Health inequalities and development plans in Iran: An analysis of the past three decades (1984–2010)

Introduction: Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues. Methods: This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984–2010. The analysis included 308,735 urban and 342,532 rural households. Results: The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time. Conclusions: According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized

Uniform non-stoichiometric titanium nitride thin films for improved kinetic inductance detector array

We describe the fabrication of homogeneous sub-stoichiometric titanium nitride films for microwave kinetic inductance detector (mKID) arrays. Using a 6 inch sputtering target and a homogeneous nitrogen inlet, the variation of the critical temperature over a 2 inch wafer was reduced to <25 %. Measurements of a 132-pixel mKID array from these films reveal a sensitivity of 16 kHz/pW in the 100 GHz band, comparable to the best aluminium mKIDs. We measured a noise equivalent power of NEP = 3.6e-15 W/Hz^(1/2). Finally, we describe possible routes to further improve the performance of these TiN mKID arrays.Comment: 7 pages, 4 figures, submitted to Journal of low temperature physics, Proceedings of LTD-1

Anomalous response of superconducting titanium nitride resonators to terahertz radiation

We present an experimental study of KIDs fabricated of atomic layer deposited TiN films, and characterized at radiation frequencies of $350$~GHz. The responsivity to radiation is measured and found to increase with increasing radiation powers, opposite to what is expected from theory and observed for hybrid niobium titanium nitride / aluminium (NbTiN/Al) and all-aluminium (all-Al) KIDs. The noise is found to be independent of the level of the radiation power. The noise equivalent power (NEP) improves with higher radiation powers, also opposite to what is observed and well understood for hybrid NbTiN/Al and all-Al KIDs. We suggest that an inhomogeneous state of these disordered superconductors should be used to explain these observations

Impact of classical strain improvement of penicillium rubens on amino acid metabolism during β-Lactam production

To produce high levels of β-lactams, the filamentous fungus Penicillium rubens (previously named Penicillium chrysogenum) has been subjected to an extensive classical strain improvement (CSI) program during the last few decades. This has led to the accumulation of many mutations that were spread over the genome. Detailed analysis reveals that several mutations targeted genes that encode enzymes involved in amino acid metabolism, in particular biosynthesis of L-cysteine, one of the amino acids used for β-lactam production. To examine the impact of the mutations on enzyme function, the respective genes with and without the mutations were cloned and expressed in Escherichia coli, purified, and enzymatically analyzed. Mutations severely impaired the activities of a threonine and serine deaminase, and this inactivates metabolic pathways that compete for L-cysteine biosynthesis. Tryptophan synthase, which converts L-serine into L-tryptophan, was inactivated by a mutation, whereas a mutation in 5-aminolevulinate synthase, which utilizes glycine, was without an effect. Importantly, CSI caused increased expression levels of a set of genes directly involved in cysteine biosynthesis. These results suggest that CSI has resulted in improved cysteine biosynthesis by the inactivation of the enzymatic conversions that directly compete for resources with the cysteine biosynthetic pathway, consistent with the notion that cysteine is a key component during penicillin production. IMPORTANCE Penicillium rubens is an important industrial producer of β-lactam antibiotics. High levels of penicillin production were enforced through extensive mutagenesis during a classical strain improvement (CSI) program over 70 years. Several mutations targeted amino acid metabolism and resulted in enhanced L-cysteine biosynthesis. This work provides a molecular explanation for the interrelation between secondary metabolite production and amino acid metabolism and how classical strain improvement has resulted in improved production strains

NIKA2: a mm camera for cluster cosmology

Galaxy clusters constitute a major cosmological probe. However, Planck 2015 results have shown a weak tension between CMB-derived and cluster-derived cosmological parameters. This tension might be due to poor knowledge of the cluster mass and observable relationship. As for now, arcmin resolution Sunyaev-Zeldovich (SZ) observations ({\it e.g.} SPT, ACT and Planck) only allowed detailed studies of the intra cluster medium for low redshift clusters ($z0.5$) high resolution and high sensitivity SZ observations are needed. With both a wide field of view (6.5 arcmin) and a high angular resolution (17.7 and 11.2 arcsec at 150 and 260 GHz), the NIKA2 camera installed at the IRAM 30-m telescope (Pico Veleta, Spain) is particularly well adapted for these observations. The NIKA2 SZ observation program will map a large sample of clusters (50) at redshifts between 0.5 and 0.9. As a pilot study for NIKA2, several clusters of galaxies have been observed with the pathfinder, NIKA, at the IRAM 30-m telescope to cover the various configurations and observation conditions expected for NIKA2.

