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Objective Potentially inappropriate medications (PIMs) use is a common phenomenon among older adults. This paper aimed to perform a systematic literature review to assess PIMs use and related costs among elderly persons. Methods This study was a systematic review. PubMed, Scopus, and the Institute for Scientific Information engines were used to search for all relevant studies published until 2020. Studies were excluded if they did not estimate the cost of PIMs for the elderly. In addition, non-English articles, editorials, letters, and review articles were excluded. All eligible articles were assessed for methodological quality. Finally, we extracted general characteristics from each eligible study. Results This study showed that the prevalence of PIMs use among older adults was more than 30%. Drugs related to the central nervous system and cardiovascular disease, benzodiazepines, analgesics, and nonsteroidal anti-inflammatory drugs were most commonly used as PIMs. These studies concluded that PIMs could impose a high economic burden on the elderly and society. The mean cost for older adults with PIMs use was almost USD$2000 more than the mean cost for older adults without PIMs. Additionally, the total cost of PIMs use for all elderly persons in Canada in 2013 was estimated at USD$419 million. Conclusions Focusing on the most common PIMs, such as benzodiazepines and nonsteroidal anti-inflammatory drugs, helps implementing cost-effective strategies for reducing PIMs use and decreasing their clinical and economic effects.

Among the ever-increasing literature of the coronavirus disease 2019 (COVID-19), there have been reports on several complications in association with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), such as secondary bacterial and fungal infections. We report a 61-year-old woman with a past history of diabetes mellitus who presented to our hospital suffering from COVID-19 infection. During the course of her hospitalization, the patient developed chemosis and proptosis in both eyes, ultimately leading to a diagnosis of invasive rhino-orbital-cerebral mucormycosis and cerebrovascular thrombosis. This study strengthens the possible association between the occurrence of COVID-19 and invasive mucormycosis infection, providing new impetus for further investigations to substantiate this correlation.

organizational culture in health care organizations to improve staff performance and quality of care. This study was conducted as a systematic review meta-analysis. The required data was searched in the databases and search engines between 2000 and 2019. CMA: 2 software was used to perform the meta-analysis. A total of 16 studies were selected for Meta-Analysis. The mean score of organizational culture of hospital staff evaluated by Denison tool was 3.063 and the mean score of organizational culture of hospital staff evaluated by Robbins tool was 2.527. It is essential for hospital managers to create a healthy and creative environment.

Water injection into petroleum reservoirs is widely performed around the world for enhancing oil recovery. Understanding the underground fluid path is an important factor in improving reservoir performance under waterflooding operation. This may be used to optimize subsequent oil recovery by changing injection patterns, assignment of well priorities in operations, recompletion of wells, targeting infill drilling, and reduce the need for expensive surveillance activities. Most of the hydrocarbon reservoirs are equipped with sensors that measure the flow rate, pressure, and temperature in the wellbores continuously. Valuable and useful information about the interwell connections can be obtained from the measured data. In the present paper, a novel data-driven approach is developed that contributes to estimating the underground interwell connections through analyzing and processing the injection and production data of a petroleum reservoir. This novel data-driven technology is named Detection of Events (DoE) and combines with the Capacitance Resistance Model (CRM) to quantify the connections between injectors and producers. The proposed approach has been applied to both synthetic and field cases. The results of the method show a good agreement between CRM and DoE for the field case (75%), and present a good insight into the better understanding of the underground connections.

In this paper, nonlinear and nonlocal thermo-elastic behavior of a microtube reinforced by Functionally Distributed Carbon Nanotubes, with internal and external piezoelectric layers, in the presence of nonlinear viscoelastic-Hetenyi foundation, and axial fluid flow inside the microtube is studied. Nonlinear partial differential equations governing the system are derived using Reddy’s third-order shear deformations theory along with the Von-Karman theory including the effect of fluid viscosity. Then, the equations are converted to time-dependent ordinary nonlinear equations using the Galerkin method. Afterward, the governing equations of the microtube’s lateral displacements are solved using the multiple scales method. The analysis of the piezoelectric’s parametric resonance is performed by obtaining trivial and nontrivial stationary solutions and plotting characteristic curves of the frequency response and voltage response. At the end, the effect of different parameters including the flow velocity, excitation voltage, parameters of the foundation, viscosity parameter, thermal loading and nanotubes’ volume fraction index on the nonlinear behavior of the system, under parametric resonance condition, is investigated.

