Dysbiosis of Fecal Microbiota in Tg2576 Mice for Alzheimer's Disease during Pathological Constipation.

Tg2576 transgenic mice for Alzheimer's disease (AD) exhibited significant phenotypes for neuropathological constipation, but no research has been conducted on the association of the fecal microbiota with dysbiosis. The correlation between fecal microbiota composition and neuropathological constipation in Tg2576 mice was investigated by examining the profile of fecal microbiota and fecal microbiota transplantation (FMT) in 9-10-month-old Tg2576 mice with the AD phenotypes and constipation. Several constipation phenotypes, including stool parameters, colon length, and histopathological structures, were observed prominently in Tg2576 mice compared to the wild-type (WT) mice. The fecal microbiota of Tg2576 mice showed decreases in Bacteroidetes and increases in the Firmicutes and Proteobacteria populations at the phylum level. The FMT study showed that stool parameters, including weight, water content, and morphology, decreased remarkably in the FMT group transplanted with a fecal suspension of Tg2576 mice (TgFMT) compared to the FMT group transplanted with a fecal suspension of WT mice (WFMT). The distribution of myenteric neurons and the interstitial cells of Cajal (ICC), as well as the enteric nervous system (ENS) function, remained lower in the TgFMT group. These results suggest that the neuropathological constipation phenotypes of Tg2576 mice may be tightly linked to the dysbiosis of the fecal microbiota.

The application of the Index of Orthognathic Functional Treatment Need (IOFTN): service evaluation and impact.

OBJECTIVES: (1) To undertake a service evaluation of the Index of Orthognathic Functional Treatment Need (IOFTN). (2) To determine its suitability to replace the Index of Orthodontic Treatment Need (IOTN) in the assessment of patients with dentofacial deformity. DESIGN: Laboratory- and questionnaire-based study. SETTING: UK hospital-based orthodontic department. METHODS: Cohen's Kappa was used to assess inter- and intra-operator reliability for the IOTN and the IOFTN against 30 orthognathic patients' models scored to a 'gold standard'. Questionnaires gathered feedback on ease of use of the IOFTN. Change in treatment need status for a further 60 orthognathic patients was estimated utilising the IOTN, the IOFTN and a modified IOTN (mIOTN). RESULTS: Inter-operator agreement with the 'gold standard' for the IOTN and the IOFTN ranged from 0.64-0.90 and 0.61-0.91, respectively. Intra-operator agreement for the IOTN and the IOFTN ranged from 0.46-1.00 to 0.59-0.95, respectively. Mean feedback score was 9.08 out of a maximum score of 10. Overall, 88.9% of patients scored grades 4 or 5 on the IOFTN (IOTN = 87.8%; mIOTN = 77.8%). CONCLUSIONS: The IOFTN is simple and reliable to use. It is an appropriate aid in the prioritisation of surgical patients. Further recommendations are given.

STAPHYLOCOCCUS AUREUS AND STREPTOCOCCUS PNEUMONIAE PREVALENCE AMONG ELDERLY ADULTS IN JAKARTA, INDONESIA.

We studied Staphylococcus aureus and Streptococcus pneumoniae carriage among elderly adults in Jakarta, Indonesia. Nasopharyngeal swabs were collected from 149 adults aged 60-97 years. Both S. aureus and S. pneumoniae were identified by conventional and molecular methods. Methicillin-resistant Staphylococcus aureus (MSRA) was determined by PCR and antibiotic susceptibility using the disk diffusion method. Pneumococcal serotyping was performed with sequential multiplex PCR. We found S. aureus and S. pneumoniae present in 42 and 4 elderly adults respectively, and MRSA prevalence of 6%. Serotypes 3, 6A/B, 15B/C and 35F were identified among the four pneumococcal isolates. The majority of S. aureus isolates were susceptible to chloramphenicol (93%) and sulfamethoxazole/trimethoprim (93%), followed by gentamicin (88%), erythromycin (83%), penicillin (79%) and tetracycline (74%). Thus S. aureus prevalence is higher than that of S. pneumoniae, and a high frequency of MRSA carried by elderly adults in Jakarta, Indonesia.

Research progress on the influencing factors and response mechanisms of plant adsorption of atmospheric particulate matter.

