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Jonathan Bergman,1–3 Aaron A Laviana,1 1Department of Urology, 2Department of Family Medicine, David Geffen School of Medicine at UCLA, 3Veterans Health Affairs-Greater Los Angeles, Los Angeles, CA, USA Abstract: Palliative care involves aggressively addressing and treating psychosocial, spiritual, religious, and family concerns, as well as considering the overall psychosocial structures supporting a patient. The concept of integrated palliative care removes the either/or decision a patient needs to make: they need not decide if they want either aggressive chemotherapy from their oncologist or symptom-guided palliative care but rather they can be comanaged by several clinicians, including a palliative care clinician, to maximize the benefit to them. One common misconception about palliative care, and supportive care in general, is that it amounts to “doing nothing” or “giving up” on aggressive treatments for patients. Rather, palliative care involves very aggressive care, targeted at patient symptoms, quality-of-life, psychosocial needs, family needs, and others. Integrating palliative care into the care plan for individuals with advanced diseases does not necessarily imply that a patient must forego other treatment options, including those aimed at a cure, prolonging of life, or palliation. Implementing interventions to understand patient preferences and to ensure those preferences are addressed, including preferences related to palliative and supportive care, is vital in improving the patient-centeredness and value of surgical care. Given our aging population and the disproportionate cost of end-of-life care, this holds great hope in bending the cost curve of health care spending, ensuring patient-centeredness, and improving quality and value of care. Level 1 evidence supports this model, and it has been achieved in several settings; the next necessary step is to disseminate such models more broadly. Keywords: palliative care, end of life, integrated, urology

PurposeWe aimed to compare patient-reported mental health outcomes for men undergoing treatment for localized prostate cancer longitudinally over 5 years.Materials and methodsWe conducted a prospective population-based analysis using the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study. Patient-reported depressive symptoms (Centers for Epidemiologic Studies Depression [CES-D]) and domains of the Medical Outcomes Study 36-item Short Form survey evaluating emotional well-being and energy/fatigue were assessed through 5 years after treatment with surgery, radiotherapy (with or without androgen deprivation therapy) and active surveillance. Regression models were adjusted for outcome-specific baseline function, demographic and clinicopathological characteristics, and treatment approach.ResultsA total of 2,742 men (median [quartiles] age 64 [59-70]) met inclusion criteria. Baseline depressive symptoms, as measured by the CES-D, were low (median 4, quartiles 1-8) without differences between groups. We found no effect of treatment modality on depressive symptoms (p=0.78), though older age, poorer health, being unmarried and baseline CES-D score were associated with declines in mental health. There was no clinically meaningful association between treatment modality and scores for either emotional well-being (p=0.81) or energy/fatigue (p=0.054).ConclusionsThis prospective, population-based cohort study of men with localized prostate cancer showed no clinically important differences in mental health outcomes including depressive symptoms, emotional well-being, and energy/fatigue according to the treatment received (surgery, radiotherapy, or surveillance). However, we identified a number of characteristics associated with worse mental health outcomes including: older age, poorer health, being unmarried, and baseline CES-D score which may allow for early identification of patients most at risk of these outcomes following treatment.

Introduction and objectiveThe timing of radiotherapy (RT) after prostatectomy is controversial, and its effect on sexual, urinary, and bowel function is unknown. This study seeks to compare patient-reported functional outcomes after radical prostatectomy (RP) and postprostatectomy radiation as well as elucidate the timing of radiation to allow optimal recovery of function.MethodsThe Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a prospective, population-based, observational study of men with localized prostate cancer. Patient-reported sexual, urinary, and bowel functional outcomes were measured using the 26-item Expanded Prostate Index Composite at baseline and at 6, 12, 36, and 60 months after enrollment. Functional outcomes were compared among men undergoing RP alone, post-RP adjuvant radiation (RP + aRT), and post-RP salvage radiation (RP + sRT) using multivariable models controlling for baseline clinical, demographic, and functional characteristics.ResultsAmong 1,482 CEASAR participants initially treated with RP for clinically localized prostate cancer, 11.5% (N = 170) received adjuvant (aRT, N = 57) or salvage (sRT, N = 113) radiation. Men who received post-RP RT had worse scores in all domains (sexual function [-9.0, 95% confidence interval {-14.5, -3.6}, P < 0.001], incontinence [-8.8, {-14.0, -3.6}, P < 0.001], irritative voiding [-5.9, {-9.0, -2.8}, P < 0.001], bowel irritative [-3.5, {-5.8, -1.2}, P = 0.002], and hormonal function [-4.5, {-7.2, -1.7}, P = 0.001]) compared to RP alone at 5 years of follow-up. Compared to men treated with RP alone in an adjusted linear model, sRT was associated with significantly worse scores in all functional domains. aRT was associated with significantly worse incontinence, urinary irritation, and hormonal function domain scores compared to RP alone at 5 years of follow-up. On multivariable modeling, RT administered approximately 24 months after RP was associated with the smallest decline in sexual domain score, with an adjusted mean decrease of 8.85 points (95% confidence interval [-19.8, 2.1]) from post-RP, pre-RT baseline.ConclusionsIn men with localized prostate cancer, post-RP RT was associated with significantly worse sexual, urinary, and bowel function domain scores at 5 years compared to RP alone. Radiation delayed for approximately 24 months after RP may be optimal for preserving erectile function compared to radiation administered closer to the time of RP.

