Bench-to-bedside review: Thrombocytopenia-associated multiple organ failure – a newly appreciated syndrome in the critically ill

New onset thrombocytopenia and multiple organ failure (TAMOF) presages poor outcome in critical illness. Patients who resolve thrombocytopenia by day 14 are more likely to survive than those who do not. Patients with TAMOF have a spectrum of microangiopathic disorders that includes thrombotic thrombocytopenic purpura (TTP), disseminated intravascular coagulation (DIC) and secondary thrombotic microanigiopathy (TMA). Activated protein C is effective in resolving fibrin-mediated thrombosis (DIC); however, daily plasma exchange is the therapy of choice for removing ADAMTS 13 inhibitors and replenishing ADAMTS 13 activity which in turn resolves platelet: von Willebrand Factor mediated thrombosis (TTP/secondary TMA)

Edge of Infinity: The Clash between Edge Effect and Infinity Assumption for the Distribution of Charge on a Conducting Plate

We re-examine a familiar problem given in introductory physics courses, about determining the induced charge distribution on an uncharged ``infinitely-large'' conducting plate when placing parallel to it a uniform charged dielectric plate of the same size. We show that, no matter how large the plates are, the edge effect will always be strong enough to influence the charge distribution deep in the central region, which totally destroyed the infinity assumption (that the surface charge densities on the two sides are uniform and of opposite magnitudes). For a more detailed analysis, we solve Poisson's equation for a similar setting in two-dimensional space and obtain the exact charge distribution, helping us to understand what happens how charge distributes at the central, the asymptotic, and the edge regions

The Effect of Charge Discretization on the Electrical Field inside a Conductor

We show how the electrical field inside the conductor changes as a function of the number of charged-particles. We show that the non-vanishing electrical field is concentrated near the surface of the conductor, at a shallow depth on the same order of magnitude as the separation between charges. Our study has illustrated the effect of charge discretization on a fundamental emergent law of electrostatics

Nano strain-amplifier: making ultra-sensitive piezoresistance in nanowires possible without the need of quantum and surface charge effects

This paper presents an innovative nano strain-amplifier employed to significantly enhance the sensitivity of piezoresistive strain sensors. Inspired from the dogbone structure, the nano strain-amplifier consists of a nano thin frame released from the substrate, where nanowires were formed at the centre of the frame. Analytical and numerical results indicated that a nano strain-amplifier significantly increases the strain induced into a free standing nanowire, resulting in a large change in their electrical conductance. The proposed structure was demonstrated in p-type cubic silicon carbide nanowires fabricated using a top down process. The experimental data showed that the nano strain-amplifier can enhance the sensitivity of SiC strain sensors at least 5.4 times larger than that of the conventional structures. This result indicates the potential of the proposed strain-amplifier for ultra-sensitive mechanical sensing applications.Comment: 4 pages, 5 figure

Strong scaling of general-purpose molecular dynamics simulations on GPUs

We describe a highly optimized implementation of MPI domain decomposition in a GPU-enabled, general-purpose molecular dynamics code, HOOMD-blue (Anderson and Glotzer, arXiv:1308.5587). Our approach is inspired by a traditional CPU-based code, LAMMPS (Plimpton, J. Comp. Phys. 117, 1995), but is implemented within a code that was designed for execution on GPUs from the start (Anderson et al., J. Comp. Phys. 227, 2008). The software supports short-ranged pair force and bond force fields and achieves optimal GPU performance using an autotuning algorithm. We are able to demonstrate equivalent or superior scaling on up to 3,375 GPUs in Lennard-Jones and dissipative particle dynamics (DPD) simulations of up to 108 million particles. GPUDirect RDMA capabilities in recent GPU generations provide better performance in full double precision calculations. For a representative polymer physics application, HOOMD-blue 1.0 provides an effective GPU vs. CPU node speed-up of 12.5x.Comment: 30 pages, 14 figure

Cost-Effectiveness Analysis of Screening for and Managing Identified Hypertension for Cardiovascular Disease Prevention in Vietnam

OBJECTIVE:To inform development of guidelines for hypertension management in Vietnam, we evaluated the cost-effectiveness of different strategies on screening for hypertension in preventing cardiovascular disease (CVD). METHODS:A decision tree was combined with a Markov model to measure incremental cost-effectiveness of different approaches to hypertension screening. Values used as input parameters for the model were taken from different sources. Various screening intervals (one-off, annually, biannually) and starting ages to screen (35, 45 or 55 years) and coverage of treatment were analysed. We ran both a ten-year and a lifetime horizon. Input parameters for the models were extracted from local and regional data. Probabilistic sensitivity analysis was used to evaluate parameter uncertainty. A threshold of three times GDP per capita was applied. RESULTS:Cost per quality adjusted life year (QALY) gained varied in different screening scenarios. In a ten-year horizon, the cost-effectiveness of screening for hypertension ranged from cost saving to Int$758,695 per QALY gained. For screening of men starting at 55 years, all screening scenarios gave a high probability of being cost-effective. For screening of females starting at 55 years, the probability of favourable cost-effectiveness was 90$ 15,883 in all screening scenarios among males. Similar results were found in females when starting screening at 55 years. Starting screening in females at 45 years had a high probability of being cost-effective if screening biannually was combined with increasing coverage of treatment by 20% or even if sole biannual screening was considered. CONCLUSION:From a health economic perspective, integrating screening for hypertension into routine medical examination and related coverage by health insurance could be recommended. Screening for hypertension has a high probability of being cost-effective in preventing CVD. An adequate screening strategy can best be selected based on age, sex and screening interval

Reply to comment on “Current separation and upwelling over the southeast shelf of Vietnam in the South China Sea”

Author Posting. © American Geophysical Union, 2013. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Journal of Geophysical Research 118 (2013): 1624, doi:10.1002/jgrc.20114.2013-09-3