Plants could effectively adsorb and remove particulate matter from the air, while could be suffered from the adverse effects. Therefore, exploring the interaction between plants and atmospheric particulate matter is crucial for profound understanding of ecological balance, microenvironmental climate, and environmental quality improvement. Few systematic literature have elaborated the adsorption and response mechanisms of atmospheric particulate matter by plants. We summarized the causes and composition of atmospheric particulate matter, as well as the adsorption methods and factors of plants on atmospheric particulate matter. Moreover, we elaborated the impact of atmospheric particulate matter stress on phenotypic and physiological characteristics, as well as molecular mechanisms. For the future researches, we proposed 1) to select plant species with strong adaptability and high dust retention capacity. Subsequently, there should be a universal green dust retention plan on account of comprehensive factors such as plant community structure, street morphology, and planting space; 2) to extend the research from urban areas to agricultural and pastoral areas, with a systematic analysis of the comprehensive dust retention capacity of communities with different plant configuration; 3) to effectively combine the dust retention capacity of plants with their own resistance. Subsequently, we should explore the physiological and molecular mechanisms of plants responding to atmospheric particulate matter stress and establish a comprehensive evaluation system and criteria; 4) to develop in situ labeling detection technology, which would be a valuable tool for accurately tracing and quanti-fying the dynamics of atmospheric particulate matter within plant at the cellular level.

Research elevation of bank lending and technological innovation in the excess liquidity countries.

This study examines the intellectual framework research in bank lending and technological innovation relationships in countries with high banking system liquidity. This study employs bibliometrics with R-studio tools and procedures to analyze documents regarding productions, collaborations, keyword occurrences, conceptual structure, and density and centrality occurrence's network. Combining data from the Web of Science and Scopus databases, this study obtained 939 documents from 527 sources with a significant opportunity for further elevation through combination with other themes. The development analysis based on the most related countries indicates that researchers from other countries have also conducted studies identified as having significant banking liquidity. Topic development and thematic evolution show that research on the role of bank lending on technological innovation evolves to environmental issues, with green credit as the most recent and emerging elaboration. For further direction, keywords in investment clusters can help elevate education, commerce, and impact clusters by combining them with research on government taxation, credit provision, sustainable development, and emission control themes.

Anabolic metabolism of autotoxic substance coumarins in plants.

Background: Autotoxicity is an intraspecific manifestation of allelopathy in plant species. The specialized metabolites and their derivatives that cause intraspecific allelopathic inhibition in the plant are known as autotoxic substances. Consequently, autotoxic substances production seriously affects the renewal and stability of ecological communities. Methods: This article systematically summarizes the types of autotoxic substances present in different plants. They mainly include phenolic compounds, terpenoids, and nitrogenous organic compounds. Phenolic coumarins are the main autotoxic substances in many plants. Therefore, we also discuss differences in coumarin types and content among plant varieties, developmental stages, and tissue parts, as well as their mechanisms of autotoxicity. In addition, we review the metabolic pathways involved in coumarin biosynthesis, the key enzymes, genes, and transcription factors, as well as factors affecting coumarin biosynthesis. Results: Coumarin biosynthesis involves three stages: (1) the formation of the coumarin nucleus; (2) acylation, hydroxylation, and cyclization; (3) structural modification. The key enzymes involved in the coumarin nuclear formation stage include PAL, C4H, 4CL, HCT, CAOMT, COSY, F6'H, and CCoAOMT1, and the key genes involved include BGA, CYP450 and MDR, among others. Ortho-hydroxylation is a key step in coumarin biosynthesis and PS, COSY and S8H are the key enzymes involved in this process. Finally, UGTs are responsible for the glycosylation modification of coumarins, and the MaUGT gene may therefore be involved in coumarin biosynthesis. Conclusion: It is important to elucidate the autotoxicity and anabolic mechanisms of coumarins to create new germplasms that produce fewer autotoxic substances.

The Effect of G. applanatum Crude Polysaccharide Extract on Proinflammatory Cytokines and Proapoptotic Caspases in HeLa Cell Line: An In Vitro Study.

