37 research outputs found

    Catheters in vascular interventional radiology: an illustrated review

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    The past five decades have seen significant developments in the knowledge and practice of interventional radiology. Advancements in angiographic equipment have made interventional radiology a safe, minimally invasive preferred option in the treatment of a variety of diseases. Today, a range of catheters are available in the armamentarium of the interventional radiologist to suit different needs when conducting diagnostic angiograms or performing interventions in various vascular territories. The hardware required for interventions includes needles, wires, catheters, balloons, and stents. Catheters, in particular, are an invaluable tool for interventionists. The purpose of this review is to describe the identification characteristics, properties, and uses of the common angiographic catheters used in interventional radiology, with a special focus on peripheral vascular interventions (excluding neurointerventions)

    Economic evaluation of participatory women's groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India

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    An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study aimed to estimate the cost, cost-effectiveness, and benefit-cost ratio of a participatory women's groups intervention scaled up by the public health system in Jharkhand, eastern India. The intervention was evaluated through a pragmatic cluster non-randomised controlled trial in six districts. We estimated the cost of the intervention at scale from a provider perspective, with a 42-month time horizon for 20 districts. We estimated costs using a combination of top-down and bottom-up approaches. All costs were adjusted for inflation, discounted at 3% per year, and converted to 2020 International Dollars (INT).Incrementalcosteffectivenessratios(ICERs)wereestimatedusingextrapolatedeffectsizesfortheimpactoftheinterventionin20districts,intermsofcostperneonataldeathsavertedandcostperlifeyearsaved.Weassessedtheimpactofuncertaintyonresultsthroughonewayandprobabilisticsensitivityanalyses.Wealsoestimatedbenefitcostratiousingabenefittransferapproach.Totalinterventioncostsfor20districtswereINT). Incremental cost-effectiveness ratios (ICERs) were estimated using extrapolated effect sizes for the impact of the intervention in 20 districts, in terms of cost per neonatal deaths averted and cost per life year saved. We assessed the impact of uncertainty on results through one-way and probabilistic sensitivity analyses. We also estimated benefit-cost ratio using a benefit transfer approach. Total intervention costs for 20 districts were INT 15,017,396. The intervention covered an estimated 1.6 million livebirths across 20 districts, translating to INT9.4perlivebirthcovered.ICERswereestimatedatINT 9.4 per livebirth covered. ICERs were estimated at INT 1,272 per neonatal death averted or INT41perlifeyearsaved.NetbenefitestimatesrangedfromINT 41 per life year saved. Net benefit estimates ranged from INT 1,046 million to INT$ 3,254 million, and benefit-cost ratios from 71 to 218. Our study suggests that participatory women's groups scaled up by the Indian public health system were highly cost-effective in improving neonatal survival and had a very favourable return on investment. The intervention can be scaled up in similar settings within India and other countries

    Economic evaluation of participatory women's groups scaled up by the public health system to improve birth outcomes in Jharkhand, eastern India

    Get PDF
    An estimated 2.4 million newborn infants died in 2020, 80% of them in sub-Saharan Africa and South Asia. To achieve the Sustainable Development Target for neonatal mortality reduction, countries with high mortality need to implement evidence-based, cost-effective interventions at scale. Our study aimed to estimate the cost, cost-effectiveness, and benefit-cost ratio of a participatory women's groups intervention scaled up by the public health system in Jharkhand, eastern India. The intervention was evaluated through a pragmatic cluster non-randomised controlled trial in six districts. We estimated the cost of the intervention at scale from a provider perspective, with a 42-month time horizon for 20 districts. We estimated costs using a combination of top-down and bottom-up approaches. All costs were adjusted for inflation, discounted at 3% per year, and converted to 2020 International Dollars (INT).Incrementalcosteffectivenessratios(ICERs)wereestimatedusingextrapolatedeffectsizesfortheimpactoftheinterventionin20districts,intermsofcostperneonataldeathsavertedandcostperlifeyearsaved.Weassessedtheimpactofuncertaintyonresultsthroughonewayandprobabilisticsensitivityanalyses.Wealsoestimatedbenefitcostratiousingabenefittransferapproach.Totalinterventioncostsfor20districtswereINT). Incremental cost-effectiveness ratios (ICERs) were estimated using extrapolated effect sizes for the impact of the intervention in 20 districts, in terms of cost per neonatal deaths averted and cost per life year saved. We assessed the impact of uncertainty on results through one-way and probabilistic sensitivity analyses. We also estimated benefit-cost ratio using a benefit transfer approach. Total intervention costs for 20 districts were INT 15,017,396. The intervention covered an estimated 1.6 million livebirths across 20 districts, translating to INT9.4perlivebirthcovered.ICERswereestimatedatINT 9.4 per livebirth covered. ICERs were estimated at INT 1,272 per neonatal death averted or INT41perlifeyearsaved.NetbenefitestimatesrangedfromINT 41 per life year saved. Net benefit estimates ranged from INT 1,046 million to INT$ 3,254 million, and benefit-cost ratios from 71 to 218. Our study suggests that participatory women's groups scaled up by the Indian public health system were highly cost-effective in improving neonatal survival and had a very favourable return on investment. The intervention can be scaled up in similar settings within India and other countries.</p

