In this paper, we study data storage systems based on MDS codes through the lens of queueing theo... more In this paper, we study data storage systems based on MDS codes through the lens of queueing theory, and term this the "MDS queue." We analytically characterize the (average) latency performance of MDS queues, for which we present insightful scheduling policies that form upper and lower bounds to performance, and are observed to be quite tight. Extensive simulations are also provided and used to validate our theoretical analysis. We also employ the framework of the MDS queue to analyse different methods of performing so-called degraded reads (reading of partial data) in distributed data storage.
When eliciting judgements from humans for an unknown quantity, one often has the choice of making... more When eliciting judgements from humans for an unknown quantity, one often has the choice of making direct-scoring (cardinal) or comparative (ordinal) measurements. In this paper we study the relative merits of either choice, providing empirical and theoretical guidelines for the selection of a measurement scheme. We provide empirical evidence based on experiments on Amazon Mechanical Turk that in a variety of tasks, (pairwise-comparative) ordinal measurements have lower per sample noise and are typically faster to elicit than cardinal ones. Ordinal measurements however typically provide less information. We then consider the popular Thurstone and Bradley-Terry-Luce (BTL) models for ordinal measurements and characterize the minimax error rates for estimating the unknown quantity. We compare these minimax error rates to those under cardinal measurement models and quantify for what noise levels ordinal measurements are better. Finally, we revisit the data collected from our experiments and show that fitting these models confirms this prediction: for tasks where the noise in ordinal measurements is sufficiently low, the ordinal approach results in smaller errors in the estimation.
ABSTRACT It is well known that Maximum-Distance-Separable (MDS) codes, such as Reed-Solomon codes... more ABSTRACT It is well known that Maximum-Distance-Separable (MDS) codes, such as Reed-Solomon codes, provide the maximum storage efficiency in distributed storage systems. While the use of codes for providing improved reliability in archival storage systems, where the data is less frequently accessed, is well understood, the role of codes in the storage of more frequently accessed 'hot data', where latency is the key metric, is less clear. In this paper, we study storage systems based on MDS codes through the lens of queueing theory, and term this the "MDS queue." We analytically characterize its latency performance, for which we present insightful scheduling policies that form upper and lower bounds to performance. Extensive simulations are also provided and used to validate our theoretical analysis. Comparisons with replication-based systems reveal that codes provide a superior latency-performance (by up to 70%) than replication. The second part of the paper considers an alternative method of reducing latency in data centers, that of sending "redundant requests". Here, a request is sent to more servers than required, and is deemed served when any requisite number of servers complete service. Several recent works provide empirical evidence of the benefits of redundant requests in various settings, and in this paper, we aim to analytically characterize the situations when can redundant requests actually help. We show that under the MDS queue model (with exponential service times and negligible costs of cancelling jobs), in a replication-based system, the average latency strictly reduces with more redundancy in the requests, and that under a general MDS code, the average latency is minimized when requests are sent to all servers. To the best of our knowledge, these are the first analytical results that prove the benefits of sending redundant requests.
The four principal results of the paper are (a) the explicit construction of a class of MDS codes... more The four principal results of the paper are (a) the explicit construction of a class of MDS codes for d = n-1 >= 2k-1 termed the MISER code, that achieves the cut-set bound on the repair bandwidth for the exact-repair of systematic nodes, (b) proof of the necessity of interference alignment in exact-repair MSR codes, (c) a proof showing the impossibility of constructing linear, exact-repair MSR codes for d < 2k-3 in the absence of symbol extension, and (d) the construction, also explicit, of MSR codes for d = k+1. Interference alignment (IA) is a theme that runs throughout the paper: the MISER code is built on the principles of IA and IA is also a crucial component to the non-existence proof for d < 2k-3. To the best of our knowledge, the constructions presented in this paper are the first, explicit constructions of regenerating codes that achieve the cut-set bound.
