Page 1 of 2 - Has anyone broken a rib coughing?! - posted in Miscellaneous: As per title. Can you really cough your way to a broken rib (or should that be a 'cracked'rib?) or is it an urban myth? Nov 08, 2014  I finished training and ran the Boston Marathon with a Fractured/Bruised rib. I tripped on some debris and did a superman dive only partially breaking my fall with hands and forearms but mostly my.

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About a week and a half ago, I suffered a cracked rib (supposing, didn't have it X-rayed but I heard it crack as did the guy who did it, and the pain has been nasty) while playing basketball. A rib fracture is a crack or break in one of the bones of the rib cage. A break in the thick tissue ( cartilage ) that connects the ribs to the breastbone may also be called a fractured rib, even if the bone itself is not broken. Bruised rib or cracked? Took a spill today on my side at Hawes, and afterwards the lower-right rib area was sore but I felt fine to complete the rest of the ride. Fractured Ribs Still Painful After 2 Months? You May Need Surgery. Obviously, you can't cast a fractured rib, so when can you surgically intervene on a fractured rib? A rib fracture is a break in a rib bone. This typically results in chest pain that is worse with breathing in. Bruising may occur at the site of the break. When several ribs are broken in several places a flail chest results.

I was thinking of implementing real time chat using a PHP backend, but I ran across this comment on a site discussing comet:

My understanding is that PHP is a terrible language for Comet, because Comet requires you to keep a persistent connection open to each browser client. Using mod_php this means tying up an Apache child full-time for each client which doesn’t scale at all. The people I know doing Comet stuff are mostly using Twisted Python which is designed to handle hundreds or thousands of simultaneous connections.

Is this true? Or is it something that can be configured around?

11 Answers

Agreeing/expanding what has already been said, I don't think FastCGI will solve the problem.

Apache

Each request into Apache will use one worker thread until the request completes, which may be a long time for COMET requests.

This article on Ajaxian mentions using COMET on Apache, and that it is difficult. The problem isn't specific to PHP, and applies to any back-end CGI module you may want to use on Apache.

The suggested solution was to use the 'event' MPM module which changes the way requests are dispatched to worker threads.

This MPM tries to fix the 'keep alive problem' in HTTP. After a client completes the first request, the client can keep the connection open, and send further requests using the same socket. This can save signifigant overhead in creating TCP connections. However, Apache traditionally keeps an entire child process/thread waiting for data from the client, which brings its own disadvantages. To solve this problem, this MPM uses a dedicated thread to handle both the Listening sockets, and all sockets that are in a Keep Alive state.

Unfortunately, that doesn't work either, because it will only 'snooze' after a request is complete, waiting for a new request from the client.

PHP

Now, considering the other side of the problem, even if you resolve the issue with holding up one thread per comet request, you will still need one PHP thread per request - this is why FastCGI won't help. Flashpoint germany torrent.

You need something like Continuations which allow the comet requests to be resumed when the event they are triggered by is observed. AFAIK, this isn't something that's possible in PHP. I've only seen it in Java - see the Apache Tomcat server.

Edit:

There's an article here about using a load balancer (HAProxy) to allow you to run both an apache server and a comet-enabled server (e.g. jetty, tomcat for Java) on port 80 of the same server.

You could use Nginx and JavaScript to implement a Comet based chat system that is very scalable with little memory or CPU utilization.

I have a very simple example here that can get you started. It covers compiling Nginx with the NHPM module and includes code for simple publisher/subscriber roles in jQuery, PHP, and Bash.

PHP

I found this funny little screencasts explaining simple comet. As a side note I really think this is going to kill your server on any real load. When just having a couple of users, I would say to just go for this solution. This solution is really simple to implement(screencasts only takes 5 minutes of your time :)). But as I was telling previously I don't think it is good for a lot of concurrent users(Guess you should benchmark it ;)) because:

1. It uses file I/O which is much slower then just getting data from memory. Like for example the functions filemtime(),
2. Second, but I don't think least PHP does not a have a decent thread model. PHP was not designed for this anyway because of the share nothing model. Like the slides says 'Shared data is pushed down to thetrue'>2626 gold badges130130 silver badges174174 bronze badges

mod_php is not the only way to use PHP. You can use fastcgi. PHP must be compiled with --enable-fastcgi.

