Persistence of advanced systemic pharmacological treatment of moderate-to-severe psoriasis among bio-naïve patients-A retrospective register-based cohort study in Finland and Sweden.

BACKGROUND: Plaque psoriasis (PsO) requires long-term treatment for symptom control and remission; thus, a long-term pharmacological intervention is necessary. Treatment persistence reflects long-term therapeutic effectiveness and tolerance. OBJECTIVES: This study investigates drug persistence and compares treatment discontinuation rates across biologic agents and apremilast used by PsO patients in Finland and Sweden. METHODS: This retrospective register-based cohort study included bio-naïve patients (≥18 years) with moderate-to-severe PsO, who initiated treatment with abatacept, adalimumab, brodalumab, certolizumab pegol, etanercept, golimumab, guselkumab, ixekizumab, risankizumab, secukinumab, tildrakizumab, ustekinumab or apremilast during 2008-2020 in Finland or Sweden. The main analysis evaluated persistence (based on duration of continuous treatment) and compared rates of treatment discontinuation using guselkumab as reference drug, during 2018-2020 in Finland. Treatment discontinuation was assessed by survival analysis of the time to first drug discontinuation, including switching to other study drugs. Due to limited sample size (n < 20), certain biologics (abatacept, brodalumab, certolizumab pegol, etanercept, golimumab, risankizumab and tildrakizumab) were excluded from the persistence analysis. RESULTS: In Finland, 709 patients fulfilled the inclusion criteria during 2018-2020 for the main analysis. The highest persistence was observed for guselkumab and ustekinumab with 90 and 85% of treated patients, respectively, continuing treatment for ≥1 year. Comparable results were observed in the expanded cohort analysis (index starting in 2008; 2745 bio-naïve patients in Finland and 10,970 in Sweden). Furthermore, patients treated with guselkumab in Finland showed lower treatment discontinuation rates compared to other study drugs. CONCLUSION: Guselkumab and ustekinumab demonstrated high persistence as measured by continued treatment for at least 1 year. Furthermore, these treatments demonstrated lower rates of discontinuation compared to other study drugs included in the analysis. Understanding the balance between efficacy and feasibility in treatment decisions is crucial, as feasibility may impact persistency outcomes and potentially increase persistency rates.

ACV with/without IVM: a new talk on intestinal CDX2 and muscular CD34 and Cyclin D1 during Trichinella spiralis infection.

The current study assessed the efficacy of Acyclovir (ACV) and Ivermectin (IVM) as monotherapies and combined treatments for intestinal and muscular stages of Trichinella spiralis infection. One-hundred Swiss albino mice received orally 250 ± 50 infectious larvae and were divided into infected-untreated (Group-1), IVM-treated (Group-2), ACV-treated (Group-3), combined IVM+ACV (Group-4), and healthy controls (Group-5). Each group was subdivided into subgroup-A-enteric phase (10 mice, sacrificed day-7 p.i.) and subgroup-B-muscular phase (10 mice, sacrificed day-35 p.i.). Survival rate and body weight were recorded. Parasite burden and intestinal histopathology were assessed. In addition, immunohistochemical expression of epithelial CDX2 in the intestinal phase and CyclinD1 as well as CD34 in the muscular phase were evaluated. Compared, IVM and ACV monotherapies showed insignificant differences in the amelioration of enteric histopathology, except for lymphocytic counts. In the muscle phase, monotherapies showed variable disruptions in the encapsulated larvae. Compared with monotherapies, the combined treatment performed relatively better improvement of intestinal inflammation and reduction in the enteric and muscular parasite burden. CDX2 and CyclinD1 positively correlated with intestinal inflammation and parasite burden, while CD34 showed a negative correlation. CDX2 positively correlated with CyclinD1. CD34 negatively correlated with CDX2 and CyclinD1. IVM +ACV significantly ameliorated CDX2, CyclinD1, and CD34 expressions compared with monotherapies. Conclusion. T. spiralis infection-associated inflammation induced CDX2 and CyclinD1 expressions, whereas CD34 was reduced. The molecular tumorigenic effect of the nematode remains questionable. Nevertheless, IVM +ACV appeared to be a promising anthelminthic anti-inflammatory combination that, in parallel, rectified CDX2, CyclinD1, and CD34 expressions.

