Development of novel fluor mop materials for remediation of perfluoroalkyl substances (PFAS) from groundwater.

In this study we synthesized a library of 12 novel adsorbent materials that utilize a chemically well-defined silica support for superior removal of PFAS from real groundwater from a contaminated United States Air Force base. The library of sorbents probed the importance of a fluorous, hydrophobic, and electrostatic components in the removal efficacy. The materials were assessed in batch studies with PFOA, PFOS, and PFBA and compared directly to GAC and Ion Exchange resin. Adsorption kinetics with PFOS were best fit to a pseudo-second order model and equilibrium data fit well to a Langmuir isotherm model. The results were also validated externally, and the best performing material removed greater than 90% of 8 PFAS tested and was able to be regenerated up to 5 cycles. The results provide a top performing material that with further testing can be used to clean up environmentally contaminated water and provide support for the theory that a fluorous component when combined with the electrostatic and hydrophobic components, imparts both enhanced PFAS selectivity and functional resilience to the material.

Quantifying the demineralisation of enamel using a hyperspectral camera measuring fluorescence loss.

BACKGROUND: The gold standard for quantifying mineral loss of enamel is transverse microradiography (TMR) and is complimented by the non-destructive quantitative light induced fluorescence (QLF) which measures changes in autofluorescence. Fluorescence loss has been shown to correlate with mineral loss. Building upon the established method, the use of hyperspectral fluorescence imaging (HI) allows the capture of a broader range of wavelengths to quantify fluorescence changes more accurately. METHODS: Bovine Enamel was demineralised within the dual constant depth film fermenter over 14 days and analysed using TMR, QLF and HI. The mineral change values were compared using Pearson's Correlation Coefficient. RESULTS: The analysis showed a statistically significant correlation that was equal between TMR and HI (r = 0.844) and TMR and QLF (r = 0.844), but weaker between QLF and HI (r = 0.811). CONCLUSIONS: The correlations indicate that HI is a promising valid non-destructive method for quantifying mineral loss from bovine enamel that is as accurate as QLF and complements TMR.

The cariogenic effect of starch on oral microcosm grown within the dual constant depth film fermenter.

Evidence on the link between starch intake and caries incidence is conflicting, therefore the cariogenicity of starch compared with sucrose was explored using a dual Constant Depth Film Fermenter (dCDFF) biotic model system. Bovine enamel discs were used as a substrate and the dCDFF was inoculated using human saliva. CDFF units were supplemented with artificial saliva growth media at a constant rate to mimic resting salivary flow rate over 14 days. The CDFF units were exposed to different conditions, 2% sucrose or 2% starch 8 times daily and either no additional fluoride or 1450 ppm F- twice daily. Bovine enamel discs were removed at intervals (days 3, 7, 10 and 14) for bacterial enumeration and enamel analysis using Quantitative Light Induced Fluorescence (QLF) and Transverse Microradiography (TMR). Results showed that in the absence of fluoride there was generally no difference in mineral loss between enamel exposed to either sucrose or starch when analysed using TMR and QLF (P > 0.05). In the presence of fluoride by day 14 there was significantly more mineral loss under starch than sucrose when analysed with TMR (P < 0.05). It was confirmed that starch and sucrose are similarly cariogenic within the dCDFF in the absence of fluoride. With the aid of salivary amylase, the bacteria utilise starch to produce an acidic environment similar to that of bacteria exposed to sucrose only. In the presence of fluoride, starch was more cariogenic which may be due to the bacteria producing a more hydrophobic intercellular matrix lowering the penetration of fluoride through the biofilm. This is significant as it indicates that the focus on sugars being the primary cause of caries may need re-evaluating and an increase in focus on carbohydrates is needed as they may be similarly cariogenic as sugars if not more so.

Venus Flagship Mission Concept: A Decadal Survey Study.

