Miracle-dz/UniFAR-FTUs huggingface dataset:
Prevalence and determinants of self-directed referrals amongst patients at hospitals in eThekwini District, KwaZulu-Natal 2015

Background: Non-compliance with designated referral pathways has ramifications such as increased patient waiting time, overburdening of higher levels of care and increasing healthcare costs on patients and the healthcare system. The purpose of this study was to assess the determinants of self-directed referrals amongst patients attending hospitals in the eThekwini district of KwaZulu-Natal. Methods: An analytic, cross-sectional study was conducted at the Medical Outpatient Departments across five district hospitals in eThekwini using interviewer-administered questionnaires. Descriptive statistics were used to determine the proportion and the most frequent factors contributing towards patient self-referral. The likelihood of patients to self-refer was tested using chi-square (X2) and a multivariate regression model. Results: There were 315 patients interviewed with 35% (n = 109/315) having self-referred. The majority (51%; 55/107) of self-referrals were male and were of African race (74%; n = 80/107). Five institutional factors, namely: availability of medication at the pharmacy (98%); quality of care at the facility (93%); waiting time at facility (92%); services provided (90%); and attitude of healthcare workers (87%), were ranked as the main drivers of self-referral. Multivariate logistic regression established a significant positive association between patient self-referral and male gender (OR 1.73; CI 1.04–2.87, p < 0.05). Age < 39 years (OR 0.96; CI 0.94–0.99, p < 0.05); and patient awareness of a referral letter (OR 0.28; CI 0.09–0.86, p < 0.05) emerged as protective factor against self-referrals. Conclusion: Males patients tend to bypass the referral pathway whilst younger patients and patients who were aware of a referral letter were less likely to bypass the referral system. In addition to addressing the systemic challenges of waiting times, quality of care and availability of medication, a patient-oriented approach that comprises education, encouragement and increased patient awareness is an important strategy to improve referral pathway compliance.
Infection of Acanthamoeba castellanii by Chlamydia pneumoniae

Chlamydia pneumoniae is an intracellular respiratory pathogen, which, similar to Legionella, might have developed mechanisms to escape the intracellular bactericidal activity of both human host cells and amoeba. We therefore investigated the intracellular growth and survival of C. pneumoniae in Acanthamoeba castellanii by using cell culture, immunofluorescence microscopy, and electron microscopy. A castellanii was incubated with purified elementary bodies of C. pneumoniae TW 183 at a concentration of 10(6) inclusion-forming units (IFU)/ml to give a ratio of approximately 1 IFU of C. pneumoniae per amoeba. Quantitative determination of chlamydial growth within A. castellanii revealed viable and infective C. pneumoniae in the range of 10(4) to 10(5) IFU/ml between days 7 and 14 postinfection. Immunofluorescence analysis and transmission electron microscopy with subsequent immunogold staining confirmed evidence of infection of the amoebae by C. Pneumoniae and additionally revealed that C. pneumoniae entered the typical growth cycle. Our results show that amoebae allow the survival of C. pneumoniae, suggesting that amoebae may serve as an additional reservoir for Chlamydia or Chlamydia-related organisms.
Deinstitutionalisation — from Hospital Closure to Service Development

The necessary components of a comprehensive service of local non-institutional forms of care for the seriously mentally ill have been researched separately in pilot trials, but not within integrated programmes for defined populations. Reported outcomes are at least as favourable as for traditional long-term hospital care, but alternative provisions are no less costly. A case manager system may allow co-ordinated formal and informal services to meet the individual needs of chronically ill patients. Poorly integrated programmes will expose discharged patients to disadvantages.
THE IMPACT OF COMMUNITY SAVINGS AND INVESTMENT PROMOTION PROGRAM ON HOUSEHOLD INCOME AND CREDIT MARKET PARTICIPATION IN KASUNGU DISTRICT, CENTRAL MALAWI

