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Background: The cancer registry provides reliable data from the population. In this article, we provide cancer burden and its patterns from the Varanasi district. Methods: The method adopted by the Varanasi cancer registry is community interaction along with regular visits to more than 60 sources to collect data on cancer patients. The cancer registry was established by the Tata Memorial Centre, Mumbai, in 2017 covering 4 million population (57% rural and 43% urban population). Results: The registry has recorded 1,907 incidence cases (1,058 male and 849 female). The age-adjusted incidence rate per 100,000 population in male and female of Varanasi district is 59.2 and 52.1, respectively. One in 15 male and one in 17 female are at risk of developing the disease. Mouth and tongue cancers are the predominant cancers in male, whereas breast, cervix uteri, and gallbladder are the leading cancer sites among the female. In female, cervix uteri cancer is significantly higher (double) in rural areas when compared with urban areas (rate ratio [RR] 0.5, 95% confidence interval [CI; 0.36, 0.72]), whereas in male, mouth cancer is higher in urban areas when compared with rural areas (RR 1.4, 95% CI [1.11, 1.72]). More than 50% of cancer cases in male are due to tobacco consumption. There may be underreporting of the cases. Conclusion: The results of the registry warrant policies and activities related to early detection services for the mouth, cervix uteri, and breast cancers. The Varanasi cancer registry is the foundation for cancer control and will play an important role in the evaluation of the interventions. Keywords: Cancer control, cancer prevention, India, population-based cancer registry, rural and urban, Author(s): Atul M Budukh (corresponding author) [1]; Satyajit Pradhan [2]; Virendra B Singh [3]; Divya Khanna [4]; Sonali S Bagal [5]; Priyal S Chakravarti [5]; Anand N Sharma [5]; Rajesh [...]

Background: Rising obesity rates in the workforce are accompanied by a hidden cost burden to employers due to work productivity loss. Understanding the impact of obesity on work productivity is essential for employers to provide tailored weight loss interventions in the workplace. Objectives: To measure work loss and associated productivity costs among employees with overweight/obesity compared with employees with normal weight. Methods: This retrospective cohort study used the MerativeTM MarketScan® Health and Productivity Management Database to identify adult employees with ≥1 diagnosis code reporting a body mass index (BMI) between 1/1/2015‐12/31/2019. Based on the earliest BMI, employees were assigned to normal weight (BMI 19–24.9), overweight (BMI 25–29.9), obesity class 1 (BMI 30–34.9), obesity class 2 (BMI 35–39.9), and obesity class 3 (BMI ≥40) cohorts. Among employees with data for each work loss category (absenteeism, short‐term disability [STD], long‐term disability [LTD], worker's compensation [WC]) during the 12‐month follow‐up, the percentage of employees with work loss, number of hours/days lost, and associated productivity costs were reported. Results: 719,482 employees (normal weight: 106,631, overweight: 230,637, obesity class 1: 185,850, obesity class 2: 101,909, obesity class 3: 94,455) were included. Outcomes increased with each higher BMI category for the mean number of absence hours ([in order of BMI category]: 262, 273, 285, 290, 304) and percentage of employees with a claim (STD: 6.8%, 7.6%, 9.7%, 11.7%, 17.0%; LTD: 0.4%, 0.4%, 0.5%, 0.6%, 0.8%; WC: 2.7%, 2.8%, 3.4%, 3.6%, 3.5%). Estimated costs to the employer associated with absenteeism, STD, LTD, and WC were $1,036, $611, $38, and $95 higher per year (respectively) in the obesity class 3 cohort relative to the normal weight cohort. Conclusions: This real‐world analysis demonstrated that employees with overweight/obesity had higher loss of work productivity compared with employees with normal weight. Further studies are warranted to determine the long‐term impacts on work productivity loss if overweight and obesity are left untreated. [ABSTRACT FROM AUTHOR]