PHP as FastCGI: http://www.fastcgi.com/drupal/node/5?q=node/10

You may also try https://github.com/reactphp/react

React is a low-level library for event-driven programming in PHP. At its core is an event loop, on top of which it provides low-level utilities, such as: Streams abstraction, async dns resolver, network client/server, http client/server, interaction with processes. Third-party libraries can use these components to create async network clients/servers and more.

The event loop is based on the reactor pattern (hence the name) and strongly inspired by libraries such as EventMachine (Ruby), Twisted (Python) and Node.js (V8).

I bought my HP Color Laserjet CM1015 MFP about 5 years ago. It worked flawlessly on Windows Vista (unsure of 32/64-bit). This worked well on Windows 7 64-bit on two different machines (I upgraded t. Download and Update HP Color LaserJet CM1015 Multifunction Printer Drivers for your Windows XP, Vista, 7, 8 and 10 32 bit and 64 bit. Here you can download HP Color LaserJet CM1015 Multifunction Printer Drivers free and easy, just update your drivers now. Hp laserjet cm1015 mfp windows 7 driver 64 bit. Learn how to install HP print and scan software for an HP Color LaserJet CM1015/CM1017 on a newer Windows PC. HP Color LaserJet CM1015 and CM1017 MFP - Install HP print and scan software on a Windows computer. If you have the printer CD for Windows Vista (32-bit or 64-bit. Nov 16, 2009  Resolved Windows 7 - Driver for HP Color Laserjet CM1015 MFP. I posted here because i just rece3nlty got a new Laptop with Windows 7, i have a HP Color LaserJet CM1015 MFP printer and i cannot get it to work, i suspect its the driver, so i tried to download a driver from the HP site but nothing i downloaded worked. Windows 7 64-bit. HP Color LaserJet CM1015 Multifunction Printer full Driver Software Download for Microsoft Windows 32-bit – 64-bit and Macintosh Operating Systems.

The introductory example shows a simple HTTP server listening on port 1337:

I'm having a similar issue. One option I'm finding interesting is to use an existing Comet server, like cometd-java or cometd-python, as the core message hub. Your PHP code is then just a client to the Comet server -- it can post or read messages from channels, just like other clients.

There's an interesting code snippet linked here: http://morglog.org/?p=22=1 that implements part of this method (although there are bits of debug code spread around, too).

I'm current implementing a scalable PHP Comet server using socket functions. It is called 'phet' ( [ph]p com[et] )

Project page: http://github.com/Tim-Smart/phet

Free free to join in on development. I have currently managed to get most of the server logic done, just need to finish off the client side stuff.

EDIT: Recently added 'Multi-threading' capabilities using the pcntl_fork method :)

You'll have a hard time implementing comet in PHP, just because of it's inherent single-threaded-ness.

Check out Websync On-Demand - the service lets you integrate PHP via server-side publishing, offloading the heavy concurrent connection stuff, and will let you create a real-time chat app in no time.

A new module just came out for the nginx web server that'll allow Comet with any language, including PHP.

You will have to create your own server in PHP. Using Apache/mod_php or even fastcgi will not scale at all. A few years old, but can get you started:

PHP-Comet-Server:http://sourceforge.net/projects/comet/

I think this is more an issue that having a lot of apache threads running all the time is a problem. That will existing with any language if it works via apache in the same way as PHP (usually) does.

Not the answer you're looking for? Browse other questions tagged phpcomet or ask your own question.

A rib fracture is a break in a rib bone.^[1] This typically results in chest pain that is worse with breathing in.^[1]Bruising may occur at the site of the break.^[3] When several ribs are broken in several places a flail chest results.^[4] Potential complications include a pneumothorax, pulmonary contusion, and pneumonia.^[2][1]

Rib fractures usually occur from a direct blows to the chest such as during a motor vehicle collision or from a crush injury.^[2][1] Coughing or metastatic cancer may also result in a broken rib.^[1] The middle ribs are most commonly fractured.^[5][1] Fractures of the first or second ribs are more likely to be associated with complications.^[6] Diagnosis can be made based on symptoms and supported by medical imaging.^[3]

Pain control is an important part of treatment.^[7] This may include the use of paracetamol (acetaminophen), NSAIDs, or opioids.^[2] A nerve block may be another option.^[1] While fractured ribs have been wrapped, this may increase complications.^[1] In those with a flail chest, surgery may improve outcomes.^[8][9] They are a common injury following trauma.^[10]

• 1Signs and symptoms
• 4Treatment

Signs and symptoms[edit]

This typically results in chest pain that is worse with breathing in.^[1]Bruising may occur at the site of the break.^[3]

