The effect of adding graphene oxide nanoplatelets to Portland cement: Potential for dental applications.

BACKGROUND: The potential of graphene-based materials to improve the physiomechanical properties of Portland cement-based materials without compromising biocompatibility is of interest to dental researchers and remains to be discovered. AIM: This study investigated the effects of adding graphene oxide nanoplatelets (GONPs) on the surface microhardness and biocompatibility of Portland cement. MATERIALS AND METHODS: Three prototype Portland cement powder formulations were prepared by adding 0, 1, and 3 wt % GONPs in powder form to Portland cement. Prototype cement specimens were in the form of disks, with a diameter of 10 mm and a thickness of 2 mm. In experiment 1, surface microhardness was measured using the through indenter viewing hardness tester, 20 surface hardness values were obtained from all specimens. In experiment 2, Balb/C 3T3 fibroblasts were cultured with the material disks and the viability of cells was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. STATISTICAL ANALYSIS: The data were analyzed using the analysis of variance followed by Dunnett test (α = 0.05) or Tukey test (α = 0.05). RESULTS: In response to material disks, the addition of 1 wt % GONPs had a proliferative effect on cells at day 3 and day 7 with a significant difference from the control. The addition of 3 wt % GONPs showed a remarkable increase in surface microhardness; however, it exhibited initial cytotoxicity. CONCLUSIONS: The addition of 1 wt % GONPs to Portland cement improved surface microhardness without compromising biocompatibility; therefore, it has a greater potential for dental applications. The results of this work give other researchers leads in future assessments of this prototype material.

Impact of Blended Learning on Dental Students' Performance and Satisfaction in Clinical Education.

The aim of this study was to evaluate the effectiveness of a blended learning model with a flipped classroom approach in a clinical dental education setting based on student performance and perceptions. Comparisons were made between blended learning and traditional methods for all fourth-year dental students in two consecutive cohorts in a conservative dentistry course at a dental school in Jordan. The 2016-17 cohort (control group) consisted of 364 students taught with conventional methods. The 2017-18 cohort (study group) consisted of 253 students taught with blended learning using a flipped classroom method. Performance measures were two exams (online and written), two assignments, inclinic quizzes, and clinical assessment. The study also assessed the number of posts made by students in the study group on an online discussion forum. The results showed that the study group students had significantly better performance on all assessments than the control group students. The students' overall grades in the blended learning cohort were an average 7.25 points higher than in the control cohort. Students who participated in the online forum also had better performance in the course: one participation correlated with 0.697 standard deviations higher score. Overall, students' perceptions were positive and supported the adoption of a blended learning model in the course. These results showing improved student performance provide support for blended learning and use of an online discussion forum.

Biocompatibility evaluation of Jordanian Portland cement for potential future dental application.

BACKGROUND: The demand for novel Portland cement (PC)-based formulations to be used in dental applications is ever increasing in viewing the foregoing knowledge on the favorable effects of these formulations on cellular proliferation and healing, leading to treatment success. AIM: This study investigated the effect of white and gray mineral trioxide aggregate (W-MTA and G-MTA) and white and gray Jordanian PC (W-PC and G-PC) in their raw state on the viability of Balb/C 3T3 fibroblasts using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. MATERIALS AND METHODS: Materials were prepared in the form of disks, with a diameter of 5 mm and a thickness of 2 mm. In the first experiment, Balb/C 3T3 fibroblasts were cultured with the material disks using culture plate inserts. In the second experiment, material elutes were added to cultured cells. The elutes were prepared by adding 2 ml serum-free media to 10 disks of each material and then incubated at 37°C for different time intervals. Material elutes were analyzed using ion chromatography for traces of calcium. The data were analyzed using analysis of variance followed by Dunnett test (α = 0.05) or Tukey test (α = 0.05). RESULTS: In response to material disks, G-PC had a proliferative effect on cells at day 1 and day 2 with a significant difference from the control at day 1. G-MTA reduced cell viability with a significant difference from the control level at day 2. Elutes of PC showed biocompatible and even proliferative effects on Balb/C 3T3 fibroblasts. Calcium ions were found to leach continuously over the measurement period for all the materials tested in this work. CONCLUSION: Jordanian PC in its raw state was found to be biocompatible, and the results of this work give promise of its wider use as a base for further development to improve the physiochemical and mechanical properties of the material.

