Oral Glyburide for the Prevention of Cerebral Edema in Acute Ischemic Stroke.

OBJECTIVE: The purpose of this study was to describe the impact of enteral glyburide on cerebral edema formation and hypoglycemia when used to treat patients diagnosed with acute ischemic stroke (AIS). METHODS: This study was a single-center, retrospective medical record review that included all patients aged ≥18 years diagnosed with AIS who received ≥1 dose of enteral glyburide for the prevention of cerebral edema from January 1, 2018 to March 31, 2022. The primary outcome was the percentage of patients requiring intervention for cerebral edema management after glyburide initiation, and the safety outcome was the occurrence of hypoglycemia in this patient population. RESULTS: The final evaluation included 44 patients, with 6 patients (14%) requiring intervention for cerebral edema after glyburide initiation. The average baseline National Institutes of Health stroke scale score was 19. Overall, in-hospital mortality was 36% (n = 17), and hypoglycemia occurred in 7 patients (15%). Of the 44 patients, 20 (45%) received a partial duration of enteral glyburide (1-4 doses) and 24 (55%) received a full duration of enteral glyburide (5-7 doses). The rate of intervention for cerebral edema (10% vs. 17%) and the incidence of hypoglycemia (5% vs. 23%) were lower in the partial duration than in the full duration group. The in-hospital all-cause mortality rate was higher in the partial duration group than in the full duration group (43% vs. 31%). CONCLUSIONS: Despite the relatively low rates of intervention for cerebral edema, hypoglycemia was common, especially for patients receiving 5-7 doses of enteral glyburide for the prevention of cerebral edema after moderate-to-severe AIS.

Estimating mussel mound distribution and geometric properties in coastal salt marshes by using UAV-Lidar point clouds.

The Atlantic ribbed mussel (Geukensia demissa) is common in southeastern US salt marshes, where they form dense aggregations (mounds), that occur in the highest densities and sizes on the marsh platform close to the tidal creeks' heads. Within these marshes, mussels help build marsh elevation via their biodeposition of organic and inorganic material, stimulate the growth of the dominant foundation species cordgrass (Spartina alterniflora), and create hotspots of invertebrate biodiversity, nutrient cycling, and drought resilience. Given their powerful role, there is rising interest in assessing natural variation in the distribution of mussel mounds and using such information to guide marsh conservation and restoration strategies. However, gathering such information is challenging, because the small dimension (∼1 m) of the mounds and the presence of overlying vegetation make it difficult to quantify mound distribution on the marsh. Therefore, this study presents a new procedure to compute the distribution, height, radius, volume, and distance of mounds in marsh environments using remote sensing. A high-resolution UAV-Lidar point cloud has been collected over a highly vegetated salt marsh in Georgia, USA, using a custom-built laser scanner system. An original detection algorithm, based on a Random Forest classifier, has been implemented to identify the mounds from the point cloud. The algorithm has been trained and tested on surveyed mounds and provides their location and geometric properties. Results indicate that the classifier can distinguish mussel mounds from non-mussel mound locations with an accuracy of 95 %. The classifier identified ∼8000 mounds, which occupy 10 % of the study domain, and a volume (shells+feces/pseudofeces) of 680 m3. The method is highly useful in efforts to monitor mussel mounds over time and scale up to assess mounds across sites, providing invaluable data for future studies related to the geomorphic evolution of marshes to sea level rise and siting marsh conservation and enhancement projects.

Patients Perceptions of Artificial Intelligence in Diabetic Eye Screening.

PURPOSE: Artificial intelligence (AI) technology is poised to revolutionize modern delivery of health care services. We set to evaluate the patient perspective of AI use in diabetic retinal screening. DESIGN: Survey. METHODS: Four hundred thirty-eight patients undergoing diabetic retinal screening across New Zealand participated in a survey about their opinion of AI technology in retinal screening. The survey consisted of 13 questions covering topics of awareness, trust, and receptivity toward AI systems. RESULTS: The mean age was 59 years. The majority of participants identified as New Zealand European (50%), followed by Asian (31%), Pacific Islander (10%), and Maori (5%). Whilst 73% of participants were aware of AI, only 58% have heard of it being implemented in health care. Overall, 78% of respondents were comfortable with AI use in their care, with 53% saying they would trust an AI-assisted screening program as much as a health professional. Despite having a higher awareness of AI, younger participants had lower trust in AI systems. A higher proportion of Maori and Pacific participants indicated a preference toward human-led screening. The main perceived benefits of AI included faster diagnostic speeds and greater accuracy. CONCLUSIONS: There is low awareness of clinical AI applications among our participants. Despite this, most are receptive toward the implementation of AI in diabetic eye screening. Overall, there was a strong preference toward continual involvement of clinicians in the screening process. There are key recommendations to enhance the receptivity of the public toward incorporation of AI into retinal screening programs.

A case of aggressive natural killer cell leukemia.

A 23-year-old man presented with a 1-month history of a red and painful right eye, with visual acuity reduced to hand motions. Examination showed uveitis with keratic precipitates, cells and flare in the anterior chamber, and vitritis that obscured visualization of the right fundus. The following week, he was noted to have the following left-sided findings: reduced visual acuity (6/18), painless upper eyelid edema, an elevated, pink bulbar conjunctival lesion, limitation of ocular abduction, paresthesia in the V1 and reduced sensation in the V2 distributions. Blood tests showed pancytopenia. Results from the aspirate and trephine biopsy of his bone marrow were consistent with aggressive natural killer (NK) cell leukemia, a rare cause of ocular and periocular inflammation that requires a multidisciplinary team approach to care.

