Innovative Financing for Urban Rail in Indian Cities: Land-based Strategic Value Capture Mechanisms

Emerging cities are seeking urban rail but have difficulty with funding. This research uses the Bangalore Metro rail to develop an innovative land-based ‘strategic value capture' (VC) financing system suitable for Indian cities and other emerging cities. It shows significant land value uplift that could be used for VC funding. The four frameworks and strategic interventions developed in this research are novel contributions in India and apply to other emerging cities as well

Participatory sustainability approach to value capture-based urban rail financing in India through deliberated stakeholder engagement

Increasingly cities around the world are seeking innovative financial mechanisms to build urban rail transit projects. Land value capture (VC) is a financing mechanism to fund urban rail transit. Often VC mechanisms are viewed only as a financing tool applied in relation to increased land values from the administration and legislation perspectives, without actively involving the community in the process. The lack of such participatory approaches has resulted in the under collection of the true value established. The transit beneficiary community and city tax payers are especially important stakeholders in this process as their willingness to participate is really critical to the overall VC success and transport outcome. This paper introduces a participatory sustainability approach identifying various stakeholder engagement interventions, and a set of appropriate deliberative democracy techniques across the VC life cycle. A four-step “Participatory Strategic Value Capture (PSVC)” framework is proposed offering step by step guidance toward facilitating a meaningful stakeholder dialogue, deliberation and collaboration around the stated engagement interests. The PSVC framework, applied to the proposed Bangalore suburban rail project in India, has demonstrated the importance of stakeholder engagement in order to enable sustainable development community goals and review VC strategies from a win-win perspective

Meningitis in HIV positive and negative patients: A comparative demographic profile.

Background: Meningitis is a serious infection in HIV patients claiming millions of lives across the world. Comparative studies of meningitis in HIV positive and negative patients are scarce. Methods: We performed a comparative study of the demographic features of meningitis in HIV positive [116] and HIV negative [218] patients at a tertiary hospital over a period of four years. Results: In HIV seropositive patients the percentage of women was lesser [29.6% vs. 42.5%], the proportion of students was lesser [4.8% vs.14%], but the proportion of professionals was higher [17.5% vs. 10.8%] when compared to HIV seronegative group. Even though Tuberculosis [82.6% vs. 68.5%] was the predominant organism causing meningitis in both the groups, Cryptococcosis [5.2% vs. 1%] was more common in the seropositive individuals. Conclusions: The study highlights the differences in the demographic profile of meningitis in a large cohort of HIV positive and HIV negative patients

Cognitive Assessment in Asymptomatic COVID-19 Subjects

Background Neurological features of COVID-19 have been reported in addition to the respiratory manifestations, but cognitive dysfunction has been scarcely described. And cognitive assessment has not been studied in asymptomatic subjects. Method We compared the cognitive assessment scores between asymptomatic SARS-CoV-2 infected subjects with that of controls to detect mild cognitive impairment by the Montreal Cognitive Assessment test. Result Asymptomatic COVID-19 subjects secured lower scores in certain domains of the MoCA in comparison with the controls. The domains were visuoperception (2.4±0.7 vs2.8±0.7, p=0.032), naming (3.6±0.5 vs3.9±0.2, p=0.016) and fluency (0.9±0.6 vs1.6±0.7, p=<0.001). Also, older aged COVID-19 positive subjects scored lower in the MoCA when compared to the younger people. Conclusion Our study shows that even otherwise asymptomatic COVID-19 subjects have cognitive deficits in certain subdomains and suggests the need for a detailed psychometric assessment especially in the elderly population

Study on knowledge, attitude and practices with respect to antibiotic use among medical students

Background: Antibiotic resistance has emerged as a serious global problem. Irrational prescribing of antibiotics is one of the key factors responsible for the development of antibiotic resistance. As today’s medical students will be the future prescribers their awareness regarding antibiotic resistance and rational prescribing of antibiotics is very much important. The main objective of the study was to evaluate the knowledge, attitude and practices of the medical students towards antibiotic use.Methods: A cross-sectional questionnaire-based study was conducted involving the medical students from all the semesters. A predesigned questionnaire was used to evaluate the knowledge, attitude and practices of the respondents. The response options were ‘yes’ or ‘no’ for some questions, and a 5 point Likert scale used to assess some questions. The data was analyzed using MS office Excel.Results: A total of 457 fully completed questionnaires from the respondents were evaluated. Majority of the respondents (70%) were females, and 91% of the respondents were aware of antibiotic resistance as a global problem. On analysis of score of questions assessing knowledge, 91% of respondents had attained a score in the range of 5-7. Majority (83%) of the respondents used antibiotics only on doctor’s prescription and 74% of the respondents had completed the prescribed course.Conclusions: The present study gives an insight on the knowledge, attitude and practices of medical students on antibiotic use, and can be used as a tool to plan educational strategies to improve the knowledge of the students regarding rational use of antibiotics

