Using State Agency Reports to Augment Ohio's Agricultural Injury Surveillance Efforts.

BACKGROUND: Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. METHODS: BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013-2014. Descriptive analyses were performed on each distinctive source. RESULTS: Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. CONCLUSIONS: Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents.

A Needs Assessment of Ohio Farmers' Self-Reported Health Behaviors.

The study purpose was a needs assessment, to identify and quantify health behavior risk-factors of Ohio farmers in sleep, mental health, fruit/vegetable serving frequency, physical activity, tobacco, alcohol and illicit drug use, and weight status. Guided by the RE-AIM implementation framework, the research question was What behavioral choices pose health risk factors for Ohio farmers? This cross-sectional, quantitative, descriptive study used Qualtrics' hyperlinks, QR codes, or paper-and-pencil surveys to collect data on seven focused health behaviors. The survey combined valid and reliable public domain questionnaires. The target audience included Ohio farmers representing various commodities. Extension educators at the county, regional, and state level provided access and data collection during their existing community-based programs and annual pesticide training sessions. The survey has been opened from January 20, 2020 to December 5, 2020 with modified recruitment during COVID. A convenience sample of 505 farmers participated. The majority self-identified as male, married, white, non-Latino, and worked full-time. The most frequent commodity was field crops. Most farmers reported 7-to-8 h of sleep, but the MOS SLP6 subscale indicated 89.5% of the farmers reported a score greater than 51. The two PHQ-2 questions showed 9.6% of the farmers scored >3, indicating a likely major depression disorder. Fruit and vegetable serving frequency appeared less than dietary recommendations. Time spent in physical activity did not meet guidelines. Almost 80% of the farmers said they did not use tobacco; the most common choice was chews and snuffs. Audit-C showed 31.4% of the men and 27.7% of the women can be categorized as hazardous drinkers. Illicit drug use was reported by 3.7%. Most farmers were obese or overweight. Male respondents were 83.5% overweight or obese; females 70.8% were overweight or obese. Males ages 55-64 years were mostly likely to be obese (58%) followed by males ages 35-44 years (46%). Results were compared to Ohio's Behavioral Risk Factor Surveillance System. These data will assist county Extension educators in identifying health prevention programming important for farm populations, utilizing community resources and services. While the findings of Ohio farmers may not be generalizable to other state farming communities, this survey and lessons learned can serve as a model for other Extension assessments.

Health Behavior Resources Available to Farmers in Rural Ohio.

Poor health habits correlate with morbidity and mortality. Rural communities often have decreased access to prevention programs and health care. As a state highly dependent on agriculture, this study identifies rural health services for Ohio farmers. This cross-sectional, descriptive study surveys key informants in Ohio at rural health clinics, critical access hospitals, health departments, Ohio State University (OSU) Extension offices, migrant clinics, and Federally Qualified Health Centers about the types of services available to address eight health behaviors. Key informants were invited via email and U.S. Postal Service to complete an electronic survey. After service types were identified, additional information to describe format, barriers to delivery and perceived importance of the service was asked. Of Ohio's 75 rural counties, 51 counties are represented in the data by at least one participating organization. Nutrition/healthy eating-related health services are provided most often by organizations (95.8%) and sleep services were least often reported (49.5%). The other health behaviors services (sun/UV exposure, physical activity, mental health, tobacco cessation, alcohol/substance abuse, and opioid abuse) fell in-between. Organizations are most likely to offer health education resources in print or web-based format across all health behaviors except for sleep, where social media promotion are the most common. The largest barrier to providing any type of health service is a lack of personnel. Providing health behavior services to farmers and farm families is important for improving their overall health. Documenting available services will assist the rural health community in future collaborative wellness projects.

Exome Sequencing of 5 Families with Severe Early-Onset Periodontitis.

