This work is concerned with the shape optimal design of an obstacle immersed in the Stokes-Brinkmann fluid, which is also coupled with a thermal model in the bounded domain. The shape optimal problem is formulated and analyzed based on the framework of the continuous adjoint method, with the advantage that the cost of computing the gradients and sensitivities is independent of the number of design variables. Then, the velocity method is utilized to describe the domain deformation, and the structure of Eulerian derivative with respect to the shape of the variable domain for a cost functional is established by applying the differentiability of a minimax problem based on the function space parametrization technique. Moreover, an iterative algorithm is proposed to optimize the boundary of the obstacle in order to reduce the total dissipation energy. Finally, numerical examples are presented to illustrate the feasibility and effectiveness of our method.

Stochastic processes are very useful and have a very important role in modeling the evolution of processes that take different states over time, a situation frequently found in fields like Medical Research and Engineering. In a previous paper and within this framework, we developed the sum of two independent phase-type (PH) distributed variables, each of them being associated with a Markovian process of one absorbing state. In that analysis, we computed the distribution function, and its associated survival function, of the sum of both variables also PH–distributed. In this work, in one more step, we have developed a first approximation of that distribution function to avoid the calculation of an inverse matrix due to the possibility of bad conditioning of the matrix involved in the expression of the distribution function in the previous paper. Next, in a second step, we improve this result, giving a second more accurate approximation. Two numerical applications, one with simulated data and the other one with bladder cancer data, are used to illustrate the two proposed approaches to the distribution function. We compare and argue the accuracy and precision of every one of them using their error bounds and the application to real data of bladder cancer.

The Rayleigh distribution is used to model the lifetime of an object or a service time. In this paper, a new distribution with two parameters (Power Rayleigh distribution) is introduced. Statistical properties of the distribution such as density function, survival function, hazard function, moments, quantile function, residual life, order statistic and extreme value distribution are discussed. Maximum likelihood method is used to estimate the unknown parameters.Simulation Schemes are produced. Finally, an application of the model to real data set is presented to show the superiority of this new distribution by comparing the fitness with its special cases.

In this paper, we study the existence of critical points for the following functional $$I(u)=\frac{1}{2}\ds\int_{\R^N}|\nabla u|^2+\ds\int_{\R^N}|u|^2|\nabla u|^2-\frac{N}{4(N+1)}\ds\int_{\R^N}|u|^{\frac{4(N+1)}{N}},$$ constrained on $S_c=\{u\in H^1(\R^N)|~\int_{\R^N}|u|^2|\nabla u|^2<+\infty,~|u|_2=c,c>0\}$, where $N\geq1$. The constraint problem is $L^2$-critical. We prove that the minimization problem $i_c=\inf\limits_{u\in S_c}I(u)$ has no minimizer for all $c>0$. We also obtain a threshold value of $c$ separating the existence and nonexistence of critical points for $I(u)$ restricted to $S_c$.

The paper is concerned with what is sometimes called “intrinsic oscillation’‘, namely originating in the structure of the differential system itself, and as distinct to “extrinsic oscillation’‘, whereby the oscillation is “pumped” into the system through an inhomogeneous term. This is an important distinction, because the two forms of oscillation are very different. In this paper, we address the highly oscillatory second-order initial value problems of the first type by extending the methods of the second. the asymptotic-numerical solvers for highly oscillatory second-order problems are developed, the error bounds are analyzed, and the accuracy is presented by numerical experiments.

