Improvements of mid-thigh circumferences following robotic rehabilitation in hemiparetic stroke patients.

INTRODUCTION: Stroke has emerged as the leading cause of disability globally. The provision of long-term rehabilitation to stroke survivors poses a health care burden to many countries. Robotic devices have created a major turning point in stroke rehabilitation program. Currently, the anthropometric evidence to support the benefit of robotic rehabilitation (RR) among stroke patients is scarce. Therefore, the aim of this study was to evaluate the impact of RR on the mid-thigh circumferences of the paretic limbs in stroke patients. METHODS: Twenty stroke patients from conventional rehabilitation (CR) (n = 10) and RR (n = 10) groups were recruited through a purposive sampling method. Patients in the CR group received a two-hour session of a five-day-a-week home-based CR program for 4 weeks. Patients in the RR group received a five-day-a-week of an hour combined physiotherapy and occupational therapy session and a one-hour robotic therapy session using the HAL® Cyberdyne lower-limb, for 4 weeks. The mid-thigh circumferences of both limbs were measured on day 1 (baseline), week 2 and week 4 of rehabilitation program. RESULTS: The results revealed no statistically significant difference in the mid-thigh circumferences between the paretic (F1.05,9.44 = 1.96, p = 0.20), and the normal (F1.05,9.44 = 1.96, p = 0.20) sides in the CR group (n = 10). For the comparison between the paretic and normal sides in the RR group (n = 10), the paretic mid-thigh circumferences revealed significant time effect results (F2,18 = 11.91, p = 0.001), which were due to changes between baseline and week 2, and baseline and week 4 measurements. Interestingly, the normal mid-thigh circumferences also revealed a significant time effect (F2,18 = 6.56, p = 0.007), which is due to changes between baseline and week 4. One-way analysis of variance was employed to compare the mean average between groups due to the difference in the baseline measurements of the mid-thigh circumferences between the paretic side of the CR and the RR groups. With this adjustment, the average means mid-thigh circumferences after 4 weeks of therapy were shown to be significantly different between the CR and RR groups (F1,18 = 12.49, p = 0.02). CONCLUSION: Significant increments in the mid-thigh circumferences following RR were seen in the paretic limbs of stroke patients. Hence, this study may provide some insights into further potential research related to the benefits of RR in stroke patients.

Amlodipine-induced buccal lichenoid lesions: A case report.

Buccal lichenoid lesions (BLLs) are characterised by a unique, linear whitish striation in the buccal region and can be accompanied by ulcers, plaques, erythemas, atrophies and blisters. They are distinguished from oral lichen planus (OLP) by the association of the administration of a drug or contact with a metal. Herein, we present the case of a 42-year-old woman with underlying hypertension with amlodipine-induced BLLs. She complained of a 1-month history of right buccal whitish streaks and oral ulcers 2 months after taking amlodipine. She visited a private otorhinolaryngology clinic, and a biopsy for the right buccal ulcer was conducted. The biopsy result showed features suggestive of OLP. The patient was then diagnosed with OLP. Her symptoms were persistent despite treatment, so a dental referral was made. Amlodipine was suspected as the cause of her condition and was therefore stopped. Her condition gradually resolved after amlodipine withdrawal. Hence, primary care physicians should be aware of BLLs as one of the adverse drug reactions of amlodipine so that prompt management can be taken to avoid further debilitating impacts on patients.

Exploring treatment outcomes in Stage II-III rectal cancer patients undergoing neoadjuvant therapy at a tertiary care center in Pakistan: a comprehensive analysis of pathological outcomes.