Periodontitis is characterized by alveolar bone loss leading to tooth loss. A small proportion of patients develop severe periodontitis at the juvenile or adolescent age without exposure to the main risk factors of the disease. It is considered that these cases carry rare variants with large causal effects, but the specific variants are largely unknown. In this study, we performed exome sequencing of 5 families with children who developed stage IV, grade C, periodontitis between 3 and 18 y of age. In 1 family, we found compound heterozygous variants in the gene CTSC (p.R272H, p.G139R), 1 of which was previously identified in a family with prepubertal periodontitis. Subsequent targeted resequencing of the CTSC gene in 24 patients <25 y of age (stage IV, grade C) identified the known mutation p.I453V (odds ratio = 4.06, 95% CI = 1.6 to 10.3, P = 0.001), which was previously reported to increase the risk for adolescent periodontitis. An affected sibling of another family carried a homozygous deleterious mutation in the gene TUT7 (p.R560Q, CADD score >30 [Combined Annotation Dependent Depletion]), which is implicated in regulation of interleukin 6 expression. Two other affected siblings shared heterozygous deleterious mutations in the interacting genes PADI1 and FLG (both CADD = 36), which contribute to the integrity of the environment-tissue barrier interface. Additionally, we found predicted deleterious mutations in the periodontitis risk genes ABCA1, GLT6D1, and SIGLEC5. We conclude that the CTSC variants p.R272H and p.I453V have different expressivity and diagnostic relevance for prepubertal and adolescent periodontitis, respectively. We propose additional causal variants for early-onset periodontitis, which also locate within genes that carry known susceptibility variants for common forms. However, the genetic architecture of juvenile periodontitis is complex and differs among the affected siblings of the sequenced families.

Microbiological and host-derived biomarker evaluation following non-surgical periodontal therapy with short-term administration of systemic antimicrobials: secondary outcomes of an RCT.

Nonsurgical periodontal therapy with adjunctive use of systemic antimicrobials (for 7-14 days) showed improved clinical, microbiological and immunological results over the mechanical protocol alone. Considering the increasing risk for antimicrobial resistance with longer antibiotic regimes, it is important to establish the optimal antibiotic protocol with a maximum antimicrobial benefit and minimum risk for adverse effects. The aim of the study was to evaluate the microbiological and inflammatory outcomes 12-months after a 3-/7-day systemic antibiotic protocol [amoxicillin (AMX) + metronidazole (MET)] adjunctive to subgingival debridement in severe periodontitis compared to mechanical treatment alone. From the initially treated 102 patients, 75 subjects (Placebo group: n = 26; 3-day AMX + MET group: n = 24; 7-day AMX + MET group: n = 25) completed the 12-month examination. Clinical parameters, eight periodontal pathogens and inflammatory markers were determined at baseline and 3-, 6-, 12-months after therapy using real-time PCR and ELISA respectively. After 6 months, several periodontopathogens were significantly more reduced in the two antibiotic groups compared to placebo (p < 0.05). After 1 year, both antibiotic protocols showed significant reductions and detection of the keystone pathogen P. gingivalis compared to placebo. Antibiotic protocols, smoking, disease severity, baseline-BOP, -CAL and -IL-1ß, as well as detection of T. denticola at 12-months significantly influenced the residual number of deep sites. The present data indicate that the systemic use of both short and longer antibiotic protocols (AMX + MET) adjunctive to nonsurgical periodontal therapy lead to higher microbiological improvements compared to subgingival debridement alone. The two investigated antibiotic protocols led to comparable microbiological and inflammatory results.

Lean on Your Land Grant: One University's Approach to Address the Food Supply Chain Workforce during the COVID-19 Pandemic.

During the spring 2020 COVID-19 outbreak, faculty and staff within Ohio State University's College of Food, Agricultural and Environmental Sciences came together from multiple disciplines to support essential agricultural workers. Concerted leadership from administration provided a framework for this interaction to occur while faculty worked off-campus to address the many issues identified by the agricultural community, the industry sector, and other state agencies. During the onset period, much of our work was reactive; our efforts to address worker safety and health involved three primary areas within: 1) production agricultural workers, 2) produce growers and direct marketing enterprises, and 3) meat supply chain workers. Communication to target audiences relied upon our ability to convert face-to-face programming into virtual webinars, social media, and digital publications. A Food System Task Force mobilized specialists to address emerging issues, with one specific topic related to Personal Protective Equipment (PPE). As we continue to face new seasons in agriculture production, and pockets of COVID-19 outbreaks within our state, we will continue to address the dynamic needs of our food supply systems. There are implications for how we will teach the agricultural workforce within a virtual platform, including the evaluation of the effectiveness of those training programs. There are renewed opportunities to integrate health and safety content into other Extension teams who conventionally focused on production practices and farm management topics. Several research themes emerged during subgroup dialog to pursue new knowledge in workers' cultural attitude and barriers, PPE design, PPE access, and overall attitude toward COVID-19 health practices.

