Nonreciprocal-Beam Phased-Array Antennas

This study presents a nonreciprocal-beam phased-array antenna constituted of phase-gradient patch radiators integrated with transistor-based nonreciprocal phase shifters. Such an antenna exhibits different beams for transmission and reception states. The proposed phased-array antenna provides power amplification for both transmission and reception states, which is of paramount importance in most practical applications. In addition, in contrast to the recently proposed time-modulated antennas, the proposed nonreciprocal-beam phased-array antenna introduces no undesired time harmonics and unwanted frequency conversion, requires no radio frequency bias signal. Furthermore, the nonreciprocal phased-array antenna is lightweight and is amenable to integrated circuit fabrication. The transmission and reception beam angles, the beam shapes, and the power amplification level may be easily tuned by changing the direct current (dc) bias of the transistors and phase of the passive phase shifters. Such a nonreciprocal-beam phased-array antenna is expected to find military and commercial applications

Demographics of Fall-Related trauma among the Elderly Presenting to Emergency Department; a Cross-Sectional Study

Introduction: Falling is reported to be the most common cause of mortality due to trauma in individuals over the age of 75 years. The present study is designed with the aim of determining the demographics of fall-related trauma among the elderly presenting to emergency department (ED). Methods: The present prospective cross-sectional study was carried out on all elderly patients ≥ 60 years old presenting to ED of a major referral trauma center in North West of Iran during 1 year. Demographic data, location and height of falling, duration of hospitalization, trauma severity and in-hospital outcome of the patients were gathered and reported via descriptive statistics. Results: 228 patients with the mean age of 70.96 ± 5.2 years were studied (53.9% female). Most patients were in the 66-70 years age range (32.6%) and had a history of hypertension (22.3%), who had visited following a fall inside the house (69.3%), due to slipping (73.7%), and from a height equal to or less than 2m (71.9%). 6 (2.6%) patients died in the hospital. Mean trauma severity of patients based on ISS, RTS, and TRISS were 10.65 ± 3.95 (3-19), 7.84 ±.21 (1.4-14.5) and 1.66 ±1.31 (-1.49-3.82), respectively. Regarding need for hospitalization, only ISS shows a significant difference between outpatients and inpatients (p = 0.023). Patients who died had a significantly higher trauma severity based on ISS (p < 0.0001) and RTS (p < 0.0001). Conclusion: Based on the findings of the present study, slipping and syncope are the most common causes of  falling in the studied elderly that had mostly happened inside the house and from a height less than 2m. Therefore, most patients were in the mild to moderate range of trauma severity. ISS and RTS were significantly higher in the 6 (2.6%) patients who died

Value of Manchester Acute Coronary Syndromes Decision Rule in the Detection of Acute Coronary Syndrome; a Systematic Review and Meta-Analysis

Introduction: There is still no consensus on the value of Manchester Acute Coronary Syndromes (MACS) decision rule in detecting acute coronary syndrome (ACS). Therefore, the purpose of the present systematic review and meta-analyzes is to summarize the clinical evidence in the evaluation of  the value of MACS in the diagnosis of ACS.Methods: A literature search was performed on the Medline, Embase, Scopus, and Web of Science databases. Outcomes included acute myocardial infarction (AMI) and major adverse cardiac event (MACE).  Data were analyzed in the STATA 14.0 statistical program and the results were reported as summary receiver operating characteristics (SROC), sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio with 95% confidence interval (95% CI).Results: Finally, 8 articles included in the meta-analysis. The area under the SROC of MACS was excellent in rule out of AMI (AUC = 0.99, 95% CI: 0.97 to 0.99) and MACE (AUC = 0.97, 95% CI: 0.95 to 0.98). The sensitivity and specificity of the troponin-only MACS/history electrocardiogram alone MACS (HE-MACS) in the rule out of AMI were0.99 (95% CI: 0.98-0.99) and 0.22 (95% CI: 0.11-0.37), respectively, and for  the original MACS were in order 0.99 (95% CI: 0.98-0.99) and 0.26 (95% CI: 0.20-0.34),. The sensitivity and specificity of the troponin-only MACS / HE-MACS in the rule out of MACE were 0.94 (95% CI: 0.92-0.96) and 0.22 (95% CI: 0.12-0.39) compared to the 0.99 (95% CI: 0.98-0.99) and 0.27 (95% CI: 0.22-0.33) for the original MACS.Conclusion: The findings of this study showed that original MACS, troponin-only MACS, and HE-MACS are able to rule out AMI and MACE. However, further studies are needed in developing countries to confirm its external validity

