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1. In recent months, several outbreaks with clinical signs of MDV-1 were reported in Iranian parent and laying hen farms, in addition to backyard chickens. Several meq gene sequences from these out...

Because of the fossil fuels crisis in recent years, increasing fossil fuel consumption and the oil crisis, energy efficiency is becoming a major concern of the twenty-first century. In this research, the combined cycle of steam Rankine and organic Rankine with the primary mover of the Allam generation cycle has been simulated. The hybrid cycle is configured in such a way that the high temperature waste heat first acts as the steam cycle evaporator and the waste heat output from the steam cycle evaporator is used as the low temperature evaporator of the organic cycle. Then, the effect of changing various parameters such as evaporator temperature and steam cycle condenser pressure on output work values, total irreversibility, energy efficiency, exergy efficiency and exergy-economic variables is investigated. The results show that the energy efficiency and exergy efficiency of the combined cycle are 0.57 and 0.66, respectively, and the amount of output work and total irreversibility are 150,125 kW and 91,237 kW, respectively. Also, according to the study results, a lot of exergy destruction takes place in the system, thus it is recommended to increase the initial price in different components in order to improve the performance of the system. Evaporators and steam cycle condensers are components that should be considered from an exergy-economic perspective, as they have the highest rate for the sum of the initial cost rate and the cost of exergy destruction.

Single-cell sequencing data has great potential in reconstructing the evolutionary history of tumors. Rapid advances in single-cell sequencing technology in the past decade were followed by the design of various computational methods for inferring trees of tumor evolution. Some of the earliest of these methods were based on the direct search in the space of trees. However, it can be shown that instead of this tree search strategy we can perform a search in the space of binary matrices and obtain the most likely tree directly from the most likely among the candidate binary matrices. The search in the space of binary matrices can be expressed as an instance of integer linear or constraint satisfaction programming and solved by some of the available solvers, which typically provide a guarantee of optimality of the reported solution. In this review, we first describe one convenient tree representation of tumor evolutionary history and present tree scoring model that is most commonly used in the available methods. We then provide proof showing that the most likely tree of tumor evolution can be obtained directly from the most likely matrix from the space of candidate binary matrices. Next, we provide integer linear programming formulation to search for such matrix and summarize the existing methods based on this formulation or its extensions. Lastly, we present one use-case which illustrates how binary matrices can be used as a basis for developing a fast deep learning method for inferring some topological properties of the most likely tree of tumor evolution.

Alzheimer’s disease is known as a most common dementia disorder in the world. The famous hypothesis about the cause of this disease is beta-amyloid (Aβ ) accumulation in the brain. There is a widespread neuroinflammation in the patient’s brain, leading to neuronal apoptosis and brain atrophy. Curcumin is a well-known anti-inflammation and anti-oxidant ingredient. It can easily cross the blood-brain barrier. There are controversial results about the effects of curcumin on Aβ clearance and metabolism in Alzheimer’s disease and the elderly. The aim of this meta-analysis and systematic review was to review the effect of curcumin on Aβ clearance in clinical studies. We performed a systematic review and meta-analysis on the three randomized clinical trials (RCTs) and one pilot study that assessed the effect of curcumin on Aβ plasma level in Alzheimer’s disease. For this purpose, we searched PubMed and Scopus databases up to December 2020. Our result showed there was no significant change in serum Aβ level (weighted mean difference [WMD]: 5.3, 95% CI: 0.78-9.97) following curcumin consumption in patients with Alzheimer’s disease. Further clinical trials should be done to evaluate the effects of curcumin in Aβ level in Alzheimer’s disease.

Background and Objectives: Non-thermal atmospheric-pressure plasma or cold plasma is defined as an ionized gas. This study aimed to investigate the effect of cold plasma on Pseudomonas aeruginosa strains. Also, the expression level of the alp virulence gene before and after treatment with cold plasma was compared with the Housekeeping gene gyrA. Materials and Methods: P. aeruginosa isolates recovered from hospitalized burn patients at Shahid Motahari Burns Hos- pital, Tehran, Iran. The Kirby Bauer disk diffusion method was used to determine the antimicrobial susceptibility test. Then, the antibacterial effect of atmospheric non-thermal plasma was evaluated on P. aeruginosa in as in vitro and in vivo studies at different times on Muller Hinton agar and in mouse model (treated by plasma every day/ 90 sec). The histopathological study was evaluated by Hematoxylin-Eosin staining. Data were analyzed using SPSS software by the Chi-square test and Pvalues less than 0.05 considered as statistically significant. Results: Results indicated that non-thermal atmospheric plasma inhibited the growth of P. aeruginosa. The non-thermal helium plasma accelerates wound healing for 6 days. Results showed that cold plasma decreased virulence gene expression alp after treatment. Therefore, cold plasma can be suggested as a complementary therapeutic protocol to reduce bacterial infection and accelerate wound healing and reduce the expression of virulence genes of pathogens. Conclusion: Cold plasma showed pathogen inhibitory properties of P. aeruginosa and virulence alkaline protease and wound healing properties in animal models, so this inexpensive and suitable method can be presented to the medical community to disinfect burn wounds and improve wound healing.

Physiological response is an automatic reaction that triggers a physical response to a stimulus such as stress, emotion, pain, etc. Examples include changes in heart rate, respiration, perspiration, and eye pupil dilation. Electrodermal Activity (EDA), also known as Galvanic Skin Response (GSR), measures changes in perspiration by detecting the changes in electrical conductivity of skin. Previous studies have already shown that EDA is one of the leading indicators for a stimulus. However, the EDA signal itself is not trivial to analyze. To detect different stimuli in human subjects, variety of features are extracted from EDA signals such as the number of peaks, max peak amplitude, to name a few, showing the prevalence of this signal in bio-medical as well as ubiquitous and wearable computing research. In this paper, we present an open-source Python toolkit for EDA signal preprocessing and statistical and automatic feature extraction. To the best of our knowledge, this is the first effort for developing a versatile and generic tool to extract any number of automatic features from EDA signals. We evaluate our toolkit using different machine learning algorithms applied to the Wearable Stress and Affect Detection (WESAD) dataset. Our results show higher validation accuracy for a stress detection task using the the features automatically extracted by pyEDA.

The problem of providing drinking water become a global crisis in the near future for arid and semiregions. Small-scale solar-based desalination proposed as one the promising technologies to encoun...

