Clinical effectiveness of pit and fissure sealants in primary and permanent teeth of children and adolescents: an umbrella review

PURPOSE

This umbrella review aimed to critically appraise the evidence published in systematic reviews (SRs) on the clinical effectiveness of sealants compared with each other/the non-use in primary/permanent teeth of children and adolescents with at least 12-month follow-up.

METHODS

A systematic literature search on 4 electronic databases was conducted up to January 18th, 2023. Following handsearching, two review authors independently screened retrieved articles, extracted data, and assessed the risk of bias (RoB) using the risk of bias in systematic reviews (ROBIS) tool. Based on a citation matrix, the overlap was interpreted by the corrected covered area (CCA).

RESULTS

Of 239 retrieved records, 7 SRs met the eligibility criteria with a moderate overlap among them (CCA = 7.4%). For primary molars, in 1120 1.5- to 8-year-old children, data on the clinical effectiveness of sealants were inconclusive. For permanent molars, 3 SRs found a significant caries risk reduction for sealants versus non-use (≤ 36-month follow-up). There was insufficient evidence to proof superiority of sealants over fluoride varnish for caries prevention (3 SRs), and to rank sealant materials according to the best clinical effectiveness in permanent molars. One study was rated at low and 6 at high RoB, which did not allow for a valid quantitative synthesis.

CONCLUSION

Considering the limitations of this umbrella review, sealants are more effective for caries prevention in children's permanent molars compared to no treatment. Future well-implemented RCTs are needed to draw reliable conclusions on the clinical effectiveness of sealants in primary and permanent teeth of children and adolescents.

Towards Clinical Translation of Microbeam Radiation Therapy (MRT) with a Compact Source

PURPOSE/OBJECTIVE(S)

MRT is an innovative concept of spatially fractionated radiation therapy that has demonstrated substantially improved normal tissue tolerance while achieving local tumor control in a wealth of preclinical studies. In MRT a collimator shapes a few micrometers wide planar x-ray beams with a spacing of a few 100 µm. MRT has the potential to improve cancer treatment substantially. However, until now, only a few large 3rd generation synchrotrons provide beam parameters that would allow patient treatments and therefore, MRT has not yet become clinically available. For a clinical translation, compact x-ray sources are required, that produce high dose rate orthovoltage x-rays from a micrometer sized emitter.

MATERIALS/METHODS

We developed and built a first prototype of a line focus x-ray tube (LFxT) dedicated to preclinical MRT research. By exploiting the heat capacity limit, the LFxT can deliver dose rates above 100 Gy/s from a just 50 µm-wide focal spot without destroying the rapidly (>200 Hz) rotating x-ray target. A bespoke collimator splits the homogeneous x-ray field into 50 µm wide high-dose peaks separated by 350 µm wide low-dose troughs (valleys). While the prototype in our lab is restricted to a power of 90 kW and 10 Gy/s at 300 kVp, we have started the development of the first clinically usable LFxT-2 at 1.5 MW power and >100 Gy/s at 600 kVp beam quality. We investigated the clinical applicability of the LFxT-2 by performing retrospective treatment planning studies. In particular, we were examining, whether 600 kVp photons would suffice to meet clinical dose constraints in MRT treatments treatment scenarios for first clinical use of MRT. We coupled the open source platform 3D Slicer with an in-house developed dose calculation algorithm for MRT treatment planning. For comparability of spatially fractionated MRT doses with conventional broad beam treatments, the MRT dose was converted to equivalent uniform dose (EUD) and equivalent doses in 2-Gy-fractions (EQD2). The 3D Slicer RT toolkit enabled the dosimetric analysis based on dose volume histograms (DVHs).

RESULTS

We installed a preclinical prototype of the LFxT that is currently put into operation and commissioned. Simulations show the feasibility of the next generation LFxT-2 with more than 100 Gy/s peak dose rate. Planned MRT dose distributions with the LFxT-2 meet established radiotherapy dose constraints in many of the investigated clinical cases. However, treatment planning procedures are not yet optimal and require improvement.

CONCLUSION

In a next step, we will build the LFxT-2 and aim for first clinical MRT trials at this source. In order to further improve calculated MRT dose distributions, we will implement inverse treatment planning techniques.

Management of proximal metaphyseal curvilinear tibial fractures in 25 skeletally immature dogs (2009 to 2020)

OBJECTIVES

To describe the occurrence, management and outcome of proximal metaphyseal curvilinear tibial fractures in skeletally immature dogs.