To determine the effectiveness of intranasal topical application of tranexamic acid in reducing the need for anterior nasal packing and determine the number of episodes of rebleeding in adult patients presenting with spontaneous atraumatic anterior epistaxis.This study was a double-blind randomized trial conducted from September to November 2021 in the ears, nose, and throat (ENT) emergency department (ED), Khalili Hospital, Shiraz, Iran. Cotton pledgets soaked in either phenylephrine and lidocaine (control group) or tranexamic acid with phenylephrine and lidocaine (intervention group) were inserted into the patients' nostrils for 15 minutes. The primary outcome was the need for anterior nasal packing. The secondary outcomes were staying in the ED for more than 2 hours, needing electrical cauterization, and rebleeding within 24 hours and 1 to 7 days of the first referral to the ED. The trial was registered with the Iranian Registry of Clinical Trials (IRCT20210403050815N1).A total of 240 patients (120 in each group) were enrolled in this study. Tranexamic acid was associated with a lower rate of need for anterior nasal packing (50.0% versus 64.2%; odds ratio [OR], 0.56; 95% confidence interval [CI], 0.33 to 0.94). There were no significant differences between the 2 groups in terms of the need for electrical cauterization and the rate of rebleeding within 1 to 7 days. Tranexamic acid was associated with a lower rate of stay in the ED for more than 2 hours (9.2% versus 20.8%; OR, 0.38; 95% CI, 0.18 to 0.82) and rebleeding in 24 hours (15.0% versus 30%; OR, 0.41; 95% CI, 0.22 to 0.78) compared with the rates in the control group.Intranasal topical application of tranexamic acid is associated with a lower rate of need for anterior nasal packing and a shortened stay in the ED; it may be considered a part of the treatment for atraumatic anterior epistaxis.

Background A significant proportion of cardiovascular disease (CVD) morbidity and mortality could be prevented via the population-based and cost-effective interventions. A fixed-dose combination treatment is known as the polypill for the primary and secondary prevention of CVD has come up in recent years. Purpose In order to provide recommendations for future economic evaluations, this systematic review aimed to review and assess the quality of published evidence on the cost-effectiveness of polypill in primary and secondary prevention of CVD, to identify the key drivers that impact the cost-effectiveness Methods A systematic review of literature, following the PRISMA guidelines, was undertaken in the electronic databases. Two researchers identified the relevant studies according to inclusion and exclusion criteria. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was used to quality assessment of included studies. ICERs value adjusted to 2020 United States Dollar using consumer price index (CPI) and purchasing power parity (PPP). Finally, data were summarized via a narrative synthesis. Results In total, 24 articles were identified based on the determined inclusion criteria. All studies met more than 50% of the CHEERS criteria. Adjusted incremental cost-effectiveness ratios varied from 24$ to 31000$(2020 US dollar) among the studies. The polypill resulted in the improved adherence and quality of life, at a price equal to or lower than multiple monotherapies. This price is typically below the commonly accepted thresholds or cost saving in both, primary and secondary prevention of CVD. The main identified cost-effectiveness drivers were the polypill price, adherence, age, CVD risk, and drug combination. Conclusions This systematic review found that the polypill seemed to be a cost-effective intervention in primary and secondary prevention of CVD. However, it is necessary to conduct more economic evaluation studies based on the long-term clinical trials with large populations. Also, studies should consider how the polypill interacts with other primary and secondary preventive strategies as a complementary health strategy.

Many methods have been described for the repair of the tympanic membrane, but there is no general consensus as to the standard method. The aim of this study was to evaluate the effect of the inferior base posterior canal skin flap on the graft success rate in large tympanic membrane perforations.After the post-auricular incision, the posterior canal skin flap with inferior pedicle was created by two vertical and one horizontal incisions. Then the flap was rotated over the temporalis fascia graft. The graft success rate and postoperation hearing test results were evaluated in 52 patients who suffered from large tympanic membrane perforations.We achieved a 92.3% total graft success rate with about 9 dB improvement in speech reception threshold (SRT).The rotational inferior base posterior canal skin flap tympanoplasty technique is simple, fast, safe, and effective for the repair of subtotal tympanic membrane perforations.

