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Mortality and Morbidity among COVID-19-Associated Mucormycosis Patients in Iran: A Prospective Cohort Study

Advances in Infectious Diseases 2023年第3期13卷 407-423页

作者： Somayeh Dolatabadi Mehdi Bakhshaee Masoumeh Hosseinpoor Ali Alizadeh Noghani Mohammadreza Afzalzadeh Imaneh Roshanzamir bashir rasoulian Zahra Eslami Mohammadie Alireza Ghodsi Nazanin Forghani Parisa Arjmand Zahra Valipour Nima Ameli Department of Biology Hakim Sabzevari University Sabzevar Iran Sinus and Surgical Endoscopic Research Center Mashhad University of Medical Sciences Mashhad Iran Student Research Committee Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran Student Research Committee Faculty of Paramedical Sciences Mashhad University of Medical Sciences Mashhad Iran Department of Otolaryngology Mashhad University of Medical Sciences Mashhad Iran

Background: The key contribution of this paper is from investigating the mortality and morbidity rates and related factors associated with COVID-19-associated-mucormycosis among Iranian patients. The existing literature is scarce on this topic, particularly in the context of Iran. The present study investigates mortality and morbidity among 62 confirmed COVID-19-associated-mucormycosis Iranian patients in relation to their demographic characteristics, laboratory test results, predisposing factors, and COVID-related factors. Material and Methods: In this prospective cohort study, the patients were identified in the fifth wave of the disease, between 1st August and 15th October 2021, with data collected at baseline with a three-week follow-up. This was a multicenter investigation with patients admitted to two clinics in Iran. 62 participants were admitted, with the key criteria of them being COVID-19-associated-mucormycosis patients. 53 out of 60 patients underwent corticosteroid therapy and debridement surgery. Intravenous remdesivir (200 mg/ kg/day at day 1, 100 mg/kg/day in following days for up to 5 days) and corticosteroids were administered for 53 out 54 patients. Oxygen therapy was only needed for 30% (n = 19) of the patients. Results: A 40% mortality rate was observed within the three-week follow-up, with deaths concentrated among those with controlled diabetes mellitus (61%) and long-term diabetes mellitus patients (an average of eight versus four years). Higher mortality was also observed in patients with higher leucocytes and those with rhino-orbital-cerebral (59%), followed by nasal (55.6%) mucormycosis. Among survivors, 32% were reinfected, and 56% suffered from loss of vision. Conclusion: The study concludes that mucormycosis is associated with a higher mortality rate among COVID-19 patients with diabetes mellitus, particularly corticosteroid recipients. Thus, urgent attention to this coinfection is warranted in Iran.

关键词： Mucorales COVID-19 Mucormycosis Coinfection Dexamethasone Diabetes Mellitus

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Pricing and Permit Loads Impact on Overlay Costs for Highways in Louisiana

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Journal of Civil Engineering and Architecture 2012年第11期6卷 1445-1452页

作者： Saber Aziz rasoulian Masood Department of Civil Engineering Louisiana Tech University Louisiana 71272 USA Louisiana Department of Transportation and Development Louisiana 70802 USA

A methodology for the evaluation of the economic impact of overweight permitted vehicles hauling agricultural products on state highways is presented in this study. The different gross vehicle weight scenarios that are selected for this investigation range between 80,000 lb. and 100,000 lb. Uniform distribution of axle loads and lumped loads are considered in this study. This study evaluates the proposed higher truck loads and their economic impact to the highways and to the industry. The effects of adapting higher truck loads on the existing highways are evaluated using a deterministic load capacity evaluation as well as a reliability assessment. The target reliability level is derived from AASHTO (American Association of State Highway and Transportation Officials) standard design specifications to satisfy safe and adequate performance level. The overlay thickness required to carry traffic from each gross vehicle weight scenario for the overlay design period is determined. Differences in overlay life were calculated for different gross vehicle weight scenarios with uniform and lumped axle loads. The overlay thickness and costs were determined for a twenty year analysis period using statistical methods. The result showed that lumped loads with allowable axle load of 48,000 lb. produce more pavement damage than the current permitted gross vehicle weight for timber trucks with equally loaded axles.

关键词：覆盖层厚度高速公路成本定价路易斯安那州许可证可靠性评估可靠性水平荷载

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