BackgroundShared decision making to guide treatment of localized prostate cancer requires delivery of the anticipated quality of life (QOL) outcomes of contemporary treatment options (including radical prostatectomy [RP], intensity-modulated radiation therapy [RT], and active surveillance [AS]). Predicting these QOL outcomes based on personalized features is necessary.ObjectiveTo create an easy-to-use tool to predict personalized sexual, urinary, bowel, and hormonal function outcomes after RP, RT, and AS.Design, setting, and participantsA prospective, population-based cohort study was conducted utilizing US cancer registries of 2563 men diagnosed with localized prostate cancer in 2011-2012.InterventionPatient-reported urinary, sexual, and bowel function up to 5 yr after treatment.Outcome measurements and statistical analysisPatient-reported urinary, sexual, bowel, and hormonal function through 5 yr after treatment were collected using the 26-item Expanded Prostate Index Composite (EPIC-26) questionnaire. Comprehensive models to predict domain scores were fit, which included age, race, D'Amico classification, body mass index, EPIC-26 baseline function, treatment, and standardized scores measuring comorbidity, general QOL, and psychosocial health. We reduced these models by removing the instrument scores and replacing D'Amico classification with prostate-specific antigen (PSA) and Gleason score. For the final model, we performed bootstrap internal validation to assess model calibration from which an easy-to-use web-based tool was developed.Results and limitationsThe prediction models achieved bias-corrected R-squared values of 0.386, 0.232, 0.183, 0.214, and 0.309 for sexual function, urinary incontinence, urinary irritative, bowel, and hormonal domains, respectively. Differences in R-squared values between the comprehensive and parsimonious models were small in magnitude. Calibration was excellent. The web-based tool is available at https://statez.shinyapps.io/PCDSPred/.ConclusionsFunctional outcomes after treatment for localized prostate cancer can be predicted at the time of diagnosis based on age, race, PSA, biopsy grade, baseline function, and a general question regarding overall health. Providers and patients can use this prediction tool to inform shared decision making.Patient summaryIn this report, we studied patient-reported sexual, urinary, hormonal, and bowel function through 5 yr after treatment with radical prostatectomy, radiation therapy, or active surveillance for localized prostate cancer. We developed a web-based predictive tool that can be used to predict one's outcomes after treatment based on age, race, prostate-specific antigen, biopsy grade, pretreatment baseline function, and a general question regarding overall health. We hope both patients and providers can use this tool to better understand expected outcomes after treatment, further enhancing shared decision making between providers and patients.

BackgroundActive surveillance (AS) is an accepted means of managing low-risk prostate cancer. Because of the rarity of downstream events, data from existing AS cohorts cannot yet address how differences in surveillance intensity affect metastasis and mortality. This study projected the comparative benefits of different AS schedules in men diagnosed with prostate cancer who had Gleason score (GS) ≤6 disease and risk profiles similar to those in North American AS cohorts.MethodsTimes of GS upgrading were simulated based on AS data from the University of Toronto, Johns Hopkins University, the University of California at San Francisco, and the Canary Pass Active Surveillance Cohort. Times to metastasis and prostate cancer death, informed by models from the Scandinavian Prostate Cancer Group 4 trial, were projected under biopsy surveillance schedules ranging from watchful waiting to annual biopsies. Outcomes included the risk of metastasis, the risk of death, remaining life-years (LYs), and quality-adjusted LYs.ResultsCompared with watchful waiting, AS biopsies reduced the risk of prostate cancer metastasis and prostate cancer death at 20 years by 1.4% to 3.3% and 1.0% to 2.4%, respectively; and 5-year biopsies reduced the risk of metastasis and prostate cancer death by 1.0% to 2.4% and 0.6% to 1.6%, respectively. There was little difference between annual and 5-year biopsy schedules in terms of LYs (range of differences, 0.04-0.16 LYs) and quality-adjusted LYs (range of differences, -0.02 to 0.09 quality-adjusted LYs).ConclusionsAmong men diagnosed with GS ≤6 prostate cancer, obtaining a biopsy every 3 or 4 years appears to be an acceptable alternative to more frequent biopsies. Reducing surveillance intensity for those who have a low risk of progression reduces the number of biopsies while preserving the benefit of more frequent schedules.

