Phytochemical management of root knot nematode (Meloidogyne incognita) kofoid and white chitwood by Artemisia spp. in tomato (Lycopersicon esculentum L.)

In vitro and screen house experiments were conducted to investigate the effectiveness of thirteen phytochemicals from Artemisia elegantissimia and A. incisa on root knot nematode, Meloidogyne incognita in tomato (Lycopersicon esculentum L.) cv. Rio Grande. A positive control (Carbofuran) and negative control (H2O) were also used for comparison. Effectiveness of phytochemicals against juveniles (J2s) mortality and egg hatch inhibition were evaluated after 24, 48 and 72 hours of incubation at three concentrations viz; 0.1, 0.2 and 0.3 mg/mL in vitro conditions. Amongst thirteen phytochemicals, Isoscopletin (Coumarin), Carbofuran and Apigenin (Flavonoid) showed the highest mortality and egg hatch inhibition of M. incognita at all intervals. Inhibition of eggs and J2s mortality were the greatest (90.0%) and (96.0%) at 0.3 mg/mL concentration. Application of phytochemicals caused reduction in number of galls, galling index, and egg masses on tomato plant and enhanced plant growth parameters under screen house conditions. Gall numbers (1.50), galling index (1.00), number of juveniles (4.83) and egg masses (4.00) were greatly reduced and plant growth parameters such as; plant height (28.48 cm), fresh (72.13 g) and dry shoot weights (35.99 g), and root fresh (6.58 g) and dry weights (1.43 g) were increased significantly by using Isoscopletin. In structure activity relationship, juveniles of M. incognita, exhibited variations in their shape and postures upon death when exposed to different concentrations of phytochemicals of Artemisia spp. The present study suggests that Artemisia based phytochemicals possess strong nematicidal effects and can be used effectively in an integrated disease management program against root knot nematodes.

miR-673/menin/JunD axis modulates hyperglycemia-induced oxidative stress and inflammation in the diabetic heart

Background

Hyperglycemia-induced reactive oxygen species generation in diabetic heart contributes to myocardial dysfunction. JunD, a member of the activated protein 1 (AP-1) family of transcription factors, is emerging as a major gatekeeper against oxidative stress. Previous studies have shown that downregulation of AP-1 transcription factor JunD is involved in vascular aging and heart failure. However, the role of JunD in diabetes-induced myocardial dysfunction is unknown.

Purpose

The present study was designed to investigate whether hyperglycemia-driven epigenetic regulation of JunD contributes to oxidative stress, inflammation and myocardial dysfunction in the diabetic heart.

Methods

Diabetes (DB) was induced in C57BL/6 wild-type (WT) mice by streptozotocin. After four weeks of DB, left ventricular (LV) function was assessed by standard and 2D speckle-tracking echocardiography in both groups (n=10). Then, the animals were euthanized and LV specimens were collected to determine JunD mRNA and protein expression as well as superoxide anion production by ESR spectroscopy. Chromatin modifications of JunD gene promoter were assessed by chromatin immunoprecipitation. Isolated DNA was analyzed for promoter methylation following Methylminer kit. Cardiac biopsies were collected from age-matched patients with and without diabetes.

Results

DB mice showed LV dysfunction with reduced ejection fraction and fractional shortening. JunD mRNA and protein expression were reduced in the myocardium of DB as compared to control mice. JunD downregulation was associated with oxidative stress, increased NF-kB binding activity and expression of inflammatory mediators. Accordingly, expression of free radical scavenger superoxide dismutase 1 and aldehyde dehydrogenase 2 was reduced, whereas nicotinamide adenine dinucleotide phosphate oxidase subunits NOX2 and NOX4 were upregulated in DB. A reduction of JunD mRNA and protein expression was confirmed in LV specimens obtained from patients with diabetes. The downregulation of JunD was epigenetically regulated by promoter hypermethylation and histone modifications. Post-translational repression by tumor suppressor menin also contributed to JunD downregulation. Indeed, menin was significantly upregulated in DB hearts and co-immunoprecipitation experiments confirmed the binding of menin to JunD. Furthermore, rat ventricular myocytes exposed to high glucose (HG) showed increased menin expression. We found that miR-673 targeting menin was downregulated in hearts of DB mice. Reprogramming miR-673 in HG-treated myocytes was able to restore both menin and JunD expression to control levels.