The native and invasive species in the Yellow River Delta were examined for their spatiotemporal characteristics and succession pattern. First, the appropriate Sentinel-2 and Landsat-8 images from 2018 were selected according to phenological characteristics. A random forest algorithm was used to verify the image spectral band significance and separability using selected images to determine the native and invasive species. Then, the spatiotemporal variation of habitat structure of native and invasive species is discussed in depth from the perspective of landscape ecology. Finally, the expansion direction and expansion mode of S. alterniflora were further analyzed, and main results were obtained as follows. (1) At the medium-high resolution multi-spectral image level, the accuracy of different vegetation community extractions can be improved by taking into consideration both the vegetation phenology and the spectral features of remote sensing images. (2) Sentinel-2 images with red edge bands have obvious advantages in vegetation community extraction as compared to Landsat-8 images (Sentinel-2, OA=82.86%, Kappa coefficient=0.79; Landsat-8, OA=78.77%, Kappa coefficient=0.74). (3) The expansion pattern of the S. alterniflora community became spatially continuous, more regularized and aggregated overtime. (4) The expansion in the north shore mainly faces to the sea, and the south bank mainly faces to the land, and this phenomena is closely related to the sedimentation of the Yellow River Delta. Marginal and external expansion both occurred, but marginal expansion predominated. The results from this study have important theoretical and scientific value for the environmental protection and sustainable development of the entire Yellow River Delta.

Abstract Objective To explore the role of fibronectin 1(FN1) in hypertensive disorder complicating pregnancy(HDCP) and human umbilical vein endothelial cells(HUVECs). Methods Plasma FN1 of 80 HDCP women and 40 healthy pregnancy were detected by ELISA and its correlation with the clinical data of HDCP were analyzed. Lentivirus vectors was transfected into HUVECs to induce the overexpression of FN1. The levels of proinflammatory cytokines TNF-ɑ, IL-6 were determined by ELISA and the activity of MMP9 and MMP2 were detected by Gelatin zymography assay. Apoptosis rate was analyzed by TUNEL, and Ad-mCherry-GFP-LC3 was transfected to observe the autophagy. The expression of IKK-α, p-P65, nuclear P65, EMT marker proteins: α-SMA, E-Cadeherin, Bcl2, Bax, caspase-9, autophagy marker proteins:LC3Ⅱ, ATG5 and BENC1were detected by western blot. Results Plasma FN1 in HDCP patients was high expressed and it was increased with the development of HDCP. Overexpression of FN1 increased the expression of TNF-α, IL-6, IKK-α, p-P65, nuclear P65, α-SMA and E-Cadeherin and the activity of MMP9 and MMP2. Overexpression of FN1 induced apoptosis, upregulated the expression of caspase-9, Bax, and downregulated Bcl-2. Overexpression of FN1 upregulated the expression of LC3Ⅱ, ATG5 and BENC1, induced autophagosome formation and inhibited autophagic degradation. MHY1485 could activate mTOR, to reverse the induction of autophagy caused by overexpression of FN1. Conclusion Plasma FN1 was related to the pathogenesis and progress of HDCP. Overexpression of FN1 in HUVECs increased the inflammation, induced the degradation of ECM, EMT and apoptosis, induced autophagosome formation and inhibited autophagic degradation by inhibiting activation of mTOR.

The outbreak of the 2019-nCoV virus has coincided with Chinese Lunar New Year, when tens of millions of people travel for the Spring Festival holiday during the world's largest annual human migration. Travellers give wings to novel coronavirus. Thanks to China's efforts that they have effectively contained the cross-border spread of the 2019-nCoV.Medicine staff make great effort to prevent and control the epidemic disease, and so do community service workers. AS of Sunday, 53 community workers had died in the line of duty in China's prevention and control of the 2019-nCoV epidemic, according to the Ministry of Civil Affairs . In the fight against 2019-nCoV, community workers have been facing enormous pressure, including a high risk of infection and inadequate protection from contamination, overwork, frustration, patients with negative emotions, a lack of contact with their families, and exhaustion. Thanks to community workers, the virus transmission route is cut off and the emergence of new cases is effectively curbed.

Letter to the Editor, BJOG Exchange

This article seeks to analyze relevant federal public policies in Brazil related to soil and water conservation in order to extract the key lessons learned upon its implementation to support the participatory formulation of the National Plan for Soil and Water Sustainable Management. The policy analysis was made based on six strategic axis: Legislation, Prevention, Conservation, Recovery, Monitoring and Integration. These analyzes results aim to contribute to subsidize the Plan construction and identify instruments to increase the use of soil and water resources efficiency in agricultural production according to the different environmental, social and economic conditions of the country’s regions. Seven public policies were selected, characterized and analyzed. The results showed that none of the analyzed public policies are taking enough actions to accomplish with the six strategic axis for soil and water sustainability. These gaps were detected and described as opportunities to be considered under the new national policy framework. The needs for greater involvement of civil society and other relevant stakeholders on policy design and decision making as well as integration among federal ministries were also identified. In conclusion, it is suggested that the new Plan should be designed under a decentralized and participatory process to effectively gather engagement and stronger commitment from governments and other strategic stakeholders in public decisions towards soil and water sustainable management in the agriculture, thus contributing to sustainable rural development.

