Prolonged fever in a case of end stage renal disease with remained guidewire

Central venous catheters,introduced for short-term dialysis,but occationally used as permanent vascular access in patient without alternative option. Hemodialysis(HD) patients presenting with fever have high rates of bacteremia,specially in patients with dialysis catheters and those with a history of bacteremia. [1]Herein,we report a case of  end stage renal disease with catheter infection complicated with endocarditi

Microspacecraft and Earth observation: Electrical field (ELF) measurement project

The Utah State University space system design project for 1989 to 1990 focuses on the design of a global electrical field sensing system to be deployed in a constellation of microspacecraft. The design includes the selection of the sensor and the design of the spacecraft, the sensor support subsystems, the launch vehicle interface structure, on board data storage and communications subsystems, and associated ground receiving stations. Optimization of satellite orbits and spacecraft attitude are critical to the overall mapping of the electrical field and, thus, are also included in the project. The spacecraft design incorporates a deployable sensor array (5 m booms) into a spinning oblate platform. Data is taken every 0.1 seconds by the electrical field sensors and stored on-board. An omni-directional antenna communicates with a ground station twice per day to down link the stored data. Wrap-around solar cells cover the exterior of the spacecraft to generate power. Nine Pegasus launches may be used to deploy fifty such satellites to orbits with inclinations greater than 45 deg. Piggyback deployment from other launch vehicles such as the DELTA 2 is also examined

University of California Santa Cruz Multicast Routing in Computer Networks

approved

Numerical study of forced convection heat transfer over three cylinders in staggered arrangement immersed in porous media

Staggered arrangement is one of the common configurations in heat exchangers that make better mixing of flow and heat transfer augmentation than other arrangements. In this paper forced convection heat transfer over three isothermal circular cylinders in staggered configuration in isotropic packed bed was investigated. In this work laminar 2-D incompressible steady-state equations of momentum and energy were solved numerically by finite volume method. Simulation was done in three Reynolds numbers of 80, 120, and 200. The results indicate that, using porous medium the Nusselt number enhanced considerably for any of cylinders and it presents thin temperature contours for them. Also is shown that by increasing Reynolds number, the heat transfer increased in both channel but the growth rate of it in porous media is larger. In addition, results of simulation in porous channel show that with increasing Peclet number, heat transfer increased logarithmically

An Iterative Approach for Delay-Bounded Minimum Steiner Tree Construction

This paper presents a delay-bounded minimum Steiner tree algorithm. The delay bounds, given as inputs to the algorithm, can be different for each individual sourcesink connection. The approach is based on feasible search optimization that satisfies the delay bounds first, then improves the routing tree for the cost minimization. Iterative cut-and-link tree transformation constrained by delay bounds provides an efficient technique to reduce the cost. Once reasonable delay bounds are set, this algorithm constructs Steiner trees with the correct timing, and by experiments the costs are always less than the trees obtained by a well-known, provably near-optimal Steiner-tree heuristic within the factor 2(1 \Gamma 1 jSj ) of the optimal Steiner tree for jSj sinks. In order to satisfy given delay bounds, we also propose a new algorithm to construct a maximaldelay -slack tree based on the global information of sink delay slacks. The use of our algorithm is especially attractive for deep-submi..

An Iterative Algorithm for Delay-Constrained Minimum-Cost Multicasting

The bounded shortest multicast algorithm (BSMA) is presented for constructing minimum-cost multicast trees with delay constraints. BSMA can handle asymmetric link characteristics and variable delay bounds on destinations, specified as real values, and minimizes the total cost of a multicast routing tree. Instead of the single-pass tree construction approach used in most previous heuristics, the new algorithm is based on a feasiblesearch optimization strategy that starts with the minimum-delay multicast tree and monotonically decreases the cost by iterative improvement of the delay-bounded multicast tree. BSMA's expected time complexity is analyzed, and simulation results are provided showing that BSMA can achieve near-optimal cost reduction with fast execution

A Source-Based Algorithm For Delay-Constrained Minimum-Cost Multicasting

A new heuristic algorithm is presented for constructing minimum-cost multicast trees with delay constraints. The new algorithm can set variable delay bounds on destinations and handles two variants of the network cost optimization goal: one minimizing the total cost (total bandwidth utilization) of the tree, and another minimizing the maximal link cost (the most congested link). Instead of the single-pass tree construction approach used in most previous heuristics, the new algorithm is based on a feasible search optimization method which starts with the minimumdelay tree and monotonically decreases the cost by iterative improvement of the delay-bounded tree. The optimality of the costs of the delay-bounded trees obtained with the new algorithm is analyzed by simulation. Depending on how tight the delay bounds are, the costs of the multicast trees obtained with the new algorithm are shown to be very close to the costs of the trees obtained by the Kou, Markowsky and Berman's algorithm. ..

