Heparin is almost universally used as an anticoagulant during hemodialysis. Rare but serious side effects of heparin therapy include heparin‐induced thrombocytopenia (HIT) and anaphylaxis, and these may lead to significant mortality and morbidity if left unrecognized. We are reporting a patient who developed HIT followed by an anaphylactoid reaction. This 8‐year‐old girl with Joubert's syndrome developed end‐stage renal disease secondary to nephronophthisis. She had a Permacath double‐lumen hemodialysis catheter placed in the right internal jugular vein and was started on hemodialysis using an Asahi B10 65 Dialyzer on 1/28/03. The platelet count at that time was 246 × 103/mL. Beef lung heparin was used for anticoagulation. She was admitted for living related donor renal transplant on 2/10/03 but was found to be thrombocytopenic with a platelet count of 49 × 103/mL. The transplant was postponed, a sepsis work‐up was performed, and she was started on antibiotics pending culture results. Hemodialysis was continued with heparin anticoagulation, and despite an improvement in the platelet count she had an acute anaphylactoid reaction 2 days later. The reaction occurred 20 min after starting her hemodialysis treatment and presented as acute onset of bronchospasm, agitation, and chest discomfort. She improved with nebulized albuterol and subcutaneous epinephrine. A review of her records revealed that she had received 6 hemodialysis treatments. The platelet count on 2/3/03, after 3 hemodialysis treatments, had been 242 × 103/mL and on 2/8/03 after 5 treatments the platelet count was 72 × 103/mL. HIT with anaphylaxis was suspected. Heparin was discontinued and the platelet count had returned to normal within 2 days. The diagnosis was confirmed by a positive heparin‐associated antibody test. While HIT is recognized as a complication in 1–5% of patients treated with heparin and has been well described in the literature, we could only find 2 reported cases of heparin‐induced anaphylaxis and in both cases there was accompanying thrombocytopenia. This patient further illustrates a possible linkage between these two phenomena. HIT is an important cause of thrombocytopenia in a patient on hemodialysis and continued exposure to heparin may induce anaphylaxis. 相似文献
Water scarcity is one of the problems affecting people’s livelihoods in arid and semi-arid areas, requiring a sustainable balance between water demands and water resources. This study was carried out to assess temporal and spatial distribution of water supply and demand in order to help managers to overcome water scarcity in Jiroft basin, southeastern Iran. Spatial supply and demand of water were mapped and standardized rainfall index (SPI) was used to assess drought for a 20 years period (1994–2014). Supply and demand of water were matched in 23% of the basin area, mostly concentrated in the cold zones. Water supply was reduced up to 80% during dry years, declining water supply-demand matching to 5% of the basin area. Shrub-grass rangelands and deciduous woodlands were the most valuable land covers for conservation with $ 1,100 and $ 936 per hectare water prices respectively. Water value dropped more than 72% in mismanaged ecosystems (p?<?0.01). Our finding showed that water supply-demand ratio can be used as a proxy of ecosystem health and water-yield, which can provide a good information for water resources managers to reduce the threats of water scarcity in arid and semi-arid regions.
Multimedia Tools and Applications - Deep learning (DL) is a type of machine learning capable of processing large quantities of data to provide analytic results based on a particular... 相似文献
Metallic foams are a class of porous materials widely used in the industry because of their advantages. In recent years, extensive studies on the behavior of these materials have been conducted. Several constitutive equations have also been presented and applied. This study proposes a new constitutive equation that predicts metallic foam behavior using the stress–strain curve in uniaxial compression. The proposed model offers a new functionality for work hardening and is evaluated for both isotropic and combined hardening. The constitutive equations are implemented in MATLAB and integrated using return mapping algorithm. The material parameters are identified using genetic algorithm and through a comparison of the experimental and numerical results. The aluminum foams discussed in this paper are the commercially available types, Foaminal and Alporas. The comparison of numerical and experimental results indicate that this new constitutive equation predicts foam behavior in a reasonable manner. Moreover, a good agreement is observed between the experimental and computational curves. 相似文献
A bipartite state is classical with respect to party A if and only if party A can perform nondisruptive local state identification (NDLID) by a projective measurement. Motivated by this we introduce a class of quantum correlation measures for an arbitrary bipartite state. The measures utilize the general Schatten p-norm to quantify the amount of departure from the necessary and sufficient condition of classicality of correlations provided by the concept of NDLID. We show that for the case of Hilbert–Schmidt norm, i.e., \(p=2\), a closed formula is available for an arbitrary bipartite state. The reliability of the proposed measures is checked from the information-theoretic perspective. Also, the monotonicity behavior of these measures under LOCC is exemplified. The results reveal that for the general pure bipartite states these measures have an upper bound which is an entanglement monotone in its own right. This enables us to introduce a new measure of entanglement, for a general bipartite state, by convex roof construction. Some examples and comparison with other quantum correlation measures are also provided. 相似文献
In this paper, we present the feed-forward neural network (FFNN) and recurrent neural network (RNN) models for predicting Boolean function complexity (BFC). In order to acquire the training data for the neural networks (NNs), we conducted experiments for a large number of randomly generated single output Boolean functions (BFs) and derived the simulated graphs for number of min-terms against the BFC for different number of variables. For NN model (NNM) development, we looked at three data transformation techniques for pre-processing the NN-training and validation data. The trained NNMs are used for complexity estimation for the Boolean logic expressions with a given number of variables and sum of products (SOP) terms. Both FFNNs and RNNs were evaluated against the ISCAS benchmark results. Our FFNNs and RNNs were able to predict the BFC with correlations of 0.811 and 0.629 with the benchmark results, respectively. 相似文献
This paper introduces a Transimpedance Amplifier (TIA) design capable of producing an incremental input resistance in the ohmic range, for input signals in the microampere range, such as are encountered in the design of instrumentation for electrochemical ampero-metric sensors, optical-sensing and current-mode circuits. This low input-resistance is achieved using an input stage incorporating negative feedback. In a Cadence simulation of an exemplary design using a 180 nm CMOS process and operating with?±?1.8 V supply rails, the input resistance is 1.05 ohms and the power dissipation is 93.6 µW. The bandwidth, for a gain of 100 dBohm, exceeded 9 MHz. For a 1µA, 1 MHz sinusoidal input signal the Total Harmonic Distortion, with this gain, is less than 1%. The input referred noise current with zero photodiode capacitance is 2.09 pA/√Hz and with a photodiode capacitance of 2pF is 8.52 pA/√Hz. Graphical data is presented to show the effect of a photodiode capacitance varying from 0.5 to 2 pF, when the TIA is used in optical sensing. In summary, the required very low input resistance, at a low input current level (µA) is achieved and furthermore a Table is included comparing the characteristics and a widely used Figure of Merit (FOM) for the proposed TIA and similar published low-power TIAs. It is apparent from the Table that the FOM of the proposed TIA is better than the FOMs of the other TIAs mentioned.