Importance of Nanoparticles in Cancer Therapy and Drug Delivery: A Detailed Theory and Gaps

Nanoparticles are a game-changing innovation in cancer therapy and drug delivery. Their ability to enhance drug targeting, overcome biological barriers, and minimize side effects makes them a cornerstone of modern oncology. The challenge lies in effectively distinguishing cancer cells from their regular counterparts in cancer therapy. Nanotechnology has emerged as a transformative solution, addressing this challenge through precise treatment modalities. This chapter delves into the pivotal role of Nanoparticles (NPs) in cancer therapy, primarily focusing on their significance in the drug delivery process. Overcoming the hurdles posed by conventional treatments, the genomic instability of tumors contributes to the variability among cancers, resulting in chemoresistance that challenges therapeutic success. A pioneering deep learning approach coupled with NPs has been proposed to tackle these issues, outshining previous methodologies by delivering drugs with accurate precision to target cancer cells and tissues. Through this innovative deep-learning technique, the proposed model achieves exceptional outcomes. With a remarkable accuracy of 97.591%, sensitivity of 96.644%, and specificity of 96.415%, the deep learning-enabled NPs demonstrate efficiency compared to the modern methods. This proposed model ushers in a new era of hope for patients and clinicians in the fight against cancer

A scoping review in Indian post-stroke patients

Stroke is the second most common cause of death worldwide and the third most common cause of disability-adjusted life years (DALYs) worldwide. According to the available evidence, 85.5 % of total stroke fatalities are reported in lowand middle-income countries compared with high-income countries. In addition, the prevalence of DALYs in low-income countries is very high. The major challenge is the vastness of India and its humongous population size, which makes it nearly impossible to reach patients far away. The quality of life (QoL) of stroke survivors is an important factor in predicting the burden of the disease and determining the effectiveness of treatment. Many research studies provide an overview of the overall estimates of QoL and contribute to research on QoL after stroke in India. Owing to the bleak post-stroke rehabilitation facilities in India, stroke patients don't get the post-stroke care they ought to. The gap is not only in the patient care management system but also in the policies laid out by the government. The unmet gaps in post-stroke rehabilitation and patient care remain a major setback in patient care management, which impacts the clinical outcomes at large. These challenges are the reasons for the increasing disease burden on society and the hampering of the socio-economic status of the country at large. The government authorities should lay down the policy that will help the patient seek the correct in-time treatment for stroke and help the post-stroke patients to live a QoL

Inactivation of Cone-Specific Phototransduction Genes in Rod Monochromatic Cetaceans

Vertebrate vision is mediated by two types of photoreceptors, rod and cone cells. Rods are more sensitive than cones in dim light, but are incapable of color discrimination because they possess only one type of photosensitive opsin protein (rod opsin = RH1). By contrast, cones are more important for vision in bright light. Cones also facilitate dichromatic color vision in most mammals because there are two cone pigment genes (SWS1, LWS) that facilitate color discrimination. Cone monochromacy occurs when one of the cone opsins (usually SWS1) is inactivated and is present in assorted subterranean, nocturnal, and aquatic mammals. Rod monochromacy occurs when both cone photoreceptors are inactivated, resulting in a pure rod retina. The latter condition is extremely rare in mammals and has only been confirmed with genetic evidence in five cetacean lineages, golden moles, armadillos, and sloths. The first genetic evidence for rod monochromacy in these taxa consisted of inactivated copies of both of their cone pigment genes (SWS1, LWS). However, other components of the cone phototransduction cascade are also predicted to accumulate inactivating mutations in rod monochromats. Here, we employ genome sequences and exon capture data from four baleen whales (bowhead, two minke whales, fin whale) and five toothed whales (sperm whale, Yangtze River dolphin, beluga, killer whale, bottlenose dolphin) to test the hypothesis that rod monochromacy is associated with the inactivation of seven genes (GNAT2, GNB3, GNGT2, PDE6C, PDE6H, CNGA3, CNGB3) in the cone phototransduction cascade. Cone-monochromatic toothed whales that retain a functional copy of LWS (beluga whale, Yangtze River dolphin, killer whale, bottlenose dolphin) also retain intact copies of other cone-specific phototransduction genes, whereas rod monochromats (Antarctic minke whale, common minke whale, fin whale, bowhead whale, sperm whale) have inactivating mutations in five or more genes in the cone phototransduction cascade. The only shared inactivating mutations that were discovered occur in the three Balaenoptera species (two minke whales, fin whale), further suggesting that rod monochromacy evolved independently in two clades of baleen whales, Balaenopteroidea and Balaenidae. We estimate that rod monochromacy evolved first in Balaenopteroidea (∼28.8 Ma) followed by P. macrocephalus (∼19.5 Ma) and Balaenidae (∼13.0 Ma)

