Cytokine responses of CD4+ T cells and NKT cells to periodontitis-associated bacteria in individuals with or without periodontitis.

AIM: Periodontitis is an inflammatory disease driven by opportunistic bacteria including Porphyromonas gingivalis and Fusobacterium nucleatum, where T-cell and NKT-cell responses to these bacteria in patients with periodontitis grade B or C are not fully elucidated. The objective is to determine if exaggerated proinflammatory Th-cell responses to periodontitis-associated bacteria, but not commensal bacteria, is a characteristic of increased periodontitis grade. METHODS: Mononuclear cells from patients with periodontitis grade C (n = 26) or grade B (n = 33) and healthy controls (HCs; n = 26) were stimulated with P. gingivalis, F. nucleatum or the commensal bacteria, Staphylococcus epidermidis and Cutibacterium acnes. Cytokine production by different T-cell populations and FOXP3-expression by regulatory T cells were assessed by flow cytometry. RESULTS: Compared to HCs, grade C patients had decreased frequencies of interleukin (IL)-10-producing CD4+ T cells before stimulation (p = .02) and increased frequencies of IFN-y-producing CD4+ T cells after stimulation with P. gingivalis (p = .0019). Grade B patients had decreased frequencies of FOXP3+ CD4+ T cells before (p = .030) before and after stimulation with anti-CD2/anti-CD3/anti-CD28-loaded beads (p = .047), P. gingivalis (p = .013) and S. epidermidis (p = .018). Clinical attachment loss correlated with the frequencies of IFN-y-producing Th1 cells in P. gingivalis- and F. nucleatum-stimulated cultures in grade B patients (p = .023 and p = .048, respectively) and with the frequencies of Th17 cells in P. gingivalis-stimulated cultures (p = .0062) in grade C patients. Patients with periodontitis grade C or grade B showed lower frequencies of IL-10-producing NKT cells than HCs in unstimulated cultures (p = .0043 and p = .027 respectively). CONCLUSIONS: Both periodontitis groups showed decreased frequencies of immunoregulatory T-cell and NKT cell subsets at baseline. Clinical attachment loss correlated with P. gingivalis-induced Th17-responses in grade C patients and with Th1-responses in grade B patients when cells were stimulated with P. gingivalis, supporting that dysregulated pro-inflammatory T-cell responses to periodontitis-associated bacteria contribute to the pathogenesis of periodontitis.

Evaluation of circulating IgG antibodies against Porphyromonas gingivalis or its gingipains as serological markers of periodontitis and carriage of the bacterium.

BACKGROUND: Increasing evidence indicates that periodontitis contributes to systemic low-grade inflammation. Porphyromonas gingivalis is strongly associated with periodontitis, and antibodies against the bacterium may be used as a serological proxy to account for periodontal status, when studying diseases associated with periodontitis. The aim of the present study is to identify an easily accessible and reliable serological biomarker for determination of periodontal status and oral carriage of the bacterium. METHODS: Saliva and serum samples were collected from periodontally healthy controls (n = 27), and patients with periodontitis stage II (n = 12) or stages III or IV (n = 44). Serum levels of immunoglobulin G (IgG) antibodies against intact and fragmented P. gingivalis, recombinant gingipains (RgpA and RgpB), and the bacteria Escherichia coli and Capnocytophaga ochracea as controls were quantified with a multiplex bead-based assay. P. gingivalis was identified in saliva using quantitative polymerase chain reaction (qPCR). RESULTS: Serum IgG antibodies against P. gingivalis whole bacteria were good indicators of periodontitis (area under the curve [AUC]: 0.75, 95% confidence interval [CI]: 0.64-0.85). The same was observed for levels of antibodies against P. gingivalis fragments (AUC: 0.78, 95% CI: 0.68-0.88). Likewise, levels of antibodies against P. gingivalis whole bacteria or P. gingivalis fragments were good indicators of oral carriage of P. gingivalis (AUC: 0.92, 95% CI: 0.86-0.98 and AUC: 0.96, 95% CI: 0.92-1, respectively). Conversely, antibodies against recombinant RgpA and RgpB were not good indicators of periodontitis or oral carriage of the bacterium. None of the antibody levels differed significantly between stage II and stage III or IV periodontitis. CONCLUSION: Serum IgG antibody levels against heat-inactivated whole P. gingivalis proved to be the preferable biomarker for periodontitis and oral carriage of the bacterium.