Introducing FDG PET/CT-guided chemoradiotherapy for stage III NSCLC in low- and middle-income countries: preliminary results from the IAEA PERTAIN trial.

PURPOSE: Patients with stage III non-small-cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT) in low- and middle-income countries (LMIC) continue to have a poor prognosis. It is known that FDG PET/CT improves staging, treatment selection and target volume delineation (TVD), and although its use has grown rapidly, it is still not widely available in LMIC. CRT is often used as sequential treatment, but is known to be more effective when given concurrently. The aim of the PERTAIN study was to assess the impact of introducing FDG PET/CT-guided concurrent CRT, supported by training and quality control (QC), on the overall survival (OS) and progression-free survival (PFS) of patients with stage III NSCLC. METHODS: The study included patients with stage III NSCLC from nine medical centres in seven countries. A retrospective cohort was managed according to local practices between January 2010 and July 2014, which involved only optional diagnostic FDG PET/CT for staging (not for TVD), followed by sequential or concurrent CRT. A prospective cohort between August 2015 and October 2018 was treated according to the study protocol including FDG PET/CT in treatment position for staging and multimodal TVD followed by concurrent CRT by specialists trained in protocol-specific TVD and with TVD QC. Kaplan-Meier analysis was used to assess OS and PFS in the retrospective and prospective cohorts. RESULTS: Guidelines for FDG PET/CT image acquisition and TVD were developed and published. All specialists involved in the PERTAIN study received training between June 2014 and May 2016. The PET/CT scanners used received EARL accreditation. In November 2018 a planned interim analysis was performed including 230 patients in the retrospective cohort with a median follow-up of 14 months and 128 patients in the prospective cohort, of whom 69 had a follow-up of at least 1 year. Using the Kaplan-Meier method, OS was significantly longer in the prospective cohort than in the retrospective cohort (23 vs. 14 months, p = 0.012). In addition, median PFS was significantly longer in the prospective cohort than in the retrospective cohort (17 vs. 11 months, p = 0.012). CONCLUSION: In the PERTAIN study, the preliminary results indicate that introducing FDG PET/CT-guided concurrent CRT for patients with stage III NSCLC in LMIC resulted in a significant improvement in OS and PFS. The final study results based on complete data are expected in 2020.

In vitro simulation of erosive challenges to human enamel using a novel artificial mouth.

This in vitro work reports upon the design, build and operation of an artificial environment (Saltus) that sought to simulate the process of in vivo dental erosion upon human enamel. A novel testing environment, housed 8 erosion testing substrate specimens, that on separate occasions were subject to 4 different experimental diets, of increasing erosive challenge, simulating the consumption of an acidic beverage. Each set of specimens was subjected to one of the experimental diets only. These were liquid only and administered the test beverage over a standardized range of volumes and durations. Flow of both artificial unstimulated and stimulated saliva was maintained throughout and the effects upon the substrates were measured by profilometry, surface microhardness determination and chemical analysis of the saliva and beverage mixture for traces of Calcium and Phosphate ions. The overall trend of surface hardness reduction, depth of surface loss and ion loss across the diets increased in proportion to the severity of insult. Accepting the limitations of this study Saltus appeared to perform well as an environment in which to simulate and assess dental erosion using parameters defined by previous in vivo observations of human drinking behaviour. The authors however acknowledge that in vitro testing can never replicate fully the in vivo situation.

Investigation of productivity in a south Indian Malabari goat herd shows opportunities for planned animal health management to improve food security.