Polysaccharide extracts exhibit promise as potential anticancer agents. Among the fungi rich in polysaccharide content, G. applanatum stands out; however, its anticancer activity necessitates further investigation. This study aims to explore the impact of G. applanatum crude polysaccharide (GACP) extract by assessing its effects on cell viability, levels of proinflammatory cytokines such as TNF-α, IFN-γ, IL-2, and IL-12, and levels of proapoptotic markers including caspase-3 and caspase-9, as well as the percentages of necrosis and apoptosis in the HeLa cell line. Employing the HeLa cell line as a research model, four groups were studied: KN (media and DMSO), K+ (doxorubicin 10 µg/mL), P1 (G. applanatum extract 200 µg/mL), and P2 (G. applanatum extract 400 µg/mL). The G. applanatum extract was obtained via boiling distilled water. Anticancer activity was evaluated through the MTT test (3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide) conducted over three treatment durations (24, 48, and 72 hours). Cytokine levels and caspase-3 and caspase-9 levels were assessed using the ELISA test. Cell apoptosis was determined using the Annexin V-PI biomarker and analyzed through flow cytometry. The MTT test exhibited optimal results at the 48-hour treatment mark. Cytokine level analysis revealed significant reductions in TNF-α, IFN-γ, IL-2, and IL-12 levels (p < 0.005). Concurrently, caspase-3 and caspase-9 levels exhibited substantial increases (p < 0.005). Flow cytometry highlighted the highest percentage of apoptosis in HeLa cells. In conclusion, G. applanatum's polysaccharide extract demonstrates potential as an anticancer and therapeutic agent for cancer treatment.

Cross-Breeding Improvement and Performance Analysis of Dominant Production Traits in Grazing-Type Alfalfa (Medicago sativa L.).

Rhizome-rooted Medicago sativa L. "Qingshui" is an excellent germplasm for establishing grazing and ecological grasslands but inferior in yield, in which both high production and ecological values can be achieved by cross-breeding. We have obtained valuable rhizome-rooted hybrid strains (RSA-01, RSA-02, and RSA-03) by crossing of Qingshui and the high-yielding Medicago sativa L. "WL168." In this study, the Qingshui plants with low production performance were crossed for improvement, and progenies with better production and higher quality than those of Qingshui were selected. The results reveal that the branch number, crude protein (CP) content, and relative feed value (RFV) of RSA-01; the stem thickness, CP content, and ether extract (EE) content of RSA-02; and the plant height, stem thickness, branch number, and dry hay yield of RSA-03 were higher than those of Qingshui. Except for the leaf/stem ratio and plant height of RSA-01, leaf/stem ratio of RSA-02, and plant height of RSA-03, the coefficient of variation (CV) of yield traits of the hybrid strains was lower than those of Qingshui, ranging from 0.1% to 4.28%. In addition to the lignin and acid detergent fiber content of RSA-01 as well as EE content of RSA-02 and RSA-03, the CV of the nutritional traits of the hybrid strains was low, ranging from 0.60% to 3.43%. The tested samples were ranked as follows based on yield performance and nutritional values: WL168 > RSA - 03 > RSA - 01 > RSA - 02 > Qingshui and RSA - 01 > WL168 > RSA - 03 > Qingshui > RSA - 02, respectively. Compared with parental Qingshui, RSA-01, RSA-02, and RSA-03 show better yield performance; meanwhile, RSA-01 and RSA-03 had higher nutritional traits. RSA-01 shows heterosis in branch number, CP content, and RFV; RSA-02 shows heterosis in stem thickness and RSA-03 in plant height, stem thickness, branch number, fresh yield, dry hay yield, and CP content. Notably, the low production performance of Qingshui was improved after crossing it with WL168, substantially resulting in an abundant rhizome-rooted germplasm resource for the establishment of grazing grasslands.

Development model of integrated development post for non-communicable diseases in West Java of Indonesia.