Objective: To assess the indications and complications of late amniocentesis, as well as the advantagement of advanced genetic test results. Design: Retrospective analysis of case notes of women who underwent late amniocentesis. Setting: A tertiary fetal medicine center in China Population or Sample: 1243 pregnant women (1272 fetuses) that underwent amniocentesis at 24+0 to 39+4 weeks, between January 2014 and June 2019 in our hospital. Methods: Indications, complications, genetic test results and pregnancy outcomes were reported for each pregnancy. Information was obtained from case records, validated by research staff and analyzed by SPSS 21. Main Outcome Measures: Indications, complications, genetic test results, and pregnancy outcomes. Results: Of the 1243 women included, late detected abnormal ultrasound finding(s) (88.3%) comes to be the most common indication. PTB rate and IUD rates were 3.1% and 1.7% separately. Sixty-six fetuses with aneuploidy (5.2%) and Sixty-seven others with a pathogenic CNVs (5.3%) were identified by CMA. One pathogenic CNV (8.3%) were reported via WES. The diagnostic yield turned to maximal (31%) in the sub-group of fetuses with suspected prenatal diagnosis results, following by combination of ultrasound findings (23.1%). Conclusions: Since CMA and ES have considerable detection rates, it is reasonable to serve late amniocentesis as an effective and safe method to detect fetal abnormalities or reassure parents following late detected abnormal ultrasound findings. However, A percentage of CMA and ES may expose uncertain results like VOUS. Therefore, comprehensive genetic counseling is necessary. Key words: Prenatal diagnosis; Chromosomal-microarray-analysis; Fetal malformations; Late amniocentesis; Exon sequencing; Third trimester

A new heterogeneous bio-catalyst was prepared by the immobilization of pseudomonas fluorescens lipase (PFL) onto metal-organic frameworks (MOF), NH2-MIL-53(Fe), using covalent cross-linking. The immobilized lipase [PEG-PFL@NH2-MIL-53(Fe)] was firstly applied for enantioselective transesterification of (R,S)-4-fluoromandelic acid (4-FMA) with acyl acetate. The effects of temperature, substrate ratio, and reaction time on conversion rates and enantiomer excess were investigated. Experimental results show that the catalytic activity, enantioselectivity, and the thermal stability of PFL are significantly improved by polyethylene glycol (PEG) modification and immobilization. By optimizing the reaction conditions, the excellent results were obtained with conversion of 49.6% and enantiomer excess of 98.0% for the immobilized PFL catalyzed transesterification reaction. Furthermore, the immobilized lipase possesses excellent reusability with 83% of its initial activity after four cycles.

Acidithiobacillus ferrooxidans cells can oxidize iron and sulfur and are key members of the microbial biomining communities that are exploited in the large-scale bioleaching of metal sulfide ores. Some minerals are recalcitrant to bioleaching due to presence of other inhibitory materials in the ore bodies. Additives are intentionally included in processed metals to reduce environmental and microbially influenced corrosion. We have previously reported a new aerobic corrosion mechanism where A. ferrooxidans cells combined with pyrite and chloride can oxidize low grade stainless steel (SS304) with a thiosulfate-mediated mechanism. Here we explore process conditions and genetic engineering of the cells to enable corrosion of a higher grade steel (SS316). The addition of elemental sulfur and an increase in the cell loading resulted in a 74% increase in the corrosion of SS316 as compared to sulfur- and cell-free control experiments. The overexpression of the endogenous rus gene, which is involved in the cellular iron oxidation pathway, led to further 85% increase in the corrosion of the steel. Thus, the modification of the culturing conditions and cell line, led to a more than 3-fold increase in the corrosion of SS316 stainless steel, such that 15% of the metal coupons was dissolved in just 2 weeks. This work demonstrates how the engineering of cells and the optimization of their cultivation conditions can be used to discover conditions that lead to the corrosion of a complex metal target.

