Diabetic Foot Due to Anaphylactic Shock: A Case Report

Introduction: Diabetic foot is a clinical disorder, which is commonly seen in patients with diabetes mellitus. It is also the major cause of below knee amputation in the world. There are many underlying causes such as neuropathic, ischemic, and infectious causes for diabetic foot. Local or systemic complications may develop after snake bite. Case Presentation: We reported a very rare case, involving a 78-year-old male admitted to the Emergency Department, who developed anaphylactic shock and diabetic foot after the snake bite. Conclusions: Reviewing the literature, this is the second reported case of snake bite associated with diabetic foot

Shifting network tomography toward a practical goal

Boolean Inference makes it possible to observe the congestion status of end-to-end paths and infer, from that, the congestion status of individual network links. In principle, this can be a powerful monitoring tool, in scenarios where we want to monitor a network without having direct access to its links. We consider one such real scenario: a Tier-1 ISP operator wants to monitor the congestion status of its peers. We show that, in this scenario, Boolean Inference cannot be solved with enough accuracy to be useful; we do not attribute this to the limitations of particular algorithms, but to the fundamental difficulty of the Inference problem. Instead, we argue that the "right" problem to solve, in this context, is compute the probability that each set of links is congested (as opposed to try to infer which particular links were congested when). Even though solving this problem yields less information than provided by Boolean Inference, we show that this information is more useful in practice, because it can be obtained accurately under weaker assumptions than typically required by Inference algorithms and more challenging network conditions (link correlations, non-stationary network dynamics, sparse topologies). © 2011 ACM

Effect of Loading Rate and Time Delay on the Tangent Modulus Method (TMM) in Coal and Coal Measured Rocks

Non-destructive techniques of in-situ stress measurement from oriented cored rocks have great potential to be developed as a cost cost-efective and reliable alternative to the conventional overcoring and hydraulic fracturing methods. The tangent modulus method (TMM) is one such technique that can be applied to oriented cored rocks to measure in-situ stresses. Like the deformation rate analysis (DRA), the rock specimen is subjected to two cycles of uniaxial compression and the stresstangent modulus curve for the two cycles is obtained from the stress–strain curve. A bending point in the tangent modulus curve of the frst cycle is observed, separating it from the tangent modulus curve of the second cycle. The point of separation between the two curves is assumed to be the previously applied maximum stress. A number of experiments were conducted on coal and coal measured rocks (sandstone and limestone) to understand the efect of loading conditions and the time delay. The specimens were preloaded, and cyclic compressions were applied under three diferent modes of loading, four diferent strain rates, and time delays of up to one week. The bending point in the stress-tangent modulus curves occurred approximately at the applied pre-stress levels under all three loading modes, and no efect of loading rate was observed on the bending points in TMM. However, a clear efect of time delay was observed on the TMM, contradicting the DRA results. This could be due to the sensitivity of TMM and the range of its applicability, all of which need further investigation for the in-situ stress measurement.Zulfqar Ali, Murat Karakus, Giang D. Nguyen, Khalid Amrouc

Compressive Creep Performance and High Temperature Dimensional Stability of Conventional Silica Refractories

Furnace designers and refractory engineers recognize that optimized furnace superstructure design and refractory selection are needed as glass production furnaces are continually striving toward greater output and efficiencies. Harsher operating conditions test refractories to the limit, while changing production technology (such as the conversion to oxy-fuel from traditional air-fuel firing) can alter the way the materials perform. Refractories for both oxy- and air-fuel fired furnace superstructures are subjected to high temperatures during service that may cause them to excessively creep or subside if the refractory material is not creep resistant, or if it is subjected to high stress, or both. Furnace designers can ensure that superstructure structural integrity is maintained if the creep behavior of the refractory material is well understood and well represented by appropriate engineering creep models. Several issues limit the abilities of furnace designers to (1) choose the optimum refractory for their applications, (2) optimize the engineering design, or (3) predict the service mechanical integrity of their furnace superstructures. Published engineering creep data are essentially non-existent for almost all commercially available refractories used for glass furnace superstructures. The limited data that do exist are supplied by the various refractory suppliers. Unfortunately, these suppliers generally have different ways of conducting their mechanical testing and they also interpret and report their data differently; this makes it hard for furnace designers to draw fair comparisons between competing grades of candidate refractories. Furthermore, the refractory supplier's data are often not available in a form that can be readily used for furnace design and for the prediction and design of long-term structural integrity of furnace superstructures. With the aim of providing such comparable data, the US DOE's Office of Industrial Technology and its Advanced Industrial Materials program is sponsoring work to conduct creep testing and analysis on refractories of interest to the glass industry. An earlier stage of the project involved identifying which refractories to test and this is described elsewhere. Conventional silica was one such identified refractory category, and the present report describes the creep behavior of this class of refractories. To portray a more complete understanding of how these refractories perform at service temperatures, their fundamental corrosion resistances, dimensional stabilities, and microstructure were characterized as well

Entry of the bat influenza H17N10 virus into mammalian cells is enabled by the MHC class II HLA-DR receptor

Haemagglutinin and neuraminidase surface glycoproteins of the bat influenza H17N10 virus neither bind to nor cleave sialic acid receptors, indicating that this virus employs cell entry mechanisms distinct from those of classical influenza A viruses. We observed that certain human haematopoietic cancer cell lines and canine MDCK II cells are susceptible to H17-pseudotyped viruses. We identified the human HLA-DR receptor as an entry mediator for H17 pseudotypes, suggesting that H17N10 possesses zoonotic potential

