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This study culturally adapted and validated a Nepalese version of the Abuse Assessment Screen (AAS) tool for identifying domestic violence among pregnant women in Nepal, creating the Nepalese Abuse Assessment Screen (N-AAS). International and national topic experts reviewed the initial N-AAS version using the Delphi method, and pregnant women participated in cognitive interviews, providing feedback on the N-AAS as user experts. Subsequent pre-testing of a comprehensive questionnaire, which included the translated version of the N-AAS, occurred in two tertiary care hospitals using an electronic format known as Color-Coded Audio Computer-Assisted Self-Interview (C-ACASI). The study assessed the content validity index, compared the concurrent validity of the N-AAS with the gold standard interview, estimated the prevalence of domestic violence from two hospitals, and calculated the Kappa coefficient. The reliability of the entire questionnaire was also evaluated through a test-retest analysis, with content validity rated as "good to excellent" by topic and user experts and high test-retest reliability (91.2-98.9%), indicating consistency across questionnaires completed at two different time points, with 12% of participants reporting any form of violence. The N-AAS demonstrated ≥91.7% specificity for all forms of abuse, accurately identifying non-abuse cases. In addition, moderate to excellent sensitivity was observed for emotional abuse (52.5%) and physical abuse since marriage (50%), while sensitivity for physical abuse in the past 12 months was 100%. Thus, the N-AAS demonstrated reliable test-retest results with a good Kappa coefficient and specificity, as well as showing excellent sensitivity for detecting recent physical abuse and moderate sensitivity for detecting emotional abuse and physical abuse since marriage. Because cultural context often leads women to normalize and tolerate abuse from spouses and family members and women are thus reluctant to report abuse, the results imply that the N-AAS can serve as a valuable screening tool for domestic abuse in antenatal care settings in Nepal.
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Violência Doméstica , Humanos , Feminino , Nepal/epidemiologia , Gravidez , Adulto , Inquéritos e Questionários , Gestantes/psicologia , Adulto Jovem , Reprodutibilidade dos Testes , Prevalência , Programas de Rastreamento/métodosRESUMO
The application of carbon fiber-reinforced composite materials in marine engineering is growing steadily. The mechanical properties of unbonded flexible risers using composite tensile armor wire are highly valued. However, the curing process generates a certain amount of internal residual stress. We present a detailed analysis of epoxy resin laminates to assess the impact of thermal, chemical, and mechanical effects on the curing stress and strain. An empirical model that correlates temperature and degree of cure was developed to precisely fit the elastic modulus data of the curing resin. The chemical kinetics of the epoxy resin system was characterized using differential scanning calorimetry (DSC), while the tensile relaxation modulus was determined through a dynamic mechanical analysis. The viscoelastic model was calibrated using the elastic modulus data of the cured resin combining temperature and degree of the curing (thermochemical kinetics) responses. Based on the principle of time-temperature superposition, the displacement factor and relaxation behavior of the material were also accurately captured by employing the same principle of time-temperature superposition. Utilizing the empirical model for degree of cure and modulus, we predicted micro-curing-induced strains in cured composite materials, which were then validated with experimental observations.
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BACKGROUND: Police road crash and injury data in low-income and middle-income countries are known to under-report crashes, fatalities and injuries, especially for vulnerable road users. Local record keepers, who are members of the public, can be engaged to provide an additional source of crash and injury data. METHODS: This paper compares the application of a local record keeper method to capture road crash and injury data in Bangladesh and Nepal, assesses the quality of the data collected and evaluates the replicability and value of the methodology using a framework developed to evaluate the impact of being a local record keeper. OUTCOME: Application in research studies in both Bangladesh and Nepal found the local record keeper methodology provided high-quality and complete data compared with local police records. The methodology was flexible enough to adapt to project and context differences. The evaluation framework enabled the identification of the challenges and unexpected benefits realised in each study. This led to the development of an 11-step process for conducting road crash data collection using local record keepers, which is presented to facilitate replication in other settings. CONCLUSION: Data collected by local record keepers are a flexible and replicable method to understand the strengths and limitations of existing police data, adding to the evidence base and informing local and national decision-making. The method may create additional benefits for data collectors and communities, help design and assess road safety interventions and support advocacy for improved routine police data.
