ObjectivesTo assess if using potassium iodide (KI) immediately after application of silver diamine fluoride (SDF) significantly reduces the staining of tooth structure.Data source and selectionFour online databases (OVID, Scopus, PubMed and Google Scholar) were searched (June 2019). Additional studies were sought through grey literature search and hand searching the reference list of included articles. All studies that analysed the effect of KI on SDF staining of tooth structure with access to full text in English language were included.Data synthesisOf the six articles included in the review, five reported stain reduction in the teeth treated with application of KI to carious tooth structure following the application of SDF while one article reported no significant beneficial effect on reducing staining, when compared to SDF alone. Of the materials selected to restore SDF + KI treated teeth, resin‐modified glass ionomer was found to produce the lightest results, followed by glass ionomer cement and composite resin. An in vivo case report also revealed some staining after six months, even with SDF + KI treatment.ConclusionsAlthough some studies reported a positive effect, insufficient evidence exists supporting a tangible clinical benefit of SDF + KI treatment on the tooth staining, mainly due to methodical variations within the current literature.

Bubbles attached to surfaces are ubiquitous in nature and in industry. However, bubbles are problematic in important technologies, including causing damage to the operation of microfluidic devices and being parasitic during heat transfer processes, so considerable efforts have been made to develop mechanical and electrical methods to remove bubbles from surfaces. In this work, liquid dielectrophoresis is used to force a captive air bubble to detach away from an inverted solid surface and, crucially, the detached bubble is then held stationary in place below the surface at a distance controlled by the voltage. In this “levitated” state, the bubble is separated from the surface by liquid layer with a voltage‐selected thickness at which the dielectrophoresis force exactly counterbalances the gravitational buoyancy force. The techniques described here provide exceptional command over repeatable cycles of bubble detachment, levitation, and reattachment. A theoretical analysis is presented that explains the observed detachment–reattachment hysteresis in which bubble levitation is maintained with voltages in an order of magnitude lower than those used to create detachment. The precision surface bubble removal and control concepts are relevant to situations such as nucleate boiling and microgravity environments and offer an approach toward “wall‐less” bubble microfluidic devices.

Cystic Fibrosis (CF) is a genetic condition affecting the ability to excrete chloride, resulting in multi-system organ damage. Liver disease is one co-morbidity that affects 20-40% of people with CF. This case describes a 16-year-old male with CF (F508Del and Q493X mutations) who was started one lexacaftor/tezacaftor/ifacaftortriple CF Transmembrane Regulator (CFTR) modulator therapy. Prior to starting treatment, it was noted that he had transaminitis (AST 69, ALT 120, Total bilirubin 0.4). His liver enzymes continued to increase with therapy and at week 8 of treatment he complained of abdominal pain, body aches, and fatigue warranting further evaluation. At that time, AST and ALT were elevated at 5- and 13-times the Upper Limits of Normal (ULN) and creatinine kinase was elevated at 12-times ULN. A dose reduction led to a decrease in AST and ALT to 2 and 4-times ULN, but total and direct bilirubin increased to 2.2 mg/dl and 0.5 mg/dl, warranting a liver ultrasound and biopsy. Pathology showed fatty liver and hepatocyte iron deposition, but no indications of cirrhosis. Iron studies and genetic testing confirmed a diagnosis of HH (Homozygous HIS63ASP gene mutation). After stopping triple CFTR modulator therapy, AST and ALT continued to rise, prompting further evaluation by hepatology and hematology. Upon discontinuation of drug therapy, his lung function dropped significantly back to baseline values and respiratory symptoms returned. Discussion: Hereditary hemochromatosis gene mutations have been shown to have a gene modulating impact on CFTR gene mutations that can affect CF disease phenotype, which negatively affects pulmonary function and gastrointestinal disease. In this case, the introduction of a new medication instigated further work-up leading to the discovery of a potential alternative cause of hepatic dysfunction while attempting to optimize medications to sustain improvements in pulmonary function. Although elevated hepatic transaminases can be expected from CF and CFTR modulator therapy, further investigation may be indicated in patients with persistent elevations despite medication adjustments. This workup may lead to important considerations in balancing liver function with lung function. Keywords: cystic fibrosis; elexacaftor; tezacaftor; ivacaftor; liver transaminases; hereditary hemochromatosis.

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IntroductionInappropriate prescribing of antibiotics is a significant driver of antimicrobial resistance (AMR) which is a global health challenge. Technological innovations present an opportunity to reduce demand for antimicrobials through infection prevention, detection, and management. The National Institute for Health and Care Research (NIHR) Innovation Observatory (IO) has developed horizon scanning methods to identify promising innovations (devices/diagnostics/digital) and anticipate technological trends. Together these insights build a comprehensive landscape and presents a significant opportunity for decision-makers and HTAs to consider the clinical, financial, infrastructural, and logistical provisions to improve preparedness for the potential adoption of these future innovations.MethodsThe IO developed a detailed dataset of technologies by formulating search strategies for AMR, based on a comprehensive list of terms and input from expert panels. Primary and secondary sources were systematically scanned using a combination of traditional scanning methods, automated and novel artificial intelligence (AI)/machine learning techniques. Sources included clinical trial registries, MedTech news, academic sources, funding agencies, commercial sites, and regulatory authorities.ResultsOur global dataset identified over 3000 innovative preventative, detection, and monitoring technologies mapped across AMR clinical pathways (including sepsis, respiratory tract infections). Development activity largely concentrated in the United States of America and United Kingdom. Emerging trends included the application of novel materials to prevent infections (e.g., catheter coatings) and novel analytical techniques (e.g., biosensors, microfluidics, breath analysis) to support optimal patient treatment. Data analysis revealed a high proportion of technologies were diagnostic innovations addressing unmet needs such as rapid and accurate detection (including drug-resistant infections).ConclusionsThe rapid development and application of technological interventions presents an opportunity to strengthen national AMR strategies worldwide, through the adoption of new innovations. Improvements in exiting technologies, along with technological advancements have the potential to support appropriate prescribing of antimicrobials and thus address the rise in AMR.