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OBJECTIVE: COVID-19 has had an unprecedented impact on medical care use and delivery, including stark reductions in emergency department (ED) volume. The aim of this study was to assess changes in incidence of OB/GYN ED visits and disease severity at time of presentation during the COVID-19 pandemic. STUDY DESIGN: We conducted a multicenter retrospective study of OB/GYN-related ED visits before and during the COVID-19 pandemic. Incidence rates (IRs) and severity measures were compared across time periods and years. RESULTS: A total of 18,668 OB/GYN ED encounters occurred between January 1 and December 31, 2020, compared to 21,014 encounters between January 1 and December 31, 2019. During shelter-in-place, visits decreased by 41% compared to the pre-pandemic period in 2020 before returning to typical rates (incidence rate ratio (IRR) = 0.98 in fall/winter). We found a similar proportion of patients with hemoglobin < 7 g/dL for diagnoses associated with bleeding and patients with white blood cell count > 12,000 per µL in the setting of infection comparing corresponding time periods in 2019 and 2020. There were fewer formal OB/GYN consults, hospital admissions at time of presentation, and urgent surgical procedures performed across all periods in 2020; however, hospitalization within 7 days substantially increased in the first half of 2020. CONCLUSION: The incidence of OB/GYN ED visits declined substantially between March and August 2020 but then returned to pre-pandemic levels by fall/winter 2020. The decreased incidence was not accompanied by an increase in severity of presentation.

Non-host resistance (NHR) is a plant defense system against the majority of microbial pathogens. Blumeria graminis f. sp. hordei (Bgh), is an obligate biotrophic ascomycete fungal pathogen that can grow and reproduce only on living cells of wild or domesticated barley (Hordeum sp.).‎ In this study, the expression pattern of eight defense-related genes including NPR1, PR2, PR5, PR1-2, Lipase, LTP, PAL and POX was assessed in bread wheat (Triticum aestivum cv. Darya) against the powdery mildew fungus Bgh. Hydrogen peroxide (H2O2) activity in leaf tissues was also detected histochemically with 3,3-diaminobenzidine (DAB) staining. Result showed that in response to virulence agent, Bgh spores, papillae and hypersensitive response (HR) were formed in the 53.9 and 40.1% of infected area, respectively while in the rest of the infected area (6%) spores were not germinated. According to the histochemical analysis, the wheat NHR against Bgh belongs to type IІ NHR and display a multi-layered feature including wax composition, pre-formed barriers, papilla formation, hypersensitive response. According to results of expression analysis, the Pox, PR5 and PR1-2 expression level were clearly upregulated 24 hours post inoculation (hpi) and LTP was identified as an early signaling response to Bgh. In this study NPR1 was down regulated during all given time points, thus we suggested that salicylic acid (SA) signaling pathway may be mediated by a NPR1-independent mechanism(s) in wheat-Bgh interaction. The coordinated induction of a set of so-called systemic acquired resistance (SAR) genes including POX, PR1-2 and PR5 was observed in wheat-Bgh interaction. Expression pattern of defense-related genes at the wheat-Bgh interaction can be taken as an indication of their functional relevance at different time points of tissue infection.

One of the significant concerns in the MTDC systems is that voltage source converters (VSCs) do not hit their limits in the post-contingency conditions. Converters outage, DC line disconnection, and changeable output power of wind farms are the most common threats in these systems. Therefore, their destructive impact on neighboring AC systems should be minimized as much as possible. The fixed droop control is a better choice than others to deal with this, although it also has some limitations. Accordingly, a novel centralized droop-based control strategy considering N-1 contingency is proposed in this paper. It prevents converters from exceeding their limits while causes optimal power sharing and minimum DC link voltage deviation immediately, without secondary control layer. It also utilizes maximum wind power without curtailment. These properties improve the performance of the MTDC system in post-contingency conditions. The effectiveness of the proposed control method is validated by simulation of a 4-terminal VSC-MTDC system in MATLAB/Simulink R2016a.

Polycarbonate (PC) wastes received from optical (CDs) and digital optical discs (DVDs) were chemical recycled by using diethylene glycol (DEG) and water as an alternative green solvents and magnetite nanomaterials coated with amine modified silica nanoshell (Fe3O4/SiO2/NH2) as the recyclable heterogeneous catalyst to recover bisphenol-A (BPA) as a valuable material in 100% yield and without using harmful reagent and environmental problems. The nano-magnetic heterogeneous catalyst can be recycled for four cycles and used next reaction. The recovered BPA and nanomaterials were examined with transmission electron microscopy (TEM), thermogravimetric analysis (TGA), X-ray powder diffraction (XRD), and spectroscopic methods (1H NMR, 13C NMR, FTIR).

