Application of machine learning approaches to predict the impact of ambient air pollution on outpatient visits for acute respiratory infections.

With a remarkable increase in industrialization among fast-developing countries, air pollution is rising at an alarming rate and has become a public health concern. The study aims to examine the effect of air pollution on patient's hospital visits for respiratory diseases, particularly Acute Respiratory Infections (ARI). Outpatient hospital visits, air pollution and meteorological parameters were collected from March 2018 to October 2021. Eight machine learning algorithms (Random Forest model, K-Nearest Neighbors regression model, Linear regression model, LASSO regression model, Decision Tree Regressor, Support Vector Regression, X.G. Boost and Deep Neural Network with 5-layers) were applied for the analysis of daily air pollutants and outpatient visits for ARI. The evaluation was done by using 5-cross-fold confirmations. The data was randomly divided into test and training data sets at a scale of 1:2, respectively. Results show that among the studied eight machine learning models, the Random Forest model has given the best performance with R2 = 0.606, 0.608 without lag and 1-day lag respectively on ARI patients and R2 = 0.872, 0.871 without lag and 1-day lag respectively on total patients. All eight models did not perform well with the lag effect on the ARI patient dataset but performed better on the total patient dataset. Thus, the study did not find any significant association between ARI patients and ambient air pollution due to the intermittent availability of data during the COVID-19 period. This study gives insight into developing machine learning programs for risk prediction that can be used to predict analytics for several other diseases apart from ARI, such as heart disease and other respiratory diseases.

Three-Dimensional Evaluation of Condyle-Glenoid Fossa Complex Following Treatment with Herbst Appliance.

The purpose of the present retrospective observational study was to compare the effects of treatment with Herbst appliance and fixed therapy with elastics on the condyle and glenoid fossa complex. Thirty patients aged between twelve and sixteen years with skeletal Class II malocclusion who met the inclusion criteria were included in the study: fifteen patients treated with Herbst appliance (Group 1), and fifteen patients treated with orthodontic camouflage using MBT prescription (MBTTM Versatile+ Appliance System) (Group 2). For Group 2, patients had CBCT scans taken before treatment either after Herbst appliance removal or at the end of treatment. CBCT scans were evaluated for changes in condyle-glenoid fossa complex using the In Vivo Dental 5.1 software. Statistical significance was set at p ≤ 0.05. On inter-group comparison, the Herbst group showed statistically significant increases in the condylar height of 1.35 mm (p ≤ 0.001) on the right and 1.21 mm (p ≤ 0.01) on the left side, and a condylar volume of 111.03 mm3 (p ≤ 0.01) on the right and 127.80 mm3 (p ≤ 0.001) on the left side. The Herbst group showed anterior remodelling on the postero-superior aspect of glenoid fossa. Herbst appliance treatment induced growth at the condylar head and anterior remodelling of glenoid fossa, thereby improving the maxilla-mandibular relationship in growing skeletal Class II patients.

Three-Dimensional Evaluation of the Tongue Volume in Different Dentoskeletal Patterns - A Cone Beam Computed Tomographic Study.

AIM: The aim of this study is to evaluate tongue volume using cone-beam computed tomographic (CBCT) and its correlation to different growth patterns in patients. MATERIALS AND METHODS: Sixty preorthodontic records of CBCT scans of subjects ranging from 14 to 25 age group from retrospective data of department were selected for the study. Patients were classified into three groups based on angle FMA; Group I (n = 20) with average growth pattern (FMA 22°-28°); Group II (n = 20) vertical growth pattern (FMA >28°); Group III (n = 25) horizontal growth pattern (FMA <20°). Tongue volume evaluation was done using Myrian® Software. Dentoskeletal features and parameters related to archform such as palatal vault depth, interpremolar, and intermolar distance were evaluated in all the subjects. ANOVA test was used for intergroup comparison of tongue volume and dentoskeletal parameters in all three groups. Correlation of the tongue volume to dentoskeletal parameters was done using Pearson's correlation test. RESULTS: Mean tongue volume in Group I was 66.10 cm3, Group II, 66.04 cm3 and Group III was 66.72 cm3. There was a statistically significant correlation (P < 0.5) of tongue volume with palatal vault width, maxillary length, and mandibular interpremolar and intermolar distance among dentoskeletal parameters. CONCLUSION: Tongue volume was found equal in all groups despite the variation in growth patterns. Skeletal differences leading to different growth patterns were found to be related to mandibular morphology. The results indicate the indirect role of the tongue in causing malocclusion in orthodontic patients.

