Nontraumatic Subarachnoid Hemorrhage and Ruptured Intracranial Aneurysm: Recognition and Evaluation.

Subarachnoid hemorrhage caused by a ruptured intracranial aneurysm is a neurosurgical emergency with a mortality rate of approximately 50%. Prompt identification and treatment of aneurysmal subarachnoid hemorrhage are paramount to reduce mortality, long-term morbidity, and health care burden for survivors. The prevalence of intracranial aneurysms is 2% to 6% of the global population, many of which are found incidentally during workup for an unrelated condition. Screening is not recommended for the general population and should be reserved for patients who have at least one family member with a history of intracranial aneurysm or subarachnoid hemorrhage or when there is a high index of suspicion for those with certain medical conditions associated with an increased incidence of intracranial aneurysms. Physicians who treat patients with headache should be aware of the spectrum of clinical presentation of aneurysmal subarachnoid hemorrhage because not all patients present with the classic thunderclap headache. The Ottawa Subarachnoid Hemorrhage Rule is a validated clinical decision tool to help determine which patients with a sudden, acute headache require imaging with noncontrast computed tomography. Based on the results of initial computed tomography and duration of symptoms, the patient may require a lumbar puncture or additional imaging to confirm the diagnosis. Prompt diagnosis of an aneurysmal subarachnoid hemorrhage is essential to patients receiving definitive treatment.

Enriched Marine Oil Supplement Increases Specific Plasma Specialized Pro-Resolving Mediators in Adults with Obesity.

BACKGROUND: Specialized pro-resolving mediators (SPMs), synthesized from PUFAs, resolve inflammation and return damaged tissue to homeostasis. Thus, increasing metabolites of the SPM biosynthetic pathway may have potential health benefits for select clinical populations, such as subjects with obesity who display dysregulation of SPM metabolism. However, the concentrations of SPMs and their metabolic intermediates in humans with obesity remains unclear. OBJECTIVES: The primary objective of this study was to determine if a marine oil supplement increased specific metabolites of the SPM biosynthetic pathway in adults with obesity. The second objective was to determine if the supplement changed the relative abundance of key immune cell populations. Finally, given the critical role of antibodies in inflammation, we determined if ex vivo CD19 + B-cell antibody production was modified by marine oil intervention. METHODS: Twenty-three subjects [median age: 56 y; BMI (in kg/m2): 33.1] consumed 2 g/d of a marine oil supplement for 28-30 d. The supplement was particularly enriched with 18-hydroxyeicosapentaenoic (HEPE), 14-hydroxydocosahexaenoic acid (14-HDHA), and 17-HDHA. Blood was collected pre- and postsupplementation for plasma mass spectrometry oxylipin and fatty acid analyses, flow cytometry, and B-cell isolation. Paired t-tests and Wilcoxon tests were used for statistical analyses. RESULTS: Relative to preintervention, the supplement increased 6 different HEPEs and HDHAs accompanied by changes in plasma PUFAs. Resolvin E1 and docosapentaenoic acid-derived maresin 1 concentrations were increased 3.5- and 4.7-fold upon intervention, respectively. The supplement did not increase the concentration of D-series resolvins and had no effect on the abundance of immune cells. Ex vivo B-cell IgG but not IgM concentrations were lowered postsupplementation. CONCLUSIONS: A marine oil supplement increased select SPMs and their metabolic intermediates in adults with obesity. Additional studies are needed to determine if increased concentrations of specific SPMs control the resolution of inflammation in humans with obesity. This trial was registered at clinicaltrials.gov as NCT04701138.

PURL: Best timing for measuring orthostatic vital signs?

We typically take a blood pressure within 3 minutes of a patient rising from a supine to a standing position. But is that too long?

Large-scale Exploration of Neuronal Morphologies Using Deep Learning and Augmented Reality.

Recently released large-scale neuron morphological data has greatly facilitated the research in neuroinformatics. However, the sheer volume and complexity of these data pose significant challenges for efficient and accurate neuron exploration. In this paper, we propose an effective retrieval framework to address these problems, based on frontier techniques of deep learning and binary coding. For the first time, we develop a deep learning based feature representation method for the neuron morphological data, where the 3D neurons are first projected into binary images and then learned features using an unsupervised deep neural network, i.e., stacked convolutional autoencoders (SCAEs). The deep features are subsequently fused with the hand-crafted features for more accurate representation. Considering the exhaustive search is usually very time-consuming in large-scale databases, we employ a novel binary coding method to compress feature vectors into short binary codes. Our framework is validated on a public data set including 58,000 neurons, showing promising retrieval precision and efficiency compared with state-of-the-art methods. In addition, we develop a novel neuron visualization program based on the techniques of augmented reality (AR), which can help users take a deep exploration of neuron morphologies in an interactive and immersive manner.