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Social tipping processes have been identified as potential mechanisms for triggering necessary socio-technical transformations to avoid or mitigate disastrous climate futures. But, the coupling of social and climate systems remains comparatively under-defined. Here, we explore how (anticipated) changes to climate systems can instigate necessary positive transformations within social systems --- the wanted social tipping points. Exemplarily adopting novel survey data from the United States, we investigate how sea-level rise (SLR) risk perceptions shape climate change relevant behavioral intentions and policies. We find that SLR risk perceptions are strongly positively related to a diverse set of behaviors and support for policy measures under analysis in this study. Furthermore, we find that SLR perceptions are one of the strongest drivers toward climate change behavioral intentions, comparatively stronger than many other common individual-level determinants (e.g., political attitudes or different forms of trust). Our findings emphasize the potential role of SLR perceptions as instigators of social tipping dynamics. Heightened risk perceptions could be influential in transcending the temporal barriers presented by the necessity for contemporary socio-technical transformations to mitigate future climate impacts --- serving as a normatively desirable trigger of positive (wanted) social tipping dynamics.

Recent research and real-world processes suggest that effective climate change mitigation policies are not feasible without at least a certain degree of public support. Hence, we investigate the link between existing domestic energy policies and individual policy instrument preferences in 21 European countries. We assume a policy feedback perspective and, thus, start from the idea that the current domestic energy context influences what future policies are possible and preferred by citizens. High political trust and strong climate change attitudes are expected to strengthen this relationship. Our results do not lend support to a general link between existing policies and future policy preferences. However, we find evidence of a positive policy feedback in individuals with strong climate change attitudes and/or high levels of political trust, which, depending on each country’s current energy policy, either hinders or facilitates the energy transition.

Global climate change has the potential to cause rapid changes throughout the world, particularly in the polar regions. While much is known about attitudes towards climate change in general, relati...

After more than a decade of consecutive crises, the issue of transnational solidarity is becoming increasingly relevant for the European Union. This research note compares the current coronavirus disease-2019 crisis to previous ones and investigates the willingness of European Union citizens to show solidarity towards fellow member states. We test the influence of socio-political attitudes of citizens on solidarity preferences in three crisis scenarios. We analyse Greece and Germany as cases differently affected by the past decade's crises and cases that chose different crisis management strategies when facing the novel virus. Our findings indicate that solidarity is highest in a pandemic, while for all crisis scenarios it is higher in Greece than in Germany. Despite variations in the degree of solidarity associated relationships with socio-political attitudes remain consistent.

Societal transformations are necessary to address critical global challenges, such as mitigation of anthropogenic climate change and reaching UN sustainable development goals. Recently, social tipping processes have received increased attention, as they present a form of social change whereby a small change can shift a sensitive social system into a qualitatively different state due to strongly self-amplifying (mathematically positive) feedback mechanisms. Social tipping processes have been suggested as key drivers of sustainability transitions emerging in the fields of technological and energy systems, political mobilization, financial markets and sociocultural norms and behaviors. Drawing from expert elicitation and comprehensive literature review, we develop a framework to identify and characterize social tipping processes critical to facilitating rapid social transformations. We find that social tipping processes are distinguishable from those of already more widely studied climate and ecological tipping dynamics. In particular, we identify human agency, social-institutional network structures, different spatial and temporal scales and increased complexity as key distinctive features underlying social tipping processes. Building on these characteristics, we propose a formal definition for social tipping processes and filtering criteria for those processes that could be decisive for future trajectories to global sustainability in the Anthropocene. We illustrate this definition with the European political system as an example of potential social tipping processes, highlighting the potential role of the FridaysForFuture movement. Accordingly, this analytical framework for social tipping processes can be utilized to illuminate mechanisms for necessary transformative climate change mitigation policies and actions., Comment: 24 pages, 4 figures