Oscillatory attention in groove.

Attention is not constant but rather fluctuates over time and these attentional fluctuations may prioritize the processing of certain events over others. In music listening, the pleasurable urge to move to music (termed 'groove' by music psychologists) offers a particularly convenient case study of oscillatory attention because it engenders synchronous and oscillatory movements which also vary predictably with stimulus complexity. In this study, we simultaneously recorded pupillometry and scalp electroencephalography (EEG) from participants while they listened to drumbeats of varying complexity that they rated in terms of groove afterwards. Using the intertrial phase coherence of the beat frequency, we found that while subjects were listening, their pupil activity became entrained to the beat of the drumbeats and this entrained attention persisted in the EEG even as subjects imagined the drumbeats continuing through subsequent silent periods. This entrainment in both the pupillometry and EEG worsened with increasing rhythmic complexity, indicating poorer sensory precision as the beat became more obscured. Additionally, sustained pupil dilations revealed the expected, inverted U-shaped relationship between rhythmic complexity and groove ratings. Taken together, this work bridges oscillatory attention to rhythmic complexity in relation to musical groove.

Improved description of terrestrial habitat types by including microbial communities as indicators.

Soils host diverse communities of microorganisms essential for ecosystem functions and soil health. Despite their importance, microorganisms are not covered by legislation protecting biodiversity or habitats, such as the Habitats Directive. Advances in molecular methods have caused breakthroughs in microbial community analysis, and recent studies have shown that parts of the communities are habitat-specific. If distinct microbial communities are present in the habitat types defined in the Habitats Directive, the Directive may be improved by including these communities. Thus, monitoring and reporting of biodiversity and conservation status of habitat types could be based not only on plant communities but also on microbial communities. In the present study, bacterial and plant communities were examined in six habitat types defined in the Habitats Directive by conducting botanical surveys and collecting soil samples for amplicon sequencing across 19 sites in Denmark. Furthermore, selected physico-chemical properties expected to differ between habitat types and explain variations in community composition of bacteria and vegetation were analysed (pH, electrical conductivity (EC), soil texture, soil water repellency, soil organic carbon content (OC), inorganic nitrogen, and in-situ water content (SWC)). Despite some variations within the same habitat type and overlaps between habitat types, habitat-specific communities were observed for both bacterial and plant communities, but no correlation was observed between the alpha diversity of vegetation and bacteria. PERMANOVA analysis was used to evaluate the variables best able to explain variation in the community composition of vegetation and bacteria. Habitat type alone could explain 46% and 47% of the variation in bacterial and plant communities, respectively. Excluding habitat type as a variable, the best model (pH, SWC, OC, fine silt, and Shannon's diversity index for vegetation) could explain 37% of the variation for bacteria. For vegetation, the best model (pH, EC, ammonium content and Shannon's diversity index for bacteria) could explain 25% of the variation. Based on these results, bacterial communities could be included in the Habitats Directive to improve the monitoring, as microorganisms are more sensitive to changes in the environment compared to vegetation, which the current monitoring is based on.

A Nurse-Led Outpatient Clinic for Patients With Decompensated Liver Cirrhosis: Staffing, Structure, and Patient Satisfaction.

