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Background: Flying accuracy is influenced by pilots' affective reactions to task demands. A better understanding of task-related emotions and flying performance is needed to enhance pilot training. Objective: Understand pilot trainees' performance and emotional dynamics (intensity, frequency and variability) based on training phase and difficulty level in a flight simulator. Methods: Twenty-three volunteers performed basic flight manoeuvres. Trials were divided into three phases: Introduction (trials 1-7), session A (trials 8-15) and session B (trials 16-22). Three task difficulty levels were implemented (low, medium and high). Flying performance was evaluated using root mean square error (RMSE) and expert ratings. Emotional intensity was inferred from physiological (electrodermal activity) and behavioural (facial expressions) emotional responses. Emotional variability was calculated to understand fluctuations among multiple emotions. Emotional responses were mapped into task-relevant emotions, like sadness with boredom, and fear with anxiety. Results and Conclusions: The most frequent facial expressions neutral, anger and surprise. Neutral and anger were interpreted as deep focus states. Surprise was likely a response to unexpected events. Flying performance and emotional dynamics varied across training phases and difficulty levels. During introduction, performance was less accurate, and emotions were less frequent. During session A, performance improved while participants experienced more physiological arousal and emotional variability. During session B, performance was the most accurate. In high-difficulty tasks, performance was the least accurate, participants expressed emotions with more frequency, more variability and higher physiological arousal. Future studies can use simulated flying tasks for trainees to familiarize with their emotional reactions to task demands expecting to improve training outcomes.

This study compared the prognostic value of quantified thoracic artery calcium (TAC) including aortic arch on chest CT and coronary artery calcium (CAC) score on ECG-gated cardiac CT.MethodsA total of 2412 participants who underwent both chest CT and ECG-gated cardiac CT at the same period were included in the Multi-Ethnic Study of Atherosclerosis Exam 5. All participants were monitored for incident atherosclerotic cardiovascular disease (ASCVD) events. TAC is defined as calcification in the ascending aorta, aortic arch and descending aorta on chest CT. The quantification of TAC was measured using the Agatston method. Time-dependent receiver-operating characteristic (ROC) curves were used to compare the prognostic value of TAC and CAC scores.ResultsParticipants were 69±9 years of age and 47% were male. The Spearman correlation between TAC and CAC scores was 0.46 (p

IntroductionCoronary artery calcium (CAC) scans contain useful information beyond the Agatston CAC score that is not currently reported. We recently reported that artificial intelligence (AI)-enabled cardiac chambers volumetry in CAC scans (AI-CAC™) predicted incident atrial fibrillation in the Multi-Ethnic Study of Atherosclerosis (MESA). In this study, we investigated the performance of AI-CAC cardiac chambers for prediction of incident heart failure (HF).MethodsWe applied AI-CAC to 5750 CAC scans of asymptomatic individuals (52% female, White 40%, Black 26%, Hispanic 22% Chinese 12%) free of known cardiovascular disease at the MESA baseline examination (2000-2002). We used the 15-year outcomes data and compared the time-dependent area under the curve (AUC) of AI-CAC volumetry versus NT-proBNP, Agatston score, and 9 known clinical risk factors (age, gender, diabetes, current smoking, hypertension medication, systolic and diastolic blood pressure, LDL, HDL for predicting incident HF over 15 years.ResultsOver 15 years of follow-up, 256 HF events accrued. The time-dependent AUC [95% CI] at 15 years for predicting HF with AI-CAC all chambers volumetry (0.86 [0.82,0.91]) was significantly higher than NT-proBNP (0.74 [0.69, 0.77]) and Agatston score (0.71 [0.68, 0.78]) (p ​

