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1.
Appl Opt ; 62(36): 9462-9469, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38108770

RESUMO

A design of a photonic crystal nanocavity based bio-sensor having a footprint of 12×8µm 2 is proposed to detect different blood components. A finite difference time domain (FDTD) numerical technique has been used to characterize the sensor by evaluating its frequency response. The shift in resonant wavelength of the proposed cavity is utilized to detect blood refractive index fluctuation due to the presence of various components. The obtained numerical findings show that the maximum sensitivity for a shift in resonant wavelength is reported as 760 nm/RIU for various blood components. Moreover, the fabrication of PhC is always prone to the fabrication induced disorders. Hence, the impact of fabrication imperfections on the sensor's performance also has been included in the analysis.


Assuntos
Técnicas Biossensoriais , Análise Química do Sangue , Fótons , Sangue
2.
Ecancermedicalscience ; 17: 1605, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37799945

RESUMO

Background: Coordinating cancer care is complicated due to the involvement of multiple service providers which often leads to fragmentation. The evolution of digital health has led to the development of technology-enabled models of healthcare delivery. This scoping review provides a comprehensive summary of the use of digital health in coordinating cancer care via hub-and-spoke models. Methods: A scoping review of the literature was undertaken using the framework developed by Arksey and O'Malley. Research articles published between 2010 and 2022 were retrieved from four electronic databases (PubMed/MEDLINE, Web of Sciences, Cochrane Reviews and Global Health Library). The preferred reporting items for systematic reviews and meta-analyses extension for the scoping reviews (PRISMA-ScR) checklist were followed to present the findings. Result: In total, 311 articles were found of which 7 studies that met the inclusion criteria were included. The use of videoconferencing was predominant across all the studies. The number of spokes varied across the studies ranging from 1 to 63. Three studies aimed to evaluate the impact on access to cancer care among patients, two studies were related to capacity building of the health care workers at the spoke sites, one study was based on a peer review of radiotherapy plans, and one study was related to risk assessment and patient navigation. The introduction of digital health led to reduced travel time and waiting period for patients, and standardisation of radiotherapy plans at spokes. Tele-mentoring intervention aimed at capacity-building resulted in higher confidence and increased knowledge among the spoke learners. Conclusion: There is limited evidence for the role of digital health in the hub-and-spoke design. Although all the studies have highlighted the digital components being used to coordinate care, the bottlenecks, Which were overcome during the implementation of the interventions and the impact on cancer outcomes, need to be rigorously analysed.

3.
Org Biomol Chem ; 20(41): 8136-8144, 2022 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-36218163

RESUMO

A new method for the stereoselective metal-, additive- and oxidant-free Friedel-Crafts-type halo-carbocyclization of N- and O-tethered arene-olefin substrates is reported, involving reaction with a suitable electrophilic halogenating reagent (NXS/DCDMH) in hexafluoroisopropanol. All halo (X = Br, I, Cl)-functionalized tetrahydroquinolines and chromans were obtained in excellent yields and with high levels of diastereocontrol (dr = >99 : 1), and these products were successfully transformed into synthetically useful compounds such as dihydroquinolines and partial or full azahelicene compounds.


Assuntos
Alcenos , Quinolinas , Alcenos/química , Catálise , Cromanos/química , Quinolinas/química
4.
Asian Pac J Cancer Prev ; 23(9): 3133-3139, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36172676

RESUMO

BACKGROUND: The technology enabled distributed model in Kerala is based on an innovative partnership model between Karkinos Healthcare and private health centers. The model is designed to address the barriers to cancer screening by generating demand and by bringing together the private health centers and service providers at various levels to create a network for continued care. This paper describes the implementation process and presents some preliminary findings.  Methods: The model follows the hub-and-spoke and further spoke framework. In the pilot phases, from July 2021 to December 2021, five private health centers (partners) collaborated with Karkinos Healthcare across two districts in Kerala. Screening camps were organized across the districts at the community level where the target groups were administered a risk assessment questionnaire followed by screening tests at the spoke hospitals based on a defined clinical protocol. The screened positive patients were examined further for confirmatory diagnosis at the spoke centers. Patients requiring chemotherapy or minor surgeries were treated at the spokes. For radiation therapy and complex surgeries the patients were referred to the hubs. RESULTS: A total of 2,459 individuals were screened for cancer at the spokes and 299 were screened positive. Capacity was built at the spokes for cancer surgery and chemotherapy. A total of 189 chemotherapy sessions and 17 surgeries were performed at the spokes for cancer patients. 70 patients were referred to the hub. CONCLUSION: Initial results demonstrate the ability of the technology Distributed Cancer Care Network (DCCN) system to successfully screen and detect cancer and to converge the actions of various private health facilities towards providing a continuum of cancer care. The lessons learnt from this study will be useful for replicating the process in other States.


