Full-thickness burn resulting from an e-sock: a case report.

Background: With the increase in lithium-ion battery-powered technology, clinicians have observed an increase in burn injuries. Typically, these injuries come from malfunctions in e-cigarettes, e-scooters and bikes, and even mobile phones. To the best of the authors' knowledge, this is the first reported case of a patient burned by the lithium-ion battery pack on an electric sock, which is commonly worn by skiers, snowboarders, and winter hikers.

Integrated pulmonary index during procedural sedation and analgesia: A cluster-randomized trial.

Aim: To evaluate the effectiveness of utilizing the integrated pulmonary index for capnography implementation during sedation administered by nurses.

Design: Cluster-randomized trial.

Methods: Participants were enrolled from the interventional radiology department at an academic hospital in Canada.

Design Specifications for an Automated System to Deliver Instructions About Preprocedure Fasting.

Purpose: Many patients undergoing surgical and other medical procedures requiring sedation or anesthesia receive standardized "no eating or drinking after midnight" instructions. This "standardized" instruction does not change regardless of potential alterations in scheduling that result in significant delays in procedure start times. As a result, the duration of preprocedure fasting often far exceeds recommended requirements.

Multi-harmonic near-infrared-ultraviolet dual-comb spectrometer.

Dual-comb spectroscopy in the ultraviolet (UV) and visible would enable broad bandwidth electronic spectroscopy with unprecedented frequency resolution. However, there are significant challenges in generation, detection, and processing of dual-comb data that have restricted its progress in this spectral region. In this work, we leverage robust 1550 nm few-cycle pulses to generate frequency combs in the UV-visible.

Integrated Pulmonary Index during nurse-administered procedural sedation: Study protocol for a cluster-randomized trial.

Aim: To determine if smart alarm-guided treatment of respiratory depression using the Integrated Pulmonary Index is an effective way to implement capnography during nurse-administered sedation.

Design: Parallel cluster-randomized trial.

Methods: Nurses will be randomized to use capnography with or without the Integrated Pulmonary Index enabled.

Conical intersection and coherent vibrational dynamics in alkyl iodides captured by attosecond transient absorption spectroscopy.

The photodissociation dynamics of alkyl iodides along the C-I bond are captured by attosecond extreme-ultraviolet (XUV) transient absorption spectroscopy employing resonant ∼20 fs UV pump pulses. The methodology of previous experiments on CHI [Chang et al., J.

Predicting Prolonged Apnea During Nurse-Administered Procedural Sedation: Machine Learning Study.

Background: Capnography is commonly used for nurse-administered procedural sedation. Distinguishing between capnography waveform abnormalities that signal the need for clinical intervention for an event and those that do not indicate the need for intervention is essential for the successful implementation of this technology into practice. It is possible that capnography alarm management may be improved by using machine learning to create a "smart alarm" that can alert clinicians to apneic events that are predicted to be prolonged.

Accuracy and precision of continuous non-invasive arterial pressure monitoring in critical care: A systematic review and meta-analysis.

Objective: To summarize the evidence regarding the accuracy of continuous non-invasive arterial pressure measurements in adult critical care patients.

Research Methodology: Medline, EMBASE, and CINAHL were searched for studies that included adult critical care patients reporting the agreement between continuous non-invasive and invasive arterial pressure measurements. The studies were selected and assessed for risk of bias using the Revised Quality Assessment of Diagnostic Accuracy Studies tool by two independent reviewers.

Mapping wave packet bifurcation at a conical intersection in CHI by attosecond XUV transient absorption spectroscopy.

Extreme ultraviolet (XUV) transient absorption spectroscopy has emerged as a sensitive tool for mapping the real-time structural and electronic evolution of molecules. Here, attosecond XUV transient absorption is used to track dynamics in the A-band of methyl iodide (CHI). Gaseous CHI molecules are excited to the A-band by a UV pump (277 nm, ∼20 fs) and probed by attosecond XUV pulses targeting iodine I(4d) core-to-valence transitions.

Ultrafast strong-field dissociation of vinyl bromide: An attosecond transient absorption spectroscopy and non-adiabatic molecular dynamics study.

Attosecond extreme ultraviolet (XUV) and soft x-ray sources provide powerful new tools for studying ultrafast molecular dynamics with atomic, state, and charge specificity. In this report, we employ attosecond transient absorption spectroscopy (ATAS) to follow strong-field-initiated dynamics in vinyl bromide. Probing the Br M edge allows one to assess the competing processes in neutral and ionized molecular species.

Midazolam for sedation before procedures in adults and children: a systematic review update.

Background: Midazolam is used for sedation before diagnostic and therapeutic medical procedures by several routes including oral, intravenous, intranasal and intramuscular. This is an update of a Cochrane review published in 2016, which aimed to determine the evidence on the effectiveness of midazolam for sedation when administered before a diagnostic or therapeutic procedure in adults and children.

Methods: We searched CENTRAL, MEDLINE, Embase and two trials registers up to May 2020 together with reference checking to identify additional studies.

Development and validation of the nursing confidence in managing sedation complications scale.

Aim: To develop the Nursing Confidence in Managing Sedation Complications Scale.

Design: A multi-phased approach was used.

Methods: An initial bank of items was created based on the authors' experience and clinical practice guidelines.

High flow nasal oxygen during procedural sedation for cardiac implantable electronic device procedures: A randomised controlled trial.

Background: High flow nasal oxygen may better support the vulnerable respiratory state of patients during procedural sedation.

Objective: The objective of this study was to investigate the effects of high flow nasal oxygen in comparison to facemask oxygen on ventilation during cardiac implantable electronic device procedures performed with procedural sedation.

