Miracle-dz/UniFAR-FTUs huggingface dataset:
To What Extent Do Free Healthcare Policies and Performance-Based Financing Reduce Out-of-Pocket Expenditures for Outpatient services? Evidence From a Quasi-experimental Study in Burkina Faso

Background: Burkina Faso has been implementing financing reforms towards universal health coverage (UHC) since 2006. Recently, the country introduced a performance-based financing (PBF) program as well as user fee removal (gratuité) policy for health services aimed at pregnant and lactating women and children under 5. We aim to assess the effect of gratuité and PBF policies on facility-based out-of-pocket expenditures (OOPEs) for outpatient services. Methods: Our study is a controlled pre- and post-test design using healthcare facility data from the PBF program’s impact evaluation collected in 2014 and 2017. We compared OOPE related to primary healthcare use incurred by children under 5 and individuals above 5 to assess the effect of the gratuité policy on OOPE. We further compared OOPE incurred by individuals residing in PBF districts and non-PBF districts to estimate the effect of the PBF on OOPE. Effects were estimated using difference-in-differences models, distinguishing the estimation of the probability of incurring OOPE from the estimation of the magnitude of OOPE using a generalized linear model (GLM). Results: The proportion of children under 5 incurring OOPE declined significantly from 90% in 2014 to 3% in 2017. Concurrently, mean OOPE also decreased. Differences in both the probability of incurring OOPE and mean OOPE between PBF and non-PBF facilities were small. Our difference in differences estimates indicated that gratuité produced an 84% (CI -86%, -81%) reduction in the probability of incurring OOPE and reduced total OOPE by 54% (CI 63%, 42%). We detected no significant effects of PBF, either in reducing the probability of incurring OOPE or in its magnitude. Conclusion: User fee removal is an effective demand-side intervention for enhancing financial accessibility. As a supply-side intervention, PBF appears to have limited effects on reducing financial burden.
Robot-assisted surgery for early uterine corpus cancer: assessing the learning curve

Minimally invasive surgery (MIS) is performed for various human cancers, among which robot-assisted surgery is widely used in the United States, Europe, and other countries. Presently, the total number of robot-assisted surgeries in gynecology exceeds that in urology and any other clinical department. Our group began using robot-assisted surgery for early-stage uterine corpus cancer as from November 2017 and has already performed 40 robot-assisted operations. For this study, we examined the cases of 35 patients, excluding 3 in whom lymphadenectomy was not performed and 2 who underwent additional vaginal wall plasty. Compared with the first 20 cases, the latter 15 had reduced bleeding and shorter operation times. No serious complications were observed in the whole cohort, but infections, including urinary tract infections and peritonitis, were common among the first 20 patients. Although robot-assisted surgery is considered more advantageous for obese patients than laparoscopic and open surgery, we found no significant differences in bleeding, surgical time, or the number of resected lymph nodes between obese patients (Body Mass Index (BMI) ≥ 30) and other patients in this present study. Robot-assisted surgery is expected to be more widely used, and further technical improvements are needed.
Effective Index Method for Modelling Sub-Wavelength Two-Dimensional Periodic Structures

An approximate method is here proposed for modelling two-dimensional sub-wavelength periodic structures. The method is based on the effective index method, where the two-dimensional problem structure is split on two one-dimensional problems, which can be solved by conventional tools. It provides in a natural way the biaxial character of a two-dimensional periodic structure with different period along different directions. The method has been tested by comparing the effective refractive index provided by more exact algorithms with the one provided by the effective index method, showing quite good agreement. Also, the EIM has been used to simulate the reflectance and transmittance behaviour of pyramidal profiles, showing also good agreement with the results supplied by exact calculations using RCWA technique. The main advantages of the method are that it is easy to implement, and the short computational time required to model a given structure.
Structure of the turbulent boundary in drag-reducing pipe flow

The effect of a drag-reducing additive on the structure of wall turbulence in pipe flow was investigated experimentally. Real-time hologram interferometry was used for flow visualization and turbulence measurements. The real-time modulation of interference fringes by a refractive-index enhancer infused into the near-wall flow was recorded by medium-speed motion photography. The spanwise direction and the direction normal to the wall were studied to investigate the ‘streaks’ and ‘bursts’ that originate in the sublayer. A region of the flow was sampled for spatial and temporal correlations of concentration fluctuations to detect the scales of eddy interaction. The addition of 50 p.p.m. by weight of Separan AP30 to water significantly altered the Newtonian wall-flow structure. The drag-reducing additive suppressed the formation of streaks and the eruption of bursts. When compared at the same wall shear, the sublayer period increased over the Newtonian value by a factor almost equal to the ratio of the corresponding non-dimensional streak spacings. These results suggest a stabilized wall layer in the drag-reducing solution as compared with that of the Newtonian solvent, resulting in less turbulence production and reduced frictional drag. The role of the extensional viscosity of the dilute polymer solution is discussed as a possible mechanism for explaining the visualized and measured phenomena.
Adjuvant nab-Paclitaxel + Gemcitabine in Resected Pancreatic Ductal Adenocarcinoma: Results From a Randomized, Open-Label, Phase III Trial

