Quantifying the Impact of Sustained Acceleration on Critical Care Transport Medical Equipment.

Introduction: Military and commercial stakeholders are investing to explore the use of hypersonic aircraft and orbital spacecraft to transport cargo, medical supplies, passengers, and casualties. These vehicle platforms require periods of sustained acceleration, but to date, these dynamic forces have not been comprehensively considered in the environment of critical care patient movement because injured patients and advanced aeromedical evacuation (AE) equipment are rarely subjected to these conditions. While military AE equipment does undergo crash hazard acceleration testing, equipment functionality during or after sustained acceleration remains to be evaluated.

Quantifying the Volume of Residual Air in Commercial Intravenous Fluids and Assessing the Stability of Airless Intravenous Fluid Containers.

Introduction: Commercial off-the-shelf (COTS) intravenous fluid (IVF) containers contain residual air, introducing the risk of venous air embolism (VAE). Venous air embolism occurs when air displaces blood flow in vasculature. The danger from residual air is often negligible in terrestrial settings, where gravitational forces generate buoyancy, pushing residual air to the top of the IVF container.

Prehospital Restraint Use in Pediatric Patients With Mental and Behavioral Health Emergencies.

Objectives: The aims of the study are to characterize children with mental and behavioral health conditions (MBH) transported by emergency medical services (EMS) and examine differences in patient, emergency department (ED), and EMS transport characteristics based on restraint interventions during EMS transport.

Methods: This is a retrospective cohort study of EMS patients with MBH crises, aged 5-18, transported to 2 pediatric EDs over 9 years. Demographic and ED data were collected electronically; EMS data were extracted manually from prehospital care records.

Emergency Medical Services and Police Utilization for Pediatric Mental and Behavioral Health Concerns Within a Large Hospital System.

Objective: This study aimed to compare emergency medical services (EMS) and police utilization trends, epidemiology, and emergency department (ED) outcomes between pediatric patients with mental or behavioral health (MBH) emergencies and those with non-MBH concerns transported to a large children's hospital system.

Methods: This was a retrospective cohort study of patients aged 5 to 18 years transported via EMS and police to two EDs affiliated with a children's hospital from January 2012 through December 2020. Data were abstracted from electronic hospital records.

Emergency Department Pediatric Mental and Behavioral Health Patients Transported by Emergency Medical Services and Police: Trends and Interventions.

Objective: We aimed to understand transport utilization trends, demographics, emergency department (ED) interventions, and outcomes of pediatric mental and behavioral health (MBH) patients transported by emergency medical services (EMS), police, or self-transported.

Methods: This retrospective cohort study utilized electronic health record data from patients aged 5 to 18 years presenting with acute MBH conditions at 2 affiliated pediatric EDs from January 2012 to December 2020. Data included demographics, ED interventions for aggression/agitation, Brief Rating of Aggression by Children and Adolescents (BRACHA) scores, and ED dispositions.

Nomenclatural history of Jefferson, 1799 (Mammalia, Xenarthra, Pilosa, Megalonychidae).

Both authorship and spelling of the extinct giant sloth genus and its type species, (Mammalia, Xenarthra, Pilosa, Megalonychidae), have been inconsistent. The genus-group name has been cited with two different authorships and three dates, and it has been spelled with two different suffixes. The species-group name has been cited with four different authors and dates, and it has been spelled with two different endings.

Replacement names for two species of Agassiz, 1843 (Chondrichthyes, Xenacanthiformes), and discussion of Whitley, 1940, replacement name for Giebel, 1848 (Chondrichthyes, Xenacanthiformes), preoccupied by Müller & Troschel, 1844 (Actinopterygii, Characiformes).

Three species assigned to the same nominal genus of Paleozoic xenacanthiform shark have been combined with the name (Chondrichthyes, Xenacanthiformes, Orthacanthidae). (Giebel, 1848), which was originally combined as Giebel, 1848, is the senior synonym; it has priority over both (Newberry, 1857), which was originally combined as Newberry, 1857, and Newberry, 1875a. Proposed species-group replacement names are for (Newberry, 1857) and for Newberry, 1875a.

