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Background: More evidence suggests how the eye health may be crucial in older adults at risk of developing cognitive impairment (CI) and Alzheimer's disease (AD). Ocular conditions and AD share several common factors, including older age behavioral and cardiometabolic disease. Poor vision can lead to reduced activation of central sensory pathways, which is associated with higher cognitive load and brain structure damage. We showed that CI is not limited to the brain but also affects the retina. However, despite recent advances in neuroimaging biomarkers (e.g., PET diagnostics), there remains a need for more readily available and affordable diagnostic testing for AD risk. While blood flow within the optic nerve head can be quantified using advanced optical imaging technologies, it is essential to measure what is going on in the brain at the same time. Method: We propose a cross‐sectional and longitudinal, observational study evaluating structural and functional biomarkers of the retina and brain associated with AD disease risk and/or progression. The study objective is to collect structural and functional data of the retina and brain to facilitate the discovery of reliable and sensitive multimodal biomarkers of AD disease risk and/or progression. We will examine participants (N = 200) aged 55‐80; 50 cognitively healthy (CH), 50 with preclinical AD, 50 with mild CI (MCI), and 50 with mild AD. Assessments will include neuropsychological testing, medical/functional assessment, retinal imaging, brain activity, electroretinography, pupillometry, and contrast sensitivity. We will use a wearable, whole‐head coverage time‐domain functional near‐infrared spectroscopy system (Kernel Inc) to measure local changes in blood oxygenation and electroencephalography. Result: The eye‐brain connectome is integral in understanding pathology in neurodegenerative diseases. We aim to use the eye‐brain data to develop screening and monitoring tools to identify and track AD risk and severity. Conclusion: This study will overcome limitations for performing functional brain imaging due to the lack of portability and user‐friendliness of neuroimaging devices. Our eye‐brain multimodal biomarker study could also facilitate a novel application for diagnostic assessment and therapeutic intervention to target neuroanatomical sites compromised early in AD, leading to a more robust technique to identify high‐risk individuals before cognitive decline with sufficient sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Background Ischemic stroke is a time-sensitive disease, with improved outcomes associated with decreased time from onset to treatment. It was hypothesised that ambulance-based assessment of the National Institutes of Health Stroke Scale (NIHSS) using a Health Insurance Portability and Accountability Act (HIPAA)-compliant mobile platform immediately prior to arrival is feasible. Methods This is a proof-of-concept feasibility pilot study in two phases. The first phase consisted of an ambulance-equipped HIPAA-compliant video platform for remote NIHSS assessment of a simulated stroke patient. The second phase consisted of remote NIHSS assessment by a hospital-based neurologist of acute stroke patients en route to our facility. Five ambulances were equipped with a 4G/LTE-enabled tablet preloaded with a secure HIPAA-compliant telemedicine application. Secondary outcomes assessed satisfaction of staff with the remote platform. Results Phase one was successful in the assessment of three out of three simulated patients. Phase two was successful in the assessment of 10 out of 11 (91%) cases. One video attempt was unsuccessful because local LTE was turned off on the device. The video signal was dropped transiently due to weather, which delayed NIHSS assessment in one case. Average NIHSS assessment time was 7.6 minutes (range 3-9.8 minutes). Neurologists rated 83% of encounters as 'satisfied' to 'very satisfied', and the emergency medical service (EMS) rated 90% of encounters as 'satisfied' to 'very satisfied'. The one failed video attempt was associated with 'poor' EMS satisfaction. Conclusion This proof-of-concept pilot demonstrates that remote ambulance-based NIHSS assessment is feasible. This model could reduce door-to-needle times by conducting prehospital data collection. [ABSTRACT FROM AUTHOR]

Background: Optical brain imaging allows an understanding of the structure and function of neurons. Researchers can help patients who suffer from nervous system diseases, such as Alzheimer's disease and Lewy's Body Dementia, by exploring brain structure and function. Despite the advent of new PET diagnostics to image amyloid deposits in living patients' brains, there remains a need for more readily available and affordable diagnostic testing. Method: A time‐domain functional near‐infrared spectroscopy (TD‐fNIRS) system (Kernel Flow, Kernel Inc.) is presented. The system has been designed as a small modular device that can provide real‐time monitoring of tissue oxygenation in the brain as subjects take tests, perform cognitive tasks, and/or receive stimulation. Result: We show the performance of the wearable TD‐fNIRS device in multiple settings and aim to use this technology to develop a protocol for identifying and tracking brain changes in aging and dementia from the preclinical stage of the disease. Conclusion: Laboratory tests with study subjects and preliminary data recorded demonstrate the potential of the system as a clinical tool to be employed in multiple settings to not only monitor brain activity but with the potential for additional human neuroscience applications, making neuroimaging more accessible across health and science platforms. [ABSTRACT FROM AUTHOR]

A 39-year-old man with Candida glabrata endophthalmitis was successfully treated with a 28-day course of intravenous caspofungin. Presence of underlying renal insufficiency and infection with a drug-resistant strain precluded use of amphotericin B or fluconazole. Intravitreal administration of antifungals and vitrectomy were not required. The role of caspofungin in Candida endophthalmitis is discussed. [ABSTRACT FROM AUTHOR]