Overall plant growth and microbial biomass can be effected by dust accumulation. The chloroform fumigation-extraction method was used to evaluating the effect of cement dust pollution emitted from Kurdistan cement factory on soil microbial biomass carbon. Chlorophyll content (a, b and total) of plants species was measured in different distance from cement factory. Microbial biomass C (Cmic) amounts ranged from 0.138 to 1.102 mg/g soils in the polluted sites and from 0.104 to 1.283 mg/g soils in the control area. Soils polluted with alkaline cement dust resulted in meaningful reduction in Cmic levels compared to control soils. Pearson correlation coefficients (r) show Cmic was positively correlated to soil CaCO3 content (r = 0.09). Cmic/Corg ratio was 2.54 and 1.92 in the control and cement polluted sites, respectively. Reduction in this ratio can be resulted from soil degradation in cement polluted soils. A significant decrease in the Cmic/Corg ratio in cement dust-polluted soils illustrated that this factor can be applied as a good indicator of soil quality. In the case of chlorophyll content of plant species, maximum reduction of total chlorophyll for Triticum aestivum L. was 45% compared to Hordeum vulgare L. with 60%. Therefore, results show higher sensitivity of H.vulgare than to T. aestivum.

As the generalization of gravitational effects on the point mass systems, we want to study the tidal effect exerted on an extended stellar system using spherical and axisymmetric elliptical models. Considering the Isochrone and Plummer models for a passing extended stellar system, the tidal distance and the equipotential surface are calculated. The corresponding critical surfaces and maps are plotted in different cases. There are different results some of them may be used in describing stellar systems deformation, 33 pages including 1 table and 15 figures; Accepted for publication in "Astrophysics and Space Science"

Land use regression (LUR) analysis has become a key method to explain air pollutant concentrations at unmeasured sites at city or country scales, but little is known about the applicability of LUR at microscales. We present a microscale LUR model developed for a heavy trafficked section of road in Auckland, New Zealand. We also test the within-city transferability of LUR models developed at different spatial scales (local scale and city scale). Nitrogen dioxide (NO

Background and Objective: Stenotrphomonas maltophilia is an opportunistic nosocomial pathogen with high mortality in immunocompromised cases. The aim of this study was to isolate and identify Stenotrphomonas maltophilia in the hospitals’ environment and wards. Material and Methods: In this cross-sectional study, a total of 1108 samples were collected from environment of two hospitals during 12 months. Identification of isolates was performed using biochemical, phenotypic (intrinsic resistance to carbapenems) and molecular methods (amplification of 23S rRNA gene). Results: Of the studied samples, 186 (16.78%) nonfermentative gram negative bacilli (NFGNB) were identified. Amongst NFGNB, 18 (1.62%) isolates were identified as S. maltophiliaby using biochemical tests. Of 18 biochemically identified isolates, 15 (83.3%) were confirmed via PCR. Sinks (40%) and men surgery ward ( 33.3 %( were the most contaminated sites and wards of hospitals, respectively. Conclusion: S. maltophilia is repeatedly isolated from sink which shows that the moist hospital environments need to be considered as a source for dissemination of bacteria. Keywords: Nosocomial Infections, Nonfermentative Gram Negative, Stenotrphomonas Maltophilia, PCR

This chapter deals with the modeling approach towards membrane reactors, making a short overview on the most significative findings in the specialized literature. In detail, 1-D, 2-D and 3-D models are analyzed, pointing out the role of such parameters as the membrane permeability mechanism and hydrogen flux, reaction kinetics, heat and mass transport inside the reactor and within the catalyst pellets, able of influencing the accuracy of the model.