Data from the West Java Health Office in 2013 stated that the prevalence of non-communicable diseases (NCD), one of which is diabetes Mellitus, was 4.2% with pre-diabetes at 7.8% and 144 cases in the work area of the Singaparna Puskesmas.1 Empowerment of Posbindu cadres with NCD (PTM) ) to reduce cases of PTM. The purpose of this research is to develop a model of empowerment of Posbindu PTM by increasing the role and skills of the Posbindu PTM cadres. This study uses a combined or collaborative method approach, namely qualitative and quantitative. Sampling by stratified random sampling from August to November 2019 consisted of four government stakeholders as research informants, and 16 Posbindu PTM cadres. Collecting data using questionnaires, in-depth interviews, and Focus Group Discussions (FGD). Analysis using thematic content analysis and Wilcoxon Test. Results shows in qualitative research that cadres have knowledge about the role of cadres, but do not yet know the main tasks and functions of cadres and do not have cadre skills. The quantitative analysis showed that there were differences in the knowledge and skills of cadres after training compared to before training p = 0.000 (p < 0.05). In conclusion, Cadres know the role of cadres through training. There were differences in the knowledge and skills of cadres after training compared to before training.

The effect of statin administration on IL-6 and IL-1b expression in peripheral blood mononuclear cells of a hypertensive patient with SARS-CoV-2 spike protein stimulation.

Aim The infection of the SARS-CoV-2 virus potentially causes a cytokine storm with elevated IL-6 and IL-1ß levels. Statin therapy was common among COVID-19 patients due to their cardiovascular comorbidities. However, the effect of statins on COVID-19 infection is unclear. The aim of this study was to evaluate the impact of statin administration on IL-6 and IL-1ß level in peripheral blood mononuclear cells (PBMCs) after SARS-CoV-2 spike protein stimulation. Methods The PBMCs were isolated from a hypertensive patient and stimulated by the SARS-CoV-2 subunit S1 spike protein. The PBMCs were then divided into four treatment groups and treated with simvastatin at various doses (10 µM, 25 µM, 50 µM, and control). IL-6 and IL-1ß were measured from the supernatant using the ELISA method. Results The stimulation of SARS-CoV-2 spike protein in PBMC cell culture statistically increased IL-6 and IL1ß expression of 5.2 and 35.07 fold, respectively (p<0.05). The expressions of IL-6 and IL-1ß were not statistically significant among three simvastatin doses and control. Conclusion Statin administration did not have significant effect on IL-6 and IL-1ß levels in PBMCs after SARS-CoV-2 spike protein stimulation in this study, a further study is needed.

Antioxidative Role of Hygrophila erecta (Brum. F.) Hochr. on UV-Induced Photoaging of Dermal Fibroblasts and Melanoma Cells.

Antioxidants are an important strategy for treating photoaging because excessive reactive oxygen species (ROS) are produced during UV irradiation. The therapeutic effects of methanol extracts of Hygrophila erecta (Brum. F.) Hochr. (MEH) against UV-induced photoaging were examined by monitoring the changes in the antioxidant defense system, apoptosis, extracellular matrix (ECM) modulation, inflammatory response, and melanin synthesis in normal human dermal fibroblast (NHDF) cells and melanoma B16F1 cells. Four bioactive compounds, including 4-methoxycinnamic acid, 4-methoxybenzoic acid, methyl linoleate, and asterriquinone C-1, were detected in MEH, while the DPPH free radical scavenging activity was IC50 = 7.6769 µg/mL. UV-induced an increase in the intracellular ROS generation, NO concentration, SOD activity and expression, and Nrf2 expression were prevented with the MEH treatment. Significant decreases in the number of apoptotic cells, the ratio of Bax/Bcl-2, and cleaved Cas-3/Cas-3 were observed in MEH-treated NHDF cells. The MEH treatment induced the significant prevention of ECM disruption and suppressed the COX-2-induced iNOS mediated pathway, expression of inflammatory cytokines, and inflammasome activation. Finally, the expression of the melanin synthesis-involved genes and tyrosinase activity decreased significantly in the α-melanocyte-stimulating hormone (MSH)-stimulated B16F1 cells after the MEH treatment. MEH may have an antioxidative role against UV-induced photoaging by suppressing ROS-induced cellular damage.

Artocarpus sericicarpus stem bark contains antimalarial substances against Plasmodium falciparum.