MATERIALS AND METHODS

A multi-centre retrospective review was conducted, searching for skeletally immature dogs presenting with proximal metaphyseal curvilinear tibial fractures between January 2009 and September 2020. Signalment, fracture description and case management data were retrieved. Outcome was assessed by retrospectively evaluating follow-up radiographs, hospital records and an owner questionnaire.

RESULTS

Twenty-five dogs met the inclusion criteria. All but one fracture was a result of minimal trauma. Twenty fractures were managed with internal fixation, two with external fixation and three conservatively. All 25 fractures healed. Eight major complications occurred in seven of 25 (28%) dogs. Twelve minor complications occurred in 10 of 25 (40%) dogs. Owner questionnaire data were available for 12 of 25 dogs; 11 of 12 were reported as having full function and one of 12 as having acceptable function at the time of questioning (median 34.5 months following presentation). At final follow-up, either by clinical examination or owner questionnaire, full function was achieved in 22 of 25 patients and acceptable function in three of 25.

CLINICAL SIGNIFICANCE

This study reported a series of proximal metaphyseal tibial fractures in skeletally immature dogs. The most common fixation method was internal fixation, which frequently resulted in full limb function at final follow-up. Owners reported outcome as fully functional in all dogs that underwent surgery at first presentation and had owner follow-up available, though positive outcomes may have been affected by participation bias.

Marker-less online MR-guided stereotactic body radiotherapy of liver metastases at a 1.5 T MR-Linac - Feasibility, workflow data and patient acceptance

INTRODUCTION

Stereotactic body radiotherapy (SBRT) is an established ablative treatment for liver tumors with excellent local control rates. Magnetic resonance imaging guided radiotherapy (MRgRT) provides superior soft tissue contrast and may therefore facilitate a marker-less liver SBRT workflow. The goal of the present study was to investigate feasibility, workflow parameters, toxicity and patient acceptance of MRgSBRT on a 1.5 T MR-Linac.

METHODS

Ten consecutive patients with liver metastases treated on a 1.5 T MR-Linac were included in this prospective trial. Tumor delineation was performed on four-dimensional computed tomography scans and both exhale triggered and free-breathing T2 MRI scans from the MR-Linac. An internal target volume based approach was applied. Organ at risk constraints were based on the UKSABR guidelines (Version 6.1). Patient acceptance regarding device specific aspects was assessed and toxicity was scored according to the common toxicity criteria of adverse events, version 5.

RESULTS

Nine of ten tumors were clearly visible on the 1.5 T MR-Linac. No patient had fiducial markers placed for treatment. All patients were treated with three or five fractions. Median dose to 98% of the gross tumor volume was 38.5 Gy. The median time from "patient identity check" until "beam-off" was 31 min. Median beam on time was 9.6 min. Online MRgRT was well accepted in general and no treatment had to be interrupted on patient request. No event of symptomatic radiation induced liver disease was observed after a median follow-up of ten month (range 3-17 months).

CONCLUSION

Our early experience suggests that online 1.5 T MRgSBRT of liver metastases represents a promising new non-invasive marker-free treatment modality based on high image quality, clinically reasonable in-room times and high patient acceptance. Further studies are necessary to assess clinical outcome, to validate advanced motion management and to explore the benefit of online response adaptive liver SBRT.

Novel effects of Foxo3a on immune system and cardiac remodeling after myocardial infarction

Background

Fibroblast/myofibroblast transdifferentiation following acute cardiac injury (MI) is a major mechanism of scar formation and adverse remodeling regulated by TGFβ/SMAD3 signaling. Myofibroblasts represent phenotypically modulated cells characterized by α-smooth muscle actin (α-SMA) and constitute the main source of extracellular matrix proteins such as collagen type I in the healing infarct wound. Moreover, the recruitment of a specific monocyte/macrophages subset (Ly6Chigh and Ly6Clow) control the healing process in the infarcted wound. The forkhead transcription factor FOXO3a has recently been shown to inhibit cardiac hypertrophy by different stressors and is involved in the immune response following injury.

Purpose

We hypothesized that FOXO3a, a key regulator of cell differentiation, cell cycle and size as well as the stress response, might inhibit matricellular remodeling following myocardial infarction by regulating transdifferentiation of fibroblasts into myofibroblasts. Moreover, we hypothesized that Foxo3a−/− mice favor the recruitment of monocytes of the type Ly6Clow leading to an anti-inflammatory profile and thus the remodeling after injury.

