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8. Nerve Segmentation Using Multi-scale Attention Mechanism-U-Net

Author

Das, Ashis, Sethy, Prabira Kumar, Sahu, Raman, Behera, Santi Kumari, Biswal, Awantika, Panigrahi, Manas Kumar, Bariha, Prafulla Kumar, Kacprzyk, Janusz, Series Editor, Gomide, Fernando, Advisory Editor, Kaynak, Okyay, Advisory Editor, Liu, Derong, Advisory Editor, Pedrycz, Witold, Advisory Editor, Polycarpou, Marios M., Advisory Editor, Rudas, Imre J., Advisory Editor, Wang, Jun, Advisory Editor, Fong, Simon, editor, Dey, Nilanjan, editor, and Joshi, Amit, editor

Published
2023
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33. Cost-effectiveness of results-based financing, Zambia: a cluster randomized trial/ Rapport cout-effkacite du financement axe sur les resultats en Zambie: un essai randomise par grappes/ La relacion entre el gasto y la efectividad del financiamiento basado en resultados, Zambia: un ensavo aleatorizado aruoal

Author

Zeng, Wu, Shepard, Donald S., Nguyen, Ha, Chansa, Collins, Das, Ashis Kumar, Qamruddln, Jumana, and Friedman, Jed

Subjects
Child health -- Analysis, Maternal health services -- Quality management, Injectable contraceptives, Oral contraceptives, Contraceptives, Preventive medicine, Vaccination, Rural areas, Medical care quality, Health
Abstract

