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Abnormal secretion of catecholamines is well known to cause delirium. In particular, disturbances of catecholamine balance can cause ICU-acquired delirium. The aim of this study was to evaluate the association between the serum levels of catecholamines and the risk of occurrence of ICU-acquired delirium separately in patients who had/had not received exogenous catecholamines before ICU admission. Design A secondary analysis of the data of 81 patients enrolled in our previous randomized clinical trial. Setting ICU of an academic hospital. Patients ICU patients in whom the serum levels of catecholamines were measured at ICU admission. Interventions None. Measurements and Main Results We evaluated the association between the serum levels of catecholamines measured at ICU admission and the risk of ICU-acquired delirium separately in patients who had received exogenous catecholamines at ICU admission (Ex[+] group) and those who had not received exogenous catecholamines (Ex[-] group). The serum levels of norepinephmines at ICU admission. JTC-801 research buy Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.Exposure to vaping is associated with a growing list of respiratory syndromes including an acute progressive form with life-threatening hypoxemic respiratory failure and pathologic changes of lung injury termed vaping-associated respiratory distress syndrome. Data Sources Center from Disease Control, Departments of Public Health, MEDLINE (via PubMed), and the Cochrane Library. Study Selection Data Extraction and Data Synthesis Cases, series, and public health reports of cases that met the Centers for Disease Control and Prevention case definition of vaping-associated respiratory disease were extracted by an author with perfect verification by a second. Cases were classified on the basis of toxin exposure, symptoms, oxygen saturation, progression to respiratory failure, and pathologic features, and a clinically actionable system of classification was based on expert opinion. Conclusions The reported spectrum of vaping-associated respiratory diseases allows clinical classification of cases into groups with distinct evaluation, management, and recommendations for prevention and follow-up. Clinical stratification also identifies a small proportion of vaping-exposed patients who are at risk for progression to hypoxemic respiratory failure and an acute respiratory distress syndrome-like illness. Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.Hospital readmissions are known to be common after sepsis but unfortunately, in a developing country like Pakistan, very little is known of the frequency or cause of these readmissions in sepsis patients and even less about how they can be prevented. To our knowledge, this is the first-ever long-term follow-up study in a developing country in which frequency and cause of readmissions are being evaluated in sepsis patients. Design This retrospective study evaluated sepsis patients admitted at the Aga Khan University Hospital in 2017. Outcome measures included in-hospital mortality and readmission within 180 days. Setting Aga Khan University Hospital, Karachi, Pakistan. Subjects Four-hundred thirty-nine sepsis patients. Interventions None. Measurements and Main Results Respiratory infections were the most common cause of sepsis (172 [39%]) followed by urinary tract infections (86 [20%]). Mortality in sepsis was 42% (183/439) and associated risk factors included ICU admission (odds ratio, 1.57; 95% CI, 1.05-2.35till inadequately characterized. Hence, we hope this study becomes a platform for larger multicenter studies in developing countries for early prediction of potential readmissions and developing precise interventions to prevent them. Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.Recent advances in high-throughput (HTP) computational power and machine learning have led to great achievements in exploration of new thermoelectric materials. However, experimental discovery and optimization of thermoelectric materials have long relied on the traditional Edisonian trial and error approach. Herein, we demonstrate that ultrahigh thermoelectric performance in a Cu-doped PbSe-PbS system can be realized by HTP experimental screening and precise property modulation. Combining the HTP experimental technique with transport model analysis, an optimal Se/S ratio showing high thermoelectric performance has been efficiently screened out. Subsequently, based on the screened Se/S ratio, the doping content of Cu has been subtly adjusted to reach the optimum carrier concentration. As a result, an outstanding peak zT~1.6 is achieved at 873 K for a 1.8 at% Cu-doped PbSe0.6S0.4 sample, which is the superior value among the n-type Te-free lead chalcogenides. We anticipate that current work will stimulate large-scale unitization of the HTP experimental technique in the thermoelectric field, which can greatly accelerate the research and development of new high-performance thermoelectric materials. Copyright © 2020 Li You et al.High-flow nasal oxygen is increasingly used in complex head and neck surgical procedures and difficult airway management. We describe a case where an operating room fire occurred while using high-flow nasal oxygen during an awake tracheostomy for an obese patient in airway extremis due to supraglottitis. Shortly after the operation began, and before incision of the trachea, electrical diathermy applied to bleeding sub-cutaneous vessels ignited a small flame. This was extinguished without harm to the patient and the procedure was completed without further complication. Fire requires three components fuel; heat; and an oxidiser. We speculate that high-flow oxygen channelled under the drapes and acted as the oxidiser; either tissue eschar or vapourised fat were the fuel; and the diathermy supplied a source of ignition to complete the fire triad. When using high flows of concentrated oxygen, practitioners should aim to minimise all of these factors and be alert for the risk of fire at every stage of the operation.

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