More than any other known planet, Venus is essential to our understanding of the evolution and habitability of Earth-size planets throughout the galaxy. We address two critical questions for planetary science: 1) How, if at all, did Venus evolve through a habitable phase? 2) What circumstances affect how volatiles shape habitable worlds? Volatile elements have a strong influence on the evolutionary paths of rocky bodies and are critical to understanding solar system evolution. It is clear that Venus experienced a different volatile element history from the Earth and provides the only accessible example of one end-state of habitable Earth-size planets. Venus will allow us to identify the mechanisms that operate together to produce and maintain habitable worlds like our own. The (VFM) concept architecture relies on five collaborative platforms: an Orbiter, Lander, variable-altitude Aerobot and two Small Satellites (SmallSats) delivered via a single launch on a Falcon 9 heavy expendable. The platforms would use multiple instruments to measure the exosphere, atmosphere and surface at multiple scales with high precision and over time. VFM would provide the first measurements of mineralogy and geochemistry of tessera terrain to examine rocks considered to be among the most likely to have formed in a habitable climate regime. Landed, descent, aerial and orbital platforms would work synergistically to measure the chemical composition of the atmosphere including the Aerobot operating for 60 days in the Venus clouds. Loss mechanisms would be constrained by the SmallSats in two key orbits. The baseline payload for VFM includes instruments to make the first measurements of seismicity and remanent magnetism, the first long-lived (60 day) surface platform and the first life detection instrument at Venus to interrogate what could be an inhabited world. The VFM concept directly addresses each of the three Venus Exploration Analysis Group (VEXAG) goals as well as several of the strategic objectives of the 2020 NASA Science Plan, Planetary Science Division, Heliophysics and Astrophysics. The simultaneous, synergistic measurements of the solid body, surface, atmosphere and space environment provided by the VFM would allow us to target the most accessible Earth-size planet in our galaxy, and gain a profound new understanding of the evolution of our solar system and habitable worlds.

A novel non-destructive technique for qualitative and quantitative measurement of dental erosion in its entirety by porosity and bulk tissue-loss.

OBJECTIVE: To explore the potential of combining non-contact profilometry (NCP) and confocal laser scanning microscopy (CLSM) data to measure the entire erosive process non-destructively and to validate findings using inductively coupled plasma-atomic emission spectroscopy (ICP-AES), scanning electron microscopy (SEM) and surface microhardness (SMH) using the same samples throughout. METHODS: Polished bovine enamel samples (n = 35) were divided into groups (7/group) with similar SMH values. Samples underwent individual erosive challenges (1 % citric acid, pH3.8) for 1, 5, 10, 15 or 30 min under stirring and aliquot extracts were analysed for Ca and P by ICP-AES. SMH was used to measure erosive softening. Profilometry was used to assess bulk volume loss (BVL). Images were captured by SEM. Samples were stained with rhodamine-B (0.1 mM, 24 h) and images captured by CLSM. Image processing was used to determine changes in fluorescent volume for the first 10 µm (ΔFV10) for each enamel sample which were combined with BVL to calculate total lesion volume (TLV). ANOVA, linear regression and Pearson correlation analysis were used where applicable. RESULTS: Surface softening, [Ca], [P], BVL and ΔFV10µm increased with acid erosion duration which were significant by 10 min (P < .01). The Ca:P ratio increased to 1.57 then decreased after 5 min erosion suggesting a sub/surface phase change, which was observed by SEM and CLSM showing significant changes to the enamel surface and subsurface morphology with time. Combination of BVL and ΔFV10 as TLV strengthened the significant correlations with [Ca], [P], and SMH (P < .01). CONCLUSION: This novel combination of CLSM and NCP allows for concurrent non-destructive quantification of the entire erosive process by mineral loss, and qualitatively characterise microstructural changes during dental erosion.

Characterisation of mineral loss as a function of depth using confocal laser scanning microscopy to study erosive lesions in enamel: A novel non-destructive image processing model.