ABSTRACT Introduction: A common reason for people to obtain orthodontic treatment is a misalignment between the upper dental midline and the midline of the face. The process of orthodontic treatment is considered to affect a patient's visual perception before and after the treatment, as well as their satisfaction with treatment, possibly due to the information received during treatment. This study aimed to analyze this visual perception of dental midline deviation differences between orthodontically completely treated and untreated patients. Methods: This was a cross-sectional survey of 90 orthodontic patients, 49 completely treated patients who had completed orthodontic treatment and 41 untreated patients who had not started treatment. Patients were asked to complete a Google Form questionnaire for evaluating 12 intraoral smiling photos with midline deviation and a Likert scale. Bivariate statistical analysis with the Mann Whitney test was carried out to see differences in visual perceptions between two groups. Results: Completely treated patients perceive a 0-1 mm (LCN/L photos) midline deviation of the upper teeth as attractive, while untreated patients perceive a 0-2 mm (LCN photos) and 0-3 mm (L photos) deviation as attractive. The statistical analysis revealed a significant difference in patient perception between completely treated and untreated groups, with a p-value of 0.001 (p

ABSTRAK Pendahuluan: Penggunaan alat ortodonti cekat dapat mempermudah penumpukan debris pada permukaan kawat dan slot breket sehingga dapat meningkatkan kekasaran permukaan dan menghasilkan gaya friksi yang dapat menghambat pergerakan gigi. Air polishing merupakan teknik untuk membersihkan permukaan email gigi dan breket dari biofilm, plak, dan stain. Tujuan penelitian imenganalisis pengaruh bubuk glycine dan erythritol pada prosedur air polishing terhadap kekasaran permukaan slot breket stainless steel. Metode: penelitian eksperimental murni dengan sampel 32 breket stainless steel edgewise slot 0,022 inci yang dilekatkan pada gigi artifisial molar pertama. Pemotongan bagian wing mesial dan distal dilakukan agar jarum detektor surface roughness tester dapat menyentuh slot breket dan dapat bergerak tanpa hambatan, Sampel dilakukan pengukuran kekasaran permukaan slot breket, lalu dibagi menjadi dua kelompok secara acak masing-masing 16 breket. kelompok pertama dilakukan air polishing menggunakan bubuk glycine, dan kelompok kedua menggunakan bubuk erythritol. Uji kekasaran permukaan slot breket diukur dengan parameter roughness average (Ra) menggunakan surface roughness tester. Analisis data menggunakan uji t berpasangan dan uji t independen. Hasil: Perubahan kekasaran permukaan slot breket stainless steel edgewise sebelum dan sesudah prosedur air polishing dengan bubuk glycine dan erythritol memiliki perbedaan yang signifikan (nilai p glycine = 0,0001; nilai p erythritol= 0,0257). Kedua kelompok mengalami penurunan kekasaran sesudah air polishing 0,115 μm dengan glycine dan 0,092 μm dengan erythritol. Penurunan kekasaran sesudah prosedur air polishing dengan bubuk glycine dibandingkan dengan bubuk erythritol tidak terdapat perbedaan yang signifikan (nilai p = 0,6085). Simpulan: Prosedur air polishing dengan bubuk glycine dan erythritol menyebabkan kekasaran permukaan slot breket stainless steel berkurang. Kata kunci: air polishing; glycine; erythritol; kekasaran permukaan slot breket stainless steel; uji kekasaran permukaan ABSTRACT Introduction: Orthodontic treatment using fixed appliances can facilitate the accumulation of debris on the surface of the wire and bracket slots to increase surface roughness and produce frictional forces that inhibit tooth movement. Air polishing is a technique to clean the surface of tooth enamel and brackets from biofilm, plaque, and stains. This study aimed to analyze the effect of glycine and erythritol powder on air polishing procedures on the surface roughness of the stainless steel brackets slot. Methods: This research is laboratory observational. This study used thirty-two first molar stainless steel brackets edgewise with slots 0.022 inches. The mesial and distal wing sections were cut so the surface roughness tester tip could touch the bracket slot and move without obstacles. The sample was measured for the bracket slot surface roughness, then divided into two groups randomly with 16 brackets each. First group consisted of sixteen brackets treated with air polishing using glycine. Second group consisted of sixteen bracket treated with air polishing using erythritol powder. The brackets slot surface roughness test was measured using surface roughness tester with roughness average (Ra) parameter. Afterward, the data were analyzed using paired sample t-test and independent sample t-test. Results: Changes in surface roughness of the stainless steel brackets slot edgewise before and after the air polishing procedure with glycine and erythritol powder had a significant difference (p glycine = 0,0001; p erythritol = 0,0257). Both groups experienced a decrease in roughness after air polishing 0.115 μm with glycine and 0.092 μm with erythritol.The decrease in surface roughness of the stainless steel brackets slot after the air polishing procedure with glycine powder compared to erythritol powder had no significant difference (p = 0,6085). Conclusions: Air polishing with glycine and erythritol powder causes surface roughness reduction of the stainless steel brackets. Keywords: air polishing; glycine, erythritol; surface roughness of stainless steel bracket slot; surface roughness tester