OBJECTIVES: The finding of alternative medicine for malarial treatment still has become a substantial demand. The plant is one of the potential sources of drugs, among other natural sources. Artocarpus species showed great potential as the antimalarial source. This study aims to obtain active antimalarial fractions from Artocarpus sericicarpus stem bark. METHODS: Stem bark of A. sericicarpus was extracted by ultrasonic-assisted extraction method using n-hexane, dichloromethane, and methanol as solvents. Fractionation of dichloromethane extract was conducted by open column chromatography using octadecyl silica as a stationary phase and gradient acetonitrile-water as a mobile phase. The antimalarial activity was determined by lactate dehydrogenase (LDH) assay against Plasmodium falciparum 3D7 strain. RESULTS: A. sericicarpus n-hexane, dichloromethane, and methanol extracts were showed antimalarial activity with an IC50 value of >4, 2.11, and >4 µg/mL, respectively. Fractionation of dichloromethane extract was obtained 13 fractions. Seven of the 13 fractions tested showed antimalarial activity. Fraction-6 performed the highest inhibition with an IC50 value of 1.53 ± 0.04 µg/mL. Phytochemistry screening revealed that Fraction-6 contains flavonoid, polyphenol, and terpenoid compounds that can take a role in its antimalarial activity. CONCLUSIONS: A. sericicarpus contains antimalarial substances mainly in Fraction-6, which strongly inhibited the growth of P. falciparum. The flavonoid, polyphenol, and terpenoid compounds were identified in Fraction-6, which need to be further isolated to obtain and elucidate the active antimalarial compounds.

Association of calcium channel blocker use with clinical outcome of COVID-19: A meta-analysis.

AIMS: This meta-analysis aims to analyze the association of calcium channel blocker (CCB) use with COVID-19 clinical outcomes. METHODS: PubMed, ProQuest, Science Direct, Scopus, and medRxiv databases were searched systematically in a limited period. The primary outcome was mortality. RESULTS: A total of 119,298 patients from 31 eligible studies were included. Pooled analysis of the random-effect model revealed CCB was not associated with reduced mortality (OR = 1.21 [95%CI: 0.98-1.49], p = 0.08). Interestingly, subgroup analysis in hypertensive patients revealed significantly reduced mortality (OR = 0.69 [95%CI: 0.52-0.91], p = 0.009). CONCLUSION: CCB usage was not associated with the outcome of COVID-19. However, CCB was associated with a decreased mortality rate in hypertensive COVID-19 patients.

Elevated fibrinogen and fibrin degradation product are associated with poor outcome in COVID-19 patients: A meta-analysis.

INTRODUCTION: COVID-19 is a systemic infection with a significant impact on coagulation which manifests in thromboembolism. There is an unknown relationship of which coagulation profile parameter at presentation has an association with poor outcome in COVID-19. OBJECTIVE: This meta-analysis aimed to determine the relationship between fibrinogen and FDP with poor outcome in COVID-19 patients. METHODS: A systematic search of all observational studies or trials involving adult patients with COVID-19 that had any data fibrinogen or FDP on admission was carried out using the PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We assessed the methodological quality assessment using the NIH Quality Assessment Tool. We performed random-effects inverse-variance weighting analysis using mean difference (MD). RESULTS: A total of 17 studies (1,654 patients) were included in this meta-analysis. It revealed a higher mean of fibrinogen levels on admission in patients with severe case compared to those with non-severe case (MD = 0.69, [95% CI: 0.44 to 0.94], p < 0.05; I2 = 72%, p < 0.05). Non-survivor group had a pooled higher mean difference of fibrinogen values on admission (MD = 0.48 [95% CI: 0.13 to 0.83], p < 0.05; I2 = 38%, p = 0.18). Higher FDP on admission was found in poor outcome (composite of severity, critically ill, and mortality) compared to good outcome (4 studies, MD = 4.84 [95% CI: 0.75 to 8.93], p < 0.05; I2 = 86%, p < 0.05). CONCLUSION: Elevated fibrinogen and FDP level on admission were associated with an increase risk of poor outcome in COVID-19 patients.

Relationship of D-dimer with severity and mortality in SARS-CoV-2 patients : A meta-analysis.

