E503 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E307 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E411 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E605 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E603 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E606 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E607 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

E204 ESAPP Project Report 2004

Annual project report. Project description, budget, impact, achievement of objectives and outputs, and appraisal by Management Team.

Wie der Euro Europa spaltet. Die Krise der gemeinsamen Währung und die Entfremdung von der Demokratie in der Europäischen Union

Um ihre verloren gegangene Wettbewerbsfähigkeit wiederherzustellen, bleibt den unter Zahlungsbilanzdefiziten leidenden Ländern des Euroraums nur die interne Abwertung: eine Politik zur Senkung des Lohn- und Preisniveaus. Wir argumentieren, dass diese Politik sowohl auf der Output- als auch auf der Input-Dimension einen Mangel an demokratischer Legitimation aufweist. Daher untersuchen wir die Entwicklung der Unterstützung des politischen Systems, sowohl auf der Ebene des Nationalstaats als auch der Europäischen Union. In einem empirischen Vergleich der 28 EU-Mitgliedsländer zwischen 2001 und 2013 zeigen wir anhand aggregierter Eurobarometerdaten, dass Europa im Bereich der politischen Legitimation auseinanderdriftet. Je stärker ein Land zur internen Abwertung gezwungen wird, desto mehr wendet sich seine Bevölkerung vom demokratischen politischen System auf der nationalen und supranationalen Ebene ab.

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS): first annual report

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) was founded on 10 December 2009 with the initiative of Roland Hetzer (Deutsches Herzzentrum Berlin, Berlin, Germany) and Jan Gummert (Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany) with 15 other founding international members. It aims to promote scientific research to improve care of end-stage heart failure patients with ventricular assist device or a total artificial heart as long-term mechanical circulatory support. Likewise, the organization aims to provide and maintain a registry of device implantation data and long-term follow-up of patients with mechanical circulatory support. Hence, EUROMACS affiliated itself with Dendrite Clinical Systems Ltd to offer its members a software tool that allows input and analysis of patient clinical data on a daily basis. EUROMACS facilitates further scientific studies by offering research groups access to any available data wherein patients and centres are anonymized. Furthermore, EUROMACS aims to stimulate cooperation with clinical and research institutions and with peer associations involved to further its aims. EUROMACS is the only European-based Registry for Patients with Mechanical Circulatory Support with rapid increase in institutional and individual membership. Because of the expeditious data input, the European Association for Cardiothoracic Surgeons saw the need to optimize the data availability and the significance of the registry to improve care of patients with mechanical circulatory support and its potential contribution to scientific intents; hence, the beginning of their alliance in 2012. This first annual report is designed to provide an overview of EUROMACS' structure, its activities, a first data collection and an insight to its scientific contributions.

Developing a point-of-care electronic medical record system for TB/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi.

BACKGROUND Implementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care. We detail the systematic, iterative process that implementation partners, Lighthouse clinic and Baobab Health Trust, employed to develop and implement a point-of-care electronic medical records system in an integrated, public clinic in Malawi that serves HIV-infected and tuberculosis (TB) patients. METHODS Baobab Health Trust, the system developers, conducted a series of technical and clinical meetings with Lighthouse and Ministry of Health to determine specifications. Multiple pre-testing sessions assessed patient flow, question clarity, information sequencing, and verified compliance to national guidelines. Final components of the TB/HIV electronic medical records system include: patient demographics; anthropometric measurements; laboratory samples and results; HIV testing; WHO clinical staging; TB diagnosis; family planning; clinical review; and drug dispensing. RESULTS Our experience suggests that an electronic medical records system can improve patient management, enhance integration of TB/HIV services, and improve provider decision-making. However, despite sufficient funding and motivation, several challenges delayed system launch including: expansion of system components to include of HIV testing and counseling services; changes in the national antiretroviral treatment guidelines that required system revision; and low confidence to use the system among new healthcare workers. To ensure a more robust and agile system that met all stakeholder and user needs, our electronic medical records launch was delayed more than a year. Open communication with stakeholders, careful consideration of ongoing provider input, and a well-functioning, backup, paper-based TB registry helped ensure successful implementation and sustainability of the system. Additional, on-site, technical support provided reassurance and swift problem-solving during the extended launch period. CONCLUSION Even when system users are closely involved in the design and development of an electronic medical record system, it is critical to allow sufficient time for software development, solicitation of detailed feedback from both users and stakeholders, and iterative system revisions to successfully transition from paper to point-of-care electronic medical records. For those in low-resource settings, electronic medical records for integrated care is a possible and positive innovation.