Periodontitis and Cardiovascular Diseases. Consensus Report.

Background: In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease. Material and Methods: There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations. Results and Conclusions: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.

Randomised clinical trial investigating self-assembling peptide P11-4 in the treatment of early caries.

OBJECTIVES: This prospective, randomised, split-mouth, clinical trial compared the efficacy of the self-assembling peptide P11-4 to fluoride varnish in the treatment of early buccal carious lesions. MATERIALS AND METHODS: Subjects presenting at least two clinically affected teeth were treated at D0 (day 0) and D90 with P11-4 (test) or fluoride varnish (control). At D180, fluoride varnish was applied on all study lesions. Standardised photographs were taken at D0, D30, D90, D180 and D360 and blindly morphometrically assessed. Hierarchical linear models (HLM) under allowance of confounders were used to compare the decrease in size between test and control groups. The visual analog scale (VAS) and Global Impression of Change Questionnaire (GICQ) were used as clinical assessments. RESULTS: Overall, 37 subjects (13-36 years) with 90 early carious lesions were included. HLM analysis showed a significant difference between test and control groups, indicating a decrease in test lesions and stabilisation of control lesions size (p = 0.001). The test lesion's mean size (SD) relative to baseline decreased to D30 = 0.936(0.127), D90 = 0.874(0.173), D180 = 0.844(0.215) and D360 = 0.862(0.352), whereas control lesions remained stable at D30 = 1.018(0.209), D90 = 1.013(0.207), D180 = 1.029(0.235) and D360 = 1.068(0.401). The effect sizes ranged from 0.47 to 0.82. CONCLUSIONS: Within the limits of this study, it was shown that the size of early carious lesions treated with P11-4 was significantly reduced; this result was superior to that of fluoride varnish treatment (DRKS00012941). CLINICAL RELEVANCE: The self-assembling peptide P11-4 is the first caries treatment approach aiming to regenerate decayed enamel. P11-4 initiates formation of de novo hydroxyapatite in the depth of early carious lesions, adding a new advanced therapy option for preventive dentistry.

Smoking Modifies the Genetic Risk for Early-Onset Periodontitis.

Periodontitis has low-prevalence, highly severe disease manifestations with an early onset and rapid progression. The diagnosis is based on severe destruction of the alveolar bone in adolescents and young adults. Genetic susceptibility variants and smoking are well-established risk factors, but their interactions in modifying disease susceptibility have not been studied. We aimed to identify genetic risk variants of early-onset periodontitis that unmask their effects on tobacco smoke exposure. To this end, we analyzed 79,780,573 common variants in 741 northwest Europeans diagnosed to have >30% bone loss at >2 teeth before 35 y of age, using imputed genotypes of the OmniExpress BeadChip. Never versus ever smokers were compared in a logistic regression analysis via a case-only approach. To explore the effect of tobacco smoke on the expression of the G×S-associated genes, cultures of primary gingival fibroblasts (n = 9) were exposed to cigarette smoke extract, and transcripts were quantified by reverse transcription polymerase chain reaction. We identified 16 loci for which our analysis suggested an association with G×S increased disease risk (P < 5 × 10-5). Nine loci had previously been reported to be associated with spirometric measures of pulmonary function by an earlier G×S genome-wide association study. Genome-wide significant cis expression quantitative trait loci were reported for G×S-associated single-nucleotide polymorphisms at ST8SIA1 and SOST, indicating a causal role of these genes in tobacco-related etiopathology. Notably, SOST is a negative regulator of bone growth, and ST8SIA1 has a role in tissue remodeling. Cigarette smoke extract significantly altered the expression of 2 associated genes: SSH1 (P = 5 × 10-07), which is required for NF-κB activation and innate immune responses to bacterial invasion, and ST8SIA1 (P = 0.0048). We conclude that the genetic predisposition to early-onset periodontitis is in part triggered by smoking and that tobacco smoke directly affects the expression of genes involved in bone homeostasis, tissue repair, and immune response.

