Electric injury: a case series

In the modern era, electricity acts as a vital zone for mankind. The most important external sign of electrocution is the electric mark. The internal findings of electrocution are usually unspecific. The electric mark can also be of postmortem origin and is therefore not a reliable proof that the electric shock occurred before death, unless the survival time was long enough for an inflammatory response of the affected tissue. Various cases of electrocution have been reported in literature but as per the best of authors knowledge none of them have been clearly explained for the establishment of complete electric circuit in reported cases; required for fatal electrocution. In the present case series, authors’ report and discuss the three cases of electrocution under different circumstances with deviations in expectations. Because of the diagnostic problems authors also discuss the significance and careful evaluation of incident/death scene in all definitive as well as suspected cases of electrocution and emphasize on various components required for complete electric circuit for flow of current

Phosphorylation of Exo1 modulates homologous recombination repair of DNA double-strand breaks

DNA double-strand break (DSB) repair via the homologous recombination pathway is a multi-stage process, which results in repair of the DSB without loss of genetic information or fidelity. One essential step in this process is the generation of extended single-stranded DNA (ssDNA) regions at the break site. This ssDNA serves to induce cell cycle checkpoints and is required for Rad51 mediated strand invasion of the sister chromatid. Here, we show that human Exonuclease 1 (Exo1) is required for the normal repair of DSBs by HR. Cells depleted of Exo1 show chromosomal instability and hypersensitivity to ionising radiation (IR) exposure. We find that Exo1 accumulates rapidly at DSBs and is required for the recruitment of RPA and Rad51 to sites of DSBs, suggesting a role for Exo1 in ssDNA generation. Interestingly, the phosphorylation of Exo1 by ATM appears to regulate the activity of Exo1 following resection, allowing optimal Rad51 loading and the completion of HR repair. These data establish a role for Exo1 in resection of DSBs in human cells, highlighting the critical requirement of Exo1 for DSB repair via HR and thus the maintenance of genomic stability

Vasospasm in children with traumatic brain injury

To determine the incidence of vasospasm in children who have suffered moderate to severe traumatic brain injury. A prospective observational pilot study in a 24-bed pediatric intensive care unit was performed. Twenty-two children aged 7 months to 14 years with moderate to severe traumatic brain injury as indicated by Glasgow Coma Score ≤12 and abnormal head imaging were enrolled. Transcranial Doppler ultrasound was performed to identify and follow vasospasm. Patients with a flow velocity in the middle cerebral artery (MCA) >120 cm/s were considered to have vasospasm by criterion A. If flow velocity in the MCA was >120 cm/s and the Lindegaard ratio was >3, vasospasm was considered to be present by criterion B. Patients with basilar artery (BA) flow velocity >90 cm/s met criteria for vasospasm in the posterior circulation (criterion C). In the MCA, 45.5% of patients developed vasospasm based on criterion A and 36.3% developed vasospasm based on criterion B. A total of 18.2% of patients developed vasospasm in the BA by criterion C. Typical day of onset of vasospasm was hospital day 2–3. Duration of vasospasm in the anterior circulation was 4 ± 2 days based on criteria A and 3 ± 1 days based on criteria B. Vasospasm in the posterior circulation persisted for 2 ± 1 days. Using the adult criteria outlined above to diagnose vasospasm, a significant proportion of pediatric patients who have suffered moderate to severe traumatic brain injury develop vasospasm during the course of their treatment

Social innovations in outsourcing: An empirical investigation of impact sourcing companies in India

This paper was accepted for publication in the journal Journal of Strategic Information Systems and the definitive published version is available at http://dx.doi.org/10.1016/j.jsis.2015.09.002Impact sourcing – the practice of bringing digitally-enabled outsourcing jobs to marginalized individuals – is an important emerging social innovation in the outsourcing industry. The impact sourcing model of delivering Information Technology and Business Process Outsourcing (IT–BPO) services not only seeks to deliver business value for clients, but is also driven by an explicit social mission to help marginalized communities enjoy the benefits of globalization. This dual focus has led to the ambitious claim that social value creation can be integral to (and not always by-products of) innovative IT–BPO models. Given the relative newness of the impact sourcing business model there is scarce research about how impact sourcing companies emerge and the process through which entrepreneurs build and operate such companies. This paper draws on a qualitative study of seven Indian impact sourcing companies and develops a process model of the individual-level motivational triggers of impact sourcing entrepreneurship, the entrepreneurial actions underpinning different phases of venture creation and the positive institutional-level influences on impact sourcing. The paper argues that since deeply personalized values are central to the creation and development of impact sourcing companies, the business model may not be easy to replicate. The analysis highlights an intensive period of embedding and robust alliances with local partners as crucial for the scalability and sustainability of the impact sourcing business model. It also emphasizes the role of ‘social’ encoding and mimicry in determining the extent to which impact sourcing companies are able to retain their commitment to marginalized communities

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Realtime Scheduling in SunOS 5.0

We describe the fundamental mechanisms in SunOS 5.0 to provide realtime scheduling functionality. Our primary goal was to provide bounded behavior for dispatching or blocking threads. To achieve this goal we have modified the kernel to be fully preemptive, guaranteeing dispatch after both synchronous and asynchronous wakeups. We have also worked toward controlling priority inversion in the kernel. The result is a kernel capable of delivering realtime scheduling and bounded response to a large class of user level applications. 1.0 Introduction A realtime operating system may be defined as one that has the ability to provide a required level of service in a bounded response time. To achieve a bounded response time, time-critical applications require control over their scheduling behavior. Increasing numbers of new, interesting applications for the desktop possess time-critical aspects. Some examples that come immediately to mind are in the area of user interfaces, multimedia, and virtu..