Societal transformations are necessary to address critical global challenges, such as mitigation of anthropogenic climate change and reaching UN sustainable development goals. Recently, social tipping processes have received increased attention, as they present a form of social change whereby a small change can shift a sensitive social system into a qualitatively different state due to strongly self-amplifying (mathematically positive) feedback mechanisms. Social tipping processes with respect to technological and energy systems, political mobilization, financial markets and sociocultural norms and behaviors have been suggested as potential key drivers towards climate action. Drawing from expert insights and comprehensive literature review, we develop a framework to identify and characterize social tipping processes critical to facilitating rapid social transformations. We find that social tipping processes are distinguishable from those of already more widely studied climate and ecological tipping dynamics. In particular, we identify human agency, social-institutional network structures, different spatial and temporal scales and increased complexity as key distinctive features underlying social tipping processes. Building on these characteristics, we propose a formal definition for social tipping processes and filtering criteria for those processes that could be decisive for future trajectories towards climate action. We illustrate this definition with the European political system as an example of potential social tipping processes, highlighting the prospective role of the FridaysForFuture movement. Accordingly, this conceptual framework for social tipping processes can be utilized to illuminate mechanisms for necessary transformative climate change mitigation policies and actions.

Objectives Survival after preoperative radiotherapy in locally advanced head and neck squamous cell cancer is associated with pathological response. The prognostic importance of p16 expression in these patients has not been established yet. Materials and methods Ninety-seven patients with oral squamous cell carcinoma, treated preoperatively with radiotherapy in combination with chemotherapy or cetuximab, were included in this retrospective analysis. Survival rates were estimated by the Kaplan-Meyer method. Pathological response was evaluated by histological analysis and p16 expression by immunohistochemistry. Results Overall survival after 2 years was 66% for the entire group, 92% in the p16-positive and 62% in the p16-negative group, respectively. 12.4% of the tumours were p16-positive. P16 expression (HR 6.98, p = .05) and regression grade (HR 2.94, p = .001) had a statistically significant impact on prognosis. 83.3% of p16-expressing tumours were pathological responders. All p16-positive patients with pathological response were alive within the observation period. Conclusion P16 expression is associated with prognosis in preoperatively irradiated OSCC patients. The association between p16 positivity, regression grade and improved survival provides a rationale for de-intensification strategies in patients with head and neck cancer who respond well to neoadjuvant therapy, a concept that is being tested in prospective clinical trials.

This article investigates the representation of women on the three subnational levels of government in Germany from 1995 to 2013, drawing on a novel data collection. Although longitudinal trends point to an overall increase on the national level, we find large variations—both upturns and downturns—from one election to the next on the state, district, and municipal levels. Our results suggest that a saturation point in women’s representation in subnational assemblies, located around 25%, largely accounts for these fluctuations. Assemblies featuring a high proportion of female officeholders before an election are more likely to experience stagnation and declines in subsequent elections. Legislatures with a low share of female representatives prior to an election, by contrast, experience the largest positive changes in their proportion of women. These findings contradict established theories that lead us to expect women’s representation to follow a self-reinforcing process, with parity as an end point. Rather, we find that women hit a ‘glass ceiling’ far sooner.

Women’s representation is highest in local assemblies in some countries, while others display the largest share of female office-holders at the national level. Drawing on a new data set mapping the representation of women at all four levels of government in Germany during the 2000s, we argue that differences in party system configurations across echelons explain these distinct patterns and provide evidence for this claim. We show that left-wing parties, the main source of female office-holders, perform better at higher echelons, while minor parties and independent representatives, which favour male candidacy, win more seats at the lowest levels of government.

Objectives The aim of this study was to assess the incidence rate for surgical site infections (SSI), patient- and therapy-related risk factors in UICC stage III and IV oral squamous cell carcinoma patients treated with preoperative radiochemotherapy, ablative surgery and immediate microvascular free flap reconstruction. Material and methods This retrospective analysis included 85 patients with oral squamous cell carcinoma treated by neoadjuvant radiochemotherapy, tumor surgery and immediate free flap reconstruction. Patient-, therapy-related factors and blood parameters were collected for this selective cohort. Results The incidence for SSI was 44.7% and for transplant loss 14.1%. Minor BMI changes (p = 0.010), diabetes (p = 0.003), edentulous status (p = 0.006) and cessation of alcohol consumption (0.034) showed to be significant patient-related risk factors. No therapy-related factors were found to be significantly influencing the risk for SSI. Neutrophil counts (p = 0.027) and GGT (p = 0.002) were found to be significantly linked to SSI. Conclusion The not so common treatment option for oral squamous cell carcinomas showed no more risk for SSI compared to standard treatment options. Preserving the ability for healthy nutrition has a significant impact on the development of SSI. This applies not only to the presented and particular treatment option