OBJECTIVE: The aim was to develop a novel image processing protocol for confocal laser scanning microscopy (CLSM) to study mineral distribution within erosive lesions as a function of depth. METHODS: Polished bovine enamel samples (n = 80) were divided into groups (8/group) with similar mean surface microhardness (SMH) values. Samples underwent erosion (1 % citric acid pH3.8) for 1,5,10,15, or 30 min, with or without stirring giving 10 treatment groups in a 2*5 factorial design. SMH was used to measure erosive softening. Profilometry was used to measure bulk tissue loss. Samples were then stained with rhodamine-B (0.1 mM, 24 h) and imaged using CLSM. Image processing was used to measure fluorescence volume (FV) as a function of depth for each image. The data from reference images were subtracted from post-erosive data to determine changes in fluorescent volume (ΔFV) as a function of depth. 2-way ANOVA and linear regression analysis were used where applicable. RESULTS: Surface softening and bulk tissue loss increased with acid erosion duration with or without stirring. Stirring significantly increased net softening at each time point; specimens underwent significantly more bulk tissue loss (P < 0.05). CLSM showed the erosive lesion deepened as exposure to acid increased, and that at the near surface (0-10 µm) FV and ΔFV increased rapidly for stirred solutions. The increase in pore space translated to a softer surface as measured by SMH. CONCLUSION: This novel non-destructive method allows concurrent quantification of dental erosion by mineral loss as a function of depth, and qualitative characterisation of microstructural changes during early erosion.

Practical Steps to Improve Air Flow in Long-Term Care Resident Rooms to Reduce COVID-19 Infection Risk.

The potential for spread of COVID-19 infections in skilled nursing facilities and other long-term care sites poses new challenges for nursing home administrators to protect patients and staff. It is anticipated that as acute care hospitals reach capacity, nursing homes may retain COVID-19 infected residents longer prior to transferring to an acute care hospital. This article outlines 5 pragmatic steps that long-term care facilities can take to manage airflow within resident rooms to reduce the potential for spread of infectious airborne droplets into surrounding areas, including hallways and adjacent rooms, using strategies adapted from negative-pressure isolation rooms in acute care facilities.

Chapter 4: Microelements: Part I: Zn, Sn, Cu, Fe and I.

Microelements are essential components of the diet. This chapter describes the effect of several such elements: zinc, copper, iron, tin, and iodine, on oral health. As part of normal diets, these elements have limited associations with specific oral conditions. This is partly because of their presence at relatively low concentrations and partly because they are most often present as mixtures where the effect of any one element is confounded by others. Deficiencies in microelements can cause health problems. Hence supplements, often containing one or more microelements, are prescribed to combat such conditions. All these ions exhibit antibacterial properties. Such effects are invariably small at the concentrations found in conventional foods and drinks. However, at higher concentrations, these ions can inhibit acid production by plaque bacteria involved in dental caries. Of more importance, zinc and tin have potentially significant effects on the de- and remineralisation processes involved in dental caries. Indeed, both elements have been included in oral hygiene products such as toothpastes for many years. Zinc, in particular, has demonstrated not only the ability to reduce dissolution rates of enamel and hydroxyapatite but also to inhibit calculus formation. Tin can also markedly reduce the dissolution rates. Both Cu and Fe have demonstrated anti-caries effects in animal models, whilst Fe-containing drinks have been shown to reduce enamel erosion in situ. The broad spectrum antibacterial properties of iodine have been promoted for its potential use against both early childhood caries and chronic periodontitis. However, more convincing clinical research is required to validate efficacy.

Chitosan-bioglass complexes promote subsurface remineralisation of incipient human carious enamel lesions.

