Prolonged Use of Ertapenem to Treat Infected Diabetic Foot Ulcers

We present the case of a diabetic man who was successfully treated with ertapenem for over 4 months for severe infection of his foot ulcers. After initial unsuccessful treatment with empirical intravenous antibiotics, ertapenem was started on microbiology advice and led to a marked improvement in the soft-tissue infection. Ertapenem was continued for a total of 137 days under close clinical and biochemical monitoring and produced a complete resolution of the foot infection. This is the first documented case that we know of in which ertapenem has been safely used for this duration of time

Migration from Circuit Switch PSTN to Packet Switch IP Platform BT 21st Century Network (21CN)

The last 30 years have seen huge technological and commercial developments in the field of telecommunications. The main product of the telecommunications industry has until recently been voice telephony. With the growth of data and multimedia services in the last decade the role of voice telephony is changing. In recent years telecommunications manufacturers have begun producing and marketing a new network concept for voice services entitled Next Generation Networks (NGN). These networks are based on packet switching technology as opposed to the circuit switching technology traditionally used in voice telephony. And telecom carriers like BT are replacing their Circuit switch based PSTN equipments by packet switching based Next Generation Networks products. Therefore in this study analysis and observation have been done of that process of migration from PSTN to IP/MPLS. Only BT has fully in progress for this migration through their 21 Century Network Project up till now and layout their plan for broadband dial tone to every customer till 2009. This study examine the each domain of the 21CN of BT and design architecture for each domain, new services and physical network and main companies involve in this project and the identification of the equipments that will be deploying in each domain of 21CN of BT with their features and functions and most importantly the advantages of the Next generation networks for the Customers and the telecom operatorsFaculty of Technolog

Tourmaline from the Archean G.R.Halli gold deposit, Chitradurga greenstone belt, Dharwar craton (India): Implications for the gold metallogeny

Tourmaline occurs as a minor but important mineral in the alteration zone of the Archean orogenic gold deposit of Guddadarangavanahalli (G.R.Halli) in the Chitradurga greenstone belt of the western Dharwar craton, southern India. It occurs in the distal alteration halo of the G.R.Halli gold deposit as (a) clusters of very fine grained aggregates which form a minor constituent in the matrix of the altered metabasalt (AMB tourmaline) and (b) in quartz-carbonate veins (vein tourmaline). The vein tourmaline, based upon the association of specific carbonate minerals, is further grouped as (i) albite-tourmaline-ankerite-quartz veins (vein-1 tourmaline) and (ii) albite-tourmaline-calcite-quartz veins (vein-2 tourmaline). Both the AMB tourmaline and the vein tourmalines (vein-1 and vein-2) belong to the alkali group and are classified under schorl-dravite series. Tourmalines occurring in the veins are zoned while the AMB tourmalines are unzoned. Mineral chemistry and discrimination diagrams reveal that cores and rims of the vein tourmalines are distinctly different. Core composition of the vein tourmalines is similar to the composition of the AMB tourmaline. The formation of the AMB tourmaline and cores of the vein tourmalines are proposed to be related to the regional D1 deformational event associated with the emplacement of the adjoining ca. 2.61 Ga Chitradurga granite whilst rims of the vein tourmalines vis-à-vis gold mineralization is spatially linked to the juvenile magmatic accretion (2.56–2.50 Ga) east of the studied area in the western part of the eastern Dharwar craton

Robust design of a closed-loop supply chain considering multiple recovery options and carbon policies under uncertainty

Increasing global warming, climate change and stringent governmental legislations are driving industry practitioners and decision makers to implement various strategies to reduce carbon emissions. One of the effective approaches to mitigate carbon emissions is the implementation of closed-loop supply chain (CLSC). The key motivation for considering multiple recovery options in the CLSC is to capture the remaining economic value and to reduce carbon emissions in the collection and recovery operations. Customer's willingness to return used product depends on the acquisition price and nearness to the collection center. This research proposes a deterministic mixed-integer linear programming (MILP) model for a multi-period and multi-product CLSC network under carbon pricing and carbon trading policies consideration. The model includes different acquisition price for returned products and multiple recovery options. Further, the study takes into consideration uncertainty in procurement cost, demand, and quantity of returned products. A robust optimization approach is adopted to address uncertainty in network parameters. Numerical results show that the proposed model captures trade-offs between total cost and carbon emission. Overall, the study reveals that the carbon trading policy incurs relatively lower total cost compared to the carbon pricing policy. Repair and recycling activities in the reverse supply chain contribute significantly to the total cost and carbon emission. This study provide evidence that it is possible to achieve an optimal CLSC network with reduced carbon emission at a moderate total supply chain cost. The proposed model could be used to guide firms to choose an appropriate budget of uncertainty toward achieving a robust supply chain network

Robust optimization for closed-loop supply chain network design considering carbon policies under uncertainty

Climate change attributed by greenhouse gas emissions have triggered some countries to implement various carbon regulatory mechanisms to curb and regulate industrial carbon emissions. To be effective, the industry environmental footprint needs to address holistically via closed-loop supply chains (CLSC). This research proposes an optimization approach to address CLSC design problem with carbon footprint considerations. It integrates the carbon emission policies into supply chain's strategic, tactical and operational selection decisions. A robust counterpart of the proposed model is developed based on three alternative uncertainty sets. The model extends further to investigate the impact of the three commonly practiced carbon regulatory policies including carbon cap, carbon tax, and carbon cap-And-Trade on the supply chain strategic and operational decisions. Numerical results indicate that carbon cap-And-Trade policy is the most flexible and efficient policy as compared to carbon cap and carbon tax policies. This study provides insightful observations with respect to robust optimization, CLSC network decisions, and carbon emissions. The proposed robust optimization models could be useful to decision-makers to achieve a robust supply chain network which can withstand any possible uncertainty in a given uncertainty set