Election studies are an important data pillar in political and social science, as most political research investigations involve secondary use of existing datasets. Researchers depend on high-quality data because data quality determines the accuracy of the conclusions drawn from statistical analyses. We outline data reuse quality criteria pertaining to data accessibility, metadata provision, and data documentation using the FAIR Principles of research data management as a framework (Findability, Accessibility, Interoperability, and Reusability). We then investigate the extent to which a selection of election studies fulfils these criteria using studies from Western democracies. Our results reveal that although most election studies are easily accessible and well documented and that the overall level of data processing is satisfactory, some important deficits remain. Further analyses of technical documentation indicate that while a majority of election studies provide the necessary documents, there is still room for improvement.

Preoperative radiotherapy followed by surgery is an effective treatment option for solid tumors including locally advanced squamous cell cancers of the head and neck region. Histopathologic response to radiation has been shown to be associated with survival. However, the relative prognostic importance of regression grade compared to other potential biomarkers has not been established yet.One-hundred forty-four oral squamous cell carcinoma patients with stage III/IV disease were included in this analysis. Patients had received preoperative radiotherapy (RT) up to 50Gy total dose in combination with 5-Fluorouracil (5-FU)/Mitomycin C (MMC) or with Cetuximab, followed by radical surgery six to eight weeks later. Outcome data were obtained from the patient's files. Survival rates were estimated by the Kaplan-Meyer method. Cox-proportional-hazard regression models were used to compare the risk of death among patients stratified according to risk factors.Five-year overall survival (OS) was 58% in the presented collective. Regression grade 4 (HR 3.58; p0.001) was most significantly associated with reduced survival, followed by elevated neutrophils (HR 2.22; p=0.01), the combination of elevated neutrophils plus elevated CRP (HR 2.40; p=0.01), and elevated CRP alone (HR 1.74; p=0.03). In a multivariate analysis, the regression grade remained the most influential predictor of outcome (HR 4.23; p0.001).In a comparative analysis, tumor response to pre-operative radiotherapy remains the strongest prognostic factor for treatment outcome, while elevated CRP, as well as neutrophils, were also found to be of significance.

Although the study of the relationship between political confidence and political participation has produced contradictory results thus far, it has established, nevertheless, that this relationship depends on the exact nature of the participation: voting, party engagement and protesting. On the basis of these findings, to further specify the nature of this relationship, we make a second distinction between confidence in representative and implementing institutions. We assume that context matters, so our multi-level approach includes individual level data from the 1999 to 2001 and 2008 to 2010 waves of the European Values Study (EVS), as well as national-level data. Our results show that different types of confidence in institutions have unique effects on these three modes of participation and that these findings hold over the last decade. While confidence in parliament is the key to the elite-driven modes of participation, grassroots-driven modes are triggered by a lack of confidence in the implementing institutions.

Women's representation in elected assemblies across varying levels of government is often theorised to be shaped as a pyramid, with the highest proportion of women at the local level, where barriers to entry are minimal. Mapping women's representation in Germany, however, we find contradictory evidence, since the pyramid is spun on its head. Looking at the representation of women in legislatures across three levels of government reveals relatively few women in district assemblies, but sizably higher proportions at the Land and federal levels. This pattern presents a challenge to conventional explanations of descriptive representation at the local level.