Here the authors report the objective veterinary clinical measurement of productivity in a representative south Indian Malabari goat herd. The authors show failure to meet pragmatic production targets that are commensurate with the animals' genetic potential or adequate to meet the demands of global food security. The authors suggest that this situation may have arisen as a consequence of animal husbandry constraints and protein undernutrition and imply the involvement of nematode parasitism. Benzimidazole resistance was detected in Haemonchus species, showing the need for better understanding of the principles of sustainable helminth parasite control within the southern Indian context. This study highlights the need to understand the true costs of goat production in seasonally resource-poor environments, while also considering its impact on the overall ecosystem in which the animals are placed. They conclude that pragmatic opportunities for improvements in goat production efficiency lie in the development of problem-focused planned animal health and nutrition management.

Pharmaceutical Care in the Community Pharmacies of Saudi Arabia: Present Status and Possibilities for Improvement.

Pharmaceutical care can be given in all settings: The community, hospitals, long-term care, and the clinic. However, published literature indicates that there is a substantial barrier to implementing pharmaceutical care programs in community pharmacies. This review was conducted to discover gaps and limitations in pharmaceutical care services in community pharmacies in the Kingdom of Saudi Arabia (KSA). We searched PubMed and other available scientific website databases using the following key words to retrieve the relevant articles: Community Pharmacy, Healthcare System, Pharmaceutical Care, KSA. Two authors independently screened the titles and abstracts of promising articles. They discarded irrelevant studies and retained studies, and reviews that held the promise of relevant data or information. The review revealed that only one out of the four studies conducted in KSA retrieved by the authors reported pharmaceutical care service other than dispensing. The same results were reported in other studies conducted in some developing countries. All pharmaceutical care services were reported in studies conducted in Europe. The authors came to the conclusion that in KSA, dispensing of medicines is the dominant service provided by community pharmacists and that there was very limited if not a total absence of other pharmaceutical care services.

First Report of Recombinant Potato virus Y Strains Infecting Potato in Jordan.

Potato (Solanum tuberosum L.) is an important vegetable crop in Jordan, occupying second position after olives. In 2012, potatoes were planted on about 6,000 ha with a production of about 141,000 t (2). Potato virus Y (PVY) is a serious problem for potato production worldwide. Recombinant strains of the virus were reported to cause tuber necrotic ringspot disease (PTNRD) in many potato-growing regions of the world. In the last few years, a new recombinant PVYNTN-NW that belongs to PVYZ (3) has been reported in the neighboring Syria. It included three recombination patterns, SYR-I, SYR-II, and SYR-III, and caused severe PTNRD (1). Since PVY is easily transmitted from one region to another by aphid vectors and infected potato seeds, this study was initiated to investigate the possible occurrence of PVY strains in Jordan. In October 2013, 33 leaf samples were collected from symptomatic potato plants cv. Spunta from Wadi Rum, Jordan (GPS coordinates 29°31'37.76″ N, 35°42'48.75″ E), the largest potato-producing area in Jordan. Sampled plants displayed leaf mottling and yellowing, symptoms similar to those caused by PVY. All samples were tested for PVY by DAS-ELISA using the ELISA kit (monoclonal cocktail) developed by BIOREBA (Reinach, Switzerland) to detect all PVY isolates. Twenty-nine samples were found positive for PVY by ELISA. To confirm virus infection, total RNA was extracted from all ELISA-positive samples and used as template in uniplex RT-PCR using strain-specific primers (1). The band pattern of PCR amplicons showed that 12 samples were infected with PVYNTN-NW genotype SYR-III and produced bands of 1,085, 441, and 278 bp. One sample was infected with PVYNTN (A) and produced bands of 1,307, 633, and 441 bp, and one other sample was infected with PVYNTN-NW genotype SYR-II and produced bands of 1,085 and 441 bp. Mixed infection with PVYNTN-NW genotype SYR-III and PVYNTN (B) was also detected in one sample producing bands of 278, 441, 1,085, and 1,307 bp. To confirm infection with the recombinant strains, PCR fragments of 278 bp amplified from three samples and 1,085 bp obtained from another three samples were directly sequenced and sequences were deposited in GenBank under accession numbers KJ159968, KJ159969, and KJ159970 for the 278-bp fragment and KJ159974, KJ159975, and KJ159976 for the 1,085-bp fragment. Sequence comparison with other PVY strains available in the NCBI database showed that the 278-bp fragment had the highest nucleotide sequence identity (100%) with PVY isolates SYR-III-A26 (AB461467) and SYR-III-2-4 (AB461457) from Syria. BLAST searches also showed that the 1,085-bp fragment shared 99% nucleotide identities with PVY isolates SYR-II-L3 (AB461482) and SYR-II-Be4 (AB461474) from Aleppo, Syria. To our knowledge, this is the first report of PVY recombinants in Jordan, and the first report of PVYNTN-NW recombinants infecting potato crop outside Syria. Since Europe is the main supplier of potato seeds for farmers in Jordan and Syria, the introduction of PVYNTN-NW to the region could have happened through infected potato seeds. Results of this study create new challenges for potato growers in Jordan as well as other countries in the region. References: (1) M. Chikh Ali et al. J. Virol. Methods 165:15, 2010. (2) FAO. http://faostat.fao.org/ (3) A. V. Karasev and S. M. Gray. Ann. Rev. Phytopathol. 51:571, 2013.