The production of zinc sulfate is important both medically and agriculturally. If zinc sulfate is produced without agglomeration at the nanoscale, its absorption in the body is more and faster. In this research, the induction time parameter is assessed for nucleation of zinc sulfate nanoparticles at room temperature and various supersaturations using acetone (as anti-solvent) in the presence of sodium dodecyl sulfate surfactant (SDS). The nucleation mechanism of zinc sulfate nanoparticles altered from primary to secondary by adding SDS surfactant in solution. The morphology of the zinc sulfate nanoparticles was analyzed by a Scanning Electron Microscope (SEM) and Transmission Electron Microscopy (TEM) tests. The TEM results revealed that the size of the nanoparticles is between 30 and 35 nm in the presence of SDS surfactant. The experimental data proved that the induction time reduces and improves with increasing supersaturation and SDS concentration, respectively. Meanwhile, the nucleation rate increases with the decrease in the interfacial tension of the zinc sulfate particles. The experimental results were also compared with the predictions of classical nucleation theory and the results proved good agreement between them.

Waterflooding is among the most common oil recovery methods which is implemented in the most of oil-producing countries. The goal of a waterflooding operation is pushing the low-pressure remained oil of reservoir toward the producer wells to enhance the oil recovery factor. One of the important objects of a waterflooding operation management is understanding the quality of connection between the injectors and the producers of the reservoir. Capacitance resistance model (CRM) is a data-driven method which can estimate the production rate of each producer and the connectivity factor between each pair of wells, by history matching of the injection and production data. The estimated connectivity factor can be used for understanding the quality of connection between the wells. In the waterflooding operation, the injected water always has the potential of causing formation damage by invasion of foreign particles deep bed filtration (DBF), mobilization of indigenous particles (fines migration), scale formation, etc. The formation damage can weaken the quality of connection (connectivity factor), between the injectors and producers of the field, increasing the skin of injection well. In this paper, DBF is used for creation of formation damage in synthetic reservoir models. Then, it has been tried to find the existence and amount of formation damage by evaluating the connectivity factor of CRM. Finally, the results of that have been used for prediction of skin variation in a real case by using the connectivity factor of CRM.

In this study using an adaptive fuzzy sliding mode control (AFSMC) scheme, the robust stabilization of multi-input–multi-output (MIMO) nonlinear aero-elastic fluttering of the Functionally Graded Piezoelectric (FGP) plate in the presence of mismatched time-varying uncertainties have been investigated. It is assumed that the aerodynamic load is modeled by the first order piston theory and the piezoelectric patches are assumed to be bonded to the top and bottom surfaces of the plate in order to produce the controlling bending moment excitations. Using the airy stress function and applying the Hamilton's principle the governing coupled partial differential equations of motion are derived. Then considering the immovable simply supported edges boundary conditions and employing the aero-elastic multi-mode interactions and applying the Galerkin's method, the nonlinear coupled partial differential equations of motion are reduced to nonlinear ordinary differential equations in time. Then using the full state input-output feedback linearization technique, the nonlinear dynamics of the model is linearized and transformed into the multiple decupled single input-single output uncertain subsystems. In order to overcome the chattering phenomenon arises due to the sliding mode control (SMC) discontinuous inputs, a hybrid adaptive fuzzy sliding mode control technique is utilized to approximate the discontinuous synthetic control inputs. It is showed that considering the physical input limitations, the designed AFSMC control system, effectively suppress the fluttering motions in presence of the bounded external inaccuracies and it prevents the unwanted chattering of the subsystems inputs.