The present study investigated the suitability of three different absorbable biocomposites for the repair of critical sized bone defects created at the mandibular angle of adult sheep. Each biocomposite was composed of a three-dimensional individualized polylactide scaffold, containing a tricalcium phosphate biomaterial (chronOS). Either autologous bone marrow (chOS/BoneMarrow) or coagulation factor XIII (chOS/FactorXIII) was added to the biomaterial for osteopromotion. Venous whole blood (chOS/Blood) added to the biomaterial served as a control. A total of 18 adult sheep were used for implantation studies, subdivided into three groups of six animals each. After 12 weeks of observation, the animals were sacrificed and the mandibles were retrieved for qualitative and quantitative histologic assessment within three regions of interest (transitional zone, center, and periphery) throughout the biocomposites. Successful bone regeneration was defined by the absence of scaffold deformation and the presence of new bone formation within the biocomposites. In histomorphometry, only chOS/BoneMarrow showed elevated area fractions of newly formed bone in all regions of interest (transitional zone 50.7 ± 7.5, center 31.9 ± 9.3, periphery 23.1 ± 13.5). This led to preservation of the macroscopic scaffold structure in all specimens. Zero hurdle regression confirmed this by validating the factor biocomposite as significant (p < 0.001) for regeneration success. In our experiment, chOS/BoneMarrow was the only biocomposite passing the hurdle of regeneration in all three regions of interest. In contrast, bone formation was less pronounced and uniform in chOS/FactorXIII and chOS/blood-containing specimens. In these groups, scaffolds showed obvious to significant deformation. Overall, autologous bone marrow showed the most promising results in our experimental setting. As opposed to reports in the literature, we could not confirm the suitability of coagulation factor XIII to promote bone formation, since bone formation rates were comparable only to those of the control venous blood.

Cross-sectional research designs show that proportional representation (PR) tends to produce more equitable outcomes in terms of gender representation. While existing research provides valuable insights into the covariates of gender representation, such cross-sectional designs fail to provide a definitive test of the influence of electoral rules both over time and in the case of mixed systems. Addressing this gap, this article proposes a longitudinal research design using the case of Germany, because half the Bundestag’s seats are allotted through majoritarian first-past-the-post methods, while the other half are allotted through proportional methods. The main findings point towards heavy interaction between the two electoral tiers that becomes visible in party quotas, double nominations and increased competitiveness of female candidates.

Our main objective was to apply a standard classification to surgical complications after free flap surgery for reconstructions of the head and neck. We used the modified Clavien-Dindo classification in a cohort of 79 patients who were having reconstructions with jejunal free flaps simultaneously with resections of oral and oropharyngeal cancer. The most common minor complication was the need for a blood transfusion, and the most common major complication of a respiratory nature. The medical complications, and those at the recipient site and the donor site were 53/79 (67%), 44/79 (56%), and 9/79 (11%), respectively. The Clavien-Dindo classification is suitable and can easily be used to evaluate postoperative complications after free tissue transfer.

The purposes of this study were: (a) to prospectively assess the correlation between apparent diffusion coefficient (ADC) values and maximum standardized uptake values (SUVmax) in patients with head and neck squamous cell carcinomas (SCC); and (b) to assess ADC and SUVmax values in relation to different tumour grades and stages in our patient population.The study group comprised 31 consecutive patients with biopsy-proven head and neck squamous cell carcinoma who were examined using a 3T MRI scanner with a 16-channel head and neck coil. In addition to routine sequences, axial (DWIBS) and sagittal (DW-EPI) diffusion-weighted sequences were obtained using b-values of 0 mm(2)/s and 800 mm(2)/s. The ADC maps were calculated automatically. The ADC values of the tumours were measured with three regions of interest (ROIs) of standard size, and an ROI covering the entire tumour. In all patients, contrast-enhanced, whole-body (18)F-FDG PET/CT was performed within 2 weeks of the MRI examination. SUVmax was measured for every tumour using a 3-D freehand ROI that covered the entire tumour. Two-way repeated measures ANOVA was used for group comparisons. The Spearman rank correlation test was performed for ADC values.Mean ADC values in the 31 SCC were 0.902 (± 0.134) with a ROI of standard size, and 0.928 (± 0.160) with the large ROI measurements on the axial DWIBS sequence. The ADC values of the tumours were significantly higher when measured with the sagittal DW-EPI sequence: 1.051 (± 0.211) and 1.082 (± 0.208). We observed no significant differences in ADC values and SUVmax between the various T stages or histological grades of the tumours. SUVmax values (26.5 ± 12) did not correlate with ADC values on DWIBS or EPI.There is no correlation between the FDG uptake and the ADC value in head and neck SCC. The three different tumour grades and four tumour stages present in our study population could not be differentiated based on ADC values or SUV.

