BackgroundWhen the COVID-19 pandemic restricted visitation between intensive care unit patients and their families, the virtual intensive care unit (vICU) in our large tertiary hospital was adapted to facilitate virtual family visitation. The objective of this paper is to document findings from interviews conducted with family members on three categories: (1) feelings experienced during the visit, (2) barriers, challenges or concerns faced using this service, and (3) opportunities for improvements.MethodsFamily members were interviewed postvisit via phone. For category 1 (feelings), automated analysis in Python using the Valence Aware Dictionary for sentiment Reasoner package produced weighted valence (extent of positive, negative or neutral emotive connotations) of the interviewees’ word choices. Outputs were compared with a manual coder’s valence ratings to assess reliability. Two raters conducted inductive thematic analysis on the notes from these interviews to analyse categories 2 (barriers) and 3 (opportunities).ResultsValence-based and manual sentiment analysis of 230 comments received on feelings showed over 86% positive sentiments (88.2% and 86.8%, respectively) with some neutral (7.3% and 6.8%) and negative (4.5% and 6.4%) sentiments. The qualitative analysis of data from 57 participants who commented on barriers showed four primary concerns: inability to communicate due to patient status (44% of respondents); technical difficulties (35%); lack of touch and physical presence (11%); and frequency and clarity of communications with the care team (11%). Suggested improvements from 59 participants included: on demand access (51%); improved communication with the care team (17%); improved scheduling processes (10%); and improved system feedback and technical capabilities (17%).ConclusionsUse of vICU for remote family visitations evoked happiness, joy, gratitude and relief and a sense of closure for those who lost loved ones. Identified areas for concern and improvement should be addressed in future implementations of telecritical care for this purpose.

Background The COVID-19 pandemic has necessitated a rapid increase of space in highly infectious disease intensive care units (ICUs). At Houston Methodist Hospital (HMH), a virtual intensive care unit (vICU) was used amid the COVID-19 outbreak. Objective The aim of this paper was to detail the novel adaptations and rapid expansion of the vICU that were applied to achieve patient-centric solutions while protecting staff and patients’ families during the pandemic. Methods The planned vICU implementation was redirected to meet the emerging needs of conversion of COVID-19 ICUs, including alterations to staged rollout timing, virtual and in-person staffing, and scope of application. With the majority of the hospital critical care physician workforce redirected to rapidly expanded COVID-19 ICUs, the non–COVID-19 ICUs were managed by cardiovascular surgeons, cardiologists, neurosurgeons, and acute care surgeons. HMH expanded the vICU program to fill the newly depleted critical care expertise in the non–COVID-19 units to provide urgent, emergent, and code blue support to all ICUs. Results Virtual family visitation via the Consultant Bridge application, palliative care delivery, and specialist consultation for patients with COVID-19 exemplify the successful adaptation of the vICU implementation. Patients with COVID-19, who were isolated and separated from their families to prevent the spread of infection, were able to virtually see and hear their loved ones, which bolstered the mental and emotional status of those patients. Many families expressed gratitude for the ability to see and speak with their loved ones. The vICU also protected medical staff and specialists assigned to COVID-19 units, reducing exposure and conserving personal protective equipment. Conclusions Telecritical care has been established as an advantageous mechanism for the delivery of critical care expertise during the expedited rollout of the vICU at Houston Methodist Hospital. Overall responses from patients, families, and physicians are in favor of continued vICU care; however, further research is required to examine the impact of innovative applications of telecritical care in the treatment of critically ill patients.