HEALTH CARE SEEKING INTERVAL AND FATALITY RATE IN SWINE FLU (H1N1) EPIDEMIC IN SURAT CITY

ABSTRACT Objectives: This study was conducted to assess influence of reporting time to health care setup on fatality rate in early 2015 swine flu epidemic. Method: All Swine flu positive cases reported to Surat Municipal Corporation (SMC) from Jan to March 2015 were included in the study. Hospital records were studied retrospectively to gather desired information. Results: Incidence rate and fatality rate of swine flu was 16.38 per lac and 5.91% respectively. Mean differences of interval between onsets of symptoms to reporting to hospital is not significant, however lesser interval between onset of symptoms to swab collection and diagnosis of swine flu were significantly associated with lesser fatality. Fatality Rate declines from January to March. Conclusion: After patient report to the health care setup, prompt sample collection and quick diagnosis help to reduce fatality rate

HEALTH CARE SEEKING INTERVAL AND FATALITY RATE IN SWINE FLU (H1N1) EPIDEMIC IN SURAT CITY

ABSTRACT Objectives: This study was conducted to assess influence of reporting time to health care setup on fatality rate in early 2015 swine flu epidemic. Method: All Swine flu positive cases reported to Surat Municipal Corporation (SMC) from Jan to March 2015 were included in the study. Hospital records were studied retrospectively to gather desired information. Results: Incidence rate and fatality rate of swine flu was 16.38 per lac and 5.91% respectively. Mean differences of interval between onsets of symptoms to reporting to hospital is not significant, however lesser interval between onset of symptoms to swab collection and diagnosis of swine flu were significantly associated with lesser fatality. Fatality Rate declines from January to March. Conclusion: After patient report to the health care setup, prompt sample collection and quick diagnosis help to reduce fatality rate

Early Life Exposure to Fructose and Offspring Phenotype: Implications for Long Term Metabolic Homeostasis

The consumption of artificially sweetened processed foods, particularly high in fructose or high fructose corn syrup, has increased significantly in the past few decades. As such, interest into the long term outcomes of consuming high levels of fructose has increased significantly, particularly when the exposure is early in life. Epidemiological and experimental evidence has linked fructose consumption to the metabolic syndrome and associated comorbidities—implicating fructose as a potential factor in the obesity epidemic. Yet, despite the widespread consumption of fructose-containing foods and beverages and the rising incidence of maternal obesity, little attention has been paid to the possible adverse effects of maternal fructose consumption on the developing fetus and long term effects on offspring. In this paper we review studies investigating the effects of fructose intake on metabolic outcomes in both mother and offspring using human and experimental studies

Clinician–patient communication about emergency aerial medical evacuation in case of infectious disease

Aerial medical evacuation (AME) refers to the removal of patients from one site to a medical facility elsewhere using medically equipped air ambulances.1 In cases of certain infectious diseases it may be necessary to isolate patients in a patient isolation unit (PIU) or ‘pod’ during AME to reduce the risk of transmission of infection to others. Used to transfer patients within and between countries during outbreaks of infectious disease,2 during the COVID-19 pandemic AME became an area of ongoing need.3 With projections indicating current increases in pandemics will likely continue,4 the need for AME will do the same. However, AME in case of infectious disease is an under researched area. There is limited information about the processes and procedures of AME in case of infectious disease,5 and no research or guidance on how to communicate these to patients. A 2019 systematic review aimed to evaluate the processes and procedures used, including pre-flight, in-flight and post-flight.6 The review highlighted the importance of effective communication, but identified a dearth of studies in this area, with just one study detailing communication with patients during the flight, and none examining pre-flight communication