This study analyses the impact of Community Savings and Investment Program (COMSIP) activities on household income and credit of member households of COMSIP groups in Kasungu District in Central Malawi. COMSIP groups are a form of village-based microcredit and community-based savings institutions with a number of socio-economic functions. The functions include mobilization of communities to save and/or invest their resources into income generating initiatives and provide credit. Using data from COMSIP Cooperative Union limited for Kasungu District in Malawi on income per capita and access to credit, this study tests the hypothesis that these variables were positively impacted on by membership to these COMSIP groups. The study uses Instrumental Variables (IV) methodology organized to reduce selection bias as well as endogeneity problems in the sample. The primary data on socio-economic and demographic variables was collected using household questionnaires, Key Informant Interviews and literature review as tools from a sample of 150 households. The study found that the variables such as sex of household head, age of household head, credit per capita, land per capita and distance of location of household to the COMSIP office, determine household decision to join COMSIP groups. Instrumental Variables analysis results show that the effect of COMSIP groups on household income and credit is very strong. The IV estimates indicate an increase of 88% income per capita and 96% increase in credit per capita of relatively poor participating households was significant at 5% and 1% levels of significance respectively. The findings also indicate that the simple targeting mechanism of COMSIP program based on household vii land ownership is effective. Thus, the efficiency of the COMSIP program can be enhanced by allocating credit to households with marginal landholding, for which the impact is the greatest. Although microfinance programs, especially among the rural poor people living below the standard poverty line of one US dollar per day have elicited different reactions from different stakeholders, there seems to be a general agreement that the program is useful amongst the strategies for ensuring improved household income and credit of rural Malawians, hence reduced poverty in the long-run.
Psychological Burden and Gender Differences in Methamphetamine-Dependent Individuals in Treatment

ABSTRACT Background and Objectives: Little is known about gender differences in methamphetamine (METH)-dependent users. The objective of this study was to examine potential gender differences in four domains: drug use history, psychological burden, current symptomology, and coping strategy. Methods: One hundred twenty four METH-dependent individuals (men; n = 75) were enrolled from substance use treatment programs. Participants filled out detailed questionnaires in the four domains. Results: Men reported earlier first alcohol and drug use than women, but there was no difference in the age of first METH use or frequency of METH use. Women reported experiencing problems because of METH use at a younger age. Women were also more likely to have injected METH in the past year and they reported greater severity of drug problems compared to men. METH-dependent women had greater psychological burden, reported more use of an emotional-coping strategy, and had greater childhood emotional and sexual trauma. Conclusions: Overall, this study suggests that, unlike many other illicit drugs, severity of use and problems associated with use were not elevated in METH-dependent men compared to women. In fact, several factors indicated more severe patterns of use or risk factors in women.
When Saving is Gambling

Prize-linked savings (PLS) accounts, which allocate interest using lottery payments rather than fixed interest, encourage savings by appealing to households’ gambling preferences. I introduce new data on casino cash withdrawals to measure gambling, and examine how individual gambling expenditures respond to the introduction of PLS in Nebraska using a difference-in-differences design. After PLS is introduced, individuals who live in counties that offer PLS reduce gambling by at least 3% more than unaffected individuals. The substitution effect is stronger in low-frills gambling environments, which most resemble PLS, indicating that these accounts fulfill the desire to gamble.
Novel Space-Time Coding and Mapping Scheme in Single-Carrier FDMA Systems

In this paper, for the frequency domain generation of SC-FDMA, i.e., DFT-SOFDMA, with the localized subcarrier mapping, we proposed novel Space-Time Coding and Mapping scheme and Space-Frequency Coding and Mapping scheme, which provides better PAPR property compared with other schemes. The new schemes also provide the capability of low-complexity frequency domain equalization and full space diversity. The low PAPR of the new schemes can be used to improve the power amplifier efficiency and/or enhance the cellular coverage, especially for the uplink of the future broadband wireless communication systems.
Dermally adhered soil: 1. Amount and particle‐size distribution

The risk associated with the dermal absorption of chemicals from contaminated soil is, in part, a function of particle size distribution, as determined by either dry or wet sieving techniques. For the soils tested, the adhered soil fractions were shown to be independent of organic matter content and soil origin. Soil moisture content becomes a factor only for very moist soils. Results show that the adhered fractions of dry or moderately moist soils with wide distributions of particle sizes generally consist of particles of diameters <63 μm. Consequently, dermal absorption experiments using larger size fractions may be of limited relevance to actual situations of soil exposure.
Function of Growth Factors for Rumen Microorganisms I. Nutritional Characteristics of Selenomonas ruminantium