Das Forschungsdatenzentrum „Wahlen“ ist eine Einrichtung von GESIS – Leibniz-Institut fur Sozialwissenschaften, die Wissenschaftlern den Zugang zu den dort archivierten Wahlstudien ermoglicht. Die Leistungen des Institutes umfassen die Erschliesung von in Deutschland erhobenen Umfragedaten und die Beratung zum Umgang mit diesen Daten ebenso wie Workshops und Seminare sowie eigene Forschung und Publikationen. Ein besonderer Stellenwert kommt dabei derzeit der Arbeit an der German Longitudinal Election Study zu, der umfangreichsten nationalen Wahlstudie, die bisher in Deutschland durchgefuhrt wurde.

In mammals, excess energy is stored in the form of triacylglycerol primarily in lipid droplets of white adipose tissue. The first step of lipolysis (i.e. the mobilization of fat stores) is catalyzed by adipose triglyceride lipase (ATGL). The enzymatic activity of ATGL is strongly enhanced by CGI-58 (comparative gene identification-58), and the loss of either ATGL or CGI-58 function causes systemic triglyceride accumulation in humans and mice. However, the mechanism by which CGI-58 stimulates ATGL activity is unknown. To gain insight into CGI-58 function using structural features of the protein, we generated a three-dimensional homology model based on sequence similarity with other proteins. Interestingly, the model of CGI-58 revealed that the N terminus forms an extension of the otherwise compact structure of the protein. This N-terminal region (amino acids 1-30) harbors a lipophilic tryptophan-rich stretch, which affects the localization of the protein. (1)H NMR experiments revealed strong interaction between the N-terminal peptide and dodecylphosphocholine micelles as a lipid droplet-mimicking system. A role for this N-terminal region of CGI-58 in lipid droplet binding was further strengthened by localization studies in cultured cells. Although wild-type CGI-58 localizes to the lipid droplet, the N-terminally truncated fragments of CGI-58 are dispersed in the cytoplasm. Moreover, CGI-58 lacking the N-terminal extension loses the ability to stimulate ATGL, implying that the ability of CGI-58 to activate ATGL is linked to correct localization. In summary, our study shows that the N-terminal, Trp-rich region of CGI-58 is essential for correct localization and ATGL-activating function of CGI-58.

Von den elf Volksentscheiden, die zwischen 1990 und 2005 in den deutschen Bundeslandern stattfanden, wurden sieben von den Wahlern im Sinne der jeweiligen Initiatoren entschieden, die ubrigen vier waren an der Urne nicht erfolgreich. Der Artikel geht der Frage nach, ob es ein Muster oder sogar ein Erfolgsrezept hinter den Ergebnissen gibt. Mit der Methode der Qualitative Comparative Analysis (QCA) soll dieses Ratsel gelost werden. Es zeigt sich, dass sich keine der untersuchten Bedingungen allein positiv auf die Erfolgschancen an der Urne auswirken; bestimmten Kombinationen ist dieser Effekt jedoch zuzuschreiben.

OBJECTIVES: This retrospective study performed a comprehensive analysis of the usage of intra-arterial chemotherapy (iaCh) for locally recurrent UICC stage IV oral squamous cell carcinoma (OSCC) over two decades at the Department of Cranio-Maxillofacial and Oral Surgery at the University Hospital Vienna to assess the utility of its future use. METHODS: Between 1994 and 2014, iaCh was indicated in 48 OSCC cases. In these, the two most frequent iaCh schemes, cisplatin/5-fluorouracil (Cis/5-FU) and methotrexate/bleomycin (MTX/Bleo), were chosen for further analysis. The effect on survival of two distinct intra-arterial protocols and their covariates were analyzed with the Kaplan-Meier method as well as univariate and multivariate Cox proportional hazard regression models. RESULTS: The mean follow-up period was 29.91 months. The two intra-arterial chemotherapy groups did not differ significantly in sample size, demographic data or therapeutic covariates. The Cis/5-FU iaCh regimen was associated with significantly better overall survival (median OS 2.6 years vs. 1.3 years; p=0.002) and had a beneficial effect on survival (HR=3.62, p=0.015). Side effects occurred at a frequency similar to that described in the literature for intravenous chemotherapy (ivCh). CONCLUSIONS: These results suggest a preference for administering Cis/5-FU for iaCh. Nevertheless, due to economic considerations in healthcare expenditures, there is no future for iaCh in the treatment of head and neck carcinomas because ivCh is known to be equivalent.