The mechanisms of hepatic stellate cell (HSC) activation and the development of liver fibrosis are not fully understood. Here, we show that deletion of a nuclear seven transmembrane protein, TM7SF3, accelerates HSC activation in liver organoids, primary human HSCs, and in vivo in metabolic-dysfunction-associated steatohepatitis (MASH) mice, leading to activation of the fibrogenic program and HSC proliferation. Thus, TM7SF3 knockdown promotes alternative splicing of the Hippo pathway transcription factor, TEAD1, by inhibiting the splicing factor heterogeneous nuclear ribonucleoprotein U (hnRNPU). This results in the exclusion of the inhibitory exon 5, generating a more active form of TEAD1 and triggering HSC activation. Furthermore, inhibiting TEAD1 alternative splicing with a specific antisense oligomer (ASO) deactivates HSCs in vitro and reduces MASH diet-induced liver fibrosis. In conclusion, by inhibiting TEAD1 alternative splicing, TM7SF3 plays a pivotal role in mitigating HSC activation and the progression of MASH-related fibrosis.

Coronary artery calcium (CAC) scans contain valuable information beyond the Agatston Score which is currently reported for predicting coronary heart disease (CHD) only. We examined whether new artificial intelligence (AI) applied to CAC scans can predict non-CHD events, including heart failure, atrial fibrillation, and stroke. We applied AI-enabled automated cardiac chambers volumetry and calcified plaque characterization to CAC scans (AI-CAC) of 5830 asymptomatic individuals (52.2% women, age 61.7 ± 10.2 years) in the multi-ethnic study of atherosclerosis during 15 years of follow-up, 1773 CVD events accrued. The AUC at 1-, 5-, 10-, and 15-year follow-up for AI-CAC vs. Agatston score was (0.784 vs. 0.701), (0.771 vs. 0.709), (0.789 vs. 0.712) and (0.816 vs. 0.729) (p

Pseudoaneurysm is a rare but fatal complication of myocardial infarction (MI). With the advances in cardiovascular disease detection and treatments, fatal structural complications post-MI are now rare. When they occur, advanced diagnostic modalities can be used for early diagnosis, aiding surgical planning, and improving prognosis. In our case, post-MI left ventricle pseudoaneurysm complicated by hemopericardium was diagnosed using cardiac computed tomography angiography (CCTA). Use of attenuation measurement on CCTA helped diagnose active extravasation into the hemopericardium. This case highlights the high index of suspicion needed for rare but fatal complications post-MI and the utility of CCTA in their management.

Abstract Coronary artery calcium (CAC) scans contain valuable information beyond the Agatston Score which is currently reported for predicting coronary heart disease (CHD) only. We examined whether new artificial intelligence (AI) applied to CAC scans can predict non-CHD events, including heart failure, atrial fibrillation, and stroke. We applied AI-enabled automated cardiac chambers volumetry and calcified plaque characterization to CAC scans (AI-CAC) of 5830 asymptomatic individuals (52.2% women, age 61.7 ± 10.2 years) in the multi-ethnic study of atherosclerosis during 15 years of follow-up, 1773 CVD events accrued. The AUC at 1-, 5-, 10-, and 15-year follow-up for AI-CAC vs. Agatston score was (0.784 vs. 0.701), (0.771 vs. 0.709), (0.789 vs. 0.712) and (0.816 vs. 0.729) (p

Abstract The objective of pilot training is to equip trainees with the knowledge, judgment, and skills to maintain control of an aircraft and respond to critical flight tasks. The present research aims to investigate changes in trainees’ cognitive control levels during a pilot training process while they underwent basic flight maneuvers. EEG microstate analysis was applied together with spectral power features to quantitatively monitor trainees’ cognitive control under varied flight tasks during different training sessions on a flight simulator. Not only could EEG data provide an objective measure of cognitive control to complement the current subjective assessments, but the application of EEG microstate analysis is particularly well-suited for capturing rapid dynamic changes in cognitive states that may happen under complex human activities in conducting flight maneuvers. Comparisons were conducted between two types of tasks and across different training stages to monitor how pilot trainees’ cognitive control responds to varied flight task types and training stages. The present research provides insights into the changes in trainees’ cognitive control during a pilot training process and highlights the potential of EEG microstate analysis for monitoring cognitive control.

