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Transient local over-dry environment might be a contributor and an explanation for the observed asynchronous local rises in Covid-19 mortality. We propose that a habitat's air humidity negatively correlate with Covid-19 morbidity and mortality, and support this hypothesis on the example of publicly available data from German federal states., Competing Interests: Declaration of competing interest The author declares that she has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

In many oscillatory or excitable systems, dynamical patterns emerge which are stationary or periodic in a moving frame of reference. Examples include traveling waves or spiral waves in chemical systems or cardiac tissue. We present a unified theoretical framework for the drift of such patterns under small external perturbations, in terms of overlap integrals between the perturbation and the adjoint critical eigenfunctions of the linearized operator (i.e., response functions). For spiral waves, the finite radius of the spiral tip trajectory and spiral wave meander are taken into account. Different coordinate systems can be chosen, depending on whether one wants to predict the motion of the spiral-wave tip, the time-averaged tip path, or the center of the meander flower. The framework is applied to analyze the drift of a meandering spiral wave in a constant external field in different regimes.

Meandering spiral waves are often observed in excitable media such as the Belousov-Zhabotinsky reaction and cardiac tissue. We derive a theory for drift dynamics of meandering rotors in general reaction-diffusion systems and apply it to two types of external disturbances: an external field and curvature-induced drift in three dimensions. We find two distinct regimes: with small filament curvature, meandering scroll waves exhibit filament tension, whose sign determines the stability and drift direction. In the regimes of strong external fields or meandering motion close to resonance, however, phase locking of the meander pattern is predicted and observed.

The BeatBox simulation environment combines flexible script language user interface with the robust computational tools, in order to setup cardiac electrophysiology in-silico experiments without re-coding at low-level, so that cell excitation, tissue/anatomy models, stimulation protocols may be included into a BeatBox script, and simulation run either sequentially or in parallel (MPI) without re-compilation. BeatBox is a free software written in C language to be run on a Unix-based platform. It provides the whole spectrum of multi scale tissue modelling from 0-dimensional individual cell simulation, 1-dimensional fibre, 2-dimensional sheet and 3-dimensional slab of tissue, up to anatomically realistic whole heart simulations, with run time measurements including cardiac re-entry tip/filament tracing, ECG, local/global samples of any variables, etc. BeatBox solvers, cell, and tissue/anatomy models repositories are extended via robust and flexible interfaces, thus providing an open framework for new developments in the field. In this paper we give an overview of the BeatBox current state, together with a description of the main computational methods and MPI parallelisation approaches.

A scroll wave in a very thin layer of excitable medium is similar to a spiral wave, but its behavior is affected by the layer geometry. We identify the effect of sharp variations of the layer thickness, which is separate from filament tension and curvature-induced drifts described earlier. We outline a two-step asymptotic theory describing this effect, including asymptotics in the layer thickness and calculation of the drift of so-perturbed spiral waves using response functions. As specific examples, we consider drift of scrolls along thickness steps, ridges, ditches, and disk-shaped thickness variations. Asymptotic predictions agree with numerical simulations.

The interaction of spiral waves of excitation with atrial anatomy remains unclear. This simulation study isolates the role of atrial anatomical structures on spiral wave spontaneous drift in the human atrium. We implemented realistic and idealised 3D human atria models to investigate the functional impact of anatomical structures on the long-term (∼40 s) behaviour of spiral waves. The drift of a spiral wave was quantified by tracing its tip trajectory, which was correlated to atrial anatomical features. The interaction of spiral waves with the following idealised geometries was investigated: (a) a wedge-like structure with a continuously varying atrial wall thickness; (b) a ridge-like structure with a sudden change in atrial wall thickness; (c) multiple bridge-like structures consisting of a bridge connected to the atrial wall. Spiral waves drifted from thicker to thinner regions and along ridge-like structures. Breakthrough patterns caused by pectinate muscles (PM) bridges were also observed, albeit infrequently. Apparent anchoring close to PM-atrial wall junctions was observed. These observations were similar in both the realistic and the idealised models. We conclude that spatially altering atrial wall thickness is a significant cause of drift of spiral waves. PM bridges cause breakthrough patterns and induce transient anchoring of spiral waves.

