interventions tailored to Black women based on their lived experiences with the goal of reducing CVD risk. GOV IDENTIFIER: NCT06150989.

Association between tooth loss and depression mediated by lifestyle and Inflammation- a cross-sectional investigation.

BACKGROUND: Depression and tooth loss are associated with the occurrence of systemic disease or the progression of multi-factorial disease, and both are considered important public health issues by World Health Organization (WHO). Previous research just suggested that tooth loss can generate psychological stress, low self-esteem, anxiety and other emotional disturbances. However, the precise correlation and underlying mechanisms between depression and tooth loss remains poorly understood. ​Consequently, we aim to explore the association between depression and tooth loss through a cross-sectional study, as well as investigate potential pathways of influence. METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES). Logistic regression models were employed to examine the relationship between depression and tooth loss, as well as the associations among healthy lifestyle, systemic immune-inflammation index (SII), depression and tooth loss. Through the mediating effect analysis by bootstrapping analysis, we evaluated the mediating effects of healthy lifestyle and SII between depression and tooth loss. RESULTS: Depressed patients were more likely to be toothless, and at the same time showed a tendency to have more missing teeth, with odds ratio (OR) = 1.305 (1.098, 1.551), p = 0.003 for 1-7 missing teeth, OR = 1.557 (1.166, 2.079), p = 0.003 for 8-14 missing teeth, and OR = 1.960 (1.476, 2.603), p<0.001 for 15-28 missing teeth. Lower healthy lifestyle scores and higher SII were both associated with more tooth loss. Healthy lifestyle and SII played a partial mediating role in this relationship, with a mediating effect ratio of 41.691% and 3.289%, respectively. CONCLUSIONS: ​Depression was positively associated with more severe tooth loss, which was partly mediated by lifestyle and SII. Therefore, attention should also be paid to the effects of depression as a mental disorder on physical health, such as depression and tooth loss. Adopting a healthier lifestyle and controlling systemic inflammation may be potential ways to reduce the impact of depression and tooth loss.

Understanding the Lifestyle Risk Profile of Men and Their Engagement With Preventive Care: A Cross-Sectional Survey.

AIM: To explore men's health status and lifestyle risk profile and understand how they engage with preventive health care. DESIGN: A cross-sectional survey within a sequential mixed-methods project. METHODS: Four hundred thirty-one adult males, working or volunteering for the New South Wales Rural Fire Service (NSW RFS) completed the survey between September and November 2022. The survey captured demographic data, health status and lifestyle characteristics, as well as engagement with preventive health care. RESULTS: Nearly three-quarters of respondents (n = 314; 72.8%) described themselves as being in good or very good health. Just 18.6% of respondents recorded a 'healthy' body mass index (BMI), despite only 29.9% having been told by a doctor that they were overweight/obese. Most (n = 344; 79.8%) respondents identified having a regular general practitioner (GP)/general practice. Nearly all respondents described having had blood pressure measurements (n = 403; 93.5%) and lipid profile (n = 346, 80.3%) in the last 2 years. Having a regular GP/general practice was significantly associated with engaging in all preventive and screening activities, except having a dental check. CONCLUSION: Our findings demonstrate a significant opportunity to support men to reduce lifestyle risk, despite their current engagement with general practice. Strategies need to support men and health professionals to have conversations about risk and risk reduction to promote behaviour change. Nurses are well placed to provide preventive health care to men in general practice. The general practice nurse has a key role in communicating lifestyle risk, supporting patients in modifying their behaviours and reducing the impact of such factors on their health and well-being. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Communicating the importance of lifestyle risk factors is imperative in supporting men to achieve behavioural change in the reduction in lifestyle risk. Nurses are well-placed to take a leading role in this area. REPORTING METHOD: The STROBE checklist guided reporting. PATIENT OR PUBLIC CONTRIBUTION: Survey development was undertaken in collaboration with members of the NSW RFS. Key contacts within the organisation were involved in reviewing the analysis and interpretation of findings.

Association between modifiable lifestyle pattern and periodontitis: a cross-sectional study based on NHANES.