Stratification of risk for emergent intracranial abnormalities in children with headaches: a Pediatric Emergency Care Applied Research Network (PECARN) study protocol.

Introduction: Headache is a common chief complaint of children presenting to emergency departments (EDs). Approximately 0.5%-1% will have emergent intracranial abnormalities (EIAs) such as brain tumours or strokes.

Speg interactions that regulate the stability of excitation-contraction coupling protein complexes in triads and dyads.

Here we show that striated muscle preferentially expressed protein kinase α (Spegα) maintains cardiac function in hearts with Spegβ deficiency. Speg is required for stability of excitation-contraction coupling (ECC) complexes and interacts with esterase D (Esd), Cardiomyopathy-Associated Protein 5 (Cmya5), and Fibronectin Type III and SPRY Domain Containing 2 (Fsd2) in cardiac and skeletal muscle. Mice with a sequence encoding a V5/HA tag inserted into the first exon of the Speg gene (HA-Speg mice) display a >90% decrease in Spegβ but Spegα is expressed at ~50% of normal levels.

Ovarian and Endometrial Endometrioid Carcinoma Following the Use of a Biologic IL-17 Inhibitor.

Evidence suggests that IL-17, a pro-inflammatory cytokine, suppresses tumor carcinogenesis; therefore, the use of IL-17 inhibitors accelerates carcinoma growth. We present a case of a perimenopausal female who was diagnosed with synchronous primary ovarian and endometrial endometrioid carcinoma following the use of secukinumab, a monoclonal antibody against IL-17. After eight months of secukinumab, she developed progressive vaginal bleeding, left upper quadrant pain, and abdominal distention.

Mental health Narrative Community-Based Group Therapy in violence-displaced Afro-Colombians: a randomized controlled trial.

This study aims to evaluate the effect of a mental health Narrative Community-Based Group Therapy (NCGT) in Afro-Colombian violence survivors. A randomized controlled trial was conducted in Buenaventura and Quibdó, Colombia. Afro-Colombian adults (=521) were randomly allocated to a NCGT (n=175), a wait-control group (n=171) or a Common Elements Treatment Approach (CETA, n=175).

Findings from a Randomized Controlled Trial of SMART: An EHealth Intervention for Mild Traumatic Brain Injury.

Objective: The aim of this study was to examine the efficacy of the SMART (Self-Management After Recent Traumatic brain injury) program and potential moderators.

Methods: Parallel randomized controlled trial (ClinicalTrials.gov Identifier: NCT03498495) was conducted.

Robotized polarization characterization platform for free-space quantum communication optics.

We develop a polarization characterization platform for optical devices in free-space quantum communications. We demonstrate an imaging polarimeter, which analyzes both incident polarization states and the angle of incidence, attached to a six-axis collaborative robot arm, enabling polarization characterization at any position and direction with consistent precision. We present a detailed description of each subsystem, including the calibration and polarization-test procedure, and analyze polarization measurement errors caused by imperfect orientations of the robot arm using a Mueller-matrix model of polarimeters at tilt incidence.

Usage Patterns of an mHealth Symptom Monitoring App Among Adolescents With Acute Mild Traumatic Brain Injuries.

Objective: To understand usage patterns of SMART (Self-Monitoring Activity Regulation and Relaxation Treatment) mHealth app among adolescents with acute mild traumatic brain injuries (mTBIs) and to identify individual characteristics that influenced app usage.

Setting: Emergency departments of tertiary care children's medical center.

Participants: Children aged 11 to 18 years with mTBI in the past 2 weeks, English-speaking, no evidence of severe TBI, and no preexisting neurological impairment.

Elevated glycohemoglobin is linked to critical illness in CoVID-19: a retrospective analysis.

Background: Several studies have explored hospitalization risk factors with the novel coronavirus disease 2019 (COVID-19) infection. Our goal was to identify clinical characteristics outside of laboratory or radiologic data associated with intubation or death within 7 days of admission.

Methods: The first 436 patients admitted to the University of Colorado Hospital (Denver metropolitan area) with confirmed COVID-19 were included.