Introduction: Weight loss has been identified as a key strategy for improving glycemic and metabolic outcomes in people with type 2 diabetes (T2D). However, the long-term, real-world impact of weight loss on these outcomes remains unclear. This study aimed to investigate (1) the association between weight loss and glycemic control, (2) association between weight loss and metabolic parameters, and (3) predictors of weight loss and how weight change trajectory varies based on index body mass index (BMI). Methods: A retrospective, longitudinal cohort study using the linked IQVIA Ambulatory electronic medical records and PharMetrics® Plus databases was performed from January 1, 2010 through December 31, 2019 in adults with T2D. Participants were categorized into 1-year and 5-year follow-up cohorts based on their observed weight change over time. Longitudinal values for vital signs and laboratory parameters, including BMI, weight, glycated hemoglobin (HbA1c), and metabolic parameters (liver enzymes and cholesterol), were reported at index date and every 6 months post index date. Multivariable logistic regression analysis was used to evaluate the factors associated with weight loss. Results: Of 1,493,964 people evaluated, 1,061,354 (71%) and 308,320 (20.6%) were classified into the 1-year and 5-year follow-up cohorts. Average HbA1c reductions of 1.2% and 0.5% were observed among people who lost ≥ 15% of index weight in the 1-year and 5-year follow-up cohorts, respectively. Higher weight loss percentages were associated with numerically greater improvements in metabolic parameters. The presence of bariatric surgery and higher index BMIs were identified as the strongest predictors of ≥ 15% and ≥ 10% weight loss in both follow-up cohorts. Conclusion: Results from this study suggest that modest and sustained weight loss can lead to clinically meaningful improvements in glycemic and metabolic parameters among people with T2D. These findings highlight the importance of weight management in managing T2D and preventing its associated complications. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to estimate clinical, economic (including productivity), and health‐related quality of life (HRQoL) outcomes and associated individual characteristics among adults with overweight (OW) or obesity in the United States. Methods: This study included adult respondents with body mass index (BMI) ≥18.5 kg/m2 in the 2017–2018 National Health and Nutrition Examination Survey (NHANES) and 2016 Medical Expenditure Panel Survey. Respondents were classified according to BMI. Individual characteristics were described by BMI categories. Multivariable regression models estimated the association between BMI categories and outcomes, adjusting for individual characteristics. Results: Nearly three‐quarters (73.7%) of NHANES participants were OW or obese. Relative to Normal weight (NW), respondents with Class 3 obesity had more obesity‐related complications (2.07 vs. 4.62, p < 0.001). Higher BMI was associated with significantly lower HRQoL, lower productivity, and higher healthcare expenditures as well as more frequent weight loss attempts in the previous 12 months. Weight loss surgery and prescription anti‐obesity medications (AOMs) were used only by a very small proportion of individuals. Despite frequent weight loss attempts, most respondents did not achieve clinically meaningful weight loss. Conclusions: Adults with OW or obesity experienced worse clinical, economic and HRQoL outcomes than those with NW. Better use of evidence‐based obesity treatments, including prescription AOMs, should be considered to achieve more clinically meaningful weight reduction and improved outcomes in individuals with OW or obesity. [ABSTRACT FROM AUTHOR]

Background: Obesity is associated with an increased risk of multiple conditions, ranging from heart disease to cancer. However, there are few predictive models for these outcomes that have been developed specifically for people with overweight/obesity. Objective: To develop predictive models for obesity‐related complications in patients with overweight and obesity. Methods: Electronic health record data of adults with body mass index 25–80 kg/m2 treated in primary care practices between 2000 and 2019 were utilized to develop and evaluate predictive models for nine long‐term clinical outcomes using a) Lasso‐Cox models and b) a machine‐learning method random survival forests (RSF). Models were trained on a training dataset and evaluated on a test dataset over 100 replicates. Parsimonious models of <10 variables were also developed using Lasso‐Cox. Results: Over a median follow‐up of 5.6 years, study outcome incidence in the cohort of 433,272 patients ranged from 1.8% for knee replacement to 11.7% for atherosclerotic cardiovascular disease. Harrell C‐index averaged over replicates ranged from 0.702 for liver outcomes to 0.896 for death for RSF, and from 0.694 for liver outcomes to 0.891 for death for Lasso‐Cox. The Harrell C‐index for parsimonious models ranged from 0.675 for liver outcomes to 0.850 for knee replacement. Conclusions: Predictive modeling can identify patients at high risk of obesity‐related complications. Interpretable Cox models achieve results close to those of machine learning methods and could be helpful for population health management and clinical treatment decisions. [ABSTRACT FROM AUTHOR]

