Virtual urgent care is here to stay: driving toward safe, equitable, and sustainable integration within emergency medicine.

BACKGROUND: Virtual care in Canada rapidly expanded during the COVID-19 pandemic in a low-rules environment in response to pressing needs for ongoing access to care amid public health restrictions. Emergency medicine specialists now face the challenge of advising on which virtual urgent care services ought to remain as part of comprehensive emergency care. Consideration must be given to safe, quality, and appropriate care as well as issues of equitable access, public demand, and sustainability (financial and otherwise). The aim of this project was to summarize current literature and expert opinion and formulate recommendations on the path forward for virtual care in emergency medicine. METHODS: We formed a working group of emergency medicine physicians from across Canada working in a variety of practice settings. The virtual care working group conducted a scoping review of the literature and met monthly to discuss themes and develop recommendations. The final recommendations were circulated to stakeholders for input and subsequently presented at the 2023 Canadian Association of Emergency Physicians (CAEP) Academic Symposium for discussion, feedback, and refinement. RESULTS: The working group developed and reached unanimity on nine recommendations addressing the themes of system design, equity and accessibility, quality and patient safety, education and curriculum, financial models, and sustainability of virtual urgent care services in Canada. CONCLUSION: Virtual urgent care has become an established service in the Canadian health care system. Emergency medicine specialists are uniquely suited to provide leadership and guidance on the optimal delivery of these services to enhance and complement emergency care in Canada.

RéSUMé: CONTEXTE: Les soins virtuels au Canada ont rapidement pris de l'ampleur pendant la pandémie de COVID-19 dans un environnement où les règles sont peu strictes, en réponse aux besoins urgents d'accès continu aux soins dans un contexte de restrictions en santé publique. Les spécialistes de la médecine d'urgence sont maintenant confrontés au défi de conseiller sur les services de soins d'urgence virtuels qui devraient rester dans le cadre des soins d'urgence complets. Il faut tenir compte des soins sécuritaires, de qualité et appropriés, ainsi que des questions d'accès équitable, de la demande publique et de la durabilité (financière et autre). L'objectif de ce projet était de résumer la littérature actuelle et l'opinion d'experts et de formuler des recommandations sur la voie à suivre pour les soins virtuels en médecine d'urgence. MéTHODES: Nous avons formé un groupe de travail composé de médecins urgentistes de partout au Canada qui travaillent dans divers milieux de pratique. Le groupe de travail sur les soins virtuels a effectué un examen de la portée de la documentation et s'est réuni chaque mois pour discuter des thèmes et formuler des recommandations. Les recommandations finales ont été distribuées aux intervenants pour obtenir leurs commentaires, puis présentées au symposium universitaire 2023 de l'Association canadienne des médecins d'urgence (ACMU) pour discussion, rétroaction et perfectionnement. RéSULTATS: Le groupe de travail a élaboré et atteint l'unanimité sur neuf recommandations portant sur les thèmes de la conception du système, de l'équité et de l'accessibilité, de la qualité et de la sécurité des patients, de l'éducation et des programmes, des modèles financiers et de la viabilité des services virtuels de soins d'urgence au Canada. CONCLUSION : Les soins d'urgence virtuels sont devenus un service établi dans le système de santé canadien. Les spécialistes en médecine d'urgence sont particulièrement bien placés pour fournir un leadership et des conseils sur la prestation optimale de ces services afin d'améliorer et de compléter les soins d'urgence au Canada.

Epigenetic and metabolic reprogramming of fibroblasts in Crohn's disease strictures reveals histone deacetylases as therapeutic targets.