A Century of Change towards Prevention and Minimal Intervention in Cariology.

Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature-coupled with limited diagnostic tools and therapeutic treatment options-meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession's move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession's greatest challenge is moving this evidence into practice.

Stimulation with Porphyromonas gingivalis enhances malignancy and initiates anoikis resistance in immortalized oral keratinocytes.

The aim of this study was to get new insights into molecular processes involved in tumor propagation of immortalized oral keratinocytes induced by the keystone pathogen Porphyromonas gingivalis. Cell culture experiments with immortalized OKF6 cells were performed to analyze cellular effects caused by bacterial stimulation focusing on altered gene expression, signaling pathways, proliferation rate, cell viability, migration and invasion behavior, and on the development of antiapoptotic pathways. Gene and protein expression were analyzed using real-time polymerase chain reaction, enzyme-linked immunosorbent assay, western blot, and protein arrays. Trypan blue staining was used to analyze proliferation and viability, transwell assays for cellular migration, Matrigel assays for invasion, and anoikis-assays for evaluating anoikis resistance. Stimulation of OKF6 cells with Porphyromonas gingivalis led to an alteration in the molecular repertoire of proteins which are involved in cell proliferation, epithelial-mesenchymal transition, stem cell formation, migration, invasion, and anoikis resistance. Higher proliferation rates were detected in conjunction with an activation of PI3K/Akt signaling and the mTOR-pathway. Additionally, inhibition of glycogen-synthase-kinase3-ß led to stabilization of ß-catenin and Snail, which resulted in a switch from predominant E-cadherin to N-cadherin expression and increased expression of the stem cell markers Oct3/4, Sox2, and Nanog. Enhanced biosynthesis and enzyme activity of matrix metalloproteinase-9 was accompanied by elevated invasion behavior. Finally, anoikis resistance was detected in stimulated keratinocytes by decreased apoptosis of nonadherent cells and elevated expression of epidermal growth factor receptor and c-Met. Hence, Porphyromonas gingivalis is able to induce a more aggressive tumor-like phenotype in immortalized oral keratinocytes, thus contributing to enhanced tumor features.

Water residence time (age) and flow path exert synchronous effects on annual characteristics of dissolved organic carbon in terrestrial runoff.

Catchment hydro-physical controls on the interannual variability of dissolved organic carbon (DOC) in terrestrial watershed runoff, important for water quality, ecosystem structure, and foodweb dynamics, are not well understood. To address this, we simulated water residence time ("age") and flow path of terrestrial runoff and analyzed their mediating effect on relationships between annual runoff volume, DOC concentration, and DOC age. We applied this analysis to a snow-influenced watershed in California's Sierra Nevada (USA) across a range of soil types, elevations (90-4210 m), and years (1950-1999). Simulated increases in annual runoff volume were accompanied by younger ages (r2 = 0.53-0.63) of DOC in quickflow, comprised of surface runoff and lateral flow through soil. Increases in annual runoff volume were also accompanied by gentler relationships between intra-annual (weekly) values of DOC concentration and runoff volume, regression-slopes of which followed a power-law relationship to annual runoff (r2 = 0.12-0.92) for approximately 70% of the watershed. Simulations including dynamics of water age and soil temperature produced annual ages of quickflow DOC ranging from 1 to 70 days over all soil types and water years. Similarity of this range to an observed, 1-69 day range in half-lives of relatively labile DOC in previous studies suggests substantial interannual and spatial variability in the biodegradability of DOC in terrestrial runoff. Simulations excluding dynamics of water age and soil temperature predicted order-of-magnitude less interannual variability in age of quickflow DOC, demonstrating the important effect of interannual variability in soil-water interaction times. These findings suggest that the distribution of DOC bioprocessing along transitions between terrestrial and aquatic systems may be strongly influenced by year-to-year variability in age of water.

Hazardous Agricultural Tasks Completed by Youth as Part of their Supervised Agricultural Experience (SAE): A Descriptive Study.

