ZnO layers deposited by Atomic Layer Deposition

The structure of 40 nm thick epitaxial ZnO layers grown on single crystalline sapphire and GaN substrates by atomic layer deposition has been studied using transmission electron microscopy. The growth is carried out between 150°C and 300°C without any buffer layer using di-ethyl zinc and water precursors. The ZnO layer on sapphire is found to be polycrystalline, which is probably due to the large misfit (~15 %) and the relatively low deposition temperature. However, the small misfit (~1.8 %) between the ZnO layer that is deposited on GaN at 300°C resulted in a high quality single crystalline layer

Preferences of Hungarian consumers for quality, access and price attributes of health care services — result of a discrete choice experiment

In 2010, a household survey was carried out in Hungary among 1037 respondents to study consumer preferences and willingness to pay for health care services. In this paper, we use the data from the discrete choice experiments included in the survey, to elicit the preferences of health care consumers about the choice of health care providers. Regression analysis is used to estimate the effect of the improvement of service attributes (quality, access, and price) on patients’ choice, as well as the differences among the socio-demographic groups. We also estimate the marginal willingness to pay for the improvement in attribute levels by calculating marginal rates of substitution. The results show that respondents from a village or the capital, with low education and bad health status are more driven by the changes in the price attribute when choosing between health care providers. Respondents value the good skills and reputation of the physician and the attitude of the personnel most, followed by modern equipment and maintenance of the office/hospital. Access attributes (travelling and waiting time) are less important. The method of discrete choice experiment is useful to reveal patients’ preferences, and might support the development of an evidence-based and sustainable health policy on patient payments

Bora-induced currents corresponding to different synoptic conditions above the Adriatic

International audienceThe Bora wind field is characterised by strong vorticity and divergence. Several numerical experiments, in which an oceanographic model was forced with northeasterly winds having climatological alongshore variability, were performed in order to study the influence of spatial variability in the bora wind field on the surface currents in the northern Adriatic. Numerical model results showed that during bora episodes with lower speeds and fast offshore decay surface currents along transect Rovinj - Po River are predominantly in the downwind direction. On the other hand, during bora episodes with strong intensity and slow offshore decay, a cyclonic gyre due to the pronounced bora alongshore variability is formed in the northernmost part of the Adriatic Sea and the studied transect is influenced by the counter currents. Moreover, bora having a high speed and a short offshore range produces the same effect in the eastern part of the Rovinj - Po River transect as low-speed bora characterised by slow offshore decay. Eulerian current measurements performed in the northern Adriatic during bora episodes characterised by different synoptic conditions supported the numerical model findings. Surface currents during the bora episode of 8-11 February 1984 were directed downwind, whereas during the episode of 12-19 February 1984 they were directed upwind. The first episode was characterised by a deep bora layer with cyclonic activity over the western Mediterranean and Genoa Bay, whereas the second one was accompanied by temperature inversion and a southwesterly tropospheric wind above a shallow bora layer. According to the hydraulic theory developed by Smith (1985), an observed descent of isentropes during the second bora episode led to the stronger acceleration in the bora layer and its larger offshore extent. Different offshore bora decays during studied events were confirmed by a comparison of the wind data originating from the meteorological stations positioned on the opposite Adriatic coasts

Trading between perceived risks and benefits related to biosimilar biological treatment in Crohn’s disease; discrete choice experiment among gastroenterologists

Objective: The objective of the study is to explore preferences of gastroenterologists for biosimilar drugs in Crohn’s Disease and reveal trade-offs between the perceived risks and benefits related to biosimilar drugs. Method: Discrete choice experiment was carried out involving 51 Hungarian gastroenterologists in May, 2014. The following attributes were used to describe hypothetical choice sets: 1) type of the treatment (biosimilar/originator) 2) severity of disease 3) availability of continuous medicine supply 4) frequency of the efficacy check-ups. Multinomial logit model was used to differentiate between three attitude types: 1) always opting for the originator 2) willing to consider biosimilar for biological-naïve patients only 3) willing to consider biosimilar treatment for both types of patients. Conditional logit model was used to estimate the probabilities of choosing a given profile. Results: Men, senior consultants, working in IBD center and treating more patients are more likely to willing to consider biosimilar for biological-naïve patients only. Treatment type (originator/biosimilar) was the most important determinant of choice for patients already treated with biologicals, and the availability of continuous medicine supply in the case biological-naïve patients. The probabilities of choosing the biosimilar with all the benefits offered over the originator under current reimbursement conditions are 89% vs 11% for new patients, and 44% vs 56% for patients already treated with biological. Conclusions: Gastroenterologists were willing to trade between perceived risks and benefits of biosimilars. The continuous medical supply would be one of the major benefits of biosimilars. However, benefits offered in the scenarios do not compensate for the change from the originator to the biosimilar treatment of patients already treated with biologicals

Influence of monsoon regime and microclimate on soil respiration in the tropical forests

