Process evaluation of a complex, multilevel, multicomponent scheme for the prevention and control of non-communicable diseases in Tamil Nadu, India: A mixed-methods protocol.

Background: Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality in India, necessitating development of multilevel and multicomponent interventions. Makkalai Thedi Maruthuvam (MTM) is a complex multilevel, multicomponent intervention developed and implemented by the south Indian State of Tamil Nadu. The scheme aims to deliver services for preventing and controlling diabetes, and hypertension at doorstep. This paper describes the protocol for planning and conducting the process evaluation of the MTM scheme. Methods and analysis: The process evaluation uses mixed methods (secondary data analysis, key informant interviews, in-depth interviews, conceptual content analysis of documents, facility-based survey and non-participant observation) to evaluate the implementation of the MTM scheme. The broad evaluation questions addressed the fidelity, contexts, mechanisms of impact and challenges encountered by the scheme using the Consolidated Framework for Implementation Research (CFIR) framework. The specific evaluation questions addressed selected inputs and processes identified as critical to implementation by the stakeholders. The CFIR framework will guide the thematic analysis of the qualitative interviews to explore the adaptations and deviations introduced during implementation in various contexts. The quantitative data on the indicators developed for the specific evaluation questions will be cleaned and descriptively analysed.

Coherent Force Chains in Disordered Granular Materials Emerge from a Percolation of Quasilinear Clusters.

Dense granular materials and other particle aggregates transmit stress in a manner that belies their microstructural disorder. A subset of the particle contact network is strikingly coherent, wherein contacts are aligned nearly linearly and transmit large forces. Important material properties are associated with these force chains, but their origin has remained a puzzle. We classify subnetworks by their linear connectivity, and show the emergence of a percolation transition at a critical linearity at which the network is sparse, coherent, and contains the force chains. The subnetwork at critical linearity closely reflects the macroscopic stress and explains distinctive features of granular mechanics.

A dilation-driven vortex flow in sheared granular materials explains a rheometric anomaly.

Granular flows occur widely in nature and industry, yet a continuum description that captures their important features is yet not at hand. Recent experiments on granular materials sheared in a cylindrical Couette device revealed a puzzling anomaly, wherein all components of the stress rise nearly exponentially with depth. Here we show, using particle dynamics simulations and imaging experiments, that the stress anomaly arises from a remarkable vortex flow. For the entire range of fill heights explored, we observe a single toroidal vortex that spans the entire Couette cell and whose sense is opposite to the uppermost Taylor vortex in a fluid. We show that the vortex is driven by a combination of shear-induced dilation, a phenomenon that has no analogue in fluids, and gravity flow. Dilatancy is an important feature of granular mechanics, but not adequately incorporated in existing models.

Phospholipids: a novel adjuvant in herbal drug delivery systems.

Phytoconstituents have been used extensively in modern science because of their various pharmacological actions with few side effects. Regardless of their excellent therapeutic activity, several phytoconstituents have shown poor bioavailability in vivo. Phytoconstituents possess properties such as poor lipid solubility, large molecular size, and degradation in the gut due to the acidic environment. Gastric enzymes always limit their use. Phospholipids seem to be a major carrier for plant active molecules, which not only interact with the plant constituents on a molecular level but also protect the active components of the plant from degradation and increase the bioavailability of the active components by imparting lipid solubility to them. Complexation techniques enable researchers to convert the phytophospholipids into various dosage forms, including tablets and capsules. In the cosmetic industry, however, these complexes have acquired wider applicability in the form of gels and emulsions. Complexation of phospholipids with active components of plants improves their bioavailability and is being extensively studied by researchers, and further research in this regard is expected in the future. This review highlights the unique property of phospholipids in drug delivery, their health benefits, and their use in the herbal medicine systems to improve the bioavailability of active herbal components.