Atypical trigeminocardiac reflex during intranasal dexmedetomidine sedation of a 6-month-old premature baby.

The trigeminocardiac reflex (TCR) is an established brainstem reflex leading to parasympathetic dysrhythmias-including haemodynamic irregularities, apnoea and gastric hypermotility-during stimulation of any sensory branches of the trigeminal nerve. Most of the clinical knowledge about TCR was gathered from general anaesthesia observations, not from procedural sedation.We present a case of a 6-month-old premature baby experiencing the reflex twice under dexmedetomidine-propofol-sedation while undergoing ophthalmic and ear examination.

Autonomous Exploration of Small Bodies Toward Greater Autonomy for Deep Space Missions.

Autonomy is becoming increasingly important for the robotic exploration of unpredictable environments. One such example is the approach, proximity operation, and surface exploration of small bodies. In this article, we present an overview of an estimation framework to approach and land on small bodies as a key functional capability for an autonomous small-body explorer.

An Algorithm for Nonparametric Estimation of a Multivariate Mixing Distribution with Applications to Population Pharmacokinetics.

Population pharmacokinetic (PK) modeling has become a cornerstone of drug development and optimal patient dosing. This approach offers great benefits for datasets with sparse sampling, such as in pediatric patients, and can describe between-patient variability. While most current algorithms assume normal or log-normal distributions for PK parameters, we present a mathematically consistent nonparametric maximum likelihood (NPML) method for estimating multivariate mixing distributions without any assumption about the shape of the distribution.

Contributors to Intensive Care Unit Clinicians' Predictions of Patient Outcomes: A Qualitative Analysis.

Background: Information about a critically ill patient's prognosis is important to the shared decision-making process. The factors that physicians and nurses consider when generating their prognoses are not well understood.

Objective: To explore the factors that intensive care unit clinicians consider when prognosticating for their patients.

Active Choice Intervention Increases Advance Directive Completion: A Randomized Trial.

Many people recognize the potential benefits of advance directives (ADs), yet few actually complete them. It is unknown whether an active choice intervention influences AD completion. New employees were randomized to an active choice intervention (n = 642) or usual care (n = 637).