This study describes tasks that middle school and high school youth, ages 13 to 18 years, completed during the 2015-2016 academic year as part of their supervised agricultural experience (SAE). The overarching goal was to collect information useful in directing classroom instruction to better prepare youth prior to engaging in agricultural tasks identified as hazardous by the U.S. Department of Labor. Using a list of eleven tasks currently identified as hazardous and 17 tasks proposed as hazardous, teachers were asked how many of their students engaged in each of the 28 tasks as part of their SAE. The 320 teachers from four U.S. geographic regions reported that students most frequently completed SAEs in the areas of livestock production (f = 6746, 26.6%), agricultural mechanics (f = 2695, 10.6%), home and/or community development (f = 2296, 9.0%), and crop production (f = 2250, 8.9%). Students often engaged in tasks associated with ATV/UTV operation (f = 7618, 10.3%), tractor operation (f = 5554, 7.5%), and assisting tractor operation (f = 5,081, 6.9%) as part of their SAE. All of these tasks are well documented in the literature as contributing to injuries and fatalities of both youth and adults.

Current Grain Storage and Safety Practices of Ohio Cash Grain Operators.

Hazards associated with grain storage facilities are a contributing factor to agricultural injuries and are a perpetual problem for Ohio farmers, especially as on-farm grain storage facilities continue to grow in popularity with producers. To establish effective injury prevention programs, safety professionals must first understand how the industry operates, the culture of the workers, and the current practices used to avoid injuries. This research project was designed to bridge the gap between what is currently known about the hazards that exist on Ohio's farms, specifically how safety and health information is incorporated at the grain handling and storage facilities. Using a four-part survey, 182 cash grain operators, comprising a convenience sample of farmers attending educational events, were surveyed to determine the type of grain storage and handling facilities used on their farms, the occurrence of out-of-condition grain, and the health and safety factors practiced at these facilities, including their knowledge about potential hazards. Results indicated that the farmers preferred to get safety knowledge from a course or seminar (53.6%) or by reading a magazine or periodical (38.8%). The surveyed farmers indicated that they had higher knowledge of the safety risks of out-of-condition grain than of the health effects from exposure to out-of-condition grain (p < 0.01). They identified personal protective equipment (PPE) as their primary measure to prevent injuries, with the top PPE items being respirators, safety glasses, hearing protection, and gloves. Farmers who encountered out-of-condition grain reported more employees on their farms compared to the other farmers in the sample and reported higher use of PPE. While these results cannot be generalized to Ohio's entire population of cash grain farmers, they provide a good understanding of the on-farm grain storage and management practices, which will allow a more targeted intervention plan, both in better engineering controls and in future outreach programs.

Response of MG63 osteoblasts on bacterial challenge is dependent on the state of differentiation.

The present in vitro study examines molecular processes that are relevant during bone homeostasis after Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis infection with a focus on the differentiation level of osteoblasts. Regenerative processes are often hindered by the recurrence of bacterial infections, which can ultimately provoke a severe destruction of bone tissue. To obtain more detailed insights into such a complex scenario, we have used undifferentiated MG63 osteoblast-like cells as an experimental paradigm to examine the impact of two oral pathogens, A. actinomycetemcomitans and P. gingivalis, on proliferation, cytotoxicity and osteogenic differentiation. Cell culture experiments were performed to analyze cellular behavior. The level of genes interfering with bone tissue integrity (matrix metalloproteinases and their tissue inhibitors) and osteogenic markers (alkaline phosphatase, Runx2, human ß-defensin-2) was compared in undifferentiated versus differentiated MG63 cells using real-time polymerase chain reaction. Functional activity of matrix metalloproteinases was quantified by zymography. Western blot analysis was used to verify the phosphorylation state of mitogen-activated protein kinases p38 and extracellular-signal-regulated kinases 1/2. When co-cultured with undifferentiated MG63 cells, oral pathogens provoked distinct cellular effects. Only A. actinomycetemcomitans reduced cell proliferation, increased cell death, and induced osteogenic differentiation. A comparison of matrix metalloproteinase network stability in the presence of oral pathogens revealed a partial sensitivity towards P. gingivalis but not A. actinomycetemcomitans. So, beside the proof of concept that MG63 cells co-cultured with oral pathogens can serve as an in vitro model for mimicking destructive and regenerative events after bacterial infections, our data indicate that double infections might counterbalance otherwise positive effects.