No data are available on the effects of the cyclooxygenase-2 (COX-2) inhibitor nimesulide in combination with irradiation on the survival of head-and-neck carcinoma cells.Two head-and-neck carcinoma cell lines (SCC9 and SCC25) were treated with nimesulide (50-600 microM) and irradiated concomitantly or sequentially. Early effects on cell survival were investigated by counting cell numbers, long-term effects by colony-forming assays. Cell-cycle effects were analyzed 24-72 h after treatment with nimesulide by flow cytometry.Unexpectedly, nimesulide solely inhibited cell proliferation without affecting colony-forming ability. In addition, no evidence for a radiosensitizing effect of nimesulide in short-term assays was seen. Nimesulide alone had no effect on clonogenic survival alone or in combination with radiation.Nimesulide differentially affects cell proliferation and clonogenic survival and may decrease the efficacy of radiotherapy. Short-term assays to assess tumor growth may not correctly predict the clinically relevant long-term effect of COX-2 inhibitors.

Despite growing interest in direct democratic institutions, the empirical evidence on the relationship between institutional design and the actual use of popular rights remains rather sparse. The authors use a novel data set on institutional openness and test its link to the number of popular initiatives in the German Länder for the period of 1997 2005. Their empirical analysis reveals a strong and robust negative effect of higher institutional requirements on the number of popular initiatives in the 16 German Länder; whereas other factors appear to be of minor importance. They thus come to the conclusion that the comparatively high institutional hurdles in the Länder impose costs of initiation, thereby limiting the number of popular initiatives.

Political Trust and Disenchantment with Politics contributes fresh empirical findings to research on the relationship between trust and participation. The results indicate that the citizens of European societies and beyond are far from an universal retreat from the political sphere.

This study examines a cohort of patients who suffered bleeding requiring hemostatic intervention after oral surgery. The reasons for bleeding and the interval between surgery and onset of bleeding are investigated. Between 1998 and 2009, 1,819 cases were eligible for this retrospective study. Factors (independent parameters) influencing the interval (dependent variable) were analyzed using negative binomial count regression models (NegBin II). The significance of each regressor’s effect was tested using Wald’s test and the total effect using likelihood ratio test. Of the patients examined, 1,101 (60.1 %) did not take anticoagulants, 394 (21.5 %) took phenprocoumon, 233 (12.7 %) took acetylsalicylic acid, 33 (1.8 %) took clopidogrel, 17 (0.9 %) took more than one anticoagulant, and 78 (4.3 %) had a congenital blood disorder. After simple tooth extraction, 95.3 % suffered bleeding; 69.7 % of extractions were performed in the molar region. Later that day of surgery, 66.0 % of all patients showed bleeding. The bleeding interval was significantly prolonged by anticoagulant therapy with phenprocoumon, by congenital clotting disorders. Normal tooth extractions are underestimated for their risk for postoperative bleeding, especially in the molar region. Anticoagulant therapy or congenital blood disorders present oral surgeons with a further challenge. Performing surgery before midday allows surgeons managing postoperative bleeding themselves for a better patient satisfaction. Intensified information about correct postoperative behavior is crucial. Prolonged blood coagulation should intensify follow-up checks. Patients with congenital blood disorders and patients at high risk for bleeding with the need for substitution of platelets or clotting factors should receive inpatient care. More potent, local applicable coagulant agents are required for these patients.

„Wahlbeteiligung erreicht historischen Tiefstand“ titelte die Welt online am 27.09.2009, denn nicht einmal drei Viertel der Wahlberechtigten hatten bei der Bundestagswahl den Weg an die Urne gefunden. Sie setzten damit einen Trend fort, der in Deutschland seit rund 30 Jahren auf allen staatlichen Ebenen festzustellen ist (Eilfort 2006: 56).

