Assessment of Registry-Based Surveillance Statistics Used for Cancer Control in the Dindigul District in South India.

Background: Cancer incidence rates from the Dindigul district were lower by 50% than Chennai in Tamil Nadu for most cancers. This study describes the cancer surveillance statistics and provides an assessment of missing cases from routine registration in the Dindigul Ambilikkai Cancer Registry (DACR), covering a predominantly rural population in the Dindigul district. Method: A total of 21,214 incident cancers in the DACR during 2003-2017 were examined for this study. Cancer registration was carried out by active case-finding following standard international norms. A total of 12,541 incident cancers registered during 2003-2012 and followed through 2014 were used to estimate survival. Data on follow-up were obtained through a mixture of active and passive methods. Survival probability was estimated by actuarial methods. A random survey carried out independently was used to assess the quality of case ascertainment. Results: The age-standardized rate (ASR) per 100,000 population was higher among women (76.2) than men (61) in 2013-2017, with both sexes reporting a 17% increase compared to 2003-2007. The most common cancers were cervix (ASR,18.5) and female breast (ASR,17.1), with percentage changes of -19% and +46.1%, respectively. Lung cancer (ASR, 5.5) was top among men with an increasing trend (+57.1%). The percent change in ASR of mouth cancer showed opposite trends among men (+24.3%) and women (- 21.4%). The ASR of colorectal cancers almost doubled among men between 2003-2007 and 2013-2017 (3.9; +94.7%). The 5- and 10-year absolute survival for all cancers were 31% and 20%, respectively. Out of 365 incident cancers that occurred during 2003-2010 in the surveyed areas, 310 (84.9%) were already registered in the DACR, while 55 were newly identified from the survey (15.1%). Inadequate coverage of sources outside the Dindigul district was significant (P = .002), with the highest number of missed cases from hospitals under nongovernment sectors (58.3%). Underascertainment was higher among cancer patients living in hilly regions (60%) and border areas (47.4%) than in core regions (P = .05). Conclusion: Because of an enacted government order making cancer a notifiable disease, the registry-based cancer surveillance could be extended, covering a population of 80 million in a cost-effective manner with enhanced coverage and systematic evaluation of cancer-screening programs.

Influence of Sn4+ ion on band gap tailoring, optical, structural and dielectric behaviors of ZnO nanoparticles.

II-VI semiconductors are being attracted due to excellent optical and electronic behaviors when they utilize for device fabrication. Among II-VI semiconductors, Zinc oxide finds cutting-edge results for various applications with a lack of toxicity. Sn4+ ion incorporated ZnO nanoparticles have been synthesized using a soft chemical route and characterized for the investigation of properties like structural, morphological, elemental, optical and dielectric responses. The prepared ZnO had a hexagonal structure and the particles size reduces by the influence of Sn4+ ion: this reduction rate increases for the increase of doping ratio. The average particles size was estimated within 24-34 nm. TEM, HRTEM and SEM results corroborate the structural aspects noticed using XRPD study. UV-vis study results showed that a blue shift on the optical band gap was received for high doping concentration (10 at.%) of Sn4+. PL peaks were observed in the UV region for 0 at.% and 2 at.% Sn4+ doped ZnO nanoparticles, and the peak position was shifted from UV to violet and blue region for 10 at.% Sn4+ doped ZnO nanoparticles. The dielectric permittivity was reduced due to the addition of Sn4+ ions. The AC conductivity was increased for higher doping concentrations. The Sn4+ ion incorporated ZnO nanoparticles shall be useful for various applications including LED fabrication for blue emission and also it is suitable to act as a buffer material in solar panel.

In vitro bioactivity, mechanical behavior and antibacterial properties of mesoporous SiO2-CaO-Na2O-P2O5 nano bioactive glass ceramics.