Regenerating codes are a class of distributed storage codes that optimally trade the bandwidth ne... more Regenerating codes are a class of distributed storage codes that optimally trade the bandwidth needed for repair of a failed node with the amount of data stored per node of the network. Minimum Storage Regenerating (MSR) codes minimize first, the amount of data stored per node, and then the repair bandwidth, while Minimum Bandwidth Regenerating (MBR) codes carry out the
Although linked to several vitreoretinal pathologies including traumatic retinal tears, breaks, a... more Although linked to several vitreoretinal pathologies including traumatic retinal tears, breaks, and symptomatic vitreomacular traction, the dynamic material behavior of the vitreous body in response to mechanical loads is not well understood. The purpose of this study was to evaluate spatiotemporal patterns of collagen fiber reorganization and vitreous deformation (strain) in response to tensile and compressive forces. Using thick slabs of bovine eyes we examined collagen fiber reorganization following tensile and compressive step-loading with quantitative polarized light imaging. Strains were measured from sparse marker arrays and temporal collagen behavior was estimated from creep compliance rheological tests. Results showed that under applied loads (1) collagen fibers became significantly more aligned at the vitreous base (near the pars plana and the ciliary body), (2) vitreous located directly behind the lens deformed significantly more than surrounding regions, and (3) changes in collagen fiber alignment occurred on a short (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5Â s) timescale. Together these results show that, despite a homogeneous visual appearance, the vitreous body exhibits anisotropic material behavior in tension and compression. Spatiotemporal patterns of collagen rearrangement were consistent with epidemiological patterns of traumatic retinal damage and vitreoretinal topology. High strains in the vitreous corresponded with locations of lower collagen content that are prone to age-related degeneration. These data suggest that differential fiber alignment and mechanical deformation could contribute to the pathogenesis of these diseases. Computational models that incorporate these experimental data will help improve our understanding of the biomechanical mechanisms that contribute to the pathogenesis of traumatic retinal damage, vitreous degeneration, and vitreoretinal disease.
Regenerating codes are a class of recently developed codes for distributed storage that, like Ree... more Regenerating codes are a class of recently developed codes for distributed storage that, like Reed-Solomon codes, permit data recovery from any subset of k nodes within the n-node network. However, regenerating codes possess in addition, the ability to repair a failed node by connecting to an arbitrary subset of d nodes. It has been shown that for the case of
Regenerating codes are a class of recently developed codes for distributed storage that, like Ree... more Regenerating codes are a class of recently developed codes for distributed storage that, like Reed-Solomon codes, permit data recovery from any arbitrary k of n nodes. However regenerating codes possess in addition, the ability to repair a failed node by connecting to any arbitrary d nodes and downloading an amount of data that is typically far less than the size
Growth factors and cytokines are thought to influence the development of uncommitted progenitor c... more Growth factors and cytokines are thought to influence the development of uncommitted progenitor cell populations, but the issue of how these factors act on individual cells remains controversial. Such factors may act simply as selective mitogens or survival factors for cells that undergo lineage restrictions stochastically. Alternatively, they may instruct or bias multipotent cells to choose one lineage at the expense of others. Here we show that glial growth factor (GGF), previously defined as a Schwann cell mitogen, strongly suppresses neuronal differentiation of rat neural crest stem cells while promoting or allowing glial differentiation. Quantitative clonal analysis suggests that the action of GGF is likely to be instructive rather than selective. Taken together with the expression pattern of GGF, these data suggest a lateral signaling model for the diversification of cell types within developing peripheral ganglia.
Data in the form of pairwise comparisons arises in many domains, including preference elicitation... more Data in the form of pairwise comparisons arises in many domains, including preference elicitation, sporting competitions, and peer grading among others. We consider parametric ordinal models for such pairwise comparison data involving a latent vector $w^* \in \mathbb{R}^d$ that represents the "qualities" of the $d$ items being compared; this class of models includes the two most widely used parametric models--the Bradley-Terry-Luce (BTL) and the Thurstone models. Working within a standard minimax framework, we provide tight upper and lower bounds on the optimal error in estimating the quality score vector $w^*$ under this class of models. The bounds depend on the topology of the comparison graph induced by the subset of pairs being compared via its Laplacian spectrum. Thus, in settings where the subset of pairs may be chosen, our results provide principled guidelines for making this choice. Finally, we compare these error rates to those under cardinal measurement models and show that the error rates in the ordinal and cardinal settings have identical scalings apart from constant pre-factors.
Hemophagocytic Lymphohistiocytosis or the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more Hemophagocytic Lymphohistiocytosis or the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Hemophagocytic Syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is a spectrum of disorders of regulatory immunomodulatory pathways inciting phagocytosis of hematopoietic cells resulting in end-organ damage. The condition appears in both heritable and non-heritable forms from a multitude of possible environmental triggers, most notably infection. The condition often results in a fatal outcome without prompt diagnosis and treatment. Cases in children have been reported much more frequently and classically than in adult patients. In this case series we examined five such cases in adult patients that were found at our institution in a window as small at 2 years with more cases having presented since the time of this writing. In these cases, likely triggers were found ranging from infectious, drug-inducing and even underlying malignancy. The condition can be diagnosed by a set of laboratory and physical criteria (Hemophagocytic Lymphohistiocytosis -2004). Treatment ranges from immunosuppressive agents to chemotherapeutic approaches with variable success. Clinicians must maintain a higher index of suspicion in cases presenting with ominous symptomatology to ensure a prompt diagnosis and effective treatment of this potentially deadly condition.