The impact of state paid sick leave policies on weekday workplace mobility during the COVID-19 pandemic.

OBJECTIVES: This study aimed to evaluate whether the Families First Coronavirus Response Act (FFCRA) modified the association between pre-existing state paid sick leave (PSL) and weekday workplace mobility between February 15 and July 7, 2020. STUDY DESIGN: This was a longitudinal, observational study. METHODS: The 50 US states and Washington, D.C., were divided into exposure groups based on the presence or absence of pre-existing state PSL policies. Derived from Google COVID-19 Community Mobility Reports, the outcome was measured as the daily percent change in weekday workplace mobility. Mixed-effects, interrupted time series regression was performed to evaluate weekday workplace mobility after the implementation of the FFCRA on April 1, 2020. RESULTS: States with pre-existing PSL policies exhibited a greater drop in mobility following the passage of the FFCRA (ß = -8.86, 95% confidence interval: -11.6, -6.10, P < 001). This remained significant after adjusting for state-level health, economic, and sociodemographic indicators (ß = -3.13, 95% confidence interval: -5.92, -0.34; P = .039). CONCLUSIONS: Pre-existing PSL policies were associated with a significant decline in weekday workplace mobility after the FFCRA, which may have influenced local health outcomes. The presence of pre-existing state policies may differentially influence the impact of federal legislation enacted during emergencies.

COVID-19 fatalities and internal conflict: Does government economic support matter?

This study examines the association between COVID-19 mortality rates and internal conflict and investigates the possible moderating role of government economic support during the pandemic years of 2020 and 2021. Our main hypothesis suggests that countries with lower levels of government economic support are more likely to experience a positive correlation between higher COVID-19 mortality rates and the emergence of internal conflict. Using cross-country data from over 100 countries and controlling for various factors that may influence internal conflict, our analysis provides some support for this hypothesis. The results suggest a possible moderating role for government economic support, with the evidence indicating a weakening or elimination of the association between COVID-19 mortality rates and internal conflict when government economic support is adequate. However, the moderating effect of government economic support is not always significant, and caution is needed when interpreting the results. Our analysis also highlights the potential risks associated with low levels of government economic support during the pandemic. Specifically, we find that in countries where the government's macro-financial package in response to the pandemic is less than approximately 25% of GDP, there is a possible risk of growth in civil disorder resulting from increased COVID-19 deaths per million.

Effects of dietary supplementation of chromium methionine chelate on growth performance, oxidative stress, hematological indices, and carcass traits of broiler chickens.

This study was conducted to evaluate the dietary effects of chromium methionine (Cr-Meth) chelate on growth performance, oxidative stress parameters, blood biochemistry, and carcass traits of broiler chickens. An experiment was conducted on 34,000 1-day-old straight-run broiler chicks (Indian River; 42.0 ± 0.03) at a commercial farm. The chicks were divided randomly into 3 groups; the first group contained 17,000 birds, which used as a control, whereas the second and third groups consisted of 7000 and 10,000 birds, respectively, with 5 replicates per group. A completely randomized design was used. The birds were fed the experimental diets containing graded levels of Cr-Meth chelate: 0 (control), 50, and 100 g/ton. This compound consisted of chromium (0.4%) chelated with methionine, and it supply the diets with 200 and 400 ppb Cr for the used levels of 50 and 100 g/ton feed, respectively. Growth performance indices (body weight, body weight gain, feed intake, and feed conversion ratio) were measured throughout the experiment. At the end of experiment, 10 birds per treatment were slaughtered, and the carcass yield with relative weight of the internal organs was determined. Also, blood samples were taken and analyzed for glutathione peroxidase activity, malondialdehyde, ALT, AST, total protein, albumin, glucose, urea, creatinine, triglycerides, and total cholesterol. It was found that Cr-Meth improved the body weight, weight gain, feed intake, and feed conversion ratio of broilers. Moreover, it reduced the mortality rate of birds. The chelated chromium can alleviate the oxidative status of birds by increasing the plasma glutathione peroxidase activity and reducing the serum malondialdehyde level. It was observed that the effects of 100 g/ton Cr-Meth chelate on performance indices, mortality rate, and oxidative stress parameters were better than that of 50 g/ton inclusion rate. Supplementation of Cr-Meth increased the total protein level, but reduced the glucose, total cholesterol, and triglyceride concentrations in the blood serum. In addition, it increased the carcass yield and reduced the abdominal fat percentage of the birds' carcass. Therefore, chromium can be included in diets of broilers at a rate of 200 to 400 ppb, and the higher concentration was more effective than the lower one. So, it can be recommended to use Cr-Meth chelate in broiler diets at 100 g/ton to improve the productive performance and reduce the oxidative stress of birds.