BACKGROUND: Periodontitis can be avoided with a healthy lifestyle. However, studies have only looked at one lifestyle, ignoring the connection between lifestyle patterns and periodontitis. The purpose of this study was to look at the association between modifiable lifestyle patterns and periodontitis. METHODS: Data were obtained from the National Health and Nutrition Examination Survey in 2009-2010 and 2011-2012. Smoke, drink, exercise, sleep duration, oral exams, and self-rated oral health were all lifestyle factors. The CDC/AAP classification/case definition was used to evaluate periodontitis. Drawing upon latent class analysis, distinct patterns of lifestyle were identified, with each participant exclusively affiliated with a single pattern. The association between lifestyle classes and periodontitis was then examined using ordinal logistic regression. RESULTS: 4686 (52%) of the total 9034 participants, with a mean age of 54.08, were women. Three lifestyle latent classes were found by fitting 2-10 models: "Class 1" (52%), " Class 2" (13%), and " Class 3" (35%). The "Class 1" displayed a prevalence of oral examination (75%), favorable self-rated oral health (92%), and engagement in physical activity (50%). The 'Class 2' exhibited the lowest alcohol consumption (64%) and smoking rates (73%) but the highest prevalence of physical inactivity (98%). The 'Class 3' showed a tendency for smoking (72%), alcohol consumption (78%), shorter sleep duration (50%), absence of oral examinations (75%), and suboptimal self-rated oral health (68%). The influencing variables for the latent classes of lifestyle were age, education, and poverty level. Periodontitis risk may rise by 24% for each additional unhealthy lifestyle practiced by participants (OR = 1.24, 95% CI: 1.18-1.31). The 'Class 3' (OR = 1.80, 95% CI: 1.52-2.13) had a greater risk of periodontitis compared to the 'Class 1'. CONCLUSIONS: Our analysis revealed that unhealthy lifestyle patterns are associated with periodontitis. These different lifestyle patterns need to be taken into account when developing public health interventions and clinical care.

Association between toothbrushing and cardiovascular risk factors: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2015-2017.

BACKGROUND: Previous studies have suggested that frequent toothbrushing is associated with a lower risk of future cardiovascular events. We sought to investigate further the relationship between toothbrushing, cardiovascular risk factors, and lifestyle behaviours. METHODS: We analysed a cross-sectional survey including 13,761 adults aged 30 years or older without a history of cardiovascular diseases from the Korean National Health and Nutritional Examination Survey. Conventional cardiovascular risk factors (blood pressure, lipid profiles, and fasting glucose), and inflammatory markers (high-sensitivity C-reactive protein [hsCRP], and white blood cell counts [WBC]) were investigated in relation to the frequency of toothbrushing. RESULTS: The estimated 10-year atherosclerotic cardiovascular disease (ASCVD) risk, calculated using the pooled cohort equations was 13.7%, 9.1%, and 7.3% for participants who reported toothbrushing 0-1, 2, and ≥ 3 times a day, respectively. Both conventional risk factors and inflammatory markers were significantly associated with frequent toothbrushing. However, after adjusting potential confounding factors such as age, sex, comorbidities, and lifestyle behaviours, only inflammatory markers were remained as significant factors. CONCLUSIONS: Oral hygiene behaviours are closely linked to cardiovascular risk factors. This study suggests that reduced systemic inflammatory burden may explain the benefit of improved oral hygiene in terms of cardiovascular risk.

Association between healthy lifestyle combinations and periodontitis in NHANES.