Methods

Acute myocardial infarction was induced in FOXO3−/− and WT mice (FVB background) by permanent LAD ligation. The myocardial infarction size was determined via ECHO. Myofibroblast trans-differentiation and fibrosis markers were analyzed by QT-PCR and protein analysis. The differentiation of macrophages studied via FACS. IP/IF and Western blotting were used to test for a direct interaction between FOXO3a and SMAD3 in vitro.

Results

FOXO3a−/− mice showed significantly higher survival rates compared to WT littermates. Myocardial inflammation (Mac-1, LFA, CD3, CD45), injury markers such as Troponin T were similar in both groups on day 4 post-MI. Myocardial expression of alpha smooth muscle actin (ASMA) and Collagen1A1 (Col1A1), as well as numbers of cardiac CD11b+/F4–80+/Ly6clow macrophages was significantly enhanced in FOXO3a−/− mice 15 days post infarction. Moreover, Foxo3a−/− mice showed larger fibrotic areas following MI. Mechanistically, immunoprecipitation showed direct interaction of FOXO3a with SMAD3a that was enhanced following activation of the transcription factor leading to diminished SMAD3 downstream gene expression.

Conclusion

Our results indicate that FOXO3a acts as a direct inhibitor of TGF-β regulated myofibroblast differentiation and matrix remodeling via FOXO3a-SMAD3 interaction following MI. Moreover, a Foxo3a deficiency might lead to the recruitment of monocytes type Ly6Clow leading to an anti-inflammatory profile in the infarct wound. Therefore, FOXO3a collectively regulates cardiac hypertrophy and fibrosis/scar formation following MI. Thus, targeting the FOXO3a-SMAD3 signaling axis might be of future therapeutic interest.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): German Resaerch Foundation

[Autopneumonectomie. A Forgotten Disease]

HISTORY

 An 80-year old female was referred to our hospital with left internal carotid artery stenosis and a childhood history of hemoptysis.

INVESTIGATIONS AND DIAGNOSIS

 The ECG showed 2nd degree Mobitz atrio-ventricular block. The chest x-ray and computerized tomography identified a shift of the mediastinum and the heart to the left. The left lung was completely destroyed whilst the right lung was enlarged and crossed the midline. Pulmonary function tests revealed a moderate restrictive ventilation disorder. The diagnosis of autopneumonectomy was based on patient history together with radiological findings.

TREATMENT AND COURSE

 A pacemaker was implanted with two stimulation electrodes via a left cephalic venous cutdown. A carotid endarterectomy was also performed without any complication.

CONCLUSION

 After autopneumonectomy, postpneumonectomy like syndrome may occur in very rare cases, whereupon operative treatment is mandatory. Any respiratory infections should be treated with antibiotics. Pacemaker electrode placement via the subclavian vein is contraindicated due to the risk of a catastrophic pneumothorax.

Supportive care needs of patients following treatment for colorectal cancer: risk factors for unmet needs and the association between unmet needs and health-related quality of life-results from the ColoREctal Wellbeing (CREW) study

Purpose

To investigate unmet needs of patients with colorectal cancer (CRC) at the end of treatment and whether unmet needs improve over time. Identify predictors of need following treatment and whether unmet need is associated with worse health-related quality of life (HRQoL).

Methods

As part of the UK ColoREctal Wellbeing (CREW) cohort study, patients treated for CRC completed the Supportive Care Needs Survey Short Form-34 (SCNS SF-34) 15 and 24 months following surgery, along with questionnaires measuring HRQoL, wellbeing, life events, social support, and confidence to manage their cancer before surgery, 3, 9, 15, and 24 months post-surgery.

Results

The SCNS SF-34 was completed by 526 patients at 15 months and 510 patients at 24 months. About one-quarter of patients had at least one moderate or severe unmet need at both time points. Psychological and physical unmet needs were the most common and did not improve over time. Over 60% of patients who reported 5 or more moderate or severe unmet needs at 15 months experienced the same level of unmet need at 24 months. HRQoL at the beginning of treatment predicted unmet needs at the end of treatment. Unmet needs, specifically physical, psychological, and health system and information needs, were associated with poorer health and HRQoL at the end of treatment.

Conclusions

Unmet needs persist over time and are associated with HRQoL. Evaluation of HRQoL at the start of treatment would help inform the identification of vulnerable patients. Assessment and care planning in response to unmet needs should be integrated into person-centred care.

Implications for Cancer Survivors

Early identification of CRC patients at risk of unmet needs will help infrom personalised survivorship care plans. The implementation of personalised and tailored services are likely to confer HRQoL gains.

