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.

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.

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.

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.

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.

Attitudes and Behaviors with Diabetes Technology Use in the Hospital: Multicenter Survey Study in the United States.

Objective: To assess the attitudes, behaviors, and barriers with diabetes technology use in the general medicine hospital wards. Research Design and Methods: The authors developed a nonincentivized web-based anonymous survey that captured demographic and practice data regarding continuous subcutaneous insulin infusion (CSII) and continuous glucose monitor (CGM) use in the hospital. Setting: Four large hospital systems in the United States. Results: Among 128 survey respondents, 76%, 10%, and 6% were hospitalists, advanced practice providers, and primary care physicians, respectively. The majority of respondents rated the treatment of inpatient hyperglycemia (96%) and the continuation of CSII during the hospital stay (93%) "important." While most respondents (64%) acknowledged knowing the existence of their institution's policies for CSII use, only 84% of those respondents felt somewhat to very familiar with the policy. The most common barrier to CSII use in the inpatient setting was lack of practitioner (70%) and nursing (67%) knowledge of using the device. With regard to CGM use in the hospital, a minority (28%) of respondents were aware of their institution's CGM policies. Less than half of the providers, 43.8%, stated that, when admitting a patient, they reviewed CGM data to guide insulin dosing. Conclusions: In this US multicenter survey, we found that most inpatient practitioners valued glycemic control, but many were not familiar with institutional policies, had lack of knowledge with CSII, and were not reviewing CGM data.

Novel urine-based DNA methylation biomarkers for urothelial bladder carcinoma detection in patients with hematuria.

Background: Urothelial bladder carcinoma (UBC) is usually detected during work-up for hematuria. Cystoscopy and/or contrast-enhanced imaging are the gold standard tools for UBC diagnosis, despite limited by being invasive, expensive and low yield in small flat tumors. Objectives: To assess the diagnostic performance of urine-based DNA methylation of six genes (GATA4, P16, P14, APC, CDH1 and CD99) for UBC detection in patients with hematuria. Patients and methods: Voided urine was collected from consecutive patients presented with hematuria for urine cytology and DNA methylation assay of the assigned genes using methylation-specific Polymerase Chain Reaction (PCR). Further assessment by office cystoscopy and imaging with subsequent inpatient cystoscopic biopsy for positive findings was done. The diagnostic characteristics of DNA methylation and urine cytology were assessed based on its capability to predict UBC. Results: We included 246 patients in the study with identified macroscopic hematuria in 204 (82.9%) patients. Positive cytology was found in 78 (31.7%) patients. DNA methylation of GATA4, P16, P14, APC, CDH1 and CD99 genes was identified in 127 (51.6%), 52 (21.1%), 117 (47.6%), 106 (43.1%), 90 (36.6%) and 71 (28.9%) patients, respectively. The sensitivity of the assigned genes for UBC detection ranges from 35% (95%CI: 31-39) to 83% (95%CI: 79-87). Optimal specificity (SP) (100%) was noted for P16, APC and CDH1 genes. While for the other genes (GATA4, P14 and CD99), the SP was 95% (95%CI: 92-98), 96% (95%CI: 92-99) and 97% (95%CI: 93-99), respectively. On multivariate logistic regression analysis, all genes exclusively demonstrated independent prediction of UBC. On receiver operator characteristic (ROC) analysis, all tested genes methylation showed superior area under the curve (AUC) when compared to urine cytology. Conclusions: We have developed a novel urine-based DNA methylation assay for detection of UBC in patients with hematuria with superior diagnostic performance and independent predictive capacity over urine cytology.

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.

Biocompatible magnetite nanoparticles coated with ionic liquid-based surfactantas a hydrophilic sorbent for dispersive solid phase microextraction of cephalosporins prior to their quantitation by HPTLC.

