The large core limit of spiral waves in excitable media: A numerical approach

We modify the freezing method introduced by Beyn & Thuemmler, 2004, for analyzing rigidly rotating spiral waves in excitable media. The proposed method is designed to stably determine the rotation frequency and the core radius of rotating spirals, as well as the approximate shape of spiral waves in unbounded domains. In particular, we introduce spiral wave boundary conditions based on geometric approximations of spiral wave solutions by Archimedean spirals and by involutes of circles. We further propose a simple implementation of boundary conditions for the case when the inhibitor is non-diffusive, a case which had previously caused spurious oscillations. We then utilize the method to numerically analyze the large core limit. The proposed method allows us to investigate the case close to criticality where spiral waves acquire infinite core radius and zero rotation frequency, before they begin to develop into retracting fingers. We confirm the linear scaling regime of a drift bifurcation for the rotation frequency and the core radius of spiral wave solutions close to criticality. This regime is unattainable with conventional numerical methods.Comment: 32 pages, 17 figures, as accepted by SIAM Journal on Applied Dynamical Systems on 20/03/1

Ansprüche an Gebäude von morgen - Integration intelligenter Systeme

Die technische Entwicklung, insbesondere auf dem Gebiet der Digitaltechnik eröffnet heute neue und sehr weitreichende Möglichkeiten für die Automatisierung in Zweck- und Wohnbauten. Die zur Verfügung stehenden technischen Komponenten (intelligente Sensoren und Aktoren sowie ein hausinternes Netz für die Datenübertragung -Feldbus-) unterscheiden sich für diese Einsatzfälle kaum. Die Zielstellungen sind jedoch gänzlich andere. Intelligenz im Wohnbau bedeutet vor allem intelligente Alltagsbewältigung (z.B. Zeiteinsparung), Komfort und Wohlbefinden. Daß im Heimbereich nichtfunktionale Faktoren (Human Interface, Ästhetik, Preis, Attraktivität) eine große Rolle spielen, ist in das Problembewußtsein der Gerätehersteller und Käufer getreten. Im Bereich der Heimautomatisierung werden zunehmend moderne, die Möglichkeiten der konventioellen Steuerungs- und Regelungstechnik ergänzende Technologien wie Fuzzy- Steuerungen zur Optimierung der internen Arbeitsweise von Geräten eingesetzt. Die informatorische Vernetzung im Wohnbau unterstützt darüberhinaus wichtige Anliegen des Gebäudemanagements (energetische, ergonomische und ökologische Betrachtungen der Gebäudenutzung unter wirtschaftlichen Gesichtspunkten)

Psychoanalytic and cognitive-behavior therapy of chronic depression : study protocol for a randomized controlled trial

Background: Despite limited effectiveness of short-term psychotherapy for chronic depression, there is a lack of trials of long-term psychotherapy. Our study is the first to determine the effectiveness of controlled long-term psychodynamic and cognitive-behavioral (CBT) treatments and to assess the effects of preferential vs. randomized assessment. Methods/design: Patients are assigned to treatment according to their preference or randomized (if they have no clear preference). Up to 80 sessions of psychodynamic or psychoanalytically oriented treatments (PAT) or up to 60 sessions of CBT are offered during the first year in the study. After the first year, PAT can be continued according to the ‘naturalistic’ usual method of treating such patients within the system of German health care (normally from 240 up to 300 sessions over two to three years). CBT therapists may extend their treatment up to 80 sessions, but focus mainly maintenance and relapse prevention. We plan to recruit a total of 240 patients (60 per arm). A total of 11 assessments are conducted throughout treatment and up to three years after initiation of treatment. The primary outcome measures are the Quick Inventory of Depressive Symptoms (QIDS, independent clinician rating) and the Beck Depression Inventory (BDI) after the first year. Discussion: We combine a naturalistic approach with randomized controlled trials(RCTs)to investigate how effectively chronic depression can be treated on an outpatient basis by the two forms of treatment reimbursed in the German healthcare system and we will determine the effects of treatment preference vs. randomization