Bioactive ceramics, glasses and glass ceramics have the ability to enhance the bone formation and bond to surrounding tissue. In this study, we report on the synthesis of mesoporous nanobioactive glass ceramic with the modified composition of quaternary system 50% SiO2 - 26% Na2O - 20% CaO- 4% P2O5 (Ca/P: 5) [i.e.50S20C] by sol-gel method and succeeded by heat treatment. The as-dried sample was calcined at various temperatures such as 100 °C, 300 °C, 500 °C, 700 °C and 900 °C for 24 h.The weight loss measurement was carried out using Thermogravimetric (TG) analysis. The structural features were characterized by X-ray diffraction (XRD), Fourier transformed infrared spectroscopy (FTIR), Field Emission Scanning Electron Microscopy (FESEM) & Energy Dispersive Spectroscopy (EDS) analysis. The results revealed that the synthesized glass ceramic stabilized at higher temperature (700 °C and 900 °C)making more formation of the crystalline phase of sodium calcium silicate. The density and porosity measurements were carried out by using the Archimedes immersion method. The mechanical properties of the glass ceramic exhibit the compressive strength as69 MPa and 72 MPa for 700 °C and 900 °C, respectively. From the obtained results, we confirmed the calcined bioactive glass ceramic nanoparticles at 700 °C and 900 °C having a better crystallization, crystallite size with high surface area, high density, suitable porosity of mesoporous with dense microstructure and adequate mechanical properties. Furthermore, in vitro bioactivity character of calcined nanobioactive glass ceramics were studied by using an immersion of nanopowders into Stimulated Body Fluid (SBF) solution for two different time periods such as 7 and 14 days. After soaking the glass ceramic nanopowders in SBF, the structural and morphological changes were determined by using XRD, FTIR and FESEM & EDS analysis, respectively. The in vitro results exhibited that crystallization did not retard the samples bioactivity which indicates the increase of material bioactivity while calcining temperature was increased and it is used to fabricate tissue engineering scaffolds with sustained mechanical properties. Moreover, the enhanced bactericidal behavior of glass ceramic has also been studied. An antibacterial study revealed that the prepared bioactive glass ceramic show a significant effect on two bacteria E. coli and S. aureus.

Deformation of dark solitons in a PT -invariant variable coefficients nonlocal nonlinear Schrödinger equation.

We derive dark and antidark soliton solutions of a parity-time reversal (PT) -invariant variable coefficients nonlocal nonlinear Schrödinger (NNLS) equation. We map the considered equation into a defocusing PT -invariant NNLS equation with a constraint between dispersion, nonlinearity, and gain/loss parameters. We show that the considered system is PT -invariant only when the dispersion and nonlinearity coefficients are even functions and gain/loss coefficient is an odd function. The characteristics of the constructed dark soliton solutions are investigated with four different forms of dispersion parameters, namely, (1) constant, (2) periodically distributed, (3) exponentially distributed, and (4) periodically and exponentially distributed dispersion parameter. We analyze in detail how the nonlocal dark soliton profiles get deformed in the plane wave background with these dispersion parameters.

HPV vaccination of immunocompromised hosts.

It is well-established that immunocompromised people are at increased risk of HPV-related disease compared with those who are immunocompetent. Prophylactic HPV sub-unit vaccines are safe and immunogenic in immunocompromised people and it is strongly recommended that vaccination occur according to national guidelines. When delivered to immunocompromised populations, HPV vaccines should be given as a 3-dose regimen.

Recommendations for screening and early detection of common cancers in India.

Cancers of the breast, uterine cervix, and lip or oral cavity are three of the most common malignancies in India. Together, they account for about 34% of more than 1 million individuals diagnosed with cancer in India each year. At each of these cancer sites, tumours are detectable at early stages when they are most likely to be cured with standard treatment protocols. Recognising the key role that effective early detection and screening programmes could have in reducing the cancer burden, the Indian Institute for Cytology and Preventive Oncology, in collaboration with the US National Cancer Institute Center for Global Health, held a workshop to summarise feasible options and relevant evidence for screening and early detection of common cancers in India. The evidence-based recommendations provided in this Review are intended to act as a guide for policy makers, clinicians, and public health practitioners who are developing and implementing strategies in cancer control for the three most common cancers in India.

The effect of 2,5-di-(tert-butyl)-1,4-benzohydroquinone (TBQ) on intracellular Ca2+ handling in rat ventricular myocytes.