INTRODUCTION: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic. Many studies have shown that several laboratory parameters are related to disease severity and mortality in SARS-CoV-2 cases. This meta-analysis aimed to determine the relationship of a prognostic factor, D-dimer, with disease severity, need for intensive care unit (ICU) care, and mortality in SARS-CoV-2 patients. METHODS: A systematic search for all observational studies and trials involving adult patients with SARS-CoV-2 that had any data related to D-dimer on admission was conducted using PubMed, Science Direct, Scopus, ProQuest, and MedRxiv databases. We performed random-effects inverse-variance weighting analysis using mean difference (MD) of D-dimer values for outcomes such as disease severity, mortality, and need for ICU care. RESULTS: A total of 29 studies (4,328 patients) were included in this meta-analysis, which revealed a higher mean of D-dimer levels on admission in severe patients than in nonsevere patients (MD = 0.95, [95% confidence interval (CI): 0.61-1.28], P < .05; I2  = 90%). The nonsurvivor group had a higher pooled MD of D-dimer values on admission (MD = 5.54 [95% CI: 3.40-7.67], P < .05; I2  = 90%). Patients who needed ICU admission had insignificantly higher D-dimer values than patients who did not need ICU admission (MD = 0.29, [95% CI: -0.05 to 0.63], P = .10; I2  = 71%). CONCLUSION: Elevated D-dimer levels on admission were associated with an increased risk of disease severity and mortality in patients with SARS-CoV-2 infection.

Evaluation of heart rate variability using 24-hour Holter electrocardiography in hypertensive patients.

BACKGROUND: Hypertension (HTN) remains a serious risk factor for cardiovascular mortality across the world. Hypertensive state has been shown to be associated with autonomic nervous function. This study aimed to explore the association between autonomic nervous impairment assessed by heart rate variability (HRV) and HTN. METHODS: A total of 52 hypertensive and 55 non-hypertensive patients were consecutively studied using 24-hour Holter. The hypertensive patients were grouped into controlled blood pressure (BP) and uncontrolled BP. This study compared HRV in non-hypertensive and hypertensive patients; and hypertensive patients with controlled and uncontrolled BP. HRV parameters include time and frequency domain. RESULTS: Mean age for hypertensive and non-hypertensive patients were 53.58 ± 14.31 and 44.89 ± 16.63 years old, respectively. Median (IQR) SDNN for hypertensive and non-hypertensive group were 109.00 (90.00-145.00) and 129.00 (107.00-169.00), respectively. SDNN, ASDNN, rMSSD, pNN50, BB50, VLF, and HF values were significantly lower in the hypertensive group compared to non-hypertensive group (all P < .05). A multiple regression analysis showed that HRV parameters: SDANN, ASDNN, rMSSD, and LF values were independent risk factors of HTN. SDNN, SDANN, ASDNN, VLF, LF, and HF values were significantly lower in the uncontrolled BP compared to controlled BP group (all P < .05). A multiple regression analysis showed that HRV parameters: SDNN, SDANN, rMSSD, and HF values were independent risk factors of uncontrolled BP in hypertensive patients. CONCLUSIONS: Our study showed that cardiac autonomic nervous impairment, as demonstrated by reduced HRV, is significantly associated with HTN. Decreased HRV was more evident in uncontrolled BP than in controlled BP group.

Electrocardiographic abnormalities among late-stage non-dialysis chronic kidney disease patients.

OBJECTIVES: Cardiovascular disease (CVD) complication is common among chronic kidney disease (CKD) patients. Thus, knowledge about CVD and ECG abnormalities in CKD are essential due to progressive nature of the disease and increased risk of sudden cardiac death. This study aims to scrutinize the ECG abnormalities among nondialysis late-stage CKD patients. METHODS: A descriptive observational study was conducted at Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with late-stage CKD between 1 January and 31 December 2019, who were consulted at the department of cardiology and vascular medicine during their initial admission at emergency room. ECG interpretation for this study was done by qualified cardiologist. RESULTS: There were 191 patients included in this study. Mean ages were 52.2 ± 11.8 years old and 51% were males. Total 143 (74.9%) patients had anemia, 111 (58.1%) had hypertension and 75 (39.3%) had type 2 diabetes mellitus. Mean serum creatinine was 10.5 ± 8.0 mg/dL. There were 176 (92.1%) patients with at least one form of ECG abnormalities. Prolonged QTc interval (36.6%), fragmented QRS complex (29.8%), poor R wave progression (24.6%), peaked T wave (22.0%) and left ventricular hypertrophy (16.7%) were the most common abnormalities. CONCLUSIONS: ECG abnormalities are common among nondialysis late-stage CKD patients. Given the fact that long-term CKD influences the pathogenesis cardiovascular diseases and substantial cardiovascular mortality, there is a need to screen Indonesian CKD patients who are at risks of getting earlier complications.

