The coronavirus disease 2019 (COVID-19) pandemic has led to economic contraction and significant restrictions on society. The shock to the economy could lead to a deterioration of physical health ...outcomes, including dental health. The present study investigated the association between worsened socioeconomic conditions due to the COVID-19 pandemic and dental pain in Japan. The mediating effects of psychological distress and oral health–related behaviors were also evaluated. Cross-sectional data from the Japan COVID-19 and Society Internet Survey conducted from August to September 2020 (n = 25,482; age range, 15–79 y) were analyzed. Multivariable logistic regression models were fitted to evaluate the independent associations of household income reduction, work reduction, and job loss due to the COVID-19 pandemic with dental pain within a month. Dental pain was reported by 9.8%. Household income reduction, work reduction, and job loss were independently associated with dental pain after adjusting for confounders (odds ratios: 1.42 95% confidence interval (CI), 1.28−1.57, 1.58 95% CI, 1.41−1.76, 2.17 95% CI, 1.64−2.88, respectively). The association related to household income reduction was mediated by psychological distress, postponing dental visits, toothbrushing behavior, and between-meals eating behavior by 21.3% (95% CI, 14.0−31.6), 12.4% (95% CI, 7.2−19.6), 1.5% (95% CI, −0.01 to 4.5), and 9.3% (95% CI, 5.4−15.2), respectively. Our findings showed that worsened socioeconomic conditions due to the COVID-19 pandemic deteriorated dental health. Policies that protect income and job loss may reduce dental health problems after the pandemic.
The global poultry trend toward the more responsible use of antibiotics is becoming recurrent and has demanded the need to generate new natural alternatives. Probiotics have gained importance as an ...option to use as growth promoters. This study aimed to evaluate Bacillus subtillis QST713 as a substitute for an antibiotic growth promoter (BMD). A total of 150 male broilers were assigned to three dietary treatments: 1) control diet (CO), 2) control diet + 500 g/t of BMD (AGP), and 3) control diet + 100 g/t of B. subtilis QST713 (PB), respectively. Each treatment was monitored for 5 wk for the productive variables: body weight, accumulated feed consumption, food conversion, and European efficiency factor. At the end of each week, fresh fecal samples were cultured and quantified for E. coli, Enterococcus spp., and Lactobacillus spp. At the end of the trial, blood samples were analyzed for hemogram and intestinal samples (anterior portion) for histomorphometry. The data were statistically analyzed with an analysis of variance and subjected to a least significant difference test (Tukey). The zootechnical yields were similar in the AGP and PB groups (P ˃ 0.05); both superior to the control group. In the hematological profiles, no difference was observed between the experimental groups. E. coli and Enterococcus counts were significantly lower (P ˂ 0.05), and Lactobacillus counts were significantly (P ˂ 0.05) higher in the PB group, relative to CO and AGP groups. No differences (P ˃ 0.05) were found in bacterial counts between the CO and AGP groups. The intestinal mucosa and villi in the PB group were significantly (P ˂ 0.05) longer and with less deeper crypts than CO and AGP groups. We conclude that B. subtillis QST713, used at the suggested commercial dose (100 g/ton), is an effective growth-promoting alternative to BMD that modulates the microbiota and intestinal architecture, thus producing zootechnical yields consistent with BMD.
Tooth loss is prevalent in older adults and associated with functional capacity decline. Studies on the susceptibility of some individuals to the effects of tooth loss are lacking. This study aimed ...to investigate the heterogeneity of the association between tooth loss and higher-level functional capacity in older Japanese individuals employing a machine learning approach. This is a prospective cohort study using the data of adults aged ≥65 y in Japan (N = 16,553). Higher-level functional capacity, comprising instrumental independence, intellectual activity, and social role, was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). The scale ranged from 0 (lowest function) to 13 (highest function). Doubly robust targeted maximum likelihood estimation was used to estimate the population-average association between tooth loss (having <20 natural teeth) and TMIG-IC total score after 6 y. The heterogeneity of the association was evaluated by estimating conditional average treatment effects (CATEs) using the causal forest algorithm. The result showed that tooth loss was statistically significantly associated with lower TMIG-IC total scores (population-average effect: −0.14; 95% confidence interval, −0.18 to −0.09). The causal forest analysis revealed the heterogeneous associations between tooth loss and lower TMIG-IC total score after 6 y (median of estimated CATEs = −0.13; interquartile range = 0.12). The high-impact subgroup (i.e., individuals with estimated CATEs of the bottom 10%) were significantly more likely to be older and male, had a lower socioeconomic status, did not have a partner, and had poor health conditions compared with the low-impact subgroup (i.e., individuals with estimated CATEs of the top 10%). This study found that heterogeneity exists in the association between tooth loss and lower scores on functional capacity. Implementing tooth loss prevention policy and clinical measures, especially among vulnerable subpopulations significantly affected by tooth loss, may reduce its burden more effectively.
