关键词： Data clustering   incremental data clustering   Namib beetle optimization (NBO)   Mayfly Algorithm (MA)   deep maxout network (DMN)   OUTBREAK  

摘要： This research introduces an efficacious model for incremental data clustering using Entropy weighted-Gradient Namib Beetle Mayfly Algorithm (NBMA). Here, feature selection is done based upon support vector machine recursive feature elimination (SVM-RFE), where the weight parameter is optimally fine-tuned using NBMA. After that, clustering is carried out utilizing entropy weighted power k-means clustering algorithm and weight is updated employing designed Gradient NBMA. Finally, incremental data clustering takes place in which centroid matching is carried out based on RV coefficient, whereas centroid is updated based on deep maxout network (DMN). Also, the result shows the better performance of the proposed method..

关键词： COVID-19   long COVID  

摘要： BACKGROUND:Internal tremors and vibrations are symptoms previously described as part of neurologic disorders but not fully described as a part of long COVID. This study compared pre-pandemic comorbidities, new-onset conditions, and long COVID symptoms between people with internal tremors and vibrations as part of their long COVID symptoms and people with long COVID but without these symptoms. METHODS:The Yale Listen to Immune, Symptom and Treatment Experiences Now (LISTEN) Study surveyed 423 adults who had long COVID between May 12, 2022 and June 1, 2023. The exposure variable was long COVID symptoms of internal tremors and vibrations. The outcome variables were demographic characteristics, pre-pandemic comorbidities, new-onset conditions, other symptoms, and quality of life. RESULTS:Among study participants with long COVID, median age was 46 years [IQR, 38-56]), 74% were female, 87% were Non-Hispanic White, and 158 (37%) reported "internal tremors, or buzzing/vibration" as a long COVID symptom. The 2 groups reported similar pre-pandemic comorbidities, but people with internal tremors reported worse health as measured by the Euro-QoL visual analogue scale (median: 40 points [IQR, 30-60] vs. 50 points [IQR, 35-62], P = 0.007) and had higher rates of new-onset mast cell disorders (11% [95% CI, 7.1-18] vs. 2.6% [1.2-5.6], P = 0.008) and neurologic conditions (22% [95% CI, 16-29] vs. 8.3% [5.4-12], P = 0.004). CONCLUSIONS:Among people with long COVID, those with internal tremors and vibrations had different conditions and symptoms and worse health status compared with others who had long COVID without these symptoms.

关键词： COVID-19   inflammation   inflammatory markers   neopterin   pteridines   NEUTROPHIL/LYMPHOCYTE   BIOMARKERS   PROGNOSIS  

摘要： In patients with coronavirus disease (COVID-19), a massive inflammatory response is a significant cause of morbidity and mortality. Inflammatory markers are prognostic indicators of disease severity and the ultimate clinical outcome. Several studies have demonstrated a correlation between serum levels of neopterin, which can be an immune system marker, disease severity, and poor outcomes in COVID-19 patients. Our study aimed to determine the diagnostic significance of neopterin in conjunction with routinely measured inflammatory markers in patients with severe COVID-19. Serum neopterin, C-reactive protein (CRP), albumin levels, and complete blood count were determined in 39 patients with severe COVID-19 and 30 healthy individuals. Demographic characteristics, serum neopterin levels, and other laboratory data were compared between patients and healthy volunteers and statistically analyzed. High neopterin levels were observed in patients with severe COVID-19 compared to healthy volunteers. Furthermore, albumin levels were decreased, while CRP levels were increased in patients, statistically significantly. Also, positive correlations were shown between serum neopterin levels and serum CRP levels, while negative correlations were shown between serum neopterin levels and serum albumin levels. Systemic inflammation markers, CRP/albumin ratio, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio were significantly higher, while lymphocyte/monocyte ratio was also significantly lower in patients with severe COVID-19 than in healthy volunteers. However, serum neopterin levels were not linked to the CRP/albumin ratio, the neutrophil/lymphocyte ratio, or the platelet/lymphocyte ratio. On the other hand, they were linked negatively to the lymphocyte/monocyte ratio. Our findings highlight the association between high neopterin levels and patients with severe COVID-19. Neopterin is correlated with traditional inflammatory biomarkers and may indicate general immune and inflam

关键词： COVID-19 pandemic   nurses   mental health   professional wellbeing   protective factors   PERCEIVED SOCIAL SUPPORT   POSTTRAUMATIC GROWTH INVENTORY   PSYCHOMETRIC PROPERTIES   MULTIDIMENSIONAL SCALE   SHORT-FORM   RESILIENCE   STRESS   VERSION   BURNOUT  