Patients with decompensated liver cirrhosis constitute a growing and vulnerable patient group with a particular need for easy outpatient access and close follow-up. By establishing a nurse-led clinic, we aimed to counter this need in a patient-centered manner within a multidisciplinary rehabilitating framework. This article presents the organization, staffing, and structure of this initiative as well as the patient population demographics and characteristics. Furthermore, patient satisfaction within the clinic was explored. Two complementary substudies are presented: a descriptive, registry-based journal audit, presenting data from the clinic's first years, 2017-2019, and a cross-sectional, descriptive survey, exploring patient satisfaction 2 years later. Different visit types with predefined content constitute an operable structure suitable for meeting patients' current needs. An increase in both the number of patients and visits from the first to second years indicates an existing need for nurse-led support. Data not only support the well-known characteristics of patients with cirrhosis but also add to a broader perspective with more nuances for this patient population. The survey shows an overall high score on satisfaction but also points out areas for improvement. The nurse-led clinic provides both structure and knowledge to facilitate patient-centered treatment and care for those suffering from liver cirrhosis.

Academic Stress, Academic Self-efficacy, and Psychological Distress: A Moderated Mediation of Within-person Effects.

Previous research has largely failed to separate the between- and within-person effects in the longitudinal associations between academic stress, academic self-efficacy, and psychological distress (symptoms of anxiety and depression). Filling this research gap, this study investigated if academic self-efficacy mediated the relationship between academic stress and psychological distress at the intraindividual level during 3 years of upper secondary school. Gender moderation was also examined in the hypothesised model. The present sample consisted of 1508 Norwegian adolescents (baseline M age = 16.42; 52.9% high perceived family wealth; 70.6% Norwegian-born). The random intercept cross-lagged panel model results indicated (1) positive and time-invariant direct effects from academic stress to psychological distress, (2) academic self-efficacy partially mediated these effects, and (3) psychological distress impacted later academic stress. Academic stress was more strongly related to academic self-efficacy and psychological distress at the interpersonal level for boys, while the intraindividual impact of academic stress on psychological distress was stronger for girls. The study findings might have implications for school-based implementation strategies and theoretical development.

Palliative needs and illness trajectory associated with metastatic upper gastrointestinal cancer.

INTRODUCTION: Patients suffering from metastatic upper gastrointestinal cancer are burdened by physical, social, existential and psychological problems, though documentation of these problems may be insufficient. In Denmark, basic palliative care is fragmented and characterised by quality differences. This challenges cohesive palliative care interventions as patients experience transitions in the course of illness. The aim of this study was to identify and present the illness trajectory and to investigate the documentation of palliative needs for patients with metastatic upper gastrointestinal cancer. METHODS: Data on the documented palliative needs and on transitions were retrospectively collected from the electronic medical records at a surgical ward at Herlev-Gentofte Hospital during a six-month period in 2019. Descriptive statistics were used to present the palliative care needs. RESULTS: Pain and nausea/vomiting were documented in 62%, constipation in 35% and fatigue in 43% of the 63 patients included. Psychological, existential and social symptoms were sparsely documented. Several patients (41%) had more than one admittance to the surgical ward, 62% were treated in the oncology department and 35% received specialised palliative care. CONCLUSION: The frequent transitions during the disease trajectory and the need to direct attention towards all four domains of palliative care should compel health professionals to adopt a systematic approach when identifying and treating their patients' palliative needs. FUNDING: none. TRIAL REGISTRATION: not relevant.

Beat alignment ability is associated with formal musical training not current music playing.

The ability to perceive the beat in music is crucial for both music listeners and players with expert musicians being notably skilled at noticing fine deviations in the beat. However, it is unclear whether this beat perception ability is enhanced in trained musicians who continue to practice relative to musicians who no longer play. Thus, we investigated this by comparing active musicians', inactive musicians', and nonmusicians' beat alignment ability scores on the Computerized Adaptive Beat Alignment Test (CA-BAT). 97 adults with diverse musical experience participated in the study, reporting their years of formal musical training, number of instruments played, hours of weekly music playing, and hours of weekly music listening, in addition to their demographic information. While initial tests between groups indicated active musicians outperformed inactive musicians and nonmusicians on the CA-BAT, a generalized linear regression analysis showed that there was no significant difference once differences in musical training had been accounted for. To ensure that our results were not impacted by multicollinearity between music-related variables, nonparametric and nonlinear machine learning regressions were employed and confirmed that years of formal musical training was the only significant predictor of beat alignment ability. These results suggest that expertly perceiving fine differences in the beat is not a use-dependent ability that degrades without regular maintenance through practice or musical engagement. Instead, better beat alignment appears to be associated with more musical training regardless of continued use.

