Smart Nanomaterials in Cancer Theranostics: Challenges and Opportunities.

Cancer is ranked as the second leading cause of death globally. Traditional cancer therapies including chemotherapy are flawed, with off-target and on-target toxicities on the normal cells, requiring newer strategies to improve cell selective targeting. The application of nanomaterial has been extensively studied and explored as chemical biology tools in cancer theranostics. It shows greater applications toward stability, biocompatibility, and increased cell permeability, resulting in precise targeting, and mitigating the shortcomings of traditional cancer therapies. The nanoplatform offers an exciting opportunity to gain targeting strategies and multifunctionality. The advent of nanotechnology, in particular the development of smart nanomaterials, has transformed cancer diagnosis and treatment. The large surface area of nanoparticles is enough to encapsulate many molecules and the ability to functionalize with various biosubstrates such as DNA, RNA, aptamers, and antibodies, which helps in theranostic action. Comparatively, biologically derived nanomaterials perceive advantages over the nanomaterials produced by conventional methods in terms of economy, ease of production, and reduced toxicity. The present review summarizes various techniques in cancer theranostics and emphasizes the applications of smart nanomaterials (such as organic nanoparticles (NPs), inorganic NPs, and carbon-based NPs). We also critically discussed the advantages and challenges impeding their translation in cancer treatment and diagnostic applications. This review concludes that the use of smart nanomaterials could significantly improve cancer theranostics and will facilitate new dimensions for tumor detection and therapy.

Relational Empathy, Holistic Care, and Quality of Life in Persons With Spinal Cord Injuries: A Cross-sectional Study.

INTRODUCTION: High-quality health systems are built on the concept of patient-centered approach, which includes holistic care and empathy. With time, this has progressively been recognized as a valuable paradigm for better health outcomes, particularly in chronic diseases. OBJECTIVES: The study aims to determine the patients' perception during their consultation and to assess the relationship between Consultation and Relational Empathy measure with demographic/injury variables and quality of life. METHODS: The present cross-sectional study was conducted among 226 individuals with spinal cord injuries. Data were collected via structured questionnaire, World Health Organization-Quality of life BREF, and Consultation and Relational Empathy measure. Independent t test is used to compare World Health Organization-Quality of life BREF domains with two groups of Consultation and Relational Empathy measure. Logistic regression was used to determine the significant factors of Consultation and Relational Empathy measure. RESULTS: In the logistic regression analysis, it was observed that higher quality of life score has significantly higher odds of getting higher Consultation and Relational Empathy score with a remarkable odds ratio (odds ratio = 1.0264, 95% confidence interval = 1.0121-1.0261, P = 0.0001, 0.0472, 0.0001). CONCLUSIONS: The quality of life of the present population is closely associated with greater perceptions of holistic care and empathy in the therapeutic patient-provider relationship. Lack of coordination, poor quality of life, and limited communication between patient and provider may arise when the latter focuses only on treating disease rather than treating a patient as a "whole person."

A Prospective Three-Months Naturalistic Follow-Up Study of Outcomes of Patients with Opioid Dependence Discharged on Buprenorphine or Oral Naltrexone.

Background: Comparative studies of the naturalistic course of patients of opioid dependence on naltrexone and buprenorphine are likely to be helpful for clinical decision-making. The article aimed to report on the three-months naturalistic outcomes of patients discharged on naltrexone or buprenorphine from the same center. Methods: Patients with opioid dependence who were discharged on either naltrexone (n = 86) or buprenorphine (n = 30) were followed up for three months for retention in treatment. The patients were also followed up telephonically, and the Maudsley Addiction Profile was applied. Results: The days of retention in treatment were significantly higher in the buprenorphine group (69.5 versus 48.7 days, P = 0.009). Heroin use, pharmaceutical opioid use, injection drug use, involvement in illegal activity, and percentage of contact days in conflict with friends in the last 30 days reduced over three months in both the groups, while the physical and psychological quality of life improved in both the groups. Additionally, in the naltrexone group, smoked tobacco use, cannabis use, and percentage of contact days in conflict with family within the last 30 days reduced at three months compared to baseline. Conclusion: With the possible limitations of choice of medication-assisted treatment for opioid dependence being determined by the patient, and prescribing related factors and sample size constraints, the study suggests that retention outcomes may vary between naltrexone and buprenorphine, though both medications may improve several patient-related parameters. However, a true head-to-head comparison of the outcomes of buprenorphine and naltrexone in a naturalistic setting may be difficult.