Iodixanol is an iso-osmolar non-ionic dimeric hydrophilic contrast agent with a higher viscosity than the monomeric agents. It is the only Food and Drug Administration (FDA)-approved iso-osmolar agent in the United States, and it is the only contrast agent with an FDA-approved indication for use in cardiac computed tomographic angiography (CCTA), to assist in the diagnostic evaluation of patients with suspected coronary artery disease. In clinical studies, it has been noted to have fewer side effects and similar image quality when compared to low-osmolar contrast media. This can be attributed to the pharmacological properties of iodixanol. These contrast agents are used for coronary computed tomography angiography and cardiac catheterization. In this article, the use, tolerability, and efficacy of iodixanol are reviewed, specifically evaluating the use of CCTA and coronary angiography, including outcome studies, randomized trials, and comparisons to other contrast agents.

Abstract Wastewater is a geospatially- and temporally-linked microbial fingerprint of a given population, making it a potentially valuable tool for tracking public health across locales and time. Here, we integrate targeted and bulk RNA sequencing (N = 2238 samples) to track the viral, bacterial, and functional content over geospatially distinct areas within Miami Dade County, USA, from 2020-2022. We used targeted amplicon sequencing to track diverse SARS-CoV-2 variants across space and time, and we found a tight correspondence with positive PCR tests from University students and Miami-Dade hospital patients. Additionally, in bulk metatranscriptomic data, we demonstrate that the bacterial content of different wastewater sampling locations serving small population sizes can be used to detect putative, host-derived microorganisms that themselves have known associations with human health and diet. We also detect multiple enteric pathogens (e.g., Norovirus) and characterize viral diversity across sites. Moreover, we observed an enrichment of antimicrobial resistance genes (ARGs) in hospital wastewater; antibiotic-specific ARGs correlated to total prescriptions of those same antibiotics (e.g Ampicillin, Gentamicin). Overall, this effort lays the groundwork for systematic characterization of wastewater that can potentially influence public health decision-making.

OBJECTIVE: This study aims to evaluate image quality in patients with heart rates above or equal to 70 beats per minute (bpm), performed on a 16 cm scanner (256-slice General Electric Revolution) in comparison to a CT scanner with only 4 cm of coverage (64 slice Volume CT). BACKGROUND: Recent advancements in image acquisition, such as whole-heart coverage in a single rotation and post-processing methods in coronary computed tomographic angiography (CCTA), include motion-correction algorithms, such as SnapShot Freeze (SSF), which improve temporal resolution and allow for the assessment of coronary artery disease (CAD) with lower motion scores and better image qualities. Studies from the comprehensive evaluation of high temporal- and spatial-resolution cardiac CT using a wide coverage system (CONVERGE) registry (a multicenter registry at four centers) have shown the 16 cm CT scanner having a better image quality in comparison to the 4 cm scanner. However, these studies failed to include patients with undesirable or high heart rates due to well-documented poor image acquisition on prior generations of CCTA scanners. METHODS: A prospective, observational, multicenter cohort study comparing image quality, quantitively and qualitatively, on scans performed on a 16 cm CCTA in comparison to a cohort of images captured on a 4 cm CCTA at four centers. Participants were recruited based on broad inclusion criteria, and each patient in the 16 cm CCTA arm of the study received a CCTA scan using a 256-slice, whole-heart, single-beat scanner. These patients were then matched by age, gender, and heart rate to patients who underwent CCTA scans on a 4 cm CT scanner. Image quality was graded based on the signal-to-noise ratio, contrast-to-noise ratio, and on a Likert scale of 0-4: 0, very poor-4, excellent. RESULTS: 104 patients were evaluated for this study. The mean heart rate was 75 ± 7 in the 4 cm scanner and 75 ± 7 in the 16 cm one (p = 0.426). The signal-to-noise and contrast-to-noise ratios were higher in the 16 cm scanner (p = 0.0001). In addition, more scans were evaluated as having an excellent quality on the 16 cm scanner than on the 4 cm scanner (p < 0.0001) based on a 4-point Likert scale. CONCLUSIONS: The 16 cm scanner has a superior image quality for fast heart rates compared to the 4 cm scanner. This study shows that there is a significantly higher frequency of excellent and good studies showing better contrast-to-noise and signal-to-noise ratios with the 16 cm scanner compared to the 4 cm scanner.