    Economic evaluation of nutrition-sensitive agricultural interventions to increase maternal and child dietary diversity and nutritional status in rural Odisha, India

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    BACKGROUND: Economic evaluations of nutrition-sensitive agriculture (NSA) interventions are scarce, limiting assessment of their potential affordability and scalability. OBJECTIVE: We conducted cost-consequence analyses of three participatory video-based interventions of fortnightly women's group meetings using: 1) NSA videos; 2) NSA and nutrition-specific videos; or 3) NSA videos with a nutrition-specific Participatory Learning and Action (PLA) cycle. METHODS: Interventions were tested in a 32-month, four-arm cluster-randomized controlled trial, UPAVAN, in Keonjhar district, Odisha, India. Impacts were evaluated in children aged 0-23 months and their mothers. We estimated program costs using data collected prospectively from expenditure records of implementing and technical partners, and societal costs using expenditure assessment of households with a child aged 0-23 months and key informant interviews. Costs were adjusted for inflation, discounted, and converted to 2019 US${\$}. RESULTS: Total program costs of each intervention ranged from US${\$}272,121 to US${\$}386,907. Program costs per pregnant woman or mother of a child aged 0-23 months were US${\$}62 for NSA videos, US${\$}84 for NSA and nutrition-specific videos, and US${\$}78 for NSA videos with PLA (societal costs: US${\$}125, US${\$}143, and US${\$}122 respectively). Substantial shares of total costs constituted developing and delivering the videos and PLA (52-69%) and quality assurance (25-41%). Relative to control, children's minimum dietary diversity was higher in the intervention incorporating nutrition-specific videos (adjusted relative risk [95% CI] 1.19 [1.03, 1.37]) and PLA (1.27 [1.11, 1.46]). Relative to control, mothers' minimum dietary diversity was higher in NSA video (1.21 [1.01, 1.45]), and NSA with PLA (1.30 [1.10, 1.53]) interventions. CONCLUSION: NSA videos with PLA can increase both maternal and child dietary diversity and has the lowest cost per unit increase in diet diversity. Building on investments made in developing UPAVAN, cost-efficiency at scale could be increased with less intensive monitoring, reduced start-up costs, and integration within existing government programs.Trial registration: ISRCTN65922679

    Protocol for the cost-consequence and equity impact analyses of a cluster randomised controlled trial comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child dietary diversity and nutritional status in rural Odisha, India (UPAVAN trial).

