995 research outputs found

    Influence of real-time information provided by a mobile phone on the management of rural water supply quality

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    In South Africa, access to safe drinking water is a human right that is explicitly stated in the constitution. Most metro municipalities are meeting the drinking water quality targets, but the smaller rural environments are failing to provide water of acceptable drinking water quality. Reasons contributing to the high incidence of unacceptable water quality are the rural municipalities' inadequate institutional capacity and lack of management and monitoring of drinking water services. This study investigates the possibilities of supporting rural water service institutions to manage their remote water supply schemes better by addressing the challenge of distance monitoring. Through the creation of real-time information flow between the water service authorities and the water supply caretakers in remote villages, it is to be tested if better information can be received and the status of the rural water supply quality can be monitored. The improvement of information flow is based on introducing a mobile phone application. The hypothesis is that through improving the information flow, decisions on water supply management will be improved. Case study research was conducted in rural municipalities situated in the Northern Cape Province and Eastern Cape Province of South Africa. Four different municipalities were chosen to reveal the diverse municipal set-up and different challenges facing rural municipalities. Data was gathered through interviews conducted with the municipal mangers over a seven month period, as well as through field investigations. The findings reveal that the mobile reporting system has improved information flow from water supply caretakers to government service providers. The mobile application allowed for distance monitoring of rural water supply schemes. It has helped address the municipalities' institutional capacity problems by improving access to information relevant to decision making. Through the data records displayed on the mobile application, municipal mangers were able to track the supply caretakers' performance and subsequently hold them accountable. Through an increase in data availability, water quality failures were easily identified, resulting in improved confidence in the quality of rural water supply. The access to real-time information has improved the monitoring and communication of rural water quality. Early intervention and the management of non-compliance improved. The mobile technology provided the municipal managers with a tool to monitor their rural water supply schemes more regularly, but it also became apparent that the management of such schemes only improved if relevant action was taken based on the information received. Greater improvement was seen in municipalities where the tool was used consistently, where time was set aside to follow up on data warnings and protocols existed to follow up on non-compliance issues. Management of the resources did not improve in areas where management staff was severely overstretched and response strategies to problems were non-existent before the implementation of the tool

    Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

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    Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

    BLOOM: A 176B-Parameter Open-Access Multilingual Language Model

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    Large language models (LLMs) have been shown to be able to perform new tasks based on a few demonstrations or natural language instructions. While these capabilities have led to widespread adoption, most LLMs are developed by resource-rich organizations and are frequently kept from the public. As a step towards democratizing this powerful technology, we present BLOOM, a 176B-parameter open-access language model designed and built thanks to a collaboration of hundreds of researchers. BLOOM is a decoder-only Transformer language model that was trained on the ROOTS corpus, a dataset comprising hundreds of sources in 46 natural and 13 programming languages (59 in total). We find that BLOOM achieves competitive performance on a wide variety of benchmarks, with stronger results after undergoing multitask prompted finetuning. To facilitate future research and applications using LLMs, we publicly release our models and code under the Responsible AI License

    Dissecting the Shared Genetic Architecture of Suicide Attempt, Psychiatric Disorders, and Known Risk Factors

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    Background Suicide is a leading cause of death worldwide, and nonfatal suicide attempts, which occur far more frequently, are a major source of disability and social and economic burden. Both have substantial genetic etiology, which is partially shared and partially distinct from that of related psychiatric disorders. Methods We conducted a genome-wide association study (GWAS) of 29,782 suicide attempt (SA) cases and 519,961 controls in the International Suicide Genetics Consortium (ISGC). The GWAS of SA was conditioned on psychiatric disorders using GWAS summary statistics via multitrait-based conditional and joint analysis, to remove genetic effects on SA mediated by psychiatric disorders. We investigated the shared and divergent genetic architectures of SA, psychiatric disorders, and other known risk factors. Results Two loci reached genome-wide significance for SA: the major histocompatibility complex and an intergenic locus on chromosome 7, the latter of which remained associated with SA after conditioning on psychiatric disorders and replicated in an independent cohort from the Million Veteran Program. This locus has been implicated in risk-taking behavior, smoking, and insomnia. SA showed strong genetic correlation with psychiatric disorders, particularly major depression, and also with smoking, pain, risk-taking behavior, sleep disturbances, lower educational attainment, reproductive traits, lower socioeconomic status, and poorer general health. After conditioning on psychiatric disorders, the genetic correlations between SA and psychiatric disorders decreased, whereas those with nonpsychiatric traits remained largely unchanged. Conclusions Our results identify a risk locus that contributes more strongly to SA than other phenotypes and suggest a shared underlying biology between SA and known risk factors that is not mediated by psychiatric disorders.Peer reviewe

    Finishing the euchromatic sequence of the human genome