Background Tolerance and dependence to anti-nociceptive effect of morphine restricted its use. Nowadays co-administration of morphine and other drugs suggests diminishing this tolerance. Baclofen is one of the drugs that may be beneficial in the attenuation of tolerance to morphine. Studies have shown that changes in transient receptor potential vanilloid type 1 (TRPV-1) expression during administration of morphine have a pivotal role in developing morphine tolerance. Therefore, the effect of baclofen on TRPV-1 expression during chronic administration of morphine was investigated in this study. Methods A total of 48 rats were divided into four groups of control, morphine single injection, morphine tolerance, and morphine tolerance + baclofen. To induce morphine tolerance in rats, animals received 10 mg/kg of i.p. morphine sulfate once a day for 10 days. In the treatment group, baclofen (0.5 mg/kg) was injected for 10 days, before morphine injection. Finally, to evaluate baclofen treatment on morphine analgesia and hyperalgesia, thermal hyperalgesia and formalin test were used. TRPV-1 and protein kinase C (PKC) expression and protein production in DRG of spinal cord were then evaluated by real-time PCR and Western blot. Results In baclofen treatment group, thermal hyperalgesia and formalin test improved in comparison with morphine tolerance group. In morphine tolerance group, both TRPV-1/PKC gene expression and protein levels increased in comparison with the control group. However, following the baclofen treatment, the TRPV-1 and PKC levels decreased. Conclusion Baclofen can enhance anti-nociceptive effect of morphine by modulating TRPV-1 channel and PKC activity.

Alzheimer’s disease (AD) is the most common neurodegenerative disease across the world. The major cause of AD is extensive oxidative stress and inflammation in central nervous system (CNS). Vitamin...

Background The most important cause of neurodegeneration in Alzheimer's disease (AD) is associated with inflammation and oxidative stress. Probiotics are microorganisms that are believed to be beneficial to human and animals. Probiotics reduce oxidative stress and inflammation in some cases. Therefore, this study determined the effects of probiotics mixture on the biomarkers of oxidative stress and inflammation in an AD model of rats. Methods In this study, 50 rats were allocated to five groups, namely control, sham, and AD groups with Aβ1-40 intra-hippocampal injection, as well as AD + rivastigmine and AD + probiotics groups with Aβ1-40 intra-hippocampal injection and 2 ml (1010 CFU) of probiotics (Lactobacillus reuteri, Lactobacillus rhamnosus, and Bifidobacterium infantis) orally once a day for 10 weeks. MWM was used to assess memory and learning. To detect Aβ plaque, Congo red staining was used. Oxidative stress was monitored by measuring the MDA level and SOD activity, and to assess inflammation markers (IL-1β and TNF-α) in the hippocampus, ELISA method was employed.. Results Spatial memory improved significantly in treatment group as measured by MWM. Probiotics administration reduced Aβ plaques in AD rats. MDA decreased and SOD increased in the treatment group. Besides, probiotics reduced IL-1β and TNF-α as inflammation markers in the AD model of rats. Conclusion Our data revealed that probiotics are helpful in attenuating inflammation and oxidative stress in AD.

Aim To investigate predictors of low birth satisfaction in a sample of Iranian postpartum women. Design This was a cross‐sectional study. Methods This study was conducted on 767 postpartum women using a convenience sampling method between June and September 2019. We collected data on socio‐demographic variables, maternal well‐being, fear of childbirth and birth satisfaction. We used multiple linear regression analyses to determine predictors of low birth satisfaction. Results The women who gave birth by elective caesarean, emergency caesarean and vaginal birth were 13.2%, 19.06% and 67.8%, respectively. Predictors of low birth satisfaction were primiparity [Beta = −0.131, CI (−2.745, −1.021)], low level of well‐being [−0.119, (−2.514, −0.844)], low [−0.193 (−5.052, −2.568)] and moderate [−0.143 (−2.999, −1.199)] satisfaction with pregnancy, moderate satisfaction with spouse's emotional/financial support [−0.150 (−3.718, −1.595)], emergency caesarean [−0.086 (−2.713, −0.360)], severe fear of childbirth [−0.315 (−5.701, −3.911)] and long interval between admission to hospital and giving birth [−0.188 (−0.233, −0.119)].

The original version of this article unfortunately contains mistakes introduced during the publishing process.

Water managers may modify many components of urban water systems to minimize water shortage. Since each modification activity has its own positive and negative effects, it is necessary to define an appropriate procedure to predict the consequences of each action. As the parameters of urban water supply and demand system have internal relationships in the time domain, a dynamic model is needed to forecast the result of changes and select the best modification activity. Here the Vensim® is applied as a modeling tool to choose the most effective water management activities in Tehran province. It has been found that the annual increase rate of water tariff by 16.4% and assigning 4.5% of revenue on reducing non-revenue water may be the most effective demand management activity to reduce water shortage in Tehran province. It has also been revealed that, even by implementing the most effective demand management activities in Tehran, the amount of required water in the next 10 years is more than the sustainable capacity of its resources and activities like seawater desalination are inevitable to prevent unsustainable use of water sources.

Background: The widespread use of antibiotics is a cause of mutation in microorganisms and leads to the emergence of new micro organisms and resistance to common antibiotics. The purpose of this study is to investigate the synergistic effect of antibacterial synthetic essential oils of Artemisia quettensis and imipenem antibiotic on Pseudomonas aeruginosa isolated from clinical specimens and comparing it with conventional antibiotics. Methods: In this in vitro study, Artemisia quettensis.podlech oil was used alone and combined used with standard antibiotics to evaluate their antimicrobial activities. The disk diffusion method was employed. Results: The essential oil of the plants with antibiotics led to a synergistic effect in some cases, because of injecting a quarter of antibiotics inhibit the growth of bacteria and prevents the creation of the colony. Conclusion: The combination of essential oils of the Artemisia quettensis with antibiotics may be useful in the fight against emerging microbial drug resistance.

The antineoplastic effects of 5-hydroxytryptamine (5-HT) receptor antagonists have been shown in previous studies. However, the exact underlying mechanisms mediating these antineoplastic effects are unclear. In the present study, we assessed the antineoplastic effects of tropisetron, a 5-HT receptor antagonist, in an experimental model of lung cancer in BALB/c mouse. Lewis lung carcinoma cell line was used to induce lung cancer. Mice were divided into four groups (n = 6) as follows: tumor-bearing mice + tropisetron (5 mg/kg intraperitoneally [IP]), tumor-bearing mice + tropisetron (10 mg/kg IP), tumor-bearing mice + saline, healthy mice + tropisetron (10 mg/kg). Tumor burden, interferon-γ (IFN-γ), interleukin (IL)-4, pathological response, Ki-67, and E-cadherin were assessed using enzyme-linked immunosorbent assay, and real-time polymerase chain reaction. Comet assay was used to assess DNA toxicity. Tropisetrone-treated animals (either 5 or 10 mg/kg) showed significantly lower tumor sizes at the day 24th after tumor induction. Tropisetron received animals also showed significantly higher levels of IFN-γ, E-cadherin, pathologic response, and necrotic cells compared to the saline-treated counterparts. In addition, the levels of IL-4, and Ki-67 were significantly lower in tropisetrone treated mice in comparison with control. Furthermore, tropisteron coadministration signifcantly reduced H2 O2 -induced DNA toxicity while treatment with tropisteron alone showed no adverse effect on DNA. Tropisetrone can be used as a potential antineoplastic drug in lung cancer. This agent can promote its antineoplastic effects in part through modulating inflammatory and proliferating markers.