BACKGROUND: Rectal cancer treatment has transformed in recent years, with neoadjuvant treatment (NT) and total neoadjuvant treatment (TNT) aiming to enhance pathological responses. This pioneering study in our country delves into rectal cancer management, offering crucial insights by examining pathological outcomes in patients treated with the NT and TNT approach, shaping the evolving landscape. METHODS: In this retrospective-cohort study spanning January 2017 to December 2022 at a tertiary care hospital in Pakistan, ethical approval was obtained to examine outcomes of two treatments. Patients were divided into TNT (chemoradiation and pre-surgery 5 FU-based chemotherapy) and NT (chemoradiation, surgery, and subsequent 5 FU-based chemotherapy). The primary end-point was response rates-no response, pathological complete response (pCR), near complete response (near CR), and partial response (PR). The Chi-Square Test for Independence assessed the association between treatment response and type (TNT or NT). Data analysis used STATA MP 64; significance was set at p < 0.05 for all two-tailed tests. RESULTS: We analyzed 77 patients, 60 underwent standard neoadjuvant chemoradiation, and 17 followed the total neoadjuvant approach. Predominantly male, most were > 65 with ECOG 0-1. The TNT group showed higher response rates (76% vs 62%, p = 0.039), with 40.38% achieving pCR. In the overall population, pCR and near-CR were similar (27.2% vs 26%), while PR were 14%. Treatment characteristics correlated significantly with chemotherapy type, concurrent chemoradiation, LVI, PNI, and T, N, M staging (p < 0.05). Median overall survival was not reached, and mean survival was 89.1 months (CI: 95.0 to 83.3). Side effects varied, with notable differences in neuropathy, diarrhea, oral mucositis, and thrombocytopenia between NT and TNT groups. CONCLUSION: Our study adds to evidence favoring neoadjuvant approaches in managing rectal cancer in pakistan. Demonstrating a favorable pcr rate, ongoing research with extended follow-up is essential, given the dynamic landscape of rectal cancer treatment for improved patient outcomes.

Purine and carbohydrate availability drive Enterococcus faecalis fitness during wound and urinary tract infections.

IMPORTANCE: Although E. faecalis is a common wound pathogen, its pathogenic mechanisms during wound infection are unexplored. Here, combining a mouse wound infection model with in vivo transposon and RNA sequencing approaches, we identified the E. faecalis purine biosynthetic pathway and galactose/mannose MptABCD phosphotransferase system as essential for E. faecalis acute replication and persistence during wound infection, respectively. The essentiality of purine biosynthesis and the MptABCD PTS is driven by the consumption of purine metabolites by E. faecalis during acute replication and changing carbohydrate availability during the course of wound infection. Overall, our findings reveal the importance of the wound microenvironment in E. faecalis wound pathogenesis and how these metabolic pathways can be targeted to better control wound infections.

RNA is a key component of extracellular DNA networks in Pseudomonas aeruginosa biofilms.

The extracellular matrix of bacterial biofilms consists of diverse components including polysaccharides, proteins and DNA. Extracellular RNA (eRNA) can also be present, contributing to the structural integrity of biofilms. However, technical difficulties related to the low stability of RNA make it difficult to understand the precise roles of eRNA in biofilms. Here, we show that eRNA associates with extracellular DNA (eDNA) to form matrix fibres in Pseudomonas aeruginosa biofilms, and the eRNA is enriched in certain bacterial RNA transcripts. Degradation of eRNA associated with eDNA led to a loss of eDNA fibres and biofilm viscoelasticity. Compared with planktonic and biofilm cells, the biofilm matrix was enriched in specific mRNA transcripts, including lasB (encoding elastase). The mRNA transcripts colocalised with eDNA fibres in the biofilm matrix, as shown by single molecule inexpensive FISH microscopy (smiFISH). The lasB mRNA was also observed in eDNA fibres in a clinical sputum sample positive for P. aeruginosa. Thus, our results indicate that the interaction of specific mRNAs with eDNA facilitates the formation of viscoelastic networks in the matrix of Pseudomonas aeruginosa biofilms.

N-Methyl Costaricine and Costaricine, Two Potent Butyrylcholinesterase Inhibitors from Alseodaphne pendulifolia Gamb.

Studies have been conducted over the last decade to identify secondary metabolites from plants, in particular those from the class of alkaloids, for the development of new anti-Alzheimer's disease (AD) drugs. The genus Alseodaphne, comprising a wide range of alkaloids, is a promising source for the discovery of new cholinesterase inhibitors, the first-line treatment for AD. With regard to this, a phytochemical investigation of the dichloromethane extract of the bark of A. pendulifolia Gamb. was conducted. Repeated column chromatography and preparative thin-layer chromatography led to the isolation of a new bisbenzylisoquinoline alkaloid, N-methyl costaricine (1), together with costaricine (2), hernagine (3), N-methyl hernagine (4), corydine (5), and oxohernagine (6). Their structures were elucidated by the 1D- and 2D-NMR techniques and LCMS-IT-TOF analysis. Compounds 1 and 2 were more-potent BChE inhibitors than galantamine with IC50 values of 3.51 ± 0.80 µM and 2.90 ± 0.56 µM, respectively. The Lineweaver-Burk plots of compounds 1 and 2 indicated they were mixed-mode inhibitors. Compounds 1 and 2 have the potential to be employed as lead compounds for the development of new drugs or medicinal supplements to treat AD.

