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
Numerical simulation has been used to construct the concentration profiles of Ga and P atoms in In-rich melt at successive equally spaced layers in front of an InGaP crystal growing under normal conditions of liquid phase epitaxy (LPE). The growth rate has been calculated using the concentration gradient at the interface. The composition and the thickness of the InGaP solid grown as a function of growth parameters, such as cooling rate, system temperature and time, have been studied. It is observed that the thickness grown depends on the cooling rate, whereas the solid composition is independent of the cooling rate. The theoretical findings of our model have been compared with experimentally reported values and the results are discussed in detail. 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 work, the effect of various effective dimensionless numbers and moisture contents on initiation of instability in combustion of moisty organic dust is calculated. To have reliable model, effect of thermal radiation is taken into account. One- dimensional flame structure is divided into three zones: preheat zone, reaction zone and post-flame zone. To investigate pulsating characteristics of flame, governing equations are rewritten in dimensionless space-time ((, r/, ~) coordinates. By solving these newly achieved governing equations and combining them, which is completely discussed in body of article, a new expression is obtained. By solving this equation, it is possible to predict initiation of instability in organic dust flame. According to the obtained results by increasing Lewis number, threshold of instability happens sooner. On the other hand, pulsating is postponed by increasing Damk6hler number, pyrolysis temperature or moisture content. Also, by considering thermal radiation effect, burning velocity predicted by our model is closer to experimental results. 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
Though various efforts on modification of electrodes are still undertaken to improve the efficiency of perovskite solar cells, attributing to the large scope of these methods, it is of significance to unveil the working principle systematically. Herein, inverted perovskite solar cells based on indium tin oxide (ITO)/poly(3,4‐ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS)/CH3NH3PbI3/phenyl‐C61‐butyric acid methyl ester (PC61 BM)/buffer metal/Al are constructed. Through the choice of different buffer metals to tune work function of the cathode, the contact nature of the active layer with the cathode could be manipulated well. In comparison with the device using Au/Al as the electrode that shows an unfavorable band bending for conducting the excited electrons to the cathode, the one with Ca/Al presents a dramatically improved efficiency over 17.1%, ascribed to the favorable band bending at the interface of the cathode with the active layer. Details for tuning the band bending and the corresponding charge transfer mechanism are given in a systematic manner. Thus, a general guideline for constructing perovskite photovoltaic devices efficiently is provided. 相似文献