BACKGROUND & AIMS: No effective therapeutic intervention exists for intestinal fibrosis in Crohn's disease [CD]. We characterised fibroblast subtypes, epigenetic and metabolic changes, and signalling pathways in CD fibrosis to inform future therapeutic strategies. METHODS: We undertook immunohistochemistry, metabolic, signalling pathway and Epigenetic [Transposase-Accessible Chromatin using sequencing] analyses associated with collagen production in CCD-18Co intestinal fibroblasts and primary fibroblasts isolated from stricturing [SCD] and non-stricturing [NSCD] CD small intestine. SCD/ NSCD fibroblasts were cultured with TGFß and valproic acid [VPA]. RESULTS: Stricturing CD was characterised by distinct histone deacetylase [HDAC] expression profiles, particularly HDAC1, HDAC2, and HDAC7. As a proxy for HDAC activity, reduced numbers of H3K27ac+ cells were found in SCD compared to NSCD sections. Primary fibroblasts had increased extracellular lactate [increased glycolytic activity] and intracellular hydroxyproline [increased collagen production] in SCD compared to NSCD cultures. The metabolic effect of TGFß-stimulation was reversed by the HDAC inhibitor VPA. SCD fibroblasts appear "metabolically primed" and responded more strongly to both TGFß and VPA. Treatment with VPA revealed TGFß-dependent and independent Collagen-I production in CCD-18Co cells and primary fibroblasts. VPA altered the epigenetic landscape with reduced chromatin accessibility at the COL1A1 and COL1A2 promoters. CONCLUSIONS: Increased HDAC expression profiles, H3K27ac hypoacetylation, a significant glycolytic phenotype, and metabolic priming, characterise SCD-derived as compared to NSCD fibroblasts. Our results reveal a novel epigenetic component to Collagen-I regulation and TGFß-mediated CD fibrosis. HDAC inhibitor therapy may 'reset' the epigenetic changes associated with fibrosis.

Effect of isolation protocols and cryoprotectants on freezing of stallion epididymal spermatozoa.

BACKGROUND: The recovery of spermatozoa from the cauda epididymis may be the only option to obtain genetic material from elite stallions that had undergone castration or sudden death due to colic or severe injury. OBJECTIVE: To evaluate two different protocols for retrieval of stallion epididymal spermatozoa and to evaluate different cryoprotectants on the freezability of the epididymal spermatozoa. MATERIALS AND METHODS: Six epididymides from three stallions were collected immediately after routine castration under general anesthesia. In the first experiment, each epididymis (of two testes) of the same stallion were processed using different methods for retrieval of the epididymal spermatozoa and were pooled and cryopreserved either using 5% glycerol or 5% dimethyl formamide (DMF) as cryoprotectant. The semen quality parameters viz., progressive motility, HOST, viability and acrosome integrity were evaluated at the fresh, pre-freeze and post-thaw stages. RESULTS: Retrograde method of flushing of epididymis yielded significantly (p < 0.05) higher concentration of the stallion sperm than that of the floating method. The qualitative semen parameters i.e., viability, plasma membrane integrity and acrosome integrity were found to be significantly restored using 5% DMF as cryoprotectant in comparison to when 5% glycerol was used. CONCLUSION: Retrograde flushing method of epididymis yielded significantly higher sperm concentration to that of the floating method, and 5% DMF as cryoprotectant provided acceptable freezability of stallion epididymal spermatozoa. DOI: 10.54680/fr23310110312.

Immune-mediated hematological disease in dogs is associated with alterations of the fecal microbiota: a pilot study.

BACKGROUND: The dog is the most popular companion animal and is a valuable large animal model for several human diseases. Canine immune-mediated hematological diseases, including immune-mediated hemolytic anemia (IMHA) and immune thrombocytopenia (ITP), share many features in common with autoimmune hematological diseases of humans. The gut microbiome has been linked to systemic illness, but few studies have evaluated its association with immune-mediated hematological disease. To address this knowledge gap, 16S rRNA gene sequencing was used to profile the fecal microbiota of dogs with spontaneous IMHA and ITP at presentation and following successful treatment. In total, 21 affected and 13 healthy control dogs were included in the study. RESULTS: IMHA/ITP is associated with remodeling of fecal microbiota, marked by decreased relative abundance of the spirochete Treponema spp., increased relative abundance of the pathobionts Clostridium septicum and Escherichia coli, and increased overall microbial diversity. Logistic regression analysis demonstrated that Treponema spp. were associated with decreased risk of IMHA/ITP (odds ratio [OR] 0.24-0.34), while Ruminococcaceae UCG-009 and Christensenellaceae R-7 group were associated with increased risk of disease (OR = 6.84 [95% CI 2-32.74] and 8.36 [95% CI 1.85-71.88] respectively). CONCLUSIONS: This study demonstrates an association of immune-mediated hematological diseases in dogs with fecal dysbiosis, and points to specific bacterial genera as biomarkers of disease. Microbes identified as positive or negative risk factors for IMHA/ITP represent an area for future research as potential targets for new diagnostic assays and/or therapeutic applications.