Nika2: A mm camera for cluster cosmology

Galaxy clusters constitute a major cosmological probe. However, Planck 2015 results have shown a weak tension between CMB-derived and cluster-derived cosmological parameters. This tension might be due to poor knowledge of the cluster mass and observable relationship. As for now, arcmin resolution Sunyaev-Zeldovich (SZ) observations (e.g. SPT, ACT and Planck) only allowed detailed studies of the intra cluster medium for low redshift clusters (z 0:5) high resolution and high sensitivity SZ observations are needed. With both a wide field of view (6.5 arcmin) and a high angular resolution (17.7 and 11.2 arcsec at 150 and 260 GHz), the NIKA2 camera installed at the IRAM 30-m telescope (Pico Veleta, Spain) is particularly well adapted for these observations. The NIKA2 SZ observation program will map a large sample of clusters (50) at redshifts between 0.5 and 0.9. As a pilot study for NIKA2, several clusters of galaxies have been observed with the pathfinder, NIKA, at the IRAM 30-m telescope to cover the various configurations and observation conditions expected for NIKA2

Multispecies methods, technologies for play

School of Desig

The NIKA2 large-field-of-view millimetre continuum camera for the 30 m IRAM telescope

Context. Millimetre-wave continuum astronomy is today an indispensable tool for both general astrophysics studies (e.g. star formation, nearby galaxies) and cosmology (e.g. cosmic microwave background and high-redshift galaxies). General purpose, large-field-of-view instruments are needed to map the sky at intermediate angular scales not accessible by the high-resolution interferometers (e.g. ALMA in Chile, NOEMA in the French Alps) and by the coarse angular resolution space-borne or ground-based surveys (e.g. Planck, ACT, SPT). These instruments have to be installed at the focal plane of the largest single-dish telescopes, which are placed at high altitude on selected dry observing sites. In this context, we have constructed and deployed a three-thousand-pixel dual-band (150 GHz and 260 GHz, respectively 2 mm and 1.15 mm wavelengths) camera to image an instantaneous circular field-of-view of 6.5 arcmin in diameter, and configurable to map the linear polarisation at 260 GHz. Aims. First, we are providing a detailed description of this instrument, named NIKA2 (New IRAM KID Arrays 2), in particular focussing on the cryogenics, optics, focal plane arrays based on Kinetic Inductance Detectors, and the readout electronics. The focal planes and part of the optics are cooled down to the nominal 150 mK operating temperature by means of an adhoc dilution refrigerator. Secondly, we are presenting the performance measured on the sky during the commissioning runs that took place between October 2015 and April 2017 at the 30-m IRAM telescope at Pico Veleta, near Granada (Spain). Methods. We have targeted a number of astronomical sources. Starting from beam-maps on primary and secondary calibrators we have then gone to extended sources and faint objects. Both internal (electronic) and on-the-sky calibrations are applied. The general methods are described in the present paper. Results. NIKA2 has been successfully deployed and commissioned, performing in-line with expectations. In particular, NIKA2 exhibits full width at half maximum angular resolutions of around 11 and 17.5 arcsec at respectively 260 and 150 GHz. The noise equivalent flux densities are, at these two respective frequencies, 33±2 and 8±1 mJy s1/2. A first successful science verification run was achieved in April 2017. The instrument is currently offered to the astronomy community and will remain available for at least the following ten years

Implementation of prehabilitation in colorectal cancer surgery:qualitative research on how to strengthen facilitators and overcome barriers

Purpose Prehabilitation is increasingly offered to patients with colorectal cancer (CRC) undergoing surgery as it could prevent complications and facilitate recovery. However, implementation of such a complex multidisciplinary intervention is challenging. This study aims to explore perspectives of professionals involved in prehabilitation to gain understanding of barriers or facilitators to its implementation and to identify strategies to successful operationalization of prehabilitation. Methods In this qualitative study, semi-structured interviews were performed with healthcare professionals involved in prehabilitation for patients with CRC. Prehabilitation was defined as a preoperative program with the aim of improving physical fitness and nutritional status. Parallel with data collection, open coding was applied to the transcribed interviews. The Ottawa Model of Research Use (OMRU) framework, a comprehensive interdisciplinary model guide to promote implementation of research findings into healthcare practice, was used to categorize obtained codes and structure the barriers and facilitators into relevant themes for change. Results Thirteen interviews were conducted. Important barriers were the conflicting scientific evidence on (cost-)effectiveness of prehabilitation, the current inability to offer a personalized prehabilitation program, the complex logistic organization of the program, and the unawareness of (the importance of) a prehabilitation program among healthcare professionals and patients. Relevant facilitators were availability of program coordinators, availability of physician leadership, and involving skeptical colleagues in the implementation process from the start. Conclusions Important barriers to prehabilitation implementation are mainly related to the intervention being complex, relatively unknown and only evaluated in a research setting. Therefore, physicians' leadership is needed to transform care towards more integration of personalized prehabilitation programs. Implications for cancer survivors By strengthening prehabilitation programs and evidence of their efficacy using these recommendations, it should be possible to enhance both the pre- and postoperative quality of life for colorectal cancer patients during survivorship