Epileptic seizures may be initiated by random neuronal fluctuations and/or by pathological slow regulatory dynamics of ion currents. This paper presents extensions to the Jansen and Rit neural mass model (JRNMM) to replicate paroxysmal transitions in intracranial electroencephalogram (iEEG) recordings. First, the Duffing NMM (DNMM) is introduced to emulate stochastic generators of seizures. The DNMM is constructed by applying perturbations to linear models of synaptic transmission in each neural population of the JRNMM. Then, the slow-fast DNMM is introduced by considering slow dynamics (relative to membrane potential and firing rate) of some internal parameters of the DNMM to replicate pathological evolution of ion currents. Through simulation, it is illustrated that the slow-fast DNMM exhibits transitions to and from seizures with etiologies that are linked either to random input fluctuations or pathological evolution of slow states. Estimation and optimization of a log likelihood function (LLF) using a continuous-discrete unscented Kalman filter (CD-UKF) and a genetic algorithm (GA) are performed to capture dynamics of iEEG data with paroxysmal transitions.

Burst suppression includes alternating patterns of silent and fast spike activities in neuronal activities observable (in micro or macro scale) electro-physiological recordings. Biological models of burst suppression are given as dynamical systems with slow and fast states. The aim of this paper is to give a method to identify parameters of a mesoscopic model of burst suppression that can provide insights into study underlying generators of intracranial electroencephalogram (iEEG) data. An optimisation technique based upon a genetic algorithm (GA) is employed to find feasible model parameters to replicate burst patterns in the iEEG data with paroxysmal transitions. Then, a continuous-discrete unscented Kalman filter (CD-UKF) is used to infer hidden states of the model and to enhance the identification results from the GA. The results show promise in finding the model parameters of a partially observed mesoscopic model of burst suppression.

Abstract The present work deals with analysis of instabilities in DCMIX1 ternary systems in the experimental geometry when two liquid layers with different concentrations are superimposed. In multicomponent mixtures, depending on the initial conditions, it is possible to have convective motion even when the top part is less dense than the bottom one. This unstable behavior destroys boundary interfaces unpredictably and affects diffusion processes. Such behavior was examined considering as multicomponent mixture the DCMIX1 ternary system. Due to its three different constituents, the mixture could easily generate two possible types of instability regimes such as: fingers and overstability. Five different compositions have been initially selected, three around the fingers-like type region and two around the overstability region. Experimental results obtained during Sliding Symmetric Tubes (SST) technique based experiments have been compared with the analytical pure diffusion solution and also with a 3D numerical simulation which includes the buoyancy effects. For this purpose, a specific solver in the open source software OpenFOAM has been created. Predicted instabilities agree well with experimental results in most of the cases, confirming the accuracy of the obtained diffusion coefficients.

Many techniques have been developed to cancel the ventricular interference in atrial electrograms (AEG) during atrial fibrillation. In particular, average beat subtraction (ABS) and interpolation are among those mostly adopted. However, ABS usually leaves high power residues and discontinuity at the borders, whereas interpolation totally substitutes the residual activity with a forecasting that might fail at the center of the cancellation segment. In this study, we proposed a new algorithm to refine the ventricular estimate provided by ABS, in such a way that the residual activity should likely be distributed as the local atrial activity. Briefly, the local atrial activity is first modeled with an autoregressive (AR) process, then the estimate is refined by maximizing the log likelihood of the atrial residual activity according to the fitted AR model. We tested the new algorithm on both synthetic and real AEGs, and compared the performance with other four algorithms (two variants of ABS, interpolation and zero substitution). On synthetic data, our algorithm outperformed all the others in terms of average root mean square error (0.043 vs 0.046 for interpolation; p < 0.05). On real data, our methodology outperformed two variants of ABS (p < 0.05) and performed similarly to interpolation when considering the high power residues left (both < 5%), and the log likelihood with the fitted AR model.

This paper presents an educational game fostering a new experience-based approach to teaching knowledge transfer using a codification strategy alone. The goal is to address and highlight some common issues and challenges that occur during knowledge transfer in product development and that are often difficult for especially students to grasp through exclusively a theoretical teaching approach. The game is introduced to 60 students in the final year of their Master's curriculum. In parallel, the game has been applied in a similar setting in a comparable higher educational institution, as well as in a product development organization.“Sometimes you win—other times you lose and learn.”

Channel coding is a common technique used to reduce bit-error rate (BER) in a communication channel. In cases where a certain block code is used, there is a known procedure for determining a residual BER (bit-error rate after encoding and decoding). Analysis in opposite direction should determine a block code parameters for optimising system performance in terms of reliability and throughput. This paper proposes an iterative method for addressed problem by introducing some auxiliary function, whose inverse can be written in closed form. We demonstrate the usage of proposed method in determining parameters of suitable binary BCH code to improve error probability during the transmission of BPSK signal over Rayleigh fading channel. The correctness of analytically obtained results are validated by simulation results.

