Lack of a Will or of a Way? Taking a Capability Approach for Analysing Disability Policy Shortcomings and Ensuring Programme Impact in Afghanistan

The present paper attempts to analyse some of the shortcomings that have impeded efforts in the field of disability in Afghanistan. After an overview of recent disability initiatives, this article presents elements that have contributed to the limited impact. The context of a Conflict Affected Fragile State (CAFS) makes particularly intricate the development of state-capacity as well as the delivery of basic services for the population. To overcome identified gaps, it is argued that Amartya Sen’s Capability Approach (CA) constitutes a relevant framework for designing disability policy and implementation. While the definition of human development has evolved considerably over the past decade, the translation of this change often remains at the theoretical level, without any visible impact on the policy-making process and in terms of well-being. We argue that one reason for this gap is the paucity of knowledge, and the insufficient focus placed on enhancing the agency of vulnerable groups. Through the example of the National Disability Survey in Afghanistan (NDSA) the paper discusses the need for scientific based knowledge and the challenges of a research initiative based on the Capability Approach to inform policy design and implementation: design of research tools and methodology for analysing disability issues

Poverty, vulnerability, and provision of healthcare in Afghanistan

This paper presents findings on conditions of healthcare delivery in Afghanistan. There is an ongoing debate about barriers to healthcare in low-income as well as fragile states. In 2002, the Government of Afghanistan established a Basic Package of Health Services (BPHS), contracting primary healthcare delivery to non-state providers. The priority was to give access to the most vulnerable groups: women, children, disabled persons, and the poorest households. In 2005, we conducted a nationwide survey, and using a logistic regression model, investigated provider choice. We also measured associations between perceived availability and usefulness of healthcare providers. Our results indicate that the implementation of the package has partially reached its goal: to target the most vulnerable. The pattern of use of healthcare provider suggests that disabled people, female-headed households, and poorest households visited health centres more often (during the year preceding the survey interview). But these vulnerable groups faced more difficulties while using health centres, hospitals as well as private providers and their outof-pocket expenditure was higher than other groups. In the model of provider choice, time to travel reduces the likelihood for all Afghans of choosing health centres and hospitals. We situate these findings in the larger context of current debates regarding healthcare delivery for vulnerable populations in fragile state environments. The ‘scalingup process’ is faced with several issues that jeopardize the objective of equitable access: cost of care, coverage of remote areas, and competition from profit-orientated providers. To overcome these structural barriers, we suggest reinforcing processes of transparency, accountability and participation

SpacTor-T5: Pre-training T5 Models with Span Corruption and Replaced Token Detection

Pre-training large language models is known to be extremely resource intensive and often times inefficient, under-utilizing the information encapsulated in the training text sequences. In this paper, we present SpacTor, a new training procedure consisting of (1) a hybrid objective combining span corruption (SC) and token replacement detection (RTD), and (2) a two-stage curriculum that optimizes the hybrid objective over the initial $\tau$ iterations, then transitions to standard SC loss. We show empirically that the effectiveness of the hybrid objective is tied to the two-stage pre-training schedule, and provide extensive analysis on why this is the case. In our experiments with encoder-decoder architectures (T5) on a variety of NLP tasks, SpacTor-T5 yields the same downstream performance as standard SC pre-training, while enabling a 50% reduction in pre-training iterations and 40% reduction in total FLOPs. Alternatively, given the same amount of computing budget, we find that SpacTor results in significantly improved downstream benchmark performance.Comment: 9+13 pages, 5 figure

High fluoroquinolone resistance proportions among multidrug-resistant tuberculosis driven by dominant L2 Mycobacterium tuberculosis clones in the Mumbai Metropolitan Region

