Strategies for primary HPV test-based cervical cancer screening programme in resource-limited settings in India: Results from a quasi-experimental pragmatic implementation trial.

BACKGROUND: In order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India. METHODS: A mixed-method, pragmatic, quasi-experimental trial design was used. HPV screening on self-collected cervical samples was offered to women aged 30-60 years. Implementation strategies were 1) Assessment of contextual factors using both qualitative and quantitative methods like key informant interviews (KII), focus group discussions (FGDs), pre-post population sample surveys, capacity assessment of participating departments 2) enhancing provider capacity through training workshops, access to HPV testing facility, colposcopy, thermal ablation/cryotherapy at the primary health care centers 3) community engagement, counselling for self-sampling and triage process by frontline health care workers (HCWs). Outcomes were assessed using the RE-AIM (Reach, Effectiveness, adoption, implementation, maintenance) framework. RESULTS: Screening rate in 8 months' of study was 31.0%, 26.7%, 32.9%, prevalence of oncogenic HPV was 12.1%, 3.1%, 5.5%, compliance to triage was 53.6%, 45.5%, 84.6% in tribal, urban slum, rural sites respectively. Pre-cancer among triage compliant HPV positive women was 13.6% in tribal, 4% in rural and 0% among urban slum women. Unique challenges faced in the tribal setting led to programme adaptations like increasing honoraria of community health workers for late-evening work and recalling HPV positive women for colposcopy by nurses, thermal ablation by gynaecologist at the outreach camp site. CONCLUSIONS: Self-collection of samples combined with HCW led community engagement activities, flexible triage processes and strengthening of health system showed an acceptable screening rate and better compliance to triage, highlighting the importance of identifying the barriers and developing strategies suitable for the setting. TRIAL REGISTRATION: CTRI/2021/09/036130.

Unraveling Interface-Driven and Loss Mechanism-Centric Phenomena in 3D/2D Halide Perovskites: Prospects for Optoelectronic Applications.

In recent years, organic-inorganic metal halide perovskite solar cells (PSCs) have attracted considerable interest due to their remarkable and rapidly advancing efficiencies. Over the past decade, PSC efficiencies have significantly approached those of state-of-the-art silicon-based photovoltaics, making them a promising material. Currently, the scientific community widely recognizes the performance of 3D-PSCs and 2D-PSCs individually. However, when both are combined to form a heterostructure, the lattice and charge dynamics at the interface undergo a multitude of mechanisms that affect their performance. The interface between heterostructures facilitates the degradation of PSCs. The degradation pathways can be attributed to lattice distortions, inhomogeneous energy landscapes, interlayer ion migration, nonradiative recombination, and charge accumulation. This Review is dedicated to examining the phenomena that arise at the interface of 3D/2D halide perovskites and their related photophysical properties and loss mechanism processes. We mainly focus on the impact of lattice mismatch, energy level alignment, anomalous carrier dynamics, and loss mechanisms. We propose a "cause-impact-identify-rectify" approach to gain a comprehensive understanding of the ultrafast processes occurring within the material. Finally, we highlight the importance of advanced spectroscopic and imaging techniques in unraveling these intricate mechanisms. This discussion delves into the future possibilities of fabricating 3D/2D heterostructure-based optoelectronic devices, pushing the boundaries of performance across diverse fields. It envisions the creation of devices with unparalleled capabilities, exceeding the limitations of current technologies.

Dimensional Stability and Retention Strength of Impressions to Custom Impression Trays Fabricated Using Conventional Method and Additive Technology - An In-vitro Study.

BACKGROUND: 3D printing technology is replacing manual fabrication in all fields. 3D-printed impression trays should be assessed as they could replace conventional impression trays in the future. AIM: In-vitro comparison and evaluation of the dimensional stability and retention strength of impressions to custom impression trays fabricated using conventional method and additive technology. MATERIALS AND METHODS: A maxillary edentulous auto-polymerizing acrylic resin model served as the master model. Two moulds were prepared from the master model in order to obtain 12 casts. One cast was scanned for 3D printing digital light processing (DLP) and fused deposition modelling (FDM) 24 impression trays using polylactic acid (PLA). Twelve casts were used to fabricate light cure impression trays. Polyvinyl-siloxane impressions were made on the master model using 36 impression trays and 18 trays each were used to assess dimensional stability and retention strength. RESULTS: In dimensional stability analysis, one sample t-test revealed a statistically significant difference between each group and the master model followed by a one-way ANOVA. There were significant differences, but the difference was less with FDM trays (P < 0.05). In retention strength analysis, one-way Analysis of variance (ANOVA) revealed statistically significant difference between each group and post-hoc test revealed specific difference, the highest with FDM trays (P < 0.05). CONCLUSION: Dimensional changes were observed at 30 minutes and 72 hours. Lesser dimensional changes were observed when impressions were made using FDM trays followed by DLP and light cure trays. The mean retention strength seen in descending order was FDM, followed by DLP and light cure trays. The best retention strength was noticed when impressions were made using FDM trays.