PURPOSE This randomized, open-label trial compared the efficacy and safety of adjuvant nab-paclitaxel + gemcitabine with those of gemcitabine for resected pancreatic ductal adenocarcinoma (ClinicalTrials.gov identifier: NCT01964430). METHODS We assigned 866 treatment-naive patients with pancreatic ductal adenocarcinoma to nab-paclitaxel (125 mg/m2) + gemcitabine (1,000 mg/m2) or gemcitabine alone to one 30-40 infusion on days 1, 8, and 15 of six 28-day cycles. The primary end point was independently assessed disease-free survival (DFS). Additional end points included investigator-assessed DFS, overall survival (OS), and safety. RESULTS Two hundred eighty-seven of 432 patients and 310 of 434 patients completed nab-paclitaxel + gemcitabine and gemcitabine treatment, respectively. At primary data cutoff (December 31, 2018; median follow-up, 38.5 [interquartile range [IQR], 33.8-43 months), the median independently assessed DFS was 19.4 (nab-paclitaxel + gemcitabine) versus 18.8 months (gemcitabine; hazard ratio [HR], 0.88; 95% CI, 0.729 to 1.063; P = .18). The median investigator-assessed DFS was 16.6 (IQR, 8.4-47.0) and 13.7 (IQR, 8.3-44.1) months, respectively (HR, 0.82; 95% CI, 0.694 to 0.965; P = .02). The median OS (427 events; 68% mature) was 40.5 (IQR, 20.7 to not reached) and 36.2 (IQR, 17.7-53.3) months, respectively (HR, 0.82; 95% CI, 0.680 to 0.996; P = .045). At a 16-month follow-up (cutoff, April 3, 2020; median follow-up, 51.4 months [IQR, 47.0-57.0]), the median OS (511 events; 81% mature) was 41.8 (nab-paclitaxel + gemcitabine) versus 37.7 months (gemcitabine; HR, 0.82; 95% CI, 0.687 to 0.973; P = .0232). At the 5-year follow-up (cutoff, April 9, 2021; median follow-up, 63.2 months [IQR, 60.1-68.7]), the median OS (555 events; 88% mature) was 41.8 versus 37.7 months, respectively (HR, 0.80; 95% CI, 0.678 to 0.947; P = .0091). Eighty-six percent (nab-paclitaxel + gemcitabine) and 68% (gemcitabine) of patients experienced grade ≥ 3 treatment-emergent adverse events. Two patients per study arm died of treatment-emergent adverse events. CONCLUSION The primary end point (independently assessed DFS) was not met despite favorable OS seen with nab-paclitaxel + gemcitabine.
Fluorescence spectroscopy and transmission electron microscopy of the same isolated semiconductor nanocrystals

We present a method to establish a correlation between the crystalline structure and the fluorescence properties of isolated semiconductor nanocrystals. By using ultrathin silicon nitride substrates with markers, we have localized and investigated the same particles in both a high-resolution transmission electron microscope (TEM) and a confocal optical microscope. We have found that the observation of strong fluorescence emission does not require single domain particles. Additionally, we have correlated the size and shape of a particle as determined by TEM and its spectral properties like emission wavelength and spectral diffusion.
Effects of the competition between the exchange and dipolar interactions in the spin-wave spectrum of two-dimensional circularly magnetized nanodots

We use a microscopic theory taking into account the dipolar and nearest-neighbour exchange interactions for exploring spin-wave excitations in two-dimensional magnetic dots in the vortex state. Normal modes of different profiles are observed: azimuthal and radial modes, as well as fundamental (quasiuniform) and highly localized modes. We examine the dependence of the frequencies and profiles of these modes on the dipolar-to-exchange interaction ratio and the size of the dot. Special attention is paid to some particular modes, including the lowest mode in the spectrum and the evolution of its profile, and the fundamental mode, the frequency of which proves almost independent of the dipolar-to-exchange interaction ratio. We also provide a selective overview of the experimental, analytical and numerical results from the literature, where different profiles of the lowest mode are reported. We attribute this diversity to the competition between the dipolar and exchange interactions. Finally, we study the hybridization of the modes, show the multi-mode hybridization and explain the selection rules.
30–60 Day Atmospheric Oscillations: Composite Life Cycles of Convection and Circulation Anomalies