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Acute myeloid leukemia is a poor-prognosis cancer commonly stratified by genetic aberrations, but these mutations are often heterogeneous and fail to consistently predict therapeutic response. Here, we combine transcriptomic, proteomic, and phosphoproteomic datasets with ex vivo drug sensitivity data to help understand the underlying pathophysiology of AML beyond mutations. We measure the proteome and phosphoproteome of 210 patients and combine them with genomic and transcriptomic measurements to identify four proteogenomic subtypes that complement existing genetic subtypes. We build a predictor to classify samples into subtypes and map them to a "landscape" that identifies specific drug response patterns. We then build a drug response prediction model to identify drugs that target distinct subtypes and validate our findings on cell lines representing various stages of quizartinib resistance. Our results show how multiomics data together with drug sensitivity data can inform therapy stratification and drug combinations in AML.
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Leucemia Mieloide Aguda , Proteogenômica , Humanos , Proteômica/métodos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Leucemia Mieloide Aguda/metabolismo , Genômica/métodos , MutaçãoRESUMO
Proteogenomics refers to the integration of comprehensive genomic, transcriptomic, and proteomic measurements from the same samples with the goal of fully understanding the regulatory processes converting genotypes to phenotypes, often with an emphasis on gaining a deeper understanding of disease processes. Although specific genetic mutations have long been known to drive the development of multiple cancers, gene mutations alone do not always predict prognosis or response to targeted therapy. The benefit of proteogenomics research is that information obtained from proteins and their corresponding pathways provides insight into therapeutic targets that can complement genomic information by providing an additional dimension regarding the underlying mechanisms and pathophysiology of tumors. This review describes the novel insights into tumor biology and drug resistance derived from proteogenomic analysis while highlighting the clinical potential of proteogenomic observations and advances in technique and analysis tools.
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Medicina de Precisão , Proteogenômica , Humanos , Proteômica , Genômica , Espectrometria de MassasRESUMO
This Research Communication aims to compare the effect of A1A2 and A2A2 cow milk diets on the biochemical and histological parameters of rats. The rats were divided into four groups and fed with a normal diet, A2 milk powder, A1A2 or A2A2 cow milk diets for 90 d. Blood glucose, kidney function, liver function and lipid profile were examined during the experimental period. The study showed an increase in the body weight of the A1A2 group whereas a slight decrease in the A2A2 group, and blood glucose levels increased from d 0 to day 90 in all experimental groups. However, none of these changes were found to be statistically insignificant (P > 0.05). Moreover, no significant changes were recorded in other parameters (serum glutamic pyruvic transferase and serum glutamic-oxaloacetic transaminase for liver function, bilirubin direct, cholesterol, triglycerides, creatinine and uric acid). The histology of the liver, kidney and pancreas also showed no changes in all groups. Overall, this study revealed no significant difference in the nutritional values of A1A2 and A2A2 milk types and hence equally beneficial for health. Although the present study showed no significant difference in the effect of both milk types in 90 d, further studies might be conducted to evaluate their longer term effects.
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Glicemia , Leite , Bovinos , Feminino , Ratos , Animais , Ratos Wistar , Dieta/veterinária , FígadoRESUMO
Unintentional injuries are one of the leading causes of ill health, disability & death among the children and young adults worldwide. As these injuries are strongly related to social determinants, the burden falls mainly upon the Low- and Middle-Income Countries (LMICs) like Nepal. Thus, the main objective was to explore the epidemiology of unintentional childhood injuries in urban and rural areas of Kavrepalanchok district. A cross sectional analytical study was done in Bethanchok rural municipality and Dhulikhel municipality of Kavrepalanchok district. The respondents were interviewed using a pretested semi-structured questionnaire. The details of injuries sustained within the past 12 months were included. A total of 667 children aged 1-16 years were surveyed, among which 26% from rural and 17.2% from urban areas had unintentional injuries in the past 12 months. Falls were the most common mode of injury in both the areas. Similarly, the proportion of burn was more in rural area (16.1%) whereas, Road Traffic Injuries were more in urban area (12.5%). Majority of the injuries occurred at home (54.5%) while the child was playing (64.1%). Factors like child's gender and place of residence affected the occurrence of unintentional injuries (p<0.05). Out of total injured children, 18 of them had not recovered and 11 were left with some form of permanent disability. As the rate and pattern of unintentional childhood injuries in the rural and urban area differ, the prevention strategies should focus on risk factors that apply to both the areas and awareness should be created among the parents and primary caregivers about the fact that childhood injuries are predictable and preventable.
