Hidradenitis suppurativa, holistic approach and surgical reconstruction

We present a young adult male patient with chronic Hidradenitis Suppurativa (HS) stage Ⅱ-Ⅲ, mostly involving buttocks, thighs and perineum. The patient has been followed initially by a dermatologist for 2 years with trials of Biologic treatments. The ongoing purulent discharges made him quite dysfunctional. Patient was offered a definitive and extensive surgical option. Considering this conditions’ devastating social, psychological effects, such patients should be managed with a multidisciplinary team, elaborated education and counseling. Initial line of treatment plans should be considered as preparatory to the definitive surgical excisional therapy. Patient’s acceptance to the entire package that goes with the definitive surgery is fundamental for a successful and lasting outcome. Complete surgical resection of the disease and reconstruction remains to be the only available option for cure in a fully established HS.

Discovery of genes that modulate flavivirus replication in an interferon-dependent manner

Establishment of the interferon (IFN)-mediated antiviral state provides a crucial initial line of defense against viral infection. Numerous genes that contribute to this antiviral state remain to be identified. Using a loss-of-function strategy, we screened an original library of 1156 siRNAs targeting 386 individual curated human genes in stimulated microglial cells infected with Zika virus (ZIKV), an emerging RNA virus that belongs to the flavivirus genus. The screen recovered twenty-one potential host proteins that modulate ZIKV replication in an IFN-dependent manner, including the previously known IFITM3 and LY6E. Further characterization contributed to delineate the spectrum of action of these genes towards other pathogenic RNA viruses, including Hepatitis C virus and SARS-CoV-2. Our data revealed that APOL3 acts as a proviral factor for ZIKV and several other related and unrelated RNA viruses. In addition, we showed that MTA2, a chromatin remodeling factor, possesses potent flavivirus-specific antiviral functions. Our work identified previously unrecognized genes that modulate the replication of RNA viruses in an IFN-dependent way, opening new perspectives to target weakness points in the life cycle of these viruses.

ANALYSIS OF LINE EFFICIENCY IN FINISHING DEPARTMENT PT PURA NUSAPERSADA UNIT PAPER MILL 7/8

Measuring line efficiency and productivity are very important to do to find out in which level the efficiency and productivity of the business process has been carried out by the company. This paper aims to determine line efficiency analysis and provide suggestions for improvements to increase line efficiency at the finishing department of PT Pura Nusapersada. Measurement of line efficiency in the finishing department of PT Pura Nusapersada paper mill unit 7 has not yet reached the company's line efficiency value target. The initial line efficiency assessment obtained a percentage of 65.14% while the company's target was 70%. In this paper, a fishbone diagram is used to determine the root cause of the problem. Based on the research results, it was found that the most dominant cause of the problem was the inefficient work elements at the cutter, sorting, pollar, and packing work stations. Improvements were made using the eliminate, combine, re-arrange, and simplify (ECRS) method and the results of the line efficiency improvements in the finishing department increased to 71.90% and the company's target can be met.

Ruger’s ‘Old Model’ Single-action Revolvers: A Cautionary Tale of Reproducing Historical Firearms in a Litigious Age

In 1953, Ruger released a single-action revolver—patterned after the original Colt Single Action Army. Whilst some changes had been made, this firearm possessed, for all intents and purposes, the handling characteristics of the original Colt design. As a result, the safety precaution was as per the original: the revolver should be loaded with five rounds, rather than six, and the hammer positioned such that it rested over an empty chamber. Despite outlining the recommended carry methods in their instruction manual, Ruger became the subject of product liability lawsuits from purchasers who incorrectly loaded and carried the firearm, resulting in negligent discharges. This article explores the history of Colt-type single-action revolvers in the post-World War II period, analyses the availability of historic mechanical safety mechanisms for double-action revolvers in the 19th and 20th centuries, and summarises the patents on single-action safeties that Ruger had received by 1973. That year, the company discontinued their initial line of Single Action Army-style revolvers—known as ‘Old Models’—for a visibly similar, but mechanically different, ‘New Model’ line of single-action revolvers featuring newly developed safety mechanisms.

