Filament tension and phase-locked drift of meandering scroll waves

Rotating scroll waves are self-organising patterns which are found in many oscillating or excitable systems. Here we show that quasi-periodic (meandering) scroll waves, which include the rotors that organise cardiac arrhythmias, exhibit filament tension when averaged over the meander cycle. With strong filament curvature or medium thickness gradients, however, scroll wave dynamics are governed by phase-locked drift instead of filament tension. Our results are validated in computational models of cycloidal meander and a cardiac tissue model with linear core.Comment: accepted for publication in Physical Review Letters (December 2017

The hospital organization of the future

The future of hospital Nuclear Medicine is triggered by the hospital organisation itself. In general, the hospital organisation of the present requires substantial changes in order to be competitive, economical, and abreast of the rapid progresses in medical developments and patient management. It also must be flexible to changes in health politics. In this special report an organisational hospital structure is outlined which may help encounter the challenging hospital future. Some hospitals have already implemented convincing changes, whereas others are far behind

Reliability of intrasubject absolute quantification of kidney function measured with 99mTc DMSA in piglets

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One pot ‘click’ reactions: tandem enantioselective biocatalytic epoxide ring opening and [3+2] azide alkyne cycloaddition

Halohydrin dehalogenase (HheC) can perform enantioselective azidolysis of aromatic epoxides to 1,2-azido alcohols which are subsequently ligated to alkynes producing chiral hydroxy triazoles in a one-pot procedure with excellent enantiomeric excess.

Adaptive Path Planning for Depth Constrained Bathymetric Mapping with an Autonomous Surface Vessel

This paper describes the design, implementation and testing of a suite of algorithms to enable depth constrained autonomous bathymetric (underwater topography) mapping by an Autonomous Surface Vessel (ASV). Given a target depth and a bounding polygon, the ASV will find and follow the intersection of the bounding polygon and the depth contour as modeled online with a Gaussian Process (GP). This intersection, once mapped, will then be used as a boundary within which a path will be planned for coverage to build a map of the Bathymetry. Methods for sequential updates to GP's are described allowing online fitting, prediction and hyper-parameter optimisation on a small embedded PC. New algorithms are introduced for the partitioning of convex polygons to allow efficient path planning for coverage. These algorithms are tested both in simulation and in the field with a small twin hull differential thrust vessel built for the task.Comment: 21 pages, 9 Figures, 1 Table. Submitted to The Journal of Field Robotic

Measurement and structure of spiral wave response functions

The rotating spiral waves that emerge in diverse natural and man-made systems typically exhibit a particle-like behaviour since their adjoint critical eigenmodes (response functions) are often seen to be localised around the spiral core. We present a simple method to numerically compute response functions for circular-core and meandering spirals by recording their drift response to many elementary perturbations. Although our method is computationally more expensive than solving the adjoint system, our technique is fully parallellisable, does not suffer from memory limitations and can be applied to experiments. For a cardiac tissue model with the linear spiral core, we find that the response functions are localised near the turning points of the trajectory

Point-of-care ultrasonography:Downstream utilization of and diagnostic (dis)agreements with additional cross-sectional imaging

OBJECTIVES: Point-of-care ultrasonography (POCUS), defined as ultrasonography (US) performed and interpreted by the clinician, is increasingly performed. This study aimed to determine the frequency of and reasons why clinicians of the emergency department request cross-sectional imaging after POCUS and how often radiologists experience diagnostic (dis)agreements. METHODS: This retrospective study included a consecutive series of 503 patients who underwent POCUS at the emergency department of a tertiary care center. RESULTS: Downstream cross-sectional imaging was performed in 77 (15.3%) of 503 POCUS examinations. Reasons for additional cross-sectional imaging were, in order of decreasing frequency: suspicion of pathology that was not assessed with POCUS in 46 cases (59.7%), confirmation of conclusive POCUS findings in 21 cases (27.3%), inconclusive POCUS (i.e. insufficient visualization of the structure of interest to make a diagnosis, despite an attempt of the POCUS operator) in 7 cases (9.6%), a combination of inconclusive POCUS and suspicion of pathology that was not assessed with POCUS in 2 cases (2.6%), and clarification of incidental findings on POCUS in 1 case (1.3%). In the 21 cases that underwent additional cross-sectional imaging to confirm POCUS findings, POCUS agreed with additional cross-sectional imaging in 19 (90.5%) and disagreed in 2 (9.5%) cases. CONCLUSIONS: The use of POCUS appears to not cause any considerable downstream overutilization of cross-sectional imaging. In addition, radiologists experience few diagnostic disagreements when asked to perform second opinion cross-sectional imaging. Future studies with more homogeneous datasets in terms of POCUS operators are required to confirm our results

