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Various chemical adjuvants are available to augment immune responses to non-replicative, subunit vaccines. Optimized adjuvant selection can ensure that vaccine-induced immune responses protect against the diversity of pathogen-associated infection routes, mechanisms of infectious spread, and pathways of immune evasion. In this study, we compare the immune response of mice to a subunit vaccine of Middle Eastern respiratory syndrome coronavirus (MERS-CoV) spike protein, stabilized in its prefusion conformation by a proprietary molecular clamp (MERS SClamp) alone or formulated with one of six adjuvants: either (i) aluminium hydroxide, (ii) SWE, a squalene-in-water emulsion, (iii) SQ, a squalene-in-water emulsion containing QS21 saponin, (iv) SMQ, a squalene-in-water emulsion containing QS21 and a synthetic toll-like receptor 4 (TLR4) agonist 3D-6-acyl Phosphorylated HexaAcyl Disaccharide (3D6AP); (v) LQ, neutral liposomes containing cholesterol, 1.2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and QS21, (vi) or LMQ, neutral liposomes containing cholesterol, DOPC, QS21, and 3D6AP. All adjuvanted formulations induced elevated antibody titers which where greatest for QS21-containing formulations. These had elevated neutralization capacity and induced higher frequencies of IFN and IL-2-producing CD4+ and CD8+ T cells. Additionally, LMQ-containing formulations skewed the antibody response towards IgG2b/c isotypes, allowing for antibody-dependent cellular cytotoxicity. This study highlights the utility of side-by-side adjuvant comparisons in vaccine development. [ABSTRACT FROM AUTHOR]

Small linear microgrooves have been observed on root surfaces associated with osseous defects when videoscope-assisted minimally invasive surgery (V-MIS) is performed. The aim of this study was to evaluate the frequency of occurrence of these microgrooves associated with osseous defects. Videos of dry skulls from an anatomy department collection and videos made during consecutive V-MIS procedures on patients were evaluated to determine the presence or absence of microgrooves associated with osseous defects. In the dry skulls, 69 areas of apparent periodontal osseous defects were evaluated. In the V-MIS videos, 63 osseous defects were evaluated. In the dry skulls, 34 sites were positive for microgrooves on the root surfaces (49%), while in the V-MIS procedures 50 sites were positive for microgrooves (79%). Microgrooves of unknown origin were detected in a high percentage of osseous defects. Microgrooves may represent risk factors for site-specific progression of periodontal destruction. [ABSTRACT FROM AUTHOR]

Objectives: Concern has been expressed about the obvious aerosol cloud that is generated during air polishing of teeth. These concerns have included infection control, potential systemic effects, and environmental surface contamination associated with the particles of sodium bicarbonate power, water, and patient-generated material. This in vitro study evaluated an aerosol reduction device designed for use during air polishing. Methods and materials: Eight artificial teeth on a Dentoform model were polished with and without the aerosol reduction device. The polishing was performed within a plastic enclosure that had a grid on the sides. The water supply for the air polisher contained a 1% fluorescein solution. The aerosol contamination was determined by counting the number of squares that showed fluorescent spots under an ultraviolet light. Results: The mean contamination without the aerosol reduction device was 175.59 cm2. The mean contamination with the aerosol reduction device was 4.37 cm2, a greater than 97% reduction in aerosol contamination. Conclusion: The aerosol reduction device significantly decreased the contamination produced during air polishing. (Quintessence Int 1999;30: 623-628) [ABSTRACT FROM AUTHOR]

The article discusses the relation of the 1942 U.S. Supreme Court case Wickard v. Filburn in relation to the aggregation principle of the Commerce Clause of the U.S. Constitution. Topics include the significance of the U.S. Supreme Court case United States v. E. C. Knight Co., the role of the U.S. federal government in regulating intrastate commerce, and the impact of the wheat industry on the case Wickard v. Filburn.

