Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children: A systematic review

Background Around the world, guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) vary greatly. To prevent occlusion, most institutions recommend the use of heparin when the CVC is not in use. However, there is debate regarding the need for heparin and evidence to suggest normal saline may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased costs. Objectives To assess the clinical effects (benefits and harms) of heparin versus normal saline to prevent occlusion in long-term central venous catheters in infants, children and adolescents. Design A Cochrane systematic review of randomised controlled trials was undertaken. - Data sources: The Cochrane Vascular Group Specialised Register (including MEDLINE, CINAHL, EMBASE and AMED) and the Cochrane Register of Studies were searched. Hand searching of relevant journals and reference lists of retrieved articles was also undertaken. - Review Methods: Data were extracted and appraisal undertaken. We included studies that compared the efficacy of normal saline with heparin to prevent occlusion. We excluded temporary CVCs and peripherally inserted central catheters. Rate ratios per 1000 catheter days were calculated for two outcomes, occlusion of the CVC, and CVC-associated blood stream infection. Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin. However, between studies, all used different protocols with various concentrations of heparin and frequency of flushes. The quality of the evidence ranged from low to very low. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). Conclusions It remains unclear whether heparin is necessary for CVC maintenance. More well-designed studies are required to understand this relatively simple, but clinically important question. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

Parts based representation for pedestrian using NMF with robustness to partial occlusion

Computer Vision has seen a resurgence in the parts-based representation for objects over the past few years. The parts are usually annotated beforehand for training. We present an annotation free parts-based representation for the pedestrian using Non-Negative Matrix Factorization (NMF). We show that NMF is able to capture the wide range of pose and clothing of the pedestrians. We use a modified form of NMF i.e. NMF with sparsity constraints on the factored matrices. We also make use of Riemannian distance metric for similarity measurements in NMF space as the basis vectors generated by NMF aren't orthogonal. We show that for 1% drop in accuracy as compared to the Histogram of Oriented Gradients (HOG) representation we can achieve robustness to partial occlusion.

Computer generated hologram with geometric occlusion using GPU-accelerated depth buffer rasterization for three-dimensional display

We present a method of rapidly producing computer-generated holograms that exhibit geometric occlusion in the reconstructed image. Conceptually, a bundle of rays is shot from every hologram sample into the object volume.We use z buffering to find the nearest intersecting object point for every ray and add its complex field contribution to the corresponding hologram sample. Each hologram sample belongs to an independent operation, allowing us to exploit the parallel computing capability of modern programmable graphics processing units (GPUs). Unlike algorithms that use points or planar segments as the basis for constructing the hologram, our algorithm's complexity is dependent on fixed system parameters, such as the number of ray-casting operations, and can therefore handle complicated models more efficiently. The finite number of hologram pixels is, in effect, a windowing function, and from analyzing the Wigner distribution function of windowed free-space transfer function we find an upper limit on the cone angle of the ray bundle. Experimentally, we found that an angular sampling distance of 0:01' for a 2:66' cone angle produces acceptable reconstruction quality. © 2009 Optical Society of America.

Multiview stereo via volumetric Graph-Cuts and occlusion robust photo-consistency.

This paper presents a volumetric formulation for the multi-view stereo problem which is amenable to a computationally tractable global optimisation using Graph-cuts. Our approach is to seek the optimal partitioning of 3D space into two regions labelled as "object" and "empty" under a cost functional consisting of the following two terms: (1) A term that forces the boundary between the two regions to pass through photo-consistent locations and (2) a ballooning term that inflates the "object" region. To take account of the effect of occlusion on the first term we use an occlusion robust photo-consistency metric based on Normalised Cross Correlation, which does not assume any geometric knowledge about the reconstructed object. The globally optimal 3D partitioning can be obtained as the minimum cut solution of a weighted graph.