We're making it work! UKM'S Speech Sciences Programs' teleclinic experience in the time of COVID-19.

This paper highlights issues, challenges, and lessons learnt from implementing a speech-language therapy teleclinic service delivery model by the Speech Sciences Program, Universiti Kebangsaan Malaysia (UKM) during the wake of the recent COVID-19 pandemic. The teleclinic service provision was initially started to help our student cohorts attain and complete the required direct contact speechlanguage therapy clinical hours for graduation during the pandemic. It has since evolved to be an integral part of the clinical practicum curriculum and a service delivery model that is here to stay. Although far from perfect, the program hopes to systematically continue our endeavours in telerehabilitation as one of our niche areas, realising the wealth of benefits that this service delivery model has to offer.

Investigations of the kinetic energy parameters of irradiated (La)-doped phosphate glass.

The current study characterizes and analyzes glow curves obtained from phosphate glass doped with different concentrations of lanthanum. Kinetic parameters of the glow curves obtained from beta-irradiated phosphate glass samples doped with lanthanum were determined using a newly designed deconvoluted software. The obtained results from the analyses indicated that the glow curves of the phosphate glass samples were composed of five overlapping peaks. The activation energies of the five electron traps were located between 0.622 and 1.133 eV. The obtained kinetic parameters were evaluated using the designed software and another two methods and all revealed good agreement. The first three traps displayed non-first-order behaviour, while the two deep traps obeyed nearly first-order kinetics.

Assessment of carvacrol for control of avian aspergillosis in intratracheally challenged chickens in comparison to voriconazole with a reference on economic impact.

AIM: This study was designed to investigate the efficacy of essential oils as an alternative prophylaxis and treatment for avian aspergillosis. METHODS AND RESULTS: The in vitro susceptibility of Aspergillus fumigatus strains to antifungal drugs and carvacrol, thymol, eugenol, thymoquinone and cinnamon was determined using the macrodiffusion and microdilution methods. Carvacrol has antifungal activity in comparison to voriconazole (VCZ) (MIC 0·5, 0·25 µg ml-1 respectively). While cinnamon, euganol, thymol and thymoquinone displayed moderate to weak inhibitory activity. For the efficacy study, five groups of 10-day-old chicks (n = 48) were infected intratracheally either with A. fumigatus conidia or saline (negative control). Chicks in carvacrol prophylactic and treatment (CRPT) group were fed for 10 days beginning from hatch with carvacrol (200 mg kg-1 per diet) supplemented diets. VCZ (VCZT:20 mg kg-1 body weight (BW)), carvacrol treatment (CRT, CRPT) was started upon appearance of the first clinical signs and continued for 10 days. Birds were monitored for an additional 15 days following treatment. Fungal burden and therapeutic efficacy were assessed by survival, BW, quantitative (q) culture (CFU), quantitative real-time PCR (qPCR) and histopathological changes at several time points. Serum biochemical changes were also assessed. VCZT, CRPT, CRT in comparison to the sham-treated (SHAM) group have prolonged survival (87·5, 83·4, 79·2, 41·7% respectively). In VCZT and CRPT, a significant reduction in clinical signs, lesions, CFU and qPCR counts to the limit of detection were observed. CRPT has the lowest BW reduction, economic losses and significant low total cholesterol levels. CONCLUSIONS: Carvacrol has a promising potential to be used as a prophylactic and treatment against A. fumigatus. SIGNIFICANCE AND IMPACT OF THE STUDY: Prognosis of avian aspergillosis is often poor due to delayed diagnosis and treatment failure. However, the widespread uses of azole prophylaxis in birds are thought to be the major driver of azole resistance. These findings create a possibility to develop an effective drug-free alternative strategy for control of avian aspergillosis.