This study investigates human semicircular canal (SCC) dynamics under off-center rotational conditions. Previous research has modeled human rotational perception and the dynamic response of the SCCs by assuming a centered rotation state, where the rotation axis aligns with the SCC's center. However, this assumption is not representative of most real-life rotational situations. Understanding the effect of the offset distance between the rotation axis and the centers of the SCCs is essential, yet many studies still rely on bandpass filter models that do not account for this factor. Experimental studies are also limited, and mock-up models have difficulty accurately depicting these dynamics due to the cupula's low Young's modulus. Therefore, this study models endolymph and cupula within the SCCs using the finite element method (FEM) and a two-way fluid-structure interaction (FSI) approach. The results compare cupula displacement across different rotational conditions: step velocity motion (SVM), step acceleration motion (SAM), and sinusoidal motion. Notably, as the offset distance increases, the gain factor increases while the long time constant decreases. This finding highlights the limitations of existing centered rotation-based bandpass filter models. Based on these findings, we propose a modified transfer function that accounts for offset distance, offering a more generalizable model for human rotational perception and the dynamic responses of the SCCs. Additionally, this study provides foundational data to address sensory conflict, spatial disorientation, and various applications that require a precise dynamics model.

The aim of this study is to provide new insights on the age and growth of H. dactylopterus in the north-western Ionian Sea (central Mediterranean) by using different data sets and comparing three different methods, one direct by otolith reading corroborated by two indirect methods, by means of back calculation and Length Frequency Distribution analysis (LFDa), in order to obtain robust data for use in analytical management models. A total of 1403 specimens of blackbelly rosefish were sampled from habitats explored on muddy bottoms in the depth range 106-721 m and 309 individuals caught in the cold-water coral habitat between 418 and 635 m in depth. The length-frequency distributions of blackbelly rosefish showed a polymodal pattern in both habitats explored, with medium-small individuals caught on muddy bottoms and larger ones in coral habitats and canyons. The maximum age observed in females was 13 years (315 mm TL), while in males it was 15 years (336 mm TL), and no significant difference was observed comparing age-length keys from otolith readings of females with the males. The analysis of the daily increments allowed us to validate the average length of the first year of age (approximately 90-100 mm LT) obtained from the three different methods used. No significant difference was highlighted comparing the average lengths of age class 1, calculated with the direct method and by counting the daily increments. The von Bertalanffy growth parameters were estimated for the sexes and for the whole population from otolith readings and for the entire population by LFD analysis and the back calculation method. The growth curves were comparable between the different methods and no significant difference was observed. The von Bertalanffy growth parameters estimated for the different methods were comparable (otolith readings L∞ 494 mm, k=0.06 years-1, t0=-3.00 years; back calculation method L∞ 487 mm, k=0.06 years-1, t0=-2.30 years; LFDa L∞ 415 mm, k=0.07 years-1, t0=-2.23 years), indicating a slow growth in accordance with what has already been observed in other areas of the Mediterranean.

With the widespread applications of cobalt in energy storage, electronics, electric vehicles, and most importantly, in the production of 60Co in nuclear industries, its recovery from secondary sources is increasingly important. On the other hand, approximately half of the 440 operating nuclear reactors, across the world, are expected to be retired in the next two decades, creating a significant amount of radioactive waste that poses a serious threat to the ecosystem. But cobalt has low adsorption capacity under low pH conditions, and competitive ions make its recovery difficult. To the best of author's knowledge, the adsorption capacity of cobalt is mostly reported under 500 mgg-1. Firstly, this review provides a comprehensive overview of the physicochemical properties of cobalt isotopes. It then presents an in-depth analysis of various separation methods for cobalt from battery waste and nuclear wastewater, including physical-chemical, electrochemical, and biological methods. All techniques are evaluated based on their selectivity, efficiency, scalability, and environmental impact. By comparing state-of-the-art technology, this review aims to address existing gaps and advance our understanding of an efficient cobalt recovery from industrial waste. The review concludes with an overview of the global cobalt market, examining both radioactive and non-radioactive cobalt, and considers the economic implications of cobalt recovery.