Background: Acute myeloid leukemia (AML) is the second common leukemia (5.18%) and the third deadliest leukemia in Iran. Moreover, it is the fifth prevalent cancer in the world, which involves 8% of all cancers. Objectives: The aim of this study was to calculate direct medical and non-medical costs of AML in 2019. Methods: The present retrospective-descriptive analysis was conducted on 192 patients with AML aged 19 to 70 years from 2016 to 2018. The data were collected from hospital records and interviews with experts. The bottom-up micro-costing approach and payer perspective was considered for cost analysis status. The relationship of affective variables was investigated, using nonparametric tests, including Mann–Whitney and Kruskal–Wallis tests. Costs were divided into costs of diagnosis, hospitalization, medication, nursing, visit and consultation, operating room, and medical supplies. The data were described by mean ± standard deviation and reported by percentage and also analyzed by SPSS 11 software. Results: According to the findings, the average age of all patients was 43.91 years and 55.7% of the patients were male. The highest and the lowest diagnostic costs were associated with laboratory tests at $1656459.48 and ultrasound charges $4229.46, respectively. The total direct medical costs per patient were $1056624.78 with an average of $4846.90 and the cost of medication included 36% of the total costs. The direct medical and non-medical costs were $10485488.48 and $487522.87, respectively Conclusions: Costs of AML treatment were estimated to be $1056624.78. Finally, it can be concluded that the cost of AML in Iran is much cheaper than that compared to other countries and also due to hidden subsidies from the public sector, the payment from the patient's pocket is very small.

Background: Chronic otitis media (COM) endures be an important health problem across the world. Unleashed usage of antibiotics caused development of resistant bacterial strains for infections such as COM as well. Useful antibiotics therapy should be selected according to especially susceptibility pattern of most common local organisms.Aim: The study was conducted from July 2018 to June 2019 in one referral otolaryngology surgical center in the south of Iran to determine the causative microorganisms, their antibiotic sensitivity pattern and occurrence of bacteremia in chronic otitis media patients undergoing tympanomastoidectomy.Patients and Methods: This study designed with eighty-seven samples from eighty- seven ears which were obtained from patients who suffer from chronic otitis media. aerobic culturing and antibiotic sensitivity testing were done with standard antibiotic discs using the National Committee for Clinical Laboratory Standards guidelines. Also, venous blood samples were taken before and after the operation for microbiological study. fun Chi-square test, t-test were used for the statistical analysis in this study.Results: No microorganisms were isolated from the preoperative and post-operative blood cultures. Out of 87 patients, microbiological culture was yielded from 51 specimens (58.6 %). Staphylococci coagulase negative (n=19, 37%) was the most common isolate followed by Staphylococci coagulase positive (n=12, 23%). Susceptibility pattern of Staphylococci spp. showed that almost 80% isolates were sensitive to Ciprofloxacin followed by almost 60% to Co-trimoxazole.Conclusion: Our results proposed that bacteremia might not happen after tympanomastoidectomy. Continuous investigation of susceptibility pattern can improve the success of treatment process for chronic otitis media.

Particle invasion in porous media is an important phenomenon that could lead to formation damage during different operations, such as waterflooding, workover, and drilling. In this paper, a 3D pore network model coupled with a particle tracking method was developed to investigate particle retention and permeability reduction of a pore network system. The proposed model considers the effect of hydraulic drag, gravity, and friction forces. Three mechanisms, including surface deposition, straining, and bridging, have been considered in the development of the proposed pore network model. The results of the proposed model show good agreement with experimental data. A sharp permeability reduction is observed in the early time of the injection, which indicates the blockage of the small radius throats by particles, as well as unstable fluid flow due to the distribution of the particles. Moreover, the number of throats with a small radius and different contributing mechanisms cause the discontinuous decrease of the porous media permeability. The proposed pore network modeling demonstrates that a small section of the pore network can reproduce the results of the experiment, and a big pore network that is too time and cost consuming is not required.

Background Studying and monitoring the efficiency of primary health care centers has a special place in the health system. Although studies have been conducted in the field of efficiency in Iran, few have focused on rural primary health care centers. In addition, previous studies have not used the child mortality rate and Behvarzes as input and output. Objective The present study was conducted aimed to estimate the technical efficiency of rural primary health care centers and determinant factors in Hamadan using data envelopment analysis and Tobit regression. Methods This is a Longitudinal study of rural primary health care centers in Hamadan province (2002–2016). Data Envelopment Analysis was employed to estimate technical efficiency of sampled health facilities while Panel Tobit Analysis was applied to predict factors associated with efficiency levels. The outputs were child mortality rate under 1 year of age and child mortality rate 1 year to 5 years of age. The input was Behvarzes (rural health workers). Results The results of efficiency analysis showed that the average efficiency scores of the centers had a fluctuating trend during the period of the study, but the average performance scores generally decreased in 2016, as compared with 2002. The highest and lowest average performance scores were observed in 2003 (0.78) and 2013 (0.56), respectively. Number of physicians and rural primary healthcare centers per population had a positive statistically significant and the number of midwives and the total fertility per population had a negative statistically significant effect on efficiency. Conclusions The findings suggest some level of wastage of health resources in primary health centers. Findings indicate a level of waste of health resources in primary health centers. Behvarz functions in providing primary care services can be considered in the reallocation and optimal use of available resources at the level of rural health centers.