Efficacy and evaluation of environmental management system to control sandfly vector of Kala-azar.

The established vector for visceral leishmaniasis, Phlebotomus argentipes (Diptera: Psychodidae) breeds inside the human dwellings and cattle shed under crevices at the base of the wall. P. argentipes was controlled by plastering the base of wall (9″height × 9″base). The study was conducted in two phases: (i) Screening of plastering materials (ii) validation of the most suitable material. During the first phase (2014); four intervention materials were evaluated in four different arms: (i) cement (ii) brick chimney fly ash (BCFA i.e. waste material from an oven for backing raw earthen brick in charcoal) mixed with lime (95:5) (iii) wire mesh (25 holes/cm2) and (iv) glazed tiles. Ten houses were selected as test and same as control in four different villages for each arm having similar ecotype and similar density of sandflies. The pre and post intervention density of sandflies were evaluated. Significant reduction in sandfly density was found with cement (46.2%) and BCFA (29.6%) plastering (P < 0.05). In the second phase of the study (2015); the two most effective interventions were validated at village level with one control. A significant reduction in the density of P. argentipes was found with cement; 60.2% (Mean ± S.D. = 2.48 ± 2.78, 95% CI = 1.93-3.02) and BCFA; 48.2% (Mean ± S.D. = 1.98 ± 2.20, 95% CI = 1.55-2.41) (P < 0.05). BCFA was found easily accessible, acceptable and cost effective that can be used in any type of wall materials at own cost. This can be implemented as one of the integrated vector control approach in the programme.

Polymeric prodrug combination to exploit the therapeutic potential of antimicrobial peptides against cancer cells.

Antimicrobial Peptides (AMPs) have unique anticancer properties, but their clinical application is currently limited by an inadequate margin of safety. A prodrug strategy associated with a combination therapy approach could address this limitation by increasing their therapeutic index and their efficacy. Accordingly, the first targeted anticancer polymeric prodrug candidates of AMPs, intended for combination therapy with another polymeric prodrug of an approved antineoplastic agent (doxorubicin), were synthesized as either a PEG-based dual-release prodrug or two individual pegylated prodrugs. The latter are based on a cathepsin B-labile peptide linker and an acid-sensitive acyl hydrazone bond for the AMP and doxorubicin prodrugs, respectively. Anticancer activities and toxicity differentials achieved with the free peptide and its polymer conjugates against ovarian, cancer and non-malignant, cells, indicate that protease-dependent reversible pegylation could be implemented to increase the therapeutic indices of AMPs in cancer therapy. The results obtained also show that this approach can be developed if the releasable PEG linker can be optimised to conciliate the attributes and restrictions of pegylation against proteases. In addition, combination of the polymeric prodrugs of the AMP and of doxorubicin provides additive antitumor effects which could be exploited to enhance the efficacy of the AMP candidate.

Molecular screening of CFTR gene in Egyptian patients with congenital bilateral absence of the vas deferens: a preliminary study.

