Anaphylaxis in Association with Heparin-Induced Thrombocytopenia

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.     

Floc size distribution in a stirred suspension.

This paper focuses on the distribution of alumino-humic flocs found in a stirred suspension. Distributions were scaled using the transformation u = d/dL in which d is floc diameter and dL its arithmetic mean value and fitted by a gamma distribution. Flocs were treated as monofractal with solids mass concentration specified by C = A'rhos (d/do)D-3 in which A' is a packing coefficient, rhos the density of the floc solids, D the fractal dimension and do a reference size. It was shown that the overall solids concentration (M) complies with the dependence M proportional to NA'dDL-S(D) in which N is the number of flocs per unit volume and S(D) a distribution moment. Initial estimates of A' and D were obtained from analysis of floc sedimentation behaviour. From knowledge of the base parameters, the calculated value of M did not match the measured M and varied with shear. This was attributed to a kinematic influence on C over and beyond changes associated with the response of dL to shear. Issues of self-similarity were examined and it was concluded that distributions did not display strict self-similarity. Data are provided on the size distribution found in the flocculators of a treatment works at full scale.     

Using Automated Negotiation for Grid Services

The popularity of grid services has widened their application to numerous domains and increased the utilization of computational resources. In order to create more incentives for the resources owners to lease their resources and prevent users from wasting the resources, the introduction of a market-oriented grid is inevitable. However, the issues for the negotiation between service provider and consumer over the supply and demand of resources can be complex, with highly interdependent issues. In this research, a simulated automated negotiation mechanism including a co-evolutionary mechanism and a modified game theory approach is proposed, to assist them in reaching an agreement over the conflicting issues. In the proposed architecture, the co-evolution process is able to reduce the multiple dimensional search space into a two-dimension search space and identify the appropriate negotiation strategies for the negotiating agents to form a payoff matrix which can be used for the game theory related stage of their interaction. The multiple stage negotiation process is introduced to improve the negotiation result. In this paper, an application which requires a large amount of computational resources to process the data generated from mobile devises is used to demonstrate that the proposed system is able to resolve the conflicts and obtain a valid solution.     

Harmonic and intermodulation performance in an R-LED series network

Analytical expressions are obtained for predicting the harmonic and intermodulation performance of R-LED series networks. These expressions are in terms of the ordinary Bessel functions with arguments depenedent on the modulation index.     

Temporal and Spatial Assessment of Supply and Demand of the Water-yield Ecosystem Service for Water Scarcity Management in Arid to Semi-arid Ecosystems

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.

     

The Bivariate Transmuted Family of Distributions: Theory and Applications

The bivariate distributions are useful in simultaneous modeling of two random variables. These distributions provide a way to model models. The bivariate families of distributions are not much widely explored and in this article a new family of bivariate distributions is proposed. The new family will extend the univariate transmuted family of distributions and will be helpful in modeling complex joint phenomenon. Statistical properties of the new family of distributions are explored which include marginal and conditional distributions, conditional moments, product and ratio moments, bivariate reliability and bivariate hazard rate functions. The maximum likelihood estimation (MLE) for parameters of the family is also carried out. The proposed bivariate family of distributions is studied for the Weibull baseline distributions giving rise to bivariate transmuted Weibull (BTW) distribution. The new bivariate transmuted Weibull distribution is explored in detail. Statistical properties of the new BTW distribution are studied which include the marginal and conditional distributions, product, ratio and conditional momenst. The hazard rate function of the BTW distribution is obtained. Parameter estimation of the BTW distribution is also done. Finally, real data application of the BTW distribution is given. It is observed that the proposed BTW distribution is a suitable fit for the data used.     

A review on fault detection and diagnosis techniques: basics and beyond

Safety and reliability are absolutely important for modern sophisticated systems and technologies. Therefore, malfunction monitoring capabilities are instilled in the system for detection of the incipient faults and anticipation of their impact on the future behavior of the system using fault diagnosis techniques. In particular, state-of-the-art applications rely on the quick and efficient treatment of malfunctions within the equipment/system, resulting in increased production and reduced downtimes. This paper presents developments within Fault Detection and Diagnosis (FDD) methods and reviews of research work in this area. The review presents both traditional model-based and relatively new signal processing-based FDD approaches, with a special consideration paid to artificial intelligence-based FDD methods. Typical steps involved in the design and development of automatic FDD system, including system knowledge representation, data-acquisition and signal processing, fault classification, and maintenance related decision actions, are systematically presented to outline the present status of FDD. Future research trends, challenges and prospective solutions are also highlighted.

     

A dynamic variability management approach working with agile product line engineering practices for reusing features

The Journal of Supercomputing - Agile software development (ASD) and software product line (SPL) have shown significant benefits for software engineering processes and practices. Although both...     

Collaborative detection and mitigation of DDoS in software-defined networks

The Journal of Supercomputing - This research presents the detection and mitigation of distributed denial of service (DDoS) in software defined networks (SDN). The proposed method consists of three...     

Smart home security: challenges,issues and solutions at different IoT layers

The Journal of Supercomputing - The Internet of Things is a rapidly evolving technology in which interconnected computing devices and sensors share data over the network to decipher different...