Consider a general template to generate sequences (or polynomials) using the inverse Mellin transform and a kernel function ϕ(s) $$ p_k(x) = f(x) ^{-1}[\phi(s) q_k(s)](x) $$ here pk(x) and qk(x) are polynomials, and f(x) is a function that cancels out with the generating form from the inverse Mellin transform. This is observed with an example setting qk(s)=sk, ϕ(s)=Γ(s) and f(x)=ex, we have $$ B'_k(x) = e^x ^{-1}[\Gamma(s) s^k](x) $$ where B′k(x) appear to be some form of alternating Bell polynomials, and the coefficients of these polynomials are made up of Stirling numbers of the second kind S₂(n, k) as $$ B'_n(x) = ^n (-1)^{n-k} S_2(n,k) x^k $$ we also find that $$ ^n S_2(n,k)}{2^n} x^{k/2} = e^{} ^{-1}[\Gamma(2s) s^n](x) $$ very interestingly $$ (1+x)^{n+1} ^{-1}[\Gamma(s)\Gamma(1-s) s^n](x) ^n (-1)^{n-k-1} A[n,k] x^{k+1}, k>0 $$ where A(n, k) as the Eulerian numbers. The agreement is off slightly for k = 0. There is a more general form to this $$ (1+x)^{n+t} ^{-1}[{\Gamma(t)} s^n](x) $$ which for t = 1 gives the Eulerian numbers, and for t = 2 is related to A199335. We can even insert t = 1/2, and get a sequence which is related to A185411 (with an additional factor to 1/2n). FIXING THE SIGNS We now consider a modification to the transform to fix the signs, define the inverse-Q transform as $$ p_n(x) = ^{-1}[\phi(s)](n,x) = ^{-1}[\phi(s) (-s)^n](-x) $$ where we have chosen the inverse because of the inverse Mellin transforms, now we have $$ ^{-1}[\Gamma(s)](x) ^{-1}[\Gamma(s)](n,x) = B_n(x) = ^n S_2(n,k) x^k $$ for Bell polynomials Bn(x) and interpreting 0⁰ as 1 which is common in combinatorics. It’s still (perhaps) not entirely right, because for ϕ(s)=Γ(s)Γ(1 − s) we have $$ (1-x)^{n+1}^{-1}[\Gamma(s)\Gamma(1-s)](n,x) = x A_n(x), n>0 $$ relating to Eularian polynomials, equally one could say $$ (1-x)^{-1}[\Gamma(s)\Gamma(1-s)](x) = {(1-x)^n}, n>0 $$ TABLE OF RELATIONS |c|c| Function & Function & Numbers Γ(s) & ex & StirlingS2 Γ(s)Γ(1 − s) & (1 + x)n + 1 & Eulerian Numbers we can see that the function f(x) is clearly related to ℳ−1[ϕ(s)], which is exciting because, by assuming qk(s)=sk for all inputs it links the function ϕ(s) directly a special class of numbers T(n, k). We can as questiosn such as , which kernel ϕ(s) produces the binomials?