The 'lifespan' of mandibular repositioning appliances.

Introduction Mandibular replacement appliances (MRAs) can be used in the treatment of snoring, mild to moderate obstructive sleep apnoea and as a second-line treatment where continuous positive airway pressure (CPAP) fails. There is currently a paucity of evidence as to how long these appliances last.Aims Assess the replacement rate for MRAs using this as a proxy for lifespan; estimate the period prevalence of temporomandibular joint disorder (TMJD) and bruxism in the study population.Methods Prospective observational study as part of service evaluation. Data from consecutive patients seeking a replacement MRA were collected over a three-month period, yielding a sample of 60. The mean time between the provision of appliances was calculated in months. Reasons for replacement were sought, collated and categorised. Patients were asked to report any TMJD symptoms and bruxing.Results The mean replacement rate was 36.7 months. The main reasons for replacement were: device condition; fit and reduced effectiveness; and other minor reasons reported. Period prevalence of TMJD was 6.7%; bruxism was reported in 5% of patients.Conclusions A 'lifespan' of ust over three years for thermoplastic MRAs is estimated. The main reasons for replacement were: condition, poor fit and reduced effectiveness. MRAs do not appear to increase the frequency of TMJD and bruxism.

The effect of advance telephone prompting in a survey of general dental practitioners in scotland: a randomised controlled trial.

OBJECTIVES: Evaluation of advance telephone prompting on the response rate to a postal, self-completed questionnaire. To provide an estimate of the cost of such a strategy. METHOD: A sample of 315 GDPs was randomly selected from a randomised database of GDPs practicing in Scotland. 157 GDPs were randomly allocated to receive an advance telephone prompt, via the practice receptionist; 158 were allocated to a control group. Four days after prompting all trial participants were mailed identical questionnaires, cover letter and postage paid return envelope. RESULTS: Response rates: 53%--advance telephone prompt group and 40%--control group. The effect size, 13%, was found to be statistically significant, p = 0.026. Total estimated strategy costs: 74.00 pounds sterling. The incremental cost was estimated to be 4.93 pounds sterling for each additional response. CONCLUSIONS: Advance telephone prompting of GDP's, via the practice receptionist, statistically significantly improves the response rate to a postal self-completed questionnaire. This is estimated to be a cost effective strategy for improving response rates to postal questionnaires.

Use and knowledge of IOTN among GDPs in Scotland.

OBJECTIVES: To evaluate the use and knowledge of the index of orthodontic treatment need (IOTN) by general dental practitioners (GDPs) working within Scotland. SETTING: Scottish general dental services (SGDS). METHODS: Questionnaires were posted to randomly selected dentists (n=356) working within the SGDS for self-completion and return. MAIN OUTCOME MEASURES: Use of IOTN.Knowledge of IOTN Participants were asked to match 12 malocclusions to the correct IOTN category. Kappa statistics evaluated agreement to a gold standard. RESULTS: The overall response rate was 64%. Sixty-one percent of respondents did not use IOTN. The most common reason for using the index was to assess treatment eligibility (40.2%). The main reason for non-use was that it was only considered suitable for secondary dental care (27%). Over half (56%) of respondents had received IOTN training at undergraduate level. Knowledge of the index was found to be low--the mean level of agreement was k=0.42 (fair). 10.5% of respondents scored k≥0.61(substantial). The factors most likely to contribute to both use and knowledge of IOTN were having a postgraduate qualification and carrying out orthodontic treatment in practice. CONCLUSION: Overall use and knowledge of IOTN among GDPs in Scotland appears to still be low. More resources need to be directed towards improving both undergraduate and postgraduate orthodontic training with the focus on IOTN in particular.