ABSTRAK Pendahuluan: Perawatan ortodonti cekat dengan retraksi gigi anterior rahang atas dapat menyebabkan penurunan tinggi puncak tulang alveolar, karena setiap pergerakan gigi menimbulkan proses resorbsi dan aposisi tulang, bila proses resorbsi lebih besar maka dapat terjadi penurunan puncak tulang alveolar. Besarnya retraksi empat gigi insisif rahang atas dapat dinilai dengan mengukur sudut I-NA. Kaitan antara besarnya retraksi dengan perubahan tinggi puncak tulang alveolar perlu dievaluasi. Metode: Metode penelitian ini adalah penelitian analitik komparatif yang melihat hubungan antara perubahan sudut I-NA dengan tinggi puncak tulang alveolar empat gigi insisif rahang atas sesudah perawatan ortodonti pada kasus retraksi empat gigi anterior. Sampel pada penelitian ini berjumlah 38 sampel dari pasien dengan maloklusi Kelas I dan II. Pengukuran tinggi puncak tulang alveolar dilakukan pada gambaran radiografi panoramik digital dengan menggunakan software Image J dan plugin dari Preus. Perubahan sudut I-NA didapatkan dari analisis sefalometri metode Steiner pada rekam medik. Hasil: Hasil analisis t-test berpasangan memperlihatkan bahwa tinggi puncak tulang alveolar empat gigi insisif rahang atas sesudah perawatan ortodonti pada kasus retraksi empat gigi anterior mengalami perubahan signifikan (p0,05). Simpulan: Tinggi puncak tulang alveolar empat gigi insisif rahang atas mengalami penurunan yang signifikan sesudah perawatan ortodonti pada kasus retraksi empat gigi anterior. Perubahan sudut I-NA tidak berhubungan tinggi puncak tulang alveolar empat gigi insisif rahang atas. Kata kunci: alveolar; insisif; software; retraksi; ortodonti; panora ABSTRACT Introduction: Fixed orthodontic treatment with anterior maxillary teeth retraction can cause a decrease in the height of the alveolar bone crest. Bone resorption and apposition are caused by tooth movement; if the resorption process is more significant than apposition, there can be a decrease in the height of the alveolar bone crest. The magnitude of the retraction of the four maxillary incisors can be assessed by measuring the I-NA angle. The relationship between the magnitude of retraction and the alveolar crest height changes needs to be evaluated. Methods: This research method is a comparative analysis to study the relationship between the changes in I-NA angle and the height of the alveolar bone crest of the four maxillary incisors after orthodontic treatment with four anterior teeth retraction. The 38 samples from patients with Class I and II malocclusion were obtained. The height of the alveolar bone was measured on a digital panoramic radiograph using Image J software and a plugin from Preus, and the changes in the I-NA angle were measured with the Steiner cephalometric analysis. Results: The results of paired t-test analysis showed that the height of the alveolar bone crest of the four maxillary incisors after orthodontic treatment with four maxillary incisors retraction experienced a significant change (p0.05). Conclusion: The height of the alveolar bone crest of the four maxillary incisors decreased significantly after orthodontic treatment in the retraction of the four anterior teeth. Changes in the I-NA angle were not related to the height of the alveolar crest of the four maxillary incisors. Keywords : alveolar; incisor; software; retraction; orthodontic ; panoramic

PurposeThe EPIC-26 (Expanded Prostate Cancer Index Composite-Short Form) is a validated questionnaire for measuring health related quality of life. However, the relationship between domain scores and functional outcomes remains unclear, leading to potential confusion about expectations after treatment. For instance, does a sexual function domain score of 80 mean that a patient can achieve erection sufficient for intercourse? Consequently we sought to determine the relationship between the domain score and the response to obtaining the best possible outcome for each question.Materials and methodsUsing data from the CEASAR (Comparative Effectiveness Analysis of Surgery and Radiation) study, a multicenter, prospective study of men diagnosed with localized prostate cancer, we analyzed 11,464 EPIC-26 questionnaires from a total of 2,563 men at baseline through 60 months of followup who were treated with robotic prostatectomy, radiotherapy or active surveillance. We dichotomized every item into its best possible outcome and assessed the percent of men at each domain score who achieved the best result.ResultsFor every EPIC-26 item the frequency of the best possible outcome was reported by domain score category. For example, a score of 80 to 100 on sexual function corresponded to 97% of men reporting erections sufficient for intercourse while at a score of 40 to 60 only 28% reported adequate erections. Also, at a score of 80 to 100 on the urinary incontinence domain 93% of men reported rarely or never leaking vs 6% at a score of 61 to 80.ConclusionsOur findings indicate a novel way to interpret EPIC-26 domain scores, demonstrating large variations in the percent of respondents reporting the best possible outcomes over narrow domain score differences. This information may be valuable when counseling men on treatment options.

