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A correlation coefficient is a statistical measure that contributes in deciding the degree to which changes in one variable predict changes in another. Wang's single-valued neutrosophic sets have still continued to improve to pentapartitioned neutrosophic sets. In this article, we analyze the characteristics of pentapartitioned neutrosophic [PN] sets and interval-valued pentapartitioned neutrosophic sets [IVPN] with improved correlation coefficients. We have also used the same approach in multiple attribute decision-making methodologies including one with a pentapartitioned neutrosophic environment. Finally, we implemented the above technique to the problem of multiple attribute group decision-making. © 2023 Elsevier Inc. All rights reserved.
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Correlation is a statistical measure that expresses the extent to which two variables are linearly related. It is a common tool for describing simple relationships without making a statement about cause and effect. Correlations are useful for describing relationships among data. In this paper, we apply the correlation coefficient to pentapartitioned neutrosophic Pythagorean sets (PNPSs). Also, we have introduced the new concept of interval-valued pentapartitioned neutrosophic Pythagorean set (IVPNPS), and some of its basic operations are also investigated. Also, the correlation measure of IVPNPS is proposed, and some of its properties are discussed. The concept of this correlation measure of PNPS is the extension of correlation measures of Pythagorean fuzzy set and pentapartitioned neutrosophic set. Then, using the correlation of PNP and IVPNP set measure, the application of COVID injection is given. © 2023 Elsevier Inc. All rights reserved.
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Coronavirus disease 2019 (COVID-19) is a worldwide public health problem that has attracted much attention due to its clinical findin gs. Measurement of IgG and IgM antibodies is of great importance for researchers and it will help t o develop a new diagnostic and therapeutic method in clinical care. In this cross-sectional study, we aim to measure th e IgG and IgM antibody levels in 401 suspected COVID-19 volunteers. We also measure the time duration for the appearance of IgG and IgM antibodies from the onset of symptoms to sa mpling time. Of 401 participants enrolled in the study, 255 (63.59%) were healthy, 79 (19.70%) were a carrier, 59 (14.71%) were cured and 8 (1.99%) were borderline. Of 142 subjects diagnosed with COVID-19, 41 (28.87%) presented with gastrointestin al (GI) symptoms, 83 (58.45%) had no GI symptoms, and 18 (12.68%) were asymptomatic. According to our findings, the measurement of IgG a nd IgM antibodies will provide the tool for the diagnosis of COVID-19 and significantly boo st research into novel diagnostic and therapeutic approaches.
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Chaotic states of abnormal vasospasms in blood vessels make heart patients more prone to severe infections of COVID-19, eventually leading to high fatalities. To understand the inherent dynamics of such abrupt vasospasms, an N-type blood vessel model (NBVM) subjected to uncertainties is derived in this paper and investigated both in integer order (IO) as well as fractional-order (FO) dynamics. Active-adaptive controllers are designed to synchronize the chaotic turbulence responsible for undesirable fluctuations in diameter and pressure variations of the blood vessel. The FO-NBVM reveals insightful rich dynamics and faster adaptive synchronization compared to its IO model. The practical implications of this work will be useful in analysing chaotic dysfunctionalities of the blood vessel such as vasoconstriction, ischaemia, necrosis, etc. and help in developing control strategies and modular responses for COVID-19 triggered heart diseases. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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Background: COVID-19 has led to the demand for finding effective antiviral agents. Preliminary experiments showed Umifenovir inhibit replication in vivo. There is limited data on the clinical efficacy of COVID-19-infected pneumonia. Therefore, we aimed to evaluate this medication based on clinical findings. Methods: The present study was designed to investigate the advantages and disadvantages of Umifenovir and compared to empirical treatments. For this purpose, multi-stage sampling was considered. 56 people who had mild-to-moderate symptoms without signs of pneumonia, were selected by accidental non-random sampling method and divided into two groups [(group A with Hydroxychloroquine (HCQ) and group B in combination with Umifenovir] by randomized block sampling (1:1). During the study, three patients left the case group. Their clinical signs and symptoms were evaluated on 3rd, 7th, and 14th day after taking these medicines in the disease course. The SPSS software was used for data analysis and the significance level was considered to be p<0.05. Results: On the seventh day after visiting the patients, there were statistically significant differences in recuperation dry cough (p=0.001), weakness (p=0.004), gastrointestinal symptoms (p=0.043) and shortness of breath (p=0.001) between the two groups so that group B patients (HCQ and Umifenovir) had a faster recovery. In patients treated with HCQ and Umifenovir compared to the control group, myalgia (p=0.03), gastrointestinal symptoms (p=0.047) and weakness (p=0.007) improved significantly earlier during the illness. Conclusion: Evaluation of the clinical findings in mild-to-moderate COVID-19 patients' symptoms was performed and it was shown that recuperation was faster in the group who received both HCQ and Umifenovir. Copyright 2022, Journal of Iranian Medical Council. All rights reserved.