Ansprüche an Gebäude von morgen - Integration intelligenter Systeme

Die technische Entwicklung, insbesondere auf dem Gebiet der Digitaltechnik eröffnet heute neue und sehr weitreichende Möglichkeiten für die Automatisierung in Zweck- und Wohnbauten. Die zur Verfügung stehenden technischen Komponenten (intelligente Sensoren und Aktoren sowie ein hausinternes Netz für die Datenübertragung -Feldbus-) unterscheiden sich für diese Einsatzfälle kaum. Die Zielstellungen sind jedoch gänzlich andere. Intelligenz im Wohnbau bedeutet vor allem intelligente Alltagsbewältigung (z.B. Zeiteinsparung), Komfort und Wohlbefinden. Daß im Heimbereich nichtfunktionale Faktoren (Human Interface, Ästhetik, Preis, Attraktivität) eine große Rolle spielen, ist in das Problembewußtsein der Gerätehersteller und Käufer getreten. Im Bereich der Heimautomatisierung werden zunehmend moderne, die Möglichkeiten der konventioellen Steuerungs- und Regelungstechnik ergänzende Technologien wie Fuzzy- Steuerungen zur Optimierung der internen Arbeitsweise von Geräten eingesetzt. Die informatorische Vernetzung im Wohnbau unterstützt darüberhinaus wichtige Anliegen des Gebäudemanagements (energetische, ergonomische und ökologische Betrachtungen der Gebäudenutzung unter wirtschaftlichen Gesichtspunkten)

Real-world Health Data and Precision for the Diagnosis of Acute Kidney Injury, Acute-on-Chronic Kidney Disease, and Chronic Kidney Disease: Observational Study.

BACKGROUND The criteria for the diagnosis of kidney disease outlined in the Kidney Disease: Improving Global Outcomes guidelines are based on a patient's current, historical, and baseline data. The diagnosis of acute kidney injury, chronic kidney disease, and acute-on-chronic kidney disease requires previous measurements of creatinine, back-calculation, and the interpretation of several laboratory values over a certain period. Diagnoses may be hindered by unclear definitions of the individual creatinine baseline and rough ranges of normal values that are set without adjusting for age, ethnicity, comorbidities, and treatment. The classification of correct diagnoses and sufficient staging improves coding, data quality, reimbursement, the choice of therapeutic approach, and a patient's outcome. OBJECTIVE In this study, we aim to apply a data-driven approach to assign diagnoses of acute, chronic, and acute-on-chronic kidney diseases with the help of a complex rule engine. METHODS Real-time and retrospective data from the hospital's clinical data warehouse of inpatient and outpatient cases treated between 2014 and 2019 were used. Delta serum creatinine, baseline values, and admission and discharge data were analyzed. A Kidney Disease: Improving Global Outcomes-based SQL algorithm applied specific diagnosis-based International Classification of Diseases (ICD) codes to inpatient stays. Text mining on discharge documentation was also conducted to measure the effects on diagnosis. RESULTS We show that this approach yielded an increased number of diagnoses (4491 cases in 2014 vs 11,124 cases of ICD-coded kidney disease and injury in 2019) and higher precision in documentation and coding. The percentage of unspecific ICD N19-coded diagnoses of N19 codes generated dropped from 19.71% (1544/7833) in 2016 to 4.38% (416/9501) in 2019. The percentage of specific ICD N18-coded diagnoses of N19 codes generated increased from 50.1% (3924/7833) in 2016 to 62.04% (5894/9501) in 2019. CONCLUSIONS Our data-driven method supports the process and reliability of diagnosis and staging and improves the quality of documentation and data. Measuring patient outcomes will be the next step in this project

Conceptualization of the use of Artificial Intelligence for Interdependencies Analysis in Requirements Engineering

The efficiency in product development is largely determined by the quality of the requirements and the ability of the product design and production planner to analyze them. Interdependencies between multiple requirements identified at an early stage enable a sustainable design of the product as well as the corresponding production system by increasing process efficiency as well as the effectiveness of development processes. However, the necessary analysis of complex interdependencies between requirements of a product and the corresponding production system is time-consuming, error-prone, and highly inefficient when performed manually. Current development processes are based on such manual processes for analyzing requirements in natural language and must therefore be adapted. This paper describes a methodical approach based on a semi-systematic literature review making the complexity of the interdependencies manageable by using existing approaches and methods in the field of model-based systems engineering (MBSE) as well as natural language processing (NLP). Thereby, a transition from informal requirements represented in natural language to analyzable and structured information, which enable interdependencies modeling for requirement chains, is described. A corresponding framework for analyzing interdependencies in the requirements engineering process is derived

Potential of Dried Blood Self-Sampling for Cyclosporine C2 Monitoring in Transplant Outpatients