Effect of Craniofacial Morphology on Pharyngeal Airway Volume Measured Using Cone-Beam Computed Tomography (CBCT)-A Retrospective Pilot Study.

BACKGROUND: The present study aimed to determine the correlation between pharyngeal airway volume and craniofacial morphology through cone-beam computed tomography (CBCT). Additionally, the study analyzed the influence of gender on pharyngeal airway volume. (2) Methods: 80 CBCT scans of 40 male and 40 female patients (mean age: 15.38 + 1.10 years) fulfilling the eligibility criteria were included. CBCT scans were evaluated for pharyngeal airway volume using the In Vivo Dental 5.1 software. Additionally, CBCT-derived lateral cephalograms were used to assess various craniofacial morphology parameters. To examine the influences of gender on airway volume, T-test was carried out. Correlation between airway volume and craniofacial parameters were measured using Pearson correlation followed by regression analysis. The value of p < 0.05 was considered statistically significant. RESULTS: The mean airway volume was significantly greater in males than in females. A statistically significant negative correlation was found between maxillary plane inclination and pharyngeal airway volume. In contrast, a positive correlation was observed between mandibular length and lower molar inclination with oropharyngeal and total pharyngeal airway volume. Females showed a statistically significant positive correlation between the pharyngeal airway volume and sagittal position of maxilla and mandible; they also showed a negative correlation between oropharyngeal airway volume and the mandibular plane angle. CONCLUSIONS: Overall, the pharyngeal airway space differs significantly between males and females. Craniofacial morphology does have a significant effect on the pharyngeal airway, especially on the oropharyngeal airway volume.

Effects of miniplate anchored Herbst appliance on skeletal, dental and masticatory structures of the craniomandibular apparatus: A finite element study.

OBJECTIVE: To analyze the stress distribution in the hard and soft tissue structures of craniomandibular complex during mandibular advancement with miniplate anchored rigid fixed functional appliance (FFA) using Finite Element Analysis (FEA). MATERIAL AND METHODS: The virtual model consisting of all the maxillofacial bones (up to calvaria), the mandible and temporomandibular joint (TMJ) was generated using the volumetric data from pre-treatment CBCT-scan of a growing patient. The masticatory muscles, other soft tissues, Herbst appliance and plate geometry were modelled mathematically. Force vectors simulating muscle contraction at rest and advanced mandibular positions, with protraction force of 8N were applied. The final model was imported into ANSYS for analysis after assigning material properties. RESULTS: The maximum von Mises stress of 11.69MPa and 11.96MPa magnitude was observed in the region of pterygoid plates and at the bone-miniplate interface respectively, with the mandibular advancement of 7mm. Stress patterns were also noted at the condylar neck. The stress values observed in the medial and lateral pterygoid muscles were of 10.42MPa and 4.16MPa magnitude, respectively. Stress was noted in the bucco-cervical region of the upper posterior teeth, but negligible change was seen on the lower anterior teeth and periodontal ligament. CONCLUSION: Miniplate Anchored Herbst Appliance brought about Class II skeletal correction in growing children as it was accompanied by minimal changes in the inclination of the lower incisors. Soft tissue structures like pterygoid muscles and discal ligaments exhibited increased stress whereas masseter muscle displayed reduction in stresses.

Cone beam computed tomographic evaluation of pharyngeal airway in North Indian children with different skeletal patterns.