摘要： Objective Using a salutogenic approach, this study aimed to identify similarities in the protective factors of nurses' psychological Quality of Life (QoL) and professional wellbeing (PWB) in four countries and to assess their variability over time during the COVID-19 *** This multicentric study used a longitudinal design with three measurements points: Autumn 2021, spring 2022, and autumn 2022. The study consisted in a self-administered online questionnaire addressed to nurses working in hospitals. Across all measurement times, 3,310 observations were collected in France, 603 in Switzerland, 458 in Portugal, and 278 in Canada. The outcomes were psychological QoL and PWB, and several potential protective factors were used as *** Analyses revealed few changes over time in the outcomes. Across all countries, psychological QoL was associated positively with resilience and perceived social support, whereas PWB was associated positively with the ability to provide quality work and support from colleagues and *** The findings of this study highlighted the potential of several factors protective of nurses' psychological QoL and PWB. These should be fostered through policies and measures to support nurses.

关键词： convalescent plasma   COVID-19   efficacy   mortality   SARS-CoV-2   systematic review  

摘要： Background Plasma collected from recovered COVID-19 patients (COVID-19 convalescent plasma, CCP) was the first antibody-based therapy employed to fight the COVID-19 pandemic. While the therapeutic effect of early administration of CCP in COVID-19 outpatients has been recognized, conflicting data exist regarding the efficacy of CCP administration in hospitalized patients. Objectives To examine the effect of CCP compared to placebo or standard treatment, and to evaluate whether time from onset of symptoms to treatment initiation influenced the effect. Data sources Electronic databases were searched for studies published from January 2020 to January 2024. Study eligibility criteria Randomized clinical trials (RCTs) investigating the effect of CCP on COVID-19 mortality in hospitalized COVID-19 patients. Participants Hospitalized COVID-19 patients. Intervention CCP versus no CCP. Assessment of risk of bias : Cochrane risk of bias tool for RCTs. Methods of data synthesis : The random-effects model was used to calculate the pooled risk ratio (RR) with 95% CI for the pooled effect estimates of CCP treatment. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the certainty of evidence. Results Twenty-seven RCTs were included, representing 18,877 hospitalized COVID-19 patients. When transfused within 7 days from symptom onset, CCP significantly reduced the risk of death compared to standard therapy or placebo (RR 0.76, 95% CI 0.61-0.95), while later CCP administration was not associated with a mortality benefit (RR 0.98, 95% CI 0.90-1.06). The certainty of the evidence was graded as moderate. Meta regression analysis demonstrated increasing mortality effects for longer interval to transfusion or worse initial clinical severity. Conclusions In-hospital transfusion of CCP within 7 days from symptom onset conferred a mortality benefit.

关键词： Diabetes ketoacidosis   DKA   Mortality   COVID-19   Precipitants   Aga Khan University Hospital.   UNITED-STATES   MANAGEMENT   COVID-19  

摘要： BackgroundPrognosis of DKA has improved over time with the availability of evidence-based protocols and resources. However, in Kenya, there are limited resources for the appropriate diagnosis and management of DKA, mostly limited to tertiary-level referral facilities. This study aimed to review the clinical presentation, management, and outcomes of adult patients admitted with DKA and assess differences in these parameters before and during the COVID-19 *** was a retrospective study of DKA admissions from January 2017 to December 2021. Patient data were retrieved from the medical records department using ICD-10 codes, and individual details were abstracted on clinical presentation, management, and outcomes of DKA. Comparisons were made between pre-COVID-19 and during COVID-19 ***150 patients admitted with DKA were included (n = 48 pre- COVID-19, n = 102 during COVID-19 (n = 23 COVID-19 positive, n = 79 COVID-19 negative)). Median age was 47 years (IQR 33.0, 59.0), median HbA1C was 12.4% [IQR 10.8, 14.6]), and most patients had severe DKA (46%). Most common DKA precipitants were infections (40.7%), newly diagnosed diabetes (33.3%) and missed medication (25.3%). There was a significant difference in pulmonary infections as a DKA precipitant, between the pre- COVID and during COVID-19 pandemic (21.6% during COVID-19 versus 6.3% pre- COVID-19; p = 0.012). Median total insulin dose used was 110.0 units [IQR 76.0, 173.0], and a 100% of patients received basal insulin. Median length of hospital stay was 4.0 days [IQR 3.0, 6.0] and time to DKA resolution was 30.0 h [IQR 24.0, 48.0]. There were 2 deaths (1.3%), none directly attributable to DKA. Severity of DKA significantly differed between pre- COVID-19, COVID-19 positive and COVID-19 negative DKA (52.2% of COVID-19 positive had moderate DKA compared to 26.6% of COVID-19 negative and 22.9% of Pre-COVID-19 (p = 0.006)).ConclusionEven in developing regions, good outcomes can be achieved with th