Hawthorn belongs to the Crataegus genus of the Rosaceae family and is an important medicinal plant. Due to its beneficial effects on the cardiovascular system and its antioxidant and antimicrobial activity hawthorn has recently become quite a popular herbal medicine in phytotherapy and food applications. In this study, physicochemical characterization (color parameters, pH, titratable acidity, total soluble solids, soluble carbohydrate, total carotenoid, total phenols, and flavonoid contents), antioxidant activity (by ferric-reducing antioxidant power, FRAP assay), and quantification of some individual phenolic compounds of fruits of 15 samples of different hawthorn species (Crataegus spp.) collected from different regions of Iran were investigated. According to findings, the total phenols, total flavonoid content, and antioxidant activity were in the range of 21.19–69.12 mg gallic acid equivalent (GAE)/g dry weight (dw), 2.44–6.08 mg quercetin equivalent (QUE)/g dw and 0.32–1.84 mmol Fe++/g dw, respectively. Hyperoside (0.87–2.94 mg/g dw), chlorogenic acid (0.06–1.16 mg/g dw), and isoquercetin (0.24–1.59 mg/g dw) were found to be the most abundant phenolic compounds in the extracts of hawthorn fruits. The considerable variations in the antioxidant activity and phenolic compounds of hawthorn species were demonstrated by our results. Hence, the evaluation of hawthorn genetic resources could supply precious data for screening genotypes with high bioactive contents for producing natural antioxidants and other phytochemical compounds valuable for food and pharma industries.

This study was undertaken to determine the total quantity of phenolic and flavonoids, as well as to find out about the HPLC quantification of some individual phenolic compounds (i.e. chlorogenic acid, vitexin 2"-O-rhamnoside, vitexin, rutin, hyperoside, quercetin, and isoquercetin) in flowers and leaves of 56 samples of different hawthorn species (Crataegus spp.) collected from different geographical regions of Iran. The amount of total phenolics ranges from 7.21 to 87.73 mg GAE/g in dry weight of the plant, and the total amount of flavonoids varied amongst species and in different plant organs ranging from 2.27 to 17.40 mg/g dry weight. Chlorogenic acid, vitexin, and vitexin 2"-O-rhamnoside were found to be the most abundant phenolic compounds in the extracts of hawthorn leaves. Meanwhile, chlorogenic acid, hyperoside, and rutin were the most abundant phenolic compounds in the extracts of hawthorn flowers in most genotypes. The antioxidant activity widely varied in species and in different organs of each individual plant, ranging from 0.9 to 4.65 mmol Fe ++ /g DW plant, calculated through the ferric-reducing antioxidant power (FRAP) method. Thus, this could provide valuable data for developing breeding strategies and plans; it can also help us in selecting genotypes with high phenolic contents for producing natural antioxidants and other bioactive compounds beneficial for food or the pharmaceutical industries.

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Changes in essential oils (EOs) content and composition of lemon verbena leave at different packaging methods (packaged with air, nitrogen, or under vacuum) and during storage period (0, 2, 4, 6 and 8 months) were determined. All the samples were hydrodistilled every 2 months during storage for EO content evaluation. EO composition was determined by gas chromatography and gas chromatography–mass spectrometry. The results showed that by extending the storage period in all packaging methods, EO content was significantly decreased. Parallel to the increase in the storage duration in all packaging methods, citral content was decreased, whereas the amounts of limonene and 1,8‐cineole were increased. Packaging of lemon verbena leaves with nitrogen preserved the highest EO content during 8 months of storage and achieved the desired amounts of citral, limonene, and 1,8‐cineole. This investigation also showed camphene may be a useful marker for the indication of storage duration of lemon verbena.

Objective To identify physiological correlates to stress in intensive care unit nurses. Background Most research on stress correlates are done in laboratory environments; naturalistic investigation of stress remains a general gap. Method Electrodermal activity, heart rate, and skin temperatures were recorded continuously for 12-hr nursing shifts (23 participants) using a wrist-worn wearable technology (Empatica E4). Results Positive correlations included stress and heart rate (ρ = .35, p < .001), stress and skin temperature (ρ = .49, p < .05), and heart rate and skin temperatures (ρ = .54, p = .0008). Discussion The presence and direction of some correlations found in this study differ from those anticipated from prior literature, illustrating the importance of complementing laboratory research with naturalistic studies. Further work is warranted to recognize nursing activities associated with a high level of stress and the underlying reasons associated with changes in physiological responses. Application Heart rate and skin temperature may be used for real-time detection of stress, but more work is needed to validate such surrogate measures.