The FOUR score is an accurate predictor of outcome in TBI patients. It has some advantages over GCS, such as all components of FOUR score but not GCS can be rated in intubated patients.

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It is believed that insertion of ICP monitors by neurointensivists is safe and may aid in providing prompt monitoring of patients with severe TBI.

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In this paper, we evaluate the conventional contrast enhancement techniques [histogram equalization (HE), adaptive HE] and the recent gray-level grouping method and the fuzzy logic method in order to find out which of these is well suited for automatic contrast enhancement for satellite images of the ocean, obtained from a variety of sensors. All the techniques evaluated were based on the principle of transforming the skewed histogram of the original image into a uniform histogram. The performance of the different contrast enhancement algorithms are evaluated based on the visual quality and the Tenengrad criterion. The inter comparison of different techniques was carried out on a standard lowcontrast image and also three different satellite images with different characteristics. Based on our study, we advocate that a modified fuzzy logic method elucidated in this paper is well suited for contrast enhancement of low-contrast satellite images of the ocean.

BackgroundAlthough the optimum hemoglobin (H) concentration for patients with septic shock (SS) has not been specifically investigated, current guidelines suggest that H of 7 - 9 g/dL, compared with 10 - 12 g/dL, was not associated with increased mortality in critically ill adults. This contrasts with early goal-directed resuscitation protocols that use a target hematocrit of 30% in patients with low central venous oxygen saturation (ScvO2) during the first 6 hours of resuscitation of SS.MethodsData elements were prospectively collected on all patients with SS patients (lactic acid (LA) > 4 mmol/L, or hypotension). Out of a total of 396 SS patients, 46 patients received red blood cell (RBC) transfusion for ScvO2 < 70% (RBC group). We then matched 71 SS patients that did not receive RBC transfusion (NRBC group) on the following goals (G): LA obtained within 6 hours (G1), antibiotics given within 3 hours (G2), 20 mL/kg fluid bolus followed by vasopressors (VP) if needed to keep mean arterial pressure > 65 mm Hg (G3), central venous pressure > 8 mm Hg within 6 hours (G4) and ScvO2 > 70% within 6 hours (G5).ResultsIn the RBC group, after one unit of RBC transfusion, ScvO2 improved from average of 63% (± 12%) to 68% (± 10%) (P = 0.02). Sixteen patients required another unit of RBC, and this resulted in increase of ScvO2 to 78% (± 11%) (P < 0.01). The RBC and NRBC groups were matched on sequential organ failure assessment (SOFA) scores and all five goals. There was no difference in mortality between the two groups: 41% vs. 39.4% (OR: 0.8, 95% CI: 0.4 - 1.7, P = 0.6).ConclusionsIn our study, transfusion of RBC was not associated with decreased mortality in SS patients.

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