Real life experience with the wearable cardioverter-defibrillator in an international multicenter Registry

Patients at high risk for sudden cardiac death (SCD) may benefit from wearable cardioverter defibrillators (WCD) by avoiding immediate implantable cardioverter defibrillator (ICD) implantation. Different factors play an important role including patient selection, compliance and optimal drug treatment. We aimed to present real world data from 4 centers from Germany and Switzerland. Between 04/2012 and 03/2019, 708 patients were included in this registry. Patients were followed up over a mean time of 28 ± 35.5 months. Outcome data including gender differences and different etiologies of cardiomyopathy were analyzed. Out of 708 patients (81.8% males, mean age 61.0 ± 14.6), 44.6% of patients had non-ischemic cardiomyopathy, 39.8% ischemic cardiomyopathy, 7.9% myocarditis, 5.4% prior need for ICD explantation and 2.1% channelopathy. The mean wear time of WCD was 21.2 ± 4.3 h per day. In 46% of patients, left ventricular ejection fraction (LVEF) was > 35% during follow-up. The younger the patient was, the higher the LVEF and the lower the wear hours per day were. The total shock rate during follow-up was 2.7%. Whereas an appropriate WCD shock was documented in 16 patients (2.2%), 3 patients received an inappropriate ICD shock (0.5%). During follow-up, implantation of a cardiac implantable electronic device was carried out in 34.5% of patients. When comparing German patients (n = 516) to Swiss patients (n = 192), Swiss patients presented with longer wear days (70.72 ± 49.47 days versus 58.06 ± 40.45 days; p = 0.001) and a higher ICD implantation rate compared to German patients (48.4% versus 29.3%; p = 0.001), although LVEF at follow-up was similar between both groups. Young age is a negative independent predictor for the compliance in this large registry. The most common indication for WCD was non-ischemic cardiomyopathy followed by ischemic cardiomyopathy. The compliance rate was generally high with a decrease of wear hours per day at younger age. Slight differences were found between Swiss and German patients, which might be related to differences in mentality for ICD implantation

Multi-dimensional gyrokinetic parameter studies based on eigenvalue computations

Plasma microinstabilities, which can be described in the framework of the linear gyrokinetic equations, are routinely computed in the context of stability analyses and transport predictions for magnetic confinement fusion experiments. The GENE code, which solves the gyrokinetic equations, has been coupled to the SLEPc package for an efficient iterative, matrix-free, and parallel computation of rightmost eigenvalues. This setup is presented, including the preconditioner which is necessary for the newly implemented Jacobi-Davidson solver. The fast computation of instabilities at a single parameter set is exploited to make parameter scans viable, that is to compute the solution at many points in the parameter space. Several issues related to parameter scans are discussed, such as an efficient parallelization over parameter sets and subspace recycling. © 2011 Elsevier B.V. All rights reserved.E. Romero and J.E. Roman were supported by the Spanish Ministry of Science and Innovation (MICINN) under project number TIN2009-07519.Merz, F.; Kowitz, C.; Romero Alcalde, E.; Román Moltó, JE.; Jenko, F. (2012). Multi-dimensional gyrokinetic parameter studies based on eigenvalue computations. Computer Physics Communications. 183(4):922-930. https://doi.org/10.1016/j.cpc.2011.12.018S922930183

Fault-tolerant grid-based solvers: Combining concepts from sparse grids and MapReduce

A key issue confronting petascale and exascale computing is the growth in probability of soft and hard faults with increasing system size. A promising approach to this problem is the use of algorithms that are inherently fault tolerant. We introduce such an algorithm for the solution of partial differential equations, based on the sparse grid approach. Here, the solution of multiple component grids are efficiently combined to achieve a solution on a full grid. The technique also lends itself to a (modified) MapReduce framework on a cluster of processors, with the map stage corresponding to allocating each component grid for solution over a subset of the processors, and the reduce stage corresponding to their combination. We describe how the sparse grid combination method can be modified to robustly solve partial differential equations in the presence of faults. This is based on a modified combination formula that can accommodate the loss of one or two component grids. We also discuss accuracy issues associated with this formula. We give details of a prototype implementation within a MapReduce framework using the dynamic process features and asynchronous message passing facilities of MPI. Results on a two-dimensional advection problem show that the errors after the loss of one or two sub-grids are within a factor of 3 of the sparse grid solution in the presence of no faults. They also indicate that the sparse grid technique with four times the resolution has approximately the same error as a full grid, while requiring (for a sufficiently high resolution) much lower computation and memory requirements. We finally outline a MapReduce variant capable of responding to faults in ways other than re-scheduling of failed tasks. We discuss the likely software requirements for such a flexible MapReduce framework, the requirements it will impose on users’ legacy codes, and the system's runtime behavior.J. W. Larson, M. Hegland, B. Harding, S. Roberts, L. Stals, A. P. Rendell, P. Strazdins, M. M. Ali, C. Kowitz, R. Nobes, J. Southern, N. Wilson, M. Li, Y. Oish

Redefining innovation processes: The digital designers at work

As design in digital innovation has become a thing, we highlight the inconclusive concepts that describe design activity in innovation processes. Proposing an alternative theoretical lens - a sociomaterial practice lens - we claim that this view can reveal the contribution of digital designers to the work of innovation. This paper draws on a research study with digital designers in the UK. At the same time as we begin to reconceptualise the ways digital design activity can be described, we also illustrate a theoretical framework based on 1) action and knowing as ordered by collectively produced objects, 2) sociomateriality and the configuration of human bodies and materials in action, 3) the co-emergence of objects and sociomaterial configurations where each is the condition of the other. This alternative way of looking at design activity may pose some challenges to the theoretical traditions in the field. We however believe that it contains immense potential too

An Opticom Method for Computing Eigenpairs

Solving the linearized and five-dimensional gyrokinetic equations can already be used to retrieve the microinstabilities driving the microturbulence of a hot magnetized plasma. The microinstabilities can be computed by calculating the eigenvalues of the linear gyrokinetic operator, which have a positive real part. The growth rate and frequency of the instability is given by the computed eigenvalue and its structure by the respective eigenvector. Due to the moderately high dimensionality, the sparse grid combination technique is used to tackle the curse of dimensionality for solving the gyrokinetic eigenvalue problem with the already highly optimized plasmaturbulence code GENE. Whereas the classical combination technique can retrieve approximation of the searched eigenvalues, the combination of the eigenvectors requires the application and reformulation of the optimized combination technique (OptiCom). The reformulation and an algorithm for solving the reformulated system to compute the eigenpairs is proposed in this paper. A first analytical test problem is solved and the applicability of the method is shown