Recently, through the Family Medicine for America’s Health (FMAHealth) Workforce team, 8 family medicine organizations endorsed a “shared aim” to: increase the percentage of US senior allopathic and osteopathic medical students choosing family medicine from 12% to 25% by 2030. Twenty-five

Openings in steel plate shear walls (SPSWs) in buildings are provided for architectural reasons as well as for access requirements. Despite the reduction of stiffness and strength in panels with an opening being well-understood, further studies are essential in order to determine both the mechanism and the degree of this degradation, as well as its dependency on the location and the size of the opening. To accomplish this aim, a non-linear finite element analysis is used in this paper to study the behaviour of both stiffened and unstiffened SPSWs with a single rectangular opening. The size and location of the opening are varied from model to model in order to determine their influences on the stiffness and strength of the system. Based on the results obtained, the strength and stiffness degradation of unstiffened panels are affected adversely by the location of the opening. In contrast, the re-location of an opening of a specific size within the panel area in stiffened panels does not appear to influence this degradation, so that the stiffness and strength deterioration are not a function of the location of the opening. As expected, both stiffened and unstiffened panels experience a progressive reduction in their stiffness and strength with an increase of the size of the opening. It is demonstrated further that with an increase in the opening ratio (width to height), the energy absorbed by the system arising from seismic loading considerations in both stiffened and unstiffened SPSWs show a linearly decreasing trend; this trend being less stiff for stiffened panels. Unstiffened SPSWs with a central opening experience the least energy absorption. It is also shown that the absorption of energy is substantially higher in stiffened panels when compared with their otherwise identical, but unstiffened, counterparts.

A novel practically implementable design approach is presented for integrated fault detection and control (IFDC) of uncertain systems. The desired constraints in relation to fault detection (FD) and control objectives are simultaneously considered throughout the design, and mapped to equivalent graphical bounds in Nichols chart. The resulting feedback law is obtained through an interactive loop-shaping technique such that the design bounds are satisfied. The proposed graphical design approach has a number of exclusive benefits from engineering perspective, in terms of simplicity and applicability to a large variety of fault types and models, that are discussed in this paper. The effectiveness of the proposed technique is experimentally assessed using the Three-Tank, Amira DTS200, benchmark system in the presence of multiplicative actuator and sensor faults.

This paper aims at developing an aeroelastic model for the instability analysis of supersonic thick fins. To this aim the modal analysis technique is used for the structural dynamics modelling of a fin with a general structure. An unsteady aerodynamic model is applied based on the shock/expansion analysis over the flat surfaces of the fin along with local application of the piston theory. Assuming a supersonic fin with an arbitrary polygonal cross-section, thickness and initial angle-of-attack, the steady flow properties (e.g. Mach number, density and temperature) are calculated over the flat surfaces of the fin. Then, assuming small amplitude vibrations, the generalised aerodynamic forces are obtained in terms of the structural modal coordinates. Using the obtained model, the effect of thickness, initial angle-of-attack, taper ratio and sweep angle on the aerodynamic derivatives and aeroelastic stability of the fin are studied which show their remarkable effects on the instability Mach number and its type. Specially, the presented results show that increasing the fin thickness dramatically diminishes the stability margin mainly at low angles of attack. Also a sharp decrease of the divergence Mach number is observed by increasing the fin’s incidence angle.

The study of Persian epic-heroic prose works, created under the influence of Shahnameh and following narrative tradition, is one of the fields which is not considered in present research trend. Amir Arsalan is the last outstanding and influential instance of declined current of Persian narrative stories which was being narrated by Naghib-al-Mamalek Shirazi in the form of Naghali in Qajar period and has been inscribed by Touran Dokht, the daughter of Nasir-al-Din Shah. The influence of this story among various socio-cultural classes of Iran shows the importance and status of this work but the real value of this story can be understood only through investigation of its structural motives. Knowing the necessity of a research on motives of Persian narratives and the lack of research on Amir Arsalan, the authors of this article study the fictional motives of this story in four sections: marvelous motives, epic-picaresque motives, romantic motives and religious motives. The main feature of motives in this work is the presence of two factors, that is, repetition and stimulation. Another characteristic of this study is the influence of Shahnameh on Amir Arsalan which has took place through Naghali and the allusions to Shahnameh which are present in Amir Arsalan is an evidence for this matter.

A Joint Automatic Dispenser Equipment (JADE) has been designed and fabricated for automatic withdrawal and calibration of radiopharmaceutical materials. The thermoluminescent dosemeter procedures have shown a reduction in dose to the technician's hand with this novel dose dispenser system JADE when compared with the manual withdrawal of (99m)Tc. This system helps to increase the precision of calibration and to minimise the radiation dose to the hands and body of the workers. This paper describes the structure of this device, its function and user-friendliness, and its efficacy. The efficacy of this device was determined by measuring the radiation dose delivered to the hands of the nuclear medicine laboratory technician. The user-friendliness of JADE has been examined. The automatic withdrawal and calibration offered by this system reduces the dose to the technician's hand to a level below the maximum permissible dose stipulated by the international protocols. This research will serve as a backbone for future study about the safe use of ionising radiation in medicine.

