Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)

Background@#The PLASMIC score is a convenient tool for predicting ADAMTS13 activity of ＜10%.Lactate dehydrogenase (LDH) is widely used as a marker of haemolysis in thrombotic thrombocytopenic purpura (TTP) monitoring, and could be used as a replacement marker for lysis. We aimed to validate the PLASMIC score in a multi-centre Asia Pacific region, and to explore whether LDH could be used as a replacement marker for lysis. @*Methods@#Records of patients with thrombotic microangiopathy (TMA) were reviewed. Patients’ ADAMTS13 activity levels were obtained, along with clinical/laboratory findings relevant to the PLASMIC score. Both PLASMIC scores and PLASMIC-LDH scores, in which LDH replaced traditional lysis markers, were calculated. We generated a receiver operator characteristics (ROC) curve and compared the area under the curve values (AUC) to determine the predictive ability of each score. @*Results@#46 patients fulfilled the inclusion criteria, of which 34 had ADAMTS13 activity levels of ＜10%. When the patients were divided into intermediate-to-high risk (scores 5‒7) and low risk (scores 0‒4), the PLASMIC score showed a sensitivity of 97.1% and specificity of 58.3%, with a positive predictive value (PPV) of 86.8% and negative predictive value (NPV) of 87.5%. The PLASMIC-LDH score had a sensitivity of 97.1% and specificity of 33.3%, with a PPV of 80.5% and NPV of 80.0%. @*Conclusion@#Our study validated the utility of the PLASMIC score, and demonstrated PLASMIC-LDH as a reasonable alternative in the absence of traditional lysis markers, to help identify high-risk patients for treatment via plasma exchange.

[Modeling of CO2 fluxes at cropland by using SiB3 model].

The aim is to study the influence of different vegetation types on CO2 fluxes at the same site, taking farmland as the object by using the simple biosphere model (SiB3) , select different vegetation types in Suzhou Dongshan site as input parameters of model to simulate CO2 fluxes, and compare with the observational data in Suzhou Dongshan site during 2011-04-16 to 2011-06-30. Results show that using corn as the site vegetation type input model to simulate CO2 fluxes showed a very good diurnal variation agreement compared to the measured data, but selecting the ordinary crop type input model to simulate CO2 fluxes, CO2 fluxes during the daytime in April and May were undervalued, and CO2 fluxes in June were overvalued; when we select the tea type to input the model, the simulated results significantly overestimated CO2 fluxes during the daytime in May and June. In addition, when using SiB3 model to simulate the daily CO2 fluxes, all three vegetation types input model can effectively simulate daily CO2 fluxes, but not significantly. It shows that choosing the right type vegetation input SiB3 model can effectively simulate the diurnal variation of CO2 fluxes, but can not effectively improve the daily CO2 fluxes simulation.

Suicide in schizophrenia: A fourteen-year survey in an English health district.

INTRODUCTION: To determine the suicide rate among patients with schizophrenia within the Rotherham health district and identify any possible risk factors for suicide in this population. METHOD: Retrospective survey of the Coroner's data and of the psychiatric records within both the community and hospital-based psychiatric services. RESULTS: Eleven suicides were identified during the years 1984-1997 who had a diagnosis of schizophrenia. This represents a suicide rate of between 86 and 280 per 100 000, depending on the prevalence of schizophrenia within the population. This is 8-27 times as high as the rate for the general population of the district. CONCLUSION: Suicide in schizophrenia remains an uncommon event despite the increased risk. This presents problems for the assessment of the efficacy of suicide prevention strategies at the level of the average-sized health district or psychiatric department. (Int J Psych Clin Pract 2000; 4:143-146).