Urticarial Rash in a Patient with Alpha-Gal Syndrome Caused by Subcutaneous Heparin at Prophylactic Dosing: A Case Report

Introduction: We report a patient with a history of red meat allergy, or alpha-gal syndrome, who had an urticarial rash after exposure to unfractionated heparin at a dose typically used for prophylaxis of deep venous thrombosis. Although anaphylactic reactions have been reported with systemic intravenous heparin, we believe this case is the first report of an immunoglobulin E–mediated reaction to subcutaneous heparin at prophylactic dosing. Clinical Findings: An 85-year-old male had a 3-year history of red meat allergy and was intolerant of pork and beef. He developed an immunoglobulin E–mediated allergic reaction to subcutaneous heparin at a dose of 5000 units twice daily. Clinical Course: The patient presented to the emergency department after a fall. He had back pain and was diagnosed with a compression fracture. He was admitted to the hospital because he was unable to safely ambulate. He was treated with subcutaneous unfractionated heparin to prevent deep venous thrombosis as part of routine care. Twenty-four hours after exposure to heparin, he developed an urticarial rash. The rash resolved promptly after discontinuing heparin and excluding other potential allergic triggers. Conclusions: In patients with alpha-gal syndrome, unfractionated heparin via a subcutaneous route at prophylactic dosing can precipitate immunoglobulin E–mediated systemic reactions and should be avoided

Integrated HPAI control in kampong chicken in Indonesia—An overview on ILRI's research and lessons learned

poultry in Indonesia in 2003. HPAI affected all production systems from parent stocks to village (kampong) chickens. The island of Java hosts 60% of the poultry population of the country. Avian influenza in poultry is considered to be endemic and fatal cases in humans are sporadic since its introduction. In an attempt to support the Indonesian government in making decisions to limit the spread of HPAI while minimising its impact on different socio-economic groups, research by the International Livestock Research Institute (ILRI) has focused on two main areas: (a) village chicken vaccination and (b) risk reduction strategies suitable for pro-poor households with backyard chicken. The vaccination component, supported by the World Bank, the Indonesian government and the United States Agency for International Development (USAID), used an operational research approach, with the objective to determine the efficacy of backyard mass vaccination by testing alternative regimes under field conditions. The mass vaccination carried out between 2007 and 2009 in 16 districts of Java was supported by targeted studies such as, the value of booster vs. non-booster vaccination, the effect of single dosage (antigen content) vs. double dosage vaccine formulations and a cost-benefit analysis of backyard vaccination. Research on pro-poor HPAI risk reduction strategies, jointly carried out from 2007–2011 with the International Food Policy Research Institute (IFPRI) and supported by the UK Department for International Development (DFID), followed an integrated research design with four main components: disease risk, institutional analysis, livelihood impacts, and synthesis (risk mitigation analysis). Within the components a number of focused studies from epidemiology, to socio-economic and livelihood impacts were implemented focusing on the districts of Bogor and Bogor Kota. Key results indicate the need for an avian influenza booster vaccination with a quarterly re-vaccination schedule due to high population turnovers in kampong chicken. Risk assessment demonstrated the value of an appropriate biosecurity and visitor’s control

COMPUTER SIMULATION OF OVERTOPPING OF LEVEES

There have been many cases of earth embankment failures, for example, Hurricane Katrina in 2005, where breaching occurred and devastated the surrounding population. Levee failures are preventable by a better understanding of the ways in which these embankments are designed and fail. The objective of this research is to protect levees against future failures. This paper studies various overtopping quantities and durations to represent the same level of levee erosion hazard. This study is based on experimental results of steady flows on the land side of a levee. The effect of water flow has been investigated and a comparison has been done between rills formations and erosion time for various water flows. Results showed that the pictures of digital simulations and real photographs which have been taken during tests in the laboratory are in a good concordance. Ha habido muchos casos de fallos de terraplén, por ejemplo, el huracán Katrina en 2005, en el cual se produjo una ruptura, devastando la población de los alrededores. Las fallas de diques se pueden prevenir, y es un objetivo de esta investigación alcanzar una mejor comprensión de las maneras en que estos diques se diseñan y fallan, a fin de poder protegerlos contra futuros fallos. Este documento desarrolla y recomienda equivalencias preliminares de combinaciones acumulativas de varias cantidades de desbordamiento y las duraciones asociadas que representan el mismo nivel de riesgo de erosión del dique. Las metodologías se basan en los resultados experimentales de flujos constantes en el lado seco de un dique. El efecto del flujo de agua se ha estudiado específicamente en esta investigación, y se ha hecho una comparación entre las formaciones de surcos y el tiempo de erosión para distintos flujos de agua

Measuring terrain distances through extracted channel networks

This paper initiates a forensic analysis of the causes of levee failures by analyzing and extracting information from a sequence of elevation data. This is a crucial step in bettering the design and construction of levees and dams. (Fully diagnosing failures usually requires knowledge beyond the geometry of the levee, such as weather conditions and material properties). We use results from computer simulations of levee overtopping for training data. The simulations use smoothed particle hydrodynamics coupled with a well-known erodibility model. Using the sequential nature of our data, we extract important channel networks that form as the soil is scoured away. We present a series of metrics to measure the distance between channel networks to assist in determining the critical threshold value used to extract important channels from the flow network. Methods for determining this ideal threshold have gone mainly unexplored, and so we present a comparison of various threshold values and how closely they identify matching channel networks on sequential terrains. These threshold values allow us to identify important properties of the terrain that form its fingerprint, a way of characterizing the geometry of the terrain. Our method for fingerprinting terrain is an important step toward the diagnosis of levee failure from digital elevation data

Simulating Levee Erosion with Physical Modeling Validation

This paper studies rill and gully initiation and propagation on levees, dams, and general earth embankments. It specifically studies where these erosion features occur, and how long a particular embankment can sustain overtopping before breaching and catastrophic failure. This contrasts to previous levee erosion analysis, which has primarily concerned the final effects of erosion, such as soil loss, depth of scour and breach width. This paper describes the construction of scaled-down physical models of levees composed of different homogeneous sands, as well as sand-clay mixtures, and their laboratory testing. A 3-D laser range scanner captured the surface features of the physical model, before and after erosion. The resulting data is utilized in developing digital simulations of the rill erosion process. Those simulations combine 3-D Navier-Stokes fluid simulations and a segmented height field data structure to produce an accurate portrayal of the erosive processes, which will be validated by physical modeling

Validation of Erosion Modeling: Physical and Numerical

The overall intent of this research is to develop numerical models of erosion of levees, dams and embankments, validated by physical models. The physical models are performed at 1-g and at high g\u27s using a geotechnical centrifuge. The erosion is modeled in detail, from beginning to end, that is from the time the levee is overtopped until the levee is breached. Typical quantities measured as a function of time are the depth, width and volume of rills, number of junction points, are the rills straight or meandering, sediment transport quantities, and finally breach. This data can be obtained from the numerical modeling, but is difficult to obtain from the physical modeling. Video images indicate the physical modeling agrees quite well with the numerical modeling. A comparison has also been done between observed breaching width and the FEMA new formula for both 1-g and centrifuge tests

Quantitative analysis of simulated erosion for different soils

Levee overtopping can lead to failure and cause catastrophic damage, as was the case during Hurricane Katrina. We present a computer simulation of erosion to study the development of the rills and gullies that form along an earthen embankment during overtopping. We have coupled 3D Smoothed Particle Hydrodynamics with an erodibility model to produce our simulation. Through comparison between simulations and between simulation and analogous laboratory experiments, we provide quantitative and qualitative results, evaluating the accuracy of our simulation