The software-defined networking (SDN) is an articulation of the idea of increasing the network programmability with the aim of solving the problems identified in earlier research, regarding the complex and the time-consuming process of the protocol and interface standardization. An analysis of research in the field of SDN, presented through various review and survey papers, has shown that previous research was not sufficiently focused on flexibility and programmability of the data plane in SDN. Therefore, the goal of this paper is to improve the flexibility of the data plane in SDN by increasing the programmability level of the packet-switching node. To achieve the set goal, it was necessary to choose an appropriate metric for evaluation of flexibility and programmability of the data plane. Since there is no common position on the choice of metrics, a novel metric based on qualitative criteria is proposed in this paper. An existing data plane architectures in SDN are observed through the proposed metric. In the end, a novel data plane architecture, with improved flexibility from the aspect of the qualitative metric, is proposed.

Abstract We study a stochastic lattice model describing the dynamics of a group chasing and escaping between two species in an environment that contains obstacles. The Monte Carlo simulations are carried out on a two-dimensional square lattice. Obstacles are represented by non-overlapping lattice shapes that are randomly placed on the lattice. The model includes smart pursuit (chasers to targets) and evasion (targets from chasers). Both species can affect their movement by visual perception within their finite sighting range σ . We concentrate here on the role that density and shape of the obstacles plays in the time evolution of the number of targets, N T ( t ) . Temporal evolution of the number of targets N T ( t ) is found to be stretched-exponential, of the form N T ( t ) = N T ( 0 ) − δ N T ( ∞ ) 1 − exp [ − ( t ∕ τ ) β ] , regardless of whether the obstacles are present or not. The characteristic timescale τ is found to decrease with the initial density of targets ρ 0 T according to a power-law, i.e., τ ∝ ( ρ 0 T ) − γ . Furthermore, temporal dependences of the number of targets N T ( t ) are compared for various combinations of chasers and targets with different sighting ranges, σ = 1 , 2 , in order to analyze the relationship between the ability of species and the capture dynamics in the presence of obstacles.

Poor adherence to medical recommendations is a well-recognized catalyst for public health consequences worldwide. The literature highlights health consciousness as a likely antecedent to patient–physician trust, which in turn promotes medical adherence. Nevertheless, principles of patient-centered care suggest that patient perceptions of their doctor’s appraisal of their emotions may influence the path between trust and medical adherence. Accordingly, this study tested the mediating role of patient–physician trust in the relation between health consciousness and medical adherence and assessed whether patient ratings of their doctor’s appraisal of their own and their patients’ emotions moderated the mediated relation. Data were collected via self-report questionnaires from two culturally and economically diverse countries: Bosnia-Herzegovina (N = 262) and the United States (N = 314). Participants were young, healthy adults who visited their primary care physician in the past year. The study employed confirmatory factor analysis, mediation, and moderated mediation analyses. The results indicate that health consciousness positively related to patient–physician trust, which was in turn related to higher medical adherence and which mediated 28% of the total effect of health consciousness. Nevertheless, among patients who rated their physicians to have low appraisal for their patients’ emotions but high appraisal for their own emotions, the path from trust to adherence was not significant. These results highlight the importance of promoting health consciousness among young individuals, all while training practitioners to be attuned to their patients’ emotions and circumstances above their own. However, additional findings indicate that the interrelation between doctors’ emotional attributes and adherence is not necessarily one directional and warrants further investigation.

Purpose To investigate modes and quality of interprofessional communication between clinicians and radiologists, and to identify difficulties and possibilities in this context, as experienced by referring clinicians. Patients and methods Focus group interviews with 22 clinicians from different specialties were carried out. The leading question was: "How do you experience communication, verbal and nonverbal, between referring clinicians and radiologists?" Content analysis was used for interpretation of data. Results Overall, referring clinicians expressed satisfaction with their interprofessional communication with radiologists, and digital access to image data was highly appreciated. However, increased reliance on digital communication has led to reduced face-to-face contacts between clinicians and radiologists. This seems to constitute a potential threat to bilateral feedback, joint educational opportunities, and interprofessional development. Cumbersome medical information software systems, time constraints, shortage of staff, reliance on teleradiology, and lack of uniform format of radiology reports were mentioned as problematic. Further implementation of structured reporting was considered beneficial. Conclusion Deepened face-to-face contacts between clinicians and radiologists were considered prerequisites for mutual understanding, deepened competence and mutual trust; a key factor in interprofessional communication. Clinicians and radiologists should come together in order to secure bilateral feedback and obtain deepened knowledge of the specific needs of subspecialized clinicians.