IntroductionObesity constitutes a complex global health that carries several comorbidities that include cardiovascular disease, diabetes, and cancer. Current treatments, such as lifestyle modifications and bariatric surgery, are often difficult to implement or carry risks, creating a need for alternative approaches. Methylphenidate (MPH), a drug commonly used to treat Attention Deficit and Hyperactivity Disorder (ADHD), has shown potential in regulating dopamine levels to modulate appetite and feeding behaviors.MethodsThis narrative review evaluated the effect of MPH in reducing food intake, body weight, and anthropometric indicators in adults with obesity or overweight. Using the PICO method, 39 studies were selected, including 14 randomized controlled trials and 3 observational studies.ResultsMPH canblead to modest weight loss of 1–2% and significant appetite suppression, with stronger effects observed in women, who reported greater reductions in appetite and food cravings. Studies could remain underpowered to detect consistent effects in men.DiscussionEven if these results suggest MPH could be an option for treating obesity, concerns regarding its safety profile and long-term efficacy persist. This review underscores the need for further investigation to confirm MPH’s therapeutic potential, particularly through studies that address gender-specific responses and evaluate its sustainability as a weight management tool.

Objetivo: O diagnóstico de tromboembolismo venoso (TEV) na infância aumentou nas últimas décadas. O avanço no reconhecimento dos eventos tromboembólicos, bem como as particularidades na população pediátrica, baseia-se principalmente na elaboração de registros, bancos de dados e estudos de coorte retrospectivos. Desde 2016, um registro prospectivo de tromboembolismo em crianças foi iniciado no Instituto da Criança/Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICR-HCFMUSP). O objetivo foi descrever o perfil epidemiológico da trombose venosa pediátrica em um serviço de saúde terciário em São Paulo. Métodos: Análise retrospectiva do registro institucional de doença tromboembólica pediátrica (idade < 18 anos) de janeiro de 2016 a novembro de 2022. Foram avaliados dados demográficos, fatores predisponentes, local da trombose, diagnóstico radiológico, trombofilias, intervenções terapêuticas e desfechos. Resultados: No período do estudo, foram registrados 256 eventos, 142 (55,5%) afetando o sexo masculino. Foram relatadas 164 tromboses venosas, além de 66 tromboses intracardíacas e 26 embolias pulmonares. O sistema venoso superior foi sítio de TEV em 74 casos (28,9%) e o sistema venoso profundo inferior em 44 (17,2%). A trombose venosa cerebral foi diagnosticada em dezenove pacientes (7,4%) e em 27 crianças (10,5%) os eventos tromboembólicos foram em sítios incomuns. Um pico de prevalência foi observado em crianças de 1 a 5 anos, inesperadamente. Dos 256 eventos reportados, 198 (77,3%) estavam relacionados a cateter venoso central e 153 (59,7%) pacientes apresentavam infecção aguda. História prévia de doença crônica foi relatada em 69,9% dos pacientes registrados. As doenças mais prevalentes foram câncer (28,1%), doença renal (12,5%) e doença cardíaca (10,9%). A ultrassonografia doppler foi o exame mais utilizado para o diagnóstico de trombose venosa profunda (46,0%), seguida pela tomografia computadorizada em 46 pacientes (18,0%). O perfil de trombofilia foi investigado em 26 casos (10,2%); destes, seis (2,3%) apresentavam alterações. Terapia antitrombótica foi administrada em 86,0% dos eventos referidos, sendo heparina de baixo peso molecular utilizada isoladamente em 89,8% dos pacientes, seguida de heparina não fracionada. Trombólise após tratamento conservador foi realizada em oito pacientes (3,6%). O acompanhamento por imagem demonstrou recanalização em 71,0% dos eventos (total em 47,6% e parcial em 23,4%). Discussão: O presente estudo demonstrou concordância com a análise dos principais Bancos de dados e registros publicados na literatura. Os casos de TEV foram mais prevalentes no sexo masculino, associaram-se a dois ou mais fatores de risco em sua maioria, sendo o cateter venoso central o mais descrito, seguido de infeção e doença crônica. Ultrassonografia com estudo doppler foi o método diagnóstico por imagem mais utilizado, seguido de tomografia computadorizada. A pesquisa de trombofilia não foi realizada de rotina. A modalidade terapêutica mais utilizada, heparina de baixo peso molecular, também foi a mesma descrita na literatura. Conclusão: Apesar das limitações, este estudo oferece dados relevantes sobre TEV pediátrico em um serviço de saúde terciário no Brasil. Os resultados são semelhantes aos descritos em outros registros pediátricos e contribuem para o estabelecimento de uma rede para estudos futuros.