Extraction of highly hydrophilic compounds from biological fluids including urine or plasma samples is a dilemma due to high hydrophilicity of the matrix itself. The main aim of the current work is to explore the competence of ionic liquid (IL)-based surfactant-coated mineral oxide nanoparticles (NPs) in dispersive solid-phase microextraction (d-SPME) of highly hydrophilic analytes taking cefoperazone (CPZ) as a model analyte for the study. The IL-based surfactant coated Fe3O4 NPs is utilized as an innovative adsorbent for the separation and pre-concentration of CPZ after intramuscular injection (I.M) in rabbits. The utilized magnetite NPs were synthesized via simple and reliable co-precipitation procedure, which doesn't require any air-free environment and depends on a single iron (III) salt. Characterization of the as-synthesized NPs was achieved by X-ray powder diffraction (XRD), Fourier transform infrared (FT-IR) and energy dispersive X-ray (EDX). Surface area measurements show that Fe3O4 NPs have large surface area of 75 m2 g-1. The developed approach utilizes the unique properties of the IL-based surfactant including multiple polar interaction types provided by the polar head in addition to merits of Fe3O4 nanoparticles, which include large adsorptive capacity and magnetic properties, to improve separation, save time, and achieve satisfactory recovery. Comprehensive study was developed for the factors, that affect the adsorption capacity such as pH, NPs amount, IL-based surfactant concentration, ionic strength, adsorption time, and desorption conditions. Moreover, the adsorption data was fitted to Langmuir and second-order kinetic models as reflected by the reasonable determination coefficients of 0.9319 and 0.9726, respectively. Under the optimized conditions, the developed approach achieves good correlation coefficient of 0.9975, and 0.9981 over linearity range of 0.7-12.0 and 4.0-50.0 µg mL-1 for both CPZ standard solutions and spiked rabbit plasma, respectively. It also provides good sensitivity expressed by the low values of limit of detection (LOD) of 0.2 and 1.2 µg mL-1 and limit of quantitation (LOQ) of 0.7 and 4.0 µg mL-1 for both the standard solutions and spiked plasma, respectively. The developed approach was also applied successfully for monitoring CPZ in rabbit plasma samples with satisfactory recovery % (83-110). In addition, a detailed pharmacokinetic study is performed where pharmacokinetic parameters of CPZ in rabbit plasma samples were calculated.

Individuals' Financial Satisfaction and National Priority: A Global Perspective.

The purpose of this study is to examine the association between financial satisfaction and individuals' preferences for various national priorities (including economic growth, national defense, freedom of speech, and having a beautiful nation). Using the sixth wave of World Value Survey (2010-2014) data for 60 countries, our Probit regression analyses show a positive and significant relationship between individuals' financial satisfaction and individuals' preferences for freedom of speech and having a beautiful nation. We also find that financial satisfaction is negatively associated with the priority of economic growth but not statistically related to the priority of national defense. These findings are robust when we use a Probit model with endogenous regressors and country-level data with a 2SLS estimator. The regression results also show that the preference for a stronger national defense is higher among individuals who are older, married, nationalistic, educated and have jobs in the public sector. Finally, we find that people with lower education and income and those with full-time employment and non-government jobs are more interested in the economic growth of their countries.

Cutaneous Sarcoidosis of a 53-Year-Old Female: A Case Report.

Sarcoidosis is a systemic disease of an unknown cause that affects multiple organs, most commonly lungs, intrathoracic lymph nodes, eyes, and skin, which accounts between 20% and 25%. However, cutaneous sarcoidosis can present without any systemic involvement in 25% of cases. We present a case of a 53-year-old female patient with cutaneous sarcoidosis with no lung involvement. The patient presented to the family medicine department with non-itchy, tender, erythematous papules occurring at the dorsal part of the hands and the right foot for three months. Skin punch biopsy demonstrated multiple dermal-based nodules consisting of non-necrotizing granulomata. Serum angiotensin-converting enzyme level and a chest radiograph were normal and not consistent with pulmonary sarcoidosis. There are different cutaneous manifestations of cutaneous sarcoidosis and early identification helps in early intervention.

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.

Impact of the Poor Oral Health Status of Children on Their Families: An Analytical Cross-Sectional Study.