BACKGROUND: In growing patients with skeletal discrepancies, early assessment of functional factors can be vital for the restoration of normal craniofacial growth. AIM: To compare airway volumes in patients with mandibular retrognathism with the normal anteroposterior skeletal relationship, thereby assessing the association between cephalometric variables and airway morphology. METHODS: Cone-beam computed tomography volume scans, and lateral cephalograms, 3-dimensional airway volume and cross-sectional areas of 120 healthy children (54 boys and 66 girls mean age 15.19 ± 1.28) which were done for orthodontic assessment were evaluated. The subjects were divided into 2 groups based on the angle formed between point A, Nasion and point B (ANB) values and cephalometric variables (such as anterior and posterior facial height, gonial angle etc.) airway volumes, and cross-sectional measurements were compared using independent t tests. Pearson's correlation coefficient test was used to detect any relationship of different parts of the airway and between airway volume and 2-dimensional cephalometric variables. RESULTS: Means and standard deviations for cephalometric, cross-sectional, and volumetric variables were compared. ANB, mandibular body length and facial convexity were statistically highly significant (P < 0.01) whereas condylion to point A, nasal airway and total airway volume (P < 0.05) were statistically significant. The nasal airway volume and the superior pharyngeal airway volume had a positive correlation (P < 0.01), nasal airway was correlated to middle (P < 0.05) and total airway superior had a relation with middle (P < 0.05), inferior and total airway (P < 0.05), middle was related to all other airways; inferior was also related to all the airways except nasal. Lateral cephalometric values were positively correlated with the airway volume with Frankfurt Mandibular Plane Angle and facial convexity showed significant correlations with total airway volume (P < 0.05). Additionally, ANB angle was significantly correlated with total airway volume and superior airway (P < 0.05). CONCLUSION: The mean total airway volume in patients with retrognathic mandible was significantly smaller than that of patients with a normal mandible.

Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms.

BACKGROUND: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. METHODS: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. RESULTS: When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. CONCLUSION: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.

Transition to clean household energy through an application of integrated model: Ensuring sustainability for better health, climate and environment.

Sustained use and adoption of clean cooking fuels have become an important concern for developing countries due to the enormous burden of diseases attributable to household air pollution (HAP). The transition and adoption of clean household energy involve various socio-economic, behavioral, and technological barriers at different community levels. Hence, the present paper aims to scrutinize the factors, key determinants, and other interventions among rural households that limit clean cookstoves' sustained uses. The study proposes an integrated model to enhance clean cooking fuel uptake and uses based on the available evidence. The health, climate and environmental factors were identified as the key to trigger the adoption of clean cooking fuel alternatives. The model comprises the integration of components for targeted clean fuel policy interventions and promotes green recovery. The elements include Knowledge, Housing characteristics, Awareness, Interventions, Willingness to pay, Adoption, Lower emissions and Gender Equality (THE KHAIWAL model) to ascertain the intervention focus regions. Integration of model components in policy implementation will promote clean household energy to reduce emissions, leading to improve quality of life, good health, women empowerment, better air quality and climate.

Intra- and Interobserver Reliability of Bone Volume Estimation Using OsiriX Software in Patients with Cleft Lip and Palate Using Cone Beam Computed Tomography.

The objective of the current study was to evaluate intra- and interobserver bone volume measurements and effect of orientation on the reliability of bone volume evaluation in as-acquired vis-à-vis oriented cone beam computed tomography scans using Osirix software and possible correlation between gender, age, and bone volume required. For this, 31 cone beam computed tomography (CBCT) scans of 14 girls and 17 boys (aged 9-13) with unilateral cleft lip and/or palate who met the inclusion criteria were analyzed. Efficacy and reliability of third party software Osirix for bone volume calculation was assessed using as acquired and oriented volumes by three specialists (a radiologist, an orthodontist, and an oral maxillofacial surgeon). The dataset and readings were anonymized to prevent any bias. Two-way mixed model analysis on as-acquired and oriented observations exhibited intra-class coefficient (ICC) values ≥ 0.90. Wilcoxon signed rank test (p = 0.10) and Kruskal-Wallis ANOVA (p = 0.46) indicated that although a clinical difference in volume assessment was seen between as-acquired and oriented observations (inter-observer and intra-observer), it was statistically insignificant. Spearman's bi-variate correlation analysis revealed a significant relation between the type (side) of cleft and bone volume required to fill the defect (p < 0.05). Although there was clinical difference in bone volume measurement by the three observers, it was insignificant statistically. Clefts on the left side in the patients had significantly more bone required than the right side, whereas age and gender had no relation with bone needed to fill the defect. OsiriX software provided good reliability in measurements of bone volume.