Background: Inter-societal Accreditation Commission (IAC) mandates using specific/appropriate image acquisition for transesophageal echocardiography (TEE). We hypothesized that an automated TEE imaging protocol improves study efficiency and workflow compared with a manual protocol. Methods: Three TEE disease-based protocols were included. Image acquisition was done twice for each TEE, once each using a manual and automated method in random order. TEE exam duration and number of sonographer keystrokes for each method were recorded. Keystrokes were grouped into specific categories. Multivariate analysis of variance was performed for each variable. The same automated TEE software was used for all automated protocol TEE exams. Results: The study included 22 patients, 14 males, ages 31-83 years, average BMI of 28.8 kg/m2 (S.D.+/-6.3). Automated protocols compared with manual protocols significantly reduced TEE exam duration (novice, 10:59±2 vs 12:23±2 min; expert, 8:35±1 vs 9:54±2 min, p<0.05). The protocol performed second was shorter regardless of protocol method; however, the percentage decrease in duration was significantly greater when the automated protocol was performed second (27% vs 6%, p <0.05). The automated protocol required fewer sonographer keystrokes than the manual protocol (novice, 206±34 automated vs 287±48 manual; expert, 185±30 automated vs 254±43 manual, p<0.05). The total number of images acquired was similar between automated and manual protocols, without a significant difference in image quality. Conclusion: Automated protocols improve TEE efficiency by reducing the study duration and sonographer keystrokes regardless of TEE operator experience and without a difference in the total number of TEE images acquired or TEE image quality.

BACKGROUND: chest tube insertion is recommended after cardiac surgery, and chest tube inserted annually for a large number of these patients. In addition to its benefits, the chest tube may have risks that are mismanaged. One of these risks is the possibility of pleural effusion, which involves relatively high rates. Therefore, we conducted a systematic review to properly manage the chest tube and reduce its complications. METHODS: This systematic review of cohort study asked the question: Is there enough evidence to determine the right time to remove the chest tube? We search ISI Web of Science, PubMed, Scopus and Embase through 1 January 2015 to 30 September 2019 to identify retrospective or prospective cohort studies. RESULTS: Three studies of the studies reviewed recommended early chest tube removal and two studies recommending delaying. Of course, early and late in the studies had different meanings and time frames that were examined. CONCLUSIONS: More and more evidence and studies are needed to determine the right timing and management of the chest tube removal but our systematic review is based on the available evidence revealed that if the chest tube removal occurs about 24 hours postoperatively, and with less than 100 ml drainage within the last 8 hours, it reduced the risk of pleural effusion and improve many other outcomes.

Ancient DNA research has developed rapidly over the past few decades due to the improvement in PCR and next-generation sequencing (NGS) technologies, but challenges still exist. One major challenge in relation to ancient DNA research is to recover genuine endogenous ancient DNA sequences from the raw sequencing data. This is often difficult due to the degradation of ancient DNA and high levels of contamination, especially homologous contamination. In this study, we collected whole genome sequencing (WGS) data from 6 ancient samples to compare different mapping algorithms. To further explore more effective methods to separate endogenous DNA from the homologous contaminations, we attempted to recover reads based on the ancient DNA specific characteristics of deamination, depurination, and DNA fragmentation with different parameters. We propose a quick and improved pipeline for separating endogenous ancient DNA while simultaneously decreasing the homologous contaminations to a very low proportion. Overall, these recommendations for ancient DNA mapping and separation of endogenous DNA in this study could facilitate future studies of ancient DNA.

An underdeveloped but potentially valuable molecular method in ecology is the ability to quantify the frequency with which foraging pollinators carry different plant pollens. Thus far, DNA metabarcoding has only reliably identified the presence/absence of a plant species in a pollen sample, but not its relative abundance in a mixed sample. Here we use a system of four congeneric, co-flowering plants in the genus Clarkia and their bee pollinators to (1) develop a molecular method to quantify different Clarkia pollens found on foraging bees; and (2) determine if bee pollinators carry Clarkia pollens in predictable ways, based on knowledge of their foraging behaviors. We develop a molecular method we call quantitative amplicon sequencing (qAMPseq) which varies cycling number (20, 25, 30, and 35 cycles) in polymerase chain reaction (PCR), individually indexing the same samples in different cycle treatments, and sequencing the resulting amplicons. These values are used to approximate an amplification curve for each Clarkia species in each sample, similar to the approach of quantitative PCR, which can then be used to estimate the relative abundance of the different Clarkia species in the sample. Using this method, we determine that bee visitation behaviors are generally predictive of the pollens that bees carry while foraging. We also show that some bees carry multiple species of Clarkia at the same time, indicating that Clarkia likely compete via interspecific pollen transfer. In addition to adding a ‘missing link’ between bee visitation behavior and actual pollen transfer, we suggest qAMPseq as another molecular method to add to the developing molecular ecology and pollination biology toolbox.