The impact of poor oral health may not just be limited to the children themselves but can impact their families. The current study aims to perform psychometric analyses of the Arabic version of the Family Impact Scale and investigate the association of its domains with the oral health status of children. This cross-sectional study was carried out in a sample of 500 parent-child dyads from high schools of Jazan city of the Kingdom of Saudi Arabia. The Arabic version of the Family Impact Scale was subjected to reliability and validity tests. The explanatory variables in the current study are: the oral health status, parents combined income, parents' education, age and sex of the child. The descriptive analysis was reported using proportions, this was followed by the bivariate and multivariable analyses. About 24.2% of children were reported to have fair, poor, and very poor oral health. A lower frequency of family impact corresponded with better oral health (OH) status of children (p < 0.001). The likelihood of parent's taking time off from work and having financial difficulties was nearly two-times greater if their children had poor oral health. Similarly, interruption in sleep and other normal activities of parents is four times and five times greater, respectively, if the child has poor oral health status. Thus, the poor oral health of school children in the Jazan region of Saudi Arabia is a matter of grave concern as it is observed to be associated with family impacts; particularly affecting the parent's work, sleep, and other normal family activities.

The potential mechanistic insights and future implications for the effect of prebiotics on poultry performance, gut microbiome, and intestinal morphology.

Prebiotics may modify the biological processes in the chickens' gastrointestinal tract to improve poultry performance and health. Prebiotics are natural feed additives that offer many economic advantages by decreasing mortality rates, increasing growth rates, and improving birds' feed efficiency. Prebiotic action potentially affects the degradation of indigestible dietary compounds, the synthesis of nitrogen components and vitamins, and simplifies the removal of undesirable elements in the diet. Prebiotics could also induce desirable gut microbiome modifications and affect host metabolism and immune health. It is worth mentioning that gut bacteria metabolize the prebiotic compounds into organic compounds that the host can subsequently use. It is important to limit the concept of prebiotics to compounds that influence the metabolism of resident microorganisms. Any medicinal component or feed ingredient beneficial to the intestinal microecosystem can be considered a prebiotic. In this review, the impacts of prebiotics on the gut microbiome and physiological structure are discussed, emphasizing the poultry's growth performance. The current review will highlight the knowledge gaps in this area and future research directions.

Chitosan nanoparticles effectively combat salinity stress by enhancing antioxidant activity and alkaloid biosynthesis in Catharanthus roseus (L.) G. Don.

Chitosan nanoparticles (CSNPs) are non-toxic and biodegradable stimulants of growth and secondary metabolite production, which offer new routes to combat plant stress. Salinity is a common and significant abiotic stress that adversely affects plant growth and development. The possible benefits of CSNPs in salt stress mitigation have not yet been reported in Catharanthus roseus, an important source of anticancer alkaloids. Plants were exposed to 150 mM NaCl as a salt stress treatment, while CSNPs were applied as a foliar spray at 1% concentration. Plant growth was considerably impaired under salt stress conditions; however, CSNPs treatment significantly reversed this effect. Specifically, CSNPs retarded chlorophyll reduction and induced activities of catalase, ascorbate peroxidase, and glutathione reductase. Thus, CSNPs alleviated the oxidative stress, indicated by lower levels of malondialdehyde and H2O2, thereby enabling membrane function retention and enhancing salt tolerance. Higher alkaloid accumulation was observed in salt-stressed plants following CSNP spraying than in controls. Interestingly, the expression levels of mitogen-activated protein kinases (MAPK3), geissoschizine synthase (GS), and octadecanoid-derivative responsive AP2-domain (ORCA3) genes were significantly elevated in salt-stressed plants sprayed with CSNPs. Overall, CSNP treatment overcame the deleterious effects of salinity in C. roseus by activating the antioxidant defense system, which helps to scavenge reactive oxygen species, and inducing expression of MAPK3, GS, and ORCA3 genes, thus, leading to higher alkaloid accumulation and better protection against salinity stress.