Assuntos
Atenção à Saúde , Neoplasias , Hospitais , Humanos , Índia/epidemiologia , Neoplasias/diagnóstico , Neoplasias/terapia , Tecnologia
5.
Front Digit Health ; 4: 916342, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35832659

RESUMO

Introduction: COVID-19 pandemic has caused major disruptions to delivery of various cancer care services as efforts were put to control the outbreak of the pandemic. Although the pandemic has highlighted the inadequacies of the system but has also led to emergence of a new cancer care delivery model which relies heavily on digital mediums. Digital health is not only restricted to virtual dissemination of information and consultation but has provided additional benefits ranging from support to cancer screening, early and more accurate diagnosis to increasing access to specialized care. This paper evaluates the challenges in the adoption of digital technologies to deliver cancer care services and provides recommendation for large-scale adoption in the Indian healthcare context. Methods: We performed a search of PubMed and Google Scholar for numerous terms related to adoption of digital health technologies for cancer care during pandemic. We also analyze various socio-ecological challenges-from individual to community, provider and systematic level-for digital adoption of cancer care service which have existed prior to pandemic and lead to digital inequalities. Results: Despite encouraging benefits accruing from the adoption of digital health key challenges remain for large scale adoption. With respect to user the socio-economic characteristics such as age, literacy and socio-cultural norms are the major barriers. The key challenges faced by providers include regulatory issues, data security and the inconvenience associated with transition to a new system. Policy Summary: For equitable digital healthcare, the need is to have a participatory approach of all stakeholders and urgently addressing the digital divide adequately. Sharing of health data of public and private hospitals, within the framework of the Indian regulations and Data Protection Act, is critical to the development of digital health in India and it can go a long way in better forecasting and managing cancer burden.

6.
Iran J Otorhinolaryngol ; 33(118): 291-299, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34692576

RESUMO

INTRODUCTION: The use of the endoscope in otological surgeries has both diagnostic and therapeutic values. It provides an excellent view in difficult nooks and corners. The use of endoscopic sandwich myringoplasty using cartilage and perichondrium has its benefit in hearing outcome and graft uptake in long-term follow-up. The main objective was to compare the long-term with short- term hearing outcomes in those who have undergone endoscopic sandwich myringoplasty with Dhulikhel hospital (D­HOS) technique. MATERIALS AND METHODS: Forty-two patients who underwent endoscopic sandwich myringoplasty with D-HOS technique using tragal cartilage perichondrium were enrolled in the study. The hearing outcome was analyzed by comparing the pre-operative findings with post-operative findings and amongst post-operative patients, long-term with short-term air bone gap (ABG) and ABG closure in speech frequencies (0.5kHz, 1kHz, 2kHz, 4kHz) were compared. RESULTS: Amongst forty-two patients, 40 (95.2%) had graft uptake in both short-term (6.08 months) and in long-term (20 months) follow-up. The mean pre-operative ABG was 28.1±9.3dB whereas the mean short-term post-operative ABG was 14.5±7.2dB, it showed statistical significance (P=0.001). Likewise, while comparing pre-operative with long-term post-operative ABG (13.4±4.8 dB), it showed statistical significance of P=0.000. While comparing short-term with long-term post-operative ABG, it did not show any statistical significance (P=0.065).The mean closure in ABG in both short-term and long-term hearing assessment was not statistically significant (P=0.077). CONCLUSION: Endoscopic sandwich myringoplasty with D-HOS technique is a reliable procedure with good hearing outcome and graft uptake in both short and long-term follow-up.