In the current study, we enrolled 14 Egyptian infertile males with isolated congenital bilateral absence of the vas deferens (CBAVD). Screening for the most commonly reported 36 CFTR mutations, and the intron 8 (T)n splice variant was performed by multiplex PCR followed by reversed hybridisation. Samples with the 5T variant were picked for DNA sequencing of intron 8/exon 9 region to identify the number of adjacent TG repeats. The p.Phe508del and the p.Ser1251Asn mutations were detected in heterozygous state in three patients (10.7% of alleles) and in one patient (3.6% of alleles), respectively, while the 5T variant was detected in five patients (28.6% of alleles). Among those five patients, four had TG12 repeats and one had TG13 repeats confirming the pathogenic penetrance of all 5T alleles in Egyptian CBAVD patients. The allelic frequencies of the mutations p.Phe508del, p.Ser1251Asn and the 5T variant in 60 Egyptian cystic fibrosis patients were 24.2%, 3.3% and 2.5% respectively. The mutation p.Ser1251Asn was detected for the first time in isolated CBAVD patient in our study. Due to the high prevalence of p.Phe508del mutation and 5T variant in Egyptian CBAVD patients, we recommend their screening initially, ideally followed by full CFTR gene sequencing in unidentified patients.

Mitochondrial Neurogastrointestinal Encephalopathy: Clinical, Biochemical and Molecular Study in Three Egyptian Patients.

Background: Mitochondrial Neurogastrointestinal Encephalopathy syndrome is a rare autosomal recessive disorder. The disease is caused by mutations in the thymidine phosphorylase gene. This article reports the clinical, biochemical and molecular findings in three Egyptian patients with Mitochondrial Neurogastrointestinal Encephalopathy sundrome from two different pedigrees. Subjects and Methods: The three patients were subjected to thorough neurologic examination. Brain Magtnetic Resonance Imaging. Histochemical and biochemical assay of the mitochondrial respiratory chain complexes in muscle homogenate was performed (1/3). Thymidine Phosphorylase enzyme activity was performed in 2/3 patients and Thymidine Phosphorylase gene sequencing was done (2/3) to confirm the diagnosis. Results: All patients presented with symptoms of severe gastrointestinal dysmotility with progressive cachexia, neuropathy, sensory neural hearing loss, asymptomatic leukoencephalopathy. Histochemical analysis of themuscle biopsy revealed deficient cytochrome C oxidase and mitochrondrial respiratory chain enzyme assay revealed isolated complex 1 deficiency (1/3). Thymidine Phosphorylase enzyme activity revealed complete absence of enzyme activity in 2/3 patients. Direct sequencing of Thymidine Phosphorylase gene revealed c.3371 A>C homozygous mutation. Molecular screening of both families revealed heterozygous mutation in both parents and 4 siblings. Conclusions: Mitochondrial Neurogastrointestinal Encephalopathy syndrome is a rare mitochondrial disorder with an important diagnostic delay. In case of pathogenic mutations in Thymidine Phosphorylase gene in the family, carrier testing and prenatal diagmosis of at risk members is recommended for early detection. The possibility of new therapeutic options makes it necessary to diagnose the disease in an early state.

Does medial tourism promote growth in healthcare sector?

The purpose of this study is to investigate the effect of medical tourism revenues on the growth of healthcare sector across 49 emerging and developed economies from 2008 to 2022. Using panel GMM and PMG/ARDL estimation methods, the results show that higher levels of medical tourism revenues promote growth in the healthcare sector. This finding remains robust across different sample periods, alternative measure of healthcare sector performance, and model specifications.

Parents' Perception on Post-tonsillectomy Hemorrhage: A Local Survey.