Providing appropriate legal mechanisms, that evaluate the progression of development from the age of childhood innocence to maturity and full responsibility, considered one of the difficult areas of criminal justice policy. The minimum age of criminal responsibility (MACR) in children varies among countries and differs widely owing to history and culture. Due to rising and brutality of criminal offenses, particularly by juveniles, few countries have lowered the minimum age of criminal responsibility, and many have considered/considering to do the same. India is one such country in which is under the proposal of lowering the age of criminal responsibility to 16 years. As there is lack of useful age assessment methods, that can indicate whether if the individual in question is younger (<16 years) or older than MACR (≥16 years), the present study was undertaken to derive a specific cut-off value of the third molar maturity index (I3M) for this purpose. The sample consisted of 1078 orthopantomograms (OPTs) from Andhra Pradesh, India, aged between 11 and 20 years (45.4% males and 54.6% females). The reproducibility of I3M was calculated by intra-class correlation coefficients, which showed an intra-rater and inter-rater agreement of 0.912 and 0.891, respectively. The sample was divided into training dataset (819 OPTs), to test I3M and gender as independent variables and MACR as a dependent variable by logistic regression analysis, and test dataset (259 OPTs). A receiver operating curve (ROC) analysis was performed to evaluate the specific cut-off value of I3M for predicting MACR status. A logistic regression analysis showed that gender was not statistically significant for predicting MACR status while ROC analysis indicated a cut-off value of I3M = 0.293 as best for predicting MACR status. The performance of derived cut-off value was tested in a test data set. The sensitivity of the test was 90.6% and 90%, while specificity was 86% and 87.1% in males and females, respectively. The proportion of correctly classified individuals was 88.0% and 88.7% in males and females, respectively. The estimated Bayes post-test probability in males was 87.2% and while in females it was 88.3%. The results highlight the contribution of the derived cut-off value of I3M for discriminating individuals around MACR and should be evaluated in other populations.

OBJECTIVE To compare and analyse the accuracy of four age estimation methods using the mineralisation stages of the permanent teeth (Cameriere et al. [16] [CAM], Liliequist and Lundberg [LLH] and Nolla without third molars [NOL7] or with them [NOL8]) in a mixed population of Brazilians and a homogeneous population of Croatians. METHODS Orthopantomograms of 930 Brazilians (366 males and 564 females) and 924 Croatians (365 males and 556 females) aged between 8 and 14.99 years were analysed using the CAM, LLH, NOL7 and NOL8 age estimation methodologies. RESULTS LLH presented the best absolute differences (ADs) among both populations without sex stratification, while CAM presented the worst results. In addition, the mean differences revealed underestimations, except when the LLH and NOL7 methods were used for the Brazilians. When the sample was stratified by sex, the best AD values were found with NOL7 (0.80) for the Brazilians and with LLH (0.98) for the Croatians. When the sample was stratified by sex and age, CAM presented high accuracy at the early ages, and LLH presented high accuracy at the older ages. The results obtained with the Nolla methods (NOL7 and NOL8) were mostly similar, but NOL7 yielded slightly better results. CONCLUSIONS The values for the Brazilians and the Croatians were relatively similar, and the techniques were properly applied in both population samples. The best method for evaluating both countries was LLH, followed by NOL7, NOL8 and CAM.

impairment. These differences could be partially attributed to the localised marketing strategy. Conclusions: This interim analysis has demonstrated that older adults (65-85 years old) are willing and able to engage in web-based assessments. Furthermore, CANTAB Recruit provides an effective strategy to identify those with impair-ments in episodic and working memory domains. The feasibility and sensitivity of online screening for older adults at risk of Alzheimer’s disease is encouraging. Background:

Metastatic involvement of the gallbladder is uncommon. We report a case of an 84-year-old male who presented with acute cholecystitis secondary to metastatic urothelial carcinoma (UC). An 84-year-old man presented with right upper quadrant pain and a positive Murphy's sign on the background of known metastatic UC. He was diagnosed with acute cholecystitis and underwent laparoscopic cholecystectomy. His postoperative period was complicated by a cardiac event, and he died 2 days later. Histology of the gallbladder revealed extensive infiltration by nested malignant epithelioid proliferation, consistent with UC. This case demonstrates that although uncommon, UC may metastasize to unusual sites, including the gallbladder. This serves as a reminder for surgeons to consider metastatic disease as a cause for acute cholecystitis.

Background Better understanding, documentation and evaluation of different refugee health interventions and their means of health system integration and intersectoral collaboration are needed. Objectives Explore the barriers and facilitators to the integration of health services for refugees; the processes involved and the different stakeholders engaged in levaraging intersectoral approaches to protect refugees’ right to health on resettlement. Design Scoping review. Methods A search of articles from 2000 onward was done in MEDLINE, Web of Science, Global Health and PsycINFO, Embase. Two frameworks were applied in our analysis, the ‘framework for analysing integration of targeted health interventions in systems’ and ‘Health in All Policies’ framework for country action. A comprehensive description of the methods is included in our published protocol. Results 6117 papers were identified, only 18 studies met the inclusion criteria. Facilitators in implementation included: training for providers, colocation of services, transportation services to enhance access, clear role definitions and appropriate budget allocation and financing. Barriers included: lack of a participatory approach, insufficient resources for providers, absence of financing, unclear roles and insufficient coordination of interprofessional teams; low availability and use of data, and turf wars across governance stakeholders. Successful strategies to address refugee health included: networks of service delivery combining existing public and private services; system navigators; host community engagement to reduce stigma; translation services; legislative support and alternative models of care for women and children. Conclusion Limited evidence was found overall. Further research on intersectoral approaches is needed. Key policy insights gained from barriers and facilitators reported in available studies include: improving coordination between existing programmes; supporting colocation of services; establishing formal system navigator roles that connect relevant programmes; establishing formal translation services to improve access and establishing training and resources for providers.