Background:The rising incidence of breast cancer places a financial burden on national health services and economies. The cost of breast cancer studies is constantly increasing; however, this cost is calculated based on the currency of the country in which the study takes place, therefore limiting national and international comparisons. On the other hand, there is no common method used to conduct such studies. The objective of this review is to contribute to this knowledge pool by examining the indirect costs of breast cancer in order to provide comparable estimates.Methods and analysis:This review will consider all relevant cost of illness studies dated from the year 2000 until the year 2018. Relevant papers will be identified through a systematic search in all major medical research databases. Two independent researchers will screen selected articles. Methodological quality of the studies will be assessed using a checklist designed by Stunhldreher et al. Discussion:The results will be presented in line with the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) checklist. While the costs of breast cancer studies are helpful in planning health interventions in terms of the severity of the problem and budget priorities, the results could also be of great help to policymakers and decision makers in health systems.Study registration number: PROSPERO CRD42018108392

The self-assembled monolayers (SAMs) of organosilanes formed on an oxide substrate are thought to have a polymerized –Si–O–Si– network due to the homocondensation of silanols of hydrolyzed silane headgroups, which is the most significant difference in the SAMs of organosilanes in comparison with those of alkanethoils and organophsosphonic acids. In order to explore the interface chemistry of organosilane SAMs, surface-sensitive time-of-flight secondary ion mass spectrometry (ToF-SIMS) was used to compare ion fragmentation differences between the SAMs of octadecyltrimethoxysilane (OTMS) formed on a SiO2 substrate and free OTMS molecules, as well as oxide substrate. The ability of ToF-SIMS to verify the hydrolysis of the methoxy groups of OTMS molecules and to assess the polymerized –Si–O–Si– network in their SAMs was demonstrated, which shows that ToF-SIMS provides unique information to help us understand the interface chemistry of OTMS SAMs formed on oxides.

The efficiency of an acidizing operation is usually assessed through ordinary well testing methods. These methods are performed only after the acidizing operation, and it is difficult to monitor and evaluate real-time efficiency of acidizing operation. Understanding the performance of the acidizing during the service, by analysis of the acidizing data is a viable approach to this costly and challenging process. The estimation of the skin changes needs an appropriate mathematical method that can handle the main aspects of an acidizing operation. It is tedious to model a real acidizing operation due to the heterogeneity of the reservoir, an unknown reaction rate of acid in reservoir condition, unwanted fluid loss, opening and closing of the wing valve, etc. In this paper, we have presented a new well testing method for calculating the skin variations of open hole vertically drilled carbonate reservoir during an acidizing operation, by using history matching of the surface pressure data. The proposed method is based on continuity equations of acid in the reservoir coupled with analytical equations of ORPM (Output Rate Prediction Method) in the wellbore. The novelty of the proposed method is using a new mass transfer coefficient in continuity equations of acid, and a mathematical approach (ORPM) for the appropriate estimation of bottomhole acid injection rate and fluid loss, that lead to a proper evaluation of the skin variation during a field acidizing operation.