The PF4/PPBP/CXCL5 Gene Cluster Is Associated with Periodontitis.

Periodontitis is a common dysbiotic inflammatory disease with an estimated heritability of 50%. Due to the limited sample size of available periodontitis cohorts and the underlying trait heterogeneity, genome-wide association studies (GWAS) of chronic periodontitis (CP) have been unsuccessful in discovering susceptibility factors. A strategy that combines agnostic GWAS with a well-powered candidate-gene approach has the potential to discover novel loci. We combined RNA-seq data from gingival tissues with quantitative trait loci (QTLs) that were identified in a F2-cross of mice resistant and susceptible to infection with oral bacterial pathogens. Four genes, which were located within the mapped QTLs, showed differential expression. The chromosomal regions across the human orthologous were interrogated for putative periodontitis-associated variants using existing GWAS data from a German case-control sample of aggressive periodontitis (AgP; 651 cases, 4,001 controls), the most severe and early onset form of periodontitis. Two haplotype blocks, one upstream to the coding region of UGT2A1 (rs146712414, P = 9.1 × 10-5; odds ratio [OR], 1.34; 95% confidence interval [CI], 1.16-1.56) and one downstream of the genes PF4/PPBP/CXCL5 (rs1595009, P = 1.3 × 10-4; OR, 1.32; 95% CI, 1.15-1.52), were associated with AgP. The association of rs1595009 was validated in an independent cohort of CP of European Americans (1,961 cases and 1,864 controls; P = 0.03; OR, 1.45; 95% CI, 1.01-1.29). This association was further replicated in another sample of 399 German CP cases (disease onset <60 y of age) and 1,633 controls ( P = 0.03; OR, 1.75; 95% CI, 1.06-2.90). The combined estimates of association from all samples were P = 2.9 × 10-5 (OR, 1.2; 95% CI, 1.1-1.3). This study shows the strength of combining QTL mapping and RNA-Seq data from a mouse model with association studies in human case-control samples to identify genetic risk variants of periodontitis.

Role of Cathepsin S in Periodontal Inflammation and Infection.

Cathepsin S is a cysteine protease and regulator of autophagy with possible involvement in periodontitis. The objective of this study was to investigate whether cathepsin S is involved in the pathogenesis of periodontal diseases. Human periodontal fibroblasts were cultured under inflammatory and infectious conditions elicited by interleukin-1ß and Fusobacterium nucleatum, respectively. An array-based approach was used to analyze differential expression of autophagy-associated genes. Cathepsin S was upregulated most strongly and thus further studied in vitro at gene and protein levels. In vivo, gingival tissue biopsies from rats with ligature-induced periodontitis and from periodontitis patients were also analyzed at transcriptional and protein levels. Multiple gene expression changes due to interleukin-1ß and F. nucleatum were observed in vitro. Both stimulants caused a significant cathepsin S upregulation. A significantly elevated cathepsin S expression in gingival biopsies from rats with experimental periodontitis was found in vivo, as compared to that from control. Gingival biopsies from periodontitis patients showed a significantly higher cathepsin S expression than those from healthy gingiva. Our findings provide original evidence that cathepsin S is increased in periodontal cells and tissues under inflammatory and infectious conditions, suggesting a critical role of this autophagy-associated molecule in the pathogenesis of periodontitis.

Oral pathogens change proliferation properties of oral tumor cells by affecting gene expression of human defensins.