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    BACKGROUND: Undernutrition causes around 3.1 million child deaths annually, around 45% of all child deaths. India has one of the highest proportions of maternal and child undernutrition globally. To accelerate reductions in undernutrition, nutrition-specific interventions need to be coupled with nutrition-sensitive programmes that tackle the underlying causes of undernutrition. This paper describes the planned economic evaluation of the UPAVAN trial, a four-arm, cluster randomised controlled trial that tests the nutritional and agricultural impacts of an innovative agriculture extension platform of women's groups viewing videos on nutrition-sensitive agriculture practices, coupled with a nutrition-specific behaviour-change intervention of videos on nutrition, and a participatory learning and action approach. METHODS: The economic evaluation of the UPAVAN interventions will be conducted from a societal perspective, taking into account all costs incurred by the implementing agency (programme costs), community and health care providers, and participants and their households, and all measurable outcomes associated with the interventions. All direct and indirect costs, including time costs and donated goods, will be estimated. The economic evaluation will take the form of a cost-consequence analysis, comparing incremental costs and incremental changes in the outcomes of the interventions, compared with the status quo. Robustness of the results will be assessed through a series of sensitivity analyses. In addition, an analysis of the equity impact of the interventions will be conducted. DISCUSSION: Evidence on the cost and cost-effectiveness of nutrition-sensitive agriculture interventions is scarce. This limits understanding of the costs of rolling out or scaling up programs. The findings of this economic evaluation will provide useful information for different multisectoral stakeholders involved in the planning and implementation of nutrition-sensitive agriculture programmes. TRIAL REGISTRATION: ISRCTN65922679 . Registered on 21 December 2016

    AI is a viable alternative to high throughput screening: a 318-target study

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    : High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, high-quality X-ray crystal structures, or manual cherry-picking of compounds. We show that the molecules selected by the AtomNet® model are novel drug-like scaffolds rather than minor modifications to known bioactive compounds. Our empirical results suggest that computational methods can substantially replace HTS as the first step of small-molecule drug discovery

    Key Developments for Electric Vehicles in Local Transport

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    Environment protection in Metro cities is a growing concern. Automobile sector play a very important role in the vision of green friendly environment. Continual reduction of reserve of fossil fuel and increased level of pollution has further forced to think of alternative is an electric vehicle. Mission 2030 for Government of India-"All vehicle will be Electric Vehicle" has given a boost to the E-vehicle and it will lead to generate cumulative savings of 846 million tons of CO2 over the total deployed vehicle's lifetime. Many corporates have already jumped to this sector as it is future of automobile sector. Now, electric vehicle is a reality and available for local public transportation. This paper covers an overview of the present status of electric vehicles in India with respect to technological growth. Key challenges faced byelectric vehicle are also discussed

    Formulation Development Studies for Sterile Dosages: A Comprehensive Review

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    Sterile generic dosage development requires that specific critical quality attributes be considered and evaluated, regardless of the route of delivery or the type of registration application. The review briefed with an overview of Pharmaceutical Development study&nbsp;requirements. Each of the various stages of studies like Compatibility with the packaging materials, manufacturing vessels, processing aids, MOCs, Filters, Tubing’s and Gaskets also with special studies to be conducted as part of Regulatory Submission, process considerations. Thus, the chapter offers the formulator an overview of the foundational principles associated with formulation development /Pre-formulation studies of sterile products. Keywords: Pharmaceutical Development, Compatibility, Studies, Hold time

    Binding of berberine to human telomeric quadruplex - spectroscopic, calorimetric and molecular modeling studies

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    This study examines the characteristics of binding of berberine to the human telomeric d[AG3(T2AG3)3] quadruplex. By employing UV-visible spectroscopy, fluorescence spectroscopy and isothermal titration calorimetry, we found that the binding affinity of berberine to the human telomeric quadruplex is 106. The complete thermodynamic profile for berberine binding to the quadruplex, at 25 °C, shows a small negative enthalpy (&#916;H) of −1.7 kcal·mol−1, an entropy change with T&#916;S of +6.5 kcal·mol−1, and an overall favorable free energy (&#916;G) of −8.2 kcal·mol−1. Through the temperature dependence of &#916;H, we obtained a heat capacity (&#916;Cp) of −94 (± 5) cal·mol−1·K−1. The osmotic stress method revealed that there is an uptake of 13 water molecules in the complex relative to the free reactants. Furthermore, the molecular modeling studies on different quadruplex–berberine complexes show that berberine stacking at the external G-quartet is mainly aided by the π–π interaction and the stabilization of the high negative charge density of O6 of guanines by the positively charged N7 of berberine. The theoretical heat capacity (&#916;Cp) values for quadruplex–berberine models are −89 and −156 cal·mol−1·K−1
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