Impact of the COVID-19 pandemic on clean fuel programmes in India and ensuring sustainability for household energy needs.

Clean cooking energy strategies are critical for reducing air pollution, improving health, and achieving related Sustainable Development Goals. The recent COVID-19 lockdowns may impact the transition towards clean cooking fuels. The nationwide lockdown is likely to affect key factors such as energy access, income, transportation, etc., that play a role in decisions influencing household fuel use. The rural population already bears the burden of poverty and may not be able to afford and access clean cooking fuels during the lockdown. They are thus vulnerable to reversion to their traditional cooking methods using solid biomass fuels. The household air pollution caused due to the use of polluting fuels increases their susceptibility to non-communicable diseases, and thus may intensify the risk and severity of COVID-19 infection. Hence, there is an urgent need to expand sustainable energy solutions worldwide. The present study applies the DPSIR modeling framework to establish a set of comprehensive indicators for addressing the transition towards clean cooking fuels during the COVID-19 pandemic. The study also provides insights on various strategies adopted in India in response to the COVID-19 pandemic for maintaining continuity of delivering benefits under a clean cookstove program. The study offers future directions to ensure the transition towards cleaner fuels and sustainability.

Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study.

The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically repaired UCLP, who met the inclusion criteria, were selected. Following the acquisition of CBCT scans, fourteen bilateral landmarks were selected. The distance of the bilateral landmark was calculated from the midsagittal plane on the cleft and non-cleft sides for both frontal and axial views. Tracings were done;the data obtained was subjected to statistical analysis;and intra-observer variability was checked with intraclass correlation coefficient (ICC) and two-way ANOVA. Subsequently, the measurements were subjected to paired t-tests at the 95% level of significance with Bonferroni correction. A significant reduction of pyriforme and an alveolar crest above the maxillary 1st molar were discerned in frontal analysis on the cleft side. In the axial view, the zygomatic arch, malar, porion and alveolar crest at the molar region were non-significant, but the alveolar crest at the premolar region (p < 0.004)) was significantly decreased. In the frontal analysis, pyriforme and the alveolar crest above the maxillary 1st molar, and, in the axial view, premolar widths, showed significant reduction when comparing the cleft vis-a-vis non-cleft sides.

Detection and identification of dust mite allergens in the air conditioning filters in Chandigarh, India.

Modern lifestyle with the increasing use of air conditioner (AC) has been linked with breathing difficulties, irritation, dryness, and other symptoms. Hence, dust mites were isolated from AC filters, which causes allergic diseases. A total of 95 dust samples were collected from AC filters from hospitals, guest house, office, school, and homes in Chandigarh, India. The highest concentration of dust mites was detected from hospitals (9/g), offices (7/g), households (6/g), guest houses (3/g), and schools (0/g). Based on the morphology of dust mites observed under a light microscope, Dermatophagoides and Acarus species were found most common. Indoor air quality was also monitored to find out their relation with dust mites present in AC filters. Further, the respiratory health status of indoor facility users was also assessed using a standard questionnaire as a study tool. It was seen that 55.3% of male among the total respondents were having an allergy and only 44.7% of the females had an allergy. The allergy among the male respondents (55.3%) was significantly more (p < 0.05) in comparison with female respondents (44.7%). Some of the respondents also reported a family history of rhinitis (31.9%), asthma (12.8%), recurrent urticaria (6.4%), and conjunctivitis (6.4%). Interestingly, 23.4% of study participants reported that they get disturbed by the use of AC and house dust was found to be the most triggering factor in enhancing the symptoms of allergy. Thus, it is recommended that air conditioner filters should be cleaned regularly to prevent the accumulation of the dust mites and related allergens on filter dust.

