A new copula-based bivariate Gompertz–Makeham model and its application to COVID-19 mortality data

One of the useful distributions in modeling mortality (or failure) data is the univariate Gompertz–Makeham distribution. To examine the relationship between the two variables, the extended bivariate Gompertz–Makeham distribution is introduced, and its properties are provided. Also, some reliability indices, including aging intensity and stress-strength reliability, are calculated for the proposed model. Here, a new copula function is constructed based on the extended bivariate Gompertz–Makeham distribution. Some of its features including dependency properties, such as dependence structure, some measures of dependence, and tail dependence, are studied. The estimation of the parameters of new copula is presented, and at the end, a simulation study and a performance analysis based on the real data are presented. So, by analyzing the mortality data due to COVID-19, the appropriateness of the proposed model is examined. [ FROM AUTHOR] Copyright of Iranian Journal of Fuzzy Systems is the property of University of Sistan & Baluchestan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Extreme Hypertension Associated with SARS-COVID-19 Infection in Pediatrics with Kidney Disease: A Retrospective Observational Study

Introduction: There are no reports of hypertensive emergency as a manifestation or comorbidity of the COVID-19 infection in pediatric patients. Method: In this retrospective observational study, we report patients diagnosed with COVID-19 with presentation of acute severe hypertension from March to February, 2021. Confirmed cases were defined by positive reverse transcription-polymerase chain reaction (RT-PCR) of nasopharynx swab, elevated antibody against, or imaging pattern in favor of it on chest CT-scan. Hypertensive crisis was elucidated by the acute rise of blood pressure more than stage 2 cut off with the potential risk of end-organ damage. Results: Six confirmed SARS-CoV-2 patients with an average age of 4.2 years old were described. Four patients with recently diagnosed nephrotic syndrome and two with chronic kidney disease who were on orderly dialysis were enrolled without clinical signs of liquid accumulation. The lowest and highest systolic and diastolic blood pressures all along hospitalization was 160-200 mmHg and 100-155 mmHg, respectively. All children had poorly controlled hypertension, managed with Labetalol infusion titrated to maximum dosage, extended for at most seven days, and their blood pressure had been regulated with four or five antihypertensive drugs. Conclusion: It is crucial to consider the COVID-19 diagnosis in a patient displaying a hypertension crisis, even in the absence of classic signs of the virus. We recommend that medical practitioners consider the probability of COVID-19 infection in cases presenting to the hospital with acute severe hypertension. © 2023 by SPC (Sami Publishing Company)

Evaluation of Psychiatric Counseling for Patients Hospitalized with COVID-19 in a University-Affiliated General Hospital in Tehran, Iran

Background: Coronavirus disease 2019 (COVID-19) is associated with a number of psychiatric problems in patients;however, mental healthcare in these patients does not appear to be adequate. Objectives: This study aimed to evaluate the extent of psychological care provided to COVID-19 patients admitted to the hospital and the most common reasons for psychiatric counseling. Methods: This study examined the electronic medical records of all COVID-19-positive patients admitted to Rasoul-e-Akram hospital in Tehran, Iran, within April 1 and September 30, 2020 (approximately 2200 cases). Results: Psychiatric consultation was requested for 5.45% of admitted patients with COVID-19 diagnosis based on a positive real-time reverse transcription-polymerase chain reaction. More than half of those who received psychiatric counseling had a previous psychiatric disorder. The most common reason for requesting psychiatric counseling in patients with a previous psychiatric disorder was the patient’s evaluation and management;the most common reason in patients without a psychiatric disorder was agitation and lack of cooperation. The most common diagnosis in patients with a positive history of psychiatric disorder was bipolar disorders (33.9%), followed by opioid use disorder (29%). Adjustment disorder (54%) and delirium (26%) were the most common diagnoses in patients without a history of psychiatric disease. Conclusions: The current study showed that psychiatric counseling in COVID-19 patients was limited to a small number, including those with a positive history of psychiatric illnesses and prominent psychiatric symptoms.