Electronic supplementary material

The online version of this article (10.1007/s11764-019-00805-6) contains supplementary material, which is available to authorized users.

Probabilistic graphical model identifies clusters of EEG patterns in recordings from neonates

OBJECTIVES

In this paper we introduce a novel method for the evaluation of neonatal brain function via multivariate EEG (electroencephalography) signal processing and embedding into a probabilistic graph, the so called Chow-Liu tree.

METHODS

Using 28 EEG recordings of preterm and term neonate infants the complex features of the EEG signals were constructed in the form of a Chow-Liu tree. The trees were embedded into a 3 dimensional Euclidean space. Clustering of specific EEG patterns was done by complete linkage algorithm.

RESULTS

Our analytic tool was able to build clusters of patients with pathological EEG findings. In particular, we were able to make a visual proof on a 3d multidimensional scaling coordinate system with a good performance. The distances (graph edit distance) between Chow-Liu trees of different infants were proportional to the clinical findings of corresponding infants.

CONCLUSION

Our method may provide a basis for the future development of a diagnostic/prognostic non-invasive brain monitoring tool which will be able to differentiate between a variety of complex clinical findings.

SIGNIFICANCE

This model addresses relevant issues in neonatology and neuropediatrics in terms of identification of possible clinical factors which interfere with normal brain development and will allow fast unbiased recognition of infants with specific pathological EEG findings.

Stimulation with Porphyromonas gingivalis enhances malignancy and initiates anoikis resistance in immortalized oral keratinocytes

The aim of this study was to get new insights into molecular processes involved in tumor propagation of immortalized oral keratinocytes induced by the keystone pathogen Porphyromonas gingivalis. Cell culture experiments with immortalized OKF6 cells were performed to analyze cellular effects caused by bacterial stimulation focusing on altered gene expression, signaling pathways, proliferation rate, cell viability, migration and invasion behavior, and on the development of antiapoptotic pathways. Gene and protein expression were analyzed using real-time polymerase chain reaction, enzyme-linked immunosorbent assay, western blot, and protein arrays. Trypan blue staining was used to analyze proliferation and viability, transwell assays for cellular migration, Matrigel assays for invasion, and anoikis-assays for evaluating anoikis resistance. Stimulation of OKF6 cells with Porphyromonas gingivalis led to an alteration in the molecular repertoire of proteins which are involved in cell proliferation, epithelial-mesenchymal transition, stem cell formation, migration, invasion, and anoikis resistance. Higher proliferation rates were detected in conjunction with an activation of PI3K/Akt signaling and the mTOR-pathway. Additionally, inhibition of glycogen-synthase-kinase3-β led to stabilization of β-catenin and Snail, which resulted in a switch from predominant E-cadherin to N-cadherin expression and increased expression of the stem cell markers Oct3/4, Sox2, and Nanog. Enhanced biosynthesis and enzyme activity of matrix metalloproteinase-9 was accompanied by elevated invasion behavior. Finally, anoikis resistance was detected in stimulated keratinocytes by decreased apoptosis of nonadherent cells and elevated expression of epidermal growth factor receptor and c-Met. Hence, Porphyromonas gingivalis is able to induce a more aggressive tumor-like phenotype in immortalized oral keratinocytes, thus contributing to enhanced tumor features.

Intermuscular implantation technique for subcutaneous cardioverter-defibrillators

BACKGROUND

The conventional technique for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation has been associated with pocket complications. The aim of this study was to evaluate the efficacy and safety of an alternative intermuscular technique for S‑ICD implantation.

METHODS

S-ICDs were implanted in ten consecutive patients (ten males, mean age: 46.8 ± 14.7 years). The pocket for the pulse generator was made above the serratus anterior muscular fascia and beneath the latissimus dorsi muscle by detaching the fibrous tissue between the muscles. Electrode implantation was performed using the three- (n = 4) or the two-incision technique (n = 6).

RESULTS

All S‑ICDs were successfully implanted in the absence of any procedure-related complications with a successful 65-J standard polarity defibrillation threshold testing, apart from one patient with Brugada syndrome who needed device repositioning more dorsally. During a mean follow-up of 16.5 ± 7.3 months, no major complications requiring surgical repair were encountered, while patients demonstrated high levels of comfort and satisfaction with the cosmetic result. One patient experienced an inappropriate shock due to noise detection, which was resolved after reprogramming to a different sensing vector.

