Vaccination is currently the most effective strategy for combating COVID-19. COVID-19 vaccines were introduced to the adult population in Israel in early December 2020 and have been available for children aged 12–15 since June 2021. Our study aimed at assessing the influence of vaccine literacy, perception, hesitancy, and behavior on Israeli parents’ intentions to have their children vaccinated. Using an anonymous online questionnaire, we recruited 520 parents; 70.4% of the parents indicated that they would get their children vaccinated. The participants’ COVID-19 vaccination status was the only socio-demographic factor significantly associated with COVID-19 vaccination acceptability (OR = 32.89; 95%CI = [13.11, 82.54]). The most common sources of information regarding the COVID-19 vaccine were health-care providers and the Internet. Parents who intend to vaccinate their children had higher mean levels of vaccine literacy (2.99 ± 0.47 vs. 3.07 ± 0.44 respectively, p = 0.06), more positive perception of the vaccine (mean scores of 2.26 ± 0.75 vs. 3.44 ± 0.68 respectively, p < 0.001), and lower perceived vaccine hesitancy (7.53 ± 2.37 vs. 4.68 ± 2.71 respectively, p < 0.001) than parents who do not intend to do so. Vaccine behavior was measured using the 5C model of psychological antecedents. All 5C components were significantly correlated with parents’ willingness to vaccinate their children. Understanding of parents’ willingness to have their children receive the COVID-19 vaccine and the barriers to and facilitators of the vaccination is crucial, as vaccination of children aged 5–11 has recently been approved by the FDA. Providing the population with reliable information regarding the COVID-19 vaccine is an important measure in the attempt to increase COVID-19 vaccine acceptance.

Objectives: Acute kidney injury in the critically ill pediatric population is associated with worse outcome. The aim of this study was to assess the prevalence, associated clinical variables, and outcomes of acute kidney injury in children admitted to the PICU with diabetic ketoacidosis. Design: Retrospective cohort. Setting: PICU of a tertiary, university affiliated, pediatric medical center. Patients: All children less than age 18 years with a primary diagnosis of diabetic ketoacidosis admitted to the PICU between November 2004 and October 2017. Interventions: None. Measurements and Main Results: Acute kidney injury was categorized into three stages using the Kidney Disease Improving Global Outcomes scale. Of the 82 children who met the inclusion criteria, 24 (30%) had acute kidney injury: 18 (75%) stage 1, five (21%) stage 2, and one (4%) stage 3. None needed renal replacement therapy. Compared with the patients without acute kidney injury, the acute kidney injury group was characterized by higher mean admission serum levels of sodium (143.25 ± 9 vs 138.6 ± 4.9 mmol/L; p = 0.0035), lactate (29.4 ± 17.1 vs 24.1 ± 10.8 mg/dL; p = 0.005), and glucose (652 ± 223 vs 542 ± 151 mg/dL; p = 0.01). There was no between-group difference in length of PICU stay (1.38 ± 0.7 vs 1.4 ± 0.7 d; p = 0.95) or hospitalization (6.1 ± 2.1 vs 5.8 ± 5.6 d; p = 0.45). Kidney injury was documented at discharge in four patients with acute kidney injury (16.7%), all stage 1; all had normal creatinine levels at the first clinical outpatient follow-up. All 82 patients with diabetic ketoacidosis survived. Conclusions: In this study, acute kidney injury was not uncommon in children with diabetic ketoacidosis hospitalized in the PICU. However, it was usually mild and not associated with longer hospitalization or residual kidney injury.

Background: During the Coronavirus disease 2019 (COVID-19) pandemic, wearing facemasks became obligatory worldwide.Objectives: The objective of this study was to evaluate the effects of facemasks on gas exchange. Methods: Healthy adults were assessed at rest and during slow and brisk 5-minute walks, with and without masks. We monitored O 2 saturation, end-tidal carbon dioxide (EtCO 2 ), and heart and respiratory rates. Participants graded their subjective difficulty and completed individual sensations questionnaires.Results: Twenty-one participants with a median age of 38 years (range, 29-57 years) were recruited. At rest, all vital signs remained normal, without and with masks. However, during slow and brisk walks, EtCO 2 increased; the rise was significantly higher while wearing masks: slow walk, mean EtCO 2 (mmHg) change 14.5 6 2.4 versus 12.9 6 2.3, P = .004; brisk walk EtCO 2 change 18.4 6 3.0 versus 16.2 6 4.0, P = .009, with and without masks, respectively. Wearing masks was also associated with higher proportions of participant hypercarbia (EtCO 2 range, 46-49 mmHg) compared with walking without masks, though this was only partially significant. Mean O 2 -saturation remained stable (98%) while walking without masks but decreased by 1.2 % 6 2.2 while walking briskly with a mask (P = .01). Mild desaturation (O 2 range, 93% to 96%) was noted during brisk walks among 43% of participants with masks, compared with only 14% without masks (P = .08). Borg's scale significantly increased while walking with a mask, for both slow and brisk walks (P < .001). Sensations of difficulty breathing and shortness of breath were more common while walking with masks.Conclusion: While important to prevent viral spread, wearing facemasks during brisk 5-minute walks might be associated with mild hypercarbia and desaturation. The clinical significance of these minor gas exchange abnormalities is unclear and should be further investigated.