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Lesões Acidentais , Queimaduras , Ferimentos e Lesões , Humanos , Criança , Nepal/epidemiologia , Estudos Transversais , Lesões Acidentais/epidemiologia , Pais , População Rural , Ferimentos e Lesões/epidemiologiaAssuntos
Antineoplásicos , Leucemia Mieloide Aguda , Humanos , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Mutação , Compostos de Anilina/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Tirosina Quinase 3 Semelhante a fms/genética , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêuticoRESUMO
The BCL2 inhibitor venetoclax combined with the hypomethylating agent azacytidine shows significant clinical benefit in a subset of patients with acute myeloid leukemia (AML); however, resistance limits response and durability. We prospectively profiled the ex vivo activity of 25 venetoclax-inclusive combinations on primary AML patient samples to identify those with improved potency and synergy compared with venetoclax + azacytidine (Ven + azacytidine). Combination sensitivities correlated with tumor cell state to discern three patterns: primitive selectivity resembling Ven + azacytidine, monocytic selectivity, and broad efficacy independent of cell state. Incorporation of immunophenotype, mutation, and cytogenetic features further stratified combination sensitivity for distinct patient subtypes. We dissect the biology underlying the broad, cell state-independent efficacy for the combination of venetoclax plus the JAK1/2 inhibitor ruxolitinib. Together, these findings support opportunities for expanding the impact of venetoclax-based drug combinations in AML by leveraging clinical and molecular biomarkers associated with ex vivo responses. SIGNIFICANCE: By mapping drug sensitivity data to clinical features and tumor cell state, we identify novel venetoclax combinations targeting patient subtypes who lack sensitivity to Ven + azacytidine. This provides a framework for a taxonomy of AML informed by readily available sets of clinical and genetic features obtained as part of standard care. See related commentary by Becker, p. 437 . This article is featured in Selected Articles from This Issue, p. 419.
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Antineoplásicos , Leucemia Mieloide Aguda , Humanos , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Azacitidina/farmacologia , Azacitidina/uso terapêuticoRESUMO
Wheat (Triticum aestivum L.) is the major global staple food crop that meets the food security demands of various nations across the continents. The recent reduction in wheat production is attributed to several biotic and abiotic factors especially, temperature and rainfall patterns, and pest occurrence. Among insect pests, aphid species are emerging as new pests of economic importance in India and elsewhere. The present investigation identified a new association of Macrosiphum euphorbiae Thomas with the wheat crop. Life table parameters were studied for M. euphorbiae and Rhopalosiphum padi fed on wheat foliage. The total nymphal duration and life cycle duration, respectively, of R. padi (4.76 ± 0.54 and 9.71 ± 1.38 days) and M. euphorbiae (5.84 ± 0.69 and 9.96 ± 1.31 days) were significantly different for these species. The fecundity of the two aphid species was 23.95 ± 8.67 and 11.6 ± 4.10 progeny/female, respectively. Age-specific survival rate (lx), age-specific fecundity (fx), and population age-specific fecundity (mx) were higher in R. Padi compared to M. euphorbiae. Reproductive value (Vxj) was high in R. padi and the duration of reproduction was less, while these parameters showed an opposite trend in M. euphorbiae. The gross reproduction rate (GRR) was found higher in R. Padi (29.17 offspring/adult lifetime) compared to M. euphorbiae (19.58 offspring/adult lifetime). The M. euphorbiae being a pest of solanaceous crops seems to have shifted to a new host, i.e., wheat. This new adaptation strategy to survive for long periods on a wheat crop might pose a serious threat to wheat crop cultivation in near future.