Objetivos: Descrever o 1ºcaso pediátrico de trombose venosa cortical (TVC) secundária a traumatismo cranioencefálico (TCE) não intencional, revisar a literatura e alertar os hematologistas e pediatras desta possibilidade diagnóstica. Material e métodos: Estudo retrospectivo de revisão de prontuário e revisão de literatura (PubMed,filtro trombose cerebral secundária a trauma craniano, idade 0-18 anos,entre 1990-2024). Resultados: Menina, 4 meses, previamente hígida, engasgou-se com alimento, seguido de apneia, cianose, perda de consciência econvulsão. No Pronto Socorro evoluiu comsonolência, hipoatividade, irritação,nova convulsão, observada paresia no braço esquerdo e hemorragia retiniana.Semsangramento/trombose na família. Exames de imagem comTVC aguda direita, trombose do seio dural, sinais de infarto venoso e coleção subduraldireita extra axial pequena sugestiva de hematoma.Revisão de vídeo da câmera doméstica revelou TCE e trauma cervical relacionado às manobras repetidas de hiperextensão e hiperflexão durante esforço de reanimação enquanto a criança estava inconsciente. Medicada com fenobarbital, levetiracetam e heparina de baixo peso molecular (anti-Xa 0,5 UI/mL), com melhora progressiva dos sintomas. Após 3 meses de tratamento houve resolução completa dos achados de imagem e recuperação neurológica, sendo suspensa aanticoagulação. Sem sangramento/piora da hemorragia retiniana durante o tratamento, com regressão da coleção subdural extra-axial direita. Discussão: Não há publicação de caso de TVC secundária a TCE não intencional em pediatria. A TVC é muito rara em crianças, a apresentação clínica é inespecífica, está associada a trombose de seio venoso cerebral (TSVC) importante e associada a um ou mais fatores de risco (infecção, desidratação, doenças renais, TCE e doenças oncológicas). Apesar das semelhanças clínicas com a Lesão Cerebral Traumática Infligida (LCTI, síndrome do bebê sacudido), o abuso foi descartado. A LCTI tem achados clínicos, radiológicos e patológicos específicos, incluindo convulsões, alteração da consciência e déficits neurológicos semelhantes à TVC e TSVC. O desafio diagnóstico decorre do quadro clínico inespecífico. A hemorragia retiniana, normalmente associada a TCE abusivo, não foi grave. As causas primárias de trombose foram excluídas (infecção, trombofilia hereditária, malformações arteriais e venosas). Os repetidos movimentos de hiperextensão e hiperflexão do pescoço podem ter contribuído para o desenvolvimento da TVC. O manejo da TVC incluiu anticoagulação, porém a literatura é escassa pela raridade da TVC na pediatria. Apesar da possibilidade de a TVC causar sequelas neurológicas duradouras, a paciente não apresentou déficits cognitivos ou motores persistentes. A pesquisa de literatura encontrou 9 relatos de caso, nenhum deles com TVC associada ou lesões secundárias a TCE não intencional. Como os principais fatores de risco para trombose foram descartados, a hemorragia retiniana e ohematoma subdurallevaram à suspeita de trauma por LCTI, suspeita descartada após investigação detalhada da história. Conclusão: Este relato ressalta a importância de considerar trombose relacionada a trauma em pediatria, mesmo na ausência de indicadores evidentes de abuso. É importante excluir as principais causas de trombose, incluindo as traumáticas. Os riscos e benefícios da terapia anticoagulantepara melhora dos sintomasdeve ser ponderada e individualizada, mesmo na ausência de evidências mais robustas.

