Quasi-Randomized Trial of Effects of Perioperative Oral Hygiene Instruction on Inpatients with Heart Diseases Using a Behavioral Six-Step Method

The assessor-blinded, parallel-design, quasi-randomized study (alternating allocation) aimed to determine the effects of the six-step method on postoperative numbers of oral bacteria, periodontal status, and atrial fibrillation (AF) among inpatients with heart diseases and periodontitis. Seventy inpatients who received preoperative periodontal treatment were quasi-randomly assigned to intervention and control groups at University Hospital. The intervention group received intensive oral hygiene instruction using a six-step method for 15 minutes per week and the control group received routine oral hygiene instruction. Significantly fewer oral bacteria were identified on the tongue at discharge compared with baseline in the intervention than the control group (ANCOVA) (large effect size, p = 0.02). Changes in scores for self-efficacy, plaque scores, probed pocket depth, and bleeding on probing between baseline and discharge were significantly greater in the intervention, than in the control group (p < 0.05). The period of postoperative AF (days) was significantly shorter in the intervention, than in the control group (p = 0.019). In conclusion, oral hygiene instruction using the six-step method decreased the numbers of oral bacteria on the tongue and improved self-efficacy, oral health behaviors, oral hygiene status, periodontal status, and period of postoperative AF among inpatients with periodontitis and heart diseases

Unemployment, Income Growth and Social Security

Considering the sustainability of social security in an aging society with fewer children, income growth and population growth are important factors. With a decrease in income growth or population growth, social security transfers such as pension benefits cannot be provided. The intergenerational social security benefit is being reassessed in some OECD countries. In Japan, social security benefits for younger people are small because of an aging society. This paper presents description of an unemployment model with a minimum wage and social security benefits and presents examination of how unemployment benefits for the younger people affect income growth, fertility, and welfare. The results described herein demonstrate that unemployment benefits raise the capital stock and income level per capita. Therefore, this benefit should be provided to maintain the tax revenue for social security. Moreover, this benefit can increase social welfare

Capital income taxation in endogenous fertility model

We build a standard overlapping generations model with endogenous fertility and involuntary unemployment. Being different from a log utility function, the capital income tax affects saving at the model of constant relative risk-averse utility function (CRRA function). In the parameter condition, to have the case of non-substitution between consumption in different periods, the capital income tax raises saving to compensate for consumption in the future. Then, results show that a capital income tax improves fertility and unemployment with no social security system

Public Investment, Health Infrastructure and Income Growth

Based on individual occupational choice in a model including a production function with public investment and public health infrastructure, this paper presents an examination of how allocation of public investment and public health infrastructure affects the dynamics of income. Individuals work as skilled laborers or unskilled laborers, as in the model described by Caselli (1999), and educational costs are necessary to work as a skilled laborer. Results show that government should provide both public investment and public health infrastructure to escape from the poverty trap with low income. Moreover, based on an initial allocation between public investment and public health infrastructure, it is decided how the government should form a policy to increase income growth

Capital income taxation in endogenous fertility model

We build a standard overlapping generations model with endogenous fertility and involuntary unemployment. Being different from a log utility function, the capital income tax affects saving at the model of constant relative risk-averse utility function (CRRA function). In the parameter condition, to have the case of non-substitution between consumption in different periods, the capital income tax raises saving to compensate for consumption in the future. Then, results show that a capital income tax improves fertility and unemployment with no social security system

Potent Inhibitory Effects of D-tagatose on the Acid Production and Water-insoluble Glucan Synthesis of Streptococcus mutans GS5 in the Presence of Sucrose

We examined and compared the inhibitory effects of D-tagatose on the growth, acid production, and water-insoluble glucan synthesis of GS5, a bacterial strain of Streptococcus mutans, with those of xylitol, D-psicose, L-psicose and L-tagatose. GS5 was cultured for 12h in a medium containing 10ｵ (w/v) of xylitol, D-psicose, L-psicose, D-tagatose or L-tagatose, and the inhibitory effect of GS5 growth was assessed. Each sugar showed different inhibitory effects on GS5. Both D-tagatose and xylitol significantly inhibited the acid production and water-insoluble glucan synthesis of GS5 in the presence of 1ｵ (w/v) sucrose. However, the inhibitory effect of acid production by D-tagatose was significantly stronger than that of xylitol in presence of sucrose

Potential Respiratory Pathogens in the Trachea and Nasal Mucosa of Intubated ICU Inpatients : Longitudinal Change and Relationship with Consciousness Level