GABAergic drugs can change analgesic effect of morphine. Wide dynamic range (WDR) neurons play an important role in pain transmission and may change behaviors in morphine tolerance. In this study WDR neuron behaviors in morphine tolerant rats and rats treated with GABA agonists, were recorded to elucidate the effect of morphine and GABA agonists on WDR behavioral changes. Rats were divided to 4 groups: 1. Control, 2. Morphine tolerance (MT), 3. MT+ muscimol, 4- MT+ baclofen. To induce morphine tolerance in rats, they received morphine sulfate 10 mg/kg intraperitoneally for 8 days. In treatment group, GABA agonists were injected on days 1, 3, 5 and 8 before injection of morphine. To confirm morphine tolerance induced, formalin test was used. Extracellular single unit recording was used to record spinal WDR neurons. Results showed that chronic administration of morphine failed to attenuate formalin pain but GABA agonists improved analgesic effect of morphine.

IoT applications demand higher Quality of Experience (QoE) to deliver satisfactory services to the end-users. Variable user behavior, diverse application requirements, and dynamic system constraints exacerbate the QoE delivery challenge. Situational-awareness encapsulates the constraints at the user, application, and system levels, quantifiably reflecting system dynamics. Such models can manage diversity among multiple layers of the system stack while improving QoE. In this paper, we investigate the diverse set of requirements and opportunities in edge paradigm that vary over time using health monitoring applications. Towards address this challenge, we propose a situational-awareness model that enables intelligent orchestration of IoT applications across networked and distributed hardware platforms.

The water scarcity in the world in the near future become to a global challenge. The main aim of present study was to elucidate the performance of the three identical solar distillation units with different configurations under climatic conditions of the city of Tehran. All systems were equipped with different heating source that are thermoelectric heating modules (TEH), copper heater (CH), and solar water heater (SWH) while all system assisted with an active external condenser. Performance of all systems is scrutinized from different thermodynamic, thermoeconomic, environmental, and energy-matrices viewpoints. Findings revealed that the highest daily and annual productivity obtained by the system with CH. Economic analysis on the basis of uniform annual cost (UAC) revealed that the system with SWH has the lowest cost per liter (CPL) rather than other system while the highest CPL was for the case of TEH. Furthermore, it was concluded that the system with TEH obtain the most promising results in terms of exergoeconomic, enviroeconomic, and energy payback time (EPBT) because of the highest daily and annual energy and exergy output. Eventually, the environmental analysis indicated that the solar still with CH with 6342, 48.169, 18.46 kg emission of CO2, SO2. And NO have the best results rather than other systems

Context: Numerous studies have indicated that vitamin D can modulate the immune system and plays an important role in regulating immune cells’ functions. Some clinical studies have assessed the effect of vitamin D supplementation on cytokine markers in multiple sclerosis (MS) as a disease in which the immune system’s function is disrupted. Evidence Acquisition: This study was designed to assess randomized clinical trial studies evaluating the overall effect of vitamin D on the levels of IL-10, IL-17, and IFN-γ in MS patients. Methods: We searched PubMed and Scopus online databases up to November 2020 for relevant randomized clinical trial studies by using certain keywords. Eight studies from 273 articles, with a total sample of 443 participants, were considered Results: The meta-analysis indicated that vitamin D consumption did not significantly change the levels of IL-10 (WMD : -174.56, 95% CI: -373.10 to 23.98), IL-17 (WMD : -0.11, 95% CI: -0.54.10 to 0.33), or IFN-γ (WMD : 61.47, 95% CI: 43.96 to 78.98) in MS patients. Conclusions: Further clinical trials are warranted to evaluate the effects of vitamin D supplement on IL-10 and IL-17, and INFγ levels in MS patients.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the cause of COVID-19, is reported to increase the rate of mortality worldwide. COVID-19 is associated with acute respiratory symptoms as well as blood coagulation in the vessels (thrombosis), heart attack and stroke. Given the requirement of angiotensin converting enzyme 2 (ACE2) receptor for SARS-CoV-2 entry into host cells, here we discuss how the downregulation of ACE2 in the COVID-19 patients and virus-induced shift in ACE2 catalytic equilibrium, change the concentrations of substrates such as angiotensin II, apelin-13, dynorphin-13, and products such as angiotensin (1–7), angiotensin (1–9), apelin-12, dynorphin-12 in the human body. Substrates accumulation ultimately induces inflammation, angiogenesis, thrombosis, neuronal and tissue damage while diminished products lead to the loss of the anti-inflammatory, anti-thrombotic and anti-angiogenic responses. In this review, we focus on the viral-induced imbalance between ACE2 substrates and products which exacerbates the severity of COVID-19. Considering the roadmap, we propose multiple therapeutic strategies aiming to rebalance the products of ACE2 and to ameliorate the symptoms of the disease., Graphical Abstract ga1

Background & Aim: Fear of childbirth and pregnancy anxiety may affect the desire for normal delivery. No study has investigated the effectiveness of solution-focused counseling on either pregnancy anxiety or all factors comprising fear of childbirth. We aimed to investigate the effects of solution-focused counseling in reducing pregnancy anxiety and fear of childbirth.Methods and materials: This randomized clinical trial study was conducted on 121 nulliparous women in 2019. Participants with moderate to severe fear of childbirth were randomly divided into the intervention and control groups. The intervention group participated in five solution-focused counseling sessions. Before and after the intervention, women filled the anxiety scale for pregnancy (ASP) and the Wijma Delivery Expectancy Questionnaire (W-DEQ). Data were analysed using t-test, paired t-test, and analysis of covariance (ANCOVA).Results: The two groups did not differ in terms of demographic and obstetric variables and pregnancy anxiety pretest scores (P>0.05). The means of the posttest total scores and the means of scores for all five factors of the ASP were significantly lower in the intervention group than the control group (pConclusions: The solution-focused counseling reduced pregnancy anxiety and fear of childbirth in women participating in counseling sessions in comparison with the controls. Solution-focused counseling therapy sessions should be held for women with pregnancy anxiety and fear of childbirth.

