Overall survival in malignant glioma is significantly prolonged by neurosurgical delivery of etoposide and temozolomide from a thermo-responsive biodegradable paste

Purpose: High-grade glioma (HGG) treatment is limited by the inability of otherwise potentially efficacious drugs to penetrate the blood brain barrier. We evaluate the unique intra-cavity delivery mode and translational potential of a blend of poly(DL-lactic acid-co-glycolic acid) (PLGA) and poly(ethylene glycol) (PEG) paste combining temozolomide and etoposide to treat surgically resected HGG. Experimental Design: To prolong stability of temozolomide pro-drug, combined in vitro drug release was quantitatively assessed from low pH-based PLGA/PEG using advanced analytical methods. In vitro cytotoxicity was measured against a panel of HGG cell lines and patient-derived cultures using metabolic assays. In vivo safety and efficacy was evaluated using orthotopic 9L gliosarcoma allografts, previously utilized pre-clinically to develop Gliadel®. Results: Combined etoposide and temozolomide in vitro release (22 and 7 days respectively) was achieved from a lactic acid-based PLGA/PEG paste, used to enhance stability of temozolomide prodrug. HGG cells from central-enhanced regions were more sensitive to each compound relative to primary lines derived from the HGG invasive margin. Both drugs retained cytotoxic capability upon release from PLGA/PEG. In vivo studies revealed a significant overall survival benefit in post-surgery 9L orthotopic gliosarcomas treated with intra-cavity delivered PLGA/PEG/temozolomide/etoposide and enhanced with adjuvant radiotherapy. Long-term survivorship was observed in over half the animals with histological confirmation of disease-free brain. Conclusions: The significant survival benefit of intra-cavity chemotherapy demonstrates clinical applicability of PLGA/PEG paste-mediated delivery of temozolomide and etoposide adjuvant to radiotherapy. PLGA/PEG paste offers a future platform for combination delivery of molecular targeted compounds

Structure and relaxations in liquid and amorphous Selenium

We report a molecular dynamics simulation of selenium, described by a three-body interaction. The temperatures T_g and T_c and the structural properties are in agreement with experiment. The mean nearest neighbor coordination number is 2.1. A small pre-peak at about 1 AA^-1 can be explained in terms of void correlations. In the intermediate self-scattering function, i.e. the density fluctuation correlation, classical behavior, alpha- and beta-regimes, is found. We also observe the plateau in the beta-regime below T_g. In a second step, we investigated the heterogeneous and/or homogeneous behavior of the relaxations. At both short and long times the relaxations are homogeneous (or weakly heterogeneous). In the intermediate time scale, lowering the temperature increases the heterogeneity. We connect these different domains to the vibrational (ballistic), beta- and alpha-regimes. We have also shown that the increase in heterogeneity can be understood in terms of relaxations

From adversity to advancement: leveraging war-tested approaches for the post-conflict reformation of the Ukrainian healthcare landscape

The Russo-Ukrainian Conflict has had significant repercussions on Ukraine’s healthcare system, resulting in civilian casualties and damage to healthcare institutions. The disruption of personnel, medical supplies, and patient transportation has created considerable challenges for healthcare services. However, there are successful approaches from comparable contexts that can serve as a catalyst for post-conflict healthcare reformation in Ukraine. Key strategies include improving healthcare accessibility for marginalized populations through standardized essential health and surgical care packages, rehabilitating damaged facilities, strengthening primary care provisions, and supporting war survivors with disabilities. By adopting these proven practices, Ukraine can stren gthen its healthcare system and facilitate a sustainable recovery, contributing to the country’s resilience and ensuring essential healthcare services for its population

Addressing Neurosurgery Research and Data Access Gaps in War-Inflicted Nations

For decades, neurosurgical research in war-torn countries has been subpar, owing to a plethora of factors that limit data accessibility and quality research. These countries are frequently affected by ongoing conflicts, which divert resources away from effective health care and research outcomes. Furthermore, they lack adequate institutes of higher education, where clinical and research excellence paves the epicenter of research institutions, trained personnel, and infrastructure, making high-quality research difficult

Avian influenza virus A (H5N1), detected through routine surveillance, in child, Bangladesh

We identified avian influenza virus A (H5N1) infection in a child in Bangladesh in 2008 by routine influenza surveillance. The virus was of the same clade and phylogenetic subgroup as that circulating among poultry during the period. This case illustrates the value of routine surveillance for detection of novel influenza virus

Inaccessibility and low maintenance of medical data archive in low-middle income countries: Mystery behind public health statistics and measures

Africa bears the largest burden of communicable and non-communicable diseases globally, yet it contributes only about 1 % of global research output, partly because of inaccessibility and low maintenance of medical data. Data is widely recognized as a crucial tool for improvement of population health. Despite the introduction of electronic health data systems in low-and middle-income countries (LMICs) to improve data quality, some LMICs still lack an efficient system to collect and archive data. This study aims to examine the underlying causes of data archive inaccessibility and poor maintenance in LMICS, and to highlight sustainable mitigation measures. Method Authors conducted a comprehensive search on PubMed, Google scholar, organization websites using the search string “data archive” or “medical data” or “public health statistics” AND “challenges” AND “maintenance” AND “Low Middle Income Countries” or “LMIC”. to Identify relevant studies and reports to be included in our review. All articles related data archive in low and middle income countries were considered without restrictions due to scarcity of data. Result Medical data archives in LMICs face challenges impacting data quality. Insufficient training, organizational constraints, and limited infrastructure hinder archive maintenance. To improve, support for public datasets, digital literacy, and technology infrastructure is needed. Standardization, cloud solutions, and advanced technologies can enhance data management, while capacity building and training programs are crucial. Conclusion The creation and maintenance of data archives to facilitate the storage of retrospective datasets is critical to create reliable and consistent data to better equip the development of resilient health systems and surveillance of diseases in LMICs

Neurological disorders in pregnant women in low- and middle-income countries - Management gaps, impacts, and future prospects: A review perspective

Neurological disorders during pregnancy are a substantial threat to women’s health, particularly in low- and middleincome countries. Furthermore, a critical shortage of mental health workers and neurologists exacerbates the already pressing issue, where a lack of coordination of respective healthcare among multidisciplinary teams involved in managing these conditions perpetuates the current state of affairs. Financial restrictions and societal stigmas associated with neurological disorders in pregnancy amplify the situation. Addressing these difficulties would necessitate a multifaceted approach comprising investments in healthcare infrastructure, healthcare professional education and training, increased government support for research, and the implementation of innovative care models. Improving access to specialized treatment and coordinated management of antenatal neurological diseases will precipitate improved health outcomes for women and their families in low- and middle-income countries