Essentials
Pediatric studies on peripherally inserted central catheter (PICC)‐related thrombosis are scarce.
This study analyzes incidence and risk factors for PICC‐related venous thrombosis in ...children.
PICC‐related thrombosis is a common, and nearly always, asymptomatic complication.
Echo‐guided insertion and a catheter to vein ratio < 0.33 may notably decrease this complication.
Summary
Background
Upper‐extremity venous thrombosis is associated with the use of peripherally inserted central catheters (PICCs). Few pediatric studies have focused on this issue.
Objectives
To determine the incidence and risk factors for PICC‐related superficial vein thrombosis (SVT) and deep vein thrombosis (DVT) in children.
Patients/methods
An observational follow‐up cohort study was conducted at a single hospital between June 2012 and June 2015. All patients receiving a PICC were enrolled and followed up, with weekly Doppler ultrasound examination of the catheterized limb until PICC removal. Patient, procedural and follow‐up data were analyzed.
Results
In the study period, 265 PICCs were inserted (median age of patients 6.5 years, interquartile range IQR 2.4–13 years; median weight 20 kg, IQR 11–38 kg; 54% males; 67.9% chronically ill), and patients were followed up for a total of 9743 days. The median indwelling time was 21 days (IQR 12–37 days). During follow‐up, 88 (33.2% of insertions) PICC‐related thromboses (incidence rate IR 9.03 per 1000 catheter‐days) were diagnosed, 66 (24.9%) as isolated SVT, seven (2.6%) as isolated DVT, and 15 (5.7%) as SVT with associated DVT (IR 6.78, 0.71 and 1.54 per 1000 catheter‐days, respectively). Only 9.9% of patients with SVT and 18.2% of those with DVT were symptomatic. The main risk factors for PICC‐related SVT and DVT were a catheter/vein ratio of > 0.33 and thrombosis of the catheterized superficial vein, respectively.
Conclusions
PICC‐related thrombosis is a common and nearly always asymptomatic complication in children, the SVT rate being approximately three times higher than the DVT rate. Optimal vein and catheter selection, yielding the lowest possible catheter/vein ratio, may decrease the rate of PICC‐related thrombosis.
Abstract Spectral K-edge subtraction (SKES) is an imaging technique that takes advantage of the sharp rise in the mass attenuation coefficient of specific elements within an object at their K-edge to ...produce separate and quantifiable distributions of each element. In this paper, a high-sensitivity and wide bandwidth SKES imaging system for computed tomography applications on biological samples is presented. X-ray images are acquired using a wide and continuous energy spectrum that encompasses the absorption edges of the target materials. System characterization shows that high energy resolution (approximately 3 × 10 − 3 ) and unprecedented large energy bandwidth (around 15%) are achieved over a field-of-view of several centimeters. Imaging results obtained on contrast elements relevant for biomedical applications, namely silver, iodine, xenon, and barium, demonstrate the system sensitivity to concentrations down to 0.5 mg ml −1 . The achievement of a large energy bandwidth allowed the simultaneous imaging of the K-edges of iodine, xenon, and barium and provided an accurate concentration estimation and distinction of co-localized contrast elements, leading the way for future simultaneous cardiovascular (iodine), pulmonary (xenon), and gastrointestinal/inflammatory (barium) imaging applications.