INTRODUCTION: Tonsillectomy (often combined with adenoidectomy) is one of the oldest and most common surgical procedures performed in otolaryngology. Post-operative complications following tonsillectomy are generally rare and include post-tonsillectomy hemorrhage, dehydration, velopharyngeal insufficiency, and others. Parents play a crucial role in the care and recovery of their children after tonsillectomy. Their perception and understanding of post-tonsillectomy hemorrhage are essential in managing and addressing this potential complication. AIM: The purpose of this study is to assess parents' perception of post-tonsillectomy hemorrhage and factors that would lead to its development. METHODS: A descriptive cross-sectional study was conducted targeting parents of children who had undergone surgical tonsillectomy. Data were collected using a pre-structured online questionnaire, biographical data, tonsillectomy data, child medical and drug history, healthcare staff role, and post-surgical complications and bleeding. RESULTS: A total of 847 parents completed the study questionnaire, and 431 (50.9%) were fathers. As for education, 164 (19.4%) had a university level of education, and 279 (32.9%) had a post-graduate degree. As for child gender, 445 (52.5%) were males, 232 (27.4%) had undergone the surgery in the first five years of their age, 208 (24.6%) at the age of 6-10 years, and 221 (26.1%) undergone the surgery at the age of 16-18 years. The most reported post-surgical complications included headaches and nausea (52.4%), swelling of the roof of the mouth (51.8%), and infection (48.9%). Primary or secondary post-tonsillectomy hemorrhage was reported among 47 (5.5%) of the children, which was during surgery among 12 (25.5%), within 24 hours after surgery among 14 (29.8%), and after 24 hours of surgery among 21 (44.7%). CONCLUSION: The current study revealed a high rate of tonsillectomy-associated bleeding with a shortage regarding the role of healthcare staff in child pre-surgical assessment and also in parents' education regarding expected complications.

An Unusual Presentation of Erythema Multiforme Following the Administration of Pfizer-BioNTech COVID-19 mRNA Vaccine in a Pediatric Patient.

Coronavirus disease 2019 (COVID-19) caused a global calamity that forced emergency use authorization to Pfizer-BioNTech COVID-19 (BNT162b2) vaccine. It is efficacious in preventing symptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in seronegative recipients. The safety profile is still unclear; however, commonly reported symptoms post-vaccination are fatigue, headache, muscle pain, chills, and injection-site pain. COVID-19 disease elicits, to some extent, cutaneous side effects like urticaria, morbilliform rash, and chilblain-like eruption. Vaccination against COVID-19 was reported to induce similar dermatologic manifestations, such as urticarial rash, delayed large-local reaction, local injection-site reaction, and morbilliform eruption. Erythema multiforme (EM) is a rare manifestation post-vaccination, and only a few reports implicate it as a culprit in cutaneous eruptions following the BNT162b2 vaccine. This report delineates the presentation of a healthy 14-year-old girl to a dermatology clinic who developed EM post-vaccination with the first dose of BNT162b2. New-onset EM-eruption post-vaccination with BNT162b2 had been reported previously in 14 cases, and one case reported on the flare of preexisting-EM.

Pityriasis Rosea Eruption Following the Administration of Oxford-AstraZeneca Vaccine.

The coronavirus disease 2019 (COVID-19) infection has led to accelerated development and utilization of vaccines to prevent its implications on health. One of these vaccines is a vector-based, Oxford-AstraZeneca Vaccine (AZD1222). Frequently reported side effects are related to host-immune response. While dermatologic manifestation is peculiar in nature and denotes a serious eruption that might defer future vaccination. Herein, we present a case of a medically free 37-year-old female who developed clinical and histological evidence of pityriasis rosea (PR) after administration of a second-dose vaccination of AZD1222. The first dose of vaccination was administered as Pfizer BioNTech COVID-19 mRNA (BNT162b2) vaccine. This case is unique in nature as this patient developed AZD1222-induced PR, while some reports in the literature have linked PR to the BNT162b2 vaccine. This patient continued to receive a booster vaccination with BNT162b2 with no reportable side effects.

Effect of using silorane-based resin composite for restoring conservative cavities on the changes in cuspal deflection.