Complications[edit]

When several ribs are broken in several places a flail chest results.^[4] Potential complications include a pneumothorax, pulmonary contusion, and pneumonia.^[2][1]

Causes[edit]

Rib fractures can occur with or without direct trauma during recreational activity. Cardiopulmonary resuscitation (CPR) has also been known to cause thoracic injury, including but not limited to rib and sternum fractures. They can also occur as a consequence of diseases such as cancer or rheumatoid arthritis. While for elderly individuals a fall can cause a rib fracture, in adults automobile accidents are a common event for such an injury.^[11]

Diagnosis[edit]

Signs of a broken rib may include:^[12]

• Pain on inhalation
• Swelling in chest area
• Bruise in chest area
• Increasing shortness of breath
• Coughing up blood (rib may have damaged lung)

Plain X-rays often pick up displaced fractures but often miss undisplaced fractures.^[13]CT scanning is generally able to pick up both types of fractures.^[13]

Because children have more flexible chest walls than adults do, their ribs are more likely to bend than to break; therefore the presence of rib fractures in children is evidence of a significant amount of force and may indicate severe thoracic injuries such as pulmonary contusion.^[4] Rib fractures are also a sign of more serious injury in elderly people.^[14]

Treatment[edit]

There is no specific treatment for rib fractures, but various supportive measures can be taken. In simple rib fractures, pain can lead to reduced movement and cough suppression; this can contribute to formation of secondary chest infection.^[15] Flail chest is a potentially life-threatening injury and will often require a period of assisted ventilation.^[16] Flail chest and first rib fractures are high-energy injuries and should prompt investigation of damage to underlying viscera (e.g., lung contusion) or remotely (e.g., cervical spine injury). Spontaneous fractures in athletes generally require a cessation of the cause, e.g., time off rowing, while maintaining cardiovascular fitness.^{[medical citation needed]}

Nerve blocks[edit]

Nerve blocks that may be used to help with pain related to rib fractures include epidural anesthesia, paravertebral block, and serratus anterior plane block.^[17][18]

Surgery[edit]

Treatment options for internal fixation/repair of rib fractures include:

• Judet and/or sanchez plates/struts are a metal plate with strips that bend around the rib and then is further secured with sutures.^[19]
• Synthes matrixrib fixation system has two options: a precontoured metal plate that uses screws to secure the plate to the rib; and/or an intramedullary splint which is tunneled into the rib and secured with a set screw.^[20]
• Anterior locking plates are metal plates that have holes for screws throughout the plate. The plate is positioned over the rib and screwed into the bone at the desired position. The plates may be bent to match the contour of the section.^[21]
• U-plates can also be used as they clamp on to the superior aspect of the ribs using locking screws.^[22]

See also[edit]

References[edit]

