Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and fibrosis.NASH has a high risk of further progression to cirrhosis and hepatocellular carcinoma.The oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome dysbiosis.Gut dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and cyclopentane.Moreover,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal circulation.In particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut dysbiosis.NAFLD,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and diabetes.Periodontal disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation cooperatively.In this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the microbiome.In conclusion,it is presumed that the pathogenesis of NAFLD involves a complex crosstalk between periodontal disease,gut microbiota,and metabolic syndrome.Thus,the conventional periodontal treatment and novel microbiome-targeted therapies that include probiotics,prebiotics and bacteriocins would hold great promise for preventing the onset and progression of NAFLD and subsequent complications in patients with periodontal disease.

Clinical evaluation of surgery-induced astigmatism in cataract surgery using 2.2 mm or 1.8 mm clear corneal micro-incisions

AIM： To evaluate corneal astigmatism after phacoemulsification using 2.2 mm or 1.8 mm clear corneal micro-incisions and its effects on visual function.METHODS： Sixty cases （60 eyes） with cataract were randomly divided into groups A （n=30） and B （n=30） respectively underwent 2.2 mm and 1.8 mm clear corneal tunnel incision phacoemulsification combined with folding intraocular lens implantation from the time direction of 11：00. On day 1 and at 1, 4, and 6wk after operation, patients’ vision was measured and both the corneal curvature and corneal thickness （CT） were recorded using Pentacam.RESULTS： The measured surgery-induced astigmatism （SIA） in both groups A and B peaked on day 1 after operation, and then gradually decreased and eventually stabilized in week 4. No statistically significant difference was found in corneal astigmatism between two groups （P〉0.05）. The measured corneal astigmatism at 4wk and 6wk postoperatively were 0.28±0.09 D and 0.27±0.10 D for groups A and 0.27±0.09 D and 0.25±0.10 D for groups B without statistically significant difference （P〉0.05）. In addition, no significant differences in visual acuity and CT were found between groups A and B before or after operation.CONCLUSION： Both 2.2 mm and 1.8 mm micro-incision cataract surgeries result in relatively small SIA with no difference in visual function and corneal astigmatism between two surgery approaches. Thus, the two types of surgical systems are safe and efficient for cataract treatment, by which satisfactory uncorrected visual acuity can be regained early postoperatively.

Factors influencing teamwork and collaboration within a tertiary medical center

AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire(SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork(TW) and collaboration(CO) as endogenous variables. The exogenous variables are effective communication(EC), safety culture(SC), job satisfaction(JS), work pressure(PR), and work climate(WC). The measure-ment instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW(0.81), CO(0.76), EC(0.70), SC(0.83), JS(0.91), WP(0.85), and WC(0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork(R2 = 0.59) and in collaboration(R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork(β = 0.26) and collaboration(β = 0.88). A relatively weak positive(β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled.CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive to intra-organizational collaboration.

Region-Aware Trace Signal Selection Using Machine Learning Technique for Silicon Validation and Debug

In today’s modern design technology,post-silicon validation is an expensive and composite task.The major challenge involved in this method is that it has limited observability and controllability of internal signals.There will be an issue during execution how to address the useful set of signals and store it in the on-chip trace buffer.The existing approaches are restricted to particular debug set-up where all the components have equivalent prominence at all the time.Practically,the verification engineers will emphasis only on useful functional regions or components.Due to some constraints like clock gating,some of the regions can be ignored during execution.Likewise,some of these regions can be verified deeply and have minimum errors compared to other control regions.The proposed system focusses on random signals that identify more errors which are prone to signal selection technique with low area overhead.To enhance the observability,a machine learning technique is developed.Based on the training samples of smaller designs,a model is developed to find out the contiguous neighbours of each flip-flop.This can eliminate the obstacles of unknown signals.This system demonstrates using Opencores and ISCAS’89 benchmark circuits that result in easy and fast error detection compared to the state-of-theart of other methods.This is also verified using gate-level error models by cross-validation of each debug run.

China's future development:a closer look at the resource environment

Thirty years of reform and opening-up has steered China toward an economic miracle.However,rapid growth has also brought about resource and environmental challenges that stand in the way of renewing the brilliant success in coming decades.Given the rapid process of industrialization and modernization,it is unrealistic to slash domestic energy use and emissions as an ultimate solution.On the contrary,we need to adopt an outward-locking approach to make use of international resources on the basis of mutual benefit.Specifically,it includes international trade, regional cooperation and the"going-out"of Chinese firms.Amid the financial turmoil,Chinese businesses are facing an unprecedented opportunity to go beyond the national border for international resources.Taking advantage of this opportunity will facilitate access to resources for China’s development in coming decades.