Development of aflatoxin B(1)-lysine adduct monoclonal antibody for human exposure studies.

Mouse monoclonal antibodies were developed against a synthetic aflatoxin B(1) (AFB)-lysine-cationized bovine serum albumin conjugate. The isotype of one of these antibodies, IIA4B3, has been classified as immunoglobulin G1(lambda). The affinity and specificity of IIA4B3 were further characterized by a competitive radioimmunoassay. The affinities of IIA4B3 for AFB and its associated adducts and metabolites are ranked as follows: AFB-lysine > 8,9-dihydro-8-(2,6-diamino-4-oxo-3,4-dihydropyrimid-5-yl formamido)-9-hydroxy-AFB > AFB = 8,9-dihydro-8-(N(7)-guanyl)-9-hydroxy-AFB > aflatoxin M(1) > aflatoxin Q(1). IIA4B3 had about a 10-fold higher affinity for binding to AFB-lysine adduct than to AFB when (3)H-AFB-lysine was used as the tracer. The concentration for 50% inhibition for AFB-lysine was 0.610 pmol; that for AFB was 6.85 pmol. IIA4B3 had affinities at least sevenfold and twofold higher than those of 2B11, a previously developed antibody against parent AFB, for the major aflatoxin-DNA adducts 8,9-dihydro-8-(N(7)-guanyl)-9-hydroxy-AFB and 8,9-dihydro-8-(2,6-diamino-4-oxo-3,4-dihydropyrimid-5-yl formamido)-9-hydroxy-AFB, respectively. An analytical method based on a competitive radioimmunoassay with IIA4B3 and (3)H-AFB-lysine was validated with a limit of detection of 10 fmol of AFB-lysine adduct. The method has been applied to the measurement of AFB-albumin adduct levels in human serum samples collected from the residents of areas at high risk for liver cancer.

Schistosoma mansoni: the immune response against cercarial glycocalyx.

Schistosoma mansoni cercarial glycocalyx was separated and purified by Sephacryl-300 SR. It was found to stimulate the humoral immune response in mice injected with it. Antiglycoalyx antibodies raised in CD/1 mice were found to be cytotoxic to schistosomula in vitro. But conversely, no protective effect was demonstrated in vivo. Eosinophil-mediated cytotoxicity was found to have no effector function in the murine immune response against schistosomes. A monoclonal antiglycocalyx IgM was prepared during our study. It was found to have no cytotoxic effect on schistosomules in vitro. However, it was found to have an inhibitory activity blocking the cytotoxic effect of other antiglycocalyx isotypes in the immune mouse. The contradiction between the result of antiglycocalyx antibody-mediated cytotoxicity obtained in vivo and that obtained in vitro is in itself revealing and suggests that the effect is crucially dependent upon factors as yet poorly understood.