Nutritional characteristics of Selenomonas ruminantium var. lactilytica isolated from a sheep rumen were studied. The organism required for growth the addition of a clarified rumen fluid to a Trypticase-yeast extract medium with either lactate or glucose as an energy source. The requirement for rumen fluid was found to be satisfied by volatile fatty acids in glucose media and by biotin in lactate media. Straight-chain saturated fatty acids with C3 to C10 carbon skeleton had been found to be effective. Among them, n-valerate was most effective at the lowest concentration. An abnormal morphology was observed with n-valerate-deficient glucose media. n-Valerate was essential in glucose media, and it was stimulatory in lactate media. Fermentation products from glucose were lactate, propionate, and acetate, and fermentation products from lactate were propionate and acetate. When cells were grown in a glucose medium containing n-valerate-C14, the label was present in cell fractions. Almost all of the activity was found in lipid materials.
Reduced Insulin Clearance in Normal Subjects Due To Extreme Hyperinsulinemia

Insulin clearance was assessed in five normal subjects infused with insulin at a rate of 10 mU.kg-1. min-1 for 12–16 hours, which produced insulin levels of 1500–2000 U/ml (-10-8 MX This level approximates the Kd of low affinity insulin binding sites, whereas previous clearance studies had been performed at insulin concentrations of 10-9 M or less, approximating the Kd of the high affinity insulin receptor. The metabolic clearance rate for insulin during the infusion averaged 214 ± 29 ml.min-1.m-2, which is half of that reported previously when lower insulin levels were achieved. Upon termination of the insulin infusion, the disappearance of insulin was markedly prolonged with an average “half-life” of 62 minutes. The rapidity with which hyper-insulinemia altered clearance suggested that down-regulation of insulin receptors was probably not the explanation for the reduced clearance. To elucidate the cause for the observed decrease in insulin clearance, five additional subjects were studied. If insulin was infused for 3.0–4.5 hours, the half-life of insulin disappearance was intermediate between that for an insulin bolus dose and that for a 12–16-hour insulin infusion. Administration of an insulin bolus dose at the end of a 12-hour infusion, while the insulin concentration was still −10-8 M, or 140 min later, when the insulin con-centration was 10-9 M, was followed by rapid disappearance with half-lives of 1.5 and 6–8 minutes, respectively. The extraordinarily short half-life of the insulin bolus dose administered at a steady-state insulin concentration of 10-8 M is compatible with a greater volume of distribution for insulin at that concentration. The prolonged rate of insulin disappearance following termination of a 12–16-hour insulin infusion suggests that clearance may have been altered as a result of reentry of insulin from a low affinity, high capacity system into the vascular compartment, since the disappearance rate was prolonged even at an insulin concentration of 10-9 M when a simultaneously administered insulin bolus dose was cleared normally. These observations suggest that low affinity binding sites served as a high capacity “reservoir” in which insulin could accumulate and from which insulin could subsequently recycle into the circulation, thereby decreasing apparent clearance rates.
GENOME‐WIDE ASSOCIATION STUDY (GWAS) AND GENOME‐WIDE BY ENVIRONMENT INTERACTION STUDY (GWEIS) OF DEPRESSIVE SYMPTOMS IN AFRICAN AMERICAN AND HISPANIC/LATINA WOMEN

Genome‐wide association studies (GWAS) have made little progress in identifying variants linked to depression. We hypothesized that examining depressive symptoms and considering gene–environment interaction (GxE) might improve efficiency for gene discovery. We therefore conducted a GWAS and genome‐wide by environment interaction study (GWEIS) of depressive symptoms.
Cognitive impairment in temporal lobe epilepsy: Role of online and offline processing of single cell information

