Stratified spatiotemporal chaos in anisotropic reaction-diffusion systems

Numerical simulations of two dimensional pattern formation in an anisotropic bistable reaction-diffusion medium reveal a new dynamical state, stratified spatiotemporal chaos, characterized by strong correlations along one of the principal axes. Equations that describe the dependence of front motion on the angle illustrate the mechanism leading to stratified chaos

Dynamic Front Transitions and Spiral-Vortex Nucleation

This is a study of front dynamics in reaction diffusion systems near Nonequilibrium Ising-Bloch bifurcations. We find that the relation between front velocity and perturbative factors, such as external fields and curvature, is typically multivalued. This unusual form allows small perturbations to induce dynamic transitions between counter-propagating fronts and nucleate spiral vortices. We use these findings to propose explanations for a few numerical and experimental observations including spiral breakup driven by advective fields, and spot splitting

Propagation Failure in Excitable Media

We study a mechanism of pulse propagation failure in excitable media where stable traveling pulse solutions appear via a subcritical pitchfork bifurcation. The bifurcation plays a key role in that mechanism. Small perturbations, externally applied or from internal instabilities, may cause pulse propagation failure (wave breakup) provided the system is close enough to the bifurcation point. We derive relations showing how the pitchfork bifurcation is unfolded by weak curvature or advective field perturbations and use them to demonstrate wave breakup. We suggest that the recent observations of wave breakup in the Belousov-Zhabotinsky reaction induced either by an electric field or a transverse instability are manifestations of this mechanism.Comment: 8 pages. Aric Hagberg: http://cnls.lanl.gov/~aric; Ehud Meron:http://www.bgu.ac.il/BIDR/research/staff/meron.htm

Four-phase patterns in forced oscillatory systems

We investigate pattern formation in self-oscillating systems forced by an external periodic perturbation. Experimental observations and numerical studies of reaction-diffusion systems and an analysis of an amplitude equation are presented. The oscillations in each of these systems entrain to rational multiples of the perturbation frequency for certain values of the forcing frequency and amplitude. We focus on the subharmonic resonant case where the system locks at one fourth the driving frequency, and four-phase rotating spiral patterns are observed at low forcing amplitudes. The spiral patterns are studied using an amplitude equation for periodically forced oscillating systems. The analysis predicts a bifurcation (with increasing forcing) from rotating four-phase spirals to standing two-phase patterns. This bifurcation is also found in periodically forced reaction-diffusion equations, the FitzHugh-Nagumo and Brusselator models, even far from the onset of oscillations where the amplitude equation analysis is not strictly valid. In a Belousov-Zhabotinsky chemical system periodically forced with light we also observe four-phase rotating spiral wave patterns. However, we have not observed the transition to standing two-phase patterns, possibly because with increasing light intensity the reaction kinetics become excitable rather than oscillatory.Comment: 11 page

Impact of chemotherapy regimen and rituximab in adult Burkitt lymphoma: a retrospective population-based study from the Nordic Lymphoma Group.

BackgroundStandard treatment of adult Burkitt lymphoma is not defined due to the lack of randomised trials. In this situation, population-based data may represent a useful contribution in order to identify an optimal treatment strategy.Patients and methodsThe aims of this study were to investigate the outcome for adult HIV-negative BL with different chemotherapy regimens, and to assess possible improvement within the time frame of the study. The study population was identified through the Swedish and Danish lymphoma registries 2000-2009.ResultsA total of 258 patients were identified. Since 2000, overall survival (OS) improved significantly only for younger patients (<65 years). Intensive regimens such as the Berlin-Frankfurt-Münster, hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) and cyclophosphamide, vincristine, doxorubicin, methotrexate, ifosfamide, etoposide, and cytarabine (CODOX-M/IVAC) were associated with a favourable 2-year OS of 82%, 83%, and 69%, respectively. The low-intensive CHOP/CHOEP regimens achieved a 2-year OS of 38.8%, confirming their inadequacy for the treatment of BL. In a multivariate analysis, rituximab was not significantly associated with improved OS.ConclusionsIn this population-based retrospective series of adult BL, intensive chemotherapy regimens were associated with favourable outcome. The impact of the addition of rituximab remains uncertain and warrants further investigation