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Background: Many people around the world have been affected by depression, which causes a great deal of problems. Emotion regulation refers to processes influencing emotion, experiences, and expresses. Objective(s): This study aimed to evaluate the role of emotion regulation to predict depressive symptoms among Kermanshah University of Medical Sciences students. Method(s): This descriptive-analytical study was conducted on 305 students at Kermanshah University of Medical Sciences, Iran, who were randomly selected by convenient sampling method. The informed consent forms were signed by the participants. Then the Beck Depression Inventory-Second Edition (BDI-II) and the Cognitive Emotion Regulation Scale (CERQ-18) were completed in a virtual/face-to-face manner due to the COVID-19 pandemic. The data were analyzed with SPSS software version 26. A total of 296 participants were analyzed, of whom 198 (66.9%) were female, and 98 (33.1%) were male. Result(s): The self-blame strategies (beta = 0.31, P <= 0.001), positive reassessment (beta =-0.26, P <= 0.001), catastrophic (beta = 0.26, P <= 0.001), numerical importance (beta =-0.12, P <= 0.001) and positive refocus (beta =-0.10, P <= 0.001) predict 40% of the variance of depression in five steps. Inconsistent strategies such as self-blame and catastrophe directly predict depression. Further, depression is inversely related to positive reassessment, insignificance, and positive refocus. Conclusion(s): According to the results, there was a significant direct relationship between self-blame and catastrophic thinking as maladaptive cognitive emotion regulation strategies with depression. In addition, positive refocusing and positive reassessment had a significant negative correlation with depression among adaptive emotion regulation strategies. Copyright © 2022 Journal of Kermanshah University of Medical Sciences.
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Background: The novel Coronavirus Disease 2019 (COVID-19) is a cause of respiratory/systemic disorder which is spread in the world since September 2019 and is now a serious pandemic. To date, there is limited data on children available in the literature especially in Middle East. Objective(s): In this article, we aimed to provide an overview of clinical and laboratory data in children with COVID-19 admitted in Mashhad, Iran. Method(s): This was a cross sectional study that was related to the Registry of COVID19 Pediatric patients in Mashhad (RCPM), from 20 February 2020 to 5 August 2020 in Akbar and Dr. Sheikh Hospitals, the tertiary referral centers of pediatric COVID19 patients in Northern East of Iran. Demographic information, clinical symptoms, laboratory results, management, and outcome data from each patient's medical records were recorded. Result(s): In this period, from 1245 patients referred to our center, 97 patients were positive for COVID19 with PCR or serologic test. Majority of them were male (58, 59.8%). The median age of patients was 5.5 years old. The mean time from beginning the symptoms to hospitalization was 6.72 +/- 9.02 days. The most age groups were 1-5 years old (28.9%) Twenty patients lead to pneumonia (20.6%), eight of them lead to Multi-Inflammatory Syndrome Of Children (MISC) (8.2%), Kawasaki disease was seen in 4 patients (4.1%), myocarditis in 4 patients (4.1%) and 14 patients were died (14.4%). Conclusion(s): The existence of asymptomatic cases indicates the difficulty in identifying pediatric patients without clear epidemiological information. This finding suggests a dangerous situation if community acquired infections occur. Copyright © 2022 Scientific Publishers of India. All rights reserved.