Objective The aim of this study was to compare the effect of 6% hydroxyl ethyl starch solution with 4% gelatin and Ringer’s solutions on the haemodynamic stability of patients after coronary artery bypass graft (CABG) surgery and immediately after discontinuation of cardiopulmonary bypass (CPB). Methods This was a randomised, double-blind clinical trial of 92 patients who were candidates for on-pump CABG. After discontinuation of CPB, all patients were transferred to the intensive care unit (ICU) and divided randomly into three groups. The first group received Ringer’s solution, the second group 4% gelatin, and the third 6% hydroxyl ethyl starch (HES) solution (Voluven). Haemodynamic parameters such as heart rate, mean arterial pressure, systolic blood pressure, diastolic blood pressure, central venous pressure, cardiac output and the presence of arrhythmias were documented. Results The volume needed for maintaining normal blood pressure and central venous pressure in the range of 10–14 mmHg was less in the HES group than in the other groups. The volume was similar however in the gelatin and Ringer’s groups in the first 24 hours after surgery. Urinary output in the first four and 24 hours after surgery were significantly higher in the HES group than in the other two groups. Mean creatinine levels were significantly lower in the HES group. Conclusion HES (6%) had a better volume-expanding effect than gelatin (4%) and Ringer’s solutions, and its short-term effects on renal function were also better than gelatin and Ringer’s solutions.

Reactive oxygen species (ROS) derived from molecular oxygen under biotic and abiotic stress such as salinity which have deleterious effects on cell metabolism. The toxic effect of ROS counteract by enzymatic as well as non-enzymatic antioxidant system. Superoxide dismutase (SOD) has a potential role for elimination of ROS. Halophytes respond to salt stress at different levels and can be a model for increasing salt tolerance in crop plants. Thus salt tolerance gene isolation and cloning of gene as well as subsequent transformation are first step for sensitive crop improvement. Aeluropus littoralis is a halophyte plant from poaceae family can be as a beneficial plant with high potential for creal breeding. There was no report on isolation of SOD gene from A. littoralis and little genomic study of this plant carried out. In this study a novel gene from A. littoralis isolated. This gene amplified by reverse transcription-PCR and cloned in E. coli pTZ57R/T cloning vector. The AlSOD gene sequence contained 456bp and the deduced transcripts encoding 152 amino acids shared a high homology with those putative CuZnSOD of higher plants like Zea mays and Oryza sativa.

In this paper, we present the modeling of a non-invasive electromagnetic sensor for the measurement glycaemia. The model is based on a bio-impedance measurement. First, we optimized the dimensions of the sensor’s parameters that can influence on measurement. Second, we investigated the influence of the dielectric parameters on the conductivity and its impact on the measurement of glycaemia. Results from this study demonstrate that the variation of the sensor impedance depends on the resistance and the inductance, which depend on the conductivity. The sensitivity of the output and input signal ratio strongly depends on the conductivity of the medium under investigation. Maximum conductivity at the resonance frequency was demonstrated.

Colour is recognized as one of the criteria for personality analysis in modern psychology. Colours are a kind of energy and visible sounds which play an important role in one's life. Their influences on human's soul and mind are undeniable. In other words, colour can be considered as a reflection of one's mental and physical situation since colours have special influence on soul and body equally. Max Lusher's study of colours is among the most recent theories which deal with psychological analysis and character explication. In this method, colours are introduced as numbers. Those which are denied and those which are well- accepted are the reflection of oneâs thoughts and feelings. Hence, word selection and colour choice can help us to analyze the poet's personality and mind. Among the modern poets, Forogh Farrokhzad has repeatedly manipulated colours in her poems among which "black" is a specific one. This paper aims at interpreting Forogh Farrokhzad poetry in terms of colour analysis on Max Lusher's theory.