Purpose Impacted, in particular transmigrated, lower canines are rare. If they transmigrate, then the most common treatment is extraction. Alternatively, the native tooth can be preserved; however, management is complex. This report describes a decision-making flowchart (DMFC) with surgical strategies for the management of impacted lower canines. Materials and Methods Fifty-six patients had impacted lower canines, of which 16 were transmigrated. A preliminary version of the DMFC was used for the development of treatment plans to decide which strategy to apply to these complex cases. After removal of associated pathologies (for experimental tooth-preserving therapies), miniscrews were used as transient skeletal anchorage devices (TADs). The TADs allowed a closed surgical approach for impacted and transmigrated lower canine eruption. For autotransplantation, a dummy tooth was used for socket preparation to minimize the period of no blood supply to the graft. Results After surgical exposure and TAD insertion, orthodontic treatment was performed in 4 patients. One patient was selected for successful autotransplantation. Nine patients had the transmigrated canines surgically removed. The remaining patients opted for “leave and observe.” Based on the satisfactory long-term results with orthodontic treatment and autotransplantation and on published reports, the resulting DMFC presents key aspects of the treatment plan, namely 1) associated pathology, 2) patient age, 3) compliance, and 4) root tip position. Conclusions TAD-assisted orthodontic treatment and autotransplantation of impacted lower canines are tooth-preserving alternatives to extraction. The developed DMFC assists the complex treatment planning of impacted and transmigrated lower canines.

Sulforaphane is a naturally occurring compound found in broccoli and other cruciferous vegetables. Recently it gained attention because of its antiproliferative properties in many cancer cell lines. The aim of this study was to investigate whether sulforaphane could act as a radiosensitizer in head and neck squamous cell carcinoma cell lines. Four head and neck squamous cell carcinoma cell lines (i.e., (HNSCC) SCC9, SCC25, CAL27, and FADU) were treated with sulforaphane and subsequently irradiated. Then proliferation and clonogenic assays were performed. Apoptosis was detected by flow cytometry. Possible regulation of Akt and Mcl-1 was investigated by western blotting. Sulforaphane and radiation in combination leads to stronger inhibition of cell proliferation and of clonogenic survival than each treatment method alone. Western blot analysis of Akt and Mcl-1 showed no changed expression. Sulforaphane is a promising agent in the treatment of head and neck cancer due to its antiproliferative and radio-sensitizing properties. A combination of sulforaphane and radiation decreases clonogenic survival. Apoptosis is not regulated through Akt or the Mcl-1 protein.

Betulinic acid, a pentacyclic triterpene, is a new cytotoxic compound active on melanoma, neuroblastoma, glioblastoma and head and neck squamous cell carcinoma (HNSCC) cells. In combination with irradiation it has been shown to have an additive effect on growth inhibition in melanoma cells. In this study, the radiosensitizing effect of betulinic acid on sequential irradiation was investigated in HNSCC cell lines. Two HNSCC cell lines, SCC9 and SCC25, were treated with increasing doses of betulinic acid and sequentially irradiated with a single boost of 4 Gy from a conventional radiation source. The cells were counted, the surviving fraction was determined, and colony-forming assays were performed. It could be shown that betulinic acid alone inhibits cell survival, affects cell survival additively in combination with irradiation and decreases clonogenic survival in both cell lines when applied alone. Betulinic acid could be a promising treatment agent in radioresistant head and neck cancer. A combination of betulinic acid with radiotherapy seems to be beneficial.

Die direkte Demokratie fristete in den deutschen Bundeslandern traditionell ein Nischendasein. Seit der Deutschen Einheit hat sich indessen eine Trendwende vollzogen: Zum einen wurden die unmittelbaren Beteiligungsrechte merklich ausgebaut, wodurch eine vielfaltige Institutionenlandschaft entstanden ist. Zum anderen kann eine intensivere Nutzung dieser Rechte beobachtet werden. In unserem Beitrag wollen wir auf diese Veranderungen eingehen und das direktdemokratische Instrumentarium in den deutschen Bundeslandern sowie seine Inanspruchnahme seit 1990 aus einer komparativ-dynamischen Perspektive untersuchen.