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BACKGROUND: The majority of patients with B-cell-depleting therapies show compromised vaccination-induced immune responses. Herein, we report on the trajectories of anti-SARS-CoV-2 immune responses in patients of the RituxiVac study compared with healthy volunteers and investigate the immunogenicity of a third vaccination in previously humoral non-responding patients. METHODS: We investigated the humoral and cell-mediated immune response after SARS-CoV-2 messanger RNA vaccination in patients with a history with anti-CD20 therapies. Coprimary outcomes were antispike and SARS-CoV-2-stimulated interferon-γ concentrations in vaccine responders 4.3 months (median; IQR: 3.6-4.8 months) after first evaluation, and humoral and cell-mediated immunity (CMI) after a third vaccine dose in previous humoral non-responders. Immunity decay rates were compared using analysis of covariance in linear regression. RESULTS: 5.6 months (IQR: 5.1-6.7) after the second vaccination, we detected antispike IgG in 88% (29/33) and CMI in 44% (14/32) of patients with a humoral response after two-dose vaccination compared with 92% (24/26) healthy volunteers with antispike IgG and 69% (11/16) with CMI 6.8 months after the second vaccination (IQR: 6.0-7.1). Decay rates of antibody concentrations were comparable between patients and controls (p=0.70). In two-dose non-responders, a third SARS-CoV-2 vaccine elicited humoral responses in 19% (6/32) and CMI in 32% (10/31) participants. CONCLUSION: This study reveals comparable immunity decay rates between patients with anti-CD20 treatments and healthy volunteers, but inefficient humoral or CMI after a third SARS-CoV-2 vaccine in most two-dose humoral non-responders calling for individually tailored vaccination strategies in this population.Trial registration numberNCT04877496; ClinicalTrials.gov number.
Subject(s)
COVID-19 , Viral Vaccines , Antibodies, Viral , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Immunity, Cellular , SARS-CoV-2 , Vaccines, Synthetic , mRNA VaccinesABSTRACT
Given the abrupt shift to online learning when schools closed down due to the COVID-19 pandemic, this chapter provides insights gained during the transition. The purpose of this chapter is to explore the use of flipped learning in teacher education courses as the courses transitioned to a virtual model. The authors discuss their participation in virtual professional learning communities (VPLCs) as well as efforts to engage students in VPLCs. This chapter offers perspectives of both instructors and students as well as insights gained while teaching in a teacher education program and while teaching at a Nicaraguan university. A primary focus within the chapter is the use of various technologies and the collaboration among colleagues in and out of the United States to instruct teachers candidates and practicing teachers from primary level through higher education programs. Practical guidance is offered to those looking to begin or further the virtual teaching and learning.
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Background: This study aimed to evaluate the demographic features in patients with Coronavirus Disease-2019 (COVID-19) and to determine the relationship between Computerized Tomography (CT) and mortality. Objectives: This study aims to evaluate the characteristics for diagnosis and severity of involvement in primary imaging, their adaptation to the course of the disease, and their relationship with mortality. Methods: This retrospective study was conducted on the medical records of 212 patients with suspected COVID-19 admitted to the teaching hospitals of Shiraz University of Medical Sciences from February 20, 2009 to August 2020. The patients’ CT images were also assessed and the frequency of abnormalities was determined. Results: The Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test was positive in 204 patients (99%). Consolidation was observed in all the 206 patients. The highest degree of lung involvement (90%) was observed in 69 patients (33.5%). Atoll sign was also diagnosed in 121 cases (58.7%). Besides, crazy-paving reticular lines, subpleural sparing, and bronchial distortion were observed in 129 (62.6%), 88 (42.7%), and 124 patients (60.2%), respectively. In addition, multi-segment was detected in the CT scan results of 194 cases (94.2%), which was higher compared to the single segment seen in 12 patients (5.8%). Conclusion: CT scan is a relatively sensitive technique for diagnosing COVID-19. The study results revealed a significant relationship between CT scan and death. The disease severity was also accurate using this method.
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The 2019 Coronavirus disease pandemic (COVID-19) has spread to over two hundred countries worldwide, affecting > 170 million people and causing >3,500,000 deaths (May 29, 2021). Severe COVID-19 disease mostly disturbs the respiratory system, but gastrointestinal symptoms, including vomiting, nausea and diarrhea, are also present. Herein, we are reporting a COVID-19 patient with acute pancreatitis (AP) in Zanjan, Iran. This patient showed acute pancreatitis as a COVID-19-related complication, emphasizing the importance of evaluating pancreas-specific plasma amylase levels in patients with COVID-19 and intestinal cramping. © 2022, Zanjan University of Medical Sciences and Health Services. All rights reserved.
