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Objective Methods Results Significance Seizures are a recognized complication of critical cardiovascular illness in infants and children. We assessed the diagnostic yield of continuous video‐electroencephalography (cEEG) in a pediatric and neonatal cardiovascular intensive care unit (CVICU) by the symptoms and risk factors prompting cEEG evaluation.This retrospective case series included all consecutive cEEGs in patients ≤21 years old performed in one CVICU over 38 months. cEEG indications were categorized as (1) index symptoms of concern and/or (2) clinical risk factors. Index symptoms were divided into (1) vital sign symptoms (i.e., heart rate, blood pressure, oxygen, respiration, or temperature) and (2) non‐vital sign symptoms (i.e., mental status, abnormal movements, eye findings, weakness, or failed extubation). Indications for cEEG were extracted by manual chart review. The presence of seizures was established electrographically from neurophysiologist reports.There were 605 cEEGs from 411 patients. The median study was 26 h (25%–75%, interquartile range = 20–41 h). Seizures were detected in 57 of 605 (9%) cEEGs overall; in 34 of 356 (10%) cEEGs obtained for risk factors alone (odds ratio [OR] = 1.03, 95% confidence interval [CI] = .60–1.82, p = .90), 0 of 104 (0%) for isolated vital sign changes (p < .001), 10 of 101 (10%) for symptoms not involving vital signs (OR = 1.06, 95% CI = .52–2.09, p = .88), and in 13 of 44 (30%) for both vital sign and non‐vital sign symptoms (OR = 4.93, 95% CI = 2.45–9.77, p < .001). On univariate analysis, symptoms involving gaze deviation, abnormal limb movements, or intermittent oxygen desaturation, and the risk factors of preexisting epilepsy, recent neurosurgery, acute stroke, and cardiac air embolism were associated with seizures (p < .05).There were zero electrographic seizures in cEEGs obtained for isolated vital sign changes, whereas cEEGs obtained for the combination of vital sign changes and other non‐vital sign symptoms were five times more likely to detect electrographic seizures than cEEGs obtained based on risk factors alone. [ABSTRACT FROM AUTHOR]

Microneedles (MNs) offer the potential for discrete and painless transdermal drug delivery, yet poor insertion and dosing consistency have hindered their clinical translation. Specifically, hollow MNs are appropriate for the administration of liquid modalities, including insulin, which could prove to be beneficial for patients with type 1 diabetes mellitus. This work aimed to design and manufacture a hollow MN with an improved insertion and delivery profile suitable for insulin administration. Ex vivo insertion studies demonstrated that oscillation of MNs upon insertion into skin produced a favorable insertion profile, with reduced variation, compared to static MN insertion. Histological staining showed that this could be due to the repeated motion of the oscillating MN disrupting elastic fibers in the dermis. Additionally, permeation studies demonstrated that increased quantities of insulin were able to permeate the skin when oscillation was employed compared to static MN insertion. This study has shown that oscillation is a valuable tool in improving the transdermal delivery of insulin via a single hollow MN in vitro . Moving forward, in vivo studies should be completed to gain a fuller understanding of the benefits of the oscillation of MNs on transdermal drug delivery.