OBJECTIVES: To test the in vitro subsurface remineralisation efficacy of chitosan-bioglass complex on artificial white spot lesions. METHODS: 64 artificial enamel white spot lesions were created by acidic gel and equally separated for static and 7d pH-cycling models. In each model, samples were assigned to 4 groups: (1) bioglass application on chitosan pre-treated lesions (CB); (2) chitosan-bioglass slurry (CBS); (3) "standard" remineralisation solution (RS - positive control); (4) deionised water (NC - negative control). Before each treatment using remineralising agents, 3-minute pellicle was formed on lesions' surfaces. Mineral content changes, surface and subsurface microhardness and ultrastructure were evaluated by Raman intensity mapping, Knoop microhardness and scanning electron microscopy, respectively. Data were statistically analysed using one-way ANOVA with Tukey's test (p < 0.05 is considered as significant). RESULTS: Chitosan-bioglass complexing was found to exhibit greater mineral regain and recovery of surface and subsurface microhardness compared to "standard" remineralisation solution and control groups, after static and dynamic pH-cycling remineralisation for 7 days (p < 0.05). Specifically, dense precipitations with Ca/P ratios similar to that in pure hydroxyapatite (HA) were observed on surfaces and subsurfaces which filled the porosities in the dynamic pH-cycling group, leaving no prismatic enamel structure exposed. CONCLUSIONS: Chitosan-bioglass complex is positive in promoting subsurface mineral deposition in spite of the presence of a short-term salivary pellicle. Clinical significance chitosan-bioglass complexing may provide an alternative clinical strategy in remineralising early enamel carious lesions as well as desensitizing exposed porous vital dental tissues clinically.

In-vitro subsurface remineralisation of artificial enamel white spot lesions pre-treated with chitosan.

OBJECTIVE: To test the null hypothesis that chitosan application has no impact on the remineralisation of artificial incipient enamel white spot lesions (WSLs). METHODS: 66 artificial enamel WSLs were assigned to 6 experimental groups (n=11): (1) bioactive glass slurry, (2) bioactive glass containing polyacrylic acid (BG+PAA) slurry, (3) chitosan pre-treated WSLs with BG slurry (CS-BG), (4) chitosan pre-treated WSLs with BG+PAA slurry (CS-BG+PAA), (5) remineralisation solution (RS) and (6) de-ionised water (negative control, NC). Surface and cross-sectional Raman intensity mapping (960cm-1) were performed on 5 samples/group to assess mineral content. Raman spectroscopy and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) were used to identify the type of newly formed minerals. Surface and cross-sectional Knoop microhardness were implemented to evaluate the mechanical properties after remineralisation. Surface morphologies and Ca/P ratio were observed using scanning electron microscopy (SEM) coupled with energy dispersive X-ray spectroscopy (EDX). Data were statistically analysed using one-way ANOVA with Tukey's test. RESULTS: BG+PAA, CS-BG, RS presented significantly higher mineral regain compared to NC on lesion surfaces, while CS-BG+PAA had higher subsurface mineral content. Newly mineralised crystals consist of type-B hydroxycarbonate apatite. CS-BG+PAA showed the greatest hardness recovery, followed by CS-BG, both significantly higher than other groups. SEM observations showed altered surface morphologies in all experimental groups except NC post-treatment. EDX suggested a higher content of carbon, oxygen and silicon in the precipitations in CS-BG+PAA group. There was no significant difference between each group in terms of Ca/P ratio. SIGNIFICANCE: The null hypothesis was rejected. Chitosan pre-treatment enhanced WSL remineralisation with either BG only or with BG-PAA complexes. A further investigation using dynamic remineralisation/demineralisation system is required with regards to clinical application.

Effect of phytate and zinc ions on fluoride toothpaste efficacy using an in situ caries model.