Aims: Atrial anti-arrhythmic effects of β-adrenoceptor antagonists (β-blockers) may involve both a suppression of pro-arrhythmic effects of catecholamines, and an adaptational electrophysiological response to chronic β-blocker use; so-called 'pharmacological remodelling'. In human atrium, such remodelling decreases the transient outward (Ito) and inward rectifier (IK1) K(+) currents, and increases the cellular action potential duration (APD) and effective refractory period (ERP). However, the consequences of these changes on mechanisms of genesis and maintenance of atrial fibrillation (AF) are unknown. Using mathematical modelling, we tested the hypothesis that the long-term adaptational decrease in human atrial Ito and IK1 caused by chronic β-blocker therapy, i.e. independent of acute electrophysiological effects of β-blockers, in an otherwise un-remodelled atrium, could suppress AF., Methods and Results: Contemporarily, biophysically detailed human atrial cell and tissue models were used to investigate effects of the β-blocker-based pharmacological remodelling. Chronic β-blockade remodelling prolonged atrial cell APD and ERP. The incidence of small amplitude APD alternans in the CRN model was reduced. At the 1D tissue level, β-blocker remodelling decreased the maximum pacing rate at which APs could be conducted. At the three-dimensional organ level, β-blocker remodelling reduced the life span of re-entry scroll waves., Conclusion: This study improves our understanding of the electrophysiological mechanisms of AF suppression by chronic β-blocker therapy. Atrial fibrillation suppression may involve a reduced propensity for maintenance of re-entrant excitation waves, as a consequence of increased APD and ERP., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.)

Sinus node dysfunction (SND) is correlated to the pacemaker sinoatrial node (SAN) cell apoptosis. This study explores the effect of such a dysfunctional SAN on electrical propagation into neighboring atrial tissue. The Fenton Karma model was extended to simulate mouse SAN and atrial cell action potentials. The cell models were incorporated into a 2D model consisting of a central SAN region surrounded by atrial tissue. The intercellular gap junctional coupling, as quantified by the diffusion constant, was estimated to give conduction speeds as observed in mouse atrial tissue. The size of mouse SAN pacemaking region was estimated using the 2D model. In multiple simulations, the effects of an increasing proportion of apoptotic pacemaker cells on atrial tissue pacing were simulated and quantified. The SAN size that gave a basal mouse atrial cycle length (ACL) of 295 ms was found to be 0.6 mm in radius. At low pacemaker cell apoptosis proportion, there was a drastic increase of ACL. At modest increase in the number of apoptotic cells, bradycardia was observed. The incidence of sinus arrest was also found to be high. When the number of apoptotic cells were 10% of the total number of pacemaking cells, all pacemaking was arrested. Phenomenological models have been developed to study mouse atrial electrophysiology and confirm experimental findings. The results show the significance of cell apoptosis as a major mechanism of SND.

This computational study quantifies the effectiveness of feedback controlled low energy cardioversion in the anisotropic human atria. An established biophysical human cell model was adopted to reproduce Control and chronic atrial fibrillation (CAF) action potentials. The cell model was combined with a detailed human atrial geometry to construct a 3D realistic human atrial model. Scroll waves were simulated under Control and CAF conditions and the cardioversion parameters of stimulation strength and pacing duration were evaluated for scroll wave termination. Scroll waves were initiated at two locations in the atria to elicit the effects of scroll wave location. The role of anisotropy was highlighted by comparison to results from the isotropic case. Under Control conditions, scroll wave self-termination was rapid in the anisotropic case. Under CAF conditions, anisotropy caused the initiated scroll wave to degenerate into multiple scrolls with each evolving erratically or pinning to anatomical defects. The cardioversion successfully terminated scroll waves within 10 s, but the stimulus strength had a strong correlation to the location of the scroll wave. The low energy stimulation strength was always lower than the threshold stimulus. Anisotropy plays an important role in atrial electrical properties. Anisotropy aggravates CAF and leads to high frequency atrial pacing. The efficacy of cardioversion is significantly affected by anisotropy.

Abnormal electrical activity from the boundaries of ischemic cardiac tissue is recognized as one of the major causes in generation of ischemia-reperfusion arrhythmias. Here we present theoretical analysis of the waves of electrical activity that can rise on the boundary of cardiac cell network upon its recovery from ischaemia-like conditions. The main factors included in our analysis are macroscopic gradients of the cell-to-cell coupling and cell excitability and microscopic heterogeneity of individual cells. The interplay between these factors allows one to explain how spirals form, drift together with the moving boundary, get transiently pinned to local inhomogeneities, and finally penetrate into the bulk of the well-coupled tissue where they reach macroscopic scale. The asymptotic theory of the drift of spiral and scroll waves based on response functions provides explanation of the drifts involved in this mechanism, with the exception of effects due to the discreteness of cardiac tissue. In particular, this asymptotic theory allows an extrapolation of 2D events into 3D, which has shown that cells within the border zone can give rise to 3D analogues of spirals, the scroll waves. When and if such scroll waves escape into a better coupled tissue, they are likely to collapse due to the positive filament tension. However, our simulations have shown that such collapse of newly generated scrolls is not inevitable and that under certain conditions filament tension becomes negative, leading to scroll filaments to expand and multiply leading to a fibrillation-like state within small areas of cardiac tissue.