Investigating Practical Impacts of Using Single-Antenna and Dual-Antenna GNSS/INS Sensors in UAS-Lidar Applications.

Data collected from a moving lidar sensor can produce an accurate digital representation of the physical environment that is scanned, provided the time-dependent positions and orientations of the lidar sensor can be determined. The most widely used approach to determining these positions and orientations is to collect data with a GNSS/INS sensor. The use of dual-antenna GNSS/INS sensors within commercial UAS-lidar systems is uncommon due to the higher cost and more complex installation of the GNSS antennas. This study investigates the impacts of using a single-antenna and dual-antenna GNSS/INS MEMS-based sensor on the positional precision of a UAS-lidar generated point cloud, with an emphasis on the different heading determination techniques employed by each type of GNSS/INS sensor. Specifically, the impacts that sensor velocity and acceleration (single-antenna), and a GNSS compass (dual-antenna) have on heading precision are investigated. Results indicate that at the slower flying speeds often used by UAS (≤5 m/s), a dual-antenna GNSS/INS sensor can improve heading precision by up to a factor of five relative to a single-antenna GNSS/INS sensor, and that a point of diminishing returns for the improvement of heading precision exists at a flying speed of approximately 15 m/s for single-antenna GNSS/INS sensors. Additionally, a simple estimator for the expected heading precision of a single-antenna GNSS/INS sensor based on flying speed is presented. Utilizing UAS-lidar mapping systems with dual-antenna GNSS/INS sensors provides reliable, robust, and higher precision heading estimates, resulting in point clouds with higher accuracy and precision.

A Rigorous Observation Model for the Risley Prism-Based Livox Mid-40 Lidar Sensor.

Modern lidar sensors are continuing to decrease in size, weight, and cost, but the demand for fast, abundant, and high-accuracy lidar observations is only increasing. The Livox Mid-40 lidar sensor was designed for use within sense-and-avoid navigation systems for autonomous vehicles, but has also found adoption within aerial mapping systems. In order to characterize the overall quality of the point clouds from the Mid-40 sensor and enable sensor calibration, a rigorous model of the sensor's raw observations is needed. This paper presents the development of an angular observation model for the Mid-40 sensor, and its application within an extended Kalman filter that uses the sensor's data to estimate the model's operating parameters, systematic errors, and the instantaneous prism rotation angles for the Risley prism optical steering mechanism. The analysis suggests that the Mid-40's angular observations are more accurate than the specifications provided by the manufacturer. Additionally, it is shown that the prism rotation angles can be used within a planar constrained least-squares adjustment to theoretically improve the accuracy of the angular observations of the Mid-40 sensor.

Scan Pattern Characterization of Velodyne VLP-16 Lidar Sensor for UAS Laser Scanning.

Many lightweight lidar sensors employed for UAS lidar mapping feature a fan-style laser emitter-detector configuration which results in a non-uniform pattern of laser pulse returns. As the role of UAS lidar mapping grows in both research and industry, it is imperative to understand the behavior of the fan-style lidar sensor to ensure proper mission planning. This study introduces sensor modeling software for scanning simulation and analytical equations developed in-house to characterize the non-uniform return density (i.e., scan pattern) of the fan-style sensor, with special focus given to a popular fan-style sensor, the Velodyne VLP-16 laser scanner. The results indicate that, despite the high pulse frequency of modern scanners, areas of poor laser pulse coverage are often present along the scanning path under typical mission parameters. These areas of poor coverage appear in a variety of shapes and sizes which do not necessarily correspond to the forward speed of the scanner or the height of the scanner above the ground, highlighting the importance of scan simulation for proper mission planning when using a fan-style sensor.

A service evaluation: impact of nurse-led regional familial hypercholesterolaemia service on a hospital adult lipid clinic.

The authors evaluated the impact of genetic screening for familial hypercholesterolaemia (FH) in a lipid clinic cohort of patients with definite and possible FH as defined by the Simon Broome Register (SBR) criteria. METHODS: Patients with a lipid clinic diagnosis of definite and possible FH based on the SBR criteria were referred to a nurse-led regional service for FH genetic testing. FINDINGS: 140 patients were referred for genetic testing. Six had SBR-definite FH due to the presence of tendon xanthomata and 134 had SBR-possible FH. A monogenic FH mutation was detected in all six patients (100%) with SBR-definite FH and in 34 (25%) of patients with possible FH. CONCLUSION: The appropriate use of molecular genetics in a lipid clinic will greatly facilitate the management of hyperlipidaemia and cardiovascular risk since the management of FH patients (National Institute for Health and Care Excellence (NICE) Clinical Guideline 71) is different from non-FH patients (NICE Clinical Guideline 181).

Near-infrared spectroscopic photoacoustic microscopy using a multi-color fiber laser source.

We demonstrate a simple multi-wavelength optical source suitable for spectroscopic optical resolution photoacoustic microscopy (OR-PAM) of lipid-rich tissue. 1064 nm laser pulses are converted to multiple wavelengths beyond 1300 nm via nonlinear optical propagation in a birefringent optical fiber. OR-PAM experiments with lipid phantoms clearly show the expected absorption peak near 1210 nm. We believe this simple multi-color technique is a promising cost-effective approach to spectroscopic OR-PAM of lipid-rich tissue.