Background: Puerperal endometritis has not been recently investigated. We aimed to describe the current dimension of the endometritis in the context of other causes of puerperal fever and investigate the microbiology and need for curettage in these patients Methods: A retrospective cohort study was conducted based on a prospectively maintained database of patients with puerperal fever, (2014–2020) in which cases fulfilling criteria for endometritis were selected for further analysis. Description of clinical and microbiological features was performed and determination of the factors related with puerperal curettage requirement were studied using univariate and multivariate analysis through binary logistic regression. Results: From 428 patients with puerperal fever, endometritis was the main cause of puerperal fever (233 patients, 52.7 %). Curettage was required in 96 of them (41.2 %). Culture of endometrial samples were performed in 62 (64.5 %), of which 32 (51.6 %) yielded bacterial growth. Escherichia coli was the most common microorganism in curettage cultures (46.9 %). Multivariate analysis identified the following predictive factors for curettage: the presence of pattern compatible with retained products of conception (RPOC) in transvaginal ultrasonography (odds ratio [OR]: 17.6 [95 % confidence interval [CI]: 8.4–36.6]; P-value

Introduction: High screen time is defined as activities in front of a screen for more than 60 minutes in 24 hours. These activities can lead to a decreased rate of physical activities in under-five children and pose a risk of turning into gaming addiction or gaming disorder. This study aimed to identify the relationship between screen time and physical activities in under-five children at PAUD Al Azhaar Tulungagung. Method: This study was designed as a correlational study with a cross-sectional approach with a purposive sampling technique. The population in this study was all mothers and children aged 24-60 months at PAUD Al Azhaar Tulungagung totaling 35 people. The number of samples was 31 respondents. The study was conducted at one of PAUD in Tulungagung area. Instruments for collecting data in this study were modified screen time and PAQ-C questionnaires to measure physical activities. Results: The results show that nearly all (83.9%) respondents had high screen time and the majority of them (51.6%) displayed decreased physical activities. An analysis with Spearman’s Rank statistical test obtained a p-value of 0.00

Transient ischemic attack (TIA) is a well-established risk factor for future strokes, making interventions that target recovery and vascular risk crucial. This study aimed to assess the safety and clinical effects of a polyphenol-rich Salicornia ramosissima extract in post-TIA patients. A randomized, triple-blind, placebo-controlled trial was conducted with participants who had a history of TIA or minor stroke and who received 1 g of Salicornia extract or placebo over 11 months. Biochemical analyses, neuropsychological assessments (MOCA test), and gait and aerobic performance tests were conducted at the beginning and the end of the study. A total of 118 individuals were screened, with 80 finally included. Importantly, no significant adverse events were reported throughout the study. A neurological analysis showed an improvement in MOCA scores in patients treated with the Salicornia extract for 11 months. The treatment did not affect spatiotemporal gait parameters, but it significantly reduced blood pressure at baseline and after the aerobic performance test. Biochemically, both groups exhibited mild hyperhomocysteinemia at baseline; however, Salicornia treatment significantly lowered homocysteine levels, bringing them within the normal range. These findings highlight the safety of the Salicornia extract in patients at a high cerebrovascular risk and suggest it as a potential therapeutic option for managing vascular risk factors, such as hyperhomocysteinemia and hypertension. However, further studies are required to confirm the underlying mechanisms and explore broader clinical applications. [ABSTRACT FROM AUTHOR]