Machine Learning Classification of Alzheimer's Disease Pathology Reveals Diffuse Amyloid as a Major Predictor of Cognitive Impairment in Human Hippocampal Subregions.

Analyzing Alzheimer's disease (AD) pathology within anatomical subregions is a significant challenge, often carried out by pathologists using a standardized, semi-quantitative approach. To augment traditional methods, a high-throughput, high-resolution pipeline was created to classify the distribution of AD pathology within hippocampal subregions. USC ADRC post-mortem tissue sections from 51 patients were stained with 4G8 for amyloid, Gallyas for neurofibrillary tangles (NFTs) and Iba1 for microglia. Machine learning (ML) techniques were utilized to identify and classify amyloid pathology (dense, diffuse and APP (amyloid precursor protein)), NFTs, neuritic plaques and microglia. These classifications were overlaid within manually segmented regions (aligned with the Allen Human Brain Atlas) to create detailed pathology maps. Cases were separated into low, intermediate, or high AD stages. Further data extraction enabled quantification of plaque size and pathology density alongside ApoE genotype, sex, and cognitive status. Our findings revealed that the increase in pathology burden across AD stages was driven mainly by diffuse amyloid. The pre and para-subiculum had the highest levels of diffuse amyloid while NFTs were highest in the A36 region in high AD cases. Moreover, different pathology types had distinct trajectories across disease stages. In a subset of AD cases, microglia were elevated in intermediate and high compared to low AD. Microglia also correlated with amyloid pathology in the Dentate Gyrus. The size of dense plaques, which may represent microglial function, was lower in ApoE4 carriers. In addition, individuals with memory impairment had higher levels of both dense and diffuse amyloid. Taken together, our findings integrating ML classification approaches with anatomical segmentation maps provide new insights on the complexity of disease pathology in AD progression. Specifically, we identified diffuse amyloid pathology as being a major driver of AD in our cohort, regions of interest and microglial responses that might advance AD diagnosis and treatment.

An Overview of Security Materials in Banknotes and Analytical Techniques in Detecting Counterfeits.

Counterfeiting or forged imitation of banknotes is a perpetual practice engulfing global economies. This not only poses challenges for the material scientists to come forth with advanced security materials but also demands veracious forensic examination to detect counterfeits. The present article pursues novel efforts in summarizing a study that lays focus on the recent optical and analytical examinations being used for the characterization and detection of chemical profiles of authentic and counterfeited banknotes. The article briefs the trends in banknote materials, security paper manufacturing process, security inks used for printing, and types of the security printing process in banknote practices. Reported literature shows the introduction of new anti-counterfeiting materials viz. magnetically-responsive photonic anti-counterfeiting watermarks, and fluorescent nanoparticles that can be used as anti-counterfeiting inks, anti-stokes inks, metameric inks, etc. Analytical techniques such as IR spectroscopy, Raman spectroscopy, Mossbauer spectroscopy, X-ray diffraction, X-ray fluorescence, LIBS, XRF, ELDI-MS, EASI/DESI-MS, HPLC, VSC, AFM, etc. in conjunction with different chemometrics approaches have been critically discussed. The study also presents the future scope in banknote examination like the use of hyper spectral imaging and sensor-based counterfeit detection systems.

