Novel Insight into the Mechanisms of the Bidirectional Relationship between Diabetes and Periodontitis

Periodontitis and diabetes are two major global health problems despite their prevalence being significantly underreported and underestimated. Both epidemiological and intervention studies show a bidirectional relationship between periodontitis and diabetes. The hypothesis of a potential causal link between the two diseases is corroborated by recent studies in experimental animals that identified mechanisms whereby periodontitis and diabetes can adversely affect each other. Herein, we will review clinical data on the existence of a two-way relationship between periodontitis and diabetes and discuss possible mechanistic interactions in both directions, focusing in particular on new data highlighting the importance of the host response. Moreover, we will address the hypothesis that trained immunity may represent the unifying mechanism explaining the intertwined association between diabetes and periodontitis. Achieving a better mechanistic insight on clustering of infectious, inflammatory, and metabolic diseases may provide new therapeutic options to reduce the risk of diabetes and diabetes-associated comorbidities.

Effect of sleep and mood on academic performance—at interface of physiology, psychology, and education

Academic achievement and cognitive functions are influenced by sleep and mood/emotion. In addition, several other factors affect learning. A coherent overview of the resultant interrelationships is essential but has not been presented till date. This unique and interdisciplinary review sits at the interface of physiology, psychology, and education. It compiles and critically examines the effects of sleep and mood on cognition and academic performance while including relevant conflicting observations. Moreover, it discusses the impact of several regulatory factors on learning, namely, age, gender, diet, hydration level, obesity, sex hormones, daytime nap, circadian rhythm, and genetics. Core physiological mechanisms that mediate the effects of these factors are described briefly and simplistically. The bidirectional relationship between sleep and mood is addressed. Contextual pictorial models that hypothesise learning on an emotion scale and emotion on a learning scale have been proposed. Essentially, convoluted associations between physiological and psychological factors, including sleep and mood that determine academic performance are recognised and affirmed. The emerged picture reveals far more complexity than perceived. It questions the currently adopted ‘one-size fits all’ approach in education and urges to envisage formulating bespoke strategies to optimise teaching-learning approaches while retaining uniformity in education. The information presented here can help improvise education strategies and provide better academic and pastoral support to students during their academic journey.

Bidirectional Relationship Between Family Accommodation and Youth Anxiety During Cognitive-Behavioral Treatment

Family accommodation is associated with an increase in anxiety and has recently received attention as a target for intervention for youth anxiety. Existing theories posit that the increase in family accommodation increases youth anxiety and can attenuate the effect of psychotherapy. However, the directionality between family accommodation and youth anxiety has not been investigated. A cross-lagged cross-panel design was used to assess accommodation and anxiety for 10 sessions for 73 youths with an anxiety disorder, who were receiving cognitive-behavioral therapy. The analysis revealed a bidirectional relationship, such that to some extent previous session family accommodation increased youth anxiety symptoms (β = 0.11, 95% CI [0.06, 0.17]), but to an even greater extent previous session youth-rated anxiety symptoms increased family accommodation (β = 0.23, 95% CI [0.08, 0.38]). Family accommodation is an important target for reducing youth anxiety but should be addressed simultaneously as interventions directly targeting youth anxiety.

Assessment of bidirectional relationships between 98 genera of the human gut microbiota and amyotrophic lateral sclerosis: a 2-sample Mendelian randomization study

Background Growing evidence suggests a mutual interaction between gut microbiome alterations and ALS pathogenesis. However, previous studies were susceptible to potential confounding factors and reverse causation bias, likely leading to inconsistent and biased results. Objectives To decipher the potentially mutual relationship between gut microbiota and ALS, we used a bidirectional two-sample MR approach to examine the associations between the gut microbiome and ALS. Results Using the inverse variance-weighted method, OTU10032 unclassified Enterobacteriaceae species-level OTU and unclassified Acidaminococcaceae were associated with a higher risk of ALS (per relative abundance: OR, 1.04; 95% CI, 1.01–1.07; P = 0.011 and OR, 1.02; 95% CI, 1.01–1.04; P = 0.009, respectively). Importantly, Gamma-Glu-Phe was showed potential deleterious effects on the risk of ALS (genetically predicted per a 1-standard deviation increase in the level of Gamma-Glu-Phe: OR, 1.96; 95% CI, 1.50–2.55; P = 0.012). Sensitivity analysis of the two candidate genera and metabolites using the MR-Egger and weighted-median methods produced similar estimates, and no horizontal pleiotropy or outliers were observed. Intriguingly, genetically predicted ALS was associated with an increase in the relative abundance of OTU4607_Sutterella (per 1-unit higher log odds: β, 2.23; 95% CI, 1.27–3.18; P = 0.020) and Lactobacillales_ORDER (per 1-unit higher log odds: β, 0.51; 95% CI, 0.09–0.94; P = 0.019). Conclusions Our findings provide novel evidence supporting the bidirectional relationship between the gut microbiota and ALS. These results may contribute to designing microbiome- and microbiome-dependent metabolite interventions in future ALS clinical trials.

