Overcoming the blood brain barrier in glioblastoma: Status and future perspective.

Glioblastoma is the most common primary brain malignancy in adults. Treatment of glioblastoma patients is based on neurosurgery, radiation therapy and chemotherapy. Despite this multimodal therapeutic regimen, the prognosis of glioblastoma patients is poor. Indeed, glioblastoma is very resistant to treatments due to multiple molecular and cellular mechanisms including the existence of the blood-brain barrier (BBB). The BBB consists of multiple layers surrounding brain vessels and limits drug penetration within the brain. Therefore, overcoming the BBB is a strategy to increase bioavailability and efficacy of therapeutic agents against glioblastoma cells. The development of two approaches is ongoing: i) enhancing the delivery of drugs to the brain and ii) improving the penetration of drugs into the brain. One way to enhance drug delivery to the brain is through high-dose intravenous chemotherapy, with or without bone marrow transplantation, or via intra-arterial chemotherapy, with or without disrupting the BBB through osmotic means. Conversely, improving drug penetration within the brain can be achieved through modifying either the drug itself or the BBB. Promising results in terms of safety and signals of efficacy were obtained with these approaches in early phase clinical trials. More advanced comparative clinical trials are needed to investigate the clinical benefit for glioblastoma patients.

Fluorinations of unsymmetrical diaryliodonium salts containing ortho-sidearms; influence of sidearm on selectivity.

Activated aromatics were reacted with two different fluoroidoane reagents 1 and 2 in the presence of triflic acid to prepare only the para-substituted diaryliodonium salts. With fluoroiodane 1 the unsymmetrical diaryliodonium salts contained an ortho-propan-2-ol sidearm, whereas the alcohol sidearm was eliminated to form an ortho-styrene sidearm in the reaction with fluoroiodane 2. Only the diaryliodonium salts containing a styrene sidearm were fluorinated successfully to deliver para-fluorinated aromatics in good yields.

Tricuspid atresia: Where are we now?

Tricuspid atresia (TA) is a complex congenital heart disease that presents with cyanosis in the neonatal period. It is invariably fatal if left untreated and requires multiple stages of palliation. Early recognition and timely surgical intervention are therefore pivotal in the management of these infants. This literature review considers the pathophysiology, presentation, investigations, and classification of TA. Moreover, it discusses the evidence upon which the latest medical and surgical treatments are based, as well as numerous recent case reports. Further work is needed to elucidate the etiology of TA, clarify the role of pharmacotherapy, and optimize the surgical management that these patients receive.

Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study.

AIM: To investigate the number of roots and root canal configurations using two coding systems and the root canal diverging and merging levels in extracted maxillary premolars in an Egyptian subpopulation using cone beam computed tomography (CBCT). METHODOLOGY: A total of 700 maxillary premolars were examined using CBCT in an Egyptian subpopulation. The number of roots was identified, and root canal configurations were classified according to Vertucci's classification and a new system for classifying root and canal morphology. In addition, the position where roots bifurcated and the levels where canals merged or diverged were identified. Fisher's exact test and independent t-test were used for statistical analysis, and the level of significance was set at 0.05 (P = 0.05). RESULTS: More than half of maxillary first premolars were double-rooted, and the majority of maxillary second premolars were single-rooted (P < 0.001). Most of the double-rooted samples had bifurcations in the middle of the root. According to the Vertucci classification, canal configuration type IV was the most common in both first and second maxillary premolars. According to the new system, the code 2 FP B1 P1 was the most common for maxillary first premolars, whilst 2 SP B1 P1 , 1 SP2 and 1 SP2-1 codes were the most common for maxillary second premolars. The three-canalled morphology in double- and three-rooted maxillary premolars had considerable variations. Root canal merging and diverging levels were comparable in both tooth types. CONCLUSION: Maxillary premolars in this Egyptian subpopulation had a wide range of root and canal anatomical variations. Clinicians should be aware of where canals merge and diverge to facilitate the treatment of all canals. The new system for classifying canal morphology describes the root and canal configurations in a more accurate and practical manner compared to the Vertucci classification.

Observations of stranded and swimming whale sharks Rhincodon typus in Khor Al-Zubair, NW Arabian Gulf and Shatt Al-Arab Estuary, Iraq.

This study is the first record of a whale shark Rhincodon typus in Iraqi waters and the second record from the Arabian (Persian) Gulf portion of the north-west Indian Ocean. The stranding and sighting events were documented by photos of three individuals: the stranded specimen was 6.5 m total length (LT ) and the free-swimming individuals were c. 1-2 and 2-3 m LT respectively. An appeal is made for Iraqi policy makers to participate in regional and international organizations for the conservation of this endangered species.

Mode-locking pulse generation with MoS2-PVA saturable absorber in both anomalous and ultra-long normal dispersion regimes.