本研究では，気管内挿管により人工呼吸管理を受けている患者のICU 入室後の鼻腔および気管内細菌の臨床検査データを解析し，その実態を把握するとともに，その経時的変化や意識レベルとの関連性を明らかにすることを目的とした．香川大学医学部附属病院ICU において，院内肺炎や市中肺炎の起炎菌として監視培養の対象としている『要注意菌』8 菌種について，気管内採痰および鼻腔スワブ中の検出状況を経時的に調べた．その結果，挿管初日の検査において32.7%の患者の気管内採痰に要注意菌が検出された．さらに，初日の検査で気管内に要注意菌が検出されなかった患者においても経時的に要注意菌の検出率が上昇することが明らかとなった．気管内で要注意菌が検出されるケースのほとんどで鼻腔内でも要注意菌が検出されることがわかった．また，患者の意識レベルと要注意菌の検出率の関連性を調べたところ，昏睡状態にある患者はそうでない患者に比べて，鼻腔内での要注意菌検出率が有意に高いことが明らかとなった（χ 2 検定；p<0.05）．気管内での肺炎原因菌の定着・増殖を阻止するには，口腔，咽頭，鼻腔に生息する細菌数を減らすことが重要と考えられる．これらのことから，意識障害が遷延化し挿管期間が長くなると見込まれる患者に対しては，より一層の徹底した鼻咽腔や口腔の衛生管理が必要であることが示唆された．また，挿管初日にある程度の細菌が気管内で検出されたことからも，挿管前の可能な限りの口腔ケアが肺炎リスクを減らすために重要であると考えられた．The aim of this study was to elucidate the longitudinal change of potential respiratory pathogens in the trachea and nasal mucosa of intubated intensive care unit (ICU) inpatients with neurological disorders. We focused on eight bacterial species designated “Bacteria requiring special attention” (SA), which are routinely under surveillance in the ICU of Kagawa University Hospital. Clinical data from bacterial testing of specimens from tracheal sputum or nasal mucosa swabs were analyzed. SA were detected in the trachea of 32.7% of patients on the first day of intubation. Furthermore, the detection rate of SA in the trachea increased over several days among patients in whom they were not detected on the first day. Most patients who were SA-positive in the trachea were also positive in the nasal mucosa. The rate of SA in the nasal mucosa of comatose patients was significantly higher than that in patients at other consciousness levels. It was suggested that thorough oral and/or nasal hygiene management is very important for comatose patients to reduce the risk of pneumonia

Novel scotoma detection method using time required for fixation to the random targets

We developed a novel scotoma detection system using time required for fixation to the random targets, or the” eye-guided scotoma detection method “. In order to verify the” eye-guided scotoma detection method “, we measured 78 eyes of 40 subjects, and examined the measurement results in comparison with the results of measurement by Humphrey perimetry. The results were as follows: (1) Mariotte scotomas were detected in 100% of the eyes tested; (2) The false-negative rate (the percentage of cases where a scotoma was evaluated as a non-scotoma) was less than 10%; (3) The positive point distribution in the low-sensitivity eyes was well matched. These findings suggested that the novel scotoma detection method in the current study will pave the way for the realization of mass screening to detect pathological scotoma earlier.[Author summary] Conventional perimeters, such as the Goldmann perimeter and Humphrey perimeter, require experienced examiners and space occupying. With either perimeter, subjects’ eye movements need to be strictly fixed to the fixation target of the device. Other perimeters can monitor fixation and automatically measure the visual field. With the eye-guided scotoma detection method proposed in the current study, subjects feel less burdened since they do not have to fixate on the fixation target of the device and can move their eyes freely. Subjects simply respond to visual targets on the display; then, scotomas can be automatically detected. The novel method yields highly accurate scotoma detection through an algorithm that separates scotomas from non-scotomas

Flame Prediction Based on Harmful Expression Judgement Using Distributed Representation

In recent years, flaming-that is, hostile or insulting interaction-on social media has been a problem. To avoid or minimize flaming, enabling the system to automatically check messages before posting to determine whether they include expressions that are likely to trigger flaming can be helpful. We target two types of harmful expressions: insulting expressions and expressions that are likely to cause a quarrel. We first constructed an original harmful expressions dictionary. To minimize the cost of collecting the expressions, we built our dictionary semi-automatically by using word distributed representations. The method used distributed representations of harmful expressions and general expressions as features, and constructed a classifier of harmful/general expressions based on these features. An evaluation experiment found that the proposed method was able to extract harmful expressions with an accuracy of approximately 70%. The proposed method was also able to extract unknown expressions; however, it tended to wrongly extract non-harmful expressions. The method is able to determine unknown harmful expressions not included in the basic dictionary and can identify semantic relationships among harmful expressions. Although the method cannot presently be applied directly to multi-word expressions, it should be possible to add such a capability by introducing time-series learning

D-Tagatose Effectively Reduces the Number of Streptococcus mutans and Oral Bacteria in Healthy Adult Subjects: A Chewing Gum Pilot Study and Randomized Clinical Trial

We examined the effect of D-Tagatose on the growth of oral bacteria including Streptococcus mutans (S. mutans). Saliva collected from 10 healthy volunteers was plated on BHI medium (to culture total oral bacteria) and MBS medium (to culture S. mutans, specifically). Agar plates of BHI or MBS containing xylitol or D-Tagatose were cultured under aerobic or anaerobic conditions. We then counted the number of colonies. In BHI plates containing D-Tagatose, a complete and significant reduction of bacteria occurred under both aerobic and anaerobic conditions. In MSB medium, significant reduction of S. mutans was also observed. We then performed a doubleblind parallel randomized trial with 19 healthy volunteers. They chewed gum containing xylitol, D-Tagatose, or both for 4 weeks, and their saliva was collected weekly and plated on BHI and MSB media. These plates were cultured under anaerobic conditions. Total bacteria and S. mutans were not effectively reduced in either the D-Tagatose or xylitol gum group. However, S. mutans was significantly reduced in volunteers chewing gum containing both D-Tagatose and xylitol. Thus, D-Tagatose inhibited the growth of S. mutans and many types of oral bacteria, indicating that D-Tagatose intake may help prevent dental caries, periodontitis, and many oral diseases