BACKGROUND: Periodontitis is closely associated with chronic systemic diseases. Healthy lifestyle interventions have health-enhancing effects on chronic systemic disorders and periodontitis, but the extent to which healthy lifestyle combinations are associated with periodontitis is unclear. Therefore, this study aimed to investigate the association between periodontitis and different healthy lifestyle combinations. METHODS: 5611 participants were included from the National Health and Nutrition Examination Survey (NHANES, 2009-2014). Six healthy lifestyles factors were defined as fulfilling either: non-smoking, moderate drinking, moderate body mass index (BMI), physical activity, healthy sleep and appropriate total energy intake. Then, the adjusted logistic regression models were performed to identify the association between the periodontitis and the scoring system composed of six lifestyles (0-6 scale). Finally, different scenarios were dynamically and randomly combined to identify the optimal and personalized combination mode. RESULTS: Higher healthy lifestyle scores were significantly associated with lower periodontitis prevalence (p < 0.05). Four lifestyle factors (smoking, drinking, BMI, and sleep) significantly varied between the periodontitis and healthy groups (p < 0.05). Smoking was considered as a strong independent risk factor for periodontitis in both former and current smokers. Results further indicated that the combination of these four lifestyles played the most essential role in determining the magnitude of periodontitis occurrence (odds ratio [OR]: 0.33; 95% confidence interval [CI]: 0.21 to 0.50). In the total population, the majority of three lifestyle combinations outperformed the two combination models, whereas the two-combination of nonsmoking-drinking (OR: 0.39; 95% CI: 0.27 to 0.58) had relatively lower periodontitis prevalence than the three-combination of healthy drinking-BMI-sleep (OR: 0.42; 95% CI: 0.26 to 0.66). CONCLUSION: This cross-sectional study suggests that smoking, drinking, BMI, and sleep are significantly related with periodontitis and smoking is the principal risk factor related among them. This study provides various customized lifestyle combinations for periodontitis prevention.

Analysis of Fluoride-Free Content on Twitter: Topic Modeling Study.

BACKGROUND: Although social media has the potential to spread misinformation, it can also be a valuable tool for elucidating the social factors that contribute to the onset of negative beliefs. As a result, data mining has become a widely used technique in infodemiology and infoveillance research to combat misinformation effects. On the other hand, there is a lack of studies that specifically aim to investigate misinformation about fluoride on Twitter. Web-based individual concerns on the side effects of fluoridated oral care products and tap water stimulate the emergence and propagation of convictions that boost antifluoridation activism. In this sense, a previous content analysis-driven study demonstrated that the term fluoride-free was frequently associated with antifluoridation interests. OBJECTIVE: This study aimed to analyze "fluoride-free" tweets regarding their topics and frequency of publication over time. METHODS: A total of 21,169 tweets published in English between May 2016 and May 2022 that included the keyword "fluoride-free" were retrieved by the Twitter application programming interface. Latent Dirichlet allocation (LDA) topic modeling was applied to identify the salient terms and topics. The similarity between topics was calculated through an intertopic distance map. Moreover, an investigator manually assessed a sample of tweets depicting each of the most representative word groups that determined specific issues. Lastly, additional data visualization was performed regarding the total count of each topic of fluoride-free record and its relevance over time, using Elastic Stack software. RESULTS: We identified 3 issues by applying the LDA topic modeling: "healthy lifestyle" (topic 1), "consumption of natural/organic oral care products" (topic 2), and "recommendations for using fluoride-free products/measures" (topic 3). Topic 1 was related to users' concerns about leading a healthier lifestyle and the potential impacts of fluoride consumption, including its hypothetical toxicity. Complementarily, topic 2 was associated with users' personal interests and perceptions of consuming natural and organic fluoride-free oral care products, whereas topic 3 was linked to users' recommendations for using fluoride-free products (eg, switching from fluoridated toothpaste to fluoride-free alternatives) and measures (eg, consuming unfluoridated bottled water instead of fluoridated tap water), comprising the propaganda of dental products. Additionally, the count of tweets on fluoride-free content decreased between 2016 and 2019 but increased again from 2020 onward. CONCLUSIONS: Public concerns toward a healthy lifestyle, including the adoption of natural and organic cosmetics, seem to be the main motivation of the recent increase of "fluoride-free" tweets, which can be boosted by the propagation of fluoride falsehoods on the web. Therefore, public health authorities, health professionals, and legislators should be aware of the spread of fluoride-free content on social media to create and implement strategies against their potential health damage for the population.

Are health promotion activities and preventive health practices predictors of adolescent eHealth literacy?

