Estimating willingness to pay for an improved service delivery to patients referring namazi hospital chemical therapy ward in Iran using contingent valuation

Objective: The aim of this study was to estimate patients' willingness to pay (WTP) for improving the quality of non-medical aspect in Namazi hospital patients chemotherapy an assessment using the contingent valuation method (CVM). Patients and Methods: This was an applied, cross-sectional and analytical-descriptive study carried out in Iran, Shiraz in 2013. A sample of 185 patients was determined using random sampling. Multiple choice questions and follow-up open-ended questions were employed to elicit patients' WTP. The question asked patients would have to pay for this improving their own pocket. linear regression were used to Econometrically estimate the maximum WTP using STATA 11 software. Results: The results of this study indicated that 31 were male and 69 were female and the adjusted mean WTP was PPPUS15 for pat maximum amount of willing to pay was for to get the same quality service in own city respondents (PPPUS16) and minimum amount of willing to pay was to get advice of experienced nurse(PPPUS10) Patients were willing to pay more if their satisfaction with two attributes of care were increased. The cancer type and income taking care of you are significant factors influencing a patient's WTP. Conclusions: In the worst socio-economic conditions of the people were willing to pay to improve the reducing wait times in receiving a drug and get the same quality service in own city respondents. In Future efforts Health policymakers should consider the ability to pay when making their decision. © 2018 Asian Pacific Organization for Cancer Prevention

Observations of large-amplitude, parallel, electrostatic waves associated with the Kelvin-Helmholtz instability by the magnetospheric multiscale mission

On 8 September 2015, the four Magnetospheric Multiscale spacecraft encountered a Kelvin-Helmholtz unstable magnetopause near the dusk flank. The spacecraft observed periodic compressed current sheets, between which the plasma was turbulent. We present observations of large-amplitude (up to 100 mV/m) oscillations in the electric field. Because these oscillations are purely parallel to the background magnetic field, electrostatic, and below the ion plasma frequency, they are likely to be ion acoustic-like waves. These waves are observed in a turbulent plasma where multiple particle populations are intermittently mixed, including cold electrons with energies less than 10 eV. Stability analysis suggests a cold electron component is necessary for wave growth

Seven Sisters: a mission to study fundamental plasma physical processes in the solar wind and a pathfinder to advance space weather prediction

This paper summarizes the Seven Sisters solar wind mission concept and the outstanding science questions motivating the mission science objectives. The Seven Sisters mission includes seven individual spacecraft designed to uncover fundamental physical processes in the solar wind and provides up to ≈ 2 days of advanced space weather warnings for 550 Earth days during the mission. The mission will collect critical measurements of the thermal and suprathermal plasma and magnetic fields, utilizing, for the first time, Venus–Sun Lagrange points. The multi-spacecraft configuration makes it possible to distinguish between spatial and temporal changes, define gradients, and quantify cross-scale transport in solar wind structures. Seven Sisters will determine the 3-D structure of the solar wind and its transient phenomena and their evolution in the inner heliosphere. Data from the Seven Sisters mission will allow the identification of physical processes and the quantification of the relative contribution of different mechanisms responsible for suprathermal particle energization in the solar wind

MicroRNA-21 and microRNA-29a modulate the expression of collagen in dermal fibroblasts of patients with systemic sclerosis

MicroRNAs (miRNAs) are well-known candidates for modulating the dysregulated signaling pathways during fibrosis. In this study, we investigated the expression pattern of 16 miRNAs, which have previously been confirmed or predicted to target genes involved in extracellular matrix (ECM) homeostasis. Primary culture of dermal fibroblasts was obtained from skin biopsies of diffused cutaneous SSc (dcSSc) patients and healthy controls. Expression of let-7a, miR-1, miR-15a, miR-17, miR-19a, miR-20a, miR-21, miR-27b, miR-26a, miR-29a, miR-29b, miR29c, miR-141, miR-125a-5p, miR-193a-3p, and miR-200a were quantified by Real-time PCR. Functional analysis of microRNAs was performed using synthetic oligonucleotides. To further confirm the pro- or anti-fibrotic effects of miRNAs, normal fibroblasts were treated with 10 ng/mL of transforming growth factor (TGF)-β to generate an in vitro model of dermal fibrosis. miR-21 and miR-29a were upregulated and downregulated, respectively, in both dcSSc and TGF-β-treated fibroblasts. We observed that restoration of miR-29a expression or blockade of miR-21 function negatively affected collagen production. COL1A1 expression in SSc fibroblasts is more sensitive to changes of miR-29a and miR-21 expression in compare to normal fibroblasts. miR-29a alone was effective to decrease TGF-β-induced collagen production in dermal fibroblasts. miR-21 and TGF-β had synergistic effects on induction of collagen production. However, neither miR-21 nor miR-29a affected alpha smooth muscle actin (α-SMA) expression in the presence or absence of TGF-β in dermal fibroblasts. miR-21 and miR-29a as pro- and anti-fibrotic miRNAs modulate collagen production in an opposing manner. Focusing on miR-21 and miR-29s as therapeutic targets would be effective in patients with SSc or other fibrotic diseases which show aberrant expression of collagen expression

Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis

Background Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0–23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. Methods The sample included 24,529 children aged 0–59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz \u3c −2SD) and severe stunting (HFAz \u3c −3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. Results The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0–23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0–59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0–23 months and 0–59 months are: sex of child (male), mother’s perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0–23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0–59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0–23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0–59 months = 1.58 (95%Cl: 1.38, 1.82)]. Conclusions In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women’s nutrition, child feeding practices and household sanitation