Conclusions

Our findings show that downregulation of AP-1 transcription factor JunD contributes to diabetes-induced myocardial dysfunction and miR-673/menin/JunD represents a novel molecular axis involved in hyperglycemia-induced ROS-driven cardiac damage.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): European Society of Cardiology (ESC) Research Grant 2017

Analysis of pressure-driven membrane preconcentration for point-of-care assays

Point-of-care diagnostic devices for both physicians and patients themselves are now ubiquitous, but often not sensitive enough for highly dilute analytes (e.g., pre-symptomatic viral detection). Two primary methods to address this challenge include (1) increasing the sensitivity of molecular recognition elements with greater binding affinity to the analyte or (2) increasing the concentration of the analyte being detected in the sample itself (preconcentration). The latter approach, preconcentration, is arguably more attractive if it can be made universally applicable to a wide range of analytes. In this study, pressure-driven membrane preconcentration devices were developed, and their performance was analyzed for detecting target analytes in biofluids in the form of point-of-care lateral-flow assays (LFAs). The demonstrated prototypes utilize negative or positive pressure gradients to move both water and small interferents (salt, pH) through a membrane filter, thereby concentrating the analyte of interest in the remaining sample fluid. Preconcentration up to 33× is demonstrated for influenza A nucleoprotein with a 5 kDa pore polyethersulfone membrane filter. LFA results are obtained within as short as several minutes and device operation is simple (very few user steps), suggesting that membrane preconcentration can be preferable to more complex and slow conventional preconcentration techniques used in laboratory practice.

The Effect of Germinated Sorghum Extract on the Pasting Properties and Swelling Power of Different Annealed Starches

Starches were extracted from chickpea (C.P.), corn (C.S.), Turkish bean (T.B.), sweet potato (S.P.S.), and wheat starches (W.S.). These starches exhibited different amylose contents. The extracted starches were annealed in excess water and in germinated sorghum extract (GSE) (1.0 g starch/9 mL water). The α-amylase concentration in the GSE was 5.0 mg/10 mL. Annealing was done at 40, 50, and 60 °C for 30 or 60 min. The pasting properties of annealed starches were studied using Rapid Visco-Analyzer (RVA), in addition to the swelling power. These starches exhibited diverse pasting properties as evidenced by increased peak viscosity with annealing, where native starches exhibited peak viscosity as: 2828, 2438, 1943, 2250, and 4601 cP for the C.P., C.S., T.B., W.S., and S.P.S., respectively, which increased to 3580, 2482, 2504, 2514, and 4787 cP, respectively. High amylose content did not play a major role on the pasting properties of the tested starches because sweet potato starch (S.P.S.) (22.4% amylose) exhibited the highest viscosity, whereas wheat starch (W.S.) (25% amylose) had the least. Therefore, the dual effects of granule structure and packing density, especially in the amorphous region, are determinant factors of the enzymatic digestion rate and product. Swelling power was found to be a valuable predictive tool of amylose content and pasting characteristics of the tested starches. The studied starches varied in their digestibility and displayed structural differences in the course of α-amylase digestion. Based on these findings, W.S. was designated the most susceptible among the starches and S.P.S. was the least. The most starch gel setback was observed for the legume starches, chickpeas, and Turkish beans (C.P. 2553 cP and T.B. 1172 cP). These results were discussed with regard to the underlying principles of swelling tests and pasting behavior of the tested starches. Therefore, GSE is an effortless economic technique that can be used for starch digestion (modification) at industrial scale.

Current concepts in the management of ankle arthritis

Ankle arthritis is a common condition. It causes a significant socioeconomic burden, and is associated with significant morbidity. Patients with ankle arthritis are either elderly with significant co-morbidities, or young adults who have previously suffered with ankle injuries, resulting in post-traumatic arthritis. There is a wide variation in the management of these patients with ankle arthritis. We therefore present an overview of the current evidence based management of patients with symptomatic ankle arthritis.