Comparison of Glasgow Coma Scale with Physiologic Scoring Scales in Prediction of In-Hospital Outcome of Trauma Patients; a Diagnostic Accuracy Study

Introduction: Limitations of Glasgow coma scale (GCS) led the researchers to designing new physiologic scoring systems such as revised trauma score (RTS), rapid acute physiology score (RAPS) and rapid emergency medicine score (REMS), and worthing physiological scoring system (WPSS). However, it is not yet known whether these models have any advantage over GCS. Objective: The present study attempted to compare the values of 4 physiologic scoring systems including RTS, RAPS, REMS and WPSS with GCS in predicting in-hospital mortality of trauma patients. Methods: The present diagnostic accuracy study was performed on trauma patients presenting to emergency departments of 4 hospitals in Iran throughout 2017. Patients were clinically evaluated and were followed until discharge from hospital. Finally, the status of patients regarding mortality and poor outcome (death, vegetative status, severe disability, and moderate disability) was recorded and predictive value of GCS was compared with physiologic scales. Results: Area under the ROC curve of GCS in prediction of in-hospital mortality was not significantly different from that of REMS (0.89 vs. 0.91; p=0.298), RAPS (0.89 vs. 0.88; p=0.657), and WPSS (0.89 vs 0.91; p=0.168) but was significantly more than RTS (0.89 vs. 0.85; p=0.002). In addition, area under the ROC curves of GCS, REMS, RAPS, WPSS and RTS in prediction of poor outcome were 0.89, 0.88, 0.88, 0.91, and 0.81, respectively. Area under the ROC curve of GCS in prediction of poor outcome did not differ from area under the ROC curves of REMS (0.89 vs. 0.88; p=0.887), RAPS (0.89 vs. 0.88; p=0.601) and WPSS (0.89 vs. 0.91; p=0.113) but was significantly higher than RTS (0.89 vs. 0.81; p<0.0001). Conclusions: Findings of the present study indicated that GCS is still the best method for evaluating injury severity and trauma patients’ outcome in the emergency department; because it is easier to calculate and assess than many physiologic scales and it has a better performance in predicting in-hospital mortality and poor outcome compared to RTS

Evaluating the Rate of Violence Against Pre-hospital Emergency Personnel; a Cross-sectional Study

مقدمه: خشونت در محل کار یک مشکل جهانی با شیوع رو به افزایش میباشد. تمام پرسنل درمانی در معرض خشونت قرار دارند اما با توجه به شرایط خاص اورژانس پیش بیمارستانی ، این افراد، در معرض خشونت محل کار بیشتری نسبت به کارکنان سایر بخشهای درمانی قرار دارند. روش کار: این مطالعه از نوع مقطعی و جامعه مورد مطالعه کارکنان بخش فوریت پزشکی استان آذربایجان شرقی بود. روش نمونه گیری به صورت نمونه گیری تصادفی ساده انجام گرفت. نتایج: در مجموع از تعداد ۷۷ نفر شرکت کننده، تمام افراد از جنس مرد بودند. متوسط سن شرکت کنندگان 5/7 ± 4/34 سال و متوسط سابقه کار 7/5 ± 6/9 سال بود. بیش از نیمی از پرسنل اورژانس پیش بیمارستانی طی یکسال گذشته، دو یا بیش از ۲ بار در هفته مورد آزار بیمار قرار گرفته بودند و در ۵/۳۲ درصد موارد پرسنل تکنسین اورژانس پیش بیمارستانی توسط همراه بیمار مورد آزار قرار گرفته بودند. نتیجه گیری: میزان خشونت علیه تکنسین های عملیاتی فوریت پزشکی بالاست.Introduction: Workplace violence is a global problem the prevalence of which is increasing. All healthcare personnel are subject to violence, but considering the special conditions of pre-hospital emergency, its personnel are exposed to a higher rate of workplace violence compared to other healthcare workers. Methods: This was a cross-sectional study and the study population consisted of pre-hospital emergency personnel of East-Azerbaijan province, Iran. The sampling method was simple random sampling. Results:  A total of 77 participants were included all of whom were male. The average age of the participants was 34.4 ± 7.5 years and their average work experience was 9.58 ± 5.7 years. More than half of the pre-hospital emergency personnel had faced violence by patients twice a week or more throughout the previous year. In 32.5% of the cases, pre-hospital emergency medical technicians had experienced violence by a patient’s friend or relative. Conclusion: The rate of violence against pre-hospital emergency medical technicians is high

Intracranial Aneurysm Rupture after SARS-CoV2 Infection : Case Report and Review of Literature