B-cell cytokine responses to Porphyromonas gingivalis in patients with periodontitis and healthy controls.

BACKGROUND: Cytokine-producing B cells play a well-established role in modifying immune responses in chronic inflammatory diseases. We characterized B-cell cytokine responses against periodontitis-associated bacteria in patients with periodontitis. METHODS: Blood and saliva samples were collected from patients with periodontitis grade B (N = 31) or grade C (N = 25), and 25 healthy controls (HCs). Mononuclear cells were stimulated with Porphyromonas gingivalis, Fusobacterium nucleatum, Staphylococcus epidermidis, or Cutibacterium acnes, and B-cell production of tumor necrosis factor (TNF)-α, interleukin (IL)-6, interferon (IFN)-γ, IL-10 and transforming growth factor (TGF)-ß by B cells was assessed by flow cytometry. RESULTS: HCs had higher baseline frequencies of B cells producing IFN-γ or TNF-α than grade B patients, but only B cells from grade B patients showed significant differentiation into IFN-γ-, TNF-α-, TGF-ß-, or IL-10-producing cells after challenge with P. gingivalis and into IFN-γ-, TGF-ß-, or IL-10-producing cells after challenge F. nucleatum. Notably, the baseline frequency of IL-10-producing B cells from grade C patients correlated inversely with clinical attachment loss (AL). The major proportion of the IFN-γ- and TGF-ß-producing B cells were CD27+ memory cells, while the IL-10-producing B cells were mainly CD27- CD5- . CONCLUSIONS: B cells from grade B patients, particularly those harboring P. gingivalis, showed proinflammatory B-cell responses to P. gingivalis. Moreover, the baseline frequency of IL-10-producing B cells in the grade C group correlated inversely with AL, suggesting a diminished immunoregulatory capacity of IL-10-producing B cells in these patients.

Motivators for physical activity in patients with minor stroke: a qualitative study.

PURPOSE: Physical inactivity is a major risk factor for stroke. However, to encourage physical activity after stroke, it is important to know what motivates the patients. We aimed to explore possible motivators and barriers for physical activity in patients discharged after minor stroke or transient ischemic attack (TIA). METHODS: A qualitative study including 35 patients (21 men) with minor stroke or TIA (median age; 69 years, range 47-90) in semi-structured focus group interviews. Audio recordings were transcribed to text verbatim and analyzed with qualitative content analysis. RESULTS: Six interviews of 60 min. revealed five categories; the patients had a positive attitude towards physical activity, and they preferred to exercise locally under supervision of health professionals. Physical activity with others was motivating and obligating, and if possible as a weekly habit. Some experienced physical- and mental sequelae, which kept them from exercising. CONCLUSION: This study provides valuable knowledge of what motivates and prevents patients with minor stroke or TIA to be physically active after hospital discharge, and what to consider when designing future exercise studies. Consequently, it is recommended that patients with minor stroke or TIA are offered supervised physical activity to prevent worsening of cardiovascular disease and recurrent cardiovascular event.Implications for rehabilitationParticipants were positive towards physical activity after minor stroke or transient ischemic attack (TIA).Physical activity with others was perceived as both motivating and obligating.Post-stroke fatigue, lack of energy, and overview should be considered when designing secondary prevention programs.Participants call for exercise opportunities arranged locally and as group exercise supervised by health professionals with knowledge of stroke.

Validity and reliability of the Rosacea Area and Severity Index: A novel scoring system for clinical assessment of rosacea severity.