Cognitive impairment is a common comorbidity in temporal lobe epilepsy (TLE) and is often considered more detrimental to quality of life than seizures. While it has been previously shown that the encoding of memory during behavior is impaired in the pilocarpine model of TLE in rats, how this information is consolidated during the subsequent sleep period remains unknown. In this study, we first report marked deficits in spatial memory performance and severe cell loss in the CA1 layer of the hippocampus lower spatial coherence of firing in TLE rats. We then present the first evidence that the reactivation of behavior‐driven patterns of activity of CA1 place cells in the hippocampus is intact in TLE rats. Using a template‐matching method, we discovered that real‐time (3–5 s) reactivation structure was intact in TLE rats. Furthermore, we estimated the entropy rate of short time scale (∼250 ms) bursting activity using block entropies and found that significant, extended temporal correlations exist in both TLE and control rats. Fitting a first‐order Markov Chain model to these bursting time series, we found that long sequences derived from behavior were significantly enriched in the Markov model over corresponding models fit on randomized data confirming the presence of replay in shorter time scales. We propose that the persistent consolidation of poor spatial information in both real time and during bursting activity may contribute to memory impairments in TLE rats. © 2014 Wiley Periodicals, Inc.
Sex and Sex-Role Differences in Locus of Control

The relations among of sex, measures of sex-role orientation, and locus of control were examined with 240 undergraduates (150 women and 90 men). Although there were no sex differences on mean locus of control scores, a significant relation between scores on sex-role orientation and locus of control was observed for women but not for men.
C-Reactive Protein Increases Oxygen Radical Generation by Neutrophils

C-reactive protein (CRP) has been suggested to play a role in the pathogenesis of atherosclerosis. Neutrophil respiratory burst and levels of CRP are increased during infection. The increase in the neutrophil respiratory burst may be due to factors that are elevated in infection, such as cytokines, tumor necrosis factor, platelet-activating factor, and CRP. The direct effect of CRP on the release of oxygen radicals by neutrophils is not known. This investigation was made to determine if CRP affects the generation of oxygen radicals by neutrophils and if this effect is blocked by antioxidants. The effect of various concentrations (1 to 200 µg/mL blood) of CRP on the generation of oxygen radicals by neutrophils was measured as luminol-dependent chemiluminescence (chemiluminescent activity) on a luminometer (Auto Lumat LB953, EG & G Berthold, Gaithersburg, MD). The unit of chemiluminescent activity is the relative light unit and was expressed as relative light unit/white blood cell (RLU/WBC). Chemiluminescent activity of blood without CRP was slightly higher than that of buffer with or without CRP. CRP markedly increased the chemiluminescent activity of blood. There was no significant change in the chemiluminescent activity of WBCs with 1 µg/mL of CRP. The chemiluminescent activity increased significantly with higher concentrations of CRP. The percent increases in the chemiluminescent activity with 2, 5, 10, 25, 50, 100 and 200 µg/mL of CRP were 45%, 72%, 50%, 70%, 52%, 67%, and 68% respectively. Antioxidants (superoxide dismutase, catalase, and dimethylthiourea) blocked CRP-induced oxygen radicals by WBCs. These results suggest that CRP increases the generation of oxygen radicals from the WBCs. CRP-induced atherosclerosis may be mediated through generation of oxygen radicals by neutrophils.
Magnetic resonance elastography for staging liver fibrosis in chronic hepatitis C.

PURPOSE We evaluated the use of magnetic resonance (MR) elastography (MRE) for staging liver fibrosis in patients with chronic hepatitis C and compared the ability of MRE and serum fibrosis markers for discriminating each stage of fibrosis. METHODS We evaluated 114 patients with chronic hepatitis C in whom the pathological fibrosis stage was determined (fibrosis stage 0 [F0], 3; F1, 15; F2, 28; F3, 25; and F4, 43). All patients underwent MRE using a 1.5-tesla MR system and pneumatic driver system. We measured stiffness values (kPa) of the liver in a circular region of interest placed on elastograms. We determined the optimal cutoff value and diagnostic ability for discriminating each stage of fibrosis using receiver operating characteristic (ROC) curve analysis and compared the discriminative ability of MRE with that of serum fibrosis markers. RESULTS The mean stiffness values of the liver increased with stage of fibrosis: F0, 2.10±0.10 kPa; F1, 2.42±0.29 kPa; F2, 3.16±0.32 kPa; F3, 4.21±0.78 kPa; and F4, 6.20±1.08 kPa. The mean area under the ROC curve (Az) values for discriminating liver fibrosis stages were: ≥F1, 0.984 (95% confidence interval, 0.933-0.996); ≥F2, 0.986 (0.956-0.996); ≥F3, 0.973 (0.935-0.989); and ≥F4, 0.976 (0.945-0.990). The Az values for discriminating fibrosis stages were significantly higher for MRE than serum fibrosis markers. CONCLUSION MRE is a reliable technique for staging liver fibrosis and discriminating liver fibrosis stages in patients with chronic hepatitis C.
Debt Sustainability Measures and Their Explanatory Power for Estimating Government Bond Yields