Pendahuluan: Perawatan ortodonti untuk memperbaiki maloklusi terus meningkat merupakan perawatan yang paling banyak diminati oleh pasien. Perawatan ortodonti dapat dilakukan dengan ekstraksi ataupun non-ekstraksi yang dapat memengaruhi kepuasan pasien seperti perubahan dentofasial, fungsi dental dan psikososial yang dapat diukur salah satunya menggunakan modifikasi Boston Orthodontic Society (BOS). Tujuan penelitian membandingkan tingkat kepuasan pasien terhadap hasil perawatan ortodonti ekstraksi dan non ekstraksi menggunakan kuesioner BOSS. Metode: Jenis penelitian observasional analitik rancangan cross sectional untuk membandingkan tingkat kepuasan kelompok pasien dengan perawatan ortodonti ekstraksi dibandingkan dengan kelompok non ekstraksi. Sampel berjumlah 60 subjek maloklusi skeletal kelas I, II, III yang terbagi atas 30 subjek ekstraksi dan 30 subjek non ekstraksi. Masing-masing subjek diberi kuesioner Bos dalam Bahasa Indonesia yang telah dimodifikasi dan telah diuji validitas dan reliabilitasnya. Kuesioner Bos modifikasi terdiri dari 22 pernyataan yang terbagi atas 3 subskala yaitu perubahan dentofasial (9 pernyataan), perubahan psikososial (9 pernyataan), dan fungsi dental (4 pernyataan). Hasil: Tingkat kepuasan pasien ekstraksi terhadap hasil perawatan ortodonti menunjukkan hasil yang lebih tinggi dibandingkan non ekstraksi, namun berdasarkan analisis Mann Whitney tidak terdapat perbedaan yang signifikan antara kelompok ekstraksi dengan non ekstraksi pada seluruh sampel; kelompok ekstraksi kasus borderline dengan non ekstraksi kasus borderline; kelompok ekstraksi kasus severe dengan non ekstraksi kasus borderline; kelompok kelas I skeletal ekstraksi dengan non ekstraksi (nilai p>0.05). Simpulan: Tidak terdapat perbedaan tingkat kepuasan pasien terhadap hasil perawatan ortodonti antara kelompok ekstraksi dibandingkan dengan kelompok non ekstraksi. Kata kunci: alat ortodonti cekat; ekstraksi, kuesioner BOS; perawatan maloklusi; tingkat kepuasan pasien ABSTRACT Introduction: Orthodontic treatment to improve malocclusion is the most popular treatment for patients. Orthodontic treatment can be done by extraction or non-extraction that can affect patient satisfaction such as dentofacial changes, dental and psychosocial functions that can be measured, one of which is using a modification of the Boston Orthodontic Society (BOS). The purpose of the study was to compare patient satisfaction level with the results of the extracted and non-extracted orthodontic treatment using the BOSS questionnaire. Methods: This type of research was an analytical observational cross-sectional design to compare the level of satisfaction of the patient group with extraction orthodontic treatment compared to the non-extraction group. The sample consisted of 60 subjects with skeletal malocclusion class I, II, and III divided into 30 extraction subjects and 30 non-extracted subjects. Each subject was given a BOSS questionnaire in Indonesian, modified and tested for validity and reliability. The Modified BOSS Questionnaire consisted of 22 statements which were divided into three subscales, namely dentofacial changes (9 statements), psychosocial changes (9 statements), and dental function (4 statements). Results: The level of satisfaction of extraction patients with orthodontic treatment results showed higher results than non-extraction but based on Mann-Whitney analysis, there was no significant difference between the extraction and non-extraction groups in all samples; borderline case extraction group with non-borderline case extraction; severe case extraction group with non-borderline case extraction; class I skeletal extraction group with non-extraction (p value>0.05). Conclusion: There was no difference in the level of patient satisfaction with the results of orthodontic treatment between the extraction group and the non-extraction group. Keywords: fixed orthodontics; extraction; BOSS questionnaire; malocclusion treatment; patient satisfaction level