Tooth loss is a risk factor for increased mortality; however, the underlying mechanism remains unclear. This study aimed to evaluate the mediating effect of weight change on the relationship between ...tooth loss and mortality risk. This was a 10-y follow-up prospective cohort study using the data from the Japan Gerontological Evaluation Study (JAGES). The participants were independent older adults aged ≥65 y at baseline and were followed up from 2010 to 2020. The incidence of death in 2013 and 2020, incidence of >5% weight loss/gain in 2010 and 2013, and the number of remaining teeth in 2010 were used as the outcome, mediator, and explanatory variables, respectively. We conducted causal mediation analysis by fitting the Cox proportional hazard model, including possible confounders. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) of the total effect (TE), natural indirect effect (NIE), and proportion mediated (PM) were estimated. Among the 34,510 participants, the mean age was 72.6 (SD = 5.4) y, and 47.6% were men. From 2013 to 2020, 14.0% of the participants (n = 4,825) died, 60.5% (n = 20,871) had 0 to 19 remaining teeth, and 17.2% (n = 5,927) and 8.4% (n = 2,907) experienced >5% weight loss and gain, respectively. The mortality rate was 0.016 per person-year among those with ≥20 remaining teeth and 0.027 per person-year among those with 0 to 19 remaining teeth. Weight loss of >5% significantly mediated the association between tooth loss and higher mortality risk (TE: HR, 1.28 95% CI, 1.16 to 1.40; NIE: HR, 1.03 95% CI, 1.02 to 1.04; PM, 13.1%); however, we observed a slight mediating effect for >5% weight gain (NIE: HR, 1.003 95%CI, 1.0001 to 1.01; PM, 1.3%). The present study suggests that a clinically meaningful level of weight loss mediated the association between tooth loss and increased risk of mortality among independent older adults.
Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of ...malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson–Holm–Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01–1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98–1.25), leaving an indirect effect of 1.03 (95% CI, 1.02–1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
Mortality of chicken embryos and first-week chickens was reported in a commercial incubator company in Costa Rica. Six 1-day-old Cobb chickens and twenty-four embryonated chicken eggs were examined ...in the Laboratory of Avian Pathology and the Laboratory of Bacteriology of the National University of Costa Rica. Twelve dead-in-shell embryos showed maceration and were immersed in a putrid, turbid, slightly thick brown liquid. Additionally, the other 12 embryonated eggs had milky yellow-orange content. The livers of those embryos had congestion, haemorrhages and multifocal cream foci of necrosis. Granulocytic infiltration was observed in the bursa of Fabricius, myocardium, liver, lung and kidney. Livers and egg yolks from six embryonated chickens and all 1-day-old chickens were aseptically collected and cultured. In addition, tissues from six better conserved embryos and all 1-day-old chickens were fixed in buffered formalin and embedded in paraffin. Biochemical and molecular tests identified Comamonas testosteroni as the cause of the early, middle and late embryo mortality. As all the eggshells from the sampled embryonated eggs were dirty with soiled a fecal matter, contamination after manipulating the eggs was considered the source of infection. C. testosteroni is an environmental microorganism that has rarely been reported to cause human disease. To our knowledge, this is the first report of C. testosteroni causing mortality in a hatchery. Cleaning and disinfection using ozone were implemented in the hatchery to eliminate the embryo mortality associated with C. testosteroni.
Despite their prevalence and burdens, oral diseases are neglected in universal health coverage. In Japan, a 30% copayment (out of pocket) by the user and a 70% contribution by Japan’s universal ...health insurance (JUHI) are required for dental and medical services. From the age of 70 y, an additional 10% is offered by JUHI (copayment, 20%; JUHI, 80%). This study aimed to investigate the effect of cost on dental service use among older adults under the current JUHI system. A regression discontinuity quasi-experimental method was used to investigate the causal effect of the JUHI discount policy on dental visits based on cross-sectional data. Data were derived from the 2016 Japan Gerontological Evaluation Study. This analysis contained 7,161 participants who used JUHI, were aged 68 to 73 y, and responded to questions regarding past dental visits. Analyses were controlled for age, sex, number of teeth, and equalized household income. Mean ± SD age was 72.1 ± 0.79 y for the discount-eligible group and 68.9 ± 0.78 y for the noneligible group. During the past 12 mo, significantly more discount-eligible participants had visited dental services than noneligible participants (66.0% vs. 62.1% for treatment visits, 57.7% vs. 53.1% for checkups). After controlling for covariates, the effect of discount eligibility was significant on dental treatment visits (odds ratio OR, 1.36; 95% CI, 1.32 to 1.40) and dental checkups (OR, 1.49; 95% CI, 1.44 to 1.54) in the regression discontinuity analysis. Similar findings were observed in triangular kernel-weighted models (OR, 1.38 95% CI, 1.34 to 1.44; OR, 1.52 95% CI, 1.47 to 1.56, respectively). JUHI copayment discount policy increases oral health service utilization among older Japanese. The price elasticity for dental checkup visits appears to be higher than for dental treatment visits. Hence, reforming the universal health coverage system to improve the affordability of relatively inexpensive preventive care could increase dental service utilization in Japan.