Background and aims: Cardiac magnetic resonance (CMR), has shown conflicting data regarding existence of structural abnormalities in patients with idiopathic premature ventricular contractions (PVCs) from the right ventricular outflow tract (RVOT). Our aim was to evaluate the prevalence of low voltage areas (LVA) in the RVOT of patients with PVCS from the outflow tract and in a control group. Secondly, assess for the presence of a non-invasive electrocardiographic (ECG) marker. Methods: 56 consecutive patients, 45 with frequent PVCs (>10000/24h) LBBB, vertical axis, negative in aVL and 11 subjects without PVCs. Arrhythmogenic right ventricular cardiomyopathy was ruled out in all patients. An ECG was performed with V1-V2 at the 2nd intercostal space and the presence of a Brugada ECG pattern (BrP) was assessed. Bipolar voltage map of the RVOT was performed in sinus rhythm (0.5 mV-1.5 mV colour display). Areas with electrograms < 1.5 mV represented the LVA. We tested for the association between high BrP and LVA. Results: None of the patients in the control group had BrP or LVA. In the PVC group, 29 patients (64%) had type 2 BrP and 28 (62%) had LVAs. LVAs were more frequent in patients with BrP; 93% versus 4%, p<0.0001, which was associated with LVA, OR (95% CI): 202.50 (16.92- 2423), p<0.0001. Conclusions: LVAs were frequently present in the RVOT of patients with idiopathic PVCs. They were absent in controls and can be unmasked by the presence of BrP in high right precordial leads.

Objectives The prevention and control of the COVID-19 pandemic might associate with paternal perinatal depression during their partners’ delivery. This study aims to investigate the prevalence of paternal perinatal depression exposure to the COVID-19 pandemic and to determine the risk factors. Design This is a cross-sectional study Population The participants of perinatal fathers were recruited in one hospital during December 31, 2019 to April 11, 2020 in Wuhan. Methods The Edinburgh Postnatal Depression Scale (EPDS) and the APGAR family function scale was used to evaluate paternal perinatal depression and family function, respectively. The chi-square tests and multivariable logistic regression were applied for data analysis. Results There were 1,187 valid fathers included and the prevalence of paternal perinatal depression was 13.82%. Compared with fathers recruited before the announcement of human-to-human transmission, fathers showed significantly lower risk of perinatal depression (OR=0.54, 95% CI: 0.34, 0.87; OR=0.30, 95% CI: 0.14, 0.63; respectively) during traffic restriction period and public transportation reopened period in Wuhan. Low or fair of family function significantly associated with elevated risk of paternal perinatal depression (OR=2.45, 95% CI: 1.56, 3.83). Moreover, fathers reported low family income, poor sleep quality, and smoking were significantly associated with increased risks of perinatal depression. Conclusions Paternal screening was suggested to early detect perinatal depression during the COVID-19 pandemic. Traffic restriction and good family function have positive impacts on paternal perinatal depression. These results could provide some evidence for health authorities to formulate targeted prevention and control strategies on paternal perinatal depression.

Objective: Polycystic Ovary Syndrome (PCOS) is associated with metabolic risk. Complement proteins regulate inflammation and lipid clearance but their role in PCOS-associated metabolic risk is unclear. We sought to establish whether the complement system is activated in PCOS in the fasting and postprandial state. Design: Case-control study Setting: University hospital Population: Fasting complement levels were measured in 84 women with PCOS and 95 healthy controls. Complement activation post-oral fat tolerance test (OFTT) was compared in 40 additional subjects (20 PCOS, 20 controls). Methods: Activation pathway (C3, C4, C3a(desArg), factor B, factor H, properdin, Factor D) and terminal pathway (C5, C5a, terminal complement complex [TCC]) proteins were measured by commercial or in-house assays. Main outcome measures: Fasting and postprandial complement proteins and their activation products. Results: Fasting C3, C3a(desArg) and TCC concentrations were increased in insulin-resistant (Adjusted differences: C3 0.13g/l [95%CI 0-0.25]; C3a(desArg) 319.2 ng/ml [19.5-619]; TCC 0.66 μg/ml [0.04-1.28]) but not in insulin-sensitive women with PCOS. C3 and factor H levels increased with obesity. Post-OFTT, C3 and C4 levels increased to a similar extent in PCOS subjects and controls, while factor H levels increased more in women with PCOS compared to controls (Adjusted differences (area under the curve): 12,167 μg min/ml [4,942-19,392]), particularly in the presence of concomitant obesity. Conclusions: Activation and terminal complement pathway components are elevated in patients with PCOS, especially in the presence of insulin resistance and obesity. Interventions which regulate complement activation may be helpful in reducing cardiometabolic risk.