7.
Ecancermedicalscience ; 15: 1198, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889207

RESUMO

BACKGROUND: Areca nut is the fourth most commonly used psychoactive substance worldwide after tobacco, alcohol and caffeine. In India, it is perceived in various ways, ranging from a 'fruit of divine origin' in Hindu religious ceremonies to a mouth freshener. Areca nut use both on its own and with tobacco additives is addictive. The aim of this study was to understand the pattern of areca nut consumption, to determine the Knowledge, Attitude and Practices (KAP) among areca nut users and the dependency associated with areca nut use. METHODS: A cross sectional study was conducted in Guwahati, Assam using a self-administered questionnaire eliciting the pattern of areca nut consumption, KAP among users and understanding their dependency using Betel Quid Dependence Scale. The chewers of areca nut alone with or without betel quid, gutkha and tobacco participated in the study. Areca nut users were selected using purposive sampling method from the vendor shops of all the four assembly areas of the city. Their participation was voluntary and free not to answer or quit the survey. The data was analysed using SPSS software. RESULTS: A total of 500 participants were approached in all four areas, 479 completed the survey (response rate 95%). The people who participated in the study were mostly male with an average age of 40 years, educated to secondary level or higher, married and self-employed. Betel quid with tamul was the most prevalent form of areca nut chewing in both men and women. About 441 (92%) participants experienced pleasure when chewing areca nut and 327 (68%) chewed it to relieve stress. Only 86 (18%) of subjects had ever tried to quit chewing areca nut and 387 (81%) thought that it was highly addictive. The results revealed relatively high levels of endorsement for 'physical and psychological urgent need' (mean = 43%) and 'increasing dose' (mean = 50%), whereas endorsement level for 'maladaptive use' was low (mean = 16%). CONCLUSION: Areca nut use (tamul) is of major concern in India and many Southeast Asian countries and its use has been increasing across the globe. The evidence suggests a dependence similar to tobacco use and policy makers need to refine its strategy for control of its use by engaging with multiple stakeholders and adapting it to local context with surveillance and cessation guidelines in order to address this issue.

8.
Asian Pac J Cancer Prev ; 22(2): 419-426, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33639656

RESUMO

BACKGROUND: Adolescence is an influential stage in students' lives when lifelong behaviours such as tobacco use are formed. During these years, school teachers are important role models for tobacco control among students. A study was conducted among school personnel and administrators to understand the key drivers for implementing an evidence-based school tobacco control program. METHODOLOGY: A cross-sectional, mixed-method study was conducted in five districts of Assam, India. The quantitative study was conducted among 565 school personnel across 40 Government-aided schools. Data was collected by means of an anonymous, self-administered questionnaire. Qualitative data was generated from 15 focus group discussions (FGDs) among 146 participants - District Program Officers, Block Education Officers, Cluster Coordinators, Headmasters and Teachers. RESULTS: While the prevalence of smoked tobacco was low (3%), the use of smokeless tobacco was higher (40%), and the prevalence of use of areca nut without tobacco (65%) was still higher among school personnel. They were aware of the school policies prohibiting the use of tobacco among students within or outside school buildings or during school-sponsored activities (81%); they had rather limited knowledge about policy for themselves (58%). There was lack of access to training materials about prevention of tobacco use among youth. The FGDs amongst school personnel resulted in several constructive suggestions on tobacco control in schools mainly in training school teachers, monitoring the program and incentives for execution of the program. However, there was a reluctance to implement a smokeless tobacco control programme since many were current users of smokeless tobacco and areca nut. CONCLUSION: Tobacco control policies as well as training school personnel in schools need to improve and further measures must be taken to prohibit use of areca nut, which contains carcinogens. The existing system of the education department can be utilised to implement tobacco control programmes effectively.


Assuntos
Instituições Acadêmicas , Prevenção do Hábito de Fumar/organização & administração , Uso de Tabaco/prevenção & controle , Adolescente , Adulto , Criança , Estudos Transversais , Humanos , Índia , Pessoa de Meia-Idade , Fumar/epidemiologia , Inquéritos e Questionários , Produtos do Tabaco , Uso de Tabaco/epidemiologia , Adulto Jovem
9.
J Cancer Policy ; 27: 100270, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-35559941