Although head and neck cancer is a common malignancy, investigations have not yet improved the poor prognosis of patients. Therefore, it is important to find new cancer treatment modalities. Recent studies showed that cyclooxygenase, especially its isoform cyclooxygenase-2, is involved in tumorigenesis, tumor growth and metastasis. Inhibition of this enzyme by cyclooxygenase inhibitors has been shown to be antiproliferative in numerous cancer cell lines. The aim of this study was to investigate if the selective cyclooxygenase-2 inhibitor nimesulide could enhance cytotoxicity of the standard chemotherapeutic agent cisplatin. Head and neck squamous cell cancer cells were incubated with nimesulide and/or cisplatin, and counted after 24, 48 and 72 h treatment. Visualization of apoptotic cells was done by immunohistochemistry. We demonstrated that nimesulide inhibits the cytotoxic effect of cisplatin in HNSCC cells. Therefore, COX-2 inhibitor nimesulide may not be a good partner for cisplatin in combination therapy for cancer.

Background. The protooncogenes Ets-1 and Ets-2 are involved in carcinogenesis of different tumors. Nime- sulide, a selective cyclooxygenase-2 (COX-2) inhibitor, has antiproliferative effects on tumor cells. The question arises whether nimesulide influences Ets-1 and Ets-2 synthesis in head and neck tumors. Methods. Expression of Ets-1 and Ets-2 was analyzed in tumor tissues by immunohistochemistry. The influence of nimesulide and an extracellular signal-regulated kinase (ERK) inhibitor on cell proliferation of two head and neck cancer cell lines and Ets-1 and Ets-2 expression was determined by automated cell counting and Western blotting, respectively. Results. Immunohistochemistry showed a high expres- sion of Ets-1 and Ets-2 in tumor tissues. In both cell lines, Ets-1 and Ets-2 expression were reduced after 24 and 48 hours by nimesulide. Conclusion. Both Ets-1 and Ets-2 are overexpressed in head and neck cancer specimens. Inhibition of Ets-1 and Ets-2 ex- pression in head and neck cancer cell lines by nimesulide might explain the proapoptotic property of this COX-2 inhibitor. A 2005 Wiley Periodicals, Inc. Head Neck 27: 1068 - 1072, 2005

Betulinic acid (BetA), a new experimental cytotoxic compound that is active against human melanoma cells and neuroectodermal tumor cells, has recently been shown to be also effective against head and neck squamous carcinoma cells (HNSCC). In this study we investigated BetA in combination with cisplatin in squamous cell carcinoma cell lines of the tongue. SCC25 and SCC9 were treated with BetA and/or cisplatin. Cells were counted with an automated analyzing system. Caspase activation was determined using the M30 Cyto-Death ELISA, expression of the anti-apoptotic protein Mcl-1 by Western blot analysis. Visualization of apoptotic cells was achieved by immunohistochemistry. Synergistic cytotoxic effect and the induction of apoptosis under combined treatment was observed in SCC25 cells only after 24 or 48 h, whereas treatment of SCC25 cells for 72 h with BetA and cisplatin showed antagonism or subadditive effects. In SCC9 cells, antagonism occurred over an increase of dose and time during treatment. Furthermore, we could not demonstrate a significant alteration in the expression of the anti-apoptotic protein, Mcl-1. Our in vitro data demonstrate that BetA seems to be an unlikely candidate for combination with cisplatin in the treatment of head and neck cancer.

Betulinic acid (BetA), a new experimental cytotoxic compound that is active against human melanoma cells and neuroectodermal tumor cells, has recently been shown to be also effective against head and neck squamous carcinoma cells (HNSCC). In this study we investigated BetA in combination with cisplatin in squamous cell carcinoma cell lines of the tongue. SCC25 and SCC9 were treated with BetA and/or cisplatin. Cells were counted with an automated analyzing system. Caspase activation was determined using the M30 Cyto-Death ELISA, expression of the anti-apoptotic protein Mcl-1 by Western blot analysis. 'Visualization of apoptotic cells was achieved by immunohistochemistry. Synergistic cytotoxic effect and the induction of apoptosis under combined treatment was observed in SCC25 cells only after 24 or 48 h, whereas treatment of SCC25 cells for 72 h with BetA and cisplatin showed antagonism or subadditive effects. In SCC9 cells, antagonism occurred over an increase of dose and time during treatment. Furthermore, we could not demonstrate a significant alteration in the expression of the anti-apoptotic protein, Mcl-1. Our in vitro data demonstrate that BetA seems to be an unlikely candidate for combination with cisplatin in the treatment of head and neck cancer.