Gender equity of authorship in pulmonary medicine over the past decade.

BACKGROUND: Gender disparity in authorship broadly persists in medical literature, little is known about female authorship within pulmonary medicine. METHODS: A bibliometric analysis of publications from 2012 to 2021 in 12 journals with the highest impact in pulmonary medicine was conducted. Only original research and review articles were included. Names of the first and last authors were extracted and their genders were identified using the Gender-API web. Female authorship was described by overall distribution and distribution by country/region/continent and journal. We compared the article citations by gender combinations, evaluated the trend in female authorship, and forecasted when parity for first and last authorship would be reached. We also conducted a systematic review of female authorship in clinical medicine. RESULTS: 14,875 articles were included, and the overall percentage of female first authors was higher than last authors (37.0% vs 22.2%, p<0.001). Asia had the lowest percentage of female first (27.6%) and last (15.2%) authors. The percentages of female first and last authors increased slightly over time, except for a rapid increase in the COVID-19 pandemic periods. Parity was predicted in 2046 for the first authors and 2059 for the last authors. Articles with male authors were cited more than articles with female authors. However, male-male collaborations significantly decreased, whereas female-female collaborations significantly increased. CONCLUSIONS: Despite the slow improvement in female authorship over the past decade, there is still a substantial gender disparity in female first and last authorship in high-impact medical journals in pulmonary medicine.

Sustained intra-cartilage delivery of interleukin-1 receptor antagonist using cationic peptide and protein-based carriers.

OBJECTIVE: Blocking the interleukin-1 (IL-1) catabolic cascade following joint trauma can be achieved using its receptor antagonist, IL-1Ra. However, its clinical translation for osteoarthritis therapy has been unsuccessful due to its rapid joint clearance and lack of targeting and penetration into deep cartilage layers at therapeutic concentrations. Here, we target the high negative charge of cartilage aggrecan-glycosaminoglycans (GAGs) by attaching cationic carriers to IL-1Ra. IL-1Ra was conjugated to the cartilage targeting glycoprotein, Avidin, and a short length optimally charged cationic peptide carrier (CPC+14). It is hypothesized that electro-diffusive transport and binding properties of IL-1Ra-Avidin and IL-1Ra-CPC+14 will create intra-cartilage depots of IL-1Ra, resulting in long-term suppression of IL-1 catabolism with only a single administration. DESIGN: IL-1Ra was conjugated to Avidin or CPC+14 using site specific maleimide linkers, and confirmed using gel electrophoresis, high-performance liquid chromatography (HPLC), and mass spectrometry. Intra-cartilage transport and retention of conjugates was compared with native IL-1Ra. Attenuation of IL-1 catabolic signaling with one-time dose of IL-1Ra-CPC+14 and IL-1Ra-Avidin was assessed over 16 days using IL-1α challenged bovine cartilage and compared with unmodified IL-1Ra. RESULTS: Positively charged IL-1Ra penetrated through the full-thickness of cartilage, creating a drug depot. A single dose of unmodified IL-1Ra was not sufficient to attenuate IL-1-induced cartilage deterioration over 16 days. However, when delivered using Avidin, and to a greater extent CPC+14, IL-1Ra significantly suppressed cytokine induced GAG loss and nitrite release while improving cell metabolism and viability. CONCLUSION: Charge-based cartilage targeting drug delivery systems hold promise as they can enable long-term therapeutic benefit with only a single dose.

Effect of Synthesis Methods and Conditions on Properties and Applications of Carbon Dots for the Detection of Potential Water Contaminants: A Review.

The worldwide pollution of water bodies by potential contaminants such as heavy metals, dyes, and pesticides etc. have severely affected the entire eco-system due to their toxic mobility and tough degradation in water. Consequently, there is a requirement to develop cost-competitive and easily handleable sensing materials which can detect targets sensitively and with selectivity. Among the low-cost sensory materials, carbon dots (CDs) constitute an important class of carbon nanomaterial with unique photostability, electronic and fluorescent properties. This review is an effort to comprehend the recent improvements in the sensing applications of CDs with prominence on synthetic routes, the effect of various synthesis parameters on physical properties (quantum yield, size range), detection mechanisms, and detection parameters (limit of detection, interference etc.). Particularly, the scope and progress for the detection of potential water contaminants using CDs have been explored and a holistic view of mechanisms of their detection has been included.