The Effect of Lecture and E-learning Methods on Learning Mother and Child Health Course in Nursing Students

Introduction: Traditional teaching methods used in medical education are not able to respond to the rapid changes and growth of information as well as continuous change in educational needs of societies. This study was performed to compare the effect of two teaching approaches, lecture and e-learning on learning outcomes of mother and child health course in nursing students of Tehran Medical University. Methods: This quasi-experimental study was performed on all third semester nursing students who had passed mother and child health course in 2006 (N=32).It was a one group two-shot study. During the first four weeks, the students received traditional education and during the second four weeks they studied the rest of the subject matter using an on-line learning method. At the end of the course, the students' opinion toward the educational methods was asked using a questionnaire. An exam that covered the content of the 4-week block was also administered. Analysis of data was done by SPSS software using mean, standard deviation, and t-test. Results: The learning outcomes in both groups were similar. Based on the students' opinion about two teaching methods, e-learning was more effective on "their capability to use the method" and "independence in using the method", and lecture was better than e-learning in "the effect on learning" and "motivation". Conclustion: E-learning can be used for teaching some nursing courses. It is recommended to use e-learning method with considering appropriate interactive and more attractive virtual environments to motivate students

Liposuction versus periareolar excision approach for gynecomastia treatment

Background: Gynecomastia (GM) is the increased fibroglandular tissue in the male breast by more than 2 cm, which is palpated under the nipple and areola. An ideal surgical approach aims to reduce the breast size, reach an acceptable breast shape, resect excessive glandular tissue, fatty tissue, and skin fatty tissue and excess skin, relocate the nipple-areolar complex, and avoid scars. Based on its importance, we aimed to compare outcomes of liposuction with and without periareolar incision in patients with GM. Materials and Methods: This was a randomized clinical trial on patients referred for plastic surgery. Patients with GM were allocated into two treatment groups. Group A underwent liposuction without any areolar skin incision and group B had liposuction with the areolar skin incision. Patients were followed-up after surgery. Data were analyzed by Statistical Package for the Social Sciences (SPSS) version 20. Results: Sixty patients aged between 20 and 27 years old participated in this study. Three hematomas, two surgical site infections, one nipple hypopigmentation after surgery, and one seroma formation were noted in group B. On the other hand, one hematoma and one seroma formation were noted in group A. The patients in group A were highly satisfied after the liposuction without skin incision procedure compared with group B (P = 0.01). Conclusions: The management of GM by liposuction, either with the periareolar excision technique or without skin incision, allows the effective removal of fat and glandular tissue of the male breast. Although there was no significant difference regarding postoperation complications between groups, patients' satisfaction should be considered

Undiagnosed interrupted aortic arch in a 59-year-old male patient with severe aortic valve stenosis: A case report and literature review

BACKGROUND: Interrupted aortic arch (IAA) is defined by a lack of the luminal continuity between the ascending and descending thoracic aorta. It is a rare, severe congenital heart defect which without surgery is associated with high mortality in the neonatal period. The aims of this study were to present a case with IAA who was alive until the age of 59 years without any surgical intervention and to review the literatures that have presented IAA cases. CASE REPORT: The patient was admitted with respiratory distress and pulmonary edema. Echocardiography showed the sever stenosis in aortic valve and sever left ventricular dysfunction. Cardiac catheterization and angiography confirmed interrupted aorta (type A). The descending thoracic aorta was supplied by extensive collateral vessels from the vertebrobasilar system down to the posterior chest wall and the spine. Surgical correction including coronary artery bypass graft and aortic valve replacement and repair of interruption of the aorta was performed. Three weeks later the patient was died due to uncontrollable gastrointestinal bleeding and hospital acquired pneumonia. We described diagnosis and management of our case. CONCLUSION: This case was very interesting for us, because the patient had not been diagnosed until the recent presentation. Similar cases with this diagnosis do not reach adulthood, but our patient was alive up to 59 years of age. &nbsp; Keywords: Interrupted, Aorta, Aortic Valve Stenosis, Thoracic Aorta, Aortic Arch</div