In this paper, we study data storage systems based on MDS codes through the lens of queueing theo... more In this paper, we study data storage systems based on MDS codes through the lens of queueing theory, and term this the "MDS queue." We analytically characterize the (average) latency performance of MDS queues, for which we present insightful scheduling policies that form upper and lower bounds to performance, and are observed to be quite tight. Extensive simulations are also provided and used to validate our theoretical analysis. We also employ the framework of the MDS queue to analyse different methods of performing so-called degraded reads (reading of partial data) in distributed data storage.
When eliciting judgements from humans for an unknown quantity, one often has the choice of making... more When eliciting judgements from humans for an unknown quantity, one often has the choice of making direct-scoring (cardinal) or comparative (ordinal) measurements. In this paper we study the relative merits of either choice, providing empirical and theoretical guidelines for the selection of a measurement scheme. We provide empirical evidence based on experiments on Amazon Mechanical Turk that in a variety of tasks, (pairwise-comparative) ordinal measurements have lower per sample noise and are typically faster to elicit than cardinal ones. Ordinal measurements however typically provide less information. We then consider the popular Thurstone and Bradley-Terry-Luce (BTL) models for ordinal measurements and characterize the minimax error rates for estimating the unknown quantity. We compare these minimax error rates to those under cardinal measurement models and quantify for what noise levels ordinal measurements are better. Finally, we revisit the data collected from our experiments and show that fitting these models confirms this prediction: for tasks where the noise in ordinal measurements is sufficiently low, the ordinal approach results in smaller errors in the estimation.
ABSTRACT It is well known that Maximum-Distance-Separable (MDS) codes, such as Reed-Solomon codes... more ABSTRACT It is well known that Maximum-Distance-Separable (MDS) codes, such as Reed-Solomon codes, provide the maximum storage efficiency in distributed storage systems. While the use of codes for providing improved reliability in archival storage systems, where the data is less frequently accessed, is well understood, the role of codes in the storage of more frequently accessed &#39;hot data&#39;, where latency is the key metric, is less clear. In this paper, we study storage systems based on MDS codes through the lens of queueing theory, and term this the &quot;MDS queue.&quot; We analytically characterize its latency performance, for which we present insightful scheduling policies that form upper and lower bounds to performance. Extensive simulations are also provided and used to validate our theoretical analysis. Comparisons with replication-based systems reveal that codes provide a superior latency-performance (by up to 70%) than replication. The second part of the paper considers an alternative method of reducing latency in data centers, that of sending &quot;redundant requests&quot;. Here, a request is sent to more servers than required, and is deemed served when any requisite number of servers complete service. Several recent works provide empirical evidence of the benefits of redundant requests in various settings, and in this paper, we aim to analytically characterize the situations when can redundant requests actually help. We show that under the MDS queue model (with exponential service times and negligible costs of cancelling jobs), in a replication-based system, the average latency strictly reduces with more redundancy in the requests, and that under a general MDS code, the average latency is minimized when requests are sent to all servers. To the best of our knowledge, these are the first analytical results that prove the benefits of sending redundant requests.
The four principal results of the paper are (a) the explicit construction of a class of MDS codes... more The four principal results of the paper are (a) the explicit construction of a class of MDS codes for d = n-1 >= 2k-1 termed the MISER code, that achieves the cut-set bound on the repair bandwidth for the exact-repair of systematic nodes, (b) proof of the necessity of interference alignment in exact-repair MSR codes, (c) a proof showing the impossibility of constructing linear, exact-repair MSR codes for d < 2k-3 in the absence of symbol extension, and (d) the construction, also explicit, of MSR codes for d = k+1. Interference alignment (IA) is a theme that runs throughout the paper: the MISER code is built on the principles of IA and IA is also a crucial component to the non-existence proof for d < 2k-3. To the best of our knowledge, the constructions presented in this paper are the first, explicit constructions of regenerating codes that achieve the cut-set bound.