Shelf-life extension of sweet basil leaves by edible coating with thyme volatile oil encapsulated chitosan nanoparticles.

Edible coatings have potential to decrease the postharvest losses of several horticultural commodities however; there is no systematic investigation focusing on fresh herbaceous aromatic plants such as basil. Herein, the effects of chitosan (CS), chitosan nanoparticles (CSNPs) and thyme volatile oil (TVO) loaded CSNPs (TVO-CSNPs) as edible coatings on preserving the quality of sweet basil leaves were investigated. All CS coatings considerably extended the shelf life and decreased the weight loss of basil leaves relative to the control. Using TVO-CSNPs showed 2.4-fold higher shelf life than the control. The loss in photosynthetic pigments and volatile oil content were significantly retarded by CS applications more so with TVO-CSNPs treatment. Contrary, treated leaves produced lower malondialdehyde (MDA) and H2O2 and therefore retained the membrane functions compared to the control. All CS applications particularly with TVO-CSNPs considerably motivated the activities of catalase (CAT) and superoxide dismutase (SOD) enzymes and reduced the polyphenol oxidase (PPO) and lipoxyganase (LOX) activities relative to uncoated leaves. Overall, using TVO-CSNPs as an edible coating has a great potential in shelf life extension of basil leaves with satisfactory exterior and interior quality. Thus, it can be a promising approach to preserve the quality of fresh cut aromatic herbs.

A vital role of chitosan nanoparticles in improvisation the drought stress tolerance in Catharanthus roseus (L.) through biochemical and gene expression modulation.

Drought is a main abiotic stress that restricts plant growth and development. The increased global demand of anti-cancer alkaloids extracted from periwinkle (Catharanthus roseus) is mainly related to plant growth and development, which are severely affected by drought. Chitosan nanoparticles (CSNPs) have been used to boost plant growth and defense mechanism, however their impact to alleviate drought stress of C. roseus has not been investigated yet. In this study, control and stressed plants (100 and 50% of field capacity [FC], respectively) were subjected to CSNPs application at 1%. Drought stress considerably reduced plant growth, relative water content (RWC), stomatal conductance and total chlorophyll; however, CSNPs mitigated these effects. They enhanced proline accumulation and the activity of catalase (CAT) and ascorbate peroxidase (APX) with possible mitigation of drought-induced oxidative stress. Therefore, they reduced H2O2 and malondialdehyde (MDA) accumulation, and eventually preserved membrane integrity. Drought stress increased alkaloid accumulation, and further increase was observed with the application of CSNPs. High alkaloid content was associated with induced gene expression of strictosidine synthase (STR), deacetylvindoline-4-O-acetyltransferase (DAT), peroxidase 1 (PRX1) and geissoschizine synthase (GS) up to 5.6 folds under drought stress, but more accumulation was noticed with the application of CSNPs. Overall, this study is the first on using CSNPs to mitigate drought stress of C. roseus by inducing the antioxidant potential and gene expression of alkaloid biosynthesis.

Towards understanding of the interaction of certain carbapenems with protein via combined experimental and theoretical approach.

The interactions of the recent carbapenems; ertapenem (ERP) and meropenem (MRP); with serum albumin (SA) were closely investigated by a combined spectrofluorometric experimental and theoretical approach. The approach is based on the quenching of fluorescence intensity of bovine serum albumin (BSA) upon binding with different carbapenems. The quenching was observed at λem 333-340 nm after excitation at 280 nm. Mechanism of interaction was found to be static quenching through hydrophobic and H-bonding interactions and confirmed with molecular docking using MOE software. Binding constant, binding number were estimated for both MRP and ERP. Thermodynamic parameters including entropy change (ΔS), enthalpy change (ΔH) and free energy change (ΔG) were calculated at three different temperatures. Moreover, BSA configuration during binding was investigated via synchronous and 3D spectrofluorimetry. Förster resonance energy transfer calculated (FRET), integration interval (J) and distance (ro) between BSA and the studied drugs were calculated to confirm the static quenching.