Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012

Background: Assessment of hospitals' performance in achieving its goals is a basic necessity. Measuring the efficiency of hospitals in order to boost resource productivity in healthcare organizations is extremely important. The aim of this study was to measure technical efficiency and determining status of resource allocation in some university hospitals, in Tehran, Iran. Methods: This study was conducted in 2012; the research population consisted of all hospitals affiliated to Iran and Tehran medical sciences universities of. Required data, such as human and capital resources information and also production variables (hospital outputs) were collected from data centers of studied hospitals. Data were analyzed using data envelopment analysis (DEA) method, Deap2,1 software; and the stochastic frontier analysis (SFA) method, Frontier 4,1 software. Results: According to DEA method, average of technical, management (pure) and scale efficiency of the studied hospitals during the study period were calculated 0.87, 0.971, and 0.907, respectively. All kinds of efficiency did not follow a fixed trend over the study time and were constantly changing. In the stochastic frontier's production function analysis, the technical efficiency of the studied industry during the study period was estimated to be 0.389. Conclusion: This study represented hospitals with the highest and lowest efficiency. Reference hospitals (more efficient states) were indicated for the inefficient centers. According to the findings, it was found that in the hospitals that do not operate efficiently, there is a capacity to improve the technical efficiency by removing excess inputs without changes in the level of outputs. However, by the optimal allocation of resources in most studied hospitals, very important economy of scale can be achieved

Dynamics of threads and polymers in turbulence: power-law distributions and synchronization

We study the behavior of threads and polymers in a turbulent flow. These objects have finite spatial extension, so the flow along them differs slightly. The corresponding drag forces produce a finite average stretching and the thread is stretched most of the time. Nevertheless, the probability of shrinking fluctuations is significant and is known to decay only as a power-law. We show that the exponent of the power law is a universal number independent of the statistics of the flow. For polymers the coil-stretch transition exists: the flow must have a sufficiently large Lyapunov exponent to overcome the elastic resistance and stretch the polymer from the coiled state it takes otherwise. The probability of shrinking from the stretched state above the transition again obeys a power law but with a non-universal exponent. We show that well above the transition the exponent becomes universal and derive the corresponding expression. Furthermore, we demonstrate synchronization: the end-to-end distances of threads or polymers above the transition are synchronized by the flow and become identical. Thus, the transition from Newtonian to non-Newtonian behavior in dilute polymer solutions can be seen as an ordering transition.Comment: 13 pages, version accepted to Journal of Statistical Mechanic

A second‐order sliding mode control with active disturbance rejection for dynamic voltage restorers

This paper proposes an extended state observer (ESO)-based second-order sliding mode control (SMC) for dynamic voltage restorers (DVRs). Unlike the conventional first-order SMC and some second-order SMC (SOSMC) methods that suffer from chattering, the proposed control method can alleviate chattering and achieve finite-time convergence. Chattering suppression (i.e. eliminating discontinuities) is achieved via continuous control input which is also used to generate the pulse width modulation signals. However, while removing the discontinuities in the control input, the performance of the control method is degraded when it is subjected to disturbances. Therefore, an active disturbance rejection (ADR) based on an ESO is proposed to enhance the performance. In addition, an advanced single-phase phase-locked loop (PLL) using linear observer and quasi-type-1 PLL is also proposed. The effectiveness of the proposed method is verified through simulation and experimental results which are compared with the results of the existing SMC methods applied to DVR

Correlation Between Mucosal IL-6 mRNA Expression Level and Virulence Factors of Helicobacter pylori in Iranian Adult Patients With Chronic Gastritis

Background: Helicobacter pylori infection is associated with gastritis and marked infiltration of the gastric mucosa by several cytokines secreting inflammatory cells that contribute to sustained local inflammation. In this study, we sought to examine IL-6 expression in H. pylori-infected and uninfected gastric mucosa and elucidate the implication in the pathogenesis of H. pylori-associated gastritis in human. Objectives: The current study aimed to determine mucosal IL-6 mRNA expression level and their correlation with virulence factors and the grade of chronic gastritis among H. pylori infected patients with chronic gastritis from Shahrekord, Iran. Patients and Methods: Mucosal IL-6 mRNA levels was measured by real-time PCR using endoscopic biopsies taken from the gastric antrum of 58 subjects infected with H. pylori and 44 uninfected subjects. Presence of vacA and cagA virulence factors was evaluated using PCR. Results: The IL-6 mRNA expression levels were significantly more elevated in H. pylori-positive patients than uninfected individuals and expression of this cytokine was independent from the virulence factors. There was a correlation between IL-6 expression level and the grade of chronic gastritis. Conclusions: Enhanced induction of IL-6 may be involved in the pathogenesis of H. pylon-associated gastritis