Pendahuluan: Maloklusi dapat menimbulkan gangguan psikologis dan sosial (psikososial) akibat susunan gigi yang tidak estetik. Gangguan psikososial tersebut dapat mengukur kebutuhan dan keberhasilan perawatan dari sudut pandang pasien dengan lebih akurat. Pengukuran dampak psikososial akibat maloklusi dapat dilakukan dengan kuesioner Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ). Penelitian ini bertujuan untuk melakukan translasi dan memvalidasi kuesioner PIDAQ dalam Bahasa Indonesia. Metode: Jenis penelitian ini merupakan penelitian cross-sectional. Prosedur penelitian diadaptasi dari pedoman yang dibuat oleh International Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network. Tahap pertama adalah tahapan linguistik, yaitu penerjemahan PIDAQ yang dibuat oleh Klages, et al., ke Bahasa Indonesia, evaluasi terjemahan PIDAQ Bahasa Indonesia, penerjemahan kembali PIDAQ Bahasa Indonesia ke Bahasa Inggris, kemudian evaluasi akhir terjemahan PIDAQ Bahasa Indonesia ke Bahasa Inggris. Tahap kedua adalah tahapan uji validitas dan reliabilitas. PIDAQ dalam Bahasa Indonesia diberikan kepada 32 orang responden untuk melihat validitas dan reliabilitas PIDAQ dalam Bahasa Indonesia. Tahap ketiga adalah tahapan analisis. Hasil uji validitas dan reliabilitas dianalisis menggunakan analisis Pearson Product Moment, Intra-Class Correlation (ICC), Cronbach Alpha, dan analisis faktor menurut Kaiser-Meyer-Olkin (KMO) dan Bartlett’s Test of Sphericity. Hasil: Penelitian ini menghasilkan kuesioner PIDAQ Bahasa Indonesia yang valid dan reliabel berdasarkan analisis Pearson Product Moment, ICC, Cronbach Alpha, analisis faktor menurut KMO, dan Bartlett’s Test of Sphericity. Nilai-nilai analisis tersebut telah menyamai nilai asli pada PIDAQ. Translasi tersebut terdiri dari 23 pernyataan yang dibagi dalam empat dimensi. Simpulan: Kuesioner Psychosocial Impact of Dental Aesthetic Questionnaire mengukur dampak psikososial dari estetika gigi pada subjek di Indonesia dan setiap item dalam kuisioner valid dan reliabel. ABSTRACT Introduction: Malocclusion will lead to psychological and social (psychosocial) disorders due to unaesthetic dental arrangement. These disorders can measure the need and success of treatment from the patient’s point of view more accurately. The psychosocial impact of malocclusion can be measured using the Psychosocial Impact of Dental Aesthetic Questionnaire (PIDAQ). This study was aimed to translate and validate the PIDAQ questionnaire in Indonesian. Methods: A cross-sectional study was performed with the procedure adapted from guidelines developed by the International Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Consortium Network. The first stage was the linguistic stage, which was the Indonesian translation of PIDAQ by Klages et al., evaluation of the Indonesian translation, retranslation of the Indonesian version of PIDAQ to the original version, and final evaluation of the Indonesian to English translation of PIDAQ. The second stage was the stage of validity and reliability testing. The Indonesian version of PIDAQ was given to 32 respondents to test its validity and reliability. The third stage was the analysis stage. The validity and reliability tests results were analysed using Pearson Product Moment, Intra-Class Correlation (ICC), Cronbach Alpha, and factor analysis according to Kaiser-Meyer-Olkin (KMO) and Bartlett’s Test of Sphericity. Results: A valid and reliable Indonesian version of the PIDAQ questionnaire was able to be created based on the Pearson Product Moment, ICC, Cronbach Alpha, KMO factor analysis, and Bartlett’s Test of Sphericity results. The analysis values of the Indonesian version of the PIDAQ questionnaire were close to the original version’s values. The translation consisted of 23 statements divided into four dimensions. Conclusions: The Psychosocial Impact of Dental Aesthetic Questionnaire measures the psychosocial impact of dental aesthetics on Indo-nesian subjects, and each item in the questionnaire is valid and reliable.

Background: Separator placement is the first step in orthodontic treatment, which aims to create space between teeth before molar band placement. This procedure can cause pain for the patient. Pain management after separator placement can be done through pharmacological and non-pharmacological approaches. Method: The aim of this rapid review was to determine the efficacy of laser therapy and ibuprofen for pain management after elastomeric separator placement in orthodontic treatment. Result: Ten articles were included in this review, four articles gave laser therapy interventions and six articles gave ibuprofen therapy interventions. The result of the quality assessment using Strength of Recommendation Taxonomy (SORT) was laser therapy intervention has one good quality articles and three limited-quality articles, while ibuprofen therapy has two good quality articles and four limited-quality articles. Conclusion: The efficacy of laser therapy and the efficacy of ibuprofen on pain after separator placement is good, with the strength of the clinical recommendation of ibuprofen is better than laser therapy.

Abstract Objectives To investigate factors predictive of postoperative recurrence and complications in patients undergoing urethroplasty for stricture repair at a single center. Patients and methods We retrospectively reviewed the records of 108 men who underwent urethroplasty for urethral stricture disease (USD) at a single center from 2016 to 2020. Demographic data, comorbidities, stricture history including etiology and prior treatments, patient‐reported symptoms, and outcomes data were collected for analysis. Data were analyzed in aggregate, then, stratified by type of urethroplasty performed. Descriptive statistics, univariate analysis, multivariate logistic regression, and intergroup comparisons were completed using STATA, with an alpha value of 0.05 and a confidence interval of 95%. Results The median age of our patients was 58 years (interquartile range: 42‐69; range: 29‐83), with a median stricture length of 2.0 cm (interquartile range: 1.0‐4.5; range: 0.5‐10). The most common stricture etiology was iatrogenic (n = 33, 31%) and the most common urethroplasty was anterior anastomotic urethroplasty (n = 38, 35%), followed by buccal mucosal graft (BMG) urethroplasty (n = 35, 32%). Twenty‐four patients (22%) had stricture recurrence. Within the aggregate data, recurrence was significantly predicted by obesity (BMI > 30) (Odds Ratio [OR] 3.2, 95% Confidence Interval [CI]: 1.06‐10), and the presence of postoperative complications (OR 6.3, CI: 1.9‐21). The presence of any postoperative complications within 90 days was significantly predicted by stricture length ≥ 5 cm (OR 3.5, CI 1.09‐12) and recurrence (OR 6.0, CI 1.7‐21). Conclusion Despite serving as the most definitive treatment for urethral stricture management, stricture recurrence and postoperative complications are not uncommon after urethroplasty. Obesity and stricture length negatively impact outcomes while a penile stricture location is associated with a lower recurrence rate, though this is not statistically significant.

