Global Survey of Clinical Oncology Workforce

A lack of well-trained clinical oncologists can result in significant cancer health disparities. The magnitude of this problem around the world is poorly described in the literature. A comprehensive global survey of the clinical oncology workforce was conducted. Data on the number of clinical oncologists in 93 countries were obtained from 30 references. The mortality-to-incidence ratio was estimated by using data on incidence and mortality rates from the GLOBOCAN 2012 database; the ratio was \u3e 70% in 26 countries (28%), which included 21 countries in Africa (66%) and five countries in Asia (26%). Eight countries had no clinical oncologist available to provide care for patients with cancer. In 22 countries (24%), a clinical oncologist would provide care for \u3c 150 patients with a new diagnosis of cancer. In 39 countries (42%), a clinical oncologist would provide care for \u3e 500 patients with cancer. In 27 countries (29%), a clinical oncologist would provide care for \u3e 1,000 incident cancers, of which 25 were in Africa, two were in Asia, and none were in Europe or the Americas. The economic and social development status of a country correlates closely with the burden of cancer and the shortage of human resources. Addressing the shortage of clinical oncologists in regions with a critical need will help these countries meet the sustainable development goals for noncommunicable diseases by 2030

Rising Thyroid Cancer Incidence in Southern India: An Epidemic of Overdiagnosis?

Background: Thyroid cancer incidence is rising in high-income countries. This increase in disease burden is attributed to the phenomenon of overdiagnosis. Objective: We aimed to investigate trends in thyroid cancer rates in India, focusing on the state of Kerala in southern India, which has reported a high incidence of the disease. Design: Population-based study using data from the National Cancer Registry Program. Participants: We used data from the Population Based Cancer Registries for Thiruvananthapuram (capital of Kerala state), Delhi, Mumbai, Bangalore, and Chennai. We used data for three reporting periods from 2005 to 2014 (represented as 2006, 2009, and 2012). Main Outcome Measures: We reported the age-adjusted incidence rate (AARi) and mortality rate (AARm) per 100,000 women and the proportion of thyroid cancers diagnosed in females per 100 cancer cases. Results: During 2006, the AARi for thyroid cancer in women in Thiruvananthapuram was 6.9 per 100,000, rising to 10 in 2009 and 13.3 in 2012. There was a 93% increase in incidence rates over less than a decade. The AARis in the other four cities were stable. In 2012, Thiruvananthapuram had at least a fourfold higher incidence compared with other regions. Thyroid was the primary site in one of every 10 cancers diagnosed in Thiruvananthapuram, and large numbers of patients were \u3c 40 years of age. The AARm remained stable in all regions. Conclusion: We reported a high burden of thyroid cancer in Kerala, India, which is most likely due to overdiagnosis

Series SRR Loaded UHF RFID Tag

AbstractAn RFID tag based on a series loaded split ring resonator (SRR) to operate in the European UHF RFID band of 865-867MHz is reported. A chip of impedance 27-j212Ω is connected at the terminals of the antenna and the read range measurements of the RFID tag are performed in the UHF RFID band. The proposed UHF tag exhibits appreciably good read range over a wide azimuth and elevation angular ranges

The Impact of General Strike on Government Healthcare Delivery in Kerala State in India

General strike (also known as hartal) is used as a mode of protest by organizations and political parties in India. It is generally thought that hartals negatively impact the healthcare delivery in a society. We used the Right to Information Act to obtain data from government health centers in Kerala state in India for four hartal days (H-day) and two control days (A-day and B-day) for each H-day, from sixteen health centers including 6 Community Health Center (CHC), 6 Secondary Health Center (SHC), and 4 Tertiary Health Center (THC). Data on emergency room visits was available for six HCs. 15 HCs had a statistically significant decrease in the number of outpatient visits on H-day. There was no difference in the number of outpatient visits between the two control days (A and B) in 15 HCs, suggesting the lack of a posthartal surge in visits. Median decrease in outpatient visits in CHCs, SHCs, and THCs was 50.4%, 59.5%, and 47.4%, respectively. Hartal did not impact the number of emergency room visits in 6 out of 7 health centers assessed. Our study identified a significant harmful impact on government healthcare delivery due to hartals in Kerala. These findings have major public health implications

Capecitabine-Induced Coronary Vasospasm

Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion. Her physical examination was unremarkable except for a rapid heart rate of 100 bpm. Electrocardiogram test showed no acute ischemic changes. Troponin tests were negative. CT angiography of the chest was negative for acute pulmonary embolism. An echocardiogram showed a left ventricular ejection fraction of 60% without any wall motion abnormalities. The chest pain resolved with aspirin and analgesic use. She was discharged following an inconclusive cardiac workup. Further use of capecitabine was discontinued

CPW fed SRR loaded monopole antenna for triple band operations

A planar CPW fed SRR loaded monopole antenna based on split ring resonator with triple-band operations is reported for passive UHF RFID, Wireless Local Area Networks (WLAN) and World Interoperability for Microwave Access (WiMAX) applications. Measured and simulated results show the effect of tapering of the SRR layer on bandwidth improvement and gain enhancement in comparison to monopole with SRR antenna. The CPW fed SRR loaded monopole antenna has a bidirectional pattern with high gain for wireless communication applications

Prevalence of Triple-Negative Breast Cancer in India: Systematic Review and Meta-Analysis

Purpose There is considerable variation in prevalence rates of triple-negative breast cancer (TNBC) reported by various studies from India. We performed a systematic review and literature-based meta-analysis of these studies. Methods We searched databases of Medline, Scopus, EMBASE, and Web of Science for studies that reported on the prevalence of TNBC in India that were published between January 1, 1999, and December 31, 2015. We extracted relevant information from each study by using a standardized form. We pooled study-specific estimates by using random-effects meta-analysis to provide summary estimates. We explored sources of heterogeneity by using subgroup analyses and metaregression. Results Data were obtained from 17 studies that involved 7,237 patients with breast cancer. Overall combined prevalence of TNBC was 31% (95% CI, 27% to 35%). There was substantial heterogeneity across the studies (I2 of 91% [95% CI, 88% to 94%]; P \u3c .001) that was not explained by available study level characteristics, including study location, definition of human epidermal growth factor receptor 2 or estrogen receptor, mean age of participants, proportion of patients with premenopausal cancer, grade 3 disease, or tumor size \u3e 5 cm. Overall combined prevalence of hormone receptor–positive and human epidermal growth factor receptor 2–positive breast cancer was 48% (95% CI, 42% to 54%) and 27% (95% CI, 24% to 31%), respectively. There was no evidence of publication bias. Conclusion Prevalence of TNBC in India is considerably higher compared with that seen in Western populations. As many as as one in three women with breast cancer could have triple-negative disease. This finding has significant clinical relevance as it may contribute to poor outcomes in patients with breast cancer in India. Additional research is needed to understand the determinants of TNBC in India