Background: Tremendous difficulties are imposed on families with preterm and premature babies, both at birth and during their lifetime. The present study aimed at evaluating the potential economic impact of preterm and premature birth in Iran. Methods: In this descriptive cross-sectional study (2014-2015), we studied preterm and premature newborns, who have been subjected to hospitalization in Ali-Asghar hospital. We followed social perspective to estimate the economic consequences of preterm and premature birth in 3 categories of direct medical, direct non-medical, and indirect costs. Required data were collected from documents in the NICU, and studying medical records, and interviewing their parents. Data were analyzed by Microsoft Excel. Results: Direct medical, direct non-medical and indirect affairs were 84%, 6%, and 10% of the total cost, respectively. The estimated social costs were 373, 529, 189; 508, 774, 181; and 529, 481, 996 US dollars (according to their corresponding incidence of 5.8%, 7.9%, and 9.9%). We also found that 75% of the direct medical costs of initial hospitalization were due to intensive care beds. Conclusion: The economic burden of preterm and premature birth in Iran is considerable and to decrease the costs, it is necessary to implement preventive programs for preterm and premature newborns and to provide management care and support for families dealing with this problem.

Background and Aim : Nowadays health systems are not only responsible for improving the health of people, but also to protect them against illness and illness costs. Hence, one of the challenges faced by governments is the reduction of out of pocket payments to health care. Unofficial or informal payments are one kind of out of pocket payments that include payments to individuals or service providers, in cash or non-cash beyond formal payment processes. According to statistics and evidences, between 10 to 45 percent of the total out of pocket payment across low-income countries are informal. Addressing this phenomenon requires information about such illegal payments and their roots. Owing to high prevalence of informal payments through many health systems and nations, this systematic review aimed at identifying the nature, types of informal payments and their causes. Materials and Methods : In this systematic review, the keywords of "unofficial payments" or "illegal payments" or "under-the table payment" or "Bribe" and "health system" in the Iranian databases of SID, IranMedex, Magiran and international databases of PubMed, Scopus, Science Direct, and Health Management Information Consortium (HMIC) were searched between years of 2000 to 2016. Also Google Scholar was used to find relevant resources and making sure about the search strategy coverage. Exclusion criteria included studies outside the health system studies published in languages other than Persian or English. Two researcher independently selected papers based on inclusion and exclusion criteria and disagreements were resolved through consultation between them. Also bibliographic search was done to find possible relevant studies. The result was 58 articles. After reviewing the titles and abstracts of the articles, 13 were excluded on relevance, 9 due to duplication and 3 because of language. Finally, 33 articles were included for the final analysis. Microsoft Excel was used for data extraction. The data were analyzed based on the emerging themes narratively. Ethical Considerations : This study was approved by the Ethics Committee of the Vice-Chancellor of Research, Iran University of Medical Sciences (IUMS / 93-04-16-25284). Integrity and trustworthiness in selecting of articles, reporting of findings and referencing were considered. Findings: Thirty-three full papers were selected for study and analysis. Seven of the studies were related to Iran and 26 of them were related to other countries, especially the Eastern European nations. No study was found from North America nor the Western Europe. Most of studies were conducted in higher-income countries. Studies described different characteristics for informal payments, so there was no uniform definition for this phenomenon. These payments are either made in cash or non-cash. Most cash payments are made before and through receiving services and non-cash payments when service is received. The causes of informal payments were categorized into three groups. First, payers, namely, patients and their families, wish to receive higher quality services, better access to services or in order to saving time, such as the waiting time for surgery and appointment of a doctor visit. Second, from the caregivers’ perspective, especially physicians, was low wages and tariffs, and irregular deductions from insurance companies. Finally, the health system's weaknesses as the third reason include insufficiency of insurance coverage, inadequate monitoring of tariffs and the lack control over charges, lack of human resources in some cases, and the asymmetry of information between provider and patient. The job and income level, level of education, age, gender and place of residence (rural or urban) of the patient and his/her family are factors influencing the amount and volume of informal payments. Among the doctors, the reputation and type of expertise are the most important determinants, so that surgeons and gynecologists had more informal inquiries in comparison to internists and psychiatrists. Also, doctors asked more money in urgent and critical cases. Famous doctors as well as doctors who worked in big cities received more informal payments. Also, the amount of payments were more in hospitals, inpatient wards and in sophisticated treatments and those used higher technology and modern facilities. Conclusion : Informal payments are not defined universally, and attitudes toward them are different among different societies, because of different norms, resulted from different cultural and social values of societies. Informal payments, with any intention and for whatever reason, have generally certain negative consequences on the health systems and can affect patients and even service providers. Catastrophic costs, inequality of access to services and discriminated access to high quality care, and inequality in health outcomes are the main consequences of informal payments. The major impact, however, is to limitation of patients’ access to health care due to their higher costs. This result in inequalities in health outcomes. In addition, social justice will be vanished as one of the main responsibilities and missions of states, which will lead to the loss of public confidence in the health system. Revisions in the payment systems along with the redefinition of charges, reinforcement of insurance systems, informing patients about their rights and improving control over the reduction of informal payments are recommended. Please cite this article as: Jahangiri R, Aryankhesal A. Factors Influencing on Informal Payments in Healthcare Systems: A Systematic Review. Med Ethics J 2017; 11(40): 73-92.