CONCLUSION

The intermuscular technique is a safe and efficacious approach for S‑ICD implantation. This technique could lead to fewer pocket-related complications and better cosmetic results.

System Design of a Computer Based Library Circulation System for the Radiology File Room

The operation and configuration of a reliable and inexpensive computer based system for locating X-ray film jackets are proposed. Card-dialer Touch-Tone telephones are used to accurately inform the computer of loans, to reserve film jackets, and to inquire about their locations. Computerassisted identification and recall of overdue and reserved film jackets increases their availability and the efficiency of file room personnel.

Das equine leukämische Lymphom – eine seltene Unterart des equinen Lymphoms

Das equine leukämische Lymphom ist eine selten vorkommende Erkrankung des hämatopoetischen Gewebes. Es entsteht durch neoplastische Entartung von B- und T-Lymphozyten im Lymphgewebe und deren Auftreten in der Blutbahn. Die klinischen Symptome sind häufig unspezifisch und umfassen chronischen Gewichtsverlust, Ödeme an Unterbrust und Unterbauch sowie regionale Lymphadenopathien. Häufig werden die Pferde erst spät im Krankheitsverlauf vorgestellt und die Behandlung führt selten zum Erfolg. Die Übersichtsarbeit beschreibt klinische Symptome des equinen leukämischen Lymphoms, Befunde der labordiagnostischen sowie anderer weiterführender Untersuchungen und stellt die bisher aus der Literatur bekannten Therapieansätze dar.

Timing of post 131I ablation diagnostic whole body scan in differentiated thyroid cancer patients

Ziel: Beantwortung der Frage, ob drei Monate nach 131I-Ablation als zu früh für eine diagnostische Radioiod-Ganzkörperszintigraphie (dxWBS) bei Patienten mit einem differenzierten Schilddrüsenkarzinom (DTC) anzusehen sind. Patienten, Material, Methode: Daten von 462 DTC-Patienten, die in unserem Klinikum behandelt worden waren, wurden analysiert. Alle Patienten wurden thyreoid ektomiert. Von 129 Patienten waren folgende Daten verfügbar a) eine dxWBS mit gleichzeitiger TSH-stimulierter Thyreoglobulin-Messung, die innerhalb von vier Monaten (max. 120 Tage) nach 131I-Ablation durchgeführt wurde ohne weitere therapeutische Maßnahmen zwischen Ablation und dxWBS, b) eine zweite dxWBS oder 131I-Therapie (rxWBS), die innerhalb von 1,5 Jahren nach Ablation durchgeführt wurde. Ergebnisse: Bei 25/129 Patienten stimmten die Ergebnisse der initialen und weiteren Scans nicht überein: Bei 15 von 54 Patienten (27%) mit einem positiven initialen dxWBS widersprachen diese Ergebnisse dem zweiten dxWBS oder rxWBS. Neue Läsionen wurden bei 10/74 (14%) Patienten mit einem initial negativen dxWBS entdeckt. Eine Diskordanz zwischen dem ersten und weiteren in der Nachsorge gemessenen stimulierten Tg-Werten wurde in 5/129 (4%) der Patienten gefunden: Bei 2/90 (2%) Patienten mit einer negativen ersten stimulierten Tg-Bestimmung wurde nachfolgend ein positives Ergebnis gefunden. Bei 3/29 (10%) Patienten mit einer positiven ersten Bestimmung wurde bei der zweiten Untersuchung ein negatives Ergebnis festgestellt. Schlussfolgerung: Weniger als vier Monate nach 131I-Ablation ist zu früh für eine diagnostische Radioiod-Ganzkörperszintigraphie mit zeitgleich TSH-stimulierter Tg-Messung. Die Ermittlung des richtigen späteren Zeitpunkts erfordert weitere Untersuchungen.

Das Zeitintervall zwischen 131I Ablation und diagnostischer Ganzkörperszintigraphie bei Patienten mit differenziertem Schilddrüsenkarzinom Weniger als vier Monate nach Ablation dürfte zu früh sein

Patients with high-risk differentiated thyroid cancer have a lower I-131 ablation success rate than low-risk ones in spite of a high ablation activity

OBJECTIVE

To examine success rates in strictly defined high-risk differentiated thyroid cancer (DTC) patients who received a high-activity (≥5550 MBq) adjuvant postoperative I-131 therapy and compare these to the rates found in highest risk and low-risk patients.

DESIGN

Retrospective database study.