Background: Facial aesthetics are closely related to the harmonious proportions of the facial components. One of the components is facial height. The reference of facial height proportion of certain racial groups needs to be known by orthodontists and surgeons to create treatment outcomes that can be specifically designed for these particular demographics. One of the factors that can affect facial height proportion is malocclusion. Purpose: This study aimed to determine facial height proportion based on Angle’s classification of malocclusion in Deutero-Malayids. Methods: This study used a descriptive cross-sectional method, which was conducted on 116 Deutero-Malayid subjects. The subjects’ malocclusion was first examined using Angle’s classification of malocclusion. Upper and lower facial height were then measured to determine the proportion of these dimensions. The results were then grouped based on each malocclusion class. Results: It was found that the upper and lower facial height proportions in the class I malocclusion group were 46.74% and 53.26% in males and 47.52% and 52.48% in females, respectively. The upper and lower facial height proportions in the class II malocclusion group were 48.46% and 51.54% in females. Upper and lower facial height proportions in the class III malocclusion group were 45.31% and 54.69% in males and 46.29% and 53.71% in females, respectively. Conclusion: The largest proportion of upper facial height in Deutero-Malayids was seen in the class II malocclusion group, followed by class I and class III. The largest proportion of lower facial height in Deutero-Malayids was seen in the class III malocclusion group, followed by class I and class II.

Abstract Background Several studies have identified different genes that control the final dimension and structure of the mandible. Prognathism of the mandible is thought to correlate with these genes; however, no specific gene has been assigned as a risk factor due to various genome-wide scan results in different races. Previous studies that involved the Han ethnic group in China and Korea suggested matrilin-1 (MATN1) polymorphism as the contributor for mandibular prognathism. To date, no study has been conducted to understand the role of MATN1 in Deutero-Malay population. This study aimed to detect MATN1 gene polymorphism in the promoter and exon 5 regions, which is a proposed risk factor in class III skeletal malocclusion with mandibular prognathism in Deutero-Malay population. This was a case-control study with purposive sampling method that involved 47 class III skeletal malocclusion subjects with mandibular prognathism (case group) and 47 class I skeletal relation subjects (control group) performed in the Molecular Genetics Laboratory of Faculty of Medicine, Universitas Padjadjaran, Indonesia. DNA isolated from buccal mucous epithelia and MATN1 gene was amplified using the polymerase chain reaction (PCR) and sequencing technique. Data were then analyzed statistically to observe the frequency of allele/genotype MATN1 in class III skeletal malocclusion and mandibular prognathism patients in comparison with the normal mandibular as well as to identify the risk factor of mandibular prognathism. Result The frequency of the 354 T > C(rs20566) CC genotype gene polymorphism in the case group was significantly higher than in the control group. The odd ratio (OR) value of the case group was also higher than in the control group (χ 2 = 4.89; p = 0.027; OR = 6.27). Conclusions Our results show that the polymorphism of 354 T > C in the exon 5 region of the CC genotype MATN1 gene is a risk factor for class III skeletal malocclusion with mandible prognathism in Deutero-Malay population.

A hemostatic sponge prototype was successfully synthesized from fish gelatin as an alternative to mammalian gelatin; it was mixed with alginate in certain combinations, double cross-linked with calcium ions, and gamma irradiated at a dose of 20 kGy to improve the characteristics and effectiveness of its function as a local hemostatic agent. There were improvements in the physicochemical and mechanical properties, porosity index, absorption capacity, biodegradation properties, biocompatibility, and hemocompatibility of the fish gelatin–alginate sponge (FGAS) prototypes compared with the pure fish gelatin sponge. Hemostatic activity tests showed that the means for clotting time, prothrombin time, and activated partial thromboplastin time were shorter in the FGAS prototype than in the negative control, and there was no significant difference compared with the commercial gelatin sponge. The hemostatic mechanism of the FGAS prototype combined a passive mechanism as a concentrator factor and an active mechanism through the release of calcium ions as a coagulation factor in the coagulation cascade process. [ABSTRACT FROM AUTHOR]