Participatory Sustainability Approach to Value Capture-Based Urban Rail Financing in India through Deliberated Stakeholder Engagement

Increasingly, cities around the world are seeking innovative financial mechanisms to build rail transit projects. Land value capture (VC) is a financing mechanism to fund urban rail transit. Often VC mechanisms are viewed only as a financing tool applied in relation to increased land values from the administration and legislation perspectives, without actively involving the community in the process. The lack of such participation has resulted in the under collection of the true value established. The transit beneficiary community and city tax payers are especially important stakeholders in this process as their willingness to participate is really critical to the overall VC success and transport outcome. This paper introduces a participatory sustainability approach to enable a more deliberated stakeholder engagement intervention across the VC life cycle. A four-step “Participatory Strategic Value Capture (PSVC)” framework is proposed offering step-by-step guidance toward facilitating a meaningful stakeholder dialogue, deliberation, and collaboration around the stated engagement interests. The PSVC framework, applied to the proposed Bangalore sub-urban rail project in India, has demonstrated the importance of stakeholder engagement using deliberated participatory approaches from a win-win perspective

Plerixafor Salvage Is Safe and Effective in Hard-to-Mobilize Patients Undergoing Chemotherapy and Filgrastim-Based Peripheral Blood Progenitor Cell Mobilization

The combination of filgrastim (G-CSF) and plerixafor is currently approved for mobilizing peripheral blood progenitor cells in patients with non-Hodgkin lymphoma and multiple myeloma undergoing autologous peripheral blood hematopoietic cell transplantation. However, chemotherapy and G-CSF-based mobilization remains a widely used strategy for peripheral blood progenitor cell collection. In this paper we describe our experience from two North American transplant centers in a series of patients who received salvage plerixafor while failing chemotherapy and G-CSF mobilization. Patients received a median of two doses of plerixafor salvage upon failure to mobilize adequate number of peripheral blood progenitor cells at neutrophil recovery. The use of plerixafor was associated with a 2.4-fold increase in peripheral blood CD34+ cell count and 3.9-fold increase in total CD34+ cell yield. All patients were able to collect ≥2 × 106 CD34+ cells/kg with this approach. These results were more pronounced in patients with a higher CD34+ cell count at the time of the first plerixafor dose. Interestingly, peripheral blood white blood cell count was not shown to correlate with a response to plerixafor. Our results provide safety and efficacy data for the use of plerixafor in patients who are destined to fail chemomobilization

Image-Guided Biopsy in the Esophagus through Comprehensive Optical Frequency Domain Imaging and Laser Marking: A Study in Living Swine

Background: Random biopsy esophageal surveillance can be subject to sampling errors, resulting in diagnostic uncertainty. Optical frequency domain imaging (OFDI) is a high-speed, 3-dimensional endoscopic microscopy technique. When deployed through a balloon-centering catheter, OFDI can automatically image the entire distal esophagus (6.0 cm length) in approximately 2 minutes. Objective: To test a new platform for guided biopsy that allows the operator to select target regions of interest on an OFDI dataset, and then use a laser to mark the esophagus at corresponding locations. The specific goals include determining the optimal laser parameters, testing the accuracy of the laser marking process, evaluating the endoscopic visibility of the laser marks, and assessing the amount of mucosal damage produced by the laser. Design: Experimental study conducted in 5 swine in vivo. Setting: Massachusetts General Hospital. Main Outcome Measurements: Success rate, including endoscopic visibility of laser marks and accuracy of the laser marking process for selected target sites, and extent of the thermal damage caused by the laser marks. Results: All of the laser-induced marks were visible by endoscopy. Target locations were correctly marked with a success rate of 97.07% (95% confidence interval, 89.8%-99.7%). Thermal damage was limited to the superficial layers of the mucosa and was observed to partially heal within 2 days. Limitations: An animal study with artificially placed targets to simulate pathology. Conclusions: The study demonstrates that laser marking of esophageal sites identified in comprehensive OFDI datasets is feasible and can be performed with sufficient accuracy, precision, and visibility to guide biopsy in vivo