2,5-Di-(tert-butyl)-1,4-benzohydroquinone (TBQ) is a reversible inhibitor of SERCA, potentially making it a useful tool to study the effects of SERCA inhibition in cardiac cells. However, it is unknown if TBQ also has effects on other components of ventricular Ca handling. The aim of these experiments was to characterise the effects of TBQ on Ca handling in rat ventricular myocytes and assess its suitability as a specific inhibitor of SERCA. This was achieved by voltage clamp via perforated patch and [Ca(2+)]i measurement using Fluo-3 AM. TBQ produced a fully reversible, concentration dependent decrease in the rate of systolic Ca decay. 10µM TBQ decreased the amplitude of the systolic Ca transient by 48±5% and the rate of decay by 54±6%. SR Ca content was also reduced by 62±4%. However, 10µM TBQ also decreased the peak L-type Ca current by 23±7%. At higher concentrations (100µM), TBQ also activated an outward current with a current-voltage relationship consistent with a potassium current. This outward current was abolished by Glibenclamide (100µM). These data show that TBQ can be used to reversibly inhibit SERCA. However, at concentrations that decrease SERCA activity, TBQ also decreases the L-type Ca current and (at higher concentrations) activates an outward current which appears to be an ATP dependent potassium current. We conclude that TBQ cannot be used as a specific inhibitor of SERCA in rat ventricular myocytes.

Using implementation science to advance cancer prevention in India.

Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence- based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

Nanostructures formed by cyclodextrin covered procainamide through supramolecular self assembly--spectral and molecular modeling study.

Inclusion complexation behavior of procainamide (PCA) with two cyclodextrins (α-CD and ß-CD) were analyzed by absorption, fluorescence, scanning electron microscope (SEM), transmission electron microscope (TEM), Raman image, FT-IR, differential scanning colorimeter (DSC), Powder X ray diffraction (XRD) and (1)H NMR. Blue shift was observed in ß-CD whereas no significant spectral shift observed in α-CD. The inclusion complex formation results suggest that water molecules also present in the inside of the CD cavity. The present study revealed that the phenyl ring of the PCA drug is entrapped in the CD cavity. Cyclodextrin studies show that PCA forms 1:2 inclusion complex with α-CD and ß-CD. PCA:α-CD complex form nano-sized particles (46 nm) and PCA:ß-CD complex form self-assembled to micro-sized tubular structures. The shape-shifting of 2D nanosheets into 1D microtubes by simple rolling mechanism were analysed by micro-Raman and TEM images. Thermodynamic parameters (ΔH, ΔG and ΔS) of inclusion process were determined from semiempirical PM3 calculations.

Screening for cancer in low- and middle-income countries.

BACKGROUND: Screening programs involve testing asymptomatic individuals with an accurate screening test to identify those likely to have the disease of interest and to further investigate them to confirm or exclude the disease. The aim of cancer screening is to prevent cancer deaths and improve quality of life by finding cancers early and by effectively treating them. A decision to introduce a screening program in public health services depends on the evidence that the benefits outweigh the harms of screening, disease burden, availability of suitable screening test, effective treatment, adequate resources, and efficient health services. Screening programs should achieve high participation for testing, diagnosis, and treatment to be effective and efficient. OBJECTIVE: To describe the current status of cancer screening programs in low- and middle-income countries (LMICs). METHOD: A review of literature and on-going cancer screening initiatives in LMICs was made to discuss cancer screening in these countries. FINDINGS: Although population-based programs offering Papanicolaou testing every 3 to 5 years have reduced cervical cancer incidence and mortality in high-income countries, such programs have been less successful in reducing cervical cancer burden in LMICs due to poor organization, lack of coverage, and lack of quality assurance. The challenges in introducing high-quality cytology screening in LMICs have led to evaluation of alternative screening approaches such as visual inspection with acetic acid (VIA), human papillomavirus (HPV) testing-based screening, and novel paradigms such as a "single-visit screen and treat" in which treatment with cryotherapy or cold coagulation is provided to screen-positive women without clinical evidence of cancer. Both HPV testing and VIA have been found to prevent cervical neoplasia and cervical cancer deaths in clinical trials. Although mammography screening reduces breast cancer mortality, associated overdiagnosis and overtreatment and the balance between benefits and harms have received much attention in recent years. Although introduction of clinical breast examination screening in LMICs should wait for evidence from ongoing trials, improving breast awareness and access to early diagnosis and treatment in health services is a valuable breast cancer control option in LMICs. Organized colorectal cancer screening programs are still evolving and are in early stages of development in many high-income countries. To date, there is insufficient evidence to support the introduction of population-based stomach, lung, ovarian, and prostate cancer screening in public health services. CONCLUSIONS: Implementation of VIA screening in several LMICs is conducive to future HPV screening programs when affordable HPV tests become widely available. Both HPV vaccination and HPV screening have a huge potential to eliminate cervical cancer in LMICs. A mammography screening program is a complex undertaking involving substantial resources and infrastructure that may not be feasible in many LMICs.