Objective To evaluate the cost-effectiveness of results-based financing and input-based financing to increase use and quality of maternal and child health services in rural areas of Zambia.Methods In a cluster-randomized trial from April 2012 to June 2014,30 districts were allocated to three groups: results-based financing (increased funding tied to performance on pre-agreed indicators), input-based financing (increased funding not tied to performance) or control (no additional funding), serving populations of 1.33,1.26 and 1.40 million people, respectively. We assessed incremental financial costs for programme implementation and verification, consumables and supervision. We evaluated coverage and quality effectiveness of maternal and child health services before and after the trial, using data from household and facility surveys, and converted these to quality-adjusted life years (QALYs) gained.Findings Coverage and quality of care increased significantly more In results-based financing than control districts: difference in differences for coverage were 12.8% for institutional deliveries, 8.2% postnatal care, 19.5% injectable contraceptives, 3.0% intermittent preventive treatment in pregnancy and 6.1 % to 29.4% vaccinations. In input-based financing districts, coverage increased significantly more versus the control for institutional deliveries (17.5%) and postnatal care (13.2%). Compared with control districts, 641 more lives were saved (lower-upper bounds: 580-700) in results-based financing districts and 362 lives (lower-upper bounds: 293-430) in input-based financing districts. The corresponding incremental cost-effectiveness ratios were 809 United States dollars (USS) and US$ 413 per QALY gained, respectively. Conclusion Compared with the control, both results-based financing and input-based financing were cost-effective in Zambia.Objectif Evaluer le rapport cout-efficacite du financement axe sur les resultats etdu financement axe sur les apports pouraccroitre l'utilisation et la qualite des services de sante maternelle et infantile dans les zones rurales deZamble.Methodes Dans un essai randomise par grappes mene d'avril 2012 a juin 2014,30 distrias ont ete repartis en trois groupes: financement axe sur les resultats (hausse du financement llee aux performances vis-a-vis d'indicateurs prealablement definis), financement axe sur les apports (hausse du financement non liee aux performances) et groupe temoin (pas de financement supplementaire), qui representaient respectivement une population de 1,33, 1,26 et 1,40 millions de personnes. Nous avons estime les couts financiers supplementaires dela mise en ceuvre et de la verification des programmes, des consommables et de la supervision. Nous avons evalue la couverture et la qualite des services de sante maternelle et Infantile avant et apres l'essai, a l'aide de donnees provenant d'enquetes aupres des menages et des etablissements, et les avons converties en annees de vle ajustees par la qualite (AVAQ) gagnees.Resultats La couverture et la qualite des soins ont nettement plus augmente dans les districts recevant un financement axe sur les resultats que dans les districts temoins: la difference des differences en matlere de couverture etait de 12,8% pour les accouchements dans des structures medlcales, de 8,2% pour les soins postnataux, de 19,5% pour les contraceptifs injectables, de 3,0% pour les traitements preventifs intermittents pendant la grossesse et de 6,1% a 29,4% pour les vaccinations. Dans les districts recevant un financement axe sur les apports, la couverture a nettement plus augmente que dans les districts temoins pour ce qui est des accouchements dans des structures medicales (17,5%) et des soins postnataux (13,2%). Par rapport aux districts temoins, 641 vies supplementaires ont ete sauvees (bornes Inferieure-superieure: 580-700) dans les districts recevant un financement axe sur les resultats et 362 vies (bornes inferieure-superieure: 293-430) dans les districts recevant un financement axe sur les apports. Les ratios cout-efficacite correspondants etaient respectivement de 809 dollars des Etats-unis ($ US) et 413 $ US en plus par AVAQ gagnee.Conclusion Compares au groupe temoin, le financement axe sur les resultats et le financement axe sur les apports presentaient tous deux un rapport cout-efficacite positif en Zambie.Objetivo Evaluar la relacion entre el gasto y la efectividad de la financiacion basada en los resultados y la financiacion basada en insumos para aumentar el uso y la calidad de los servicios de salud materno-infantil en las zonas rurales de Zambia.Metodos En un ensayo aleatorio por conglomerados de abril de 2012 a junio de 2014, se asignaron 30 distritos a tres grupos: financiamiento basado en resultados (aumento de fondos ligados al desempeno en indicadores previamente acordados), financiamiento basado en insumos (aumento de fondos no vinculados a rendimiento) o control (sin financiacion adicional), atendiendo poblaciones de 1,33,1,26 y 1,40 millones de personas, respectivamente. Evaluamos los gastos financieros incrementales para la implementacion y verificacion del programa, los consumibles y la supervision. Evaluamos la cobertura y la efectividad de la calidad de los servicios de salud materno-infantil antes y despues del ensayo, utilizando datos de encuestas domiciliarias y de establecimientos, y los convertimos en anos de vida ajustados por calidad (QALY) obtenidos.Resultados La cobertura y la calidad de la atencion aumentaron mas significativamente en el financiamiento basado en resultados que en los distritos de control: la diferencia de diferencias para la cobertura fue 12,8% para partos Institucionales, 8,2% para el cuidado postnatal, 19,5% para anticonceptivos inyectables, 3,0% para el tratamiento preventivo intermitente en embarazo y de 6,1 % a 29,4% para vacunas. En los distritos de financiacion basados en insumos, la cobertura aumento mas significativamente en comparacion con el control para los partos institucionales (17,5%) y la atencion posnatal (13,2%). En comparacion con los distritos de control, se salvaron 641 vidas mas (limites inferiores-superiores: 580-700) en distritos de financiamiento basado en resultados y 362 vidas (limites inferiores-superiores: 293-430) en distritos de financiamiento basados en insumos. Las correspondientes ratios incrementales entre gasto y efectividad fueron de 809 dolares estadounidenses (USD) y de 413 USD por AVA, respectivamente.Conclusion En comparacion con el control, tanto el financiamiento basado en resultados como el basado en insumos fueron rentables en Zambia., [phrase omitted]IntroductionOver the last two decades, Zambia's health indicators have improved substantially. Between 1990 and 2013, the underfive mortality rate dropped from 193 to 87 deaths per 1000 live births, [...]

Published
2018
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39. LBMON176 Management, Safety, And Efficacy Of Osilodrostat Treatment In US Patients With Non-pituitary Cushing's Syndrome: Results From The ILLUSTRATE Study

Author

Auchus, Richard Joseph, primary, Fleseriu, Maria, additional, Huang, Wenyu, additional, Spencer-Segal, Joanna L, additional, Yuen, Kevin Choong Ji, additional, Dacus, Kelley C, additional, Ludlam, William Henry, additional, Babler, Elizabeth Kay, additional, Das, Ashis K, additional, Campos, Cynthia, additional, Broder, Michael S, additional, and Ioachimescu, Adriana Gabriela, additional

