Is near-infrared spectroscopy a promising predictor for early intracranial hemorrhage diagnosis in the Emergency Department?

Intracranial hemorrhage (ICH) is a serious medical condition that can lead to significant morbidity and mortality if not diagnosed and treated promptly. Early detection and treatment are essential for improving the outcome in patients with ICH. Near-infrared spectroscopy (NIRS) is a non-invasive imaging technique that has been used to detect changes in brain tissue oxygenation and blood flow in various conditions. The aim of this study was to investigate the predictive potential of NIRS for early diagnosis of ICH in patients presenting to the Emergency Department (ED) triage with headache. A total of 378 patients were included in the study. According to the final diagnosis of the patients, 4 groups were formed: migraine, tension-cluster headache, intracranial hemorrhage and intracranial mass, and control group. Cerebral NIRS values "rSO2" were measured at the first professional medical contact with the patient. The right and left rSO2 (RrSO2, LrSO2) were significantly lower and the rSO2 difference was significantly higher in the intracranial hemorrhage group compared to all other patient groups (P<0.001). The cut-off values determined in the receiver operating characteristics (ROC) analysis were RrSO2 ≤67, LrSO2 ≤67, and ΔrSO2 ≥9. This study found that a difference of more than 9 in cerebral right-left NIRS values can be a non-invasive, easy-to-administer, rapid, and reliable diagnostic test for early detection of intracranial bleeding. NIRS holds promise as an objective method in ED triage for patients with intracranial hemorrhage. However, further research is needed to fully understand the potential benefits and limitations of this method.

Evaluation of consecutive skylines yarding and gravity skidding systems in primary forest transportation on steep terrain.

This investigation evaluates two primary forest transportation systems, consecutive skyline yarding system integrated with two different types of skyline yarding systems and the gravity skidding system, considering technical, economical and environmental aspects. The results indicated that the productivity of consecutive skyline yarding system was 4.97 m3 hr -1, while the productivity of the gravity skidding system was 0.74 m3 hr -1. The unit costs of these primary transportation systems were found to be $5.98 and $51.28 m3, respectively. Besides, the gravity skidding system caused more damages on skidded logs, residual trees, and forest soil than that of consecutive skyline yarding system. It was also indicated that two different skyline yarding systems produced definite and different average yarding distances and technical capacities, which negatively affected the overall performance of the consecutive skyline yarding system. Therefore, different types of skyline yarding systems should not be integrated into the consecutive yarding systems.