Can probiotic supplements prevent early childhood caries? A systematic review and meta-analysis.

The aim of this study was to explore the preventive effect of probiotic supplements on the development of early childhood caries (ECC). We searched the PubMed, Google Scholar and Cochrane databases up to January 15, 2021. The authors screened the hits independently for relevance, extracted outcome data and assessed the risk of bias. We performed a random effects meta-analysis to pool and compare the incidence of ECC in children assigned to test or placebo groups, respectively. The authors included nine randomised controlled trials published between 2001 and 2021, involving 2,363 preschool children. We assessed two publications with a moderate risk of bias and seven with high risk of bias. The median caries incidence in the probiotic test groups was 8.5% compared with 17.5% in the placebo groups and this difference was statistically significant (P<0.001). A pooled random effects meta-analysis on caries incidence on subject level showed a small but statistically significant risk difference in favour of the probiotic intervention (-0.05, 95% confidence interval (CI) -0.10, -0.00; P<0.05). The mean difference in caries increment on tooth/surface level was -0.57, (95% CI -0.91, -0.23; P<0.01). In conclusion, we demonstrated a small but statistically significant preventive effect of probiotic supplements on ECC. However, the certainty of this finding was low due to the risk of bias, heterogeneity and inconsistencies across the studies. Further long-term randomised controlled trials with low risk of bias are required in order to answer the research question with a higher certainty.

A systematic review of risk assessment tools for early childhood caries: is there evidence?

AIM: To evaluate the accuracy of commonly advocated caries risk assessment (CRA) tools in preschool children and to search for evidence whether or not this process provides better oral care and less caries in the future. METHODS: As an update of a previous systematic review, a search of electronic databases for relevant literature published between 2008 and 2018 was performed with aid of predetermined search strings. We considered only true prospective trials validating baseline risk categories over at least a 12-month period, and extracted the predictive values and assessed the quality of the papers by the QUIPS tool for prospective studies. RESULTS: Six studies were included, reporting on three manual checklists and two software tools. The National University of Singapore model displayed a good accuracy in two studies, while the accuracy of Cariogram ranged from poor to good in various populations. The manual checklists were only validated in one study each and displayed limited to poor accuracy. No study was identified that addressed questions around the long-term benefits of CRA. CONCLUSIONS: This systematic review showed a relative paucity of prospective trials validating the existing caries risk assessment tools in preschool children and the question whether or not the CRA process results in better oral care remained unanswered. Although the accuracy was far from excellent, we still recommend the CRA tools in paediatric dentistry practice because the desirable effects most likely outweigh the undesirable effects.

Stabilization of Polar Nanoregions in Pb-free Ferroelectrics.

The formation of polar nanoregions through solid-solution additions is known to enhance significantly the functional properties of ferroelectric materials. Despite considerable progress in characterizing the microscopic behavior of polar nanoregions (PNR), understanding their real-space atomic structure and dynamics of their formation remains a considerable challenge. Here, using the method of dynamic pair distribution function, we provide direct insights into the role of solid-solution additions towards the stabilization of polar nanoregions in the Pb-free ferroelectric of Ba(Zr,Ti)O_{3}. It is shown that for an optimum level of substitution of Ti by larger Zr ions, the dynamics of atomic displacements for ferroelectric polarization are slowed sufficiently below THz frequencies, which leads to increased local correlation among dipoles within PNRs. The dynamic pair distribution function technique demonstrates a unique capability to obtain insights into locally correlated atomic dynamics in disordered materials, including new Pb-free ferroelectrics, which is necessary to understand and control their functional properties.

Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.

BACKGROUND: Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. METHODS: Retrospective study of adult patients admitted at Aarhus University Hospital, Denmark between 1 January 2011 and 1 July 2015 with witnessed, refractory, normothermic OHCA treated with ECPR. OHCA was managed with pre-hospital advanced airway management and mechanical chest compression during transport. Relevant pre-hospital and in-hospital data were collected with special focus on low-flow time and ECPR duration. Survival to hospital discharge with Cerebral Performance Category (CPC) of 1 and 2 at hospital discharge was the primary endpoint. RESULTS: Twenty-one patients were included. Median pre-hospital low-flow time was 54 min [range 5-100] and median total low-flow time was 121 min [range 55-192]. Seven patients survived (33%). Survivors had a CPC score of 1 or 2 at hospital discharge. Five survivors had a shockable initial rhythm. In all survivors coronary occlusion was the presumed cause of cardiac arrest. CONCLUSION: Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration.

