Epigallocatechin gallate-immobilized antimicrobial resin with rechargeable fluorinated synergistic composite for enhanced caries control.

OBJECTIVES: Given the global prevalence of dental caries, impacting 2.5 billion individuals, the development of sophisticated prevention filling materials is crucial. Streptococcus mutans, the principal caries-causing strain, produces acids that demineralize teeth and initiate dental caries. To address this issue, we aimed to develop a synergistic resin-based composite for enhancing caries control. METHODS: The synergistic resin composite incorporates fluorinated kaolinite and silanized Al2O3 nanoparticle fillers into an epigallocatechin gallate (EGCG) immobilized urethane-modified epoxy acrylate (U-EA) resin matrix, referred to the as-prepared resin composite. The EGCG-modified TPGDA/U-EA network was synthesized by preparing methacrylate-functionalized isocyanate (HI), reacting it with EGCG to form HI-EGCG, and then incorporating HI-EGCG into the TPGDA/U-EA matrix. The lamellar space within the kaolinite layer was expanded through the intercalation of acrylamide into kaolinite, enhancing its capability to adsorb and release fluoride ions (F-). The layered structure of acrylamide/ kaolinite in the U-EA resin composite acts as a F- reservoir. RESULTS: The physico-mechanical properties of the as-prepared resin composites are comparable to those of commercial products, exhibiting lower polymerization shrinkage, substantial F- release and recharge and favorable diametral tensile strength. The immobilized EGCG in the composite exhibits potent antimicrobial properties, effectively reducing the biofilm biomass. Furthermore, the synergistic effect of EGCG and fluorinated kaolinite efficiently counteracts acid-induced hydroxyapatite dissolution, thereby suppressing demineralization and promoting enamel remineralization. SIGNIFICANCE: Our innovative EGCG and fluoride synergistic composite provides enhanced antimicrobial properties, durable anti-demineralization, and tooth remineralization effects, positioning it as a promising solution for effective caries control and long-term dental maintenance.

Peak-Inspiratory-Flow-Rate Guided Inhalation Therapy Reduce Severe Exacerbation of COPD.

Optimal peak inspiratory flow rate (PIFR) is crucial for inhalation therapy in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the impact of PIFR-guided inhalation therapy on the clinical outcomes among patients with varying severities of COPD. A PIFR-guided inhalation therapy, including PIFR assessment and PIFR-guided inhaler education, was introduced in a pay-for-performance COPD management program in National Taiwan University Hospital. Among 383 COPD patients, there was significant reduction in incidence of severe acute exacerbation in the PIFR-guided inhalation therapy (PIFR group) than conventional inhaler education (control group) (11.9 vs. 21.1%, p = 0.019) during one-year follow-up. A multivariable Cox's proportional-hazards analysis revealed that the PIFR-guided inhalation therapy was a significant, independent factor associated with the reduced risk of severe exacerbation (adjusted hazard ratio = 0.49, 95% confidence interval, 0.28-0.84, p = 0.011). Subgroup analysis found PIFR-guided inhalation therapy was more beneficial to patients with older age, short body stature, COPD stage 1&2, group C&D (frequent exacerbation phenotype), and using multiple inhalers. This study showed the PIFR-guided inhalation therapy significantly reduced the incidence of severe acute exacerbation than conventional inhaler education in patients with COPD. Careful PIFR-assessment and education would be crucial in the management of COPD.

Electrospun Hydrophobic Polyaniline/Silk Fibroin Electrochromic Nanofibers with Low Electrical Resistance.

Electronic textiles (E-textiles) have been an area of intense industrial and academic research for years due to their advanced applications. Thus, the goal of this study was to develop highly conductive silk fibroin electrochromic nanofibers for use in E-textiles. The silk nanofibers were prepared by an electrospinning technique, and the conductive polyaniline (PANI) was added to impart the electrical conductivity and electroactive property to the resultant electrospun silk composite nanofibers. The experimental results showed that tuning the electrospinning procedure could control the morphology of the composite nanofibers, thus altering their mechanical properties and surface wettability. Furthermore, the developed PANI/silk composite fibers possess electroactive and electrochromic properties, such as adjusting the applied voltage. The developed strategy demonstrated the feasibility of incorporating not only electrical functionality but also electroactivity into sustainable silk nanofibers using electrospinning technique.

Electroactive Composites with Block Copolymer-Templated Iron Oxide Nanoparticles for Magnetic Hyperthermia Application.

Cancer has been one of the leading causes of human death for centuries. Magnetic hyperthermia is a promising technique to confine and control cancers. However, particles used in magnetic hyperthermia leaking from where the cancers are located could compromise human health. Therefore, we developed electroactive iron oxide/block copolymer composites to tackle the leakage problem. Experimental results show that oleylamine-modified magnetic iron oxide (Fe3O4) particles and electroactive tetraaniline (TA) could be templated in the self-assembled microstructures of sulfonated [styrene-b-(ethylene-ran-butylene)-b-styrene] (S-SEBS) block copolymers. Various amounts of Fe3O4 particles and TA oligomer were incorporated in S-SEBS block copolymer and their electroactive behavior was confirmed by exhibiting two pairs of well-defined anodic and cathodic current peaks in cyclic voltammetry tests. The heating performance of the resultant TA/Fe3O4/polymer composites improved on increasing the added amount of Fe3O4 particles and TA oligomers. Both Fe3O4 and TA can contribute to improved heating performance, but Fe3O4 possesses a greater contribution than TA does. Hence, the main source for increasing the composites' temperature is Neel relaxation loss from Fe3O4 magnetic particles.

Safety of rifabutin replacing rifampicin in the treatment of tuberculosis: a single-centre retrospective cohort study.

OBJECTIVES: The safety of rifabutin replacing rifampicin among adults having rifampicin-related adverse reactions (ARs) during the treatment of tuberculosis remains unknown. METHODS: From June 2006 to June 2010, a total of 2868 newly treated tuberculosis patients without HIV infection in a referral hospital were screened in this retrospective cohort study. RESULTS: Among the screened patients, a total of 221 (8%) patients who received rifabutin replacing rifampicin were included. Of these patients, 158 (72%) tolerated rifabutin during treatment, but 47 (21%) and 16 (7%) experienced mild and severe rifabutin-related ARs (including neutropenia, severe hepatitis and uveitis), respectively, and needed to discontinue rifabutin. Those having previous rifampicin-related arthralgia, dermatological events and cholestasis had a higher AR recurrence rate (60%, 23% and 9%, respectively) than others (5% for hepatitis and gastrointestinal intolerance and 0% for flu-like syndrome, neutropenia and others; P < 0.01). Multivariate logistic regression analysis showed that females (OR 3.35; 95% CI 1.06-10.56; P = 0.04) and patients with hepatitis virus B (HBV) or hepatitis C virus (HCV) coinfection (OR 3.72; 95% CI 1.19-11.67; P = 0.02) were at a higher risk of rifabutin-related severe ARs. No development of new drug resistance and no relapse of tuberculosis were found during 2 years of follow-up. CONCLUSIONS: Rifabutin replacing rifampicin was well tolerated in most adults who had rifampicin-related ARs. Females and those with HCV or HBV coinfection were more prone to rifabutin-related severe ARs and required more cautious monitoring.