Recent studies exploring the impact of methylation in tumor evolution suggest that while the methylation status of many of the CpG sites are preserved across distinct lineages, others are altered as the cancer progresses. Since changes in methylation status of a CpG site may be retained in mitosis, they could be used to infer the progression history of a tumor via single-cell lineage tree reconstruction. In this work, we introduce the first principled distance-based computational method,Sgootr, for inferring a tumor’s single-cell methylation lineage tree and jointly identifying lineage-informative CpG sites which harbor changes in methylation status that are retained along the lineage. We applySgootron the single-cell bisulfite-treated whole genome sequencing data of multiregionally-sampled tumor cells from 9 metastatic colorectal cancer patients made available by Bianet al., as well as multiregionally-sampled single-cell reduced-representation bisulfite sequencing data from a glioblastoma patient made available by Chaligneet al.. We demonstrate that the tumor lineages constructed reveal a simple model underlying colorectal tumor progression and metastatic seeding. A comparison ofSgootragainst alternative approaches shows thatSgootrcan construct lineage trees with fewer migration events and more in concordance with the sequential-progression model of tumor evolution, in time a fraction of that used in prior studies. Interestingly, lineage-informative CpG sites identified bySgootrare in inter-CpG island (CGI) regions, as opposed to CGI’s, which have been the main regions of interest in genomic methylation-related analyses.Sgootris implemented as aSnakemakeworkflow, available athttps://github.com/algo-cancer/Sgootr.Abstract Figure

Emerging data suggest that the effects of infection with SARS-CoV-2 are far reaching extending beyond those with severe acute disease. Specifically, the presence of persistent symptoms after apparent resolution from COVID-19 have frequently been reported throughout the pandemic by individuals labeled as “long-haulers”. The purpose of this study was to assess for symptoms at days 0-10 and 61+ among subjects with PCR-confirmed SARS-CoV-2 infection. The University of California COvid Research Data Set (UC CORDS) was used to identify 1407 records that met inclusion criteria. Symptoms attributable to COVID-19 were extracted from the electronic health record. Symptoms reported over the previous year prior to COVID-19 were excluded, using nonnegative matrix factorization (NMF) followed by graph lasso to assess relationships between symptoms. A model was developed predictive for becoming a long-hauler based on symptoms. 27% reported persistent symptoms after 60 days. Women were more likely to become long-haulers, and all age groups were represented with those aged 50 ± 20 years comprising 72% of cases. Presenting symptoms included palpitations, chronic rhinitis, dysgeusia, chills, insomnia, hyperhidrosis, anxiety, sore throat, and headache among others. We identified 5 symptom clusters at day 61+: chest pain-cough, dyspnea-cough, anxiety-tachycardia, abdominal pain-nausea, and low back pain-joint pain. Long-haulers represent a very significant public health concern, and there are no guidelines to address their diagnosis and management. Additional studies are urgently needed that focus on the physical, mental, and emotional impact of long-term COVID-19 survivors who become long-haulers.

This study aimed to investigate the health-related quality of life (HRQoL) of type 2 diabetic patients and its relationship with the complications of diabetes in Farashband County, Fars, Iran. Data of this cross-sectional study were collected by a researcher-made demographic questionnaire, EuroQol-5 Dimensions questionnaire (EQ-5D) and Visual Analog Scale (VAS) and also from patient records. Multivariate regression model was used to investigate the net effect of diabetes complications on HRQoL after controlling for other independent variables. A total of 685 patients with a mean age of 58.36 and a disease duration of 7.64 years participated in the study. The mean EQ-5D and EQ-VAS scores of all patients were 0.64 and 56.53, respectively. The HRQoL dimensions in which the largest portions of the population had problems were Pain/Discomfort (77.23%) and Anxiety/Depression (63.50%). Among the studied diabetic patients, women, divorcees, and widows were more likely to report problems in all dimensions of HRQoL, and people without complications, people with university degrees, and employed people were more likely to report fewer problems in these dimensions (P

Background Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth. Methods This cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth. Results The percentage of women with mild (score ≤ 37), moderate (38–65), high (66–84), severe (85–99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age Conclusions The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband’s attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women’s common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC.

Background COVID-19 caused some worries among pregnant women. Worries during pregnancy can affect women’s well-being. We investigated worry and well-being and associated factors among pregnant women during the COVID-19 pandemic. Methods This descriptive cross-sectional study was conducted on 484 pregnant women using an online questionnaire. Sampling was performed in a period between May 5 and Aug 5, 2020. Inclusion criteria were having a single healthy fetus and having no significant psychological disorder. We collected the data using the Persian versions of the World Health Organization’s Well-Being Index (WHO-5 Well-Being Index) and the Cambridge Worry Scale. We used univariate and multivariate logistic regression analyses to identify predictors of women’s worry and well-being. Results The mean total scores of the WHO-5 Well-Being Index and the percentage of WHO-5 score p p p = 0.019), nulliparity (OR = 1.68, p = 0.024), having a COVID-19 infected person among relatives (OR = 2.45, p = 0.036), having a history of abortion (OR = 1.86, p = 0.012), having participated in the study after the first wave of COVID-19 outbreak (OR = 2.328, p = 0.003), and women’s age p = 0.002). Predictors of low level of well-being in pregnant women are worry about their own health and relationships (OR = 1.789, p = .017), worry about fetus health (OR = 1.946, p = 0.009), and having at least one infected person with COVID-19 among relatives (OR = 2.135, p = 0.036). Conclusions The percentage of women experiencing a low well-being state was relatively high. This result is worthy of attention by health care providers and policy makers. Providing care and support to pregnant women should have high priority during the COVID-19 pandemic.

Background: Blood exchange transfusion (ECT) therapy is an essential part of the modern health care for high-risk icteric neonates. Objectives: Therefore, this study sought to examine the effectiveness of monitoring sodium disorders and the required interventions indicating the overall state of health of hospitalized jaundiced neonates. Methods: This prospective analytic study was performed on 49 neonates diagnosed with severe jaundice undergoing screened exchange blood transfusion from November 2018 to May 2019. Serum sodium ion concentrations testing was performed before the exchange, then 1 - 3 hours later, and again 24 hours after receiving ECT, using a sensitive ELISA kit in a laboratory. Using the newest version of SPSS 24 software program, the association between different numerical variables was calculated by a repeated-measure ANOVA test. P < 0.05 criterion was set as the threshold of significance. Results: Out of the total 49 neonates, 24 (48.5%) were girls and 25 (51.5%) were boys, of which 93.9% and 6.1% were term and preterm-born neonates, respectively. The average birth weight was 2843 ± 267/510 g and the mean period of hospital stay was 4.55 ± 2.399 days. The various causes of severe neonatal jaundice of all the hospitalized cases were 45% unknown, 43% combined ABO and Rh incompatibility, 10% breastfeeding pattern, and 2% G6PD deficiency. A continual fall in serum sodium was observed following banked blood exchange (P < 0.05). However, these reversible changes were outside the expected normal range. Despite a diminished sodium concentration, the mean sodium levels were within the laboratory reference range of serum (137 - 142 mEq/L) in all the three measured duration times. Moreover, variation in the amount of serum sodium was associated with an unknown underlying cause that led to neonatal jaundice (P = 0.04) and this difference did not reach statistical significance in terms of birth weight, gestational age, and other causes accounting for high bilirubin (P > 0.05). Conclusions: Given these facts, it was concluded that neonatal jaundice was significantly associated with post-exchange serum sodium changes within the laboratory reference range of serum.