Appraisal of thermal comfort in rural household kitchens of Punjab, India and adaptation strategies for better health.

There is increasing evidence of adverse health impact of solid biomass fuel, and its use may hinder thermal comfort, which may lead to lower quality of life. Hence, current study aims to assess the thermal comfort at a rural location of Punjab, India. The indoor air temperature and relative humidity in rural households during winter varied from 11.9-25.2 °C and 63.4-90.5% respectively, during pre-summer it ranged between 21.3 and 27.4 °C and 48.4-78.4% while during summer it ranged between 28.4 and 37.8 °C and 13.7-63.8% respectively. The PMV of the households ranged between -0.85 to 0.69 (winter), -0.32 to 0.4 (pre-summer) and 0.53 to 1.25 (summer) for American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) 55-2017 and -0.56 to 1.11 (winter), 0.04 to 0.99 (pre-summer) and 1.21-2.36 (summer) for European Committee for Standardization (CEN) European standard EN15251 while the Predicted Percentage of Dissatisfied ranged between 5 and 20% (winter), 5-8% (pre-summer) and 11-38% (summer) for ASHRAE 55-2017 and 5-31% (winter), 5-26% (pre-summer) and 36-90% (summer) for EN15251 guidelines. On the other hand, Adaptive thermal comfort (ATC) during winter and pre-summer was comfortable for 80 and 90% acceptable limits (ASHRAE-2017) and ranged between too cool to comfortable for EN15251 (Class I, II and III) while during summer thermal comfort for occupants was comfortable for ASHRAE 2017 and EN15251 (Class I, II, III) but did not comply with EN guidelines in some households using either clean fuel or chullah. Thermal comfort sensation was observed to be slightly cool to neutral during winter, neutral during pre-summer and slightly warm during summer according to Predicted Mean Vote method. The results were also compared using a thermal comfort and household survey and found to be similar with the model results. Climate change is leading to changes in temperature which may have an impact on the built environment. Hence, the current study suggests formulating policies on the uses of household fuel and design of kitchen with proper ventilation to increase thermal comfort which in turn will also reduce air pollutants.

Development of a subunit vaccine for prevention of Clostridium difficile associated diseases: Biophysical characterization of toxoids A and B.

Inactivation of bacterial toxins for use in human vaccines traditionally is achieved by treatment with formaldehyde. In contrast, the bivalent experimental vaccine for the prevention of C. difficile infections (CDI) that is currently being evaluated in clinical trials was produced using a different strategy. C. difficile toxins A and B were inactivated using site-directed mutagenesis and treatment with 1-ethyl-3-[3-dimethylaminopropyl]carbodiimide hydrochloride/N-hydroxysulfosuccinimide (EDC/NHS). In the present work we investigate the effect of genetic and chemical modifications on the structure of inactivated toxins (toxoids) A and B. The far-UV circular dichroism (CD) spectra of wild type toxins, mutated toxins, and EDC/NHS-inactivated toxoids reveal that the secondary structure of all proteins is very similar. The near-UV CD spectra show that aromatic residues of all proteins are in a unique asymmetric environment, indicative of well-defined tertiary structure. These results along with the fluorescence emission maxima of 335 nm observed for all proteins suggest that the tertiary structure of toxoids A and B is preserved as well. Analytical ultracentrifugation data demonstrate that all proteins are predominantly monomeric with small fractions of higher molecular weight oligomeric species present in toxoids A and B. Differential scanning calorimetry data reveal that genetic mutations induce thermal destabilization of protein structures. Subsequent treatment with EDC/NHS results either in a minimal (1 °C) increase of apparent thermostability (toxoid B) or no change at all (toxoid A). Therefore, our two-step inactivation strategy is an effective approach for the preparation of non-toxic proteins maintaining native-like structure and conformation.