Wheat-millet flour cookies: Physical, textural, sensory attributes and antioxidant potential

Millet flour (water washed or alkali washed) was replaced with wheat flour (WF) at 0, 25, 50, 75, and 100% levels. Objectives of the research were to characterize the flour blends for their technical properties and to produce cookies with less or no gluten contents. All types of flour blends were evaluated for their pasting properties. The cookies were baked and evaluated for their textural and physical attributes. Inclusion of millet flour (both types) in wheat flour resulted in significant reduction in peak and final viscosities while setback viscosities were affected non-significantly. Pasting temperature was increased from 65 ℃ (100% wheat flour) to 91 ℃ (100% millet flour). The hardness of cookies was reduced in the presence of millet flour. Fracturability values of cookies with higher millet flour were higher as compared to control cookies (prepared from 100% wheat flour). Cookies prepared from blends having more that 50% millet flour were not much liked by sensory panelists. The phenolic contents of cookies containing higher levels of either water washed or alkali washed millet flour were found to be higher when compared to cookies prepared from plain WF (1.90 ± 0.14 mg gallic acid/g sample). The 2,2-diphenyl-1-picrylhydrazyl activity (%) of cookies ranged from 16.39 ± 0.34 (100% water washed millet flour) to 10.39 ± 0.26 (100% WF; control). The study will help the non-coeliac people to consume low gluten (≈1.6-6.5%) or gluten intolerant people to consume gluten-free cookies (0%) from millet flour having abundant of antioxidants and health-promoting polyphenols.

Maintenance of SOX9 stability and ECM homeostasis by selenium-sensitive PRMT5 in cartilage

OBJECTIVES

Selenium (Se) plays pivotal roles in maintaining optimal health. Nevertheless, how Se influences the metabolism of extracellular matrix (ECM) in cartilage remains unclear. The aim of the present study was to observe protein dimethylation by certain Se-sensitive PRMT and to elucidate its effects on the key transcriptional factor in cartilage.

METHODS

We observed the expression of selenoproteins and markers of ECM metabolism in chondrocytes and articular cartilage of the rats under Se-deficiency by RT-qPCR, immunoblotting and immunohistochemistry. Then, we analyzed the expression of total dimethylated protein by using specific antibody under different Se statuses. After Se sensitive PRMT was identified, we used siRNA or PRMT inhibitor or stably overexpressing vector to intervene in the PRMT expression and identified the key transcriptional factor. Co-immunoprecipitation was applied to verify the interaction between PRMT and the key transcriptional factor. Finally, we measured the half-life time of the key transcriptional factor by immunoblotting after cycloheximide treatment.

RESULTS

In chondrocytes and cartilage of the rats with Se deficiency, we found an aberrant metabolism manifesting decreased expression of Col2a1 and increased expression of Mmp-3. Then, we identified that PRMT5 was the unique type II PRMT, sensitive to Se status. PRMT5 upregulation led to the increased COL2A1 expression but decreased MMP-3 expression in chondrocytes. Furthermore, we revealed that PRMT5 improved SOX9 stability by dimethylating the protein, which contributed to maintain the matrix metabolic homeostasis of the chondrocytes.

CONCLUSIONS

Se-sensitive PRMT5 increases the half-life of SOX9 protein via PTM and helps to maintain ECM homeostasis of the articular cartilage.

Antibodies raised against aldehyde-fixed antigens improve sensitivity for postembedding electron microscopy

BACKGROUND

Antibodies are one of the most important tools in biological research. High specificity and sensitivity of antibodies are crucial to obtain reliable results. Tissue fixed with glutaraldehyde (GA) is commonly used in electron microscopical investigations. The fixation and embedding routine in preparation of tissue for post-embedding electron microscopy (EM) will mask and structurally alter epitopes, making antibody-antigen interaction inefficient, with low labeling intensities. One of the main factors in this regard is the use of GA as fixative.

NEW METHOD

To alleviate these technical challenges, we immunized rabbits with antigen pre-fixed with GA. We hypothesized that the resulting antibodies would have stronger affinity to antigens that have been conformationally changed and denatured by GA, the way they are in fixed tissue.

COMPARISON WITH EXISTING METHOD AND RESULTS

An initial screening with western blotting (WB) showed results consistent with our hypothesis. In-house antibodies raised against GA-fixed SNARE proteins SNAP-25 and VAMP2, binds more strongly to fixed proteins compared to non-fixed proteins, while the pattern is opposite with the commercially available antibodies raised against non-fixed antigens (standard antibodies). Quantitative post-embedding EM of hippocampal synapses gave higher labeling intensities with anti-GA-SNAP-25 and anti-GA-VAMP2 compared to standard antibodies. Importantly, light microscopy (LM) and EM with our antibodies revealed stronger labeling of GA-fixed than formaldehyde (FH) treated brains.

CONCLUSION

Our results highlight the experimental potential of raising antibodies against GA-treated antigen to improve sensitivity of the antibodies for postembedding immunogold EM.