Background. Close therapeutic drug monitoring of Cyclosporine (CsA) in transplant outpatients is a favourable procedure to maintain the long-term blood drug levels within their respective narrow therapeutic ranges. Compared to basal levels (C0), CsA peak levels (C2) are more predictive for transplant rejection. However, the application of C2 levels is hampered by the precise time of blood sampling and the need of qualified personnel. Therefore, we evaluated a new C2 self-obtained blood sampling in transplant outpatients using dried capillary and venous blood samples and compared the CsA levels, stability, and clinical practicability of the different procedures. Methods. 55 solid organ transplant recipients were instructed to use single-handed sampling of each 50 μL capillary blood and dried blood spots by finger prick using standard finger prick devices. We used standardized EDTA-coated capillary blood collection systems and standardized filter paper WS 903. CsA was determined by LC-MS/MS. The patients and technicians also answered a questionnaire on the procedure and sample quality. Results. The C0 and C2 levels from capillary blood collection systems (C0 [ng/mL]: 114.5 ± 44.5; C2: 578.2 ± 222.2) and capillary dried blood (C0 [ng/mL]: 175.4 ± 137.7; C2: 743.1 ± 368.1) significantly (P < .01) correlated with the drug levels of the venous blood samples (C0 [ng/mL]: 97.8 ± 37.4; C2: 511.2 ± 201.5). The correlation at C0 was ρcap.-ven. = 0.749, and ρdried blood-ven = 0.432; at C2: ρcap.-ven. = 0.861 and ρdried blood-ven = 0.711. The patients preferred the dried blood sampling because of the more simple and less painful procedure. Additionally, the sample quality of self-obtained dried blood spots for LC-MS/MS analytics was superior to the respective capillary blood samples. Conclusions. C2 self-obtained dried blood sampling can easily be performed by transplant outpatients and is therefore suitable and cost-effective for close therapeutic drug monitoring

Comparison of German and Japanese general practitioners' awareness of suicide and attitudes toward patients with suicidal ideation.

The authors designed a questionnaire to investigate the differences in German and Japanese general practitioners? (GP) awareness of suicide and attitudes toward patients with suicidal ideation in their respective societies. The purpose of this study was to obtain insights leading to a better means of suicide prevention in primary care in Japan. The background for conducting the study was declining suicides in the past 20 years and the lower suicide rate in Germany compared with the present situation in Japan, where the number of suicides has in recent years continued to exceed 30,000, resulting in a suicide rate approximately 2 times higher than that in Germany. The questionnaire was randomly mailed to GPs in Okayama-Prefecture (western Japan) and Hamburg-State (northern Germany) and was collected in the same way. The patterns of answers were compared between the 2 countries, and the differences were statistically analyzed. Japanese GPs seem to have a lower will to prevent suicide in daily practice compared to German GPs and a great lack of knowledge about treatment of suicidal patients. These observations suggest that improving GPs? interest in the problem of suicide and providing training programs for the treatment of patients with suicidal intentions might be a means of achieving better suicide prevention in Japan

Spatial Distribution of Macrophages During Callus Formation and Maturation Reveals Close Crosstalk Between Macrophages and Newly Forming Vessels

Macrophages are essential players in the process of fracture healing, acting by remodeling of the extracellular matrix and enabling vascularization. Whilst activated macrophages of M1-like phenotype are present in the initial pro-inflammatory phase of hours to days of fracture healing, an anti-inflammatory M2-like macrophage phenotype is supposed to be crucial for the induction of downstream cascades of healing, especially the initiation of vascularization. In a mouse-osteotomy model, we provide a comprehensive characterization of vessel (CD31+, Emcn+) and macrophage phenotypes (F4/80, CD206, CD80, Mac-2) during the process of fracture healing. To this end, we phenotype the phases of vascular regeneration-the expansion phase (d1-d7 after injury) and the remodeling phase of the endothelial network, until tissue integrity is restored (d14-d21 after injury). Vessels which appear during the bone formation process resemble type H endothelium (CD31hiEmcnhi), and are closely connected to osteoprogenitors (Runx2+, Osx+) and F4/80+ macrophages. M1-like macrophages are present in the initial phase of vascularization until day 3 post osteotomy, but they are rare during later regeneration phases. M2-like macrophages localize mainly extramedullary, and CD206+ macrophages are found to express Mac-2+ during the expansion phase. VEGFA expression is initiated by CD80+ cells, including F4/80+ macrophages, until day 3, while subsequently osteoblasts and chondrocytes are main contributors to VEGFA production at the fracture site. Using Longitudinal Intravital Microendoscopy of the Bone (LIMB) we observe changes in the motility and organization of CX3CR1+ cells, which infiltrate the injury site after an osteotomy. A transient accumulation, resulting in spatial polarization of both, endothelial cells and macrophages, in regions distal to the fracture site, is evident. Immunofluorescence histology followed by histocytometric analysis reveals that F4/80+CX3CR1+ myeloid cells precede vascularization