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Choi BH, Yaya K, Prabhu V, Fefferman N, Mitchell B, Kuenzler KA, Ginsburg HB, Fisher JC, Tomita S. Simple preoperative radiation safety interventions significantly lower radiation doses during central venous line placement in children. J Pediatr Surg 2019; 54:170-173. [PMID: 30415958 DOI: 10.1016/j.jpedsurg.2018.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 10/01/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study was to reduce radiation exposure during pediatric central venous line (CVL) placement by implementing a radiation safety process including a radiation safety briefing and a job-instruction model with a preradiation time-out. METHODS We reviewed records of all patients under 21 who underwent CVL placement in the operating room covering 22 months before the intervention through 10 months after 2013-2016. The intervention consisted of a radiation safety briefing by the surgeon to the intraoperative staff before each case and a radiation safety time-out. We measured and analyzed the dose area product (DAP), total radiation time pre- and postintervention, and the use of postprocedural chest radiograph. RESULTS 100 patients with valid DAP measurements were identified for analysis (59 preintervention, 41 postintervention). Following implementation of the radiation safety process, there was a 79% decrease in median DAP (61.4 vs 13.1 rad*cm2, P < 0.001) and a 73% decrease in the median radiation time (28 vs 7.6 s, P < 0.001). Additionally, there was a significant reduction in use of confirmatory CXR (95% vs 15%, P < 0.01). CONCLUSION A preoperative radiation safety briefing and a radiation safety time-out supported by a job-instruction model were effective in significantly lowering the absorbed doses of radiation in children undergoing CVL insertion. TYPE OF STUDY Case-control study. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Beatrix Hyemin Choi
- Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY.
| | - Kamalou Yaya
- Department of Radiology, NYU School of Medicine, NYU Langone Health, New York, NY
| | - Vinay Prabhu
- Department of Radiology, NYU School of Medicine, NYU Langone Health, New York, NY
| | - Nancy Fefferman
- Department of Radiology, NYU School of Medicine, NYU Langone Health, New York, NY
| | - Beverly Mitchell
- Department of Surgery, NYU School of Medicine, NYU Langone Health, New York, NY
| | - Keith A Kuenzler
- Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY
| | - Howard B Ginsburg
- Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY
| | - Jason C Fisher
- Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY
| | - Sandra Tomita
- Division of Pediatric Surgery, Department of Surgery, NYU School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY
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Casey CS, Orozco-terWengel P, Yaya K, Kadwell M, Fernández M, Marín JC, Rosadio R, Maturrano L, Hoces D, Hu Y, Wheeler JC, Bruford MW. Comparing genetic diversity and demographic history in co-distributed wild South American camelids. Heredity (Edinb) 2018; 121:387-400. [PMID: 30061581 DOI: 10.1038/s41437-018-0120-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 05/11/2018] [Accepted: 05/28/2018] [Indexed: 11/09/2022] Open
Abstract
Vicuñas and guanacos are two species of wild South American camelids that are key ruminants in the ecosystems where they occur. Although closely related, these species feature differing ecologies and life history characters, which are expected to influence both their genetic diversity and population differentiation at different spatial scales. Here, using mitochondrial and microsatellite genetic markers, we show that vicuña display lower genetic diversity within populations than guanaco but exhibit more structure across their Peruvian range, which may reflect a combination of natural genetic differentiation linked to geographic isolation and recent anthropogenic population declines. Coalescent-based demographic analyses indicate that both species have passed through a strong bottleneck, reducing their effective population sizes from over 20,000 to less than 1000 individuals. For vicuña, this bottleneck is inferred to have taken place ~3300 years ago, but to have occurred more recently for guanaco at ~2000 years ago. These inferred dates are considerably later than the onset of domestication (when the alpaca was domesticated from the vicuña while the llama was domesticated from the guanaco), coinciding instead with a major human population expansion following the mid-Holocene cold period. As importantly, they imply earlier declines than the well-documented Spanish conquest, where major mass mortality events were recorded for Andean human and camelid populations. We argue that underlying species' differences and recent demographic perturbations have influenced genetic diversity in modern vicuña and guanaco populations, and these processes should be carefully evaluated in the development and implementation of management strategies for these important genetic resources.
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Affiliation(s)
- C S Casey
- School of Biosciences, Cardiff University, Cathays Park, Cardiff, CF10 3AX, UK.,School of Life Sciences, University of Lincoln, Riseholme Park, Lincoln, LN2 2LG, UK
| | - P Orozco-terWengel
- School of Biosciences, Cardiff University, Cathays Park, Cardiff, CF10 3AX, UK
| | - K Yaya
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru
| | - M Kadwell
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - M Fernández
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru
| | - J C Marín
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad del Bío - Bío, Casilla 447, Chillan, Chile
| | - R Rosadio
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru.,Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - L Maturrano
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru.,Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - D Hoces
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru
| | - Y Hu
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, 1-5 Beichen West Road, 100101, Beijing, China
| | - J C Wheeler
- CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru.
| | - M W Bruford
- School of Biosciences, Cardiff University, Cathays Park, Cardiff, CF10 3AX, UK. .,CONOPA, Instituto de Investigación y Desarrollo de Camélidos Sudamericanos, Avenida Reusche Mz. M Lt. 4, Pachacamac, Lima 19, Peru.
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Marín JC, Casey CS, Kadwell M, Yaya K, Hoces D, Olazabal J, Rosadio R, Rodriguez J, Spotorno A, Bruford MW, Wheeler JC. Mitochondrial phylogeography and demographic history of the Vicuña: implications for conservation. Heredity (Edinb) 2007; 99:70-80. [PMID: 17426731 DOI: 10.1038/sj.hdy.6800966] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The vicuña (Vicugna vicugna; Miller, 1924) is a conservation success story, having recovered from near extinction in the 1960s to current population levels estimated at 275,000. However, lack of information about its demographic history and genetic diversity has limited both our understanding of its recovery and the development of science-based conservation measures. To examine the evolution and recent demographic history of the vicuña across its current range and to assess its genetic variation and population structure, we sequenced mitochondrial DNA from the control region (CR) for 261 individuals from 29 populations across Peru, Chile and Argentina. Our results suggest that populations currently designated as Vicugna vicugna vicugna and Vicugna vicugna mensalis comprise separate mitochondrial lineages. The current population distribution appears to be the result of a recent demographic expansion associated with the last major glacial event of the Pleistocene in the northern (18 to 22 degrees S) dry Andes 14-12,000 years ago and the establishment of an extremely arid belt known as the 'Dry Diagonal' to 29 degrees S. Within the Dry Diagonal, small populations of V. v. vicugna appear to have survived showing the genetic signature of demographic isolation, whereas to the north V. v. mensalis populations underwent a rapid demographic expansion before recent anthropogenic impacts.
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Affiliation(s)
- J C Marín
- Laboratorio de Genómica y Biodiversidad, Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad del Bio-Bio, Chillán, Chile.
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