The epoxidation of styrene–butadiene rubber (SBR) was carried out using in situ generated dimethyldioxirane (DMD) as an epoxidant and tetra n-butyl ammonium bromide as phase-transfer catalyst. The epoxidation progress was monitored by 1H-, 13C-NMR and FT-IR spectroscopy. In order to optimize the epoxidation yields, kinetic studies were performed and the influences of different reaction parameters were determined. It is found that the epoxidation of SBR corresponds to second-order reaction relative to the concentration of double bonds in polymer backbone and DMD. The rate constant as well as the activation energy was established.

The bulk free-radical polymerization of styrene was carried out on a spinning disc reactor (SDR) with prepolymer feeds previously prepared in a stirred batch reactor at 70°C. The SDR significantly enhanced the reaction rate when the conversion of the prepolymer feed was about 50%. There was an optimal disc rotation speed, that is, 1500 rpm, at which the conversion enhancement was maximized. Increasing the disc rotation speed up to 1500 rpm increased the conversion, but a further increase beyond this speed caused the conversion enhancement to decrease. This behavior could be attributed to the dual effect of the disc speed (controlling both the residence time and the effective radial mixing of the reaction media) on the disc. On the other hand, the multipass disc feeding mode was used as an approach to increase the residence time and evolution of the conversion of the reacting mixture in the SDR. Surprisingly, a maximum conversion change of about 40% was achieved for a prepolymer feed of 50% after three passes across the rotating disc. Furthermore, the effect of multipass disc feeding on the molecular characteristics of the SDR products was investigated. In comparison with the results obtained at a feed conversion of 30%, the weight-average molecular weight, the z-average molecular weight, and the polydispersity index of the three-pass SDR products prepared with a 50% feed conversion at a rotation speed of 1500 rpm were lower than those of the one-pass products. This behavior could be attributed to probable chain scission of long polymer chains as a result of the high shear and elongation forces that arose on the disc surface. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2009

In order to determine zinc and catalase content of seminal plasma in the buffalo and to study their associations with the semen characteristics, 54 semen samples were collected from 10 buffalo bulls; semen volume and sperm concentration, gross and progressive motility and viability were evaluated, seminal plasma was then harvested by centrifugation and its zinc content was estimated by atomic absorption spectrophotometer and its catalase activity determined by using a commercial kit. The zinc content of the seminal plasma (Mean +/- SEM) was recorded as 154.40 +/- 1.74 mg L(-1), while, the mean catalase value was 32.00 +/- 0.42 U mL(-1). The mean zinc values was highly correlated with sperm progressive motility and viability and with catalase values (p = 0.000 for all) and also was associated with gross motility (p = 0.020) and negatively with abnormal morphology (p = 0.049). The catalase values were highly associated with sperm progressive motility, viability and zinc content (p = 0.000 for all) and was associated with sperm gross motility (p = 0.024). For further clarification of these correlations, the samples were categorized in three groups of excellent (Ex, >90% motile, n = 33), good (Go, 80-89% motile, n = 15) and moderate (Mo

Hydroxyl terminated polybutadiene (HTPB) was epoxidized using in situ generated dimethyl dioxirane (DMD) as an oxidant and MoO 3 as a catalyst at 25 °C. Different reaction factors such as reaction time and catalyst concentration were examined. The ability of different C=C geometries toward epoxidation was evaluated in detail at various reaction times and the products were characterized by H NMR, 13 C NMR and FT-IR techniques and no side reaction were detected. It was found that hydroxyl group of the polymer chain was preserved in the oxidation reaction without using any conditional control and relative reactivity depended on chain microstructure in the following way: 1,4-cis > 1,4-trans > 1,2-vinyl. This method is easy, environmentally friendly, convenient and the reaction conditions are straightforward.

Background and Aims: Work related musculoskeletal disorders are common in midwiferypractice which requires extensive labor-intensive tasks. Therefore midwives are prone tomusculoskeletal disorders. This study aims at investigating the risk factors and musculoskeletalsymptoms among in midwives.Method: we conducted this cross-sectional study in Hamedan, western Iran. Active Midwives(n=134) were asked to complete the questionnaires (demographic and a version of the Nordicquestionnaire) if they had at least 1 year experience in practice and were not pregnant during theprevious year. 102 Midwives completed the questionnaires. Data were analysed by SPSS v.10software.Results: 66.7% of the Midwives reported some musculoskeletal symptoms, of whom 54% waswork related. The most common musculoskeletal symptoms were low back pain (50%), shouldersand wrists (46%). There were significant associations between musculoskeletal symptoms andmarital status (p< 0.001), duration of employment (p