Vaccine hesitancy due to vaccine country of origin, vaccine technology, and certification.

Vaccine hesitancy is a global health threat which may hinder the widespread acceptance of several COVID-19 vaccines. Following the collection of 2470 responses from an anonymous questionnaire distributed between October and November 2020 across Israel, we analyzed the responses of physicians, life science graduates (biology, virology, chemistry, etc.), and the general public to whether they would obtain a COVID-19 vaccine with particular vaccine characteristics such as vaccine country of origin, technology, side effect profile, efficacy, and other attributes. Physicians and life science graduates were least likely to accept a vaccine based on mRNA technology (30%) while the general population seemed to adopt any vaccine technology if the declared efficacy is above 90% and the country of manufacturing is the USA/UK rather than China or Russia. However, current inoculation rates in Israel far outpace our predicted rate. Our results highlight the importance of tailored vaccine educational campaigns based on population demographic details and specific vaccine concerns.

First Record of Aedes albopictus in Jordan.

The presence of Aedes albopictus in Jordan is reported for the 1st time based on collections of larvae and adults from 7 sites representing 3 governorates (Irbid, Ajloun, and Balqa). Adults were recovered from around houses, while larvae were collected from concrete reservoirs, water tanks for irrigation, small containers, and water barrels. Larvae of Ae. albopictus were found along with larvae of Culiseta longiareolata and Culex laticinctus.

A tail of sacral agenesis: delayed presentation of meningocele in sacral agenesis.

INTRODUCTION: Sacral agenesis is a congenital condition associated with multiple orthopedic, spinal, abdominal and thoracic organ deformities. Meningocele is commonly found among patients with sacral agenesis. DESCRIPTION: We present the first case in the literature describing a delayed presentation of terminal (posterior) meningocele in an adult patient born with sacral agenesis. CONCLUSION: Surgical repair was performed and is the best treatment option for significantly large lesions, with postoperative CSF leak being the main complication.

Periorbital Ecchymosis Post Closed Rhinoplasty: Natural History, Risk Factors, and Validation of a New Scoring System.

Postrhinoplasty periorbital ecchymosis is an inevitable side effect contributing to patients' psychological aspect and early postoperative morbidity. Efforts are constantly being made to reduce ecchymosis using different methods with varying success. To evaluate treatment response, it is mandatory to have a reliable score. Several studies suggest other scoring systems, but none has been postrhinoplasty-specific, validated, and accepted. This study aimed to demonstrate the natural history of postrhinoplasty ecchymosis, find potential risk factors for worsening patterns, and suggest a useful and reliable periorbital ecchymosis scoring system for postrhinoplasty follow-up. Methods: This prospective study included 183 patients who underwent closed rhinoplasty by the same surgeon and the same principle method. Photographs of the periorbital ecchymosis were taken on postoperative days 1, 2, and 7. The periorbital area was divided into quarters, and three independent physicians assigned the dominant color of each quarter. Results: There were no significant variations between the three physicians' scoring. The interobserver consistency defined as an excellent scoring system reliability, according to our statistical analysis. The postoperative ecchymosis demonstrated a consistent pattern of spread over time, dominating the medial quarters on early postoperative days 1 and 2, following into the lower lateral quarters in postoperative day 7. We found no correlation between patient demographics and clinical characteristics to ecchymosis patterns and temporal spread. Conclusions: Our study suggests a reliable and easy-to-use postrhinoplasty ecchymosis scoring system. This scoring method can be used for postrhinoplasty ecchymosis assessment and as a research-validated tool to quantify different perioperative treatments to reduce ecchymosis and estimate mid-face trauma.

Utility of the Pediatric Bleeding Questionnaire in Predicting Posttonsillectomy Bleeding.

OBJECTIVE: Posttonsillectomy bleeding is a dreadful complication that may be life-threatening. Preoperative coagulation tests have not been shown to be effective in predicting this complication. The Pediatric Bleeding Questionnaire (PBQ) is a validated and sensitive tool in diagnosing children with abnormal hemostatic functions, and the objective of our study was to assess its utility as a preoperative screening tool for predicting posttonsillectomy bleeding. STUDY DESIGN: Prospective single-blinded cohort study. SETTING: Tertiary care hospital system. METHODS: All children scheduled for tonsil surgery between 2017 and 2019 in the Galilee Medical Center were included. The PBQ was completed by the caregivers prior to surgery, and all children underwent coagulation tests. Each PBQ item is scored on a scale of -1 to 4, and the total score per candidate is based on summation of all items. RESULTS: An overall 272 patients were included in the study with a mean age of 5.2 years; 57.7% were boys. The main finding was that in a multivariable model adjusted to age, a PBQ score of 2 is correlated with increased postoperative bleeding risk (odds ratio, 10.018 [95% CI, 1.20-82.74]; P = .046). The results of the PBQ demonstrated better predictive ability when compared with abnormal coagulation test results (odds ratio, 1.76 [95% CI, 0.63-4.80]; P = .279). Sex was not found to be significant (odds ratio, 1.45 [95% CI, 0.70-3.18]; P = .343). CONCLUSIONS: This study demonstrated that a PBQ score ≥2 has a higher yield for detecting children at risk for posttonsil surgery bleeding as compared with coagulation studies.