Holistic view of mechanisms for different types of signals generated by CDs.

Zirconia-based nanomaterials: recent developments in synthesis and applications.

In the last decade, the whole scientific community has witnessed great advances and progress in the various fields of nanoscience. Among the different nanomaterials, zirconia nanomaterials have found numerous applications as nanocatalysts, nanosensors, adsorbents, etc. Additionally, their exceptional biomedical applications in dentistry and drug delivery, and interesting biological properties, viz. anti-microbial, antioxidant, and anti-cancer activity, have further motivated the researchers to explore their physico-chemical properties using different synthetic pathways. With such an interest in zirconia-based nanomaterials, the present review focuses systematically on different synthesis approaches and their impact on the structure, size, shape, and morphology of these nanomaterials. Broadly, there are two approaches, viz., chemical synthesis which includes hydrothermal, solvothermal, sol-gel, microwave, solution combustion, and co-precipitation methods, and a greener approach which employs bacteria, fungus, and plant parts for the preparation of zirconia nanoparticles. In this review article, the aforementioned methods have been critically analyzed for obtaining specific phases and shapes. The review also incorporates a detailed survey of the applications of zirconia-based nanomaterials. Furthermore, the influence of specific phases, morphology, and the comparison with their counterpart composites for different applications have also been included. Finally, the concluding remarks, prospects and possible scope are given in the last section.

"Learning from the experts" - a novel advanced cadaveric course for Gynaecological Oncology (GO) Cytoreductive Surgery.

Background: Ovarian cancer cytoreductive surgery necessitates the use of advanced Simulation-Based Learning (SBL) to optimise skill-based teaching and achieve technical proficiency. Objective: We describe and appraise the role of a novel postgraduate cadaveric course for cytoreductive surgery for advanced ovarian/fallopian tube or primary peritoneal cancer. Materials and Methods: Several consultant-level surgeons with expertise in upper gastrointestinal, colorectal, hepatobiliary and urological surgery, were invited to teach their counterpart gynaecological oncology (GO) surgeons. The 2-day course curriculum involved advanced dissections on thiel-embalmed cadavers. All dissections included applicable steps required during GO cytoreductive surgeries. Outcome measures: We used a feedback questionnaire and structured interviews to capture trainers and delegates views respectively. Results: All delegates reported a positive educational experience and improvement of knowledge in all course components. There was no difference in the perception of feedback across junior versus senior consultants. Trainers perceived this opportunity as a "2-way learning" whether they got to explore in depth the GO perspective in how and which of their skills are applicable during cytoreductive surgery. Conclusions: Collaborating with other surgical specialities promotes a "learning from the experts" concept and has potential to meet the rapidly increased demand for multi-viscera surgical excellence in GO surgery. What's new?: The concept of involving experts from other surgical disciplines in advanced cadaveric courses for cytoreductive surgery in ovarian cancer, will solidify the effort to achieve excellence in the GO training. Such courses can be essential educational adjunct for most GO fellowships.

Cobalt-based co-ordination complex-derived nanostructure for efficient oxygen evolution reaction in acidic and alkaline medium.