The consequence of precipitation and how environmental factors influence soil respiration remain poorly understood in the tropical forest ecosystems under a monsoon climate in Malaysia. This study was conducted in a recovering tropical lowland Dipterocarpus forest in Peninsular Malaysia, and its monthly variations were examined in association with changing precipitation. Soil respiration was measured using a continuous open flow chamber system connected to a multi gas-handling unit and an infrared gas analyser. The aim of this study was to determine the effects of the monsoon period and microclimate of the tropical region on soil respiration. The average monthly soil respiration rates were 152.79 to 528.67, 120.97 to 500.73, 106.77 to 472.89, 122.89 to 453.89 and 120.33 to 434.89 mg m⁻² h⁻¹ in the respective months from September to January. The emission rate varied across the days and months, with the highest value recorded between September and October, and then gradually decreasing from November to January. Soil temperature explained more than 90% of the soil respiration rate whereas precipitation had a major effect during the monsoon regime. Soil organic carbon (SOC), total organic carbon (TOC), soil organic carbon stock (SOCstock), forest biomass, carbon to nitrogen ratio (C/N) and soil pH were found to vary in considerable amounts, provide nutrients and the environment favourable for microorganism activities, leading to emission of soil CO₂. The low values of soil respiration rate between November and January were due not only on the amount of soil moisture and water potential but also on the intensity and frequency of precipitation. Therefore, these results indicate that the monsoon regime can significantly alter the emission of soil CO₂ and influence the microclimatic conditions and other environmental factors

Determinants of biological drug survival in rheumatoid arthritis:Evidence from a Hungarian rheumatology center over 8 years of retrospective data

OBJECTIVE: To compare drug survival of biological therapies in patients with rheumatoid arthritis (RA), and analyze the determinants of discontinuation probabilities and switches to other biological therapies. MATERIALS AND METHODS: Consecutive RA patients initiating first biological treatment in one rheumatology center between 2006 and 2013 were included. Log-rank test was used to analyze the differences between the survival curves of different biological drugs. Cox regression was applied to analyze the discontinuation due to inefficacy, the occurrence of adverse events, or to any reasons. RESULTS: A total of 540 patients were included in the analysis. The most frequently used first-line biological treatments were infliximab (N=176, 33%), adalimumab (N=150, 28%), and etanercept (N=132, 24%). Discontinuation of first tumor necrosis factor-alpha (TNF-α) treatment was observed for 347 (64%) patients, due to inefficacy (n=209, 60%), adverse events (n=103, 30%), and other reasons (n=35, 10%). Drug survival rates for TNF-α and non-TNF-α therapies were significantly different, and were in favor of non-TNF-α therapies. Every additional number of treatment significantly increased the risk of inefficacy by 27% (p<0.001) and of adverse events by 35% (p=0.002). After the discontinuation of the initial TNF-α treatment, switching to rituximab and tocilizumab was associated with significantly longer treatment duration than switching to a second TNF-α. The non-TNF-α therapies resulted in significantly longer treatment duration, due to both less adverse events and longer maintenance of effectiveness. CONCLUSION: Non-TNF-α therapies resulted in significantly longer treatment duration, and lost their effectiveness later. Increase in the number of switches significantly increased the risk of discontinuation of any biological therapy

Quality of Life and Costs in Parkinson's Disease: A Cross Sectional Study in Hungary.

BACKGROUND: Patient reported outcomes and costs of illness are useful to capture some of the multiple effects of a disease and its treatments. Our aim was to assess quality of life (QoL) and costs of Parkinson's disease (PD) in Hungary, and to analyze their associations. METHODS: A cross-sectional questionnaire survey was conducted in one neurology university clinic. Clinical characteristics, PD related resource utilizations and productivity loss in the past 12 months were recorded; the Hoehn&Yahr (HY) scale, PDQ-39 and EQ-5D questionnaires were applied. Cost calculation was performed from the societal perspective. RESULTS: 110 patients (34.5% female) were involved with mean age of 63.3 (SD = 11.3) and disease duration of 8.2 (SD = 5.8) years. PDQ-39 summary score was 48.1 (SD = 13.4). The average EQ-5D score was 0.59 (SD = 0.28), and was significantly lower than the population norm in age-groups 45-74. The correlation was significant between EQ-5D and PDQ-39 (-0.47, p = 0.000), the HY scale and EQ-5D (-0.3416, p = 0.0008) and PDQ-39 (0.3419, p = 0.0006) scores. The total mean cost was euro6030.2 (SD = 6163.0)/patient/year (direct medical 35.7%, direct non-medical 29.4%, indirect cost 34.9%). A one year increase in disease duration and 0.1 decrease of the EQ-5D utility score increase the yearly costs by 8 to 10%, and 7.8%, respectively. The effect of the PDQ-39 score on total cost was not significant. CONCLUSIONS: Disease severity and public health importance of PD are clearly demonstrated by the magnitude of QoL loss. PD-related costs are substantial, but are much lower in Hungary than in Western European countries. Disease duration and EQ-5D score are significant proxy of costs