Brain function monitors have improved safety and efficiency in general anesthesia; however, they have not been adequately tested for guiding conscious sedation for periodontal surgical procedures. This study evaluated the patient state index (PSI) obtained from the SEDline monitor (Sedline Inc., San Diego, CA) to determine its capacity to improve the safety and efficiency of intravenous conscious sedation during outpatient periodontal surgery. Twenty-one patients at the periodontics clinic of Baylor College of Dentistry were admitted to the study in 2009 and sedated to a moderate level using midazolam and fentanyl during periodontal surgery. The PSI monitoring was blinded from the clinician, and the following data were collected: vital signs, Ramsay sedation scale (RSS), medications administered, adverse events, PSI, electroencephalography, and the patients' perspective through visual analogue scales. The data were correlated to evaluate the PSI's ability to assess the level of sedation. Results showed that the RSS and PSI did not correlate (r = -0.25) unless high values associated with electromyographical (EMG) activity were corrected (r = -0.47). Oxygen desaturation did not correlate with the PSI (r = -0.08). Satisfaction (r = -0.57) and amnesia (r = -0.55) both increased as the average PSI decreased. In conclusion, within the limits of this study, PSI appears to correlate with amnesia, allowing a practitioner to titrate medications to that effect. It did not provide advance warning of adverse events and had inherent inaccuracies due to EMG activity during oral surgery. The PSI has the potential to increase safety and efficiency in conscious sedation but requires further development to eliminate EMG activity from confounding the score. [ABSTRACT FROM AUTHOR]

Background: Control or contamination in the dental office has sometimes deterred practitioners from using ultrasonic scalers. Recent studies point to the aerosol and splatter produced during ultrasonic scaling as a vehicle for the possible transmission of bloodborne pathogens. A recently introduced ultrasonic insert that focuses the spray produced during scaling may reduce this aerosol contamination. An aerosol reduction device (ARD) that is attached to the ultrasonic handpiece has been shown to reduce the contamination cloud by placing suction in close proximity to the ultrasonic tip. The purpose of this study was to compare the contamination produced by a standard insert (S) and the new focused spray (F) insert with and without the use of the aerosol reduction device (ARD). Methods: The testing was conducted in vitro within a plastic enclosure using a dye in the coolant spray. After mock scaling of a dentoform model, the number of contaminated squares on the enclosure was counted and recorded. Results: Analysis of the data indicated no significant difference (P >0.05, Mann-Whitney U test) between the S or F inserts in the amount of contamination produced. When the aerosol reduction device was used, there was a significant reduction (P <0.05, Mann-Whitney U test) in the amount of contamination for both inserts with a greater reduction for the standard insert. Conclusions: The traditional style of ultrasonic insert (S) and the newer focused coolant water insert (F) produce an equal amount of aerosol contamination. The amount or aerosol contamination produced by both inserts is copious. The ARD significantly reduced contamination with both styles of inserts. These findings support the use of a large bore high-volume evacuator whenever an ultrasonic scaler is used. [ABSTRACT FROM AUTHOR]

DISEASE TRANSMISSION AND BARRIER TECHNIQUES during dental treatment have been areas of recent concern in dentistry. Ultrasonic sealers are known to produce aerosols, and these aerosols are often produced from areas of significant disease activity, including bleeding. This study was performed to determine if these aerosols contain blood from the gingival sulcus. Forty areas consisting of two contiguous periodontally involved teeth [probing depth of at least 5 mm on one site of each tooth) were scaled subgingivally with an ultrasonic scaler for 30 seconds. A high volume evacuator (HVE) tip was positioned 3 to 5 cm away from the operating site and utilized to capture the aerosols produced. The water remaining in and on the HVE tube was tested lot occult blood by the guiac resin method. Gingival index, mean probing depth, presence of bleeding with scaling, and presence of visible blood in the HVE tip were recorded. All 40 test sites showed a positive result for blood in the captured aerosols despite the wide variation in the measured parameters. It may be concluded that sub-gingival scaling on periodontally involved teeth with ultrasonic sealers would be expected to produce aerosols containing blood. [ABSTRACT FROM AUTHOR]

