Synchronization of Coupled Chaotic Dynamics on Networks

We review some recent work on the synchronization of coupled dynamical systems on a variety of networks. When nodes show synchronized behaviour, two interesting phenomena can be observed. First, there are some nodes of the floating type that show intermittent behaviour between getting attached to some clusters and evolving independently. Secondly, two different ways of cluster formation can be identified, namely self-organized clusters which have mostly intra-cluster couplings and driven clusters which have mostly inter-cluster couplings.Comment: 15 pages, 3 figure

Waitlist Priority for Patients with Acute-on-Chronic Liver Failure: Not Just Horseplay

Acute on chronic liver failure (ACLF) is a syndrome of systemic inflammation and multiple organ system failures that is associated with a significantly high 28-day mortality ranging from 15-89%,(1) and which is increasing in prevalence in the United States and globally.(2) Although several definitions for ACLF exist, it is generally agreed upon that this condition yields greater non-transplant mortality than mere decompensated cirrhosis. The EASL-CLIF definition of ACLF categorizes patients according to the number of organ failures present, specifically as 1 organ failure (ACLF-1), 2 organ failures (ACLF-2) and 3 or more organ failures (ACLF-3).(1) Liver transplantation (LT) remains the only life-saving intervention in this population, especially among those with ACLF-3

Extracorporeal liver support devices in the ICU

Liver failure is common and carries high morbidity and mortality. Liver transplantation (LT) is the only definitive treatment available performed as an emergency in acute liver failure and electively for chronic liver disease. In the last 50 years, a number of extracorporeal liver support devices and modifications have emerged , some of them purely mechanical in nature aimed at detoxification, while others are cell based systems possessing bio-transformational capability. Mechanical devices are mainly based on albumin dialysis, albumin being a key transporter protein that is severely deficient and irreversibly destroyed in liver diseases. Despite a sound scientific rationale and good safety profile, none of the currently available devices have shown enough promise to be incorporated in routine clinical practice, their use being limited to specific clinical situations. This chapter describes currently available devices, their operational characteristics, current evidence of their utility and limitation, and the future developments in the field of extracorporeal liver support