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Skin conditions are a common problem addressed by medical providers. Up to 25% of individuals in the United States will seek attention for these conditions each year. The same problem occurs in the athletic training room, where athletes with infectious skin conditions can be seen. Most conditions are simple and can be treated without concern for spread to susceptible athletes. However, others can be quite serious and spread rapidly through a team and opponents during competition. Knowledge of the different types of skin infections is necessary to help treat these athletes and prevent spread to others. With proper diagnosis and treatment, certified athletic trainers can keep the athlete off the field of play for a minimum period and prevent transmission. [ABSTRACT FROM AUTHOR]

We model an interval of remarkable interplanetary magnetic field (IMF), for which we have a comprehensive set of observational data. This interval is associated with the arrival of an interplanetary coronal mass ejection. The solar wind densities at the time are particularly high and the IMF is primarily northward over many hours. This results in strong auroral emissions within the polar cap in a cusp spot, which we associate with lobe reconnection at the high‐latitude magnetopause. We also observe areas of upwards field‐aligned current (FAC) within the summer Northern Hemisphere polar cap that exhibit large current magnitudes. The model can reproduce the spatial distribution of the FACs well, even under changing conditions in the incoming IMF. Discrepancies exist between the modeled and observed current magnitudes. Notably, the winter Southern Hemisphere exhibits much lower current magnitudes overall. We also model a sharp transition of the location of magnetopause reconnection at the beginning of the interval, before the IMF remained northward for many hours. The reconnection location changed rapidly from a subsolar location at the low‐latitude magnetopause under southward IMF conditions, to a high‐latitude lobe reconnection location when the field is northward. This occurs during a fast rotation of the IMF at the shock front of a magnetic cloud. Plain Language Summary: Under extreme incoming interplanetary magnetic field conditions following the impact of an Interplanetary Coronal Mass Ejection (CME) on the Earth's system, we observe a range of phenomena in the Northern Hemisphere ionosphere. This includes auroral emissions in the form of a cusp spot and associated precipitating particles, ionospheric flows, and strong field‐aligned currents (FACs) in the high‐latitude polar cap. These phenomena change in orientation and strength following variations in the incoming solar wind. We model the state of the magnetosphere during these observations. The modeled currents correspond well spatially with the observed currents, however, the current magnitudes are very different. The modeled FACs indicate that the site of magnetic reconnection can change rapidly from a lower‐latitude dayside position to a high‐latitude location in the magnetospheric lobes, which is reflected in field orientation within the magnetic cloud associated with the passing CME. Key Points: We model an interval of interplanetary BY‐dominated field and high solar wind densities during the impact of a Coronal Mass EjectionThe reconnection site moves rapidly from the subsolar to the high‐latitude magnetopause during a rotation of interplanetary magnetic fieldModeled and observed currents are spatially consistent in the polar cap although modeled to observed current magnitudes are often discrepant [ABSTRACT FROM AUTHOR]

Introduction: Dexmedetomidine is the sedative agent administered in combination with remifentanil and low dose of sevoflurane in the interventional arm of the ongoing TREX trial (Trial Remifentanil DExmedetomidine). The TREX pilot study (published in Paediatr Anaesth 2019;29:59-67) established infusion rates higher than those initially proposed. This could be attributed to an inappropriate target concentration for sedation or incorrect initial pharmacokinetic parameter estimates., Methods: The TREX study is a Phase III, randomized, active controlled, parallel group, blinded evaluator, multicentre, superiority trial comparing neurological outcome after standard sevoflurane anaesthesia with dexmedetomidine/remifentanil and low dose sevoflurane anaesthesia in children aged less than 2 years undergoing anaesthesia of 2 hours or longer. In this report, dexmedetomidine pharmacokinetics were analysed in the interventional arm of the Italian population., Results: There were 162 blood samples from 32 infants (22 male and 10 female). The median (IQR) age was 12 (5.2-15.5) months, weight 9.9 (7.3-10.8) kg. Duration of anaesthesia ranged from 2-6 hours. None of the children were born premature (median postnatal age 39 weeks, IQR 38-40 weeks). A 3-compartment PK model that incorporated allometric scaling and a maturation function demonstrated plasma concentration observations from the current Italian arm of the TREX study were consistent with those predicted by a "universal" model using pooled data obtained from neonates to adults., Conclusions: This current PK analysis from the Italian arm of the TREX study confirms that plasma concentration of dexmedetomidine is predictable using known covariates such as age and size. The initial target concentration (0.6 μg.L -1 ) used to sedate children cared for in the intensive care after cardiac surgery was inadequate for infants in the current TREX study. A target concentration 1 mcg.L -1 , corresponding to a loading dose of 1 mcg.kg -1 followed by an infusion of 1 mcg.kg -1 .hour -1 , provided adequate sedation., (This article is protected by copyright. All rights reserved.)