Aim: Describe the clinical profile, treatment, and outcome of the patients with Cerebral Venous Thrombosis (CVT). Materials and methods: Single-center retrospective study of pediatric CVT patients (< 18y) treated between October 2003 and December 2023. Results: We analyzed 44 patients,59.1% were male;median age 5.6 years (1 day-16.1).Headache (40.9%), seizure (27.3%) and vomit (27.3%) were common presenting clinical features.CT or MRI scans were performed in 65.9% of the patients, and 34.1% presented intracranial hemorrhage at the admission.Sigmoid sinus (61.4%), sagittal (59.1%), and transverse (52.3%) were the common sites of thrombosis.Risk factors included infection (47.6%), catheter (21.4%), cancer (18.2%), and head trauma (15.9%).All patients with trauma presented bleeding at the diagnosis, and 2 patients (4.5%) required surgical intervention.Fourty-one patients (93.2%) received anticoagulant therapy (low molecular- weight heparin, 78.0%; unfractionated heparin, 18.2%).Two patients (4.5%) had no clinical condition to treat, and one (2.3%) lost follow up.None patient underwent mechanical thrombectomy.One patient (2.3%) on anticoagulant therapy experienced major bleeding.Partial recanalization was achieved in 23 (59.0%), and complete recanalization in 16 (41.0%).Eight patients (18.2%) presented neurological sequelae. No child died due to thrombosis or treatment.Thrombophilia tests were performed in 3patients (6.8%), without risk factors identified.High lipoprotein (a) [Lp(a)], lupus anticoagulant (LAC), and heterozygous protein S deficiency were detected.In addition, 18 patientswith identified triggers underwent thrombophilia screening,and 55.5% presented a positivetest result (4: high Lp(a), 2: LAC, 3: prothrombin G20210A mutation, 1: heterozygous protein C deficiency). Discussion: The age distribution of pediatric thrombosis is bimodal, revealing peaks in neonates and adolescents. CVT is common in neonates (40%) because they have lower concentrations of anticoagulant proteins, and some patients have congenital heart disease. Our median age (5,6y) probablyi s related to the limited hematological evaluations requested in the neonatal ICU and the cardiology unit.Our results are consistent with literature. In children, the most common symptoms are headache, vomit and altered level of consciousness;and the main risk factors are contiguity head and neck infections, cancer, catheter, and head trauma.In spite of the anticoagulant treatment in the acute phase is controversial, due to an increased risk of hemorrhage during treatment, fourty-one patients (93.2%) were treated, and our frequenceof major bleeding was similar with the literature (2.3-6.0%), without any death.According to literature, the overall mortality rate that varies from 3.0 to 4.2%. Although many studies suggest that thrombophilia screening is unnecessary in patients with an identified trigger factor, 10 patients (55.5%) presented a positive thrombophlia test result. Despite de limitations of our study, this prompts us to reconsider whether thrombophilia screening should be performed for our patients, as such identification could influence their management. Conclusion: Pediatric CVT is rare,requiring early suspicion, and diagnosis. Although treatment issues are not well defined, there is evidence that anticoagulation has an important role in all age groups. Clinical trials are essential to address the optimal therapeutics, efficacy, morbidity and mortality in this disease.