The purpose of this article is to explain changes in sovereign yields using conventional “rating agency style” measures in comparison to contingent claims valuation-based measures. I will show that – in contrast to most conventional sovereign credit quality measures – contingent claims valuation-based credit measures have significant power in explaining the spread between 10-year sovereign yields and the expected future monetary policy rate.
Chronic Fluoride Toxicity and Myocardial Damage: Antioxidant Offered Protection in Second Generation Rats

This experiment was designed to investigate the extent of peroxidative changes and histological alterations in the myocardium of rats exposed to high fluoride for two generations, in addition to ameliorative role of selenium and vitamin E on the above indices. Adult albino Wistar rats were given fluoride through drinking water (200 ppm F) and maintained subsequently for two generations, while they were exposed to fluoride throughout the experiment. Fluoride treatment significantly increased the lipid peroxidation and decreased the activity of antioxidant enzymes, viz., catalase, superoxide dismutase, and glutathione level in auricle and ventricle regions of the heart. Decreased feed and water consumption, organ somatic index and marginal drop in body growth rate were observed. Decreased antioxidant enzymes and increased malondialdehyde levels might be related to oxidative damage that occurs variably in the myocardium of rats. Biochemical changes were supported by the histological observations, which also revealed that chronic exposure to fluoride causes damage to the myocardium. Results of this study can be taken as an index of cardio-toxicity in rats exposed to water fluoridation. Further, oral supplementation of selenium and vitamin E not only inhibited oxidative stress but also enhanced the activities of antioxidant enzymes. Administration of antioxidants during fluoride exposure significantly overcame cardiac fluoride toxicity and therefore may be a therapeutic strategy for fluorotic victims.
The effect of endotracheal 1% lidocaine administration to reduce emergence phenomenon after general anesthesia

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright c the Korean Society of Anesthesiologists, 2019 The effect of endotracheal 1% lidocaine administration to reduce emergence phenomenon after general anesthesia
Interlocal Service Cooperation and Metropolitan Problems: A Note on Attitudinal and Ecological Forces*

Students of urban politics and administration have long been interested in improving the operating effectiveness of metropolitan areas and their governments. ' While attention has usually been focused upon the desirability of consolidated or regional governments, adoptions of this type of political arrangement have been few. In response to the difficulty of effecting structural change at the metropolitan level, and, in part, as a response to the intractable nature of many area-wide problems, municipalities have increasingly begun to enter into cooperative agreements for delivery of services. Indeed, attacking certain problems through interlocal cooperation has come to be characterized in recent years as fairly common.2
An Adaptive Amplifier System for Wireless Sensor Network Applications

This paper presents an adaptive amplifier that is part of a sensor node in a wireless sensor network. The system presents a target gain that has to bemaintained without direct human intervention despite the presence of faults. In addition, its bandwidthmust be as large as possible. The system is composed of a software-based built-in self-test scheme implemented in the node that checks all the available gains in the amplifiers, a reconfigurable amplifier, and a genetic algorithm (GA) for reconfiguring the node resources that runs on a host computer. We adopt a PSoC device from Cypress for the node implementation. The performance evaluation of the scheme presented is made by adopting four different types of fault models in the amplifier gains. The fault simulation results show that GA finds the target gain with low error, maintains the bandwidth above theminimum tolerable bandwidth, and presents a runtime lower than exhaustive search method.