UAV-based remote sensing of turbidity in coastal environment for regulatory monitoring and assessment.

The adoption of Unmanned Aerial Vehicle (UAV) remote sensing for the regulatory monitoring of turbidity plumes induced by land reclamation operations remains a difficult task. Compared to UAV remote sensing on ambient turbidity in estuaries and rivers, such monitoring of construction-induced turbidity plumes requires significantly higher spatial resolutions and accuracy as well as wider turbidity ranges with nonlinear reflectance. In this study, a pilot-scale deployment of UAV-based hyperspectral sensing is carried out for this objective, with specific new elements developed to overcome the challenges and minimise the uncertainties involved. In particular, Machine learning (ML) models for the turbidity determination were trained by the large dataset collected to better capture the non-linearity of the relationship between the water leaving reflectance and turbidity level. The models achieve a good accuracy with a R2 score of 0.75 that is deemed acceptable in view of the uncertainties associated with construction and land reclamation work.

Spontaneous Hepatic Rupture in a Pregnant Woman with Preeclampsia and HELLP Syndrome.

Spontaneous hepatic rupture is a rare complication associated with preeclampsia and is characterized by hemolysis, elevated liver enzymes, and a low platelet count (HELLP syndrome), with a nonspecific clinical presentation and high mortality rate. We present the case of a 34-year-old primigravida woman in whom spontaneous hepatic rupture associated with HELLP syndrome was accidentally detected during cesarean delivery. The patient was successfully managed with liver packing and transcatheter arterial embolization, followed by plasmapheresis. Spontaneous hepatic rupture should be considered in any HELLP syndrome patient presenting with epigastric or right upper quadrant pain and early signs of hemodynamic instability. A multimodal approach can help achieve good clinical outcomes in patients with this rare presentation.

Major Bleeding in Adults Undergoing Peripheral Extracorporeal Membrane Oxygenation (ECMO): Prognosis and Predictors.

BACKGROUND: Major bleeding has been a common and serious complication with poor outcomes in ECMO patients. With a novel, less-invasive cannulation approach and closer coagulation monitoring regime, the incidence of major bleeding is currently not determined yet. Our study aims to examine the incidence of major bleeding, its determinants, and association with mortality in peripheral-ECMO patients. METHOD: We conducted a single-center retrospective study on adult patients undergoing peripheral-ECMO between January 2019 and January 2020 at a tertiary referral hospital. Determinants of major bleeding were defined by logistic regression analysis. Risk factors of in-hospital mortality were determined by Cox proportional hazard regression analysis. RESULTS: Major bleeding was reported in 33/105 patients (31.4%) and was associated with higher in-hospital mortality [adjusted hazard ratio (aHR) 3.56, 95% confidence interval (CI) 1.63-7.80, p < 0.001). There were no significant difference in age, sex, ECMO indications, ECMO modality, pre-ECMO APACHE-II and SOFA scores between two groups with and without major bleeding. Only APTT >72 seconds [adjusted odds ratio (aOR) 7.10, 95% CI 2.60-19.50, p < 0.001], fibrinogen <2 g/L [aOR = 7.10, 95% CI 2.60-19.50, p < 0.001], and ACT >220 seconds [aOR = 3.9, 95% CI 1.20-11.80, p=0.017] on days with major bleeding were independent predictors. CONCLUSIONS: In summary, major bleeding still had a fairly high incidence and poor outcome in peripheral-ECMO patients. APTT > 72 seconds, fibrinogen < 2 g/L were the strongest predicting factors for major bleeding events.