Rotating spiral and scroll waves (vortices) are investigated in the FitzHugh-Nagumo model of excitable media. The focus is on a parameter region in which there exists bistability between alternative stable vortices with distinct periods. Response functions are used to predict the filament tension of the alternative scrolls and it is shown that the slow-period scroll has negative filament tension, while the filament tension of the fast-period scroll changes sign within a hysteresis loop. The predictions are confirmed by direct simulations. Further investigations show that the slow-period scrolls display features similar to delayed after-depolarization and tend to develop into turbulence similar to ventricular fibrillation (VF). Scrolls with positive filament tension collapse or stabilize, similar to monomorphic ventricular tachycardia (VT). Perturbations, such as boundary interaction or shock stimulus, can convert the vortex with negative filament tension into the vortex with positive filament tension. This may correspond to transition from VF to VT unrelated to pinning., (© 2010 American Institute of Physics.)

Rotating spiral waves are a form of self-organization observed in spatially extended systems of physical, chemical, and biological nature. In the presence of a small perturbation, the spiral wave's center of rotation and fiducial phase may change over time, i.e., the spiral wave drifts. In linear approximation, the velocity of the drift is proportional to the convolution of the perturbation with the spiral's response functions, which are the eigenfunctions of the adjoint linearized operator corresponding to the critical eigenvalues λ=0,±iω . Here, we demonstrate that the response functions give quantitatively accurate prediction of the drift velocities due to a variety of perturbations: a time dependent, periodic perturbation (inducing resonant drift); a rotational symmetry-breaking perturbation (inducing electrophoretic drift); and a translational symmetry-breaking perturbation (inhomogeneity induced drift) including drift due to a gradient, stepwise, and localized inhomogeneity. We predict the drift velocities using the response functions in FitzHugh-Nagumo and Barkley models, and compare them with the velocities obtained in direct numerical simulations. In all cases good quantitative agreement is demonstrated.

Spiral waves in active media react to small perturbations as particlelike objects. Here we apply asymptotic theory to the interaction of spiral waves with a localized inhomogeneity, which leads to a novel prediction: drift of the spiral rotation center along circular orbits around the inhomogeneity. The stationary orbits have fixed radii and alternating stability, determined by the properties of the bulk medium and the type of inhomogeneity, while the drift speed along an orbit depends on the strength of the inhomogeneity. Direct numerical simulations confirm the validity and robustness of the theoretical predictions and show that these unexpected effects should be observable in experiment.

Rotating spiral waves are a form of self-organization observed in spatially extended systems of physical, chemical, and biological natures. A small perturbation causes gradual change in spatial location of spiral's rotation center and frequency, i.e., drift. The response functions (RFs) of a spiral wave are the eigenfunctions of the adjoint linearized operator corresponding to the critical eigenvalues lambda=0,+/-iomega. The RFs describe the spiral's sensitivity to small perturbations in the way that a spiral is insensitive to small perturbations where its RFs are close to zero. The velocity of a spiral's drift is proportional to the convolution of RFs with the perturbation. Here we develop a regular and generic method of computing the RFs of stationary rotating spirals in reaction-diffusion equations. We demonstrate the method on the FitzHugh-Nagumo system and also show convergence of the method with respect to the computational parameters, i.e., discretization steps and size of the medium. The obtained RFs are localized at the spiral's core.

We aim to assess the effectiveness of feedback-controlled resonant drift pacing as a method for low energy defibrillation. Antitachycardia pacing is the only low energy defibrillation approach to have gained clinical significance, but it is still suboptimal. Low energy defibrillation would avoid adverse side effects associated with high voltage shocks and allow the application of implantable cardioverter defibrillator (ICD) therapy, in cases where such therapy is not tolerated today. We present results of computer simulations of a bidomain model of cardiac tissue with human atrial ionic kinetics. Reentry was initiated and low energy shocks were applied with the same period as the reentry, using feedback to maintain resonance. We demonstrate that such stimulation can move the core of reentrant patterns, in the direction that depends on the location of the electrodes and the time delay in the feedback. Termination of reentry is achieved with shock strength one-order-of-magnitude weaker than in conventional single-shock defibrillation. We conclude that resonant drift pacing can terminate reentry at a fraction of the shock strength currently used for defibrillation and can potentially work where antitachycardia pacing fails, due to the feedback mechanisms. Success depends on a number of details that these numerical simulations have uncovered.