Presence of Lactobacillus reuteri in saliva coincide with higher salivary IgA in young adults after intake of probiotic lozenges.

The aim of this study was to compare the concentration of salivary immunoglobulin A (IgA) and the selected interleukins (IL)-1ß, IL-6, IL-8 and IL-10 in young individuals with presence and non-presence of Lactobacillus reuteri in saliva after a three-week intervention with probiotic lozenges. The study group consisted of 47 healthy individuals aged 18-32 years with no clinical signs of oral inflammation. In a randomised, double-blind, placebo-controlled, cross-over trial participants ingested two lozenges per day containing two strains of the probiotic bacterium L. reuteri or placebo lozenges. The intervention and wash-out periods were three weeks. Stimulated and unstimulated whole saliva was collected at baseline and immediately after termination of the intervention periods. The samples were analysed for total protein, salivary IgA and selected cytokines. In this extended analysis, data were collected by analysing baseline and follow-up saliva samples related to ingestion of the probiotic lozenges for the presence of L. reuteri through DNA-extraction, PCR-amplification and gel-electrophoresis. At baseline, 27% of the individuals displayed presence of L. reuteri and 42% were positive immediately after the three-week probiotic intervention. Individuals with presence of L. reuteri in saliva had significantly higher (P<0.05) concentrations of salivary IgA and %IgA/protein at the termination of the probiotic intake compared with non-presence. No differences in the cytokine levels were observed. In conclusion, detectable levels of L. reuteri in saliva coincided with higher concentrations of salivary IgA and %IgA/protein in stimulated whole saliva after the three-week daily intake of probiotic lozenges. Our findings suggest that monitoring the presence of probiotic candidates in the oral environment is important to interpret and understand their possible immune-modulating role in maintaining oral health.

Spin-orbit coupling of light in asymmetric microcavities.

When spinning particles, such as electrons and photons, undergo spin-orbit coupling, they can acquire an extra phase in addition to the well-known dynamical phase. This extra phase is called the geometric phase (also known as the Berry phase), which plays an important role in a startling variety of physical contexts such as in photonics, condensed matter, high-energy and space physics. The geometric phase was originally discussed for a cyclically evolving physical system with an Abelian evolution, and was later generalized to non-cyclic and non-Abelian cases, which are the most interesting fundamental subjects in this area and indicate promising applications in various fields. Here, we enable optical spin-orbit coupling in asymmetric microcavities and experimentally observe a non-cyclic optical geometric phase acquired in a non-Abelian evolution. Our work is relevant to fundamental studies and implies promising applications by manipulating photons in on-chip quantum devices.

Effect of Probiotic Bacteria on Oral Candida in Frail Elderly.

The aim of this study was to investigate the effect of a daily intake of probiotic lactobacilli on the prevalence and counts of oral Candida in frail elderly patients living in nursing homes. The study had a double-blind randomized placebo-controlled design with 2 parallel arms. The study group consisted of 215 older adults (range, 60 to 102 y) who were enrolled after informed consent. After baseline examination and randomization, the subjects were given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo twice daily (morning and evening). The intervention period was 12 wk, and saliva and plaque samples were collected at baseline and follow-up. The primary end point was prevalence of high Candida counts assessed from chairside tests. Secondary end points were levels of dental plaque and gingival inflammation. The groups were balanced at baseline. The attrition rate to follow-up was 19%. There was a statistically significant reduction in the prevalence of high Candida counts in the probiotic group but not in the placebo group, and the difference was statistically significant in both saliva and plaque (P < 0.05). No significant differences between the groups were noted concerning the levels of supragingival plaque or bleeding on probing. Thus, daily use of probiotic lozenges may reduce the prevalence of high oral Candida counts in frail elderly nursing homes residents (ClinicalTrials.gov NCT02391532).