Cometchat Php Cracked Rib

1. ^ ^abcdefghijklMosby's Medical Dictionary(E-Book). Elsevier Health Sciences. 2013. p. 1567. ISBN978-0323112581. Archived from the original on 2017-10-13.Cite uses deprecated parameter deadurl= (help)
2. ^ ^abcdefghMay, L; Hillermann, C; Patil, S (January 2016). 'Rib fracture management'. BJA Education. 16 (1): 26–32. doi:10.1093/bjaceaccp/mkv011.
3. ^ ^abcdeAdams, James G. (2012). Emergency Medicine E-Book: Clinical Essentials (Expert Consult – Online). Elsevier Health Sciences. p. 682. ISBN978-1455733941. Archived from the original on 2017-10-13.Cite uses deprecated parameter deadurl= (help)
4. ^ ^abcWanek, Sandra; Mayberry, John C (2004). 'Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury'. Critical Care Clinics. 20 (1): 71–81. doi:10.1016/S0749-0704(03)00098-8. PMID14979330.
5. ^Nanni, Christina (2012). PET-CT: Rare Findings and Diseases. Springer. p. 257. ISBN978-3-642-24698-2.
6. ^Murphy CE, 4th; Raja, AS; Baumann, BM; Medak, AJ; Langdorf, MI; Nishijima, DK; Hendey, GW; Mower, WR; Rodriguez, RM (27 May 2017). 'Rib Fracture Diagnosis in the Panscan Era'(PDF). Annals of Emergency Medicine. 70 (6): 904–909. doi:10.1016/j.annemergmed.2017.04.011. PMID28559032.
7. ^Brown, SD; Walters, MR (2012). 'Patients with rib fractures: use of incentive spirometry volumes to guide care'. Journal of Trauma Nursing. 19 (2): 89–91, quiz 92–03. doi:10.1097/JTN.0b013e31825629ee. PMID22673074.
8. ^Schuurmans, J; Goslings, JC; Schepers, T (April 2017). 'Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review'. European Journal of Trauma and Emergency Surgery. 43 (2): 163–68. doi:10.1007/s00068-016-0721-2. PMC5378742. PMID27572897.
9. ^Coughlin, TA; Ng, JW; Rollins, KE; Forward, DP; Ollivere, BJ (August 2016). 'Management of rib fractures in traumatic flail chest: a meta-analysis of randomised controlled trials'. The Bone & Joint Journal. 98-B (8): 1119–25. doi:10.1302/0301-620X.98B8.37282. PMID27482027.
10. ^Senekjian, L; Nirula, R (January 2017). 'Rib Fracture Fixation: Indications and Outcomes'. Critical Care Clinics. 33 (1): 153–65. doi:10.1016/j.ccc.2016.08.009. PMID27894495.
11. ^Rib Fracture at eMedicine
12. ^'Broken or bruised ribs'. NHS.UK. 2015. Archived from the original on 20 August 2015. Retrieved 15 August 2015.Cite uses deprecated parameter deadurl= (help)
13. ^ ^abDennis, BM; Bellister, SA; Guillamondegui, OD (October 2017). 'Thoracic Trauma'. The Surgical Clinics of North America. 97 (5): 1047–1064. doi:10.1016/j.suc.2017.06.009. PMID28958357.
14. ^Kent, Richard; Woods, William; Bostrom, Ola (2008-01-01). 'Fatality Risk and the Presence of Rib Fractures'. Annals of Advances in Automotive Medicine / Annual Scientific Conference. 52: 73–84. ISSN1943-2461. PMC3256783. PMID19026224.
15. ^Morice, A H; McGarvey, L; Pavord, I (2006). 'Recommendations for the management of cough in adults'. Thorax. 61 (Suppl 1): i1–24. doi:10.1136/thx.2006.065144. PMC2080754. PMID16936230.
16. ^Paul, Pauline; Williams, Beverly (2009-01-01). Brunner & Suddarth's Textbook of Canadian Medical-surgical Nursing. Lippincott Williams & Wil. p. 637. ISBN9780781799898. Archived from the original on 2016-06-29.Cite uses deprecated parameter deadurl= (help)
17. ^Wardhan, R (October 2013). 'Assessment and management of rib fracture pain in geriatric population: an ode to old age'. Current Opinion in Anesthesiology. 26 (5): 626–31. doi:10.1097/01.aco.0000432516.93715.a7. PMID23995061.
18. ^Grant, Stuart A.; Auyong, David B. (2016). Ultrasound Guided Regional Anesthesia. Oxford University Press. p. PT388. ISBN9780190630478.
19. ^Fitzpatrick, D. C.; Denard, P. J.; Phelan, D.; Long, W. B.; Madey, S. M.; Bottlang, M. (2010). 'Operative stabilization of flail chest injuries: review of literature and fixation options'. European Journal of Trauma and Emergency Surgery. 36 (5): 427–33. doi:10.1007/s00068-010-0027-8. PMC3150812. PMID21841954.
20. ^Mathison, Douglas (2014). Master Techniques in Surgery: Thoracic Surgery: Transplantation, Tracheal Resections, Mediastinal Tumors, Extended Thoracic Resections. Walters-Kluwer Health. ISBN978-1-46988-903-0. Archived from the original on 12 May 2016. Retrieved 15 August 2015.Cite uses deprecated parameter deadurl= (help)Rib fracture at Google Books
21. ^Browner, Bruce D. (2009-01-01). Skeletal Trauma: Basic Science, Management, and Reconstruction. Elsevier Health Scien. p. 1418. ISBN978-1416022206. Archived from the original on 2016-05-08.Cite uses deprecated parameter deadurl= (help)
22. ^de Jong, M. B.; Kokke, M. C.; Hietbrink, F.; Leenen, L. P. H. (2014). 'Surgical Management of Rib Fractures: Strategies and Literature Review'. Scandinavian Journal of Surgery. 103 (2): 120–25. doi:10.1177/1457496914531928. PMID24782038.

External links[edit]

Comet Chat Php Cracked Ribbon

How To Make Live Chat Php