A Client Bootstrapping Protocol for DoS Attack Mitigation on Entry Point Services in the Cloud

This paper presents a client bootstrapping protocol for proxy-based moving target defense system for the cloud. The protocol establishes the identity of prospective clients who intend to connect to web services behind obscure proxy servers in a cloud-based network. In client bootstrapping, a set of initial line of defense services receive new client requests, execute an algorithm to assign them to a proxy server, and reply back with the address of the chosen proxy server. The bootstrapping protocol only reveals one proxy address to each client, maintaining the obscurity of the addresses for other proxy servers. Hiding the addresses of proxy servers aims to lower the likelihood that a proxy server becomes the victim of a denial-of-service (DoS) attack. Existing works address this problem by requiring the solution of computationally intensive puzzles from prospective clients. This solution slows the progression of attacks as well as new clients. This paper presents an alternative idea by observing that limited capacity of handling initial network requests is the primary cause of denial-of-service attacks. Thus, the suggested alternative is to utilize cost-effective high-capacity networks to handle client bootstrapping, thus thwarting attacks on the initial line of defense. The prototype implementation of the protocol using Google’s firebase demonstrates the proof of concept for web services that receive network requests from clients on mobile devices.

1320Effectiveness of atrial flutter ablation line selection using SOUNDSTAR catheter

Background Cavotricuspid isthmus (CTI) ablation for atrial flutter (AFL) shows a high success rate and effective for patients. However, operators experience difficulties in CTI ablation in some cases and need additional ablation for repeated recurrence. We investigated whether the SOUNDSTAR® (Biosense. Webster, Diamond Barr, CA, USA) catheter would be effective to select a CTI line of high therapeutic effect. Methods We have investigated the anatomy of around CTI by SOUNDSTAR® catheter and decided the CTI line using the anatomical information in AFL ablation (Figure1). We assumed two CTI lines of medial and lateral line. Medial CTI (M-CTI) line was more common and shorter line. Lateral CTI (L-CTI) line was uncommon and slightly longer line. We use 3.5mm tip catheter with NxT steerable introducer. The target Ablation Index (AI) was 400, and the target VisTtag™ interval was 6 mm or less. Results A total 30 of AFL ablated cases were investigated retrospectively. We surveyed 15 cases in M-CTI group and 15 cases in L-CTI group. Comparing the length of CTI in all cases, the length of M-CTI line was shorter than L-CTI line (M-CTI 32.1 ± 6.6mm vs. L-CTI 38.4 ± 8.3mm, n = 30, p <0.01). The atrial wall thickness of midsection and tricuspid valve (TV) side were thicker in M-CTI line (Midsection: M-CTI 4.0 ± 1.2mm vs. L-CTI 3.3 ± 0.8mm, n = 30, p <0.05, TV side: M-CTI 5.4 ± 1.4mm vs. L-CTI 4.3 ± 1.1mm, n = 30, p <0.05,). There was no difference in the required number of points to complete initial line (M-CTI 8.4 ± 1.6 vs. L-CTI 8.1 ± 1.7, n = 15, ns). Eustachian ridge in IVC side was thicker and higher in the M-CTI group (3.4 ± 3.3mm vs. 0.9 ± 1.9mm, n =30, p <0.01) and ablation on the Eustachian ridge showed instability of catheter placement. A lot of RF delivery was required on Eustachian ridge in M-CTI (2.6 ± 0.6 vs. 2.1 ± 0.7, n =15, p <0.05) and AI had resulted lower in M-CTI (351 ± 42.8 vs. 381 ± 27.1, n =15, p <0.05). Recurrence is more common in M-CTI group (9/15, 60% vs. 3/15, 20%). Recurrence sites in M-CTI group were distributed ((IVC side 3/9 (33%), midsection 5/9 (56%), TV side 5/9 (56%)) and multiple recurrences occurred in 3/9 (33%). Recurrence sites in L-CTI were only midsection of CTI (3/3, 100%). Conclusions CTI ablation at the shorter distance M-CTI, which is commonly selected, resulted in more recurrences due to the unevenness including Eustachian ridge and the myocardium thickness. However, ablation at slightly longer L-CTI line showed lower recurrence and effective for CTI ablation. Abstract Figure 1

Optimal load redistribution on interdependent networks under a novel flow interaction model

Complex systems are always composed of many subsystems that exhibit interdependent relationship with each others. It becomes increasingly important across many fields to understand the effect of interdependence among these subsystems. In this paper, we consider a novel flow interaction model on a system comprising two networks with initial line loads and capacities. Once a line in one network is subjected to overload failure, its load will be redistributed to the whole system. Based on this model, we study how load transfer due to redistribution affects the dynamic process of failure propagation and the failure outbreak threshold. Furthermore, we solve an optimal load transfer problem to find the minimum cumulative cost on the low failure level. Our results provide theoretical guidance for optimal load scheduling to suppress cascades in the interdependent networks.