Development and Evaluation of an e-Book for Bone Health and Osteoporosis Education in Adolescents.

Achieving optimum peak bone mass during adolescence is crucial for lifetime bone health. This study is aimed at developing and assessing an e-book designed for adolescent bone health knowledge and osteoporosis education. A needs assessment was conducted among 43 adolescents, aged 13-16 years, living in urban areas in Malaysia to determine their needs and preference for health educational material. The researchers also searched for relevant guidelines and articles regarding adolescent bone health. Subsequently, an e-book was developed based on the needs assessment and literature search. Five expert panelists (mean work experience = 11.3 years) validated the e-book contents and assessed its understandability and actionability using the Patient Educational Materials Assessment Tool for Audio-Visual Material (PEMAT-A/V). The internet (72.1%), parents (44.2%), television (41.9%), and teachers (39.5%) were the top four sources of health information among the respondents. Magazines (4.6%) and newspapers (11.6%) were the least preferred resources. Most adolescents were interested in cartoon-themed educational materials, and they perceived that including a short video, quiz, and infographic in the educational material would make it much more interactive for users. The developed e-book includes seven infographic chapters, a link to a quiz, and a summary video. The topics cover basic information on bones and the formation and resorption processes, osteoporosis and its risk factors, key nutrients for bone health (calcium and vitamin D), along with their sources and recommended amounts, physical activity and exercise for bone health, and tips for healthy lifestyle practices for bone health. All chapters and the video were rated with a median score of 100% for understandability and actionability, respectively. Some of the comments received from evaluators included that the e-book made good use of infographics, was easy to understand and interesting, and contained well-organized content. Some suggestions for improvement included adding take-home messages relevant to the topic, using colors to highlight keywords, and narrating all points presented in the video. Overall, the newly developed e-book on adolescent bone health was highly rated by expert panelists. However, the acceptance and effectiveness of the e-book in increasing bone health and osteoporosis knowledge among adolescents are yet to be evaluated. The e-book could be used as one of the educational tools to promote bone health in adolescents.

Polydimethylsiloxane/Magnesium Oxide Nanosheet Mixed Matrix Membrane for CO2 Separation Application.

Carbon dioxide (CO2) concentration is now 50% higher than in the preindustrial period and efforts to reduce CO2 emission through carbon capture and utilization (CCU) are blooming. Membranes are one of the attractive alternatives for such application. In this study, a rubbery polymer polydimethylsiloxane (PDMS) membrane is incorporated with magnesium oxide (MgO) with a hierarchically two-dimensional (2D) nanosheet shape for CO2 separation. The average thickness of the synthesized MgO nanosheet in this study is 35.3 ± 1.5 nm. Based on the pure gas separation performance, the optimal loading obtained is at 1 wt.% where there is no observable significant agglomeration. CO2 permeability was reduced from 2382 Barrer to 1929 Barrer while CO2/N2 selectivity increased from only 11.4 to 12.7, and CO2/CH4 remained relatively constant when the MMM was operated at 2 bar and 25 °C. Sedimentation of the filler was observed when the loading was further increased to 5 wt.%, forming interfacial defects on the bottom side of the membrane and causing increased CO2 gas permeability from 1929 Barrer to 2104 Barrer as compared to filler loading at 1 wt.%, whereas the CO2/N2 ideal selectivity increased from 12.1 to 15.0. Additionally, this study shows that there was no significant impact of pressure on separation performance. There was a linear decline of CO2 permeability with increasing upstream pressure while there were no changes to the CO2/N2 and CO2/CH4 selectivity.

Detection of Enterocytozoon hepatopenaei (EHP) (microsporidia) in several species of potential macrofauna-carriers from shrimp (Penaeus vannamei) ponds in Malaysia.