Abstract Life cycles of the 30–60 day atmospheric oscillation were examined by compositing 30–60 day filtered NMC global wind analyses (250 mb and 850 mb) and outgoing longwave radiation (OLR) for the years 1979–84. Separate composite life cycles were constructed for the May–October and November–April seasons using empirical orthogonal function analysis of the large-scale divergent wind field (250 mb velocity potential) to define the oscillation's phase. Monte Carlo simulations were used to assess the statistical significance of the composite OLR and vector wind fields. Large-scale (wavenumber one) tropical divergent wind features propagate eastward around the globe throughout the seasonal cycle. The spatial relationships between these propagating circulation features and OLR are shown using sequences of composite maps. Good agreement exists between areas of upper-air divergence and areas of convection inferred from the OLR satellite data. Convection anomalies are smaller over tropical Africa and South Am.
Signatures of naturally induced variability in the atmosphere using multiple reanalysis datasets

A multiple linear regression analysis of nine different reanalysis datasets has been performed to test the robustness of variability associated with volcanic eruptions, the El Niño Southern Oscillation, the Quasi‐Biennial Oscillation and with a specific focus on the 11‐year solar cycle. The analysis covers both the stratosphere and troposphere and extends over the period 1979–2009. The characteristic signals of all four sources of variability are remarkably consistent between the datasets and confirm the responses seen in previous analyses. In general, the solar signatures reported are primarily due to the assimilation of observations, rather than the underlying forecast model used in the reanalysis system. Analysis of the 11‐year solar response in the lower stratosphere confirms the existence of the equatorial temperature maximum, although there is less consistency in the upper stratosphere, probably reflecting the reduced level of assimilated data there. The solar modulation of the polar jet oscillation is also evident, but only significant during February. In the troposphere, vertically banded anomalies in zonal mean zonal winds are seen in all the reanalyses, with easterly anomalies at 30°N and 30°S suggesting a weaker and possibly broader Hadley circulation under solar maximum conditions. This structure is present in the annual signal and is particularly evident in NH wintertime. As well as the ‘top‐down’ solar contribution to Northern Annular Mode variability, we show the potential contribution from the surface conditions allowing for a ‘bottom‐up’ pathway. Finally, the reanalyses are compared with both observed global‐mean temperatures from the Stratospheric Sounding Unit (SSU) and from the latest general circulation models from CMIP‐5. The SSU samples the stratosphere over three different altitudes, and the 11‐year solar cycle fingerprint is identified in these observations using detection and attribution techniques.
Indicators of Immunity in Associated Mycotoxicosis of Cows

The issue of cattle reproduction was and still is one of the main tasks in cattle breeding. Losses of farms from infertility of cows are quite significant and range within 3.19-5.41 per 1 day of infertility. Mycotoxins produced by fungi of the Fusarium family, namely deoxynivalenol (DON) and zearalenone (ZEN) adversely affect not only the functioning of all organs and systems of the cow’s body, but also produce an immunosedative effect. The purpose of this study was to establish the effect of the DON and ZEN complex on the main indicators of the immune response of cows and its correction in a comparative aspect using a feed additive based on zeolite and organic acids and recombinant α-, g-interferons. The study material was the blood of cows (serum and stabilized) sick with mycotoxicosis caused by the association of DON and ZEN. Methods used: photonephelometric using E. coli test culture, spontaneous rosette formation with sheep red blood cells according to M. Jondal, modified method of rosette formation according to M. Wansbrough-Jones, R. Limatibul’s method, simple radial immunodiffusion in gel according to G. Mancini, precipitation in a polyethylene glycol solution according to M. Digeon. Experimental studies were performed on black-spotted cows in farms of the Sumy Oblast. The dynamics of the immune indicators of cows during the development of mycotoxicosis and upon treatment with products zeolite-based, organic acids, and an aqueous solution of recombinant α-, g-interferons were studied. It was found that the indicator of bactericidal, lysozyme, complementary, and phagocytic activity of cow blood serum under treatment increased to the indicator inherent in healthy animals. The dynamics of immunoglobulins in the treatment with zeolite and organic acids and recombinant α-, g-interferons was investigated, and an increase to the level of intact cows was established. It was proved that the indicators of the immune response of cows upon using a feed additive based on zeolite and organic acids at a dose of 2.5 kg per tonne of fodder and a preparation based on an aqueous solution of recombinant α-, g-interferons at a dose of 3 ml per animal were significantly higher
Solid Lipid Microparticles by Spray Congealing of Water/Oil Emulsion: An Effective/Versatile Loading Strategy for a Highly Soluble Drug