Background Technology enables the continuous monitoring of personal health parameter data during pregnancy regardless of the disruption of normal daily life patterns. Our research group has established a project investigating the usefulness of an Internet of Things–based system and smartwatch technology for monitoring women during pregnancy to explore variations in stress, physical activity and sleep. The aim of this study was to examine daily patterns of well-being in pregnant women before and during the national stay-at-home restrictions related to the COVID-19 pandemic in Finland. Methods A longitudinal cohort study design was used to monitor pregnant women in their everyday settings. Two cohorts of pregnant women were recruited. In the first wave in January-December 2019, pregnant women with histories of preterm births (gestational weeks 22–36) or late miscarriages (gestational weeks 12–21); and in the second wave between October 2019 and March 2020, pregnant women with histories of full-term births (gestational weeks 37–42) and no pregnancy losses were recruited. The final sample size for this study was 38 pregnant women. The participants continuously used the Samsung Gear Sport smartwatch and their heart rate variability, and physical activity and sleep data were collected. Subjective stress, activity and sleep reports were collected using a smartphone application developed for this study. Data between February 12 to April 8, 2020 were included to cover four-week periods before and during the national stay-at-home restrictions. Hierarchical linear mixed models were exploited to analyze the trends in the outcome variables. Results The pandemic-related restrictions were associated with changes in heart rate variability: the standard deviation of all normal inter-beat intervals (p = 0.034), low-frequency power (p = 0.040) and the low-frequency/high-frequency ratio (p = 0.013) increased compared with the weeks before the restrictions. Women’s subjectively evaluated stress levels also increased significantly. Physical activity decreased when the restrictions were set and as pregnancy proceeded. The total sleep time also decreased as pregnancy proceeded, but pandemic-related restrictions were not associated with sleep. Daily rhythms changed in that the participants overall started to sleep later and woke up later. Conclusions The findings showed that Finnish pregnant women coped well with the pandemic-related restrictions and lockdown environment in terms of stress, physical activity and sleep.

The preliminary feasibility analysis of using Rocstar Multiphysics for high fidelity modeling and simulation of wind turbines is demonstrated in light of a simple wind turbine problem. To address some of the issues of existing open-source offerings in the multiphysics modeling of wind turbine systems, Rocstar integrates highly featured, well maintained, community-driven flow field and structural solvers. Governing equations are discussed along with the boundary conditions alongside the setup of a simple demonstrative problem. It is shown that by proper choice of materials and modifications to the structure, it is possible to limit the deflections and stress levels in turbine blades. The study is also featured by several analyses of the steady-state and dynamic response of the CFRP and GFRP blades to the wind load under normal and harsh atmospheric conditions.

Complex Internet of Things (IoT) applications such as Healthcare IoT include a variety of compute, data, and communication kernel intensities and have diverse sensitivities of QoS requirements including latency, throughput, availability, accuracy, etc. Ensuring QoS requirements for the applications requires a comprehensive tool to perform efficient full-stack analysis. Per our observation, the literature lacks a simulator capable of supporting a full-stack communication-computation co-simulation of an IoT system. Furthermore, IoT system behavior can dramatically change during run-time due to variation in status and context. Therefore, such a system must be dynamically controlled over time. In this paper, for the first time, we propose a full-stack framework to co-simulate communication and computation aspects of an IoT system in a dynamic scenario. We integrate a Transmission Control Protocol (TCP) latency model with the iFogSim simulator. We conduct a health-care IoT-based case study to evaluate the framework. The framework is open-sourced and available on GitHub in the following repository: https://github.com/HealthSciTech/Dynamic iFogSim.

Addressing security misconfiguration in complex distributed systems, such as networked Industrial Control Systems (ICS) and Internet of Things (IoT) is challenging. Owners and operators must go beyond tuning parameters of individual components and consider the security implications of configuration changes on entire systems. Given the growing scale of cyber systems, this task must be highly automated. Unfortunately, prior work on configuration errors has largely ignored the security impact of configurations of connected components. To address this gap, we present SCIBORG, a framework that improves the security posture of distributed systems by examining the impact of configuration changes across interdependent components using a graph-based model of the system and its vulnerabilities. It formulates a Constraint Satisfaction Problem from the graph-based model and uses an SMT solver to find optimal configuration parameter values that minimize the impact of attacks while preserving system functionality. SCIBORG also provides supporting evidence for the proposed configuration changes. We evaluate SCIBORG on an IoT testbed.

BACKGROUND: nocardiosis is an opportunistic infectious disease in immunocompromised patients. The most common form of nocardiosis infection in humans is pulmonary nocrdiosis caused by inhaling Nocardia species from the environment. Thus, this study aimed to evaluate the pulmonary nocardiosis in patients with suspected tuberculosis using systematic review and meta-analysis.METHODS: We conducted a systematic search for cross-sectional studies focused on the pulmonary nocardiosis among patients with pulmonary tuberculosis based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) published from January 2001 to October 2019. The search was conducted in MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, Science Direct databases, and Iranian databases. Medical subject headings (MeSH) and text words were searched: “pulmonary nocardiosis”, “nocardiosis”, OR “nocardial infection”, “pulmonary nocardial infections/agents”, AND “pulmonary tuberculosis”, OR “pulmonary TB”, AND “Iran”. Two of the reviewers enrolled independently articles published in English and Persian languages according to the inclusion and the exclusion criteria. Comprehensive Meta-Analysis software (Version 3.3.070) was used for meta-analysis.RESULTS: Only 4 studies met the eligibility criteria. The pulmonary nocardiosis prevalence varied from 1.7% to 6.7%. The combined prevalence of nocardiosis among patients with suspected pulmonary tuberculosis in Iran was 4.8% (95% CI: 3-7.3, Q=5.8, Z=12.7). No heterogeneity was observed between studies because I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as the prevalent isolates, respectively.CONCLUSIONS: This review showed in patients suspected TB when they were negative in all diagnosis laboratory tests, nocardiosis cases which be considered.

An emerging body of evidence has associated exposure to traffic-related air pollution (TRAP) during pregnancy with birth outcomes. However, the evidence on the association of TRAP exposure and neonatal anthropometric measurements (NAPM) in low and middle-income countries is very scarce yet. Therefore, we investigate the association of prenatal exposure to indicators of traffic and ambient particulate matter (PM) with NAPM. This cross-sectional study was based on hospital medical records of 4053 mother-neonate pairs between May 16, 2016, and December 5, 2018. PMs were estimated at residential addresses based on validated spatiotemporal models. Moreover, total street length in 100, 300 and 500m buffers around the home, residential distance to the ring road, major roads, heavy-traffic lights, gas station, motorway junction, bank, square, bus terminal, public parking and industrial land-use were calculated as indicators of traffic. The head circumference (HC), birth weight (BW) and birth length (BL) of neonates were collected as NAPM. Multivariate regression models were applied to evaluate the relationship between PMs and indicators of traffic with NAPM, controlled for relevant covariates. The median (IQR) of BW, BL, and HC of newborns were 3250 (592) gr, 51.0 (3.5) cm, 35 (2) cm, respectively. The adjusted models revealed that higher exposure to PM2.5 and PM10 was significantly related with lower BW and BL. Similar results were observed for total street length in a 100 m buffer around maternal home with BW and BL. Moreover, higher distance to heavy traffic lights was significantly associated with higher BW and BL. An IQR increase in PM10 was significantly related to lower HC (95% CI: 0.11, −0.01, P-value = 0.03). An increase in distance from residential address to heavy traffic lights, ring roads, bus terminal, and transportation land-use was associated with higher HC. Overall, our findings suggested that higher prenatal exposure to TRAP was related with lower BW, BL and HC.