Design: A randomised controlled trial.

Optimizing the Meaningful Engagement of Older Adults With Multimorbidity and Their Caregivers as Research Partners: A Qualitative Study.

It is widely recognized that the engagement of older adults with multimorbidity and their caregivers as partners in health care research is important and invaluable. The objective of this study was to examine how researchers can best engage and support older adults with multimorbidity and informal friend or family caregivers of older adults with multimorbidity as research partners in health care research teams. The persona-scenario method was used for participants to create fictional stories.

Revealing electronic state-switching at conical intersections in alkyl iodides by ultrafast XUV transient absorption spectroscopy.

Conical intersections between electronic states often dictate the chemistry of photoexcited molecules. Recently developed sources of ultrashort extreme ultraviolet (XUV) pulses tuned to element-specific transitions in molecules allow for the unambiguous detection of electronic state-switching at a conical intersection. Here, the fragmentation of photoexcited iso-propyl iodide and tert-butyl iodide molecules (i-CHI and t-CHI) through a conical intersection between Q/Q spin-orbit states is revealed by ultrafast XUV transient absorption measuring iodine 4d core-to-valence transitions.

Accuracy and precision of zero-heat-flux temperature measurements with the 3M™ Bair Hugger™ Temperature Monitoring System: a systematic review and meta-analysis.

Zero-heat-flux thermometers provide clinicians with the ability to continuously and non-invasively monitor body temperature. These devices are increasingly being used to substitute for more invasive core temperature measurements during surgery and in critical care. The aim of this review was to determine the accuracy and precision of zero-heat-flux temperature measurements from the 3M™ Bair Hugger™ Temperature Monitoring System.

Pre-apneic capnography waveform abnormalities during procedural sedation and analgesia.

Capnography monitoring is recommended for use during procedural sedation. This study examined associations between capnography waveform abnormalities and the onset of apnea. Capnography waveforms from a sample of 102 participants undergoing moderate procedural sedation with bolus doses of midazolam and fentanyl were analyzed using a mixed effects Cox model.

Sequence analysis of capnography waveform abnormalities during nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory.

Identifying common patterns in capnography waveform abnormalities and the factors that influence these patterns could yield insights to optimize responses to sedation-induced respiratory depression. Respiratory state sequences for 102 patients who had a procedure in a cardiac catheterisation laboratory with procedural sedation and analgesia were developed by classifying each second of procedures into a state of normal breathing or other capnography waveform abnormalities based on pre-specified cut-offs for respiratory rate and end-tidal CO concentration. Hierarchical clustering identified four common patterns in respiratory state sequences, which were characterized by a predominance of the state assigned normal breathing (n = 42; 41%), hypopneic hypoventilation (n = 38; 38%), apnea (n = 15; 15%) and bradypneic hypoventilation (n = 7; 7%).

Direct mapping of curve-crossing dynamics in IBr by attosecond transient absorption spectroscopy.

The electronic character of photoexcited molecules can abruptly change at avoided crossings and conical intersections. Here, we report direct mapping of the coupled interplay between electrons and nuclei in a prototype molecule, iodine monobromide (IBr), by using attosecond transient absorption spectroscopy. A few-femtosecond visible pulse resonantly excites the [Formula: see text], Y(0), and Z(0) states of IBr, and the photodissociation dynamics are tracked with an attosecond extreme-ultraviolet pulse that simultaneously probes the I-4 and Br-3 core-level absorption edges.

Selectivity of Electronic Coherence and Attosecond Ionization Delays in Strong-Field Double Ionization.

Experiments are presented on real-time probing of coherent electron dynamics in xenon initiated by strong-field double ionization. Attosecond transient absorption measurements allow for characterization of electronic coherences as well as relative ionization timings in multiple electronic states of Xe^{+} and Xe^{2+}. A high degree of coherence g=0.

A rare case of severe third degree friction burns and large Morel-Lavallee lesion of the abdominal wall.

Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients.

Case Presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL.

Generating high-contrast, near single-cycle waveforms with third-order dispersion compensation.

Femtosecond laser pulses lasting only a few optical periods hold the potential for probing and manipulating the electronic degrees of freedom within matter. However, the generation of high-contrast, few-cycle pulses in the high power limit still remains nontrivial. In this Letter, we present the application of ammonium dihydrogen phosphate (ADP) as an optical medium for compensating for the higher-order dispersion of a carrier-envelope stable few-cycle waveform centered at 735 nm.

Vpu-deficient HIV strains stimulate innate immune signaling responses in target cells.

Acute virus infection induces a cell-intrinsic innate immune response comprising our first line of immunity to limit virus replication and spread, but viruses have developed strategies to overcome these defenses. HIV-1 is a major public health problem; however, the virus-host interactions that regulate innate immune defenses against HIV-1 are not fully defined. We have recently identified the viral protein Vpu to be a key determinant responsible for HIV-1 targeting and degradation of interferon regulatory factor 3 (IRF3), a central transcription factor driving host cell innate immunity.

Vpu mediates depletion of interferon regulatory factor 3 during HIV infection by a lysosome-dependent mechanism.

HIV has evolved sophisticated mechanisms to avoid restriction by intracellular innate immune defenses that otherwise serve to control acute viral infection and virus dissemination. Innate defenses are triggered when pattern recognition receptor (PRR) proteins of the host cell engage pathogen-associated molecule patterns (PAMPs) present in viral products. Interferon regulatory factor 3 (IRF3) plays a central role in PRR signaling of innate immunity to drive the expression of type I interferon (IFN) and interferon-stimulated genes (ISGs), including a variety of HIV restriction factors, that serve to limit viral replication directly and/or program adaptive immunity.