BACKGROUND: Rosacea is a common chronic inflammatory facial skin disorder. Standardized evaluation of the severity and extent of rosacea is important for baseline assessment and treatment effect. The currently used Investigator's Global Assessment (IGA) is unspecific and fails to consider subtypes/phenotypes of rosacea and area involvement. The Rosacea Area and Severity Index (RASI) was developed to give a more nuanced evaluation of rosacea features in four facial skin areas adjusted to the relative importance of each area of the face to obtain an overall severity score. OBJECTIVES: To validate RASI against the IGA and to assess the inter- and intraobserver reliability for RASI. METHODS: Sixteen dermatologists evaluated photographs of 60 adult patients with rosacea (3 photographs per patient, one from the front and one from each side). IGA and RASI scores were performed for interobserver reliability assessment. To determine intraobserver reliability, 14 dermatologists evaluated 10 other patients twice with at least 1 week interval. RESULTS: The IGA and RASI correlated well (Spearman correlation coefficient (SCC) = 0.75, 95% confidence interval (CI) = 0.72-0.78). Interobserver reliability was moderate for RASI and poor to moderate for IGA. Reliability was strongest for rhinophyma, followed by papules/pustules and erythema, and rather weak for telangiectasia. For area scores, interobserver reliability was strongest for cheeks, followed by nose, chin and forehead. We found a moderate-to-strong intraobserver agreement both for IGA and RASI. CONCLUSIONS: We have designed a new practical tool to examine clinical severity of rosacea. RASI proved simple and reliable in scoring clinical severity of rosacea with an agreement comparable to the currently used IGA although RASI will provide a more nuanced view of the current rosacea extent and severity. We suggest that RASI is used in the daily clinical setting as well as in clinical studies assessing the efficacy of rosacea therapies.

Hello Darkness, My Old Friend: Moderating a Random Intercept Cross-lagged Panel Model of Loneliness and Symptoms of Anxiety and Depression.

The present study investigated the trait- and state-like associations between loneliness and symptoms of anxiety and depression during three years in middle to late adolescence. The moderating effect of gender and social self-efficacy was examined on the hypothesised model. The sample consisted of 1508 Norwegian upper secondary school students (61% female; mean age at T1 = 16.33; 52.9% high socioeconomic position; 70.6% Norwegian-born). We found 1) strong and positive trait- and state-like associations between loneliness and symptoms of anxiety and depression, 2) that anxiety and depressive symptoms consistently predicted later loneliness but not the other way around, 3) that gender moderated parts of the state-like associations between loneliness and symptoms of anxiety and depression, and 4) that social self-efficacy had no moderating effect on the longitudinal relationship between loneliness and anxiety and depressive symptoms. The present study might inform future research, theory development, and intervention strategies in middle to late adolescent samples.

A trio of biological rhythms and their relevance in rhythmic mechanical stimulation of cell cultures.

The primary aim of this article is to provide a biological rhythm model based on previous theoretical and experimental findings to promote more comprehensive studies of rhythmic mechanical stimulation of cell cultures, which relates to tissue engineering and regenerative medicine fields. Through an interdisciplinary approach where different standpoints from biology and musicology are combined, we explore some of the core rhythmic features of biological and cellular rhythmic processes and present them as a trio model that aims to afford a basic but fundamental understanding of the connections between various biological rhythms. It is vital to highlight such links since rhythmic mechanical stimulation and its effect on cell cultures are vastly underexplored even though the cellular response to mechanical stimuli (mechanotransduction) has been studied widely and relevant experimental evidence suggests mechanotransduction processes are rhythmic.

Pupil drift rate indexes groove ratings.