Isofuranodiene, a natural sesquiterpene isolated from wild celery (Smyrnium olusatrum L.), protects rats against acute ischemic stroke

The myrrh-like furanosesquiterpene isofuranodiene (IFD) is the main constituent of wild celery (Smyrnium olusatrum L., Apiaceae), an overlooked vegetable that was cultivated during the Roman Empire. In the present study, we investigated the protective effects of IFD pre-treatment against oxidative stress and inflammatory response in an animal model of ischemic stroke. IFD was isolated by the crystallization of Smyrnium olusatrum essential oil, and its structure and purity were confirmed by NMR and HPLC analyses. Acute pre-treatment of IFD (10 mg/kg i.p.) significantly reduced the levels of the inflammatory cytokines IL-1β and TNF-α, the expression of pNF-κB/NF-κB, and the lipid peroxidation indicator MDA. Finally, IFD boosted a faster recovery and better scores in grid-walking and modified neurological severity scores (mNSS) tests. Taken together, these findings indicate IFD as a promising lead compound for the discovery of new treatments of brain ischemia

Effects of Chlamydia trachomatis Infection on Fertility; A Case-Control Study.

BACKGROUND: Nowadays, Chlamydia trachomatis is known as a causative agent of infertility. Because of, asymptomatic nature of infection, many may suffer from its lasting complications such as infertility. This study was performed in Tehran during April 2007 to April 2008 to compare the prevalence of Chlamydia trachomatis infection in fertile and infertile women using ELISA and PCR methods. METHODS: Overall, 234 infertile and 223 pregnant women, as the fertile group, participated in this hospital-based case-control study. After completing an informed consent form and the questionnaire, first catch urine and blood sample were obtained for PCR and ELISA (IgG, IgM) tests, respectively. Logistic regression analysis was used to control possible confounding factors, and determine adjusted odds ratio of infertility due to the infection. RESULTS: PCR results revealed that 29 (12.4%) of the infertile and 19 (8.5%) of the fertile women were positive for C. trachomatis infection (p = 0.440). IgG was positive in 21 (9.0%) of the infertile and 11 (5.0%) in the fertile group (p = 0.093). IgM assays identified that 2 (0.9%) of the infertile and 4 (1.8%) of the fertile women were positive for the micro-organism (p = 0.375). CONCLUSION: We found no significant differences among fertile and infertile women for Chlamydia trachomatis infection. Nevertheless, molecular techniques which are more sensitive, more specific and non-invasive can be used to detect C. trachomatis infection

CXCL-10: a new candidate for melanoma therapy?

Background: Melanoma is a malignancy that stems from melanocytes and is defined as the most dangerous skin malignancy in terms of metastasis and mortality rates. CXC motif chemokine 10 (CXCL10), also known as interferon gamma-induced protein-10 (IP-10), is a small cytokine-like protein secreted by a wide variety of cell types. CXCL10 is a ligand of the CXC chemokine receptor-3 (CXCR3) and is predominantly expressed by T helper cells (Th cells), cytotoxic T lymphocytes (CTLs), dendritic cells, macrophages, natural killer cells (NKs), as well as some epithelial and cancer cells. Similar to other chemokines, CXCL10 plays a role in immunomodulation, inflammation, hematopoiesis, chemotaxis and leukocyte trafficking. Conclusions: Recent studies indicate that the CXCL10/CXCR3 axis may act as a double-edged sword in terms of pro- and anti-cancer activities in a variety of tissues and cells, especially in melanoma cells and their microenvironments. Most of these activities arise from the CXCR3 splice variants CXCR3-A, CXCR3-B and CXCR3-Alt. In this review, we discuss the pro- and anti-cancer properties of CXCL10 in various types of tissues and cells, particularly melanoma cells, including its potential as a therapeutic target. © 2020, International Society for Cellular Oncology

Optimal confidence regions for the two-parameter exponential distribution based on records

In this article, we propose two families of optimal confidence regions for the location and scale parameters of the two-parameter exponential distribution based on upper records. Constrained optimization problems are used to find the smallest-area confidence regions for the exponential parameters with a specified confidence level. Optimal prediction interval for the future records is also proposed. Two numerical examples as well as a simulation study, are presented for illustrative purposes. It is shown that the reduction in area of the optimal joint confidence region with respect to the existing confidence regions is substantial