Efficacy and safety of inhaled anaesthetic for postoperative sedation during mechanical ventilation in adult cardiac surgery patients: a systematic review and meta-analysis

The aim was to evaluate the efficacy and safety of volatile anaesthetic for postoperative sedation in adult cardiac surgery patients through a systematic review and meta-analysis. We retrieved randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Web of Science, clinical trials registries, conference proceedings, and reference lists of included articles. Independent reviewers extracted data, including patient characteristics, type of intraoperative anaesthesia, inhaled anaesthetic used, comparator sedation, and outcomes of interest, using pre-piloted forms. We assessed risk of bias using the Cochrane Tool and evaluated the strength of the evidence using the GRADE approach. Eight studies enrolling 610 patients were included. Seven had a high and one a low risk of bias. The times to extubation after intensive care unit (ICU) admission and sedation discontinuation were, respectively, 76 [95% confidence interval (CI) -150 to - 2, I2=79%] and 74 min (95% CI - 126 to - 23, I2=96%) less in patients who were sedated using volatile anaesthetic. There was no difference in ICU or hospital length of stay. Patients who received volatile anaesthetic sedation had troponin concentrations that were 0.71 ng ml-1 (95% CI 0.23-1.2) lower than control patients. Reporting on other outcomes was varied and not suitable for meta-analysis. Volatile anaesthetic sedation may be associated with a shorter time to extubation after cardiac surgery but no change in ICU or hospital length of stay. It is associated with a significantly lower postoperative troponin concentration, but the impact of this on adverse cardiovascular outcomes is uncertain. Blinded randomized trials using intention-to-treat analysis are required. PROSPERO registry number: 2016:CRD42016033874. Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016033874.

A possible postsynaptic role for SNAP-25 in hippocampal synapses

The SNARE protein SNAP-25 is well documented as regulator of presynaptic vesicle exocytosis. Increasing evidence suggests roles for SNARE proteins in postsynaptic trafficking of glutamate receptors as a basic mechanism in synaptic plasticity. Despite these indications, detailed quantitative subsynaptic localization studies of SNAP-25 have never been performed. Here, we provide novel electron microscopic data of SNAP-25 localization in postsynaptic spines. In addition to its expected presynaptic localization, we show that the protein is also present in the postsynaptic density (PSD), the postsynaptic lateral membrane and on small vesicles in the postsynaptic cytoplasm. We further investigated possible changes in synaptic SNAP-25 protein expression after hippocampal long-term potentiation (LTP). Quantitative analysis of immunogold-labeled electron microscopy sections did not show statistically significant changes of SNAP-25 gold particle densities 1 h after LTP induction, indicating that local trafficking of SNAP-25 does not play a role in the early phases of LTP. However, the strong expression of SNAP-25 in postsynaptic plasma membranes suggests a function of the protein in postsynaptic vesicle exocytosis and a possible role in hippocampal synaptic plasticity.

Lung Cancer–Related Clinical and Economic Impacts of Achieving a 5% Smoking Prevalence Rate by 2035 in Canada

Background: Smoking is responsible for nearly 85% of lung cancer cases and 30% of all cancer-related deaths. Canada has set an ambitious target to reduce tobacco use to 5% by 2035 in alignment with a world-wide tobacco endgame initiative. Aim: We project the impact of achieving a national 5% smoking prevalence rate by 2035 on population-level lung cancer outcomes and costs. Methods: OncoSim-Lung (version 2.5), led by the Canadian Partnership Against Cancer with model development by Statistics Canada, is a microsimulation model that incorporates Canadian demographics, risk factors, registry data, resource utilization and other data to project clinical and economic impacts of cancer control measures. Smoking cessation parameters were modified to reduce the current average national smoking prevalence rate of 18% over time to 5% in 2035. Impacts were compared with those in a reference scenario, which maintained the current prevalence rate. Outputs of interest included lung cancer incidence, mortality, treatment costs, and quality-adjusted life-years (QALYs). Costs and QALYs are undiscounted and reported in 2016 CAD. Results: Achieving a 5% smoking rate by 2035 would result in a 2017-2035 cumulative total of 31,000 fewer lung cancer cases, 21,000 fewer lung cancer-related deaths, and 457,000 additional QALYs compared with projections based on a constant smoking prevalence rate of ∼20%. When stratified by sex, there would be 15,600 and 15,700 fewer lung cancer diagnoses and 11,000 and 10,000 fewer lung cancer-related deaths for males and females respectively. Furthermore, treatment-related costs would be reduced by $680 million dollars. On average there would be 4,500 fewer lung cancer cases, 3,500 fewer deaths, and $35 million in cost savings annually. If a 5% smoking rate is sustained until 2050, then there would be a 15% reduction in lung cancer cases and a 13% reduction in deaths from 2017-2050. Conclusion: Reducing Canada's smoking prevalence to 5% by 2035 could result in a significant reduction in lung cancer cases, deaths and treatment costs. Like Canada, other countries with relatively high smoking prevalence could use averted treatment costs to offset costs of aggressive smoking prevention and cessation programs or redirect them to other healthcare services.