Groove, understood as an enjoyable compulsion to move to musical rhythms, typically varies along an inverted U-curve with increasing rhythmic complexity (e.g., syncopation, pickups). Predictive coding accounts posit that moderate complexity drives us to move to reduce sensory prediction errors and model the temporal structure. While musicologists generally distinguish the effects of pickups (anacruses) and syncopations, their difference remains unexplored in groove. We used pupillometry as an index to noradrenergic arousal while subjects listened to and rated drumbeats varying in rhythmic complexity. We replicated the inverted U-shaped relationship between rhythmic complexity and groove and showed this is modulated by musical ability, based on a psychoacoustic beat perception test. The pupil drift rates suggest that groovier rhythms hold attention longer than ones rated less groovy. Moreover, we found complementary effects of syncopations and pickups on groove ratings and pupil size, respectively, discovering a distinct predictive process related to pickups. We suggest that the brain deploys attention to pickups to sharpen subsequent strong beats, augmenting the predictive scaffolding's focus on beats that reduce syncopations' prediction errors. This interpretation is in accordance with groove envisioned as an embodied resolution of precision-weighted prediction error.

Is paternal age associated with transfer day, developmental stage, morphology, and initial hCG-rise of the competent blastocyst leading to live birth? A multicenter cohort study.

In this study we investigated whether age of men undergoing assisted reproductive technology (ART) treatment was associated with day of transfer, stage, morphology, and initial hCG-rise of the competent blastocyst leading to a live birth? The design was a multicenter historical cohort study based on exposure (age) and outcome data (blastocyst stage and morphology and initial hCG-rise) from men whose partner underwent single blastocyst transfer resulting in singleton pregnancy/birth. The ART treatments were carried out at sixteen private and university-based public fertility clinics. We included 7246 men and women, who between 2014 and 2018 underwent controlled ovarian stimulation (COS) or Frozen-thawed Embryo Transfer (FET) with a single blastocyst transfer resulting in singleton pregnancy were identified. 4842 men with a partner giving birth were included, by linking data to the Danish Medical Birth Registry. We showed that the adjusted association between paternal age and transfer day in COS treatments was OR 1.06, 95% CI (1.00;1.13). Meaning that for every increase of one year, men had a 6% increased probability that the competent blastocyst was transferred on day 6 compared to day 5. Further we showed that the mean difference in hCG values when comparing paternal age group 30-34, 35-39 and 40-45 with the age group 25-29 in those receiving COS treatment, all showed significantly lower adjusted values for older men. In conclusion we hypothesize that the later transfer (day 6) in female partners of older men may be due to longer time spent by the oocyte to repair fragmented DNA of the sperm cells, which should be a focus of future research in men.

[Neurosyphilis].

This review focuses on typical and atypical manifestations of neurosyphilis. The manifestations of neurosyphilis are manyfold and may involve many specialties. Today, clinicians have limited experience with the well-described manifestations of neurosyphilis. Many screening opportunities for men who have sex with men might catch the majority of cases of syphilis in this group. However, a concern could be if disclosure about heterosexuality or, in general, monosymptomatic neurosyphilis constitute a risk for delayed diagnosis.

Establishment of a nurse-led clinic for late complications after colorectal and anal cancer surgery: a descriptive study.

PURPOSE: Survival rates after colorectal and anal cancer are increasing and more patients have late complications to treatment. This represents a clinical field under development, and we have established a specialized clinic for late complications after colorectal and anal cancer. With this paper, we want to give our experiences and present the organizational setup with a nurse as the primary contact person. METHODS: We have established a multidisciplinary clinic for the treatment of late complications and the clinic is organized with specialized nurses as the front persons. The structure includes a stepwise increase in expertise level when needed, and the patient has one common entry regardless of symptoms. Initial screening is performed by an electronic questionnaire which is followed up by a consultation with the nurse. The nurse can provide primary treatment according to local algorithms developed in the clinic and refer the patient to more specialized care if needed. RESULTS: Experiences from the first year of service show that more than half of the patients needs this and wants consultation in the late complication clinic. We also found that most of the consultations were performed successfully by phone instead of by physical visits, and the most common clinical problem was bowel symptoms including diarrhea and urge. CONCLUSION: We have established a nurse-led clinic for late complications after colorectal and anal cancer. There seems to be a high need for this function in a department taking care of colorectal and anal cancer.