SWOG 1815: A phase III randomized trial of gemcitabine, cisplatin, and nab-paclitaxel versus gemcitabine and cisplatin in newly diagnosed, advanced biliary tract cancers

Background: Biliary tract cancers (BTCs) are a heterogeneous group of malignancies with a dismal prognosis. Gemcitabine-based regimens are the standard of care in advanced disease, but median overall survival (OS) is roughly 12 months. The addition of albumin-bound paclitaxel to gemcitabine and cisplatin (GAP) demonstrated promising efficacy in a 60 patient, single-arm phase II study (Shroff et al, JAMA Oncol 2019), with observed median OS of 19.2 months. Methods: SWOG 1815 is a randomized, open-label, phase III trial comparing GAP to gemcitabine/cisplatin (GC). The study included newly diagnosed advanced BTC patients (pts), randomized 2:1 to GAP vs. GC. GAP included gemcitabine at 800 mg/m2, cisplatin at 25 mg/m2 and albumin-bound paclitaxel at 100 mg/m2 on days 1 and 8 of a 21-day cycle. GC included standard dosing of gemcitabine at 1000 mg/m2 and cisplatin at 25 mg/m2 on days 1 and 8 of a 21-day cycle. Pts were treated until progression. The primary endpoint was overall survival (OS) with a target hazard ratio of 0.7 with 90% power and a 1-sided alpha of 0.025; randomization was stratified by disease site (intrahepatic cholangiocarcinoma [CCA] vs gallbladder adenocarcinoma [GBC] vs extrahepatic CCA), disease stage (locally advanced vs metastatic), and Zubrod PS 0 vs 1. Results: Of 441 eligible pts randomized, 55% were female. 67% of patients had intrahepatic CCA, 16% had GBC and 17% had extrahepatic CCA. Most pts had metastases (73%). Median OS with GAP vs. GC was 14 vs. 12.7 mo respectively (HR 0.93, 95% CI 0.74-1.19, p=0.58), ORR (confirmed and unconfirmed) 34% vs25% (p=0.11) and median PFS 8.2 vs 6.4 mo (HR 0.92, 95% CI 0.72-1.16, p=0.47), respectively. Grade 3 and 4 treatment related adverse events (TRAEs) in ≥10% of pts for GAP and GC were anemia, neutropenia, and thrombocytopenia. GAP had more ≥ grade 3 hematologic AEs compared to the GC arm (60% vs. 45%, p=0.003). Discontinuation due to toxicity was at 24% vs 19% (p=0.26) with GAP vs GC. In exploratory subset analyses, GAP vs GC improved OS in pts with locally advanced disease (medians 19.2 vs 13.7 mo; HR 0.67, 95% CI 0.42- 1.06, p=0.09) and in GBC pts (medians 17.0 vs 9.3 mo; HR 0.74, 95% CI 0.41-1.35, p=0.33). ORR for GAP vs GC in GBC was 50% vs 24% (p=0.09) and for locally advanced disease 28 vs 21% p=0.74. Conclusions: SWOG 1815 did not result in a statistically significant improvement in median OS with GAP vs. GC. The GAP regimen had higher rates of TRAEs without a statistically significant difference in discontinuation rates. Pts with locally advanced disease and GBC may benefit from the use of GAP. Further analyses are ongoing to understand potential benefit of GAP in subsets of BTC pts. Funding: NIH/National Cancer Institute grants CA180888, CA180819, CA180820, CA180821, and CA180868; and in part by Celgene Corporation, Summit, NJ (subsidiary of Bristol Myer Squibb)