Infection by the microsporidian parasite Enterocytozoon hepatopenaei (EHP) has become a significant problem in the shrimp cultivation industry in Asian countries like Thailand, China, India, Vietnam, Indonesia, and Malaysia. The outbreak of this microsporidian parasite is predominantly related to the existence of macrofauna-carriers of EHP. However, information about potential macrofauna-carriers of EHP in rearing ponds is still limited. In this study, the screening of EHP in potential macrofauna-carriers was conducted in farming ponds of Penaeus vannamei in three states in Malaysia, namely Penang, Kedah, and Johor. A total of 82 macrofauna specimens (phyla: Arthropoda, Mollusca, and Chordata) were amplified through a polymerase chain reaction (PCR) assay targeting genes encoding spore wall proteins (SWP) of EHP. The PCR results showed an average prevalence of EHP (82.93%) from three phyla (Arthropoda, Mollusca and Chordata). The phylogenetic tree generated from the macrofauna sequences was revealed to be identical to the EHP-infected shrimp specimens from Malaysia (MW000458, MW000459, and MW000460), as well as those from India (KY674537), Thailand (MG015710), Vietnam (KY593132), and Indonesia (KY593133). These findings suggest that certain macrofauna species in shrimp ponds of P. vannamei are carriers of EHP spores and could be potential transmission vectors. This study provides preliminary information for the prevention of EHP infections that can be initiated at the pond stage by eradicating macrofauna species identified as potential vectors.

Prediction of CO2 Permeance across ZIF-L@PDMS/PES Composite Membrane.

The current work predicted the permeance of CO2 across a ZIF-L@PDMS/PES composite membrane using two different models. The membrane was fabricated by dipping a PES hollow fiber membrane in a coating solution made using PDMS that contained ZIF-L. First, flat sheet ZIF-L@PDMS membranes were fabricated to verify the role of ZIF-L on the gas separation performance of the membrane. Based on the data, the presence of ZIF-L in the PDMS matrix allowed enhancement of both permeability and selectivity of CO2, where the maximum value was obtained at 1 wt% of ZIF-L. The performance of ZIF-L@PDMS layer, as a function of ZIF-L loading, was well-predicted by the Cussler model. Such information was then used to model the CO2 permeance across ZIF-L@PDMS/PES composite membrane via the correction factor, which was introduced in the resistance in series model. This work discovered that the model must consider the penetration depth and the inorganic loading (in the case of ZIF-L@PDMS/PES). The error between the predicted CO2 permeance and the experimental results was found to be minimal.

Progress and Trends of Optical Microfiber-Based Biosensors.

Biosensors are central to diagnostic and medicinal applications, especially in terms of monitoring, managing illness, and public health. Microfiber-based biosensors are known to be capable of measuring both the presence and behavior of biological molecules in a highly sensitive manner. In addition, the flexibility of microfiber in supporting a variety of sensing layer designs and the integration of nanomaterials with biorecognition molecules brings immense opportunity for specificity enhancement. This review paper aims to discuss and explore different microfiber configurations by highlighting their fundamental concepts, fabrication processes, and performance as biosensors.

Effect of Short-Term Ageing Treatment on Bending Force Behavior of Commercial Nickel-Titanium Archwire.

Superelastic nickel-titanium (NiTi) archwires have become the preferred archwire for orthodontic alignment and the levelling stage due to their ability to exert a light force on teeth throughout a wide range of tooth movement. The magnitude and trend of the force exerted on the malposed tooth is influenced by the orthodontist's consideration of the size and geometry of the NiTi archwire during orthodontic therapy. In this work, a novel approach of a short-term ageing treatment was utilized to modify the magnitude and trend of the bending force of a commercial superelastic NiTi archwire. The bending behavior of the superelastic NiTi archwire was altered by subjecting it to different temperatures in an ageing treatment for 15 min. The bending behavior of the aged NiTi archwire was examined using a three-point and three-bracket setup. The commercial NiTi archwire's bending forces in both the three-point and three-bracket configurations were successfully altered by the 15 min ageing treatment. During unloading in the three-bracket arrangement, the NiTi archwires aged at 490 °C or 520 °C exhibited a lower magnitude and more consistent force compared to the NiTi archwires aged at 400 °C or 430 °C. Ageing the archwire for 15 min at 490 °C produced a suitable size of Ni4Ti3 precipitate, which makes the wire more flexible during bending and reduces the unloading force in the three-bracket bending configuration. The short-term aged NiTi archwire could be used to enhance the force delivery trend to the malposed tooth by lowering the amplitude of the force delivered and sustaining that force throughout the orthodontic treatment duration.