OBJECTIVES: To compare and explore the dose-response of phytate-containing 1150 ppm fluoride toothpastes on model caries lesions and to determine the impact of zinc ions. METHODS: This was a single-centre, randomised, blinded (examiner/laboratory analyst), six-treatment, four-period crossover, in situ study in adults with a removable bilateral maxillary partial denture. Study treatments were toothpastes containing: 0.425% phytate/F; 0.85% phytate/F; 0.85% phytate/Zn/F; F-only; Zn/F and a 0% F placebo. Where present, F was 1150 ppm as NaF; Zn was 0.3% as ZnCl2. Human enamel specimens containing early-stage, surface-softened (A-lesions) or more advanced, subsurface (B-lesions) caries lesions were placed into the buccal flanges of participants' modified partial denture (one of each lesion type per side). A-lesions were removed after 14 days of twice-daily treatment use; B-lesions were removed after a further 14 days. A-lesions were analysed for surface microhardness recovery. Both lesion types were analysed by transverse microradiography and for enamel fluoride uptake, with B-lesions additionally analysed by quantitative light-induced fluorescence. Comparison was carried out using an analysis of covariance model. RESULTS: Statistically significant differences between 1150 ppm F and the placebo toothpastes (p < 0.05) were shown for all measures, validating the model. No differences between fluoride toothpastes were observed for any measure with little evidence of a dose-response for phytate. Study treatments were generally well-tolerated. CONCLUSIONS: Results suggest phytate has little impact on fluoride's ability to promote early-stage lesion remineralisation or prevent more advanced lesion demineralisation in this in situ caries model. Similarly, results suggest zinc ions do not impair fluoride efficacy. CLINICAL SIGNIFICANCE: Toothpastes may contain therapeutic or cosmetic agents that could interfere with fluoride's caries prevention efficacy. The present in situ caries study has demonstrated that phytate, added to provide enhanced extrinsic stain removal/prevention, and zinc, added to inhibit malodour, do not impair fluoride efficacy.

Field of genes: using Apache Kafka as a bioinformatic data repository.

Background: Bioinformatic research is increasingly dependent on large-scale datasets, accessed either from private or public repositories. An example of a public repository is National Center for Biotechnology Information's (NCBI's) Reference Sequence (RefSeq). These repositories must decide in what form to make their data available. Unstructured data can be put to almost any use but are limited in how access to them can be scaled. Highly structured data offer improved performance for specific algorithms but limit the wider usefulness of the data. We present an alternative: lightly structured data stored in Apache Kafka in a way that is amenable to parallel access and streamed processing, including subsequent transformations into more highly structured representations. We contend that this approach could provide a flexible and powerful nexus of bioinformatic data, bridging the gap between low structure on one hand, and high performance and scale on the other. To demonstrate this, we present a proof-of-concept version of NCBI's RefSeq database using this technology. We measure the performance and scalability characteristics of this alternative with respect to flat files. Results: The proof of concept scales almost linearly as more compute nodes are added, outperforming the standard approach using files. Conclusions: Apache Kafka merits consideration as a fast and more scalable but general-purpose way to store and retrieve bioinformatic data, for public, centralized reference datasets such as RefSeq and for private clinical and experimental data.

Remineralisation of enamel white spot lesions pre-treated with chitosan in the presence of salivary pellicle.

OBJECTIVE: To investigate the remineralisation of chitosan pre-treated enamel white spot lesions (WSLs) by bioglass in the presence of the pellicle layer. METHODS: 50 artificial enamel white spot lesions were created by acidic gel. Two lesions were used to investigate the formation of the pellicle layer by treating with human whole saliva for 3 min. 48 lesions were assigned to 6 experimental groups (n = 8): (1) bioactive glass slurry, (2) bioactive glass containing polyacrylic acid (BG + PAA) slurry, (3) chitosan pre-treated WSLs with BG slurry (CS-BG), (4) chitosan pre-treated WSLs with BG + PAA slurry (CS-BG + PAA), (5) "standard" remineralisation solution (RS) and (6) de-ionised water (negative control, NC). Remineralisation was carried out using a pH-cycling model for 7 days. Before each treatment using remineralising agents, 3-min pellicle was formed on lesions' surfaces. Mineral content changes, surface and subsurface microhardness and ultrastructure were evaluated by Raman intensity mapping, Knoop microhardness and scanning electron microscopy, respectively. Data were statistically analysed using one-way ANOVA with Tukey's test (p < 0.05 is considered as significant). RESULTS: Despite the heterogeneously formed pellicle layer, all groups showed an increase in surface mineral content after pH-cycling. Chitosan pre-treatment enhanced the subsurface remineralisation of WSLs using bioglass as both pre-treated groups showed greater surface and subsurface microhardness compared to NC. CS-BG exhibited denser subsurface structure than BG, while in CS-BG + PAA the crystals were bigger in size but resemble more enamel-like compared to BG + PAA as shown in SEM observations. Remineralisation of RS was limited to the surface as no significant subsurface changes of mechanical properties and structure were found. CONCLUSIONS: Chitosan pre-treatment can enhance WSL remineralisation with bioglass biomaterials when a short-term salivary pellicle is present. A further investigation using a long-term pH-cycling model with mature pellicle is suggested with regards to clinical application. CLINICAL SIGNIFICANCE: Chitosan pre-treatment has the potential in clinical application to remineralise subsurface lesions to achieve lesion consolidation.