Purpose Our aim was to describe trends in the prescription of domperidone for insufficient lactation in England, the characteristics of women prescribed it postpartum, and the impact of a 2014 European Medicines Agency (EMA) recommendation to restrict its use due to a potential increased risk of sudden cardiac death associated with its use. Methods We conducted a population-based cohort study with interrupted time series analysis using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics. We identified women with live births from 2002 to 2015, excluding those with nonlactation indications for domperidone (n = 247 349). We evaluated trends in the prescription rate of domperidone in the 6 months postpartum and differences in this rate before and after the EMA recommendation. Results Domperidone was prescribed among 1438 deliveries at a rate of 1.24 per 100 person-years. This rate increased from 0.56 to 2.1 per 100 person-years between 2002-2004 and 2011-2013 (rate ratio: 3.8; 95% confidence interval [CI], 3.2-4.6). Prescribing decreased in level by 0.35 (95% CI, -0.86 to 0.16) per 100 person-years immediately following the recommendation with little change in trend (0.003; 95% CI, -0.059 to 0.065 per 100 person-years). Following the recommendation, prescription of doses >30 mg and coprescription of drugs with a risk of torsade de pointes decreased. No arrhythmic events were observed among domperidone users. Conclusions Although we observed an important increase in prescribing during the study period, domperidone remains infrequently prescribed postpartum in England. While overall prescribing changed little, some prescribing practices became more restricted following the EMA's recommendation.

This study investigates the potential of “ methanol + acetaldehyde ↔ hemiacetal ” as a liquid phase thermoreversible reaction for long-term storing of low-grade thermal energy to overcome the mismatch between energy supply and demand. Both forward and backward reactions are studied experimentally and the technical issues associated with employing such a system are discussed. Methanol and acetaldehyde would react via an exothermic reaction ( - Δ H r = 31.8 kJ mole or 104.7 kWh m 3 ) at low temperature range ( k = 26.26 × 10 2 exp - 4099 T ). The regeneration of parent reactants with high purity occurs at 48 °C which can easily be delivered using low-grade heat. The low operating temperature required for forward reaction and the reduction in backward reaction rate caused by methanol accumulated are the main engineering challenges. These technical problems need to be solved before this reaction could be utilised commercially.

Background The physical and emotional well-being of women is critical for healthy pregnancy and birth outcomes. The Two Happy Hearts intervention is a personalized mind-body program coached by community health workers that includes monitoring and reflecting on personal health, as well as practicing stress management strategies such as mindful breathing and movement. Objective The aims of this study are to (1) test the daily use of a wearable device to objectively measure physical and emotional well-being along with subjective assessments during pregnancy, and (2) explore the user’s engagement with the Two Happy Hearts intervention prototype, as well as understand their experiences with various intervention components. Methods A case study with a mixed design was used. We recruited a 29-year-old woman at 33 weeks of gestation with a singleton pregnancy. She had no medical complications or physical restrictions, and she was enrolled in the Medi-Cal public health insurance plan. The participant engaged in the Two Happy Hearts intervention prototype from her third trimester until delivery. The Oura smart ring was used to continuously monitor objective physical and emotional states, such as resting heart rate, resting heart rate variability, sleep, and physical activity. In addition, the participant self-reported her physical and emotional health using the Two Happy Hearts mobile app–based 24-hour recall surveys (sleep quality and level of physical activity) and ecological momentary assessment (positive and negative emotions), as well as the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. Engagement with the Two Happy Hearts intervention was recorded via both the smart ring and phone app, and user experiences were collected via Research Electronic Data Capture satisfaction surveys. Objective data from the Oura ring and subjective data on physical and emotional health were described. Regression plots and Pearson correlations between the objective and subjective data were presented, and content analysis was performed for the qualitative data. Results Decreased resting heart rate was significantly correlated with increased heart rate variability (r=–0.92, P Conclusions The Two Happy Hearts intervention prototype shows promise for potential use by underserved pregnant women.

Rigorous studies carried out by the National Center for Health Statistics show that previously reported increases in maternal mortality rates in the United States were an artifact of changes in surveillance. The pregnancy checkbox, introduced in the revised 2003 death certificate and implemented by the states in a staggered manner, resulted in increased identification of maternal deaths and in reported maternal mortality rates. This Commentary summarizes the findings of the National Center for Health Statistics reports, describes temporal trends and the current status of maternal mortality in the United States, and discusses future concerns. Although the National Center for Health Statistics studies, based on recoding of death certificate information (after excluding information from the pregnancy checkbox), showed that crude maternal mortality rates did not change significantly between 2002 and 2018, age-adjusted analyses show a temporal reduction in the maternal mortality rate (21% decline, 95% CI 13-28). Specific causes of maternal death, which were not affected by the pregnancy checkbox, such as preeclampsia, showed substantial temporal declines. However, large racial disparities continue to exist: Non-Hispanic Black women had a 2.5-fold higher maternal mortality rate compared with non-Hispanic White women in 2018. This overview of maternal mortality underscores the need for better surveillance and more accurate identification of maternal deaths, improved clinical care, and expanded public health initiatives to address social determinants of health. Challenges with ascertaining maternal deaths notwithstanding, several causes of maternal death (unaffected by surveillance artifacts) show significant temporal declines, even though there remains substantial scope for preventing avoidable maternal death and reducing disparities.

Objectives Given the aging process of the population and the important role of lifestyle in common and chronic diseases, especially osteoporosis in the elderly, this study was conducted to evaluate the lifestyle of elderly people with osteoporosis. Methods & Materials This cross sectional (descriptive-analytic) study was carried out in 2013 on 300 osteoporotic elderly people who were referred to the bone densitometry centers of Tehran University of Medical Sciences, Tehran, Iran. Convenience sampling method was used, and the data were collected using a questionnaire for measuring healthy lifestyle in Iranian elderly. The collected data were analyzed by descriptive statistics including ANOVA and t-test by using SPSS-PC (V. 21) and P≤0.05. Results Results showed that the lifestyle of most osteoporotic elderly people (71.3%) was moderate, 10.7% of them had a desirable lifestyle, and 18% had an undesirable lifestyle. There was no statistically significant difference between the overall average score of lifestyle with age (P=0.499) and sex (P=0.176) in older adults with osteoporosis, but significant difference was statistically observed between the overall average score of lifestyle and marital status (P=0.001), educational level (P=0.027), and chronic disease (P=0.009). Conclusion Due to the increasing elderly population and the prevalence of osteoporosis in them, it is recommended that health officials and policy makers in the country should pay more attention in this area to prevent the occurrence of the disease as well as improve the lifestyle of elderly people with osteoporosis.