Microbiological Etiology and Treatment of Complicated Skin and Skin Structure Infections in Diabetic and Nondiabetic Patients in a Population-Based Study

Background. Diabetes is a major risk factor for skin and skin structure infection (SSSI), and the global burden of diabetics with SSSI is enormous. The more complex microbiology of diabetic foot infection (DFI) is well established, but it is not known whether microbiological etiology differs between diabetics and nondiabetics in other disease entities under the umbrella of complicated SSSI (cSSSI). Methods. This retrospective, population-based study included patients with cSSSI, and it was conducted in 2 Nordic cities with a low prevalence of antimicrobial resistance. In analyses, patients (N = 460) were separated into 3 groups: diabetics (n = 119), nondiabetics (n = 271), and patients with DFI (n = 70). Results. After exclusion of patients with DFI, there was no difference in the microbiological etiology or initial antimicrobial treatment of cSSSI between diabetics and nondiabetics. Gram-positive bacteria encountered 70% of isolations in diabetics and 69% in nondiabetics, and the empirical treatment covered initial pathogens in 81% and 86% of patients, respectively. However, diabetes was the only background characteristic in the propensity score-adjusted analysis associated with broad-spectrum antimicrobial use and longer antibiotic treatment duration. Patients with DFI had Gram-negative and polymicrobial infection more often than nondiabetics. Conclusions. These observations suggest that diabetics without DFI are not different in the causative agents of cSSSI, although they are more exposed to antimicrobial therapy of inappropriate extended spectrum and long duration. Broad-spectrum coverage was clearly needed only in DFI. A clear opportunity for antimicrobial stewardship was detected in the rapidly growing population of diabetic patients with cSSSI.Peer reviewe

Order Parameter Equations for Front Transitions: Planar and Circular Fronts

Near a parity breaking front bifurcation, small perturbations may reverse the propagation direction of fronts. Often this results in nonsteady asymptotic motion such as breathing and domain breakup. Exploiting the time scale differences of an activator-inhibitor model and the proximity to the front bifurcation, we derive equations of motion for planar and circular fronts. The equations involve a translational degree of freedom and an order parameter describing transitions between left and right propagating fronts. Perturbations, such as a space dependent advective field or uniform curvature (axisymmetric spots), couple these two degrees of freedom. In both cases this leads to a transition from stationary to oscillating fronts as the parity breaking bifurcation is approached. For axisymmetric spots, two additional dynamic behaviors are found: rebound and collapse.Comment: 9 pages. Aric Hagberg: http://t7.lanl.gov/People/Aric/; Ehud Meron: http://www.bgu.ac.il/BIDR/research/staff/meron.htm

A potential benefit from infectious disease specialist and stationary ward in rational antibiotic therapy of complicated skin and skin structure infections

Background: Management practices of complicated skin and skin structure infections (cSSSI) were compared between two areas with similar healthcare structure and low prevalence of antimicrobial resistance.Methods: The high affinity to public health-care in the Nordic countries enabled population-based approach used in this retrospective study. The study population (n=460) consisted of all adult residents from Helsinki (Finland) and Gothenburg (Sweden) treated in hospital due to cSSSI during 2008-2011.Results: The majority of patients in Helsinki (57%) visited more than one ward during their hospital stay while in Gothenburg the majority of patients (85%) were treated in one ward only. Background and disease characteristics were largely similar in both cities but patients in Helsinki were younger [mean(SD) 59(18) versus 63(19) years, p=.0117], and greater proportions had diabetes (50% versus 32%, pPeer reviewe

A Phase Front Instability in Periodically Forced Oscillatory Systems

Multiplicity of phase states within frequency locked bands in periodically forced oscillatory systems may give rise to front structures separating states with different phases. A new front instability is found within bands where $\omega_{forcing}/\omega_{system}=2n$ ($n>1$). Stationary fronts shifting the oscillation phase by $\pi$ lose stability below a critical forcing strength and decompose into $n$ traveling fronts each shifting the phase by $\pi/n$. The instability designates a transition from stationary two-phase patterns to traveling $n$-phase patterns