Artefact mimicking torsades: treat the patient not the ECG.

ECG interpretation is an essential skill in the management of the acutely unwell patient and in addition to history taking and physical examination has been shown to have a significant effect on referral patterns to cardiologists. One of the basic initial steps in ECG interpretation is assessment for the presence of artefact which if present can dramatically influence the diagnosis. The most common sources of artefact are tremor e.g. in Parkinson's disease, loose skin electrodes and electromagnetic interference from other medical devices and mobile phones. The Medicines and Healthcare products Regulatory Agency in the UK advises that mobile phones should be kept at least one metre away from equipment that is sensitive to electromagnetic interference. The possibility that artefact is the cause of the ECG appearance should always be considered if bizarre ECG changes are present particularly in an asymptomatic patient. The ECG should always be interpreted in the context of the patient's condition. If artefact is thought to be the cause of the ECG appearance, then any contributory factors present should be corrected and the ECG should be repeated before invasive investigations are undertaken or treatment is administered.

A Novel Kinetic Method to Measure Apparent Solubility Product of Bulk Human Enamel.

Introduction: Tooth enamel mineral loss is influenced by its solubility product value, which is fundamental to the understanding of de- and remineralization resulting from a carious or erosive challenge. Published pKsp values for human enamel and hydroxyapatite range from 110 to 126 suggesting a heterogeneous nature of enamel solubility. However, this range of values may also result from the variety of methods used, e.g., some authors reporting values for suspensions of enamel powder and others for bulk enamel. The aim of this study was to develop a method to measure the solubility of bulk human enamel under controlled in vitro conditions simulating demineralization behavior of enamel within the oral environment using scanning microradiography (SMR). SMR was used to monitor real-time changes in enamel demineralization rates at increasing calcium concentrations in a caries simulating demineralization solution until the concentration at which thermodynamic equilibrium between enamel and solution was achieved. Method: 2 mm thick caries free erupted human enamel slabs with the natural buccal surfaces exposed were placed in SMR cells exposed to circulating caries-simulating 2.0 L 0.1 M pH = 4.0 acetic acid, at 25°C. SMR was used to continuously measure in real-time the decrease in mineral mass during the demineralization at 5 different points from on each slab. Demineralization rates were calculated from a linear regression curve of projected mineral mass against demineralization time. Changes in the demineralization rates were monitored following a series of successive increases in calcium (and phosphate at hydroxyapatite stoichiometric ratios of Ca:P 1.67) were added to the demineralizing solution, until demineralization ceased. The pH was maintained constant throughout. Results: Demineralization halted when the calcium concentration was ~30 mM. At higher calcium concentrations, mineral deposition (remineralization) occurred. By comparison with results from speciation software calculations for the calcium phosphate ternary system, this result suggests that the bulk solubility product of enamel (pKspBEnamel) under the conditions used is 121. Discussion: The apparent pKspBEnamel under these conditions was higher than many previous reported values, and much closer to those previously reported for HAp. However, this is a bulk value, and does not reflect that enamel is a heterogeneous material, nor the influence of ionic inclusions.

Longitudinal correlation of 3D OCT to detect early stage erosion in bovine enamel.