Avian influenza A virus (AIV) subtype H9N2 is the most prevalent subtype found in terrestrial poultry throughout Eurasia and has been isolated from poultry outbreaks worldwide. Tracheal tissue specimens from 100 commercial broiler flocks in Afghanistan were collected between 2016 and 2017. After real-time RT-PCR, AI-positive samples were further characterized. A part of the HA gene was amplified using RT-PCR and sequenced. The results of real-time RT-PCR showed that 40 percent of the flocks were AI positive. Phylogenetic studies showed that these H9N2 AIVs grouped within the Eurasian-lineage G1 AIVs and had a correlation with H9N2 AIV circulating in the poultry population of the neighboring countries over the past decade. Analysis of the amino acid sequence of HA revealed that the detected H9N2 viruses possessed molecular profiles suggestive of low pathogenicity and specificity for the avian-like SAα2,3 receptor, demonstrating their specificity for and adaptation to domestic poultry. The results of the current study provide great insights into H9N2 viruses circulating in Afghanistan's poultry industry and demonstrate the necessity of planning an applied policy aimed at controlling and managing H9N2 infection in Afghan poultry.

This study aimed to investigate the role of education in promoting citizens’ awareness about the issue of wastewater network and facilities in order to reduce the technical, economic, social and environmental problems. This is a descriptive-survey research. Questionnaire was used to collect data. Citizens of district 1 of Water and Wastewater of Mashhad were population of this research including 384 people. SPSS 18 was used to analyze data both descriptive and inferential statistics. Kolmogorov-Smirnov test was used for testing normality of the data. One-sample t-test, chi-square test and Spearman rank correlation test, were used to test hypotheses of research. Both of hypotheses of research were confirmed. Hypotheses are effective including raising awareness of citizens in the implementation and proper operation of wastewater network. The results show there is a direct relationship between knowledge level and education level. Due to management, economic, cultural problems, lack of trust and lack of citizen satisfaction, as well as their low level of awareness, implementation and operation of the facility are faced with a problem. According to the results, developing an educational program for citizens and its implementation by public relations and public education by water and Wastewater Company seems essential.

Wastewater treatment high rate algal pond (WWT HRAP) performance and the potential for low-cost biofuel production from its biomass are affected by the composition of the algal community. While several unicellular algal species have been evaluated extensively for their wastewater treatment and biofuel production potential, there has been little focus on the colonial species that typically predominate in high rate algal ponds and which have the benefit of being easily harvested by cost-effective, simple gravity settling. This study investigates the wastewater treatment performance of five wastewater colonial algal species that are common in high rate algal ponds: Mucidosphaerium pulchellum, Micractinium pusillum, Coleastrum sp., Desmodesmus sp. and Pediastrum boryanum and their potential value for biofuel production in terms of their biochemical composition and biomass energy yield. The algae were isolated from pilot-scale WWT HRAPs and used in batch monoculture experiments with pre-frozen and pre-filtered primary settled sewage that were conducted over 10 days under simulated New Zealand summer and winter conditions. Under summer conditions, all species showed similar efficient nutrient removal (> 95% of NH4+-N and > 85% of PO43 −-P within 4 days) whereas, under winter conditions, only the Mucidosphaerium pulchellum and Micractinium pusillum cultures showed efficient nutrient removal by the end of the experiment. Algal biomass yield, lipid and energy content varied with species and were higher in summer than winter (respectively 991–1700 mg/L, 14.4–48.2 wt% and 19.1–25 kJ/g in summer, and 158.7–584 mg/l, 15.1–31.4 wt% and 17.7–21.1 kJ/g in winter). The Mucidosphaerium pulchellum and Micractinium pusillum cultures had the highest biomass yield, lipid and energy content under both summer and winter conditions. However the settleability of Micractinium pusillum is much better than Mucidosphaerium pulchellum suggesting that of the colonial algal species tested, Micractinium pusillum has the greatest potential for both wastewater treatment and low-cost energy production in WWT HRAP.

Background: Pregnancy and postpartum are critical periods for patients with neurological complications. In this study, we aimed to evaluate the clinical characteristics and outcome of pregnant women with neurological conditions. Materials and Methods: This cross-sectional study reviewed pregnant women with neurological signs and symptoms, who were registered in the Medical Care Monitoring Center (MCMC) database of Shiraz University of Medical Sciences 2013-15. A questionnaire was designed to record each patient’s information including demographic variables, past medical history, clinical presentation, obstetric profile, and fetal/maternal outcomes. Results: Totally, 332 mothers were registered in the database. The main neurological complaints in our population were headache, seizure, unilateral neurological symptoms, multiple sclerosis, neuromuscular disorder, and brain tumor. More than half of the patients (54%) experienced headache during the pregnancy and postpartum period. Conclusion: Evaluating the neurological disorders separately, based on the time of symptom onset indicates the importance of follow-up of mothers during peripartum. Our findings suggest that decisions for pregnancy in women with neurological disorders should be based on risks outweighing for the mother and the fetus, particularly regarding the pharmacological side effects. [GMJ.2019;8:e1616]

Background: Adiantum capillus-veneris L. (Family: Pteridaceae) is a well-known safe medicinal herb used in traditional and modern medicine due to its beneficial pharmacological properties. The current study aimed to compile a review on phytochemicals, pharmacological properties and toxicological effects of this plant. Methods: An incisive search was conducted through electronic scientific databases including PubMed, Scopus, ScienceDirect, and Cochrane Library using keyword ‘Adiantum capillusveneris’. All related in vivo, in vitro, human (English papers), were selected from the beginning up to 1st January 2019. All letters, conference papers, papers dealing with genetics, agriculture, and pure phytochemistry of the herb were excluded. Results: A. capillus veneris revealed various pharmacological activities including the effects on the remodeling of lung alveolar epithelial cells in a hypoxic environment, anti-toxicity properties in liver and testes, anti-hyperglycemic, and wound healing effects in diabetic or non-diabetic patients, protection against damage to fibroblasts via free radicals, activity against testosteroneinduced alopecia, anticonvulsant, depressant, analgesic and anti-nociceptive activities, as well as effects on urinary output, anti-inflammatory, anti-microbial, antilithiatic, hypothyroidism regulatory, anti-cancer, antidiarrheal and antispasmodic, anti-asthmatic and anti-histaminic, and enzyme inhibition (in Alzheimer’s, diabetes and skin disorders) activities. Conclusion: This plant can be used as a natural potent and safe agent to alleviate numerous medical symptoms and diseases due to its useful pharmacological properties. Thus, further researches are needed in order to compile the clinical effects of this plant via human studies.