Azo dye/cyclodextrin: new findings of identical nanorods through 2:2 inclusion complexes.

Inclusion complexation behavior of 4-aminoazobenzene (AAB) and 4-amino-2,3'-dimethyl azobenzene (GBC, fast grant GBC) with α- and ß-cyclodextrins (α-CD, ß-CD) is analyzed by scanning electron microscope, transmission electron microscope, Fourier transform infrared spectroscopy, differential scanning calorimetry, powder X-ray diffraction, and proton nuclear magnetic resonance spectroscopy techniques. Transmission electron microscope analysis suggests that identical nanorods formed in AAB/CD inclusion complexes while different dimension nanostructures were observed in GBC/CD inclusion complexes. The nanostructures confirmed that the ratio of 2:2 (guest:host) inclusion complex has been developed to a miniature nanorod. Nanosecond time-resolved fluorescence studies indicated that AAB/GBC have fast life time in water, whereas slow life time in CDs corresponds to a higher-order structure of 2:2 complexes. Thermodynamic parameters and binding affinity of the inclusion complex formation were determined and discussed. van der Waals interactions are mostly responsible for enthalpy-driven complex formation of AAB and GBC with cyclodextrins.

Nanostructures formed by cyclodextrin covered aminobenzophenones through supramolecular self assembly.

Cyclodextrin (α and ß) based nanostructures formed with 2-aminobenzophenone, 3-aminobenzophenone through the supramolecular self assembly are studied by absorption, fluorescence, time-resolved fluorescence, SEM, TEM, FT-IR, DSC, PXRD and (1)H NMR. The unequal layer by layer nanosheets and nanoribbons are formed through self assembly of 3ABP/CD inclusion complexes. 2ABP/α-CD complex nanostructures show the self assembly hierarchical thread structure and ß-CD complexes displays a nanobrick structure. The formation of nanostructures are prearranged to HO⋯H, NH2⋯O and H2N⋯H intermolecular hydrogen bond between individual complexes. The absorption and fluorescence spectral changes explicit formation of 1:1 inclusion complexes and solvent study demonstrate the ESIPT and TICT present in both molecules. The thermodynamic parameters (ΔH, ΔG and ΔS) of 2ABP and 3ABP molecule and the inclusion complexes were determined from semiempirical PM3 calculations.

Meta-analysis of the efficacy of cold coagulation as a treatment method for cervical intraepithelial neoplasia: a systematic review.

BACKGROUND: Cold coagulation is an ablative method for treatment of cervical intraepithelial neoplasia (CIN). Despite reports of efficacy against all grades of CIN (CIN1-3), cold coagulation has been infrequently used since the 1980s, and was absent from the recent Cochrane review on CIN treatment. OBJECTIVES: To provide a systematic review of cold coagulation efficacy and acceptability for CIN treatment through meta-analysis of clinical reports and a randomised control trial. SEARCH STRATEGY: A literature search in PubMed, Web of Science, EMBASE, and regional databases yielded 388 papers. Title, abstract and/or reference list review identified 22 papers describing cold coagulation treatment of CIN, with 13 providing adequate data for inclusion in the meta-analysis. SELECTION CRITERIA: Publications or conference abstracts describing original data (number of women treated, followed up and cured, provider type, cure definition) were retained. No language or publication date limitations were imposed. DATA COLLECTION AND ANALYSIS: Data extracted from 13 studies were pooled, and statistical analyses of proportion cured were conducted with data stratified by lesion grade and study region. MAIN RESULTS: Among 4569 CIN patients treated with cold coagulation, summary proportion cured of 96% [95% confidence interval (CI) 92-99%] and 95% (92-98%) were obtained for CIN1 and CIN2-3 disease, respectively. Side-effects and adverse effects were infrequent, and fertility was not impaired. CONCLUSIONS: Cold coagulation CIN cure rates were comparable to those of other excisional and ablative methods. Cold coagulation is indicated for all grades of CIN, is safe, quick and acceptable, and may be of particular relevance for use in resource-limited settings.