Reasons for leaving treatment among patients with opioid dependence: A 3-month prospective follow-up study.

OBJECTIVE: This study aimed to ascertain the reasons why patients with opioid dependence leave treatment. DESIGN: Prospective follow-up observational study. SETTING: This study was carried out at a tertiary care substance use treatment facility in north India with both outpatient and inpatient services. The facility is a public-funded institution. PARTICIPANTS: One hundred and twenty opioid-dependent male patients with age 18 years or more who were willing to provide a valid telephone number for followup and willing to consent for the study were included. MAIN OUTCOME MEASURE(S): Enquiries were made using the Reasons to Leave Treatment Questionnaire (RLTQ) and an open-ended question about why the patient left treatment. RESULTS: As per the RLTQ, the most common reasons for patients with opioid dependence leaving treatment were in the domains of external influence, motivational inconsistencies, and problem severity. Logistic problem was another issue that was highlighted by the patients. On open-ended question, the most common reason for leaving treatment pertained to feeling that one has improved and does not need treatment. Baseline characteristics that predicted patients leaving treatment were not being prescribed buprenorphine at discharge, not being formally educated, and living alone or in a nuclear family. CONCLUSION: Several factors may lead to patients with opioid dependence leaving treatment prematurely after receiving inpatient care. Addressing these reasons might help to better retain patients in treatment and improve their outcomes.

Coping with COVID: Cross-sectional study to assess the psychological impact and coping strategies utilized by Indian internet users during the lockdown of the COVID-19 pandemic.

INTRODUCTION: The sudden and extended lockdown imposed by the government as an attempt to break the transmission chain of COVID disrupted the lives and plans of many. The impact on mental health of people is variable depending on the appraisal of the situation and the resources and coping strategies. AIM AND OBJECTIVES: The aim of the study was to know the impact on mental health and coping strategies used by internet users dealing with the COVID-19 pandemic and involved difficulties in India. MATERIALS AND METHODS: The survey was conducted using Google doc application. Tools included Generalized Anxiety Disorder-7 (GAD-7) questionnaire, Patient Health Questionnaire (PHQ), and brief COPE questionnaire. STATISTICAL ANALYSIS: Descriptive statistics were used to assess the sociodemographic characteristics, GAD-7, PHQ-2, and brief COPE scales. The group differences were analyzed using appropriate parametric or nonparametric tests for the quantitative variable and Chi-square/Mc-Nemar's test for categorical variables. The data were analyzed using SPSS software. RESULTS: Three hundred and twenty six responses were analyzed. Nearly 35.3% screened positive for anxiety disorder and 12% for major depression. Respondents who were screened positive for anxiety disorder used active coping, denial, substance use, behavioral disengagement, planning, and self-blame more often than those screened negative. Those screened positive for major depression used all the coping strategies similar to anxiety disorder except for active coping more often than those who screened negative. While females used adaptive coping more frequently than males, respondents those engaged in essential services employed maladaptive coping less often. CONCLUSIONS: Acceptance, positive reframing, and positive coping were the most often employed strategies, while denial, self-blame, and substance use were least often employed.

Ultrasound-propelled nanowire motors enhance asparaginase enzymatic activity against cancer cells.

Ultrasound-(US) propelled nanowires consisting of Au/Ni/Au/PEDOT-PPy-COOH segments are modified with asparaginase enzyme and applied as an effective anti-cancer agent. After immobilization of asparaginase onto the surface of the nanowire motors, the enzyme displays enhanced thermal and pH stabilities, improved resistance towards protease, and higher affinity for the substrate. The fast motion of the motor-carrying asparaginase leads to greatly accelerated biocatalytic depletion of asparagine and hence to a significantly enhanced inhibition efficacy against El4 lymphoma cancer cells (92%) as compared to free enzyme counterpart (17%) and other control groups. Such enhanced enzymatic activity against cancer cells is attributed to the fast motion of the motors which facilitates the interaction between the enzyme and the cancer cells. While asparaginase and EL4 tumor cells are used as a model system in the present study for cancer cell inhibition, the same mechanism can be expanded to other types of enzymes and biomolecules for the corresponding biofunctions.

Determinants of Smoking Habit among Medical Students.

A cross sectional study of smoking habits among medical students was carried out to find out the prevalence of smoking and its association with certain factors such as parental smoking, peer pressure, use of alcohol and other drugs. Prevalence of smoking was 46%. There was significant association of smoking with parental smoking habit, peer pressure, use of alcohol and other drugs. Strategies to counter these social determinants have been discussed.