We examined the roles of type 2 diabetes (T2D) and obesity in disease activity and fibrosis progression/regression in patients with non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH). This multi-center, retrospective study included patients with suspected or histologically proven NAFLD/NASH from the NASH Clinical Research Network. Outcomes included disease activity and rate of fibrosis, assessed using liver-biopsy driven measures (NAFLD activity score [NAS] and fibrosis score [FS]). Logistic regression and doubly robu estimation of causal effects tested relationships among T2D, obesity, and NAFLD/NASH. The analytical sample included 870 adult patients with baseline biopsy data and 157 patients with multiple biopsy data. Patients with NAFLD/NASH and T2D had significantly higher baseline average NAS (4.52 vs. 4.13; p = 0.009) and FS (2.17 vs. 1.56; p < 0.0001); those with T2D had a significantly greater reduction in average NAS over time (−0.77/year vs. −0.17/year; p = 0.0008). Change in FS over time did not differ significantly by T2D status (−0.23/year vs. −0.04/year; p = 0.34). Baseline NAS, baseline FS, and change in average NAS over time did not differ significantly by obesity status (4.17 vs. 4.47; p = 0.16; 1.73 vs.1.92; p = 0.31; −0.40/year vs. −0.59/year; p = 0.62, respectively). Patients with obesity had a slight increase in FS but those without obesity had a reduction in average FS over time (0.07/year vs. −0.27/year; p = 0.008). Patients with NAFLD/NASH and T2D had greater baseline disease activity versus those without T2D, but there was greater regression of disease activity over time among those with T2D. Patients with NAFLD/NASH and obesity had worsening of fibrosis versus those without obesity. NCT00063622 [ABSTRACT FROM AUTHOR]

Online education has become increasingly popular in recent years, especially with the COVID-19 pandemic. However, it is not without its challenges. Some of the biggest challenges of online learning for students include feelings of isolation, lack of motivation, technical issues, and distractions. Teachers also face challenges such as low student engagement, tight budgets, and safety risks. To overcome these challenges, teachers and students can use various solutions such as creating a more impactful experience for students, increasing remote engagement, and implementing a sound eLearning strategy. Many students are drawn to online education because it offers better learning opportunities. But there are a lot of obstacles and difficulties that make learning difficult. The benefits that could help students with enhanced learning sessions are being suppressed by the obstacles in the way of learning. The article lists a few difficulties that educators and students encounter and provides suggestions about how to overcome them. [ABSTRACT FROM AUTHOR]

Bio-waste material-assisted nanomaterials synthesis is a newer aspect of modern nanotechnology. It is preferred over orthodox approaches for its merits, including affordability, safety, eco-benevolentness, and biocompatibility. In this report, the green fabrication of heterogeneous Cu/CuO/Cu2O NPs using groundnut shell extract and assessed for their diverse biomedical properties. Diverse spectroscopic and microscopic characterization techniques such as X-ray diffraction (XRD), Fourier-transformed infrared spectroscopy (FTIR), scanning electron microscope (SEM), energy-dispersive X-ray spectroscopy (EDX) and transmission electron microscope (TEM) were performed to confirm the synthesis of groundnut shells extract mediated Cu/CuO/Cu2O NPs. XRD data demonstrated a high degree of crystallinity of the Cu/CuO/Cu2O NPs and a median diameter of about 34 nm. HRTEM and SEM images disclosed the quasi-spherical morphology of NPs. FTIR study ascertained the involvement of diverse functional groups that reduced and stabilized the Cu/CuO/Cu2O NPs. Moreover, the anticancer efficacy of synthesized Cu/CuO/Cu2O NPs was evaluated against breast cancer cell lines (MCF-7) through an MTT assay and displayed activity at the IC50 of 42.66 μg/mL. Antioxidant properties of Cu/CuO/Cu2O NPs were surveyed through the ABTS and DPPH assays. Furthermore, the agarose gel electrophoresis technique has scrutinized the DNA cleavage abilities of the as-prepared Cu/CuO/Cu2O NPs. Hence, the present green approach represents a facile, greener, safe and cost-effective route for synthesizing Cu/CuO/Cu2O NPs and opening new horizons for the biomedical sector. Highlights: First-time report on groundnut shell extracts-mediated synthesis of heterogeneous Cu/CuO/Cu2O NPs through a cost-effective and eco-friendly approach. Optical, structural, and topological properties of Cu/CuO/Cu2O NPs were studied using XRD, FTIR, SEM, EDX and HRTEM techniques. As-prepared Cu/CuO/Cu2O NPs exhibited effective cytotoxic activity against breast cancer cell lines (MCF-7) using MTT assay. Moreover, antioxidant and DNA cleavage studies of Cu/CuO/Cu2O NPs investigated. [ABSTRACT FROM AUTHOR]