Background: Multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) strains are a serious health problem in India, also contributing to one-fourth of the global MDR tuberculosis (TB) burden. About 36% of the MDR MTBC strains are reported fluoroquinolone (FQ) resistant leading to high pre-extensively drug-resistant (pre-XDR) and XDR-TB (further resistance against bedaquiline and/or linezolid) rates. Still, factors driving the MDR/pre-XDR epidemic in India are not well defined. Methods: In a retrospective study, we analyzed 1852 consecutive MTBC strains obtained from patients from a tertiary care hospital laboratory in Mumbai by whole genome sequencing (WGS). Univariate and multivariate statistics was used to investigate factors associated with pre-XDR. Core genome multi locus sequence typing, time scaled haplotypic density (THD) method and homoplasy analysis were used to analyze epidemiological success, and positive selection in different strain groups, respectively. Results: In total, 1016 MTBC strains were MDR, out of which 703 (69.2%) were pre-XDR and 45 (4.4%) were XDR. Cluster rates were high among MDR (57.8%) and pre-XDR/XDR (79%) strains with three dominant L2 (Beijing) strain clusters (Cl 1–3) representing half of the pre-XDR and 40% of the XDR-TB cases. L2 strains were associated with pre-XDR/XDR-TB (P < 0.001) and, particularly Cl 1–3 strains, had high first-line and FQ resistance rates (81.6–90.6%). Epidemic success analysis using THD showed that L2 strains outperformed L1, L3, and L4 strains in short- and long-term time scales. More importantly, L2 MDR and MDR + strains had higher THD success indices than their not-MDR counterparts. Overall, compensatory mutation rates were highest in L2 strains and positive selection was detected in genes of L2 strains associated with drug tolerance (prpB and ppsA) and virulence (Rv2828c). Compensatory mutations in L2 strains were associated with a threefold increase of THD indices, suggesting improved transmissibility. Conclusions: Our data indicate a drastic increase of FQ resistance, as well as emerging bedaquiline resistance which endangers the success of newly endorsed MDR-TB treatment regimens. Rapid changes in treatment and control strategies are required to contain transmission of highly successful pre-XDR L2 strains in the Mumbai Metropolitan region but presumably also India-wide

A practical perspective on the potential of rechargeable Mg batteries

Emerging energy storage systems based on abundant and cost-effective materials are key to overcome the global energy and climate crisis of the 21st century. Rechargeable Magnesium Batteries (RMB), based on Earth-abundant magnesium, can provide a cheap and environmentally responsible alternative to the benchmark Li-ion technology, especially for large energy storage applications. Currently, RMB technology is the subject of intense research efforts at laboratory scale. However, these emerging approaches must be placed in a real-world perspective to ensure that they satisfy key technological requirements. In an attempt to bridge the gap between laboratory advancements and industrial development demands, herein, we report the first non-aqueous multilayer RMB pouch cell prototypes and propose a roadmap for a new advanced RMB chemistry. Through this work, we aim to show the great unrealized potential of RMBs.This work was funded by European Union's Horizon 2020 research and innovation program under the FET Proactive call with grant agreement no 824066 via the “E-MAGIC” project

A practical perspective on the potential of rechargeable Mg batteries

Emerging energy storage systems based on abundant and cost-effective materials are key to overcome the global energy and climate crisis of the 21st century. Rechargeable Magnesium Batteries (RMB), based on Earth-abundant magnesium, can provide a cheap and environmentally responsible alternative to the benchmark Li-ion technology, especially for large energy storage applications. Currently, RMB technology is the subject of intense research efforts at laboratory scale. However, these emerging approaches must be placed in a real-world perspective to ensure that they satisfy key technological requirements. In an attempt to bridge the gap between laboratory advancements and industrial development demands, herein, we report the first non-aqueous multilayer RMB pouch cell prototypes and propose a roadmap for a new advanced RMB chemistry. Through this work, we aim to show the great unrealized potential of RMBs

The CHORUS neutrino oscillation search experiment

The CHORUS experiment has successfully finished run I (320~000 recorded \numu\ CC in 94/95) and performed half of run II (225~000 \numu\ CC in 96). The analysis chain was exercised on a small data sample for the muonic \tdecay\ search using for the first time fully automatic emulsion scanning. This pilot analysis, resulting in a limit \sintth \leq 3 \cdot 10^{-2}, confirms that the CHORUS proposal sensitivity (\sintth \leq 3 \cdot 10^{-4}) is within reach in two years