Glucocerebrosidase (GCase, deficient in Gaucher disease) enzymatic activity measured in dried blood spots of Parkinson's Disease (PD) cases is within healthy range but reduced compared to controls. ...It is not known whether activities of additional lysosomal enzymes are reduced in dried blood spots in PD. To test whether reduction in lysosomal enzymatic activity in PD is specific to GCase, we measured GCase, acid sphingomyelinase (deficient in Niemann–Pick disease types A and B), alpha galactosidase A (deficient in Fabry), acid alpha-glucosidase (deficient in Pompe) and galactosylceramidase (deficient in Krabbe) enzymatic activities in dried blood spots of PD patients (n = 648) and controls (n = 317) recruited from Columbia University. Full sequencing of glucocerebrosidase (GBA) and the LRRK2 G2019S mutation was performed. Enzymatic activities were compared between PD cases and controls using t-test and regression models adjusted for age, gender, and GBA and LRRK2 G2019S mutation status. Alpha galactosidase A activity was lower in PD cases compared to controls both when only non-carriers were included (excluding all GBA and LRRK2 G2019S carriers and PD cases with age-at-onset below 40) 2.85 μmol/l/h versus 3.12 μmol/l/h, p = 0.018; after controlling for batch effect, p = 0.006 (468 PD cases and 296 controls), and when including the entire cohort (2.89 μmol/l/h versus 3.10 μmol/l/h, p = 0.040; after controlling for batch effect, p = 0.011). Because the alpha galactosidase A gene is X-linked, we stratified the analyses by sex. Among women who were non-carriers of GBA and LRRK2 G2019S mutations (PD, n = 155; control, n = 194), alpha galactosidase A activity was lower in PD compared to controls (2.77 μmol/l/h versus 3.10 μmol/l/h, p = 0.044; after controlling for a batch effect, p = 0.001). The enzymatic activity of acid sphingomyelinase, acid alpha-glucosidase and galactosylceramidase was not significantly different between PD and controls. In non-carriers, most lysosomal enzyme activities were correlated, with the strongest association in GCase, acid alpha-glucosidase, and alpha galactosidase A (Pearson correlation coefficient between 0.382 and 0.532). In a regression model with all five enzymes among non-carriers (adjusted for sex and age), higher alpha galactosidase A activity was associated with lower odds of PD status (OR = 0.54; 95% CI:0.31–0.95; p = 0.032). When LRRK2 G2019S PD carriers (n = 37) were compared to non-carriers with PD, carriers had higher GCase, acid sphingomyelinase and alpha galactosidase A activity. We conclude that alpha galactosidase A may have a potential independent role in PD, in addition to GCase.
•Activity was measured for 5 lysosomal enzymes in blood spots of PD and controls.•Alpha galactosidase A (deficient in Fabry disease) activity is reduced in PD cases.•Alpha galactosidase A and acid sphingomylinase are elevated in LRRK2 carriers.
Due to the high variability of biomes throughout the country, the classification of burned areas is a challenge. We calibrated a random forest classifier to account for all this variability and ...ensure an accurate classification of burned areas. The classifier was optimized in three steps, generating a version of the burned area product in each step. According to the visual assessment, the final version of the BA product is more accurate than the perimeters created by the Chilean National Forest Corporation, which overestimate large burned areas because it does not consider the inner unburned areas and, it omits some small burned areas. The total burned surface from January to March 2017 was 5,000 km2 in Chile, 20 % of it belonging to a single burned area in the Maule Region, and with 91 % of the total burned surface distributed in 6 adjacent regions of Central Chile.
Abstract
We present Keck/OSIRIS (OH Suppressing Infrared Imaging Spectrograph) adaptive optics observations with 150–400 pc spatial sampling of seven turbulent, clumpy disc galaxies from the DYnamics ...of Newly-Assembled Massive Objects (DYNAMO) sample (0.07 < z < 0.2). DYNAMO galaxies have previously been shown to be well matched in properties to main-sequence galaxies at z ∼ 1.5. Integral field spectroscopy observations using adaptive optics are subject to a number of systematics including a variable point spread function and spatial sampling, which we account for in our analysis. We present gas velocity dispersion maps corrected for these effects, and confirm that DYNAMO galaxies do have high gas velocity dispersion (σ = 40–80 km s−1), even at high spatial sampling. We find statistically significant structure in six out of seven galaxies. The most common distance between the peaks in velocity dispersion (σpeaks) and emission line peaks is ∼0.5 kpc; we note this is very similar to the average size of a clump measured with Hubble Space Telescope H α maps. This could suggest that σpeaks in clumpy galaxies likely arise due to some interaction between the clump and the surrounding interstellar medium of the galaxy, though our observations cannot distinguish between outflows, inflows or velocity shear. Observations covering a wider area of the galaxies will be needed to confirm this result.