Radiological features of infantile glioblastoma and desmoplastic infantile tumors: British Columbia's Children's Hospital experience.

OBJECT Two of the more common infantile brain tumors, glioblastoma multiforme (GBM) and desmoplastic infantile tumors (DITs), can be difficult to distinguish on MRI. Both tumors occur in the supratentorial compartment and both have solid and cystic components. Differentiating between the 2 on MRI studies could assist the surgeon in discussions with family and child management. The authors report on their institutional experience with both tumors, focusing on radio-graphic features, especially the diffusion studies, which might be useful in distinguishing between infantile GBM and DIT. METHODS A retrospective review was undertaken of all infantile brain tumors treated at British Columbia's Children's Hospital between 1982 and 2012, and cases of GBM and DIT were recorded. Only cases that had imaging were included in the study. A literature review was completed to identify reported cases of infantile GBM and DIT. Only reports that described or included radiological studies (particularly MRI) of the tumors were included. Certain radiographic features of the tumors were reviewed, including location, size, consistency, pattern of enhancement, and features on MR diffusion studies. RESULTS Of 70 cases of infantile brain tumors, 2 GBM cases and 3 DIT cases (all 3 of which were desmoplastic infantile gangliogliomas [DIGs]) met the inclusion criteria. The radiological studies obtained in all 5 cases were reviewed by a neuroradiologist. All 5 patients had supratentorial tumors with cystic-solid consistency. Diffusion MRI studies showed restricted diffusion in the 2 GBM cases, but no evidence of restricted diffusion in the DIG tumors. The GBM tumors were heterogeneously enhancing, and the DIG tumors showed avid and homogeneous enhancement. The literature review revealed 29 cases of infantile GBM and 32 cases of DIG/DIT that met the inclusion criteria. The tumors were large in both groups. The tumors were cystic-solid in consistency in 10 of 30 (33%) of GBM cases and 28 of 32 (87.5%) of DIT cases. The contrast enhancement was heterogeneous in 9 of 30 (30%) GBM cases, and it was homogeneous and avid in 27 of 32 (84%) of DIT cases. Diffusion studies were recorded in 2 published infantile GBM cases, and in both of them diffusion was restricted. The authors only found 1 report that discussed DIG tumor features on MR diffusion studies, but the interpretation was difficult and unclear. CONCLUSIONS Magnetic resonance imaging, especially diffusion-weighted imaging, may be a useful aid in distinguishing between infantile GBM and DIT tumors, with infantile GBM demonstrating restricted diffusion.

Composition of the essential oil of leaves, galls, and ripe and unripe fruits of Jordanian Pistacia palaestina Boiss.

Pistacia palaestina Boiss. (Pistacia terebinthus L. var. palaestina (Boiss.) Engl.) is a medicinal and foodstuff plant. The ripe fruits are used largely in the Middle East as a component of the so-called Zaatar, a mix of aromatic and food plants. Results of GC and GC-MS analyses of the essential oils of leaves, galls produced by Baizongia pistaciae (L.), and ripe and unripe fruits of Pistacia palaestinaBoiss. collected in Jordan are reported. Both qualitative and quantitative differences between different parts of the plant were observed. The oil was rich in monoterpenes, and the main constituents were alpha-pinene (63.1%) and myrcene (13.3%) in the leaves and alpha-pinene (49.4%), sabinene (22.8%), and limonene (8.1%) in the galls. (E)-Ocimene (33.8-41.3%), sabinene (20.3-24.1%), and (Z)-ocimene (3.8-13.0%) were the main ones in both unripe and ripe fruits. Sesquiterpenes have been detected in small quantities in leaves and fruits and in trace amounts in galls.

Facial myiasis and canthariasis associated with systemic lupus panniculitis: a case report.

BACKGROUND: Infestation of insects can cause myiasis due to dipetran larvae and canthariasis due to coleopteran larval or adult stages. OBJECTIVE: To report a case of facial myiasis and canthariasis in a patient known to have panniculitis due to systemic lupus erythematosus and autoimmune hemolytic anemia. METHOD: Larval and pupal stages of insects were recovered from the face of a patient, mounted, and identified. RESULT: Initially, the pupal stage of the common green bottle fly Lucilia sericata was extracted from the patient's face, treated, and then came back with secondary infestation caused by two species of beetles, the drugstore beetle, Stegobium paniceum, and a beetle of the genus Trogoderma. CONCLUSION: This is the first report on facial canthariasis due to larval stages caused by two species of beetles and recovery of pupal stages of the common green bottle fly.