Regenerating codes are a class of distributed storage codes that optimally trade the bandwidth ne... more Regenerating codes are a class of distributed storage codes that optimally trade the bandwidth needed for repair of a failed node with the amount of data stored per node of the network. Minimum Storage Regenerating (MSR) codes minimize first, the amount of data stored per node, and then the repair bandwidth, while Minimum Bandwidth Regenerating (MBR) codes carry out the
Although linked to several vitreoretinal pathologies including traumatic retinal tears, breaks, a... more Although linked to several vitreoretinal pathologies including traumatic retinal tears, breaks, and symptomatic vitreomacular traction, the dynamic material behavior of the vitreous body in response to mechanical loads is not well understood. The purpose of this study was to evaluate spatiotemporal patterns of collagen fiber reorganization and vitreous deformation (strain) in response to tensile and compressive forces. Using thick slabs of bovine eyes we examined collagen fiber reorganization following tensile and compressive step-loading with quantitative polarized light imaging. Strains were measured from sparse marker arrays and temporal collagen behavior was estimated from creep compliance rheological tests. Results showed that under applied loads (1) collagen fibers became significantly more aligned at the vitreous base (near the pars plana and the ciliary body), (2) vitreous located directly behind the lens deformed significantly more than surrounding regions, and (3) changes in collagen fiber alignment occurred on a short (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5Â s) timescale. Together these results show that, despite a homogeneous visual appearance, the vitreous body exhibits anisotropic material behavior in tension and compression. Spatiotemporal patterns of collagen rearrangement were consistent with epidemiological patterns of traumatic retinal damage and vitreoretinal topology. High strains in the vitreous corresponded with locations of lower collagen content that are prone to age-related degeneration. These data suggest that differential fiber alignment and mechanical deformation could contribute to the pathogenesis of these diseases. Computational models that incorporate these experimental data will help improve our understanding of the biomechanical mechanisms that contribute to the pathogenesis of traumatic retinal damage, vitreous degeneration, and vitreoretinal disease.
Regenerating codes are a class of recently developed codes for distributed storage that, like Ree... more Regenerating codes are a class of recently developed codes for distributed storage that, like Reed-Solomon codes, permit data recovery from any subset of k nodes within the n-node network. However, regenerating codes possess in addition, the ability to repair a failed node by connecting to an arbitrary subset of d nodes. It has been shown that for the case of
Regenerating codes are a class of recently developed codes for distributed storage that, like Ree... more Regenerating codes are a class of recently developed codes for distributed storage that, like Reed-Solomon codes, permit data recovery from any arbitrary k of n nodes. However regenerating codes possess in addition, the ability to repair a failed node by connecting to any arbitrary d nodes and downloading an amount of data that is typically far less than the size
Growth factors and cytokines are thought to influence the development of uncommitted progenitor c... more Growth factors and cytokines are thought to influence the development of uncommitted progenitor cell populations, but the issue of how these factors act on individual cells remains controversial. Such factors may act simply as selective mitogens or survival factors for cells that undergo lineage restrictions stochastically. Alternatively, they may instruct or bias multipotent cells to choose one lineage at the expense of others. Here we show that glial growth factor (GGF), previously defined as a Schwann cell mitogen, strongly suppresses neuronal differentiation of rat neural crest stem cells while promoting or allowing glial differentiation. Quantitative clonal analysis suggests that the action of GGF is likely to be instructive rather than selective. Taken together with the expression pattern of GGF, these data suggest a lateral signaling model for the diversification of cell types within developing peripheral ganglia.
Data in the form of pairwise comparisons arises in many domains, including preference elicitation... more Data in the form of pairwise comparisons arises in many domains, including preference elicitation, sporting competitions, and peer grading among others. We consider parametric ordinal models for such pairwise comparison data involving a latent vector $w^* \in \mathbb{R}^d$ that represents the "qualities" of the $d$ items being compared; this class of models includes the two most widely used parametric models--the Bradley-Terry-Luce (BTL) and the Thurstone models. Working within a standard minimax framework, we provide tight upper and lower bounds on the optimal error in estimating the quality score vector $w^*$ under this class of models. The bounds depend on the topology of the comparison graph induced by the subset of pairs being compared via its Laplacian spectrum. Thus, in settings where the subset of pairs may be chosen, our results provide principled guidelines for making this choice. Finally, we compare these error rates to those under cardinal measurement models and show that the error rates in the ordinal and cardinal settings have identical scalings apart from constant pre-factors.
Hemophagocytic Lymphohistiocytosis or the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;am... more Hemophagocytic Lymphohistiocytosis or the &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;Hemophagocytic Syndrome&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; is a spectrum of disorders of regulatory immunomodulatory pathways inciting phagocytosis of hematopoietic cells resulting in end-organ damage. The condition appears in both heritable and non-heritable forms from a multitude of possible environmental triggers, most notably infection. The condition often results in a fatal outcome without prompt diagnosis and treatment. Cases in children have been reported much more frequently and classically than in adult patients. In this case series we examined five such cases in adult patients that were found at our institution in a window as small at 2 years with more cases having presented since the time of this writing. In these cases, likely triggers were found ranging from infectious, drug-inducing and even underlying malignancy. The condition can be diagnosed by a set of laboratory and physical criteria (Hemophagocytic Lymphohistiocytosis -2004). Treatment ranges from immunosuppressive agents to chemotherapeutic approaches with variable success. Clinicians must maintain a higher index of suspicion in cases presenting with ominous symptomatology to ensure a prompt diagnosis and effective treatment of this potentially deadly condition.
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