Adolescents' general health status and health behaviors have been closely monitored in recent years. It is estimated that adolescents comprise one-sixth of the world's population. This study examined whether eHealth literacy was predicted via health promotion activities and preventive health practices among Turkish adolescents. This cross-sectional study was conducted between March and May 2022 with 706 adolescents in Çorum, Turkey. A face-to-face questionnaire form was used, including socio-demographic characteristics, preventive health practices, eHealth literacy scale and Adolescent Health Promotion Scale. The data of the research were analyzed with the SPSS 22.0 program. Percentage, mean, Pearson Correlation analysis, and multiple regression analysis were used in the analyzes. The p < 0.05 value was considered statistically significant in the evaluations. In the study, 55.8% were female, and the mean age of the whole group was 16.09 ±â€…2.63 years. The mean score on the eHealth literacy scale was 29.40 ±â€…6.29. The mean of the total scores obtained from the Adolescent Health Promotion Scale was 137.97 ±â€…21.87. There was a significant positive correlation between eHealth literacy and the Adolescent Health Promotion Scale (p < 0.001). Multiple linear regression analysis was performed to predict eHealth literacy using the variables of Adolescent Health Promotion and preventive health practices. eHealth literacy positively and significantly predicts health promotion activities (ß = 0.27, t (695) = 7.54, p < 0.001). eHealth literacy increased annual weight measurement by more than 0.13 (ß = 0.13), annual blood iron measurement by more than 0.16 (ß = 0.16) and annual dental examination by more than 0.11 (ß = 0.11). Developing eHealth literacy interventions will be necessary for environments with a high concentration of adolescents (schools and courses). Also, primary health care services should be integrated with the school environment.

Predictors of Oral Health Behaviors among Dental Students.

Background and Objectives: College life is a time when students take more responsibility for health-related behaviors. Aim: To determine the oral health behaviors of dental students, to motivate their transformation into cyanogenic behaviors by applying the planned behavior model, and to determine the degree to which students can modify behavior for oral health. Material and Methods: The results of the initial and final assessment (4 months apart) of the bacterial plaque present by means of the Quigley Hein and API indexes were collected from the student files. The Health-Promoting Lifestyle Profile II -HPLP II and Generalized Self-Efficacy Scale (GSE) questionnaires were used to determine the variables with predictor values that influence the cognitive-perceptual factors. Results: For the "health responsibility" domain, the average total value was 2.53 ± 0.9 (SD). For the "interpersonal relationships" domain, the average value was 2.82 ± 0.79. In the case of the "nutrition" domain, the desire to change the behavior of the participants was moderate (2.53 ± 1.19). "Physical activity" represents an important field in the everyday life of young adults. The results of the study indicated a moderate desire for change (2.52 ± 0.97). In the case of "spiritual growth", in which self-esteem, the way the individual perceives the environment and the adaptation to it were evaluated, a great desire for change was observed (2.74 ± 0.82). Scale GSE questionnaire showed an α coefficient of 28.52 ± 0.82, a value that indicated a moderate to a high level of efficacy and self-confidence. Conclusions: The results of the study showed that students have a moderate tendency to change in all areas, except for interpersonal relationships, where the desire to change something is increased. The participants have a moderate to a high level of self-efficacy and self-confidence.

Influence of nervous tendencies on oral health status and lifestyle habits.

OBJECTIVE: It is presumed that people with nervous tendencies brush their teeth for long durations, and, we aimed to investigate how nervous tendencies affect oral health status and lifestyle habits. SUBJECTS AND METHODS: Three hundred and sixty patients who visited the Senri Dental Clinic, affiliated with the Sunstar Foundation, and were being treated for periodontal diseases between 11 January 2017 and 10 April 2017 were enrolled. A total of 323 respondents (101 men and 222 women) were considered eligible. Nervous tendencies were investigated using the Fujinami neurotic index (FNI) and its derivative, the neurotic index (NI). Patients with NIs of ≥20 were included in the 'needs caution' group, whereas those with NIs of <19 comprised the 'healthy' group. The plaque score; periodontal pocket depth; bleeding on probing degree; gingival recession; crevice defects; oral conditions, such as cervical fillings and lifestyle habits were compared between the groups. RESULTS AND DISCUSSION: No statistically significant differences in oral status were observed between the groups. On the other hand, the needs caution group had significantly longer brushing durations and lower usage of auxiliary teeth cleaning tools than the healthy group. Sleep duration was significantly shorter in the needs caution group than in the healthy group. CONCLUSIONS: Patients with strong nervous tendencies had long oral brushing durations and low usage of auxiliary cleaning tools. However, these factors did not negatively affect oral health status. These results could aid in understanding patients with strong nervous tendencies and in developing appropriate dental health guidance measures.

Genomic Analysis Enlightens Agaricales Lifestyle Evolution and Increasing Peroxidase Diversity.