Myxovirus resistance (Mx) proteins are dynamin-like GTPases that are inducible by interferons (IFNs) following virus infections. Most studies investigating Mx proteins have focused on their activity against influenza A viruses (IAV), although emerging evidence suggests that some Mx proteins may exhibit broader antiviral activity. Herein, we demonstrate that in addition to IAV, overexpression of mouse Mx1 (mMx1), but not mMx2, resulted in potent inhibition of growth of the human alphaherpesviruses herpes simplex virus 1 (HSV-1) and HSV-2, whereas neither inhibited the mouse betaherpesvirus murine cytomegalovirus (MCMV) in vitro. IFN induction of a functional endogenous mMx1 in primary mouse fibroblasts ex vivo was also associated with inhibition of HSV-1 growth. Using an in vitro overexpression approach, we demonstrate that mutations that result in redistribution of mMx1 from the nucleus to the cytoplasm or in loss of its combined GTP binding and GTPase activity also abrogated its ability to inhibit HSV-1 growth. Overexpressed mMx1 did not inhibit early HSV-1 gene expression but was shown to inhibit both replication of the HSV-1 genome as well as subsequent late gene expression. In a mouse model of cutaneous HSV-1 infection, mice expressing a functional endogenous mMx1 showed significant reductions in the severity of skin lesions as well as reduced HSV-1 titers in both the skin and dorsal root ganglia (DRG). Together, these data demonstrate that mMx1 mediates potent antiviral activity against human alphaherpesviruses by blocking replication of the viral genome and subsequent steps in virus replication. Moreover, endogenous mMx1 potently inhibited pathogenesis in the zosteriform mouse model of HSV-1 infection. IMPORTANCE While a number of studies have demonstrated that human Mx proteins can inhibit particular herpesviruses in vitro, we are the first to report the antiviral activity of mouse Mx1 (mMx1) against alphaherpesviruses both in vitro and in vivo. We demonstrate that both overexpressed mMx1 and endogenous mMx1 potently restrict HSV-1 growth in vitro. mMx1-mediated inhibition of HSV-1 was not associated with inhibition of virus entry and/or import of the viral genome into the nucleus, but rather with inhibition of HSV-1 genomic replication as well as subsequent late gene expression. Therefore, inhibition of human alphaherpesviruses by mMx1 occurs by a mechanism that is distinct from that reported for human Mx proteins against herpesviruses. Importantly, we also provide evidence that expression of a functional endogenous mMx1 can limit HSV-1 pathogenesis in a mouse model of infection. [ABSTRACT FROM AUTHOR]

Brain function monitors have improved safety and efficiency in general anesthesia; however, they have not been adequately tested for guiding conscious sedation for periodontal surgical procedures. This study evaluated the patient state index (PSI) obtained from the SEDline monitor (Sedline Inc., San Diego, CA) to determine its capacity to improve the safety and efficiency of intravenous conscious sedation during outpatient periodontal surgery. Twenty-one patients at the periodontics clinic of Baylor College of Dentistry were admitted to the study in 2009 and sedated to a moderate level using midazolam and fentanyl during periodontal surgery. The PSI monitoring was blinded from the clinician, and the following data were collected: vital signs, Ramsay sedation scale (RSS), medications administered, adverse events, PSI, electroencephalography, and the patients' perspective through visual analogue scales. The data were correlated to evaluate the PSI's ability to assess the level of sedation. Results showed that the RSS and PSI did not correlate (r = -0.25) unless high values associated with electromyographical (EMG) activity were corrected (r = -0.47). Oxygen desaturation did not correlate with the PSI (r = -0.08). Satisfaction (r = -0.57) and amnesia (r = -0.55) both increased as the average PSI decreased. In conclusion, within the limits of this study, PSI appears to correlate with amnesia, allowing a practitioner to titrate medications to that effect. It did not provide advance warning of adverse events and had inherent inaccuracies due to EMG activity during oral surgery. The PSI has the potential to increase safety and efficiency in conscious sedation but requires further development to eliminate EMG activity from confounding the score.