Comparison of the Modified Barthel Index (MBI) Score Trends Among Workers With Stroke Receiving Robotic and Conventional Rehabilitation Therapy.

INTRODUCTION:  Stroke is one of the top causes of adult-acquired disabilities and the fifth most prominent cause of death worldwide. Working-age populations contribute about 40% of the stroke cases which occur annually in Malaysia. The modified Barthel Index (MBI) score has been used for self-care assessment to determine if stroke patients can meet their fundamental needs. The study was designed to compare the trend of MBI scores of workers who had a stroke and underwent robotic rehabilitation therapy to those who had conventional therapy. METHODOLOGY:  A cohort study was conducted among workers who had a stroke in northeastern Malaysia. They were assigned either to undergo robotic or conventional rehabilitation therapy. The robotic therapy is performed three times per day for four weeks. Meanwhile, conventional therapy involved walking exercises five days per week for two weeks. Data were collected for both therapies on the admission, at week 2 and week 4. The MBI, modified Rankin Scale (mRS) and Hospital Anxiety and Depression Scale (HADS) trends were examined one month after the therapies. The R (version 4.2.1) (R Core Team, Vienna, Austria) and RStudio (R Studio PBC, Boston, USA) were applied to perform the descriptive analyses on the respective platforms. Repeated measures of analysis of variance were performed to evaluate the outcomes trend and the effectiveness of the two therapies was also compared. RESULTS: A total of 54 stroke patients participated in this study of which 30 (55.6%) of them received robotic therapy. The age of the subjects ranged from 24 to 59 years and the majority (74.1%) were male. Stroke outcomes were evaluated using mRS, HADS, and MBI scores. Except for their age, the individuals' characteristics did not significantly differ between those undergoing conventional therapy and those receiving robotic therapy. After four weeks, it was found that the good mRS had increased, whereas the poor mRS had decreased. Comparing the therapy groups, the MBI scores improved significantly with time, although there were no significant differences between the therapy groups. However, the interaction term between the treatment group (p=0.031) and improvements over time was significant (p=0.001), indicating that robotic was more effective than conventional therapy in improving the MBI scores. For HADS score, there was a significant difference between the therapy groups (p=0.001), with those receiving robotic therapy having higher HADS score. CONCLUSION:  Functional recovery occurs in acute stroke patients when the mean Barthel Index score rises from the baseline (on admission) to week 2 (during therapy) and subsequently on discharge (week 4). Based on these findings, it appears that there was not one therapy superior to the other; nevertheless, robotic therapy may be better tolerated and more effective in certain individuals.

Associational Resistance to Predation by Protists in a Mixed Species Biofilm.

Mixed species biofilms exhibit increased tolerance to numerous stresses compared to single species biofilms. The aim of this study was to examine the effect of grazing by the heterotrophic protist, Tetrahymena pyriformis, on a mixed species biofilm consisting of Pseudomonas aeruginosa, Pseudomonas protegens, and Klebsiella pneumoniae. Protozoan grazing significantly reduced the single species K. pneumoniae biofilm, and the single species P. protegens biofilm was also sensitive to grazing. In contrast, P. aeruginosa biofilms were resistant to predation. This resistance protected the otherwise sensitive members of the mixed species biofilm consortium. Rhamnolipids produced by P. aeruginosa were shown to be the primary toxic factor for T. pyriformis. However, a rhamnolipid-deficient mutant of P. aeruginosa (P. aeruginosa ΔrhlAB) maintained grazing resistance in the biofilm, suggesting the presence of at least one additional protective mechanism. P. aeruginosa with a deleted gene encoding the type III secretion system also resisted grazing. A transposon library was generated in the ΔrhlAB mutant to identify the additional factor involved in community biofilm protection. Results indicated that the Pseudomonas Quinolone Signal (PQS), a quorum sensing signaling molecule, was likely responsible for this effect. We confirmed this observation by showing that double mutants of ΔrhlAB and genes in the PQS biosynthetic operon lost grazing protection. We also showed that PQS was directly toxic to T. pyriformis. This study demonstrates that residing in a mixed species biofilm can be an advantageous strategy for grazing sensitive bacterial species, as P. aeruginosa confers community protection from protozoan grazing through multiple mechanisms. IMPORTANCE Biofilms have been shown to protect bacterial cells from predation by protists. Biofilm studies have traditionally used single species systems, which have provided information on the mechanisms and regulation of biofilm formation and dispersal, and the effects of predation on these biofilms. However, biofilms in nature are comprised of multiple species. To better understand how multispecies biofilms are impacted by predation, a model mixed-species biofilm was here exposed to protozoan predation. We show that the grazing sensitive strains K. pneumonia and P. protogens gained associational resistance from the grazing resistant P. aeruginosa. Resistance was due to the secretion of rhamnolipids and quorum sensing molecule PQS. This work highlights the importance of using mixed species systems.