NONLINEAR TIME SERIES/SYSTEM ANALYSIS (STATE-SPACE, DYNAMICS, INTERVENTION, RESILIENCE, KALMAN)

A discussion of nonlinear dynamics, demonstrated by the familiar automobile, is followed by the development of a systematic method of analysis of a possibly nonlinear time series using difference equations in the general state-space format. This format allows recursive state-dependent parameter estimation after each observation thereby revealing the dynamics inherent in the system in combination with random external perturbations.^ The one-step ahead prediction errors at each time period, transformed to have constant variance, and the estimated parametric sequences provide the information to (1) formally test whether time series observations y(,t) are some linear function of random errors (ELEM)(,s), for some t and s, or whether the series would more appropriately be described by a nonlinear model such as bilinear, exponential, threshold, etc., (2) formally test whether a statistically significant change has occurred in structure/level either historically or as it occurs, (3) forecast nonlinear system with a new and innovative (but very old numerical) technique utilizing rational functions to extrapolate individual parameters as smooth functions of time which are then combined to obtain the forecast of y and (4) suggest a measure of resilience, i.e. how much perturbation a structure/level can tolerate, whether internal or external to the system, and remain statistically unchanged. Although similar to one-step control, this provides a less rigid way to think about changes affecting social systems.^ Applications consisting of the analysis of some familiar and some simulated series demonstrate the procedure. Empirical results suggest that this state-space or modified augmented Kalman filter may provide interesting ways to identify particular kinds of nonlinearities as they occur in structural change via the state trajectory.^ A computational flow-chart detailing computations and software input and output is provided in the body of the text. IBM Advanced BASIC program listings to accomplish most of the analysis are provided in the appendix. ^

POPULATION CODING IN LAMINAR CORTICAL CIRCUITS

One of the fundamental questions in neuroscience is to understand how encoding of sensory inputs is distributed across neuronal networks in cerebral cortex to influence sensory processing and behavioral performance. The fact that the structure of neuronal networks is organized according to cortical layers raises the possibility that sensory information could be processed differently in distinct layers. The goal of my thesis research is to understand how laminar circuits encode information in their population activity, how the properties of the population code adapt to changes in visual input, and how population coding influences behavioral performance. To this end, we performed a series of novel experiments to investigate how sensory information in the primary visual cortex (V1) emerges across laminar cortical circuits. First, it is commonly known that the amount of information encoded by cortical circuits depends critically on whether or not nearby neurons exhibit correlations. We examined correlated variability in V1 circuits from a laminar-specific perspective and observed that cells in the input layer, which have only local projections, encode incoming stimuli optimally by exhibiting low correlated variability. In contrast, output layers, which send projections to other cortical and subcortical areas, encode information suboptimally by exhibiting large correlations. These results argue that neuronal populations in different cortical layers play different roles in network computations. Secondly, a fundamental feature of cortical neurons is their ability to adapt to changes in incoming stimuli. Understanding how adaptation emerges across cortical layers to influence information processing is vital for understanding efficient sensory coding. We examined the effects of adaptation, on the time-scale of a visual fixation, on network synchronization across laminar circuits. Specific to the superficial layers, we observed an increase in gamma-band (30-80 Hz) synchronization after adaptation that was correlated with an improvement in neuronal orientation discrimination performance. Thus, synchronization enhances sensory coding to optimize network processing across laminar circuits. Finally, we tested the hypothesis that individual neurons and local populations synchronize their activity in real-time to communicate information about incoming stimuli, and that the degree of synchronization influences behavioral performance. These analyses assessed for the first time the relationship between changes in laminar cortical networks involved in stimulus processing and behavioral performance.

Strain-gauge, brushless torque meter

A torque meter comprising hollow-keyed, input and output female shafts adapted to receive the male shafts of the power source and machine respectively. Each shaft has a circular flange whose face is perpendicular to the center line of the shafts. Each flange has a plurality of equally spaced cylindrical recesses machined into the inside face thereto adapted to receive conical inserts therein. Balls are contained by the conical inserts and transmit the rotational movement from the input to the output shaft. A stationary housing extends around the input and output shaft and has a transducer shell secured thereto. When force is applied to the input shaft to cause movement, the balls encounter torsional resistance which causes the balls to roll up the ramps of the conical seat inserts to separate the two torque flanges. The force transmitted through the balls causes rotation to the output shaft and produces tension to the stationary transducer shell. The stationary transducer shell is instrumented with semi-conductor strain gauges.

Stable isotope records of corals from the northern Red Sea

We present a study based on X-ray chronologies and the stable isotopic composition of fossil Porites spp. corals from the northern Gulf of Aqaba (Red Sea) covering the mid-Holocene period from 5750 to 4450 14C years BP (before present). The stable oxygen and carbon isotopic compositions of five specimens reveal regular annual periodicities. Compared with modern Porites spp. from the same environment, the average seasonal delta18O amplitude of the fossil corals is higher (by ca. 0.35-0.60?), whereas annual growth rates are lower (by ca. 3.5 to 2 mm/year). This suggests stronger seasonality of sea surface temperatures and increased variability of the oxygen isotopic composition of the sea water due to changes in the precipitation and evaporation regime during the mid-Holocene. Most likely, summer monsoon rains reached the northern end of the Red Sea at that time. Average annual coral growth rates are diminished probably due to an increased input and resuspension of terrestrial debris to the shallow marine environment during more humid conditions. Our results corroborate published reports of paleodata and model simulations suggesting a northward migration of the African monsoon giving rise to increased seasonalities during the mid-Holocene over northeastern Africa and Arabia.