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The novel coronavirus infection involves both the Central and Peripheral Nervous systems. Some of the presentations include acute cerebrovascular disease, impaired consciousness, transverse myelitis, encephalopathy, encephalitis, and epilepsy. Our patient was a 78-year-old man with dementia and diabetic nephropathy who was admitted two times for possibly COVID-19 infection. At the first hospitalization, the patient is treated with hydroxychloroquine and Kaletra based on clinical symptoms and initial laboratory findings due to suspicion of COVID-19. After the negative RT-PCR test of the nasopharyngeal sample for COVID-19 and evidence of aspiration pneumonia in CT scan, the patient was discharged with oral antibiotics. Five weeks later, he was rehospitalized with loss of consciousness, fever, and hypoxemia in the physical exam;he had neck stiffness in all directions, So the central nervous system (CNS) infection was suspected, the cerebrospinal fluid (CSF) sample was in favor of aseptic meningitis and second RT-PCR test of nasopharyngeal sample for COVID-19 was positive, but Brain MRI just showed small vessel disease without evidence of encephalitis. In the second hospitalization, he had acute renal failure, which was treated with supportive care, and also suffered from pulmonary embolism with cavitary lesions in his lungs. Meningitis with pulmonary embolism and acute renal failure have not yet been reported. Our patient is the first one, so we decided to share it. This case showed a different presentation of COVID-19 without typical lung involvement. So, we must pay attention to any signs and symptoms in a patient suspected of having a COVID-19.
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Background: B-cell depleting therapies increase COVID19 morbidity and mortality. For this specific population, evidencebased vaccination strategies are lacking. Here, we investigated humoral and cell mediated immune responses to SARS-CoV2 mRNA-based vaccines in patients receiving CD20-B-cell depleting agents for autoimmune disease, malignancy, or transplantation. Methods: Patients at the Bern University Hospital with a treatment history of anti-CD20 depleting agents (rituximab or ocrelizumab) were enrolled for analysis of humoral and cell-mediated immune responses (by IFN-g release assay) after completing vaccination against SARS-CoV2. Primary outcome was the the anti-spike antibody response in anti-CD20-treated patients (n = 96) in comparison to immunocompetent controls (n = 29). Results: Anti-spike IgG antibodies were detected in 49% of patients 1.79 months after the second vaccine dose (interquartile range, IQR: 1.16-2.48) compared to 100% of controls (p <0.001). SARS-CoV2 specific interferon-γ release was detected in 20% of patients and 75% of healthy controls (p <0.001). Only 11% of patients, but 75%of healthy controls showed positive reactions in both assays, respectively (p <0.001). Time since last anti-CD20 therapy (7.6 months), peripheral CD19+ (>27/μl), and CD4+ lymphocyte count (>653/μl) predicted humoral vaccine response (area under the curve [AUC]: 67% [CI 56-78], 67% [CI 55-80] and 66% [CI 54-79], (positive predictive value [PPV]: 0.78, 0.7 and 0.71). Conclusions: This study provides evidence for blunted humoral and cell-mediated immune responses elicited by SARS-CoV2 mRNA vaccines in patients with CD20-depleting treatment history. Lymphocyte subpopu-lation counts including CD4+ T helper cell counts are associated with vaccine response in this highly vulnerable population.
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BACKGROUND: B-cell-depleting therapies increase the risk of morbidity and mortality due to COVID-19. Evidence-based SARS-CoV-2 vaccination strategies for patients on B-cell-depleting therapies are scarce. We aimed to investigate humoral and cell-mediated immune responses to SARS-CoV-2 mRNA-based vaccines in patients receiving CD20-targeted B-cell-depleting agents for autoimmune disease, malignancy, or transplantation. METHODS: The RituxiVac study was an investigator-initiated, single-centre, open-label study done at the Bern University Hospital (Bern, Switzerland). Patients with a treatment history of anti-CD20-depleting agents (rituximab or ocrelizumab) and with no previous history of SARS-CoV-2 infection were enrolled between April 26 and June 30, 2021, for analysis of humoral and cell-mediated immune responses (by interferon-γ [IFNγ] release assay) at least 4 weeks after completing vaccination against SARS-CoV-2. Healthy controls without a history of SARS-CoV-2 infection were also enrolled at least 4 weeks after completing vaccination against SARS-CoV-2. All study participants received two doses of either the Pfizer-BioNTech BNT162b2 vaccine or the Moderna mRNA-1273 vaccine. The primary outcome was the proportion of patients with a history of anti-CD20 treatment who showed a humoral immune response against the SARS-CoV-2 spike protein in comparison with immunocompetent controls. Prespecified secondary endpoints were the effect of anti-CD20 therapy (including time since last treatment and cumulative dose) on