RESUMO

BACKGROUND: Cancer patients in the North East Region (NER) of India have poorer survival rates compared with the rest of India. This is due to late stage at presentation related to poor awareness, risk factors such as use of tobacco, alcohol consumption and less physical activity, This study aims to determine the association between socio-demographic characters and use of tobacco, alcohol consumption and physical activity among people in the NER. METHODS: A cross-sectional study of 1400 participants was conducted across Assam, Nagaland and Meghalaya in the NER. A questionnaire was developed to study the socio-demographic profile and factors such as use of tobacco, alcohol consumption and physical activity among participants. Multivariate analysis was performed to understand tobacco and alcohol use and physical activity and a logistic regression analysis was performed to understand the association of different independent variables with lifestyle practice. RESULTS: Use of tobacco and alcohol consumption was highest amongst males, 25-44 years age range and middle income group as defined in this study. The main reasons given for quitting tobacco and alcohol were becoming aware of the harmful effects of using tobacco, pressure from family and friends, and noticing a deterioration in health. Over 90 % of tobacco users and consumers of alcohol initiated this between 10-30 years of age. In all, 62 % of participants rarely or never engaged in any physical recreational activity. CONCLUSION: Patterns of use of tobacco and consumption of alcohol and recreational physical activity undertaken in the NER show a strong relationship with gender, age and household income. POLICY IMPLICATIONS: The paper finds a close association of different pattern of modifiable habits which are the risk factors for cancer in the Northeast Region. The limited awareness about the risk factors strengthen the case of context specific prevention strategies and constant reinforcement of behavior communication strategies by using multipronged approach.


Assuntos
Consumo de Bebidas Alcoólicas , Nicotiana , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Exercício Físico , Humanos , Índia/epidemiologia , Masculino , Prevalência
10.
Tob Prev Cessat ; 6: 51, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33083679

RESUMO

INTRODUCTION: Tobacco use is a major risk factor for cancer and other non-communicable diseases and is the single largest cause of preventable deaths worldwide causing premature death. There are various laws and legislations for tobacco control in India. The Cigarettes and Other Tobacco Products Act (COTPA) 2003 was enacted in 2004 but is not enforced rigorously. The aim of this study was to determine any violation of COTPA Section 4 (prohibition of smoking in public places) around educational institutions and Section 6b (prohibition of sale of tobacco products near educational institutions). METHODS: A cross-sectional, observational study was conducted in 307 schools and colleges selected across 12 districts in 5 states in India. Data were collected by the tobacco control coordinators. From the centre of the city, the coordinators travelled in four different directions to a maximum distance of 10 km radius. Along the path, any educational institutions that were encountered were surveyed for violation of COTPA Sections 4 and 6b. RESULTS: Out of 307 schools surveyed across the five states, an average of 85% of the schools violated Section 4 and an average of 69% violated Section 6b. CONCLUSIONS: A coordinated effort by all stakeholders, especially by the police, educational institutions, and the community, is required. Adherence to the guidelines on Tobacco-Free Educational Institutions can improve the implementation of COTPA in and around educational institutions.

11.
JCO Glob Oncol ; 6: 601-609, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32302235

RESUMO

PURPOSE: The burden of cancer is increasing globally, with poor outcomes in terms of morbidity and mortality in patients, especially in low- and middle-income countries. Lack of awareness of the risk factors, symptoms, and signs of common cancers in addition to inadequate cancer prevention programs at the community level are a major hindrance to the early detection of cancer. METHODS: A cross-sectional study was conducted in the North East Region (NER) of India, with a sample population of 1,400 participants from Assam (n = 1,000), Meghalaya (n = 200), and Nagaland (n = 200). The questionnaire developed for the study consisted of sociodemographic profile, knowledge about cancer (oral, breast, and cervical), its warning signs, risk factors, and attitude toward cancer screening. Statistical analysis was performed using STATA version 13.0. RESULTS: Among all the participants, 59% had heard about oral cancer, 50% about breast cancer, and 31% about cervical cancer. A limited understanding of risk factors, symptoms, and signs was reported for oral cancer (45%), breast cancer (54%), and cervical cancer (63%). A total of 34% of participants were aware of cancer screening. Among those who were aware of cancer screening, only six people had undergone any form of cancer screening, and 71% cited media as the major source of information. CONCLUSION: The level of cancer awareness is low in the NER. A multipronged approach is needed with assistance from government and nongovernment organizations for training, providing adequate human resources and equipment, and developing cancer screening infrastructure. This needs to be coupled with mass media communication and interpersonal communication through frontline health workers.


Assuntos
Detecção Precoce de Câncer , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias do Colo do Útero , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia
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