Sex and Age Differences in Patient-Reported Acute Stroke Symptoms.

Background: Identification of sex- and age-related differences in the presentation of atypical symptoms at stroke onset may reduce prehospital delay and improve stroke treatment if acknowledged at first contact. Aim: To explore sex- and age-related differences in patient-reported typical and atypical symptoms of a stroke. Methods: We used data from a cross-sectional survey at two non-comprehensive stroke units in the Capital Region of Denmark. Patient-reported symptoms, stroke knowledge, and behavioral response were analyzed by the Chi-square test or a Fisher's exact test separated by sex. Multivariable logistic regression adjusted for covariates were used to explore sex- and age-related differences according to each patient-reported typical or atypical symptoms. Results: In total, 479 patients with acute stroke were included (median age 74 years [25th to 75th percentile: 64-80], and 40.1% were women). Female sex was associated with higher odds of presenting with atypical symptoms, such as loss of consciousness (OR 2.12 [95% CI 1.08-4.18]) and nausea/vomiting (OR 2.33 [95% CI 1.24-4.37]), and lower odds of presenting with lower extremity paresis (OR 0.59 [95% CI 0.39-0.89). With each year of age, the odds decreased of presenting with sensory changes (OR 0.95 [95% CI 0.94-0.97]) and upper extremity paresis (OR 0.98 [95% CI 0.96-0.99]), whereas odds of presenting with dysphagia (OR 1.06 [95% CI 1.02-1.11]) increased. Conclusions: Patients of female sex and younger age reported on admission more frequently atypical stroke symptoms. Attention should be drawn to this possible atypical first presentation to facilitate correct identification and early stroke revascularization treatment to improve the outcome for both sexes.

Danish translation and qualitative validation of the Measure Yourself Medical Outcome Profileand the Measure Yourself Concerns and Wellbeing.

INTRODUCTION: Patients may experience late complications following surgical treatment for colorectal and anal cancer, and we need instruments in Danish to plan treatment and person-centred follow-up treatment approaches. For this purpose, we chose the Measure Yourself Medical Outcome Profile (MYMOP) and Measure Yourself Concerns and Wellbeing (MYCaW). The aim of this study was to translate the two instruments into Danish and conduct a subsequent qualitative validation. METHODS: The translation process consists of five stages: forward translation, synthesis, back translation, expert panel review and pretesting. Qualitative validation included interview with target audience representatives, testing of face-validity and evaluation by lay persons. RESULTS: Through the translation process and qualitative validation, we produced Danish versions of the MYMOP and the MYCaW. CONCLUSIONS: The Danish versions of the two questionnaires are now ready for use in clinical practice and research after individual licensing consultation with the copyright holders. FUNDING: none. TRIAL REGISTRATION: not relevant.

Complement component 3 and its activation split-products in saliva associate with periodontitis.

BACKGROUND: Periodontitis (PD) is classified by Grades A through C according to the risk of further progression, PD Grade C (PD-C) being the most severe progressing form. It is a matter of controversy, whether the disease activity observed in PD-C is due to impaired immune reactivity toward bacteria embedded in biofilms or a hyper-reactive immune response causing tissue damage as a bystander phenomenon. Little is known about the role of complement in this respect. METHODS: Plasma and unstimulated saliva samples were collected from patients with PD-B (n = 34) or -C (n = 27) and healthy controls (HCs) (n = 28). Salivary and plasma levels of total C3, C3c, and C3dg were quantified using sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: Salivary levels of total C3 and C3dg were elevated in PD-B and PD-C patients compared to HCs (both P < 0.05), while the levels of C3c were elevated in PD-C compared to HCs. Plasma levels of C3c were higher in PD-B patients than in HCs (P < 0.05). CONCLUSION: PD-B and PD-C patients show increased complement activation compared to HCs, but no difference was found between the two disease grades. PD-B, but not PD-C, is associated with increased systemic complement activation as assessed by C3c in plasma.