BACKGROUND AND OBJECTIVES:
With the onset of the coronavirus disease 2019 (COVID-19) pandemic, pediatric ambulatory encounter volume and antibiotic prescribing both decreased; however, the durability of these reductions in pediatric primary care in the United States has not been assessed.
METHODS:
We conducted a retrospective observational study to assess the impact of the COVID-19 pandemic and associated public health measures on antibiotic prescribing in 27 pediatric primary care practices. Encounters from January 1, 2018, through June 30, 2021, were included. The primary outcome was monthly antibiotic prescriptions per 1000 patients. Interrupted time series analysis was performed.
RESULTS:
There were 69 327 total antibiotic prescriptions from April through December in 2019 and 18 935 antibiotic prescriptions during the same months in 2020, a 72.7% reduction. The reduction in prescriptions at visits for respiratory tract infection (RTI) accounted for 87.3% of this decrease. Using interrupted time series analysis, overall antibiotic prescriptions decreased from 31.6 to 6.4 prescriptions per 1000 patients in April 2020 (difference of −25.2 prescriptions per 1000 patients; 95% CI: −32.9 to −17.5). This was followed by a nonsignificant monthly increase in antibiotic prescriptions, with prescribing beginning to rebound from April to June 2021. Encounter volume also immediately decreased, and while overall encounter volume quickly started to recover, RTI encounter volume returned more slowly.
CONCLUSIONS:
Reductions in antibiotic prescribing in pediatric primary care during the COVID-19 pandemic were sustained, only beginning to rise in 2021, primarily driven by reductions in RTI encounters. Reductions in viral RTI transmission likely played a substantial role in reduced RTI visits and antibiotic prescriptions.
This study investigates two questions: first, how individuals with high-intelligence allocate cognitive resources while solving linguistic, mathematical and visuo-spatial tasks with varying degree of difficulty as compared to individuals with low intelligence? Second, how to distinguish between high and low intelligent individuals by analyzing pupil dilation and eye blink together? We measured the response time, error rates along with pupil dilation and eye blink rate that indicate resource allocation. We divided the whole processing into three stages namely: pre-stimuli (5s prior to stimuli onset), during stimuli and post stimuli (until 5s after the response) for better assessment of preparation and resource allocation strategies. Individuals with high intelligence showed greater task evoked pupil dilation, decreased eye blink with less response time and error rates during-stimuli stage (processing) of tough linguistic and visuo-spatial tasks but not during mathematical tasks. The finding suggests that individuals with high intelligence allocate more resources if the task demands are high else they allocate less resources. Greater pre-stimuli pupil dilation and increased eye blink of high intelligent individuals in all tasks indicated their attentiveness and preparedness. The result of our study shows that individuals with high intelligence are more attentive and flexible in terms of altering the resource allocation strategy according to task demand. Eye-blinks along with pupil dilation and other behavioral parameters can be reliably used to assess the intelligence of an individual and the analysis of pupil dilation and blink rate at pre-stimuli stage can be crucial in distinguishing individuals with varying intelligence.
Objectives: Suggested therapeutic options for Multisystem Inflammatory Syndrome in Children (MIS-C) include intravenous immunoglobulins (IVIG) and steroids. Prior studies have shown the benefit of combination therapy with both agents on fever control or the resolution of organ dysfunction. The primary objective of this study was to analyze the impact of IVIG and steroids on hospital and ICU length of stay (LOS) in patients with MIS-C associated with Coronavirus Disease 2019 (COVID-19).
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