Translocations are an increasing feature of threatened species conservation plans, but the impact of removal of individuals on the source population is seldom studied. Using computational Population ...Dynamics P System models and the Pyrenean Bearded Vulture population as a case study we looked at: the effect on the source population of alternative strategies for removal of individual birds for use in reintroduction projects; and the trade‐offs between the various management options. According to our models (over a 30 year prediction horizon) the removal of one clutch, juvenile or non‐territorial adult each year over an 11 year period, results in an annual loss of 1.57, 3.71 and 0.97 territories, respectively. We forecast the impact of a plausible removal scenario for the Pyrenees source population (the removal of five clutches and five non‐territorial adults each year over 11 years), leading to a predicted loss of 16 breeding territories. Nevertheless, changes in demographic parameters, mainly in productivity and adult survival, could substantially affect these predicted results. With the current demographic parameters, the removal scenarios that were estimated to not affect population size after 30 years (95% CI) are limited to: (1) the removal of five clutches and five non‐territorial adults during a single year; (2) the annual removal of five non‐territorial adults during a 6 year period; and (3) the annual removal of five clutches during a 6 year period. Our results suggest that removals from the Pyrenean Bearded Vulture source population should be performed with caution due to uncertainties arising from stochastic changes in survival and productivity.
Using computational Population Dynamics P System models and the Pyrenean Bearded Vulture population as a case study, we looked at alternative strategies for removal of individual birds for use in reintroduction projects and their effects on the source population, as well as the trade‐offs between the various management options. According to our models (over a 30‐year prediction horizon) the removal of one clutch, juvenile or non‐territorial adult each year over an 11‐year period results in an annual loss of 1.57, 3.71 and 0.97 territories, respectively. Our results suggest that removals from the Pyrenean Bearded Vulture source population should be performed with caution due to uncertainties arising from stochastic changes in survival and productivity.
Over millennia, human intervention has transformed European habitats mainly through extensive livestock grazing. "Dehesas/Montados" are an Iberian savannah-like ecosystem dominated by oak-trees, ...bushes and grass species that are subject to agricultural and extensive livestock uses. They are a good example of how large-scale, low intensive transformations can maintain high biodiversity levels as well as socio-economic and cultural values. However, the role that these human-modified habitats can play for individuals or species living beyond their borders is unknown. Here, using a dataset of 106 adult GPS-tagged Eurasian griffon vultures (Gyps fulvus) monitored over seven years, we show how individuals breeding in western European populations from Northern, Central, and Southern Spain, and Southern France made long-range forays (LRFs) of up to 800 km to converge in the threatened Iberian "dehesas" to forage. There, extensive livestock and wild ungulates provide large amounts of carcasses, which are available to scavengers from traditional exploitations and rewilding processes. Our results highlight that maintaining Iberian "dehesas" is critical not only for local biodiversity but also for long-term conservation and the ecosystem services provided by avian scavengers across the continent.
Ketamine and psychedelics have abuse liability. They can also induce "transformative experiences" where individuals experience enhanced states of awareness. This enhanced awareness can lead to ...changes in preexisting behavioral patterns which could be beneficial in the treatment of substance use disorders (SUDs). Preclinical and clinical studies suggest that ketamine and psychedelics may alter markers associated with synaptic density, and that these changes may underlie effects such as sensitization, conditioned place preference, drug self-administration, and verbal memory performance. In this scoping review, we examined studies that measured synaptic markers in animals and humans after exposure to ketamine and/or psychedelics.