Electrochemical water splitting is one of the most important method for energy conversion and storage. For this, the design and development of a low-cost robust electrocatalyst are highly desirable. In this study, Cobalt-based electrocatalyst for Oxygen Evolution Reaction was synthesized by thermal treatment of Cobalt-dehydroacetic acid (Co-DHA). The as-synthesized Co nanostructures and Co-DHA crystals were characterized with powder X-ray diffraction, X-ray photoelectron spectroscopy thermo-gravimetric analysis, and field emission scanning electron microscopy. The electrochemical O2 evolution study shows the overpotential (at 10 mV/cm-2) correspond to 294 mV vs reference hydrogen electrode (RHE) for K-300 (Co3O4@300), whereas K-500 (Co3O4@500) shows 170 mV vs RHE values in 1 M KOH solution, respectively. Similar trends have been observed for electrochemical O2 evolution studies in 0.5 M H2SO4, where K-300 and K-500 shows the overpotential (at 10mV/cm-2) of 234 mV vs RHE, and 199 mV vs RHE, respectively. The outcomes show better catalytic efficiency of K-500 as compared to K-300.

Prevalence and correlates of stocking up on drugs during the COVID-19 pandemic: Data from the C3PNO Consortium.

BACKGROUND: Data from the COVID-19 pandemic describes increases in drug use and related harms, especially fatal overdose. However, evidence is needed to better understand the pathways from pandemic-related factors to substance use behaviours. Thus, we investigated stockpiling drugs among people who use drugs (PWUD) in five cities in the United States and Canada. METHODS: We used data from two waves of interviews among participants in nine prospective cohorts to estimate the prevalence and correlates of stockpiling drugs in the previous month. Longitudinal correlates were identified using bivariate and multivariate generalized linear mixed-effects modeling analyses. RESULTS: From May 2020 to February 2021, we recruited 1873 individuals who completed 2242 interviews, of whom 217 (11.6%) reported stockpiling drugs in the last month at baseline. In the multivariate model, stockpiling drugs was significantly and positively associated with reporting being greatly impacted by COVID-19 (Adjusted Odds Ratio [AOR]= 1.21, 95% CI: 1.09-1.45), and at least daily use of methamphetamine (AOR = 4.67, 95% CI: 2.75-7.94) in the past month. CONCLUSIONS: We observed that approximately one-in-ten participants reported stocking up on drugs during the COVID-19 pandemic. This behaviour was associated with important drug-related risk factors including high-intensity methamphetamine use. While these correlations need further inquiry, it is possible that addressing the impact of COVID-19 on vulnerable PWUD could help limit drug stockpiling, which may lower rates of high-intensity stimulant use.

New insight into the pigmented rice of northeast India revealed high antioxidant and mineral compositions for better human health.

Northeast (NE) India possesses a rich diversity of rice cultivars including pigmented and non pigmented varieties. The pigmented rice is reported to possess a considerable amount of antioxidant compounds, free radical scavengers etc. In this study, eleven (black, red and white) rice cultivars of NE India were analyzed for antioxidant potentials, mineral and protein contents. Total phenolic content ranged from 94.8 (Idaw) to 900.90 mg GAE/100 g (Lumre). Total flavonoid content varied from 3.46 (Idaw) to 286.76 mg QE/100 g (Menil mibabaret). Total anthocyanin content varied from 0.23 (Farel) to 93.52 mg/100 g (Chakhao poireiton). The pigmented rice is also good sources of Catalase (CAT), Ascorbate peroxidase (APX) and Superoxide Dismutase (SOD) that can significantly reduce stress oxidative reactions. Chakhao poireiton possessed the highest Ni and Mn content, Tsulu tsuk had the highest Zn content, while Fazu and Tasung contained the highest Fe and Ca. The highest total protein was found in Chakhao poireiton (11.06%). And all the cultivars were found to be aromatic. Fourier Transformed Infra-Red spectroscopy (FTIR) identified various signature peaks and could discriminate the cultivars into pigmented and non pigmented. Principle Component Analysis (PCA) revealed the grouping of the cultivars based on the functional groups present. The present study could provide a better understanding of choosable rice lines for human consumption and also as germplasm resources for future rice improvement programs.

Internet-delivered cognitive behaviour therapy for chronic health conditions: self-guided versus team-guided.