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BACKGROUND: The development of drug delivery carriers is the key area of research in the field of novel drug delivery systems. To date, a long list of carriers has been identified for this purpose but the deliveries of poorly water-soluble active substances are still facing challenges and hence, such substances are pharmacologically unsafe and economically incompetent. OBJECTIVE: This article aims to review the applications of casein as a drug carrier and its potential for clinical use. METHODS: The relevant literature on the casein protein was collected from authentic online scientific databases like PubMed, Scopus and Google Scholar using different keywords including "casein", "drug delivery system", "drug carrier" and "bioavailability". The articles and books accessed online have been thoroughly reviewed and the most relevant reports on casein as a drug carrier have only been included in the present study. RESULTS: Casein is a milk protein that has many structural and physicochemical properties which facilitate its functionality in delivery systems. Moreover, its amphiphilic nature makes it the most suitable carrier for both hydrophobic and hydrophilic drugs without showing any toxic effects. The carriers obtained from natural sources are trustworthy over synthetic carriers and in the demand of the market due to their easy availability, low-cost factor, bio-friendly and nontoxic nature. CONCLUSION: Casein was found to be an effective natural drug carrier in various delivery systems due to its unique applications in improving the bioavailability and efficacy of a drug.
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Caseínas , Portadores de Fármacos , Portadores de Fármacos/química , Caseínas/química , Caseínas/metabolismo , Sistemas de Liberação de Medicamentos , Micelas , Disponibilidade BiológicaRESUMO
A new species of scale insect in the genus Aulacaspis (Hemiptera: Coccomorpha: Diaspididae) is described and illustrated from Kerala, India. Aulacaspis elettaria Joshi & Nafeesa sp. n. was collected from the host plant Elettaria cardamomum (L.) Maton (Zingiberaceae). Biological notes on the species are provided, including information on the occurrence, spread and pest status of this species in Kerala. An identification key based on adult females is given to separate Indian species of Aulacaspis.
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Elettaria , Hemípteros , Lepidópteros , Feminino , Animais , ÍndiaRESUMO
BACKGROUND: Routinely collected injury data can help to identify populations at risk of injury, circumstances surrounding those injuries, and can be used to develop targeted interventions. However, routinely collected injury data in Nepal are at risk of being incomplete or poorly coded and are underutilised. Therefore, this study aimed to explore the strengths, and opportunities for improvement, of systems that routinely measure injury incidence in Nepal. METHODS: This study employed a qualitative design where data were collected through interviews with personnel working in four routine data systems; the Health Management Information System, the Road Accident Reporting System, the Daily Incident Reporting System, and the Civil Registration System. Interviews were conducted with front-line data collectors as well as strategic decision makers working in these data systems. Interviews were audio-recorded, transcribed, translated into English and analysed using framework analysis. RESULTS: A total of 32 interviews were completed, 19 interviews with front-line data collectors and 13 interviews with strategic decision makers. The data recording and reporting process of the four systems were identified and described. The analysis of data yielded 11 themes that described the strengths and limitations of the data collected through the four systems, challenges for effective data systems, and user recommendations for system improvement. CONCLUSIONS: This study identified the strengths, limitations, system challenges, and opportunities to improve data quality of each of the four routine data collection systems. These findings may be useful in engaging stakeholders in strengthening existing routine injury data collection systems or implementing alternative systems.
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Sistemas de Informação em Saúde , Humanos , Nepal/epidemiologia , Pesquisa QualitativaRESUMO
BACKGROUND: Gender inequality and violence are not mutually exclusive phenomena but complex loops affecting each other. Women in Nepal face several inequalities and violence. The causes are diverse, but most of these results are due to socially assigned lower positioning of women. The hierarchies based on power make women face subordination and violence in Nepal. The study aims to explore participants' understanding and experience to identify the status of inequality for women and how violence emerges as one of its consequences. Furthermore, it explores the causes of sex trafficking as an example of an outcome of inequality and violence. METHOD: The study formulated separate male and female groups using a purposive sampling method. The study used a multistage focus group discussion, where the same groups met at different intervals. Six focus group discussions, three times each with male and female groups, were conducted in a year. Thirty-six individuals, including sixteen males and twenty females, were involved in the discussions. The study used constructivist grounded theory for the data analysis. RESULTS: The study participants identify that a power play between men and women reinforce inequality and increases the likelihood of violence for women. The findings suggest that the subjugation of women occurs due to practices based on gender differences, constricted life opportunities, and internalization of constructed differences among women. The study identifies that interpersonal and socio-cultural violence can result due to established differences between men and women. Sex trafficking, as an example of the outcome of inequality and violence, occurs due to the disadvantageous position of women compounded by poverty and illiteracy. The study has developed a concept of power-play which is identified as a cause and consequence of women's subordination and violence. This power play is found operative at various levels with social approval for men to use violence and maintain/produce inequality. CONCLUSION: The theoretical concept of power play shows that there are inequitable power relations between men and women. The male-centric socio-cultural norms and practices have endowed men with privilege, power, and an opportunity to exploit women. This lowers the status of women and the power-play help to produce and sustain inequality. The power-play exposes women to violence and manifests itself as one of the worst expressions used by men.