Effect of surgical and N95 facial masks on exercise tolerance, heart rate, respiratory rate and blood oxygen saturation

Background - Although wearing masks is inevitable these days, the effects of wearing them on physiologic parameters have not been reported. This study aimed to assess the effects of wearing no mask, a three-layer standard surgical mask, and wearing an N95 mask on blood oxygen saturation, aerobic tolerance, and performance during exercise. Methods - Twenty-one participants were enrolled in the study. Each participant was monitored with electrocardiography (ECG) while performing an exercise tolerance test using the Bruce treadmill protocol. Testing was conducted three times on different dates. Participants did not use any mask in the first test but did wear surgical and N95 masks during the second and third tests respectively. Respiratory rate (RR) was assessed for 10 seconds and then multiplied by 6. Heart rate (HR) was monitored by ECG, and oxygen saturation levels were monitored (O2Sat) via digital pulse-oximetry. Assessments were done before warm-up, at the middle and end of each Bruce stage, and as well at 1, 2, and 5 minutes into recovery (masks were worn during recovery). Results - HR, RR, and O2Sat measured data were all significantly different between the three trials at end-stage 3 of Bruce treadmill protocol (p<0.05). Although HR was still higher through the recovery period in the N95 trial in comparison with other trials (p<0.05), RR and O2Sat measured data were not different in the recovery phase. Conclusion - HR, RR, O2Sat and exercise tolerance are significantly affected by wearing surgical and N95 masks.

Cancer Patients' Challenges During COVID-19 Pandemic: An Approach to Decision-Making in Management and Policy-Making

Context: Cancer patients are more susceptible to novel coronavirus infection due to their immune system deficiency and anticancer treatments. During the COVID-19 outbreak, cancer patients have faced many challenges. The present study aimed to review the literature on cancer patients' challenges during the COVID-19 pandemic to offer an approach to decision-making in management and policy-making. Evidence Acquisition: In this review study, national and international databases were searched. Inclusion Criteria were the risk of COVID-19 in cancer patients, medical services, surgery, and cancer screening during the COVID-19 pandemic, cancer patients' challenges during the COVID-19 pandemic, and management and policy-making in this pandemic. Results: Cancer patients' challenges during the COVID 19 pandemic were classified as follows: (1) risk of COVID-19 for cancer patients;(2) access to medical services and screening during the COVID-19 pandemic;and (3) psychological disorders during the COVID-19 pandemic. Studies have revealed that individuals with cancer experience a higher risk of the COVID-19 infection and mortality compared to healthy individuals. Most oncology clinics postpone unnecessary appointments;however, patients with invasive cancer are treated with no delay. Proper management, disease control, and attention to mental health care can prevent psychological disorders. Conclusions: Managing cancer patients' challenges during the SARS-CoV-2 is of paramount importance. Cancer clinics need to develop new care and follow-up protocols. Moreover, policy-makers should provide appropriate policies to address the challenges of this disease in the future.

Therapeutic challeng es of COVID-19 in a patient admitted to the psychosomatic ward: A case report

Introduction: Early diagnosis of 2019-nCoV infection is of great importance and can be challenging in psychiatric patients, especially when a mental illness such as somatoform disorder causes one or more bodily symptoms because the clinical features of this group of patients may be more confusing compared with non-psychiatric patients. On the other hand, treating this infection in psychiatric patients faces some challenges. Case Presentation: A case of the 2019-nCoV infection is reported in a patient who was admitted to the psychosomatic ward with a diagnosis of somatic symptom disorder. The patient had a history of numerous unexplained physical complaints, usually complained of some new physical symptoms when informed of the time of his discharge. Although the possibility of misdiagnosis was high, based on examinations and some paraclinical evaluations, the patient underwent a simultaneous diagnosis of COVID-19. Unlike usual, he did not complain of any new physical complaints after informing of the 2019-nCoV infection and was willing to be discharged. Some diagnostic and therapeutic challenges regarding 2019-nCoV infection in the patient were examined. Conclusions: There are three clinically relevant learning points to be noted from this case report. Firstly, the importance of paying attention to the patient’s complaints in any mental patient, even disorders related to unexplained physical complaints. Secondly, the introduction highlights the differences in the care of patients with COVID-19 between psychiatric and non-psychiatric patients and the need for a multidisciplinary approach. Third, this introduction identifies a crucial diagnostic role for CT thorax in symptomatic patients with suspected COVID-19 because the false-negative rate with RT-PCR COVID-19 nasopharyngeal swabs is high.