Human papillomavirus infection among human immunodeficiency virus-infected women in Maharashtra, India.

INTRODUCTION: Frequency and distribution of HPV types in HIV-infected women with and without cervical neoplasia and their determinants have not been widely studied in India. We report and discuss HPV prevalence and type distribution in HIV-infected women. METHODS: HPV genotyping was done using cervical samples from 1109 HIV-infected women in a cross-sectional study. RESULTS: Any HPV was detected in 44.8% and high-risk ones in 41.0% women. Frequency of single and multiple high-risk infections were 26.7% and 14.3%, respectively. Frequencies of high-risk HPV infections in women with and without cervical neoplasia were 73.5% and 37.6%, respectively. HPV16 was the most common genotype, present in 11.5%, and 58.5% of women with cervical intraepithelial neoplasia (CIN) 2 and 3. Other most common high-risk HPV types in CIN 2-3 lesions were HPV 31 (22.6%); 56 (13.2%); 18 and 68a (11.3%) and 33, 35 and 51 (9.4%); and 70 (7.5%). Women under 30 or over 44 years, no abortions, and women with diagnosis of HIV infection within the last 5 years were at high risk of multiple oncogenic HPV infection. CONCLUSION: We observed a very high frequency of high-risk HPV and multiple infections in HIV-infected women.

Dual fluorescence of fast blue RR and fast violet B: effects of solvents and cyclodextrin complexation.

Absorption and steady-state and time-resolved fluorescence spectra of fast blue RR (FBRR) and fast violet B (FVB) were studied in solvents with different polarities and in the presence of α- and ß-cyclodextrins (CDs). Dual emission observed in nonpolar solvents suggested that the energy of the intramolecular charge transfer (ICT) state is lower than that of the locally excited state. The normal Stokes-shifted band originated from the locally excited state, and the large Stokes-shifted band was due to the emission from a planar intramolecular charge transfer (PICT) state. The ratio of the PICT emission to the normal emission increased with ß-CD concentration, whereas it was constant upon addition of α-CD. This behavior is in accordance with CD-dependent decay times of PICT and normal emissions, indicating the formation of different 1:1 FBRR/CD inclusion complexes. The rise time for the PICT emission increased with ß-CD concentration, whereas no rise time was observed in the case of the α-CD complex. The size of the dimethoxyaniline ring suggested that the orientation of FBRR in the ß-CD complex was different from that in the α-CD complex. The benzamido moiety of FBRR is deeply encapsulated in the CD cavity, whereas the aniline ring is exposed to the hydrophilic part. Semiempirical quantum-mechanical (ΔE, ΔG, ΔH, ΔS, and HOMO-LUMO) calculations were also carried out to assign the encapsulation of FBRR and FVB.

Development of a cardiologist delivered service leads to improved outcomes following admission with acute coronary syndromes in a large district general hospital.

BACKGROUND: East Lancashire Hospitals NHS Trust reorganized its services in October 2007 with acute admissions sent to one site which allowed the development of a 24/7 Consultant delivered cardiology service. METHODS: A retrospective analysis of all patients admitted with an acute coronary syndrome between two periods: Group 1: October 2006 to September 2007 and Group 2: October 2007 and September 2008. We looked at the following end points-length of stay, in-hospital and 30 day all cause mortality. RESULTS: 633 patients in group 1 and 748 patients in group 2. There was significant reduction in length of stay from a median (IQ range) 7 (5-11) days to 5 (3-9) days; P<0.0001. The in-hospital mortality reduced from 15.8% (n=100) to 7.6% (n=56); P<0.0001. The mortality at 30 days reduced from 15.2% (n=96) to 8.3% (n=62); P<0.0001. These reductions remained significant after adjustment for demographic and risk factor variables. CONCLUSION: A 24/7 Consultant Cardiologist delivered cardiac care is associated with marked reductions in all cause mortality following admission with acute coronary syndromes. This improvement occurred with a significant reduction in hospital length of stay.