Implications of Obama's Re-election for U.S.Security Policy towards East Asia

The quadrennial U.S.presidential election was held on November 6,2012.President Barack Obama was re-elected,defeating the Republican candidate.The results of the election will undoubtedly have significant impacts on future

United States and East Asian Integration

Witnessing the development and progress of East Asian integration,especially the adoption of the goal of East Asian Community,both U.S. officials and academic circles have been showing more interest in and paying growing attention to

Positive and Negative Impacts of Cross-border M&A

Mergers and acquisitions of Chinese enterprises by foreign investors have moved onto the public radar in recent years.To date,the M&A frenzy has drawn widespread attention,with a mixed reaction from proponents and opponents.Proponents consider such mergers and acquisitions conducive to realizing strategic readjustment of the national economic structure,optimizing resource allocation and improving the corporate governance structure.Opponents,however,are concerned that foreign mergers and acquisitions may jeopardize China’s industrial security and erode the executive power of the central government in undertaking industrial development planning.Are the benefits of M&A outweighed by the costs,or vice versa? The focus column of this edition features two articles which debate this issue from opposing viewpoints.In the article"Positive and Negative Impacts of Cross-border M&A",the authors consider foreign M(?)A to be a new way of boosting the level of foreign investment utilization,and advocate China taking full advantage of this approach.The authors of the article"Self-Improvement Or Self-Mutilation",meanwhile,hold foreign M&A to blame for state-owned asset erosion,and insist that China should oppose mergers and acquisitions of key state- owned enterprises by foreign investors at fire-sale prices.

化学气候变化对北美和欧洲森林的影响

1.前言近年来,科学界和公众对酸雨、大气污染及全球气候变化等问题的争论发生了重大转变。人们认识到,所有这些问题都是相关的,因为它们:①都是全球化学气候变化的具体表现;②都和化石燃料燃烧排放物的增加有关;③都涉及到大气污染物短距离和长距离迁移中的光化学变化;④都被人们怀疑或认为增加了对森林的负担;⑤都对人类健康、工程材料的腐蚀、文化资源的破坏、大气烟雾的形成以及其它社会问题增加了直接和间接的危险。本文扼要综述了北美和欧洲化学气候引起生物学上的有关变化。

Openness of the Country and Good Leadership

When I was growing up in the United States in the 1950s and 1960s,the country was full of optimism about the future. We were building a magnificent infrastructure of roads,airports,railroads and seaports that would link each part of the country for commerce and tourism. We all believed in President John F.Kennedy when he challenged the country to land a man on the moon by the end of the 1960s. The first jumbo jet,the Boeing 747,was a product of this belief in the future. We even believed that nuclear power would change the way we powered America. There was a widespread assumption that the nation would become wealthy and prosper,propelled by both technology and diligence. There were many reasons for this mood and these achievements,but I believe that nothing was more important than the great leaders who had the vision and communicated these ideas to the American people.

动脉血气分析的ABC：酸碱失衡的判断指南

目的本文目的是为临床药师、药学研究者及学生提供有用的评价动脉血气分析（arterial bloodgas analysis，ABGs）的方法。概论酸碱平衡的病理生理可分为代谢性或呼吸性酸中毒和碱中毒，以及那些可以被代偿的酸碱失衡。文章为读者提供了评估ABG的途径与步骤，还提供了实际病例，以便读者掌握酸碱失衡的概念。通过阅读本文，读者将能掌握必要的方法，来评估临床实践中遇到的任何酸碱失衡。结论酸碱病平衡的病理生理学复杂，对新接触临床的医师来说，不可能像经验丰富的老医师那样容易理解，本文介绍的方法能帮助和训练各个层次的临床医师，使其在实践中能评估和制定治疗酸碱失衡的方法。

Climate Change, Weather Conditions, and Population Health

There is near unanimous consensus that the global climate is warming and most of the warming is attributable to human activities.The world economic expansion has largely been driven by fossil fuels,leading to increasing emissions of greenhouse gases(GHGs).The world’s average temperature has risen at a rate of 0.07℃per decade since 1880 and nearly triple that rate since the 1990s.In addition to heat waves and cold spell,climate change may lead to a wide range of extreme weather conditions,including drought,floods,typhoons,windstorms,and landslides.Exposure to non-optimal temperatures and extreme weather conditions has been associated with a range of adverse health outcomes,including excess mortality and morbidity from various causes,and changes in the ecology of infectious diseases.For example,in China,14.3%of non-accidental mortality during 2013–2015 may be related to non-optimal temperatures,with 11.6%and 2.7%explainable by exposure to cold and heat,respectively(1).The recent global burden of diseases study(GBD 2019)shows that non-optimal temperatures are among the ten leading causes of death worldwide(2).A projection study showed that under high-emission scenarios,the negative health impacts of climate change would disproportionately affect warmer and poorer regions of the world(3).Climate change can also affect climate-sensitive infectious diseases carried by animal hosts or vectors,including malaria,dengue fever,schistosomiasis,Japanese encephalitis,and Angiostrongylus cantonensis.