PERHITUNGAN EFEKTIFITAS LINTASAN PRODUKSI MENGGUNAKAN METODE LINE BALANCING

: This study aims to determine how effective and efficient the production line and calculate the optimal time to process a candy product. The data was measured by stopwatch, then tested for uniformity and adequacy to obtain a value to do line balancing analysis using the Killbridge and Wester methods and Rank Position Weight, then performance of the initial line is compared with the results of analysis. The results of analysis using both line balancing methods, show that line efficiency were 76.1%, increasing by 43.1% from the efficiency of the initial line by 33%. The result of the balance delay (BD) calculation is 23.92% decreased by 53%, and the smoothness index 17.79 fell by 74.98 from the initial line which means that the proposed production line are more efficient than the initial line. The optimum time needed for production start from sugar tipping to the packaging are 91,29 minutes.Keywords: line balancing; line efficiency; Killberg & Wester; Rank Position WeightAbstrak : Penelitian bertujuan untuk mengetahui seberapa efektif dan efisien lintasan produksi yang digunakan pada proses produksi permen, serta menghitung waktu optimal yang dibutuhkan dalam produksi. Pengambilan data primer dilakukan dengan metode pengukuran langsung menggunakan jam henti yang selanjutnya diuji keseragaman, dan kecukupan datanya sehingga diperoleh sebuah nilai untuk kemudian dilakukan analisis keseimbangan lini dengan menggunakan metode Killbridge dan Wester dan Rank Position Weight. Selanjutnya performansi lintasan awal dibandingkan dengan hasil analisis keseimbangan lini. Dari hasil analisis menggunakan kedua metode line balancing tersebut diperoleh hasil efisiensi lini sebesar 76,1%, meningkat sebesar 43,1% dari efisiensi keadaan lintasan awal sebesar 33%. Hasil perhitungan balance delay (BD) adalah sebesar 23,92% turun 53% dari kondisi awal; dan smoothness index 17,79 turun sebesar 74,98 yang artinya hasil analisis lintasan usulan lebih efisien dibandingkan dengan keadaan lintasan awal. Hasil analisis waktu optimum yang dibutuhkan untuk produksi mulai dari tipping gula sampai proses pengemasan adalah 91,29 menit.Kata kunci: efisiensi lini produksi, keseimbangan lintasan; Killberg & Wester; Rank Position Weight

Influence of mutation in pea (Pisum sativum L.) cdt (cadmium tolerance) gene on histological and ultrastructural nodule organization

Background. A comparative analysis out of the structural organization of the symbiotic nodules of the pea initial line SGE and the mutant line SGECdt, characterized by increased tolerance to cadmium and increased its accumulation, was carried out. Materials and methods.Nodules of initial line SGE and mutant SGECdt were analyzed using light and transmission electron microscopy. Results. The non-treated nodules of SGE and SGECdt were characterized by a similar histological and ultrastructural organization. In the nodules of SGE exposed to 100 M CdCl2 in infected cells, the following abnormalities were observed: expansion of the peribacteroid space, destruction of the symbiosome membrane, fusion of symbiosomes and, as a result, the formation of symbiosomes containing several bacteroids. In the nodules of SGECdt, infected cells did not undergo pronounced changes. In the nodules of SGE exposed to 1 mM CdCl2, at the base of the nodule, senescent infected cells with completely destroyed cytoplasm and degrading bacteroids appeared. Also there were present cells in which the contents of symbiosomes were lysing, and only the ghosts of the bacteroids remained in them. In SGECdt, in some infected cells, abnormalities were manifested in an increase in the peribacteroid space, partial destruction of symbiosome membranes, fusion of symbiosomes, and release of bacteroids into the vacuole. Conclusions. The tolerance of pea nodules to cadmium can be significantly increased due to a single recessive cdt mutation.

The Relationship between Streetcars and Development Activity: An Examination of Portland and Seattle

In most U.S. cities, streetcars are not primarily pursued for the transportation benefits they might provide but instead for their anticipated development impacts. This paper examines the experiences of Portland and Seattle in order to better understand the nature of development activity around their streetcars. Using a multivariate analysis, the authors found that areas around Portland’s initial line experienced higher levels of development activity than areas not served by the streetcar, although the differences in activity between served and not served areas since the opening of the second line have been insignificant. In Seattle, areas around the first streetcar line experienced greater commercial development activity but less residential activity than nearby unserved areas. These results remained consistent when focusing on the expanded Seattle Streetcar system since the opening of the second line. These findings indicate that in certain contexts streetcars are associated with increased development activity. The results also suggest the need for a more nuanced understanding of the relationship between streetcars and development.