Published
2022
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40. LBMON177 Dosing And Titration Of Osilodrostat In A Real-world Cohort Of US Patients With Endogenous Cushing's Disease: Analysis Of The ILLUSTRATE Study

Author

Ioachimescu, Adriana Gabriela, primary, Joseph Auchus, Richard, additional, Huang, Wenyu, additional, Spencer-Segal, Joanna L, additional, Ji Yuen, Kevin Choong, additional, Dacus, Kelley C, additional, Ludlam, William Henry, additional, Babler, Elizabeth Kay, additional, Das, Ashis K, additional, Campos, Cynthia, additional, Broder, Michael S, additional, and Fleseriu, Maria, additional

Published
2022
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48. Rh-catalyzed C-H Bond Heteroarylation with Hypervalent Iodine Reagents and Pd-Catalyzed Tethered Functionalizations of Carbon-Carbon Multiple Bonds

Author

Das, Ashis Kumar and Waser, Jérôme

Subjects
alkene difunctionalization, in situ tethering, 2-amino alcohol, alkyne dual-functionalisations, hydroalkoxylation, Palladium catalysis
Abstract

Transition metal-catalyzed C-H activation is a powerful tool for the synthesis of organic building blocks, materials, and natural products. Over the last decade, directing-group-assisted metal-catalyzed C-H functionalization has attracted increasing interest as a means to target specific C-H bonds. Moreover, a large variety of electrophiles has been employed in this kind of processes. In this thesis, we describe a novel C-6 selective C-H heteroarylation of pyridine-2-ones using indoleBX reagents as coupling partners under Rh(I)-catalysis. The reaction worked efficiently also with other analogous heterocyclic substrates and with a quinoline-N-oxide. We were able to obtain 6-(indol-3-yl)pyridinone and 8-(indol-3-yl)quinolone after cleavage of the directing group or rearrangement of the N-oxide moiety. 1,2-Amino alcohols are important structural motifs in organic chemistry that can be observed in natural products, pharmaceutically and biologically active molecules. The palladium-catalyzed difunctionalization of C-C multiple bonds has been broadly investigated as an efficient strategy to access such substructures. This transformation has been reported using either Pd(0)/Pd(II) or Pd(II)/Pd(IV) catalytic cycles, in which the nucleophilic functionalization of a putative Pd(II)-alkyl intermediate is achieved prior to beta-hydride elimination. As a further topic of this thesis, we developed new methods for the synthesis of amino alcohols whereby the Pd-catalyzed difunctionalization of alkynes and alkenes was combined with the tethering approach previously established in our laboratories. We first investigated the Pd-catalyzed enantioselective hydroalkoxylation of propargylic amines. The latter were tethered in situ with a trifluoroacetaldehyde hemiacetal. Best results were obtained with commercially available DACH-Phenyl Trost ligand. Aryl iodides were required as an additive in catalytic amount for successful outcome. A large variety of chiral oxazolidines were obtained in good to excellent yields and ee, followed by a diastereoselective reduction to give protected enantioenriched amino alcohols. A possible mechanism for this transformation relies on a Pd(0)/Pd(II) catalytic cycle involving oxidative addition of aryl iodide with a subsequent oxypalladation/protodemetallation (or reductive elimination) reaction. This is necessary to generate the active complex, not as the start of a cross-coupling event. The use of a commercially available DACH-Ph Trost ligand to produce high enantioselectivity in an unprecedented DYKAT process was critical to success. The Pd-catalyzed amino acetoxylation of cinnamyl alcohols was next taken into consideration towards the synthesis of valuable amino diol derivatives. In this case, preformed substrates were used, where the alcohol moiety was tethered to N-nucleophilic groups. Conditions involving Pd(II)/Pd(IV) catalysis and employing PIDA as a strong oxidant were employed. The use of this hypervalent iodine reagent was key to the success of the transformation. Amino acetoxylated products were obtained in moderate to good yields and dr. The scope of this reaction remains mostly limited to cinnamyl derived substrates. The reaction conditions did not tolerate substituents on the alpha, beta, and gamma positions of the allylic chains. Alkyl chain containing unsaturated alcohols delivered Aza-Wacker-type products.

Published
2022
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