Turbulence of scroll waves is a sort of spatiotemporal chaos that exists in three-dimensional excitable media. Cardiac tissue and the Belousov-Zhabotinsky reaction are examples of such media. In cardiac tissue, chaotic behavior is believed to underlie fibrillation which, without intervention, precedes cardiac death. In this study we investigate suppression of the turbulence using stimulation of two different types, "modulation of excitability" and "extra transmembrane current." With cardiac defibrillation in mind, we used a single pulse as well as repetitive extra current with both constant and feedback controlled frequency. We show that turbulence can be terminated using either a resonant modulation of excitability or a resonant extra current. The turbulence is terminated with much higher probability using a resonant frequency perturbation than a nonresonant one. Suppression of the turbulence using a resonant frequency is up to fifty times faster than using a nonresonant frequency, in both the modulation of excitability and the extra current modes. We also demonstrate that resonant perturbation requires strength one order of magnitude lower than that of a single pulse, which is currently used in clinical practice to terminate cardiac fibrillation. Our results provide a robust method of controlling complex chaotic spatiotemporal processes. Resonant drift of spiral waves has been studied extensively in two dimensions, however, these results show for the first time that it also works in three dimensions, despite the complex nature of the scroll wave turbulence.

We analyse small parameters in selected models of biological excitability, including Hodgkin-Huxley (Hodgkin & Huxley 1952 J. Physiol.117, 500-544) model of nerve axon, Noble (Noble 1962 J. Physiol.160, 317-352) model of heart Purkinje fibres and Courtemanche et al. (Courtemanche et al. 1998 Am. J. Physiol.275, H301-H321) model of human atrial cells. Some of the small parameters are responsible for differences in the characteristic time-scales of dynamic variables, as in the traditional singular perturbation approaches. Others appear in a way which makes the standard approaches inapplicable. We apply this analysis to study the behaviour of fronts of excitation waves in spatially extended cardiac models. Suppressing the excitability of the tissue leads to a decrease in the propagation speed, but only to a certain limit; further suppression blocks active propagation and leads to a passive diffusive spread of voltage. Such a dissipation may happen if a front propagates into a tissue recovering after a previous wave, e.g. re-entry. A dissipated front does not recover even when the excitability restores. This has no analogy in FitzHugh-Nagumo model and its variants, where fronts can stop and then start again. In two spatial dimensions, dissipation accounts for breakups and self-termination of re-entrant waves in excitable media with Courtemanche et al. kinetics.

We demonstrate and explain a wave-particle dualism of such classical macroscopic phenomena as spiral waves in active media. That means although spiral waves appear as nonlocal processes involving the whole medium, they respond to small perturbations as effectively localized entities. The dualism appears as an emergent property of a nonlinear field and is mathematically expressed in terms of the spiral waves response functions, which are essentially nonzero only in the vicinity of the spiral wave core. Knowledge of the response functions allows quantitatively accurate prediction of the spiral wave drift due to small perturbations of any nature, which makes them as fundamental characteristics for spiral waves as mass is for the condensed matter.

We test the asymptotical theory of dynamics of spiral waves by applying it to inhomogeneity-induced drift of the spiral waves in the Complex Ginzburg-Landau equation for two different types of weak media inhomogeneities and demonstrate good quantitative agreement with numerical simulations for both.

We consider an excitable medium moving with relative shear, subjected to a localized disturbance that in a stationary medium would produce a pair of spiral waves. The spiral waves so created are distorted and then broken by the motion of the medium. Such breaks generate new spiral waves, and so a "chain reaction" of spiral wave births and deaths is observed. This leads to a complicated spatiotemporal pattern, the "frazzle gas" [term suggested by Markus et al., Nature (London) 371, 402 (1994)], which eventually fills the whole medium. In this paper, we display and interpret the main features of the pattern.

If an excitable medium is moving with relative shear, the waves of excitation may be broken by the motion. We consider such breaks for the case of a constant linear shear flow. The mechanisms and conditions for the breaking of solitary waves and wavetrains are essentially different: the solitary waves require the velocity gradient to exceed a certain threshold, whilst the breaking of repetitive wavetrains happens for arbitrarily small velocity gradients. Since broken waves evolve into new spiral wave sources, this leads to spatio-temporal irregularity.

Weak periodic external perturbations of an autowave medium can cause large-distance directed motion of the spiral wave. This happens when the period of the perturbation coincides with, or is close to the rotation period of a spiral wave, or its multiple. Such motion is called resonant or parametric drift. It may be used for low-voltage defibrillation of heart tissue. Theory of the resonant drift exists, but so far was used only qualitatively. In this paper, we show good quantitative agreement of the theory with direct numerical simulations. This is done for Complex Ginzburg-Landau Equation, one of the simplest autowave models.