OBJECTIVE: To investigate the effect of using two resin-composite materials for restoring conservative mesio-occluso-distal (MOD) cavities on the changes (incremental and cumulative) in cuspal deflection. METHODS: Forty extracted sound human maxillary second premolars were subjected to standardized MOD cavity preparation and then divided into two groups (n=20). The first group of teeth was restored with Filtek Z250 (3M ESPE, St Paul, MN, USA), and Filtek P90 (3M ESPE, St Paul, MN, USA) was used in the second group. Incremental cuspal deflection was calculated by measuring the intercuspal distance between the indexed cusp tips before the restoration and at five-minute intervals up to 30 minutes using a stereomicroscope connected to a digital camera. Cumulative cuspal deflection for both materials was also calculated. RESULTS: Comparing the incremental cuspal deflection of the tested groups at each time interval, it was found that there was no significant difference immediately after curing and at five, 15, 20, and 25 minutes. However, a significant difference was recorded at 10 and 30 minutes. For the cumulative cuspal deflection, Filtek P90 showed significantly lower deflection values than Filtek Z250 only after five minutes. CONCLUSIONS: Incremental cuspal deflections of both materials over the tested intervals were almost comparable. However, after five minutes of curing, silorane-based resin composite surpassed the methacrylate-based resin composite in controlling the cumulative cuspal deflection.

Using telephone logs instead of databases to accurately estimate neurosurgical on-call workload.

BACKGROUND: Maintenance of on-call referrals databases is on the rise in neurosurgical units across the UK and helps provide data to estimate workload. We hypothesize that these databases underestimate the workload and propose the use of the number of telephone calls to the on-call registrar as an easily obtainable and valid measure of workload. METHODS: Data were obtained from a referrals database maintained and completed by the neurosurgical registrars and the hospital switchboard telephone logs. Data were analysed using JMP 8.0.2 (SAS Institute, Cary, NC). RESULTS: We found a large degree of disparity between the number of phone calls and the number of recorded referrals. The median number of phone calls to the on-call registrar per day was 78 (Interquartile range 59-106); but the median number of recorded referrals was 12 (Interquartile range 8-16). 49.8% of the calls were received out-of-hours (1700-0800 and weekends) and the maximum number of calls was received on a Friday. Data derived from both sources (database and switchboard logs) showed a close visual correlation. CONCLUSION: We argue that on-call logs are an easily obtainable, reliable and internally validated measure of activity. We recommend the use of such data in other centers to establish the nature of on-call activity and tailoring of the rotas to comply with current guidance to provide a mix of service and training.

Governments' economic support for households during the COVID-19 pandemic and consumer confidence.

To combat the adverse consequences of the COVID-19 pandemic, governments have implemented various economic policies. This study examines how different types of government economic support for households are associated with consumer confidence. Utilizing data from 35 countries in the Organization for Economic Co-operation and Development for January 2020-October 2021 and applying panel fixed effect and system generalized methods of moments regressions, we show that higher levels of government economic support lead to higher levels of consumer confidence. The results also suggest that government income support for households has a stronger impact than debt/contract relief on consumer confidence during the pandemic in the full sample. Moreover, we find that debt/contract relief is a more effective policy to boost confidence in emerging economies. Finally, COVID-19 fatalities have a significant negative effect on consumer confidence.

Thermoluminescence Characteristics of Copper and Terbium Co-Doped Lithium Tetraborate Glass.

In this study, the preparation and characterization of copper (Cu) and terbium (Tb) co-doped lithium borate glass using spectroscopic and thermoluminescence techniques are reported. A thermal treatment was introduced to increase the degree of crystallinity. The thermoluminescence glow curve signal of the samples displayed upon exposure to beta radiation was measured and analyzed. It was found that the samples doped with 0.1% of copper and co-doped with 0.3% terbium showed the highest thermoluminescent (TL) signal in response to the irradiated dose. The analyses revealed that the glow curves of the doped samples were composed of nine overlapping glow peaks with activation energies between 0.73 and 2.78 eV. As a whole area under the glow curve, the TL signals displayed a linear dose response in the range from 110 mGy to 55 Gy. The minimum detectible dose of the samples was found to be 10.39 µGy. It was found that peaks 1 and 2 disappear after one day of storage. The rest of the peaks (3-9) remain almost constant up to 74 days of storage.