Childhood vaccine hesitancy has been studied extensively before the COVID-19 pandemic. The pandemic presented new barriers to pediatric vaccinations. Furthermore, the development of COVID-19 vaccines has complicated factors underlying vaccine hesitancy. We performed a cross-sectional mobile phone-based survey at Children's Hospital Los Angeles querying parents regarding perspectives on vaccines before and during the pandemic. Our primary aim was to understand the impact of the pandemic on routine childhood vaccine hesitancy. Secondarily, we examined intent to vaccinate, COVID-19 vaccine hesitancy, and key contributing demographic factors. Among 252 participants, we found overall increased childhood vaccine hesitancy (p = 0.006), increased risk perception (p = 0.006), and unchanged vaccine confidence during the COVID-19 pandemic. Increased hesitancy did not translate into decreased intent to vaccinate with routine childhood vaccines or influenza vaccines. During the pandemic, households with higher income (50-99 K, > 100 K) correlated with decreased routine childhood vaccine hesitancy, while Hispanic ethnicity and African American race had increased risk perception. For COVID-19 vaccine hesitancy, households with higher income (> 100 K) correlated with decreased hesitancy, while non-White ethnicity and race had increased risk perception. We found that routine childhood vaccine hesitancy increased during the COVID-19 pandemic, mainly due to increased risk perception. Key contributing demographic factors behind both childhood vaccine hesitancy and COVID-19 vaccine hesitancy included household income and race. Understanding factors behind routine childhood vaccine hesitancy is crucial to maintaining pediatric vaccination rates and promoting vaccine confidence during and after the COVID-19 pandemic.

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The recent advent of satellite swarm technologies has enabled space exploration with a massive number of picoclass, low-power, and low-weight spacecraft. However, developing swarm-based satellite systems, from conceptualization to validation, is a complex multidisciplinary activity. One of the primary challenges is how to achieve energy-efficient data transmission between the satellite swarm and terrestrial terminal stations. Employing Lyapunov optimization techniques, we present an online control algorithm to optimally dispatch traffic load among different satellite-ground links for minimizing overall energy consumption over time. Our algorithm is able to independently and simultaneously make control decisions on traffic dispatching over intersatellite-links and up-down-links so as to offer provable energy and delay guarantees, without requiring any statistical information of traffic arrivals and link condition. Rigorous analysis and extensive simulations have demonstrated the performance and robustness of the proposed new algorithm.

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Since the sudden outbreak in 2019, COVID-19 has had a great impact on the whole social economy. By analyzing the specific reasons for the blow or promotion of all industries, This paper discuss the specific countermeasures to promote the future development of the industry. Research shows that the impact of the COVID-19 on tourism and catering industry is rapid and destructive. But it has a significant role in promoting the Internet industry. Today, when the epidemic situation is gradually stabilized and normalized, enterprise managers can no longer imagine returning to the normal operation mode, and should actively reform to adapt to the stable development of the overall environment. For some industries that are currently enjoying the dividends brought by the epidemic, they should be soberly aware of the strength of their products, analyze the actual growth rate brought by the epidemic and make plans for long-term development.

A 7-year-old boy with recent left elbow septic arthritis and osteomyelitis presented with new left knee swelling. The patient was recovering from recurrence of traumainduced left elbow septic arthritis and osteomyelitis, which had resulted in 2 admissions within the preceding 2 months. Approximately 1 month into his antibiotic treatment for these conditions, he had developed Clostridioides difficile (C difficile) enterocolitis and was treated with metronidazole. Presenting symptoms began with left knee pain 3 days prior to presentation, with subsequent redness, swelling, pain, and refusal to ambulate, prompting a visit to the Emergency Department. At this time, he was still completing a 6-week course of cephalexin 3 times daily for prior diagnosis. He had experienced mild back pain for approximately 2 weeks prior to admission but had no other significant musculoskeletal complaints. He had no rashes, no visual symptoms, no urogenital symptoms, and no current complaints of diarrhea, after his C difficile diagnosis and treatment 3 weeks prior.At the Emergency Department, he was afebrile (T 36.7°C), had tachycardia to 125 bpm, with normal respiratory rate (26 bpm), blood pressure (102/77 mm Hg), and oxygen saturating 98% on room air. Physical examination was notable for erythema of the left knee, with warmth, swelling, and tenderness to palpation, as well as a palpable effusion. Patient preferred to keep the left leg flexed at the knee and reported pain with full extension. Neurovascular examination was intact. He had negative examination at all other joints, except his left elbow which showed only mild swelling, but no tenderness or limited range of motion, felt to be secondary to improving previous infection.Diagnostic testing showed evidence of inflammation, with white blood cell (WBC) count of 14 000/uL, elevated platelets to 627 000/uL, erythrocyte sedimentation rate to 60 mm/h, C-reactive protein (CRP) reaching a peak of 15.9 mg/dL. Comprehensive metabolic panel was within normal limits. He was SARS-COv-2 PCR 1098977C PJXXX10.