Early Neurologic Recovery, Practice Pattern Variation, and the Risk of Endotracheal Intubation Following Established Status Epilepticus.

Objective: To quantify the association between early neurologic recovery, practice pattern variation, and endotracheal intubation during established status epilepticus, we performed a secondary analysis within the cohort of patients enrolled in the Established Status Epilepticus Treatment Trial (ESETT).

Methods: We evaluated factors associated with the endpoint of endotracheal intubation occurring within 120 minutes of ESETT study drug initiation. We defined a blocked, stepwise multivariate regression, examining 4 phases during status epilepticus management: (1) baseline characteristics, (2) acute treatment, (3) 20-minute neurologic recovery, and (4) 60-minute recovery, including seizure cessation and improving responsiveness.

Acute care research competencies for clinical research professionals.

Introduction: Acute care research (ACR) is uniquely challenged by the constraints of recruiting participants and conducting research procedures within minutes to hours of an unscheduled critical illness or injury. Existing competencies for clinical research professionals (CRPs) are gaining traction but may have gaps for the acute environment. We sought to expand existing CRP competencies to include the specialized skills needed for ACR settings.

Comparison of children receiving emergent sepsis care by mode of arrival.

Objective: To determine if differences in patient characteristics, treatments, and outcomes exist between children with sepsis who arrive by emergency medical services (EMS) versus their own mode of transport (self-transport).

Methods: Retrospective cohort study of patients who presented to the Emergency Department (ED) of two large children's hospitals and treated for sepsis from November 2013 to June 2017. Presentation, ED treatment, and outcomes, primarily time to first bolus and first parental antibiotic, were compared between those transported via EMS versus patients who were self-transported.

User experience (re)design and evaluation of a self-guided, mobile health app for adolescents with mild Traumatic Brain Injury.

Mild Traumatic Brain Injury (mTBI) is a significant cause of morbidity for adolescents. Currently, there is a lack of evidence-based interventions to address common sequelae of mTBI. To address this gap, we designed a program to promote recovery for adolescents following mTBI.

Pathological mechanisms of vacuolar aggregate myopathy arising from a Casq1 mutation.

Mice with a mutation (D244G, DG) in calsequestrin 1 (CASQ1), analogous to a human mutation in CASQ1 associated with a delayed onset human myopathy (vacuolar aggregate myopathy), display a progressive myopathy characterized by decreased activity, decreased ability of fast twitch muscles to generate force and low body weight after one year of age. The DG mutation causes CASQ1 to partially dissociate from the junctional sarcoplasmic reticulum (SR) and accumulate in the endoplasmic reticulum (ER). Decreased junctional CASQ1 reduces SR Ca release.

Early Exposure of Fosphenytoin, Levetiracetam, and Valproic Acid After High-Dose Intravenous Administration in Young Children With Benzodiazepine-Refractory Status Epilepticus.

Fosphenytoin (FOS) and its active form, phenytoin (PHT), levetiracetam (LEV), and valproic acid (VPA) are commonly used second-line treatments of status epilepticus. However, limited information is available regarding LEV and VPA concentrations following high intravenous doses, particularly in young children. The Established Status Epilepticus Treatment Trial, a blinded, comparative effectiveness study of FOS, LEV, and VPA for benzodiazepine-refractory status epilepticus provided an opportunity to investigate early drug concentrations.

Author Correction: A Silurian ancestral scorpion with fossilised internal anatomy illustrating a pathway to arachnid terrestrialisation.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

MyoSight-semi-automated image analysis of skeletal muscle cross sections.

Background: Manual analysis of cross-sectional area, fiber-type distribution, and total and centralized nuclei in skeletal muscle cross sections is tedious and time consuming, necessitating an accurate, automated method of analysis. While several excellent programs are available, our analyses of skeletal muscle disease models suggest the need for additional features and flexibility to adequately describe disease pathology. We introduce a new semi-automated analysis program, MyoSight, which is designed to facilitate image analysis of skeletal muscle cross sections and provide additional flexibility in the analyses.