The impact of oral pathogens onto the generation and variability of oral tumors has only recently been investigated. To get further insights, oral cancer cells were treated with pathogens and additionally, as a result of this bacterial cellular infection, with human defensins, which are as anti-microbial peptide members of the innate immune system. After cell stimulation, proliferation behavior, expression analysis of oncogenic relevant defensin genes, and effects on EGFR signaling were investigated. The expression of oncogenic relevant anti-microbial peptides was analyzed with real-time PCR and immunohistochemistry. Cell culture experiments were performed to examine cellular impacts caused by stimulation, i.e., altered gene expression, proliferation rate, and EGF receptor-dependent signaling. Incubation of oral tumor cells with an oral pathogen (Porphyromonas gingivalis) and human α-defensins led to an increase in cell proliferation. In contrast, another oral bacterium used, Aggregatibacter actinomycetemcomitans, enhanced cell death. The bacteria and anti-microbial peptides exhibited diverse effects on the transcript levels of oncogenic relevant defensin genes and epidermal growth factor receptor signaling. These two oral pathogens exhibited opposite primary effects on the proliferation behavior of oral tumor cells. Nevertheless, both microbe species led to similar secondary impacts on the proliferation rate by modifying expression levels of oncogenic relevant α-defensin genes. In this respect, oral pathogens exerted multiplying effects on tumor cell proliferation. Additionally, human defensins were shown to differently influence epidermal growth factor receptor signaling, supporting the hypothesis that these anti-microbial peptides serve as ligands of EGFR, thus modifying the proliferation behavior of oral tumor cells.

Examining the Quality of Life of Farmers with Disabilities: The Ohio AgrAbility Study.

Quality of life is a broad concept that presents a challenge to measure as a scientific category. Quality of life encompasses a broad range of variables based on an individual's expression of life satisfaction, perceptions, values, feelings of subjective well-being, and happiness. This study identified and examined factors that influenced the quality of life of Ohio farmers with disabilities who were enrolled in the Ohio AgrAbility Program (OAP) (n = 55) and participated in this study (60% response rate). A 34-item questionnaire was created. The sample of OAP farmers reported stress many days a week, had a negative outlook on life, and were less satisfied with their overall quality of life because of their health. The OAP participants reported external factors, such as cost of equipment, financial pressures, and input costs, as having a negative effect on their quality of life. The participants also reported that they were not satisfied with the amount of vacation time (60.6%), managing farm work and family life (54.6%), overall health (55%), and quality of life (27%). The results showed a significant difference between the OAP participants' overall quality of life and the following variables: gender, net cash income, outlook on life, health, stress, farm work, managing farm and family, social activities, and emotional support for farmers with disabilities. The findings of this exploratory study allowed farmers to identify factors that they perceived as important to their quality of life. Moreover, the results may be helpful for stakeholders to better understand the needs of farmers with disabilities and provide appropriate educational and other services to enhance their quality of life.

Reconstruction of Peri-implant Osseous Defects: A Multicenter Randomized Trial.

There is a paucity of data for the effectiveness of reconstructive procedures in the treatment of peri-implantitis. The objective of this study was to compare reconstruction of peri-implant osseous defects with open flap debridement (OFD) plus porous titanium granules (PTGs) compared with OFD alone. Sixty-three patients (36 female, 27 male; mean age 58.4 y [SD 12.3]), contributing one circumferential peri-implant intraosseous defect, were included in a multinational, multicenter randomized trial using a parallel-group design. After OFD and surface decontamination using titanium brushes and hydrogen peroxide, 33 defects received PTGs. The implants were not submerged. All patients received adjunctive perioperative systemic antibiotics. The primary outcome variable (defect fill) was assessed on digitalized radiographs. Clinical measurements of probing depth (PPD), bleeding on probing (BoP), suppuration, and plaque were taken by blinded examiners. After 12 mo, the test group (OFD plus PTG) showed a mean radiographic defect fill (mesial/distal) of 3.6/3.6 mm compared with 1.1/1.0 in the control group (OFD). Differences were statistically significant in favor of the test group (P < 0.0001). The OFD plus PTG group showed a mean reduction in PPD of 2.8 mm compared with 2.6 mm in the OFD group. BoP was reduced from 89.4% to 33.3% and from 85.8% to 40.4% for the test and control groups, respectively. There was no significant difference in complete resolution of peri-implantitis (PPD ≤4 mm and no BoP at six implant sites and no further bone loss), because this finding was accomplished at 30% of implants in the test group and 23% of implants in the control group. Reconstructive surgery using PTGs resulted in significantly enhanced radiographic defect fill compared with OFD. However, limitations in the lack of ability to discern biomaterial from osseous tissue could not be verified to determine new bone formation. Similar improvements according to clinical measures were obtained after both surgical treatment modalities (ClinicalTrials.gov NCT02406001).