Household air pollution from various types of rural kitchens and its exposure assessment.

Exposure to household air pollutants has become a leading environmental health risk in developing countries. Considering this, real-time temporal variation in fine particulate matter (PM2.5) and carbon monoxide (CO) concentrations were measured in various types of rural household kitchens. Observed average concentrations of PM2.5, CO, percent relative humidity (%RH) and temperature (T) in five different kitchen types were 549.6µg/m3, 4.2ppm, 70.2% and 20°C respectively. Highest CO and PM2.5 concentration were found in household performing cooking in indoor kitchens (CO: 9.3ppm; PM2.5: 696.5µg/m3) followed by outdoor kitchens (CO: 5.8ppm; PM2.5: 539.5µg/m3). The concentration of PM2.5 and CO varied according to the fuel type and highest concentration was observed in kitchens using cowdung cakes followed by agricultural residue>firewood>biogas>Liquefied Petroleum Gas (LPG). Results revealed that the pollutants concentration varied with kitchen type, fuel type and the location of kitchen. An exposure index was developed to calculate the exposure of cook, non-cook and children below 5years. Analysis of exposure index values shows that cooks, who use solid biomass fuel (SBF) in indoor kitchen, are four times more exposed to the harmful pollutants than the cooks using clean fuel. Further, using indoor PM2.5 concentrations, hazard quotient was calculated based on evaluation of intake concentration and toxicological risk, which also shows that SBF users have higher health risks (hazard quotient>1) than the clean fuel (LPG) users.

Evaluation of stress changes in the mandible with a fixed functional appliance: a finite element study.

INTRODUCTION: The aim of this study was to evaluate the effects of a fixed functional appliance (Forsus Fatigue Resistant Device; 3M Unitek, Monrovia, Calif) on the mandible with 3-dimensional finite element stress analysis. METHODS: A 3-dimensional finite element model of the mandible was constructed from the images generated by cone-beam computed tomography of a patient undergoing fixed orthodontic treatment. The changes were studied with the finite element method, in the form of highest von Mises stress and maximum principal stress regions. RESULTS: More areas of stress were seen in the model of the mandible with the Forsus compared with the model of the mandible in the resting stage. CONCLUSIONS: This fixed functional appliance studied by finite element model analysis caused increases in the maximum principal stress and the von Mises stress in both the cortical bone and the condylar region of the mandible by more than 2 times.

Three-dimensional evaluation of pharyngeal airway in complete unilateral cleft individuals and normally growing individuals using cone beam computed tomography.

AIMS: The aim of the present study was to evaluate pharyngeal airway in cleft individuals and normally growing individuals using cone beam computed tomography. MATERIALS AND METHODS: Cone beam computed tomography scans of 22 individuals were obtained from the Department of Orthodontics and divided in two groups. Group 1 includes 11 cases with complete unilateral cleft lip and palate (mean age, 12 years) and group 2 includes 11 noncleft cases (mean age, 14 years). The oropharyngeal, nasopharyngeal, and oronasal pharyngeal airway was evaluated between the two groups. RESULTS: In the cleft group, the volume of the nasopharyngeal airway was found to be 3.66 cm(3); of the oropharyngeal airway, 9.28 cm(3); and of the oronasal pharyngeal airway, 12.67 cm(3). The volume of the nasopharyngeal airway was found to be significantly reduced in the cleft palate group when compared with the noncleft group. CONCLUSION: The nasopharyngeal airway was found to be significantly smaller among the children with cleft palate than among those in the control group.

Nonreplicating vaccines can protect african green monkeys from the memphis 37 strain of respiratory syncytial virus.