Computers in Secondary Schools: Educational Games

This entry introduces educational games in secondary schools. Educational games include three main types of educational activities with a playful learning intention supported by digital technologies: educational serious games, educational gamification, and learning through game creation. Educational serious games are digital games that support learning objectives. Gamification is defined as the use of "game design elements and game thinking in a non-gaming context" (Deterding et al. 2011, p. 13). Educational gamification is not developed through a digital game but includes game elements for supporting the learning objectives. Learning through game creation is focused on the process of designing and creating a prototype of a game to support a learning process related to the game creation process or the knowledge mobilized through the game creation process. Four modalities of educational games in secondary education are introduced in this entry to describe educational games in secondary education: educational purpose of entertainment games, serious games, gamification, and game design

Enantioselective Phytotoxicity of the Herbicide Imazethapyr on the Response of the Antioxidant System and Starch Metabolism in Arabidopsis thaliana

Background: The enantiomers of a chiral compound possess different biological activities, and one of the enantiomers usually shows a higher level of toxicity. Therefore, the exploration of the causative mechanism of enantioselective toxicity is regarded as one of primary goals of biological chemistry. Imazethapyr (IM) is an acetolactate synthase (ALS)-inhibiting chiral herbicide that has been widely used in recent years with racemate. We investigated the enantioselectivity between R- and S-IM to form reactive oxygen species (ROS) and to regulate antioxidant gene transcription and enzyme activity. Results: Dramatic differences between the enantiomers were observed: the enantiomer of R-IM powerfully induced ROS formation, yet drastically reduced antioxidant gene transcription and enzyme activity, which led to an oxidative stress. The mechanism by which IM affects carbohydrate metabolism in chloroplasts has long remained a mystery. Here we report evidence that enantioselectivity also exists in starch metabolism. The enantiomer of R-IM resulted in the accumulation of glucose, maltose and sucrose in the cytoplasm or the chloroplast and disturbed carbohydrates utilization. Conclusion: The study suggests that R-IM more strongly retarded plant growth than S-IM not only by acting on ALS, but also by causing an imbalance in the antioxidant system and the disturbance of carbohydrate metabolism wit

Clinically relevant potential drug-drug interactions in intensive care patients:A large retrospective observational multicenter study

Purpose: Potential drug-drug interactions (pDDIs) may harm patients admitted to the Intensive Care Unit (ICU). Due to the patient's critical condition and continuous monitoring on the ICU, not all pDDIs are clinically relevant. Clinical decision support systems (CDSSs) warning for irrelevant pDDIs could result in alert fatigue and overlooking important signals. Therefore, our aim was to describe the frequency of clinically relevant pDDIs (crpDDIs) to enable tailoring of CDSSs to the ICU setting. Materials & methods: In this multicenter retrospective observational study, we used medication administration data to identify pDDIs in ICU admissions from 13 ICUs. Clinical relevance was based on a Delphi study in which intensivists and hospital pharmacists assessed the clinical relevance of pDDIs for the ICU setting. Results: The mean number of pDDIs per 1000 medication administrations was 70.1, dropping to 31.0 when considering only crpDDIs. Of 103,871 ICU patients, 38% was exposed to a crpDDI. The most frequently occurring crpDDIs involve QT-prolonging agents, digoxin, or NSAIDs. Conclusions: Considering clinical relevance of pDDIs in the ICU setting is important, as only half of the detected pDDIs were crpDDIs. Therefore, tailoring CDSSs to the ICU may reduce alert fatigue and improve medication safety in ICU patients

Joint Effects of Febrile Acute Infection and an Interferon-γ Polymorphism on Breast Cancer Risk

BACKGROUND: There is an inverse relationship between febrile infection and the risk of malignancies. Interferon gamma (IFN-γ) plays an important role in fever induction and its expression increases with incubation at fever-range temperatures. Therefore, the genetic polymorphism of IFN-γ may modify the association of febrile infection with breast cancer risk. METHODOLOGY AND PRINCIPAL FINDINGS: Information on potential breast cancer risk factors, history of fever during the last 10 years, and blood specimens were collected from 839 incident breast cancer cases and 863 age-matched controls between October 2008 and June 2010 in Guangzhou, China. IFN-γ (rs2069705) was genotyped using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometry platform. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using multivariate logistic regression. We found that women who had experienced ≥1 fever per year had a decreased risk of breast cancer [ORs and 95% CI: 0.77 (0.61-0.99)] compared to those with less than one fever a year. This association only occurred in women with CT/TT genotypes [0.54 (0.37-0.77)] but not in those with the CC genotype [1.09 (0.77-1.55)]. The association of IFN-γ rs2069705 with the risk of breast cancer was not significant among all participants, while the CT/TT genotypes were significantly related to an elevated risk of breast cancer [1.32 (1.03-1.70)] among the women with <1 fever per year and to a reduced risk of breast cancer [0.63 (0.40-0.99)] among women with ≥1 fever per year compared to the CC genotype. A marked interaction between fever frequencies and the IFN-γ genotypes was observed (P for multiplicative and additive interactions were 0.005 and 0.058, respectively). CONCLUSIONS: Our findings indicate a possible link between febrile acute infection and a decreased risk of breast cancer, and this association was modified by IFN-γ rs2069705