We experimentally demonstrate a stable and simple mode locked erbium doped fiber laser (EDFL) utilizing passive few-layer molybdenum disulfide (MoS2) as a saturable absorber. The MoS2 is obtained by liquid phase exfoliation before it is embedded in a polymer composite film and then inserted in the laser cavity. A stable soliton pulse train started at a low threshold pump power of 20 mW in the anomalous dispersion regime after fine-tuning the rotation of the polarization controller. The central wavelength, 3 dB bandwidth, pulse width, and repetition rate of the soliton pulses are 1574.6 nm, 9.5 nm, 790 fs, and 29.5 MHz, respectively. By inserting a 850 m long dispersion shifted fiber (DSF) in the cavity, a dissipative soliton with square pulse train is obtained in the normal dispersion regime where the operating wavelength is centered at 1567.44 nm with a 3 dB bandwidth of 19.68 nm. The dissipative soliton pulse has a pulse width of 90 ns at a low repetition rate of 231.5 kHz due to the long DSF used. These results are a contribution to the pool of knowledge in nonlinear optical properties of two-dimensional nanomaterials especially for ultrafast photonic applications.

Epidemiology of tuberculosis and evaluation of treatment outcomes in the national tuberculosis control programme, River Nile state, Sudan, 2011-2013.

Tuberculosis is a major health problem in Sudan, a country that carries 11-15% of the tuberculosis burden in the Eastern Mediterranean Region. This study aimed to describe the epidemiology of tuberculosis in River Nile State and to compare treatment outcomes with WHO recommended indicators. A descriptive study was conducted on data collected from records of 1221 patients registered at tuberculosis management units over the 3 years 2011-2013. The mean age of cases was 37.7 (SD 21.5) years and 65.9% were males; 76.3% were pulmonary tuberculosis and 36.9% were sputum smear-positive cases. Average values for all outcome indicators were suboptimal, notably rates of case notification (30.8 per 100 000), case detection (10.3%), treatment success (79.6%), treatment failure (3.0%), default (8.1%) and death (8.0%). Of the 264 patients tested for HIV, 3.8% were positive. Outcome indicators for the national tuberculosis control programme are lagging behind the required targets.

Undiagnosed diabetes mellitus in rural communities in Sudan: prevalence and risk factors.

Undiagnosed diabetes constitutes a challenge for health providers, especially in rural areas. The aim of this study was to determine the prevalence of undiagnosed diabetes mellitus and glucose intolerance among adults in rural communities in River Nile State, north Sudan. In a cross-sectional community-based study, blood glucose, anthropometric, demographic and clinical history data were obtained from 1111 individuals from 35 villages. The prevalence of undiagnosed diabetes was 2.6% (29 individuals); glucose intolerance was detected in 1.3% (14 individuals). Classic symptoms (polydipsia, polyuria and weight loss) were present in around half of the participants but were not more prevalent in those with diabetes. Lower educational level, increasing age, hypertension and unexplained weight loss were significant risk factors for diabetes. Other variables (obesity, sex, occupation, alcohol consumption and cigarette smoking) were not significant risk factors. There is a low prevalence of undiagnosed diabetes and glucose intolerance in the rural population of River Nile State.

Influence of airborne particle abrasion on dentin bonding effectiveness of a 2-step universal adhesive.

OBJECTIVE: To determine the effect of airborne particle abrasion (APA) on micro-tensile bond strength (µTBS) to dentin using different air-abrasion/polishing powders. METHODS: The bonding effectiveness of G2 Bond Universal (G2B), used in etch-and-rinse (E&R) and self-etch mode (SE), was tested on bur-cut dentin and dentin air abraded/polished using six different powders (aluminum oxide 29 µm (AO29) and 53 µm (AO53), aluminum trihydroxide (AT), sodium bicarbonate (SB), sodium bicarbonate soft (SBsoft) and bioactive glass (BG); Velopex). Adhesive-composite resin specimens were immersed in distilled water at 37 °C for one week and cut into microspecimens. Half of the specimens were subjected to 50,000 thermocycles (aged). Immediate and aged µTBS to dentin were measured. Statistical analysis was performed using linear mixed-effects (LME) modeling (p < 0.05). RESULTS: Comparing the aged bond strengths to air-abraded/polished dentin with bur-cut dentin, pretreatment with SB and SBsoft in combination with G2B used in E&R mode, and BG air polishing in combination with both application modes (E&R, SE), resulted in a significantly higher bond strength. Dentin bond strength was only significantly lower when air abraded with AO29 and using G2B in SE mode. Aging did not significantly influence bond strength for both application modes (E&R, SE), except for AO29 and AT-treated dentin, where bond strengths decrea sed significantly using G2B in SE mode. In general, G2B reached significantly higher bond strengths on air-abraded/polished dentin in E&R mode than in SE mode. CONCLUSION: Air-abrasion/polishing did not impair dentin bond strength using G2B, except when dentin was air abraded with AO29 and using G2B in SE mode. Air polishing positively influenced the bond strength to dentin in specific groups. CLINICAL SIGNIFICANCE: APA is safe concerning bonding to dentin. The E&R application mode is preferred using G2B as adhesive on air-abraded/polished dentin. Air polishing with BG positively influenced dentin bond strength for both application methods.