Stephen Bullivant, Catholicism in the time of Coronavirus, Park Ridge, IL: Word on Fire Catholic Ministries 2020

The book is divided into 4 chapters followed by an afterword, appendix and notes; the foreword is written by Bishop Robert Barron; sources gotten from books, the internet, and the Catholic Church. Notably, the whole process, from pitch to perfect, happened over the space of twelve days: Monday, March 30 to Friday, April 10, 2020. The book contains a collection of “structured thoughts” about the COVID-19 crisis and its aftermath, and their likely impacts upon the Church’s pastoral and evangelistic mission, focusing on the Catholic Church in the US and UK. Chapter 2 has a table on annual average percentage change in typical Sunday mass attendance in England and Wales, and 22 US (arch)dioceses.

Revisiting the Carnegie Public Library built form: the design and early history of three Illinois Carnegie Library buildings

Despite the challenges involved in re-cycling older library buildings, it is important not to underestimate the value of extant Carnegie libraries, which in many places are among the most celebrated and cherished structures in the community. Any tendency to underestimate the possibilities for extant Carnegie library buildings can be reduced by revisiting their original designs and challenging popular impressions that are based on unwarranted retrospective history. Case studies of three Illinois Carnegie libraries are presented: Decatur (opened 1903), Paxton (opened 1904), and Park Ridge (opened 1913). These case studies are followed by a positive interpretation of the built form of the three libraries studied, by drawing on recent accounts of the material culture of Carnegie public libraries in the decades immediately prior to the First World War, as well as by referring to contemporary policy on architectural control by Carnegie's office and critical reporting in the later stage of the Carnegie programme on its successes and failures.

Patella Fracture Fixation Via Wide Awake Local Anesthesia No Tourniquet (Walant) Technique

Introduction: Fracture of the tibia are the most common long bone fracture, with an incidence greater than 75,000 per year in the US1. With the recent breakthrough of operation under WALANT (Wide Awake Local Anaesthesia No Tourniquet) technique. We reported a patient with midshaft tibia fracture who underwent plating under the WALANT technique Methodology: 18 yearold gentleman sustained a closed fracture of his left tibia after his motorbike skidded. He wascounselled for the surgery to be done under the wide-awake technique as we have limited operating theatre time for the case to be done under general/regional anaesthesia. Preoperatively, the WALANT solution is prepared using 50 cc lidocaine 2%, 1cc of epinephrine, 10cc of sodium bicarbonate 8.4% then dilute into 50 cc normal saline. Total of 50 cc WALANT solution was injected along the planned skin incision and at subperiosteum 30 minutes before operation started. Result: Pain score patient remain 0-3/10 during and after removal of backslab, throughout the surgery and postoperatively. The use of epinephrine for hemostasis provide good surgical field view since there is minimal bleeding. Postoperatively the anaesthesia effect lasted for 6 hour and was patient able to move the leg straight away without have to keep lying in bed for 6 hours after spinal or drowsiness from sedation. Conclusion: Plating of tibia under WALANT is a good alternative for patient who have financial difficulty, high risk operation under general anaesthesia, hospital which have limited slot for operation under general anaesthesia and etc. Additionally, the strength and stability of the plate can be assessed intraoperatively by asking the patient to actively move his limb. Reference: Praemer A, Furner S, Rice DP. Musculoskeletal Conditions in the United States. Park Ridge, IL: American Academy of Orthopaedic Surgeons; 1992.

Evaluating the Transition From Dexmedetomidine to Clonidine for the Prevention of Withdrawal in Critically Ill Pediatric Patients

OBJECTIVES To evaluate clonidine for preventing withdrawal from dexmedetomidine infusions and describe the incidence of withdrawal symptoms and adverse cardiovascular effects in critically ill pediatric patients. METHODS Retrospective, descriptive study of patients in Advocate Children's Hospital-Park Ridge PICU who received dexmedetomidine infusion for ≥72 hours, followed by clonidine for ≥48 hours, between January 1, 2015, and August 31, 2017. RESULTS Thirty-eight patients (median age 4.3 years; IQR, 2–11.5) received 39 dexmedetomidine courses. The median duration of dexmedetomidine exposure was 7.6 days (IQR, 5–11.5) at an average dose of 1 mcg/kg/hr. The median dose of clonidine at initiation was 8.3 mcg/kg/day (for <50 kg) and 4.1 mcg/kg/day (for ≥50 kg). The most common oral administration frequency was every 8 hours. Dexmedetomidine infusions for 7 days or longer and a higher dexmedetomidine dose 24 hours prior to clonidine transition both correlated with increased initial clonidine doses. Fourteen patients (37%) had at least 1 WAT-1 score of ≥3 during the transition between dexmedetomidine and clonidine, with 7 (18%) requiring an increase in sedation. Adverse cardiovascular events were possibly attributable to dexmedetomidine and/or clonidine in 4 patients. CONCLUSIONS Patients receiving prolonged infusions of dexmedetomidine may transition to clonidine to help prevent withdrawal symptoms. Duration of dexmedetomidine infusion of 7 days or longer and higher average dexmedetomidine dose 24 hours prior to the transition are important considerations when determining the initial clonidine dose. Transition from dexmedetomidine to clonidine was found to be safe and efficacious in our patients, with minimal adverse effects.