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Violência de Gênero , Feminino , Masculino , Humanos , Nepal , Pesquisa Qualitativa , Grupos Focais , Violência , Identidade de GêneroRESUMO
Background and aim: The ingredients viz., Artemisia roxburghiana, Cissampelos pareira, Stephania glabra, Drimia indica, Roylea cinerea, Tinospora sinensis and Curcuma longa of the present formulation are used to treat diabetes in the Indian traditional medical system. Adopting the concept of multiple herbal mixtures for better therapeutic effects from the ancient Ayurvedic text Sarangdhar Samhita, the present study aimed to develop a polyherbal formulation (PHF) of seven herbs and to evaluate its sodium-glucose cotransporter protein-2 (SGLT2) inhibitory effect on type 2 diabetic rats. Experimental procedure: Streptozotocin (STZ) (60 mg/kg) and nicotinamide (NAM) (120 mg/kg) were intraperitoneally administered to induce type 2 diabetes in Wistar rats. The animals were divided into 5 groups viz. normal control, diabetic control, positive control (dapagliflozin at 0.1 mg/kg) and two test groups (PHF at 250 and 500 mg/kg). Various parameters including blood glucose, serum glutamic pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), bilirubin, triglycerides and creatinine were measured. Results and conclusion: The treatment with PHF (250 and 500 mg/kg) showed a significant (p < 0.05) decrease in blood glucose levels by 56.37% and 58.17%, respectively. The levels of SGOT, SGPT and bilirubin were significantly reduced in PHF-fed diabetic rats. Histopathological examination revealed no major changes in the treated groups as compared to the normal control. The molecular docking study showed strong binding of ß-sitosterol, insulanoline, warifteine, dehydrocorydalmine, taraxerol acetate, lupeol, corydalmine and luteolin to SGLT2 protein. The present study concludes that PHF has promising antidiabetic activity via inhibiting SGLT2 protein without showing any adverse effects.
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The male of Anagyrus almoriensis Shafee, Alam Agarwal (Hymenoptera: Encyrtidae) is described and illustrated from India along with notes on its associated hosts and types.
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Hemípteros , Himenópteros , Rubus , Animais , MasculinoRESUMO
Acute Myeloid Leukemia (AML) affects 20,000 patients in the US annually with a five-year survival rate of approximately 25%. One reason for the low survival rate is the high prevalence of clonal evolution that gives rise to heterogeneous sub-populations of leukemic cells with diverse mutation spectra, which eventually leads to disease relapse. This genetic heterogeneity drives the activation of complex signaling pathways that is reflected at the protein level. This diversity makes it difficult to treat AML with targeted therapy, requiring custom patient treatment protocols tailored to each individual's leukemia. Toward this end, the Beat AML research program prospectively collected genomic and transcriptomic data from over 1000 AML patients and carried out ex vivo drug sensitivity assays to identify genomic signatures that could predict patient-specific drug responses. However, there are inherent weaknesses in using only genetic and transcriptomic measurements as surrogates of drug response, particularly the absence of direct information about phosphorylation-mediated signal transduction. As a member of the Clinical Proteomic Tumor Analysis Consortium, we have extended the molecular characterization of this cohort by collecting proteomic and phosphoproteomic measurements from a subset of these patient samples (38 in total) to evaluate the hypothesis that proteomic signatures can improve the ability to predict response to 26 drugs in AML ex vivo samples. In this work we describe our systematic, multi-omic approach to evaluate proteomic signatures of drug response and compare protein levels to other markers of drug response such as mutational patterns. We explore the nuances of this approach using two drugs that target key pathways activated in AML: quizartinib (FLT3) and trametinib (Ras/MEK), and show how patient-derived signatures can be interpreted biologically and validated in cell lines. In conclusion, this pilot study demonstrates strong promise for proteomics-based patient stratification to assess drug sensitivity in AML.