PATIENTS

We examined 377 patients with DTC who received I-131 ablation. Patients with distant metastases were classified as very high risk. Patients with primary tumours >4 cm, extensive extrathyroidal invasion (pT4a or pT4b in accordance with the 7th edition of the TNM system), and patients with ≥5 lymph node metastases or any lateral compartment lymph node metastases were considered high risk. All other patients were considered low risk.

MEASUREMENTS

Ablation success rate at first TSH-stimulated follow-up.

RESULTS

The ablation success rate was 72·6% in low-risk patients, 51·7% in high-risk patients and 13·8% in highest risk patients (all differences P < 0·001). In none of the groups, a significant difference in the initial I-131 activity was found between patients with successful and unsuccessful ablation (low risk: P = 0·16, high risk: P = 0·91 and highest risk: P = 0·48). Furthermore, there was no difference in ablation success between patients who received <5550 MBq and those who received ≥5550 Mbq (low risk: P = 0·31, high risk: P = 0·69 and highest risk: P = 0·22).

CONCLUSIONS

Patients with high-risk DTC have a significantly reduced I-131 ablation success rate compared to low-risk ones in spite of high initial I-131 activities. As successful ablation is prognostically important, efforts should be made to improve outcome in these patients.

Integrated oxidation membrane filtration process - NOM rejection and membrane fouling

The extent and mechanisms by which organic matter in a solution can be retained and foul a membrane largely depends on the molecular weight of the material being filtered and the molecular weight cut-off (MWCO) of the membrane. The present study investigated the effect of the MWCO of a membrane and the molecular weight distribution of natural organic matter (NOM) in a source water on the increase in resistance to the permeate flux over time. Of particular interest was the effect of oxidation, applied prior to membrane filtration, on the predominant fouling mechanism. Oxidation can change the molecular weight distribution of organic matter in raw water, and therefore the ability of a membrane to retain this organic matter. Oxidation, using both ozonation and UV/H₂O₂, could effectively reduce the extent of fouling for higher MWCO membranes. However, neither oxidation approaches could effectively reduce the extent of fouling for lower MWCO membranes, likely because oxidation could not effectively oxidize lower molecular weight organic matter. Althoug the data indicated that the extent of fouling is increasing with the amount of DOC retained by the membrane, no statistically significant correlation was observed between these parameters. The results suggest that oxidation did not affect the predominant fouling mechanism. However, it did affect the molecular weight distribution of the organic matter retained by the membranes, and as a result, the resistance offered by the foulant cake layer.

Oral pathogens change proliferation properties of oral tumor cells by affecting gene expression of human defensins

The impact of oral pathogens onto the generation and variability of oral tumors has only recently been investigated. To get further insights, oral cancer cells were treated with pathogens and additionally, as a result of this bacterial cellular infection, with human defensins, which are as anti-microbial peptide members of the innate immune system. After cell stimulation, proliferation behavior, expression analysis of oncogenic relevant defensin genes, and effects on EGFR signaling were investigated. The expression of oncogenic relevant anti-microbial peptides was analyzed with real-time PCR and immunohistochemistry. Cell culture experiments were performed to examine cellular impacts caused by stimulation, i.e., altered gene expression, proliferation rate, and EGF receptor-dependent signaling. Incubation of oral tumor cells with an oral pathogen (Porphyromonas gingivalis) and human α-defensins led to an increase in cell proliferation. In contrast, another oral bacterium used, Aggregatibacter actinomycetemcomitans, enhanced cell death. The bacteria and anti-microbial peptides exhibited diverse effects on the transcript levels of oncogenic relevant defensin genes and epidermal growth factor receptor signaling. These two oral pathogens exhibited opposite primary effects on the proliferation behavior of oral tumor cells. Nevertheless, both microbe species led to similar secondary impacts on the proliferation rate by modifying expression levels of oncogenic relevant α-defensin genes. In this respect, oral pathogens exerted multiplying effects on tumor cell proliferation. Additionally, human defensins were shown to differently influence epidermal growth factor receptor signaling, supporting the hypothesis that these anti-microbial peptides serve as ligands of EGFR, thus modifying the proliferation behavior of oral tumor cells.

Test of Electric Charge Conservation with Borexino

Borexino is a liquid scintillation detector located deep underground at the Laboratori Nazionali del Gran Sasso (LNGS, Italy). Thanks to the unmatched radio purity of the scintillator, and to the well understood detector response at low energy, a new limit on the stability of the electron for decay into a neutrino and a single monoenergetic photon was obtained. This new bound, τ≥6.6×10^{28}  yr at 90% C.L., is 2 orders of magnitude better than the previous limit.