Erosive tissue-loss in dental enamel is of significant clinical concern because the net loss of enamel is irreversible, however, initial erosion is reversible. Micro-hardness testing is a standard method for measuring initial erosion, but its invasive nature has led to the investigation of alternative measurement techniques. Optical coherence tomography (OCT) is an attractive alternative because of its ability to non-invasively image three-dimensional volumes. In this study, a four-dimensional OCT system is used to longitudinally measure bovine enamel undergoing a continuous erosive challenge. A new method of analyzing 3D OCT volumes is introduced that compares intensity projections of the specimen surface by calculating the slope of a linear regression line between corresponding pixel intensities and the associated correlation coefficient. The OCT correlation measurements are compared to micro-hardness data and found to exhibit a linear relationship. The results show that this method is a sensitive technique for the investigation of the formation of early stage erosive lesions.

Evidence of an in vitro Coupled Diffusion Mechanism of Lesion Formation within Microcosm Dental Plaque.

The purpose of this study was to determine whether or not the dual constant-depth film fermenter (dCDFF) is able to produce caries-like enamel lesions and to ascertain further information regarding the performance of this fully functional biological caries model. Conditions were defined by the continuation (CF) or cessation (FF) of a saliva-type growth medium supply during 50-mM sucrose exposures (8 times daily). Hydroxyapatite (n = 3) and bovine enamel (n = 3) substrata were included within each condition and samples extracted after 2, 4, 8, and 16 days. Community profiles were generated for fastidious anaerobes, Lactobacillus spp., Streptococcus spp., mutans streptococci (MS), and Veillonella spp. using selective culture techniques and enamel demineralisation assessed by transverse microradiography. Results demonstrated that the dCDFF model is able to produce caries-like enamel lesions with a high degree of sensitivity where reduced ionic strength within the FF condition increased surface layer mineral deposition. Between conditions, biofilm communities did not differ significantly, although MS in the biofilms extracted from the FF condition rose to a higher proportion (by 1.5 log10 units), and Veillonella spp. were initially greater within the CF condition (by 2.5 log10 units), indicating an enhanced ability for the clearance of low-pKa acids following exposures to sucrose. However, both conditions retained the ability for caries-like lesion formation.

Sequential bilateral anterior dislocation of the shoulder.

A rare case of sequential bilateral anterior shoulder dislocation in an older adult after trauma is presented. The shoulders were dislocated sequentially in 2 separate falls. To the best of our knowledge, this is the second case of sequential or non simultaneous bilateral anterior shoulder dislocation reported to date.

Inhibitory Effects of Zinc Ions on Enamel Demineralisation Kinetics in vitro.

Metal ions including zinc have the ability to influence enamel demineralisation. However, there is a paucity of data regarding reductions in demineralisation effected by zinc ions (Zn2+) in the literature. Therefore the aim was to measure the effects of zinc ion concentration ([Zn2+]) on the real-time in vitro demineralisation of enamel, during exposure to caries-simulating conditions, using scanning microradiography (SMR). Human enamel blocks were fixed in SMR environmental cells, through which acidic solutions (0.1 M acetic acid, pH 4.0) were circulated for periods of 50 h. SMR was used to quantitatively measure continuous mineral mass loss. Subsequently, the effects of sequentially increasing [Zn2+] (0.1-3,565 ppm) in the acidic solutions were measured on the rate of enamel demineralisation. This study demonstrated that Zn2+ even at low concentrations significantly reduces enamel demineralisation. There was a log-linear relationship between the mean percentage reduction in demineralisation and increasing [Zn2+] up to 3,565 ppm, i.e. the change in the overall percentage reduction in demineralisation was greater at lower concentrations than at higher concentrations, with 60% reduction at 36 ppm increasing to 90% at 3,565 ppm. In conclusion, SMR demonstrated the ability of Zn2+ to reduce the rate of enamel demineralisation under real-time in vitro acid conditions simulating dental caries. The results suggest that Zn2+ in the oral fluids could protect against enamel demineralisation during an acidic challenge. The log-linear relationship between [Zn2+] and demineralisation suggests that the reduction in enamel dissolution is limited by the saturation of surface sites on the enamel surface.