Comparing the burden of dental conditions to other health outcomes provides useful insight for public policy. We aimed to estimate quality-adjusted life expectancy (QALE) loss due to dental ...conditions in the US adult population. Social inequalities in QALE loss by dental conditions were also examined. Data from 3 cross-sectional waves of the National Health and Nutrition Examination Survey (NHANES waves 2001 to 2002, 2003 to 2004, and 2011 to 2012) were pooled and analyzed. The average age of study participants (n = 9,445) was 48.4 y. Disutility scores were derived from self-rated health and the numbers of physically unhealthy days, mentally unhealthy days, and days with activity limitation, employing a previously published algorithm. The associations between the disutility scores and the numbers of decayed teeth, missing teeth, and periodontitis were examined by multiple linear regression stratified by age groups (20–39, 40–59, and ≥60 y), adjusted for other covariates (age, sex, wave fixed effect, educational attainment, smoking, and diabetes). The QALE loss due to dental conditions at the age of 20 was estimated using life tables. Decayed and missing teeth, but not periodontitis, were associated with a larger disutility score. The coefficient for decayed teeth was larger among the older population, whereas that of missing teeth was smaller among them. The estimated QALE loss was 0.43 y (95% confidence interval CI, 0.28–0.59), which reached 5.3% of QALE loss (8.15 y; 95% CI, 8.03–8.27) due to overall morbidity. There were clear social gradients in QALE loss by dental conditions across the life course, and people with high school or less education had 0.32 y larger QALE loss in total compared with people with college or more education. This study suggests that improvements in people’s dental health may yield substantial gains in population health and well-being. The necessity of more comprehensive public health strategies is highlighted.
This study assessed the presence of sialic acid α-2,3 and α-2,6 linked glycan receptors in seven avian species. The respiratory and intestinal tracts of the chicken, common quail, red-legged ...partridge, turkey, golden pheasant, ostrich, and mallard were tested by means of lectin histochemistry, using the lectins Maackia amurensis agglutinin II and Sambucus nigra agglutinin, which show affinity for α-2,3 and α-2,6 receptors, respectively. Additionally, the pattern of virus attachment (PVA) was evaluated with virus histochemistry, using an avian-origin H4N5 virus and a human-origin seasonal H1N1 virus. There was a great variation of receptor distribution among the tissues and avian species studied. Both α-2,3 and α-2,6 receptors were present in the respiratory and intestinal tracts of the chicken, common quail, red-legged partridge, turkey, and golden pheasant. In ostriches, the expression of the receptor was basically restricted to α-2,3 in both the respiratory and intestinal tracts and in mallards the α-2,6 receptors were absent from the intestinal tract. The results obtained with the lectin histochemistry were, in general, in agreement with the PVA. The differential expression and distribution of α-2,3 and α-2,6 receptors among various avian species might reflect a potentially decisive factor in the emergence of new viral strains.
Natural disasters are often associated with forced residential relocation, thereby affected people experience a change of food environment that results in the increased body mass index. However, ...there are a few studies that examined whether a change in food environment caused risk of obesity after a natural disaster. To address this question, we leveraged a natural experiment of residential relocation in the aftermath of the 2011 Japan Earthquake and Tsunami. Our baseline data came from a nationwide cohort study of older community-dwelling adults conducted 7 months prior to the disaster. By chance, one of the field sites (Iwanuma City, Miyagi Prefecture) was directly in the line of the tsunami. Approximately 2.5 years after the disaster, we ascertained the residential addresses and health status of 3,594 survivors aged 65 years or older (82.1% follow-up rate). Fixed effects multinomial logistic regression showed that shortened distances to food outlets/bars increased the risks of transitioning from BMI in the normal range (18.5-22.9) to obesity (≥25.0) (Odds ratios: 1.46 for supermarkets; 1.43 for bars; 1.44 times for fast food outlets). Radically changed food access after a natural disaster may raise the risk of obesity among older survivors.
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