There is growing interest in offering Internet-delivered cognitive behaviour therapy (ICBT) to individuals with chronic health conditions, with this process often being guided by a single clinician. Due to lack of full time personnel, it is sometimes necessary to have multiple clinicians offer guidance or for no guidance to be offered. In this randomized trial, we compared team-guided ICBT (n = 90) to self-guided ICBT (n = 88). Participants completed measures at pre-, post-, and 3-months post-ICBT. Both groups showed similar rates of treatment completion and large improvements on depression and anxiety at post-treatment and follow-up. Unexpectedly, more participants in the self-guided versus team-guided condition showed clinically significant improvement on depression at post-treatment (76.5% vs 49.2%) and follow-up (70% vs 45.6%). Thus, team-guided ICBT may not provide significant benefits compared to self-guided ICBT. However, it may be an alternative approach to consider among a population of high risk individuals that wants or requires closer monitoring of symptoms.Trail registration TRN: NCT03500237; Date: April 18, 2018.

A facile synthesis of palladium nanoparticles decorated bismuth oxybromide nanostructures with exceptional photo-antimicrobial activities.

Assessing the interaction between microbes and nanocatalysts for finding an inclusive, proactive and deep understanding of nanoparticles-based toxicity is vital for discovering their broad range of applications. Palladium based photocatalysts owing to their unique fundamental characteristics and brilliant physicochemical potential have gained immense interest in environment remediation as disinfection system. In the present study, we report synthesis of a novel palladium nanoparticles decorated bismuth oxybromide (Pd/BiOBr) nanostructures using an energy efficient solution-based method, having excellent photocatalytic antibacterial action. The synthesized nanomaterials was thoroughly characterized using various analytical techniques. The photocatalytic antibacterial efficiency of Pd/BiOBr was evaluated against some common pathogenic strains of Gram-positive and Gram-negative bacteria (Pseudomonas fluorescens, Pseudomonas aeruginosa, Escherichia coli, Aeromonas salmonicida, Salmonella typhimurium, Klebsiella pneumoniae, Bacillus subtilis). In our results Pd/BiOBr showed excellent photocatalytic disinfection efficacy with > 99.9% bacterial inactivation. A very low concentration of Pd/BiOBr (0.5 µg/mL) effectively inhibited the bacterial growth in response to just 2 h of visible light irradiation, while 1 µg/mL of Pd/BiOBr completely killed all the tested bacterial strains proving their magnificent bactericidal potential. The developed materials with exceptional antibacterial broad range efficiency can be used in different photocatalytic disinfection systems including water purification systems, biofilm exclusion and combating differential antibiotic resistance.

An evaluation of remineralised MIH using CPP-ACP and fluoride varnish: An in-situ and in-vitro study.

BACKGROUND: Molar incisor hypomineralization (MIH) affected teeth have enamel with altered mineral content like decreased calcium and phosphorus and increased carbon content leading to porous enamel and subsequent post-eruptive breakdown. AIM: An in situ study was conducted to evaluate and compare the effects of a Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP)-based cream and fluoride varnish on the remineralization of MIH affected teeth. METHODS: Enamel slabs were prepared from MIH affected teeth that had been extracted for various reasons and inserted in appliances of 30 participants who were undergoing interceptive orthodontic therapy. They were randomly divided into two groups using block randomization technique: Group A-daily single application of CPP-ACP cream (n = 15); Group B-professional application of fluoride varnishes every 3 months (n = 15). After 6 months of regular wear of the appliance, the enamel slabs were placed under Field Emission Scanning Microscope (FESEM) and Energy-Dispersive Spectroscopy (EDS) for evaluation of ultra structure and mineral content, respectively. RESULTS: A significant increase in calcium and phosphorus content, and a decrease in carbon content was observed within the 6 months period, suggesting remineralization in both the groups. On comparing the Ca:P and Ca:C ratios, a significant increase in the Ca:C ratio was evident in the two groups. No significant difference was seen in the Ca:P ratio in the CPP-ACP group at six months. The inter-group comparison did not reveal any significant difference between the two groups either at baseline or at 6 months post-intervention. CONCLUSION: Remineralization can be achieved in MIH affected teeth with the use of remineralizing agents.