humoral or cell-mediated immune responses to SARS-CoV-2 vaccination, and biomarkers of immunocompetence. This study is registered with ClinicalTrials.gov, NCT04877496. FINDINGS: The final study population comprised 96 patients and 29 immunocompetent controls. The median age of patients was 67 years (IQR 57-72) and of controls was 54 years (45-62), and 51 (53%) of 96 patients and 19 (66%) of 29 controls were female. The median time since last anti-CD20 treatment was 1·07 years (IQR 0·48-2·55) and the median cumulative dose of an anti-CD20 depleting agent was 2·80 g (1·50-5·00). Anti-spike IgG antibodies were detected in 47 (49%) of 96 patients 1·79 months (IQR 1·16-2·48) after the second vaccine dose compared to 29 (100%) of 29 controls 1·81 months (1·17-2·48) after the second vaccine dose (p<0·001). SARS-CoV-2-specific IFNγ release was detected in 13 (20%) of 66 patients and 21 (75%) of 28 of healthy controls (p<0·001). Only nine (14%) of 66 patients were double positive for anti-SARS-CoV-2 spike IgG and cell-mediated responses, compared with 21 (75%) of 28 healthy controls (p<0·001). Time since last anti-CD20 therapy (>7·6 months; positive predictive value 0·78), peripheral CD19+ cell count (>27 cells per µL; positive predictive value 0·70), and CD4+ lymphocyte count (>653 cells per µL; positive predictive value 0·71) were predictive of humoral vaccine response (area under the curve [AUC] 67% [95% CI 56-78] for time since last anti-CD20 therapy, 67% [55-80] for peripheral CD19+ count, and 66% [54-79] for CD4+ count). INTERPRETATION: This study provides further evidence of blunted humoral and cell-mediated immune responses elicited by SARS-CoV-2 mRNA vaccines in patients with a history of CD20 B-cell-depleting treatment. Lymphocyte subpopulation counts were associated with vaccine response in this highly vulnerable population. On validation, these results could help guide both the administration of SARS-CoV-2 vaccines and B-cell-depleting agents in this population. FUNDING: Bern University Hospital.
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An attempt that is made here is to apply neutrosophic sets to a medical data. By means of extended Hausdorff minimum distance we find out the core symptoms of the patients. From the minimum distance or the core symptoms we can get a clue for the type of disease affecting the patient.
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Objectives: The first case of 2019 novel coronavirus disease (COVID-19) was reported in Iran in February 2020. Here, we report the epidemiological and clinical characteristics of patients with COVID-19 and factors associated with mortality in these patients. Methods: A retrospective cohort study was conducted from February 22, 2020, to March 24, 2020, in Golestan Hospital in Kerman-shah, Iran. Demographic data including underlying diseases and clinical data including the presenting symptoms, chest computed tomography (CT) scan, reverse transcription polymerase chain reaction (RT-PCR) test results, and outcomes were extracted from electronic medical records. Simple and multiple logistic regression methods were used to explore the factors associated with mor-tality. Results: Of 245 patients admitted with COVID-19, 155 (63.30%) were male. The mean age of the subjects was 54.68 ± 19.21. Forty-five (18.48%) patients had underlying diseases. Common symptoms were dyspnea (n = 137;55.9%), cough (n = 93;38.0%), and fever (n = 78;31.8%). All patients had pneumonia with abnormal findings on chest CT scan (100%), and RT-PCR test results were positive in 87 (35.50%) patients. Of the total admitted cases, 38 (15.5%) patients died during hospitalization. An old age (OR = 1.09;95% CI: 1.02 to 1.06), history of heart disease (OR = 5.07;95% CI: 1.46 to 17.58), hypertension (OR = 5.82;95% CI: 1.13 to 30.04), smoking (OR = 11.44;95% CI: 1.01 to 29.53), history of at least one underlying disease (OR = 3.31;95%CI: 1.54 to 7.09), and symptoms of decreased consciousness at the time of admission (OR = 24.23;95% CI: 2.62 to 223.39) were associated with mortality. Also, the symptoms of cough (OR = 0.383;95% CI: 0.17 to 0.88) and fever (OR = 0.278;95% CI: 0.10 to 0.74) had a negative association with mortality. Conclusions: In the current study, factors including old age, smoking, symptoms of decreased consciousness, and underlying diseases such as heart disease, hypertension, and history of at least one underlying disease were associated with mortality. Factors associated with mortality should be considered so that we can better manage patients with COVID-19.
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In this study a decision making model through Neutrosophic Q-fuzzy set has been designed. During Covid-19 – Pandemic situation, education sector is stabilizing its work through online mode. Information Communication Technology (ICT) platforms offer many opportunities for the academicians and Learners. This study intends to analyse the selection of best ICT tool by fixing important criteria. The selection of optimal ICT tool is scrutinized in this study using Significant Score of a Neutrosophic fuzzy number. © 2020. All Rights Reserved.