A systematic search was conducted following PRISMA guidelines, through PubMed, EBSCO, Scopus, and Web of Science, based on a published protocol (Open Science Framework, DOI: 10.17605/OSF.IO/43FQ9). Both
and
studies were included. Studies on the following synaptic markers were included: dendritic structural changes, PSD-95, synapsin-1, synaptophysin-1, synaptotagmin-1, and SV2A.
Eighty-four studies were included in the final analyses. Seventy-one studies examined synaptic markers following ketamine treatment, nine examined psychedelics, and four examined both. Psychedelics included psilocybin/psilocin, lysergic acid diethylamide, N,N-dimethyltryptamine, 2,5-dimethoxy-4-iodoamphetamine, and ibogaine/noribogaine. Mixed findings regarding synaptic changes in the hippocampus and prefrontal cortex (PFC) have been reported when ketamine was administered in a single dose under basal conditions. Similar mixed findings were seen under basal conditions in studies that used repeated administration of ketamine. However, studies that examined animals during stressful conditions found that a single dose of ketamine counteracted stress-related reductions in synaptic markers in the hippocampus and PFC. Repeated administration of ketamine also counteracted stress effects in the hippocampus. Psychedelics generally increased synaptic markers, but results were more consistently positive for certain agents.
Ketamine and psychedelics can increase synaptic markers under certain conditions. Heterogeneous findings may relate to methodological differences, agents administered (or different formulations of the same agent), sex, and type of markers. Future studies could address seemingly mixed results by using meta-analytical approaches or study designs that more fully consider individual differences.
The aim of the SYRMA-CT collaboration is to set-up the first clinical trial of phase-contrast breast CT with synchrotron radiation (SR). In order to combine high image quality and low delivered dose ...a number of innovative elements are merged: a CdTe single photon counting detector, state-of-the-art CT reconstruction and phase retrieval algorithms. To facilitate an accurate exam optimization, a Monte Carlo model was developed for dose calculation using GEANT4. In this study, high isotropic spatial resolution (120 μm)3 CT scans of objects with dimensions and attenuation similar to a human breast were acquired, delivering mean glandular doses in the range of those delivered in clinical breast CT (5-25 mGy). Due to the spatial coherence of the SR beam and the long distance between sample and detector, the images contain, not only absorption, but also phase information from the samples. The application of a phase-retrieval procedure increases the contrast-to-noise ratio of the tomographic images, while the contrast remains almost constant. After applying the simultaneous algebraic reconstruction technique to low-dose phase-retrieved data sets (about 5 mGy) with a reduced number of projections, the spatial resolution was found to be equal to filtered back projection utilizing a four fold higher dose, while the contrast-to-noise ratio was reduced by 30%. These first results indicate the feasibility of clinical breast CT with SR.
We have analysed the growth of Brightest Group Galaxies and Brightest Cluster Galaxies (BGGs/BCGs) over the last 3 billion years using a large sample of 883 galaxies from the Galaxy And Mass Assembly ...survey. By comparing the stellar mass of BGGs and BCGs in groups and clusters of similar dynamical masses, we find no significant growth between redshift z = 0.27 and 0.09. We also examine the number of BGGs/BCGs that have line emission, finding that approximately 65 per cent of BGGs/BCGs show Hα in emission. From the galaxies where the necessary spectroscopic lines were accurately recovered (54 per cent of the sample), we find that half of this (i.e. 27 per cent of the sample) harbour ongoing star formation with rates up to 10 M yr−1, and the other half (i.e. 27 per cent of the sample) have an active nucleus (AGN) at the centre. BGGs are more likely to have ongoing star formation, while BCGs show a higher fraction of AGN activity. By examining the position of the BGGs/BCGs with respect to their host dark matter halo, we find that around 13 per cent of them do not lie at the centre of the dark matter halo. This could be an indicator of recent cluster-cluster mergers. We conclude that BGGs and BCGs acquired their stellar mass rapidly at higher redshifts as predicted by semi-analytic models, mildly slowing down at low redshifts.
PDF