Spray congealing technique was exploited to produce solid lipid microparticles (SLMp) loaded with a highly water-soluble drug (metoclopramide hydrochloride) dissolved in the aqueous phase of a water in oil (W/O) emulsion. The use of an emulsion as starting material for a spray congealing treatment is not so frequent. Moreover, for this application, a W/O emulsion with a drug dissolved in water is a totally novel path. A ternary diagram was built to optimize the emulsion composition, a factorial design was used to identify the factors affecting the properties of the microparticles and a Design of Experiment strategy was applied to define the impact of process conditions and formulation variables on the SLMp properties. SLMp were characterized by particle size distribution, morphology, residual moisture, drug content, release behavior, FT-IR analysis and XRPD. The obtained microparticles presented a spherical shape, particle size distribution between 54–98 µm depending on atomizing pressure used during the production step and 2–5% residual moisture 4 days after the preparation. XRPD analysis revealed that lipid polymorphic transition alfa-beta occurs depending on the presence of water. In vitro drug release tests highlighted that all the formulations had a reduced release rate compared to the drug alone. These results suggest that spray congealing of a W/O emulsion could be proposed as a good strategy to obtain SLMp with a high loading of a hydrophilic drug and able to control its release rate.
Functional groups of Afrotropical EPT (Ephemeroptera, Plecoptera and Trichoptera) as bioindicators of semi-urban pollution in the Tsitsa River Catchment, Eastern Cape, South Africa

We examined the distribution patterns of Ephemeroptera, Plecoptera, and Trichoptera functional feeding groups (EPT FFGs) in five streams that drain semi-urban landscapes in the Tsitsa River catchment, Eastern Cape Province of South Africa. We undertook macroinvertebrate and physicochemical analysis over four seasons between 2016 and 2017 at eight sites in three land-use categories (Sites 1, 2 and 3), representing an increasing gradient of semi-urban pollution. Five EPT FFGs (shredders, grazers/scrapers, predators, collector-gatherers and collector-filterers) were fuzzy coded and analyzed using RLQ-R (environmental characteristics of samples), L (taxa distribution across samples) and Q (species traits) and fourth-corner analyses. Physicochemical variables, including phosphate-phosphorus, total inorganic nitrogen and temperature, were the most influential variables that significantly influenced the distribution patterns of EPT FFGs in the Tsitsa River. RLQ and the fourth-corner model revealed varying responses of FFGs to semi-urban pollution. Of the five FFGs, collectors were the most abundant EPT FFGs in the study area, exhibiting disparate responses to disturbances, with collector-gatherers associated with impacted sites and significantly associated with phosphate-phosphorus. On the other hand, collector-filterers decreased with increasing semi-urban disturbance and exhibited a significant negative association with phosphate-phosphorus, total inorganic nitrogen and temperature. Overall, this study provides further insights into the environmental factors that influence the distribution patterns of FFGs in Afrotropical streams and the potential use of FFGs as indicators of anthropogenic pollution in tropical streams and rivers.
Ranking the Recreational Leadership Factors in the Behavioral Dimension and Selection of the Most Ideal Organizational Citizenship Model

: The concepts of management and organization are concepts that have existed throughout human history and are necessary for regular human life. Since people live in groups, management is needed to ensure the order of these groups, to establish a hierarchical structure, and to achieve goals and objectives. In order for these groups to reach their goals and objectives, someone (from within the group or outside of the group) needs to take a managing and guiding role. It is possible to state that these guides are leaders who can gather people around certain goals and objectives with their own beliefs and opinions, rather than being appointed by someone, who can influence and mobilize them. Therefore, the concept of leadership also emerges as a phenomenon that has existed in every period of history. For this reason, leadership styles and behaviors are important issues that need to be focused on, regardless of any field such as production, management, marketing, tourism, engineering. In this study, it is aimed to rank the recreational leadership factors of tourist guides in behavioral dimension according to their importance and to determine the most ideal organizational citizenship behavior model at this point. According to the results of the study, in which Entropy and Grey Incidence Analysis (GIA) methods were used, it was determined that the most important criterion in behavioral recreational leadership factors was “paternalistic leadership”, and the most ideal organizational citizenship model alternative criterion was "altruism". Therefore, it can be said that it would be more beneficial for the tourist guides, who constitute the sample group of the study, to exhibit leadership behavior at the paternalistic level and organizational citizenship behavior in the altruism dimension
The 6Li/7Li ratio in the metal-poor halo dwarfs HD 19445 and HD 84937

High-resolution high signal-to-noise spectra of the Li I 6707 A line in the subdwarfs HD 19445 and HD 84937 have been analyzed for the presence of 6 Li. By measurement of the Li I lines's wavelength and analysis of its profile, the atmosphere of HD 84937 is shown to have a small amount of 6 Li: R= 6 Li/Li=0.05±0.02. For HD 19445, an upper limit is set of R<0.02. The presence of 6 Li in HD 84937 is consistent with the mild depletion of 6 Li predicted by standard (nonrotating) models and the initial presence of 6 Li in the halo produced by (principally) α-on-α fusion reactions involving the cosmic rays that are required to account for the Be and B observed in subdwarfs