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
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
Protection of Metals and Physical Chemistry of Surfaces - Corrosion protective coatings were developed on 1050 aluminum alloy through the sol–gel process using... 相似文献
The thermomechanical behavior of micro/nano-alumina (Al2O3) ceramics reinforced with 1-5 wt.% of acid-treated oil fly ash (OFA) was investigated. Composites were sintered using spark plasma sintering (SPS) technique at a temperature of 1400°C by applying a constant uniaxial pressure of 50 MPa. It was evaluated that the fracture toughness of micro- and nanosized composites improved in contrast with the monolithic alumina. Highest fracture toughness value of 4.85 MPam1/2 was measured for the nanosized composite reinforced with 5 wt.% OFA. The thermal conductivity of the composites (nano-/microsized) decreased with the increase in temperature. However, the addition of OFA (1-5 wt.%) in nanosized alumina enhanced the thermal conductivity at an evaluated temperature. Furthermore, a minimum thermal expansion value of 6.17 ppm*K−1 was measured for nanosized Al2O3/5 wt.% OFA composite. Microstructural characterization of Al2O3-OFA composites was done by x-ray diffraction and Raman spectroscopy. Oil fly ash particles were seen to be well dispersed within the alumina matrix. Moreover, the comparative analysis of the nano-/microsized Al2O3/OFA composites shows that the mechanical and thermal properties were improved in nanosized alumina composites. 相似文献