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BACKGROUND: Road traffic injuries are a significant and increasing public health burden in Nepal, but there is no national coverage of regulated and standardized emergency medical service systems. Therefore, this study was designed to develop a first responder trauma training program for the Nepal traffic police and to evaluate the feasibility of its delivery and follow up. METHODS: A training needs assessment with traffic-police officers in a single district of Nepal informed the development of a 3-day first-response course which was provided to officers in May 2019. Participants were supplied with a trauma-pack and asked to complete a report form when first-responder skills were used. Knowledge and confidence face-to-face surveys were used before and after training to assess learning, and were repeated at 6 months to assess retention of knowledge. The surveys at 6 months assessed the factors affecting application of first response skills. RESULTS: Most (97%) participants believed giving first-aid was part of their responsibilities and 95% had experience of transporting road crash victims to hospital with a range of injuries. Low levels of first-aid training and variable course content were reported. Knowledge and confidence scores improved post-intervention but were reduced at 6-months. During attendance at 303 road crashes in the 6-months follow-up period, 44% of the participants self-reported using at least one skill from the course; applying them on 92 occasions. Incident report-forms were frequently not completed. Barriers to providing treatment included: the patient already en-route to hospital when police arrived at scene; resistance to providing care from relatives or bystanders; and competing police duties (e.g., traffic management). CONCLUSIONS: Delivering a first-response training program for traffic-police in Nepal is feasible. Knowledge was retained and used, and skills were in frequent demand. A study of effectiveness and cost-effectiveness appears warranted to determine if extending the training to other districts can improve outcomes in road traffic injury patients in the absence of formal emergency medical services.
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Polícia , Ferimentos e Lesões , Acidentes de Trânsito , Estudos de Viabilidade , Primeiros Socorros , Humanos , Nepal/epidemiologiaRESUMO
Acute myeloid leukemia (AML) is a cancer of myeloid-lineage cells with limited therapeutic options. We previously combined ex vivo drug sensitivity with genomic, transcriptomic, and clinical annotations for a large cohort of AML patients, which facilitated discovery of functional genomic correlates. Here, we present a dataset that has been harmonized with our initial report to yield a cumulative cohort of 805 patients (942 specimens). We show strong cross-cohort concordance and identify features of drug response. Further, deconvoluting transcriptomic data shows that drug sensitivity is governed broadly by AML cell differentiation state, sometimes conditionally affecting other correlates of response. Finally, modeling of clinical outcome reveals a single gene, PEAR1, to be among the strongest predictors of patient survival, especially for young patients. Collectively, this report expands a large functional genomic resource, offers avenues for mechanistic exploration and drug development, and reveals tools for predicting outcome in AML.
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Leucemia Mieloide Aguda , Diferenciação Celular , Estudos de Coortes , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Receptores de Superfície Celular/genética , TranscriptomaRESUMO
BACKGROUND: Suicide is a significant public health concern in Nepal and there is a need for an evidence-based suicide prevention programme to facilitate stakeholders working towards suicide prevention in Nepal. Collaborative research between stakeholders focussing on shared priorities can help to prevent and control suicide. Hence, we aimed to develop a consensus list of research priorities for suicide prevention in Nepal. METHODS: The Delphi expert consensus method was used to elicit the prioritized research questions for suicide prevention in Nepal. Participants comprised suicide prevention experts (psychologists, psychiatrists, psychiatric nurses, researchers and advocates) and people with lived experience. Three rounds of Delphi were conducted; round 1: one to one interviews involving open ended questions used to generate research questions; round 2: ranking of the research questions using a 5-point Likert scale, and round 3: re-ranking of research questions in light of individual and group responses. RESULTS: Forty-two participants participated in round 1 followed by 38 in round 2 and 39 in round 3 . 522 research questions were generated through round 1 which were grouped together and reduced to 33 research questions sent for ranking in round 2. Using a cut off of at least 70% of the panel ranking questions as 'very important' or 'important', 22 questions were retained. These research questions were sent for re-rating in round 3 resulting in a final list of prioritized questions. CONCLUSIONS: This is the first expert consensus study to identify the top research priorities for suicide prevention in Nepal, and used experts in suicide prevention and those with lived experience. A consensus was reached regarding the studies needed to improve suicide data quality, assess the burden and identify factors associated with suicide. A priority driven approach to suicide prevention research may ensure that the research endeavour provides the most useful information for those whose day-to-day work involves trying to prevent suicide.