As actors of global carbon cycle, Agaricomycetes (Basidiomycota) have developed complex enzymatic machineries that allow them to decompose all plant polymers, including lignin. Among them, saprotrophic Agaricales are characterized by an unparalleled diversity of habitats and lifestyles. Comparative analysis of 52 Agaricomycetes genomes (14 of them sequenced de novo) reveals that Agaricales possess a large diversity of hydrolytic and oxidative enzymes for lignocellulose decay. Based on the gene families with the predicted highest evolutionary rates-namely cellulose-binding CBM1, glycoside hydrolase GH43, lytic polysaccharide monooxygenase AA9, class-II peroxidases, glucose-methanol-choline oxidase/dehydrogenases, laccases, and unspecific peroxygenases-we reconstructed the lifestyles of the ancestors that led to the extant lignocellulose-decomposing Agaricomycetes. The changes in the enzymatic toolkit of ancestral Agaricales are correlated with the evolution of their ability to grow not only on wood but also on leaf litter and decayed wood, with grass-litter decomposers as the most recent eco-physiological group. In this context, the above families were analyzed in detail in connection with lifestyle diversity. Peroxidases appear as a central component of the enzymatic toolkit of saprotrophic Agaricomycetes, consistent with their essential role in lignin degradation and high evolutionary rates. This includes not only expansions/losses in peroxidase genes common to other basidiomycetes but also the widespread presence in Agaricales (and Russulales) of new peroxidases types not found in wood-rotting Polyporales, and other Agaricomycetes orders. Therefore, we analyzed the peroxidase evolution in Agaricomycetes by ancestral-sequence reconstruction revealing several major evolutionary pathways and mapped the appearance of the different enzyme types in a time-calibrated species tree.

Recruitment methods and yield rates in a clinical trial of physical exercise for older adults with hypertension-HAEL Study: a study within a trial.

BACKGROUND: Although the prevalence of hypertension is high in older adults, clinical trial recruitment is a challenge. Our main aim was to describe the HAEL Study recruitment methods and yield rates. The secondary objectives were to explore the reasons for exclusion and to describe the characteristics of the enrolled participants. METHODS: This is a descriptive study within a trial. The HAEL Study was a Brazilian randomized two-center, parallel trial with an estimated sample of 184 participants. The recruitment strategy was based on four methods: electronic health records, word of mouth, print and electronic flyer, and press media. The yield rate was the ratio of the number of participants who underwent randomization to the total number of volunteers screened, calculated for overall, per recruitment method, by study center and by age group and sex. Additionally, we described the reasons for exclusion in the screening phase, as well as the demographic characteristics of those enrolled. The data are presented in absolute/relative frequencies and mean ± standard deviation. RESULTS: A total of 717 individuals were screened, and 168 were randomized over 32 months. The yield rate was higher for word of mouth (30.1%) in the overall sample. However, press media contributed the most (39.9%) to the absolute number of participants randomized in the trial. The coordinating center and participating center differed in methods with the highest yield ratios and absolute numbers of randomized participants. The main reason for exclusion in the screening phase was due to the physically active status in those intending to participate in the study (61.5%). Out of 220 participants included, 52 were excluded mainly because they did not meet the eligibility criteria (26.9%). Most of the screened volunteers were women (60.2%) age 60-69 years (59.5%), and most of the randomized participants were Caucasian/white (78.0%). CONCLUSIONS: Multiple recruitment methods constituted effective strategies. We observed that approximately one of every four individuals screened was allocated to an intervention group. Even so, there were limitations in obtaining a representative sample of older Brazilian adults with hypertension. Data show an underrepresentation of race and age groups. TRIAL REGISTRATION: This SWAT was not registered.

COVID-19: Ramifications and Effects on University Healthcare Students.