Determination of bioaccumulation and microscopic survey of LAS pollutant effect on the liver, kidney and gill tissues of Rutilus frisii kutum in Caspian sea

Linear alkylbenzene sulfonate (LAS) are widely used in detergent industry. Due to contaminants entering the water, and the effects of their accumulation in fish, LAS, has a great importance in environmental pollution. In the present study, accumulation of LAS and its histological effects on gill tissue, liver and kidney of Caspian kutum (Rutilus frisii kutum) were studied. Caspian kutum is the most important and most valuable teleosts of the Caspian Sea. Due to releasing Caspian Kutum in rivers and Anzali Lagoon and unlimited entry of wastewater to the aquatic ecosystem, research on the impact of LAS on Caspian kutum is important. In the present study, fish exposed to sublethal concentrations of LAS (0.58, 1.16 and 2.32 mg/l) for 192 hours. Control treatments with three replicates at 0, 24, 48, 72, 96 and 192 hours were done. For assessments of the histological effects of LAS, tissue sections prepared and by using Hematoxylin - Eosin were stained, then the prepared sections, examined by light microscopy. For determination of the bio accumulation of LAS, the soxhlet extraction and solid phase extraction was performed to determine the amount of LAS using HPLC with fluorescence detector. According to results average of bioconcentration factor and LAS concentrations in fish had reached stable levels after approximately 72 h and thus represented steady state BCF values in this species. The value of steady-state bio-concentration factor of total LAS was 33.96 L.Kg- 1 and for each of the homologous C10-n-LAS, C11-n-LAS, C12-n-LAS and C13-n- LAS were 3.84, 6.15, 8.58 and 15.57 L.Kg-1 respectively. According to the results obtained in gills exposed to LAS, histopathological alteration include hypertrophy, lifting of lamella epithelium, edema, clubbing of lamellae hyperplasia, lamellar fusion and aneurysm were seen. In liver tissue exposed to three concentrations of LAS, congestion and dilation of sinusoids, irregular-shaped nuclei and degeneration in the hepatocyte, vacuolar degeneration and necrosis were observed. In kidney exposed to three concentrations of LAS, reduction of the interstitial haematopoietic tissue, degeneration in the epithelial cells of renal tubule, tubular degeneration, necrosis, shrinkage and luminal occlusion were observed. According to the results the most alteration due to exposure to LAS was seen in the gill tissue. None of the control samples showed histological effects of LAS.

High-level scene structure using visibility and occlusion

We demonstrate a new method for extracting high-level scene information from the type of data available from simultaneous localisation and mapping systems. We model the scene with a collection of primitives (such as bounded planes), and make explicit use of both visible and occluded points in order to refine the model. Since our formulation allows for different kinds of primitives and an arbitrary number of each, we use Bayesian model evidence to compare very different models on an even footing. Additionally, by making use of Bayesian techniques we can also avoid explicitly finding the optimal assignment of map landmarks to primitives. The results show that explicit reasoning about occlusion improves model accuracy and yields models which are suitable for aiding data association. © 2011. The copyright of this document resides with its authors.

Improved Tracking of Multiple Humans with Trajectory Prediction and Occlusion Modeling

A combined 2D, 3D approach is presented that allows for robust tracking of moving bodies in a given environment as observed via a single, uncalibrated video camera. Tracking is robust even in the presence of occlusions. Low-level features are often insufficient for detection, segmentation, and tracking of non-rigid moving objects. Therefore, an improved mechanism is proposed that combines low-level (image processing) and mid-level (recursive trajectory estimation) information obtained during the tracking process. The resulting system can segment and maintain the tracking of moving objects before, during, and after occlusion. At each frame, the system also extracts a stabilized coordinate frame of the moving objects. This stabilized frame is used to resize and resample the moving blob so that it can be used as input to motion recognition modules. The approach enables robust tracking without constraining the system to know the shape of the objects being tracked beforehand; although, some assumptions are made about the characteristics of the shape of the objects, and how they evolve with time. Experiments in tracking moving people are described.

Facial Feature Tracking and Occlusion Recovery in American Sign Language

Facial features play an important role in expressing grammatical information in signed languages, including American Sign Language(ASL). Gestures such as raising or furrowing the eyebrows are key indicators of constructions such as yes-no questions. Periodic head movements (nods and shakes) are also an essential part of the expression of syntactic information, such as negation (associated with a side-to-side headshake). Therefore, identification of these facial gestures is essential to sign language recognition. One problem with detection of such grammatical indicators is occlusion recovery. If the signer's hand blocks his/her eyebrows during production of a sign, it becomes difficult to track the eyebrows. We have developed a system to detect such grammatical markers in ASL that recovers promptly from occlusion. Our system detects and tracks evolving templates of facial features, which are based on an anthropometric face model, and interprets the geometric relationships of these templates to identify grammatical markers. It was tested on a variety of ASL sentences signed by various Deaf native signers and detected facial gestures used to express grammatical information, such as raised and furrowed eyebrows as well as headshakes.