Drift of scrollwaves in a mathematical model of a heterogeneous human heart left ventricle

Rotating spiral waves of electrical excitation underlie many dangerous cardiac arrhythmias. The heterogeneity of myocardium is one of the factors that affects the dynamics of such waves. In this paper, we present results of our simulations for scroll wave dynamics in a heterogeneous model of the human left ventricle with analytical anatomically based representation of the geometry and anisotropy. We used a set of 18 coupled differential equations developed by ten Tusscher and Panfilov (TP06 model) which describes human ventricular cells based on their measured biophysical properties. We found that apicobasal heterogeneity dramatically changes the scroll wave dynamics. In the homogeneous model, the scroll wave annihilates at the base, but the moderate heterogeneity causes the wave to move to the apex and then continuously rotates around it. The rotation speed increased with the degree of the heterogeneity. However, for large heterogeneity, we observed formation of additional wavebreaks and the onset of complex spatio-temporal patterns. Transmural heterogeneity did not change the dynamics and decreased the lifetime of the scroll wave with an increase in heterogeneity. Results of our numerical experiments show that the apex may be a preferable location of the scroll wave, which may be important for development of clinical interventions. © 2020 by the authors.AAAA-A18-118020590031-8Russian Foundation for Basic Research, RFBR: 18-29-13008Russian Science Foundation, RSF: 14-35-00005Ural Federal University, UrFUP.K., S.P., O.S., and A.V.P. were funded by the Russian Science Foundation (project 14-35-00005). A.V.P., P.K., and O.S. were funded by the Russian Foundation for Basic Research (#18-29-13008). A.V.P. and O.S. were funded by RF Government Act #211 of 16 March 2013 (agreement 02. A03.21.0006). P.K. and O.S. work was carried out within the framework of the IIF UrB RAS theme No. AAAA-A18-118020590031-8. A.V.P. and H.D. were partially funded by BOF Ghent University. Simulations were performed at the supercomputer Uran of Institute of Mathematics and Mechanics (Ekaterinburg, Russia) and at the supercomputer of Ural Federal University (Ekaterinburg, Russia)

Radiologist-patient consultation of imaging findings after neck ultrasonography:An opportunity to practice value-based radiology

Objective: To investigate how patients experience a radiologist-patient consultation of imaging findings directly after neck ultrasonography (US), and how much time this consumes. Materials and methods: This prospective randomized study included 109 consecutive patients who underwent neck US, of whom 44 had a radiologist-patient consultation of US results directly after the examination, and 65 who had not. Results: The median ratings of all healthcare quality metrics (friendliness of the radiologist, explanation of the radiologist, skill of the radiologist, radiologist's concern for comfort during the examination, radiologist's concern for patient questions/worries, overall rating of the examination, and likelihood of recommending the examination) were either good/high or very good/very high, without any significant differences between both patient groups. Patients who did not discuss the US results with the radiologist, were significantly more worried during the examination (P = 0.040) and had significantly higher anxiety levels after completion of the US examination (P = 0.027) than patients who discussed the US results with the radiologist. Fifty-one out of 55 responding patients (92.7%) indicated a radiologist-patient consultation of US results to be important. The median duration of US examinations that included a radiologist-patient consultation of US results was 7.57 min (range: 5.15-12.10 min), while the median duration of US examinations without a radiologist-patient consultation of US results was 7.34 min (range: 3.45-14.32 min), without any significant difference (P = 0.637). Conclusion: A radiologist-patient consultation of imaging findings after neck US decreases patient anxiety, is desired by most patients, and does not significantly prolong total examination time