Human Papillomavirus (HPV) Infection As an Emerging Risk Factor in Prostate Cancer

Background: Epidemiologic investigations confirm that prostate tissue is prone to sexually transmitted infection and human papilloma virus (HPV) is the most common sexually transmitted infection. Owing to the controversy on the role of HPV infection in prostate carcinogenesis, it is appropriate to determine and validate the prevalence of HPV infection in a controlled prospective study, and its role in prostate carcinogenesis. It is crucial to investigate the prognostic impact of HPV infection in prostate cancer from a clinical point of view. Aim: The overall aim of our research is to address the possibility of using therapeutic interventions against HPV infection in young boys to prevent the development of prostate cancer in their older age. Establishment of clinical importance of HPV infection in prostate cancer and its prognostic impact for overall survival. Methods: The prostate cancer tissue specimens were obtained from Sahlgrenska University Hospital, Sahlgrenska Academy (SA), Gothenburg, Sweden. The exclusion criteria included patients undergoing any preoperative radiation or chemotherapy. Only histopathologically confirmed cases were processed for DNA, protein and RNA extraction. Histopathological grades and clinical staging was evaluated by pathologists using the Gleason scoring system for prostate cancer. The study is approved by the ethics committee of the institute. High molecular-weight genomic DNA was isolated from tumor/control tissue samples and were subjected to PCR genotyping for detection of the viral DNA. Cases and controls was compared using univariate methods. An independent t-test was performed for the comparison of clinicopathological parameters. Results: The pilot study identified HPV infection in advanced grade of prostate cancer cases in Sweden. HPV infection was identified in 57% of the prostate cancer cases with advanced pathologic grade in Swedish men compared with 11% in the normal controls. The investigation comprised of detailed analysis of the correlation between the clinical parameters and HPV genotyping. Conclusion: The research investigation substantiates the clinical significance of HPV infection in prostate carcinogenesis that has been underestimated till date. The research investigation was funded by Swedish Research Council (Vetenskaprådet) Grant no. 2015-06705.

Evaluating Clinical and Cost Impacts of Achieving 90% HPV Vaccination Rate Against Cervical Cancer in Canada Using the OncoSim Cancer Simulation Model

Background: Cervical cancer can be largely prevented through vaccination against the human papillomavirus (HPV). In Canada, HPV vaccination of school-aged girls started in 2008 and has reached an average rate of 67% across the country. However, this rate is below a current national target of 90%. Aim: We project the difference in lifetime clinical outcomes and health system costs of achieving a 90% HPV vaccination rate versus a 67% rate for girls vaccinated in 2015 using the OncoSim-Cervical model. Methods: The OncoSim-Cervical model (version 2.5) is a microsimulation model led by the Canadian Partnership Against Cancer, with model development by Statistics Canada, to evaluate the impacts of cervical cancer interventions in Canada. It has two parts, the first, the HPV Microsimulation Model, simulates the transmission of HPV between males and females including possible modulation by vaccination and herd immunity, and provides projections of HPV infection and prevalence for input to the cervical cancer natural history component in the second part. We simulated two cohorts of 5-10 year old girls in 2015; one receiving HPV vaccination at the rate of 67% and another at 90%. Their relative lifetime cervical cancer outcomes and costs were compared. Assumptions included: 100% efficacy of the HPV vaccine; triennial cytology screening between ages 21 and 65; 90% screening recruitment of age-eligible women with 80% rescreening; and a $500 cost for a 3-dose quadrivalent HPV vaccine regimen. Projected costs were undiscounted and are in 2016 CAD. Results: Compared with the 67%-vaccinated cohort, in the 90%-vaccinated cohort there was a lifetime reduction of 23% in cervical cancer incident cases and 21% in cervical cancer deaths. Lifetime cancer treatment costs decreased by $26 million (23%), and wart treatment costs and precervical cancer costs decreased by $3.2 million (15%) and $45 million (16%) respectively. Lifetime screening costs decreased by $47 million (2%). Conclusion: Achieving a nationally-set target of 90% HPV vaccination in Canadian girls would not only save more lives but would free up funds that could be redirected to other health system needs. Planners could aim for relatively high nation-wide rates of HPV vaccination coverage to enhance their cervical cancer control strategy.