Background: SARS-CoV virus infection results in a dysbalanced and severe inflammatory response with hypercytokinemia and immunodepression. Viral infection triggers systemic inflammation and the virus itself can potentially cause vascular damage, including blood-brain barrier (BBB) disruption and alterations in the coagulation system, which may result in cardiovascular and neurovascular events. Here, we review the literature and present a case of COVID-19 infection leading to an aneurysmal subarachnoid haemorrhage (aSAH). Case Description: A 61-year-old woman presented with dyspnea, cough, and fever. She had a history of hypertension and was overweight with a body mass-index of 34. There was no history of subarachnoid hemorrhage in the family. Due to low oxygen saturation (89%) she was admitted into ICU. A chest CT showed a typical picture of COVID-19 pneumonia. The PCR-based test of an oropharyngeal swab was COVID-19-positive. In addition to oxygen support she was prescribed with favipiravir and hydroxychloroquine. She experienced a sudden headache and lost consciousness on the second day. Computer tomography (CT) with CT-angiography revealed a subarachnoid haemorrhage in the basal cisterns from a ruptured anterior communicating artery aneurysm. The aneurysm was clipped microsurgically through a left-sided standard pterional approach and the patient was admitted again to the intensive care unit for further intensive medical treatment. Post-operatively, the patient showed slight motor dysphasia. No other neurological deficits. Conclusion: Systemic inflammation and ventilator support-associated blood pressure fluctuations may trigger aneurysmal subarachnoid haemorrhage secondary to COVID-19 infection. COVID-19 infection could be considered as one of the possible risk factors leading to instability and rupture of intracranial aneurysm.Peer reviewe

Analysis and Professional Designing of COBRA (Computationally Optimized Broadly Reactive Antigen) Vaccine for Bm86 midgut Protein of R. microplus and R. annulatus Ticks

Introduction: The cattle tick Rhipicephalus spp. causes significant economic losses due to diseases in animals and human. Bm86 is a midgut protein and vaccine candidate, which its sequences among the isolates of Ripsephalus spp are geographically separated, variable, and are the main reason for reducing effectiveness, and subsequently, the failure of the recombinant vaccines. Method: In this bioinformatics study, the sequences of R. microplus and R. annulatus were retrieved, aligned, and edited. Then, the variation plot and phylogenetic tree were constructed. Afterwards, grouping and taxa marking for designing evolutionary vaccine, COBRA antigen, center of tree and ancestral were done. Also, over COBRA vaccine sequences, modeling analysis and superimpose test were done. Results: In both R. microplus and R. annulatus, the most variable region were residues 177-181, 270-276, and 351-352, respectively. 6 sequences were selected as appropriate sequences for design of evolutionary vaccine, and 12 for the realignment of and achieving sequences for design of COBRA antigen. On the other hand, R. annulatus sequences were in sister branches and more similar to each other compared to Bm86 protein sequences in R. microplus except ADQ19687. The sequences selected for vaccine design based on the center of tree and ancestral, were AJE29931, AJE29932, and ATW75472, and ATW5476, ADM86722, ACZ55133 sequences, respectively. Conclusion: Anti-tick COBRA-based vaccines of Bm86 could be more cost-effective and better alternative with broader spectrum, compared to the commonly used recombinant vaccines

Copper-nickel oxide nanofilm modified electrode for non-enzymatic determination of glucose

CuxO-NiO nanocomposite film for the non-enzymatic determination of glucose was prepared by the novel modifying method. At first, anodized Cu electrode was kept in a mixture solution of CuSO4, NiSO4 and H2SO4 for 15 minutes. Then, a cathodization process with a step potential of -6 V in a mixture solution of CuSO4 and NiSO4 was initiated, generating formation of porous Cu-Ni film on the bare Cu electrode by electrodeposition assisted by the release of hydrogen bubbles acting as soft templates. Optimized conditions were determined by the experimental design software for electrodeposition process. Afterward, Cu-Ni modified electrode was scanned by cyclic voltammetry (CV) method in NaOH solution to convert Cu and Ni nanoparticles to the nano-scaled CuxO-NiO film. The electrocatalytic behavior of the novel CuxO-NiO film toward glucose oxidation was studied by CV and chronoamperometry (CHA) techniques. The calibration curve of glucose was found linear in a wide range of 0.04–5.76 mM, with a low limit of detection (LOD) of 7.3 μM (S/N = 3) and high sensitivity (1.38 mA mM-1 cm-2). The sensor showed high selectivity against some usual interfering species and high stability (loss of only 6.3 % of its performance over one month). The prepared CuxO-NiO nanofilm based sensor was successfully applied for monitoring glucose in human blood serum and urine samples