关键词： Herding   Supply chain disruption   COVID-19   Financial impact   Stock performance   STOCK-MARKET   INSTITUTIONAL INVESTORS   RETURNS   DISRUPTIONS   PERFORMANCE   MISMATCHES   GLITCHES   IMPACT   MATTER  

摘要： PurposeThis study aims to test the market anomaly of herding behavior driven by the response to supply chain disruptions in extreme market conditions such as those observed during COVID-19. The authors empirically test the response of the capital market participants for B2B firms, resulting in herding ***/methodology/approachUsing the event study approach based on the market model, the authors test the impact of supply chain disruptions and resultant herding behavior across six sectors and among different B2B firms. The authors used cumulative average abnormal returns (CAAR) and cross-sectional absolute deviation (CSAD) to examine the significance of herding behavior across *** event study results show a significant effect of COVID-19 due to supply chain disruptions across specific sectors. Herding was detected across the automotive and pharmaceutical sectors. The authors also provide evidence of sector-specific disruption impact and herding behavior based on the black swan event and social learning ***/valueThe authors examine the impact of COVID-19 on herding in the stock market of an emerging economy due to extreme market conditions. This is one of the first studies analyzing lockdown-driven supply chain disruptions and subsequent sector-specific herding behavior. Investors and regulators should take sector-specific responses that are sophisticated during extreme market conditions, such as a pandemic, and update their responses as the situation unfolds.

关键词： Lean supply chain   COVID-19   qualitative research   disruptions   normal accidents theory   MANAGEMENT   PERFORMANCE   RESILIENCE   DISRUPTIONS   IMPACT   AGILE   RELIABILITY   OPERATIONS   VALIDITY   COST  

摘要： This research aims to empirically examine how Lean Supply Chains (LSC) have coped with the disruptive effects of the COVID-19 pandemic from the normal accidents theory (NAT) perspective. Initially, a literature review was conducted to identify the main dimensions of LSC. Then, four experts were interviewed, offering insight into how each of the LSC dimensions copes with disruptions in general. Finally, three case studies of manufacturing shed light on the LSC implications for the pandemic context in particular. From the NAT viewpoint, the effects of the pandemic are analyzed according to two dimensions of the interactions that make up an LSC: linear to non-linear, and loosely to tightly-coupled. The more non-linear and tightly-coupled the interactions the more vulnerable the LSC is to disruptions. Results indicated that LSC might effectively and quickly adapt to keep interactions as linear as possible through transparent information flows and collaborative work while at the same time temporarily reducing tight-couplings through inventory increases. Some of the countermeasures to cope with the disruptions caused by the COVID-19 pandemic conflict with LSC principles, such as inventory reduction, developing a solid customer-supplier relationship, and long-term orientation. This points out the contingent nature of some lean principles as well as the meta principle that guided companies' behaviours in the case studies, namely adding value to internal and external customers.

关键词： COVID-19   SARS-CoV-2   Primarily-infected subjects   Serum cytokine/chemokines levels   Anti-SARS-CoV-2 IgG   RESPONSES  

摘要： BackgroundThe systemic inflammatory syndrome called "cytokine storm" has been described in COVID-19 pathogenesis, contributing to disease severity. The analysis of cytokine and chemokine levels in the blood of 21 SARS-CoV-2 positive patients throughout the phases of the pandemic has been studied to understand immune response dysregulation and identify potential disease biomarkers for new treatments. The present work reports the cytokine and chemokine levels in sera from a small cohort of individuals primarily infected with SARS-CoV-2 during the first wave of the COVID-19 pandemic in Milan (Italy).ResultsAmong the 27 cytokines and chemokines investigated, a significant higher expression of Interleukin-9 (IL-9), IP-10 (CXCL10), MCP-1 (CCL2) and RANTES (CCL-5) in infected patients compared to uninfected subjects was observed. When the change in cytokine/chemokine levels was monitored over time, from the hospitalization day to discharge, only IL-6 and IP-10 showed a significant decrease. Consistent with these findings, a significant negative correlation was observed between IP-10 and anti-Spike IgG antibodies in infected individuals. In contrast, IL-17 was positively correlated with the production of IgG against *** cytokine storm and the modulation of cytokine levels by SARS-CoV-2 infection are hallmarks of COVID-19. The current global immunity profile largely stems from widespread vaccination campaigns and previous infection exposures. Consequently, the immunological features and dynamic cytokine profiles of non-vaccinated and primarily-infected subjects reported here provide novel insights into the inflammatory immune landscape in the context of SARS-CoV-2 infection, and offer valuable knowledge for addressing future viral infections and the development of novel treatments.