Reuse of waste cooking oil (WCO) as diluent in green emulsion liquid membrane (GELM) for zinc extraction.

Zinc (Zn) was identified as one of the most toxic heavy metals and often found contaminating the water sources as a result of inefficient treatment of industrial effluent. A green emulsion liquid membrane (GELM) was proposed in this study as a method to minimize the concentration of Zn ions in an aqueous solution. Instead of the common petroleum-based diluent, the emulsion is reformulated with untreated waste cooking oil (WCO) collected from the food industry as a sustainable and cheaper diluent. It also includes Bis(2-ethylhexyl) phosphate (D2EHPA) as a carrier, Span 80 as a surfactant, sulfuric acid (H2SO4) as an internal phase, and ZnSO4 solution as an external phase. Such formulation requires a thorough understanding of the oil characteristics as well as the interaction of the components in the membrane phase. The compatibility of WCO and D2EHPA, as well as the external phase pH, was confirmed via a liquid-liquid extraction (LLE) method. To obtain the best operating conditions for Zn extraction using GELM, the extraction time and speed, carrier, surfactant and internal phase concentrations, and W/O ratio were varied. 95.17% of Zn ions were removed under the following conditions; 0.001 M of H2SO4 in external phase, 700 rpm extraction speed for 10 min, 8 wt% of carrier and 4 wt% of surfactant concentrations, 1:4 of W/O ratio, and 1 M of internal phase concentration.

Cardiovascular Diseases in the Patients With Psoriatic Arthritis.

There are limited data regarding the burden and trend of cardiovascular diseases (CVD) in psoriatic arthritis (PsA). We analyzed the National Inpatient Sample database from January 2005 to December 2018 to examine the hospitalization trends amongst adults with PsA primarily for heart failure (HF), acute myocardial infarction (AMI), and stroke. The primary outcomes of interest included in-hospital mortality, length of stay (LOS), and inflation-adjusted cost. The age-adjusted percentage of HF hospitalizations among PsA patients decreased from 2.5% (2005/06) to 1.4% (2011/12; P-trend 0.013) and subsequently increased to 2.0% (2017/18; P-trend 0.044). The age-adjusted percentage of AMI hospitalizations among PsA patients showed a non-statistically significant decreasing trend from 2.1% (2005/06) to 1.7% (2011/12; P-trend 0.248) and showed a non-statistically significant increase to 2.3% (2017/18; P-trend 0.056). The age-adjusted stroke hospitalizations increased from 1.1% (2005/06) to 1.3% (2017/18; P-trend 0.036). Apart from a decrease in adjusted inflation-adjusted cost among heart failure hospitalizations, there was no significant change in inpatient mortality, length of stay or hospital cost, during the study period. We found an increasing trend of cardiovascular hospitalizations in patients with PsA. These findings will raise awareness and inform further research and clinical practice for PSA patients with CVD.

Analysing Public Health Impact of Misinformation During COVID-19 Pandemic using the Socio-Ecological Model: A Systematic Review

@#Introduction: Social media and Internet use during disasters have been proven to be useful tools in helping public health agencies to respond to pandemics. However, this tool can also be the culprit in the spread of misinformation to the public. This study aims to identify the public health impact of misinformation during the COVID-19 pandemic using the socio-ecological model. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was initially undertaken by searching relevant articles published from January to November 2020 in several electronic databases including Medline, PubMed, and Springer link. All publications produced in English regarding the impact of misinformation during the COVID-19 outbreak were included except review articles. Results: Eleven articles were identified from these databases. The public health impact of misinformation from these articles was analysed and discussed according to the domains of the socio-ecological model. It was found that various elements of misinformation on the COVID-19 pandemic caused a significant impact on the individual, interpersonal, organisational, community, and policy levels across various nations. Conclusion: This study concludes that addressing misinformation during a pandemic such as the COVID-19 phenomenon is an important measure to improve public health response in mitigating the spread of pandemics.