AIM: This study was carefully designed to analyze the perceived psychological impact of the COVID-19 pandemic among Roseman dental students. Students assessed their perceived changes in stress, self-esteem, and lifestyle behavior changes based on the impact of the pandemic. MATERIALS AND METHODS: A self-designed, anonymous, 18-item questionnaire was administered to Roseman dental students after being approved by the Institutional Review Board. Independent samples t-test and one-way ANOVA were utilized for comparison of psychological factors toward gender, as well as year of study. Chi-square correlations between stress and self-esteem, as well as lifestyle behavior, were also reported. RESULTS: In total, 313 students with a mean age of 28.15 (SD:4.21) completed the survey. Statistically significant differences were shown between students based upon age and year of study, with regard to stress and lifestyle behavior changes. Cross-tabulations of stress with self-esteem and lifestyle behavior changes showed positive relationships, as students with higher levels of stress showed significant self-esteem problems and lifestyle behavior changes. The largest frequency of stress/anxiety and lifestyle behavioral changes was found in the age range of 25-34 years old, particularly in the Class of 2024 and 2025. CONCLUSION: The COVID-19 pandemic has imposed a significant psychological impact on dental students at Roseman. However, further studies are needed to assess the long-lasting impacts of the pandemic on University healthcare students as a whole. CLINICAL SIGNIFICANCE: The pandemic has not only affected the way in which dental students progress academically but also as healthcare providers now and into the future.

Environmental factors associated with biological use and surgery in inflammatory bowel disease.

BACKGROUND AND AIM: While major efforts were made studying the complex etiology of inflammatory bowel disease (IBD) including environmental factors, less is known about underlying causes leading to the heterogeneous and highly variable course of disease. As cigarette smoking cessation is the best-known environmental factor with beneficial effect in Crohn's disease (CD), more exposome factors are likely involved. Further insights into the role of the exposome in heterogeneity of disease might not only further knowledge of underlying pathways, but also allow for better risk stratification. METHODS: Seven hundred twenty-eight IBD patients completed the validated Groningen IBD Environmental Questionnaire, collecting exposome data for 93 exposome factors. Associations with disease course, that is, for need for surgery or biological therapy, were evaluated using univariate and multivariate-adjusted logistic regression modeling. RESULTS: No significant associations were seen after Bonferroni correction. However, 11 novel exposome factors were identified with P < 0.05. Two factors were associated with course of CD and ulcerative colitis (UC): beer (CD OR0.3/UC OR0.3) and cannabis (0.5/2.2). While in CD, carpet flooring (0.5) was associated with biological use, and four factors were associated with surgery: working shifts (1.8), appendectomy (2.4), frequent tooth brushing (2.8), and large household size (0.1). For UC, migrants more often required biologicals (10.2). Childhood underweight (3.4), amphetamine use (6.2), and cocaine use (4.8) were associated with surgery. Five factors were replicated. CONCLUSIONS: We identified 16 environmental factors nominally associated with biological use and surgery in established IBD. These new insights form an important stepping stone to guide research on biological pathways involved, risk stratification, tailor-made interventions, and preventive strategies in IBD.

Oral Health and the Altered Colonic Mucosa-Associated Gut Microbiota.

BACKGROUND: Systemic diseases have been associated with oral health and gut microbiota. We examined the association between oral health and the community composition and structure of the adherent colonic gut microbiota. METHODS: We obtained 197 snap-frozen colonic biopsies from 62 colonoscopy-confirmed polyp-free individuals. Microbial DNA was sequenced for the 16S rRNA V4 region using the Illumina MiSeq, and the sequences were assigned to the operational taxonomic unit based on SILVA. We used a questionnaire to ascertain tooth loss, gum disease, and lifestyle factors. We compared biodiversity and relative abundance of bacterial taxa based on the amount of tooth loss and the presence of gum disease. The multivariable negative binomial regression model for panel data was used to estimate the association between the bacterial count and oral health. False discovery rate-adjusted P value (q value) < .05 indicated statistical significance. RESULTS: More tooth loss and gum disease were associated with lower bacterial alpha diversity. The relative abundance of Faecalibacterium was lower (q values < .05) with more tooth loss. The association was significant after adjusting for age, ethnicity, obesity, smoking, alcohol use, hypertension, diabetes, and the colon segment. The relative abundance of Bacteroides was higher in those with gum disease. CONCLUSIONS: Oral health was associated with alteration in the community composition and structure of the adherent gut bacteria in the colon. The reduced anti-inflammatory Faecalibacterium in participants with more tooth loss may indicate systemic inflammation. Future studies are warranted to confirm our findings and investigate the systemic role of Faecalibacterium.

Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents.

Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.