Objective To analyze the factors of BPPV patients increased significantly in our hospital. Methods From February 5, 2020 to March 7, 2020, 29 patients were diagnosed as BPPV with detailed physical examination records. Age, sex, risk factors of cerebrovascular diseases, exercise, time spent asleep or in bed, and time spent outside during sunny periods were analyzed. A total of 26 BPPV patients were reviewed during the period of February 9, 2019 to April 30, 2019, and the above information was recorded through a telephone survey. Using Stata 15.1 statistical software, the measurement data in accordance with normal distribution are expressed by \(\overline{x}\pm S\), and the comparison between groups is expressed by t test; the counting data is expressed by frequency or percentage, and the comparison between groups is performed by Fisher exact test. Results Analysis between male and female found a difference that females were still the main group of BPPV; there were significant differences in exercise time, time spent in bed and time spent in the sun between the two groups (P < 0.001). Conclusion The BPPV of young and middle-aged people increased significantly during a period 30 days under the quarantine policy in Hangzhou. Age, risk factors of cerebrovascular diseases is not the main risk factor of BPPV. Lack of exercise and the prolonged time spent lying are the important risk factors. Changing unhealthy lifestyles may be the solution to decreasing the morbidity of BPPV. Significance Finding the possible mechanism for BPPV, put forward new hypothesis.

The peninsular effect is a geographical phenomenon that explains patterns of species richness. Hypotheses regarding the peninsular effect in bird taxa should be more focused on testing not only recent deterministic processes but also migrant inflow associated with recent environmental variations. We aimed to identify the latitudinal patterns of passerine species richness and test hypotheses regarding recent deterministic processes (climate, primary productivity, habitat diversity, forest area, and anthropogenic disturbances) and migration influence (ratio of migrant species richness) in the Korean peninsula. We used the distribution data of 147 passerine species from 2006 to 2012. Single regression between passerine species richness and latitude supported the existence of the peninsular effect. Mean temperature induced by latitude gradient negatively affected LAI and forest area, and positively habitat diversity. However, passerine species richness was only influenced by LAI and forest area. Ratio of migrant species richness increased as decreasing habitat diversity and was not influenced by LAI and forest area. And we found that ratio of migrant species richness increased with increasing latitude, and contributed to the increasing in passerine species richness. No. of patches did not influenced passerine species richness. These results support the existence of the peninsular effect in the distribution of passerine birds induced by recent deterministic processes such as primary productivity and habitat area, and migrant species inflow caused by competition.