The article's abstract is not available.

Operational modal analysis (OMA) aims at identifying the modal properties of a structure based on response data of the structure excited by ambient sources. Modal parameters of the ambient vibration structures consist of natural frequencies, mode shapes, and modal damping ratios. In this paper, a typical frame with arbitrary loading has been modeled in finite element software, ANSYS, and the responses (accelerations of nodes) have been achieved. By using these data and the codes written in MATLAB, the modal parameters (natural frequencies, mode shapes) of the beams are identified with FDD (Frequency Domain Decomposition) and PP (Peak Picking) methods and then justified with the results of input-output method which was determined by modal analysis. The results indicate that there is a good agreement between three methods for determining the dynamic characteristics of frames. Then, the minimum number of required accelerometer has been determined that recording the acceleration in that location leads to identifying all the natural frequencies of the frame., Comment: Conference Paper

Cardiovascular disease is one of the major causes of mortality in the world, with high human and financial burdens on communities. Telemedicine is a tool for providing services for patients that are difficult to access or in need of immediate care. The aim of this study was to systematically review economic evaluation studies that compared telemedicine with usual care for cardiovascular patients. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and related articles published up to December 2018 were searched in different databases (PubMed, Embase, SCOPUS, Global Health, Google Scholar, Magiran, SID). The articles were selected based on inclusion and exclusion criteria. Consolidated health economic evaluation reporting standards statement checklist was used to qualitatively evaluate the papers. Overall, 20 articles were included in the study. The studies used quality-adjusted life years to measure outcomes. The highest and lowest values of Incremental Cost-effectiveness Ratio were $515,082 and $2099 that had been reported in the UK and New Zealand, respectively. Most of the items of the checklist were reported and the quality of most of the studies was excellent and very good. According to the results, telemedicine improves the clinical outcomes and results in considerable saving in costs. Utilizing telemedicine concurrent with the usual care for service delivery is more cost-effective. The reviewed studies had been conducted in high-income countries, hence, it is essential to be cautious when generalizing the results and applying them in health systems policymaking.

Background: The exchange rate is one of the factors whose deviation from equilibrium amounts can lead to the instability in economy performance at the macro level. This study attempted to investigate the effects of exchange rate fluctuations on the import and export of medicine in Iran during 2001-2014. Methods: This longitudinal study collected the required data in each season from 2001 to 2014. The sources of our data were Iran Central Bank, Islamic Republic of Iran Customs Administration, and Food and Drug Administration. The exchange rate and some other variables such as gross domestic product (GDP), oil revenues, and the relative price of medicine import and export were used in the medicine export and import model. Finally, by using E-views software, version 8, an Engle-Granger approach was utilized to investigate the long-term relationship between the study variables. The autoregressive integrated moving average model (ARIMA) was used to estimate the fluctuations in the exchange rate. Results: The results of estimating the equations by the use of the regression method indicated that every 1% increase in oil revenues would lead to a 0.13% increase in the medicine import in short-term. Every 1% increase in GDP would averagely lead to a 1.61% increase in the same variable in long-term. Moreover, the exchange rate fluctuations had a reverse effect on medicine exports so that a 1% increase in the exchange rate fluctuations would moderately result in a 0.17% decrease in medicine export in short-term. The relative price of import had no statistically significant relationship with any of the variables. Conclusions: Since medicine plays a specifically significant role in the health system and the pharmaceutical industry uses a large amount of exchange, fluctuations in the exchange rate have negative effects on the export of medicine; therefore, health officials and policy-makers need to pay much more attention to this issue.