OBJECTIVES: We examined demographic characteristics and birth outcomes of infants with neonatal abstinence syndrome (NAS) and their mothers in Canada. METHODS: This retrospective, population-based, descriptive cross-sectional study of mother-infant dyads included all singleton live births in Canada (excluding Quebec), from 2005–2006 to 2015–2016 (N = 2 881 789). Demographic characteristics, NAS, and neonatal and maternal morbidities were identified from delivery hospitalization data (including diagnostic codes). The main composite outcomes were maternal and neonatal mortality and/or severe morbidity, including death and potentially life-threatening conditions in the mother and the infant, respectively. Logistic regression yielded adjusted odds ratios (aORs) and 95% confidence intervals (CIs). RESULTS: The study included 10 027 mother-infant dyads with NAS. The incidence of NAS increased from 0.20% to 0.51%. Maternal mortality was 1.99 vs 0.31 per 10 000 women in the NAS group versus the comparison group (aOR = 6.53; 95% CI: 1.59 to 26.74), and maternal mortality and/or severe morbidity rates were 3.10% vs 1.35% (aOR = 2.21; 95% CI: 1.97 to 2.49). Neonatal mortality was 0.12% vs 0.19% (aOR = 0.28; 95% CI: 0.15 to 0.53), and neonatal mortality and/or severe morbidity rates were 6.36% vs 1.73% (aOR = 2.27; 95% CI: 2.06 to 2.50) among infants with NAS versus without NAS. CONCLUSIONS: NAS incidence increased notably in Canada between 2005–2006 and 2015–2016. Infants with NAS had elevated severe morbidity, and their mothers had elevated mortality and severe morbidity. These results highlight the importance of implementing integrated care services to support the mother-infant dyad during childbirth and in the postpartum period.

Highlights • An updating data about avian infectious bronchitis genotypes circulating in Iran. • First detection of D274 genotype in Iran., The coronavirus avian Infectious bronchitis virus (IBV) poses economic threats to poultry farms worldwide, affecting the performance of both meat-type and egg-laying birds. To define the evolution of recent IBVs in Iran, a genetic analysis based on hypervariable nucleotide sequences of S1 gene was carried out. Tracheal swab samples were collected from 170 Broiler flocks during 2017. Ten tracheal swabs from each flock pooled. From a total number of 170 flocks tested, 84.71% found to be positive. Phylogenetic tree analysis revealed the presence of D274 as a first time in Iran. IS/1494/06 was showed to be dominant IBV type circulating in broiler farms with a significantly higher prevalence than other four genotypes. Considering fluctuations in QX-type prevalence in recent years, continuous monitoring is necessary to reduce economic consequences in layer and broiler farms. The findings highlight the importance of using modified vaccination strategies that are adapted to the changing disease scenario.

Exposure to air pollution has been associated with a wide range of adverse health outcomes. However, the available evidence on the impact of air pollution exposures on liver enzymes is still scarce. The aim of the present study was to assess the relationship between exposure to ambient PM1, PM2.5 and PM10 during pregnancy and serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) in cord blood samples of newborns. Moreover, the association between total street length in different buffers and distance to major roads at the maternal residential address and liver enzymes were investigated. This cross-sectional study was based on data from a sample of 150 newborns, from Sabzevar, Iran. Land use regression models were used to estimate concentrations of air pollutants at home during pregnancy. Multiple linear regression was developed to estimate association of AST, ALT, ALP and GGT with air pollution controlled for relevant covariates. In fully adjusted models, increase in PM1 and PM2.5 as well as PM10 were associated with higher levels of AST, ALT and GGT. Moreover, there was a significant association between total street length in a 100 m buffer at residential address with AST, ALT and GGT. Each meter increase in distance to major roads was associated with −0.017 (95% confidence interval (CI): -0.028, −0.006) decrease in AST. Overall, our findings were supportive for association between PMs exposure during pregnancy and increase in liver enzymes in newborns. Further studies are needed to confirm these findings in other settings and populations.

Importance Seasonal influenza vaccination in pregnancy can reduce influenza illness among pregnant women and newborns. Evidence is limited on whether seasonal influenza vaccination in pregnancy is associated with adverse childhood health outcomes. Objective To assess the association between maternal influenza vaccination during pregnancy and early childhood health outcomes. Design, Setting, and Participants Retrospective cohort study, using a birth registry linked with health administrative data. All live births in Nova Scotia, Canada, between October 1, 2010, and March 31, 2014, were included, with follow-up until March 31, 2016. Adjusted hazard ratios (HRs) and incidence rate ratios (IRRs) with 95% confidence intervals were estimated while controlling for maternal medical history and other potential confounders using inverse probability of treatment weighting. Exposures Seasonal influenza vaccination during pregnancy. Main Outcomes and Measures Childhood outcomes studied were immune-related (eg, asthma, infections), non–immune-related (eg, neoplasms, sensory impairment), and nonspecific (eg, urgent or inpatient health care utilization), measured from emergency department and hospitalization databases. Results Among 28 255 children (49% female, 92% born at ≥37 weeks’ gestation), 10 227 (36.2%) were born to women who received seasonal influenza vaccination during pregnancy. During a mean follow-up of 3.6 years, there was no significant association between maternal influenza vaccination and childhood asthma (incidence rate, 3.0 vs 2.5 per 1000 person-years; difference, 0.53 per 1000 person-years [95% CI, −0.15 to 1.21]; adjusted HR, 1.22 [95% CI, 0.94 to 1.59]), neoplasms (0.32 vs 0.26 per 1000 person-years; difference, 0.06 per 1000 person-years [95% CI, −0.16 to 0.28]; adjusted HR, 1.26 [95% CI, 0.57 to 2.78]), or sensory impairment (0.80 vs 0.97 per 1000 person-years; difference, −0.17 per 1000 person-years [95% CI, −0.54 to 0.21]; adjusted HR, 0.82 [95% CI, 0.49 to 1.37]). Maternal influenza vaccination in pregnancy was not significantly associated with infections in early childhood (incidence rate, 184.6 vs 179.1 per 1000 person-years; difference, 5.44 per 1000 person-years [95% CI, 0.01 to 10.9]; adjusted IRR, 1.07 [95% CI, 0.99 to 1.15]) or with urgent and inpatient health services utilization (511.7 vs 477.8 per 1000 person-years; difference, 33.9 per 1000 person-years [95% CI, 24.9 to 42.9]; adjusted IRR, 1.05 [95% CI, 0.99 to 1.16]). Conclusions and Relevance In this population-based cohort study with mean follow-up duration of 3.6 years, maternal influenza vaccination during pregnancy was not significantly associated with an increased risk of adverse early childhood health outcomes.