BACKGROUND: We evaluated the immunological responses of African green monkeys immunized with multiple F and G protein-based vaccines and assessed protection against the Memphis 37 strain of respiratory syncytial virus (RSV). METHODS: Monkeys were immunized with F and G proteins adjuvanted with immunostimulatory (CpG) oligodeoxyribonucleotides admixed with either Alhydrogel or ISCOMATRIX adjuvant. Delivery of F and G proteins via replication incompetent recombinant vesicular stomatitis viruses (VSVs) and human adenoviruses was also evaluated. Mucosally or parenterally administered recombinant adenoviruses were used in prime-boost regimens with adjuvanted proteins or recombinant DNA. RESULTS: Animals primed by intranasal delivery of recombinant adenoviruses, and boosted by intramuscular injection of adjuvanted F and G proteins, developed neutralizing antibodies and F/G protein-specific T cells and were protected from RSV infection. Intramuscular injections of Alhydrogel (plus CpG) adjuvanted F and G proteins reduced peak viral loads in the lungs of challenged monkeys. Granulocyte numbers were not significantly elevated, relative to controls, in postchallenge bronchoalveolar lavage samples from vaccinated animals. CONCLUSIONS: This study has validated the use of RSV (Memphis 37) in an African green monkey model of intranasal infection and identified nonreplicating vaccines capable of eliciting protection in this higher species challenge model.

Non-propagating, recombinant vesicular stomatitis virus vectors encoding respiratory syncytial virus proteins generate potent humoral and cellular immunity against RSV and are protective in mice.

Respiratory syncytial virus (RSV) is a major cause of severe lower respiratory tract illness in infants, the elderly, and other high-risk individuals. Despite years of research in this field, there is no effective licensed vaccine to prevent RSV infection. We have generated candidate RSV vaccines using a recombinant vesicular stomatitis virus (rVSV) replicon in which the attachment and fusion domains of the VSV glycoprotein (G) have been deleted (rVSV-Gstem), rendering the virus propagation-defective except in the presence of complementing VSV G provided in trans. A form of this vector encoding the RSV fusion protein (F) gene expressed high levels of F in vitro and elicited durable neutralizing antibody responses as well as complete protection against RSV challenge in vivo. Mice vaccinated with rVSV-Gstem-RSV-F replicons also developed robust cellular responses characterized by both primary and memory Th1-biased CD8+ and CD4+ T cells. Furthermore, a single high dose of the Gstem-RSV-F replicon was effective against challenge with both RSV A and B subgroup viruses. Finally, addition of an RSV glycoprotein (G)-expressing Gstem vector significantly improved the incomplete protection achieved with a single low dose of Gstem-RSV-F vector alone.

Characterization of a posed smile and evaluation of facial attractiveness by panel perception and its correlation with hard and soft tissue.

AIM: To examine whether specific hard and soft tissue had any effect on smile characteristics and to ascertain the opinions of laypersons and clinicians in evaluating facial attractiveness among different occlusions. METHOD: Photographs of posed smiles, along with profiles and full faces, of 76 patients with different occlusions were captured, and a lateral cephalogram of each subject was traced. These photographs were judged by a panel of 10 clinicians and 10 laypersons on a 5-point visual analog scale. Quantitative measurements were carried out on the smile images for 14 smile characteristics. The effect of hard and soft tissue on these characteristics was also examined. RESULTS: The upper vermilion lip thickness was affected by Pt.A-UI and E-line to upper lip, while the lower vermilion lip thickness was affected by lower anterior facial height. FMA had a significant positive effect on gingival display (P ≤ .05). This meant that an increase in FMA also caused the gingival display to increase. The nasolabial angle showed a significant positive effect on incisal display, while FMA showed a negative effect on intercanine width. Lower facial height and FMA had a significant negative effect on the smile index. A correlation was found between the judgments of clinicians and laypersons. Both judged Class I relationships to be the most attractive. CONCLUSION: FMA was found to have a positive effect on the amount of gingival display. It was also observed that patients with Class II Division 1 relationships had the thickest lips compared with patients having other types of occlusions. Class III patients exhibited no gingival display on smile. Patients with Class I showed the maximum smile width, while patients with Class III showed the least amount of buccal corridor.