Impact of Follow-Up Colonoscopy Quality on Canadian Colorectal Cancer Outcomes and Costs

Background: Most colorectal cancer (CRC) cases develop from precancerous polyps. Screening using fecal testing for occult blood, with follow-up diagnostic colonoscopy to remove polyps, can prevent invasive cancer from occurring. However, there is variation in the quality of colonoscopy, which may result in nonoptimal health outcomes. Aim: We evaluated the impact of follow-up colonoscopy quality on health outcomes, resource utilization and costs using the OncoSim-CRC microsimulation model (version 2.5). Methods: OncoSim is a microsimulation model led by the Canadian Partnership Against Cancer with model development by Statistics Canada. We compared results of high quality follow-up colonoscopy after positive fecal immunochemical testing (FIT) (colonoscopy sensitivity for cancer detection= 95%; compliance to follow-up colonoscopy = 85%) with that of reduced quality colonoscopy. Variations in colonoscopy performance were simulated through plausible overall effectiveness reduction (ER) and incomplete colonoscopy (IC). Screening system/patient follow-up deficiencies were simulated through poor compliance to diagnostic colonoscopy (PC). Modeling assumptions included: Biennial FIT screening of average-risk people aged 50-74; positive FIT followed by diagnostic colonoscopy; ER = 20% reduction in overall sensitivity; IC = zero sensitivity in proximal colon; PC = compliance reduction by 50%. Overall cost was calculated for 2017-2036 in undiscounted 2016 CAD, and included screening, treatment and end-of-life costs. Results: Compared with high quality colonoscopy follow-up, incomplete colonoscopy with poor compliance over 20 years led to as many as 12% new cases of CRC; 23% more CRC deaths; 89% more interval cancers; and 6% increased costs to the health care system, annually. Conclusion: Reduced colonoscopy quality can lead to considerable declines in the predicted effectiveness of screening and to increased costs to the healthcare system. Efforts to increase and maintain colonoscopy performance is a necessary component of CRC control planning.

The OncoSim Cancer Simulation Platform: A Tool to Project the Population Effects of Cancer Control Interventions in Canada

Background: Cancer control interventions exert their effects over multiple decades. To evaluate diverse and competing opportunities to reduce future cancer burden it is desirable to understand long-term effects prior to any new program implementation or significant change. Internationally, modeling is becoming an accepted source of planning information for decision-makers. Aim: We will describe the construction and use of the OncoSim microsimulation model, which was developed to evaluate cancer control strategies in Canada. Methods: OncoSim is a suite of models (cancers of the lung, colorectum, cervix and breast, plus a composite 32-cancer model) used to address key policy questions and support decision-making. It is led by the Canadian Partnership Against Cancer with model development by Statistics Canada. OncoSim incorporates risk factors, cancer natural history, screening, treatment, survival and end-of-life care. Wherever possible it is informed by Canadian data sources. Models are calibrated to reproduce a range of cancer-specific statistics, e.g., current and historical Canadian cancer-specific incidence and mortality, smoking patterns, and results of screening. The site-specific models have undergone further validation by replicating reported short-term effects of cancer prevention and screening interventions. Users may customize interventions through modifying input parameters. Outputs include incidence, mortality, costs, cost-effectiveness, and resource utilization. Users from the public sector have access at no cost to OncoSim and receive extensive support from a multidisciplinary technical team. The model is continually updated to incorporate emerging knowledge. Results: OncoSim has been used to support cancer control decision-making at the national and provincial/territorial levels. Applications include: national guidelines recommendations for colorectal and lung cancer screening; comparison of cytology vs. HPV based cervical cancer screening; and integration of smoking cessation into low-dose CT lung cancer screening. Conclusion: Validated simulation models such as OncoSim can be a versatile and efficient tool for cancer control planners to evaluate and prioritize cancer control strategies.