Discussion Coronavirus disease 2019 (COVID-19) is highly transmittable pathogenic viral infection caused by a novel coronavirus (2019-nCoV) closely related to the Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS) Coronaviruses. was first identified in Wuhan, Hubei province, China on December 8, 2019. and has rapidly spread around the world causing a global health crisis.The signs & symptoms of SARS-CoV-2 induced COVID-19 are a bit similar to those seen in other respiratory infections and include the following finding at onset of illness [1, 2 ,3] fever (83 % -98.6 %), Dry cough (59.4-82) & fatigue, myalgia “(muscle pain) (69.6 % -44 %) with less common symptoms headache (8%), sore throat (5%) & diarrhea (3%)Until presently there are no safe promising clinical treatments, no vaccine or documented anti COVID 19 drugs are validated to develop efficient therapeutic strategies except for Remdesivir, in addition favipiravir & combination therapy with hydroxychloroquine plus azithromycin which all been evaluated against COVID-19 in clinical trials, resulted in clinical recovery [4]The World Health Organization had declared the outbreak to be Public Health emergency of international concern on 30 January 2020 and as the cases spread from Wuhan, throughout China and into other countries. The first case of 2019-20 corona virus was confirmed to have reached Bahrain in February 21st 2020, substantially followed by Saudi Arabia in March 2nd 2020, soon after on march 11 2020 as the cases surged the world health Organization (WHO) recognized it as pandemicAs COVID-19 began to spread and according to the current evidence [5] the primary method of transmission between people is thought to occur through respiratory droplets and contact routes. In order to protect the health care workers and non-infected patients from potential COVID-19 patients, infection control measures were established in most of institutes especially the ENT departments to minimize the nosocomial spread among the health workerThe strategy for infection control against COVID-19 includes material preparation and distribution upon the availability, triage strategy, training on infection prevention measures, limiting the traffic to the hospital inpatient and outpatient, preparedness for hospital disaster plan and specific disaster plan for each department, emergency expansion plan for the intensive care unit capacity, Preparedness for field medical words and Intensive care unit, etc.5 days after WHO announced the CoVid 19 pandemic We followed the new policy guidelines by avoiding the grouping so decisions were made regarding departmental meeting including the training activities and journal club to withhold it and transferred into a virtual meeting and internal memo which is distributed through emails till recentlyTo reduce the number of patients’ visits in our clinics, in a manner without compromising the patientcare we started using phone call consultation method (figure 1). We offered to refill medication for stable patient’s and sending medications using the hospital pharmacy transport service (figure 2)We confined the appointments for the emergency and the post-operative cases, we Minimize the elderly patients and the patients with comorbidities traffic into the hospital and we restricted the walk-in patients for the clinics for all the consultants.As well as we follow the policy of separating or distancing the appointment time for the patient presented to the departmentWe also limited access to the clinics by arranging the following: we started sending List of Outpatients appointments information at least one day in advanced to the Security Gates for allowing only the scheduled patients to enter, then the patient had to pass by two visual triage units one at the hospital entrances and other at the clinic entrance following the score criteria for the COVID-19After being screened by the triage station the patients were requested to get seated in the Waiting area and the seats arrangements were distant for the safety precautions (figure 3)In the clinical room, nose and throat examinations were considered to present the highest risk, and additional protective measures were implemented from our side., so all patients have been requested to sit on the non-clinical chair and in case of the condition required clinical examination then they are requested to get seated on the clinical examination chairOn the Ent clinical examination, the threshold for the endoscopic examination of the nose and pharynx have been reduced to the maximum and the personal protective equipment use has been implicated as the rules and hospital guidelines and in case of endoscopic examination needed a local anesthetic spray was replaced by gel anesthesia, and the smallest possible diameter laryngoscope was recommended to reduce sneezing and cough reflexesHence the endoscopic procedures are considered an aerosol generating so all surfaces in the clinic room can potentially become contaminated thus we performed an appropriate disinfection between each patients & post the endoscopy proceduresOur department has decided to reschedule and postpone all elective procedures that may aerosolize tissue including tonsillectomy, adenoidectomy Sino-nasal surgery, and other airway procedures. While we agreed that’s the otological procedures along with the oncology procedure where continued until further notice for phase 1 emergency response to an outbreakWhen a procedure is indicated, appropriate personal protective equipment must be worn including fluid-resistant gown, gloves, eye protection, full face shield, fit-tested N95 respirator, head cover, and impermeable shoes that can be disinfected (figure 4)Inside the operating room we Limited the number of healthcare providers participating in any procedure to only those absolutely necessary.After surgery we try to minimize the hospital stay postoperatively and trying to discharge the patient same day of the surgeryWith fewer cases and clinics, we have begun assigning our staff to attend a comprehensive training and Operational courses to support country preparedness and response to this pandemic as well we encourage them to be involved in research related activities & creating a database for departmental and/or multidisciplinary