Suchergebnisse

Poor control of cardiovascular disease accounts for a substantial proportion of the disease burden in developing countries, but often essential anticoagulant medicines for preventing strokes and embolisms are not widely available. In 2019, direct oral anticoagulants were added to the World Health Organization's WHO Model list of essential medicines. The aims of this paper are to summarize the benefits of direct oral anticoagulants for patients with cardiovascular disease and to discuss ways of increasing their usage internationally. Although the cost of direct oral anticoagulants has provoked debate, the affordability of introducing these drugs into clinical practice could be increased by: price negotiation; pooled procurement; competitive tendering; the use of patent pools; and expanded use of generics. In 2017, only 14 of 137 countries that had adopted national essential medicines lists included a direct oral anticoagulant on their lists. This number could increase rapidly if problems with availability and affordability can be tackled. Once the types of patient likely to benefit from direct oral anticoagulants have been clearly defined in clinical practice guidelines, coverage can be more accurately determined and associated costs can be better managed. Government action is required to ensure that direct oral anticoagulants are covered by national budgets because the absence of reimbursement remains an impediment to achieving universal coverage. Tackling cardiovascular disease with the aid of direct oral anticoagulants is an essential component of efforts to achieve the World Health Organization's target of reducing premature deaths due to noncommunicable disease by 25% by 2025.

This work was funded by Engineering and Physical Sciences Research Council of the UK (grants EP/I00243X and EP/J009016) and the European Research Council of the European Union (grant 321305). I.D.W.S. also acknowledges support from a Royal Society Wolfson Research Merit Award. AJW acknowledges the Scottish Doctoral Training Centre in Condensed Matter Physics for financial support. ; The effect of acceptor energy level on electron transfer rate in blends of the polymer solar cell material poly[[4,8-bis[(2-ethylhexyl)oxy]benzo[1,2-b:4,5-b′]dithiophene-2,6-diyl][3-fluoro-2-[(2-ethylhexyl)carbonyl]thieno[3,4-b]thiophenediyl]] (PTB7) is studied using time-resolved fluorescence. Fast electron transfer in <2 ps is observed for driving force between 0.2 and 0.6 eV and slower electron transfer outside this range. This dependence is described by Marcus theory with a reorganization energy of ≈0.4 eV. ; Publisher PDF ; Peer reviewed