Opportunities to prevent and manage undernutrition to amplify efforts to end TB

The bidirectional relationship between TB and nutrition is well recognized – primary undernutrition is a risk factor for developing TB disease, while TB results in wasting. Although nutrition support is acknowledged as an important intervention in TB programmes, it is seldom afforded commensurate priority for action. TB incidence and deaths worldwide are falling too slowly to meet WHO End TB Strategy milestones, and the number of undernourished people is increasing, likely to be further exacerbated by the ongoing COVID-19 pandemic. Undernutrition needs to be more urgently and intensively addressed. This is especially true for the WHO South-East Asia Region, where the high rates of undernutrition are a key driver of the TB epidemic. The evidence base has been sufficiently robust for clear and workable programmatic guidance to be formulated on assessment, counselling and interventions for TB patients. Many high-burden countries have developed policies addressing TB and nutrition. Gaps in research to date have frustrated the development of more refined programmatic approaches related to addressing TB and malnutrition. Future research can be shaped to inform targeted, actionable policies and programmes delivering dual benefits in terms of undernutrition and TB. There are clear opportunities for policy-makers to amplify efforts to end TB by addressing undernutrition.

Neuroinflammation, diabetes, and COVID-19: Perspectives coming from Ca2+/cAMP signalling

Background: A link between inflammatory diseases, e.g., epilepsy, dementia, diabetes, and COVID-19, has been established. For instance, observational studies with several individuals established that people with epilepsy have shown an enhanced incidence of manifesting dysfunctions related to cognition, e.g., dementia, while people with dementia have a higher incidence of manifesting epilepsy, thus an evident bidirectional relationship between epilepsy and dementia might occur. In addition, epilepsy commonly cooccurs in patients with diabetes, so an association between these two disorders is also discussed. Intriguingly, some reports have also observed a poor prognosis for people with both diabetes and COVID-19. It is recognized that a dyshomeostasis of both Ca2+ and cAMP signalling pathways could be a molecular connection for these disorders. Objectives: Therefore, clarifying this clinical relationship among epilepsy, dementia, diabetes, and COVID-19 may outcome in novel hypotheses for identifying the etiology of these disorders.

Diabetes Mellitus: Worst Comorbidity to have in COVID-19 Pandemic

Background: Diabetic patients have shown the worst clinical manifestation of the COVID-19. They are at higher risk of being infected and producing severe clinical outcomes, challenging to manage. Also, the share of the diabetic patient among case fatalities is large. Summary: COVID-19 is a disease pandemic that has spread worldwide. All sections and age groups of people worldwide have been affected by the pandemic. Diabetes mellitus is the worst disease to have in OVID-19, as studies have shown some adverse clinical outcome that needs sophisticated medical attention. In lack of resources and overwhelmed infrastructure, the availability of these is tricky. Conclusion: More study is needed about the bidirectional relationship between COVID-19 and diabetes mellitus so that a clearer picture can be emerged out of the fogged situation. Diabetes is already grappling the world, which is suggested by increasing the number of diabetic patient’s number worldwide. Especially in COVID-19, it has become a challenge to contain the disease along with all these comorbidities. The immunosuppressive state brought about by various underlying medical conditions like diabetes mellitus is suitable ground for novel coronavirus to propagate itself.

Longitudinal Study of Maternal Beliefs About Infant Crying During the Postpartum Period: Interplay With Infant’s Temperament

Infant crying is an important signal for their survival and development, and maternal beliefs about crying predict responsiveness to crying. Most studies have considered caregivers’ reactions to crying to be fixed, and it is unclear how they change with their caregiving experience. Additionally, it has recently been suggested that there is a bidirectional relationship between changes in mothers’ beliefs about crying and infants’ temperament. This study examined that relationship using a longitudinal study design. Maternal beliefs about crying and infant temperament of 339 Asian first-time mothers (mean age = 28.7 years, SD = 4.1) were measured at 1-month intervals over 4 months. There were 289 participants in Wave 2, 240 in Wave 3, and 164 in Wave 4. Prior to the main survey, we conducted a pre-survey to confirm the reliability and validity of the Japanese version of the Infant Crying Questionnaire. The results showed that parent-oriented beliefs, which focus on the caregiver rather than the crying infant, increased in mothers who had infants aged 3 months or older at Wave 1. We also found that the process of change in maternal beliefs was not uniform, and that infants high on surgency predicted changes in maternal beliefs about infant crying. Longitudinal studies of caregivers’ changes, such as the present study, are expected to contribute to understanding the co-development of caregivers and infants.