Oral Health Status and Salivary Parameters in Stroke Patients at a Tertiary Hospital

@#Introduction: Dental caries and impaired salivary function are very common but undertreated. The aim of this study was to investigate the oral health status and salivary parameters of stroke patients. Methods: A cross-sectional study was carried out on 54 stroke and 54 non-stroke patients attending rehabilitation treatment at Hospital Universiti Sains Malaysia. Decay, Missing and Filled Teeth (DMFT) index and plaque scores were used to evaluate patients’ oral health. Salivary parameters such as salivary cortisol, salivary flow rate, pH and buffering capacity were measured. Salivary cortisol was analysed using Cobas E6000 automated immunoassay. Results: Among the 54 stroke patients, the majority were Malays 72.2% and 63.0% were male, with a mean age of 48.1 (14) years. There was a significant difference of dental caries between stroke patients, at 17.6 (4.26), compared to 15.7 (5.38) for non-stroke patients (p=0.042). Only 53.7% of stroke patients had good oral hygiene, compared to, 85.2% among non-stroke patients’ (p-value= 0.001). Salivary parameters showed no significant differences (p>0.05). However salivary cortisol levels were higher in stroke patients 5.2(5.1) nmol/L) than in non-stroke patients 4.0 (3.6) nmol/L). There was no significant correlation between salivary parameters and DMFT index (P>0.05). Conclusion: Stroke patients had more dental caries and poor oral hygiene compared to non-stroke patients. Salivary parameters showed no significant difference between stroke and non-stroke patients.

Potential Effects of Non-Surgical Periodontal Therapy on Periodontal Parameters, Inflammatory Markers, and Kidney Function Indicators in Chronic Kidney Disease Patients with Chronic Periodontitis.

Chronic kidney disease (CKD) and chronic periodontitis (CP) contribute to the increased level of inflammatory biomarkers in the blood. This study hypothesized that successful periodontal treatment would reduce the level of inflammatory biomarkers in CKD patients. This prospective study recruited two groups of CP patients: 33 pre-dialysis CKD patients and 33 non-CKD patients. All patients underwent non-surgical periodontal therapy (NSPT). Their blood samples and periodontal parameters were taken before and after six weeks of NSPT. The serum level of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and periodontal parameters were compared between groups. On the other hand, kidney function indicators such as serum urea and estimated glomerular filtration rate (eGFR) were only measured in CKD patients. Clinical periodontal parameters and inflammatory markers levels at baseline were significantly higher (p < 0.05) in the CKD group than in the non-CKD group and showed significant reduction (p < 0.05) after six weeks of NSPT. CKD patients demonstrated a greater periodontitis severity and higher inflammatory burden than non-CKD patients. Additionally, CKD patients with CP showed a good response to NSPT. Therefore, CKD patients' periodontal health needs to be screened for early dental interventions and monitored accordingly.

Evaluation of SARS-CoV-2 Antibody Response Post Third Dose COVID-19 mRNA Vaccination at Universitas Indonesia Hospital.

OBJECTIVE: The longevity of vaccine effectiveness and antibody titer after the Moderna mRNA COVID-19 vaccination booster in healthcare workers in Indonesia is not known. MATERIALS AND METHODS: We performed a prospective observational study of healthcare workers at the Universitas Indonesia Hospital after Moderna mRNA COVID-19 booster vaccination. An Immunology Analyzer with Chemiluminescence Immunoassay (CLIA) test was used to examine Anti SARS-CoV-2 S-RBD levels. Antibody levels were classified into two systems (3 categories, and 2 categories). RESULTS: There were 31 male subjects (75.6%), 33 subjects (80.5%) aged 25-39 years, 17 subjects (41.5%) with overweight BMI, 35 subjects (85.4%) without comorbidities, and 29 subjects without previous history of COVID-19 infection (70.7%) who had antibody titer >1000 AU/ml. There were 27 subjects (65.9%) who had a booster shot ≥6 months after the second vaccination with antibody titer >1000 AU/ml. In this study, there was no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination. CONCLUSION: There is no significant correlation between antibody titer with factors such as gender, age, BMI, comorbidities, history of COVID-19 infection and time between the 2nd vaccination and booster vaccination.