Novel chitosan based thin sheet nanofiltration membrane for rejection of heavy metal chromium.

In recent years, polymeric membranes holds superior position in filtration processes as it was cost effective and simple to prepare. In the present study we have synthesized a novel organic-inorganic hybrid thin sheet membrane using chitosan/polyvinyl alcohol and montmorillonite clay followed by non-solvent induced phase inversion technique. This hybrid clay-polymeric nanofiltration membrane possesses excellent overall performance, such as enhanced hydrophilic nature, and holds good rejection rate. Analytical techniques such as Fourier transform infrared spectroscopy (FT-IR), X-ray diffractometer (XRD) and Scanning Electron Microscopy (SEM) have been employed to characterize the membrane material. Membrane characterizations such as pure water flux, membrane hydraulic resistance, water content, percentage of porosity and pore size were also evaluated. An important characteristic of membrane for long term usage "anti-biofouling activity" is investigated by determining zone of inhibition of membrane on pathogens of bacterial and fungal strains. The remediation of chromium was performed by varying the parameters such as pH, metal ion concentration, applied pressure and thickness of membrane. The rejection of chromium removal by CS/PVA/MMT membrane is confirmed by comparing the spectral images of EDAX and FT-IR taken before and after filtration.

FTIR, XRD and DSC studies of nanochitosan, cellulose acetate and polyethylene glycol blend ultrafiltration membranes.

In the present work, a series of novel nanochitosan/cellulose acetate/polyethylene glycol (NCS/CA/PEG) blend flat sheet membranes were fabricated in different ratios (1:1:1, 1:1:2, 2:1:1, 2:1:2, 1:2:1, 2:2:1) in a polar solvent of N,N'-dimethylformamide (DMF) using the most popular phase inversion method. Nanochitosan was prepared by the ionotropic gelation method and its average particle size has been analyzed using Dynamic Light Scattering (DLS) method. The effect of blending of the three polymers was investigated using FTIR and XRD studies. FTIR results confirmed the formation of well-blended membranes and the XRD analysis revealed enhanced amorphous nature of the membrane ratio 2:1:2. DSC study was conducted to find out the thermal behavior of the blend membranes and the results clearly indicated good thermal stability and single glass transition temperature (Tg) of all the prepared membranes. Asymmetric nature and rough surface morphology was confirmed using SEM analysis. From the results it was evident that the blending of the polymers with higher concentration of nanochitosan can alter the nature of the resulting membranes to a greater extent and thus amorphous membranes were obtained with good miscibility and compatibility.

Spectral characterisation, antiviral activities, in silico ADMET and molecular docking of the compounds isolated from Tectona grandis to chikungunya virus.

Chikungunya infection is treated symptomatically with antipyretics and anti-inflammatory drugs without any specific antiviral drug till date. The lack of an approved antiviral drug and the emergence of virulent strains after 2006 epidemics emphasize the need for the development of potential antiviral drugs to Chikungunya virus. Hence, we studied the antiviral activity of the extracts and compounds isolated from Tectona grandis leaves to both the Asian and East central South African strains of Chikungunya virus. Five compounds were isolated from the ethanolic extract of Tectona grandis by bioactivity guided fractionation followed by Spectral Characterisation through GC-MS and NMR spectroscopy and investigated for the antiviral activity. Also in silico ADMET and Molecular Docking of the characterised compounds against the structural and non structural proteins of Chikungunya virus were performed. The characterised compound Benzene-1-carboxylic acid hexadeconate was effective at IC 50 3.036µg/ml (7.5µM) and 76.46µg/ml (189.02µM) to Asian and ECSA strain of CHIKV respectively. The compound showed desirable pharmacokinetic properties and significant molecular interactions with the E1 protein of Chikungunya virus by in silico analysis. Thus Benzene-1-carboxylic acid-2-hexadeconate isolated from Tectona grandis was found to be a promising drug candidate to both the Asian and ECSA strains of Chikungunya virus with high selectivity indices in comparison to the reference RNA antiviral drug Ribavirin.

Clinicopathological profile of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (POEMS) syndrome.

Patients with polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes (POEMS) syndrome caused by underlying plasma cell dyscrasias, although rare, may present with peripheral neuropathy. In this retrospective study we describe the clinical, electrophysiological and pathological profile of 29 patients (27 males and two females, with a mean age of 45.9±7.9 years) seen between 1983 to 2009 who satisfied the Dispenzieri criteria. Polyneuropathy with weakness and paresthesias of the limbs evolving over 8.3±9.1 months, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes were seen in all patients. Other features included pedal edema (25 patients), papilledema (24), weight loss (23), clubbing (20) and Castleman disease (three patients). We report the pathological features seen in nerve biopsies, osteosclerotic lesions, skin biopsies, lymph node biopsies and bone marrow aspirates. We report the method of a diagnosis confirmation and compare the clinicopathological features of our patients with other published series. Our findings highlight the importance of a meticulous systemic examination and systematic laboratory investigations in the diagnosis of POEMS syndrome.