A Quantitative Assessment of Cerebral Hemodynamic Perturbations Associated with Long R-R Intervals in Atrial Fibrillation: A Pilot-Case-Based Experience.

Background and Objectives: Atrial fibrillation (AF) results in systemic hemodynamic perturbations which impact cerebral circulation, possibly contributing to the development of dementia. However, evidence documenting effects in cerebral perfusion is scarce. The aim of this study is to provide a quantitative characterization of the magnitude and time course of the cerebral hemodynamic response to the short hypotensive events associated with long R-R intervals, as detected by near-infrared spectroscopy (NIRS). Materials and Methods: Cerebral NIRS signals and arterial blood pressure were continuously recorded along with an electrocardiogram in twelve patients with AF undergoing elective electrical cardioversion (ECV). The top 0.5-2.5% longest R-R intervals during AF were identified in each patient and used as triggers to carry out the triggered averaging of hemodynamic signals. The average curves were then characterized in terms of the latency, magnitude, and duration of the observed effects, and the possible occurrence of an overshoot was also investigated. Results: The triggered averages revealed that long R-R intervals produced a significant drop in diastolic blood pressure (-13.7 ± 6.1 mmHg) associated with an immediate drop in cerebral blood volume (THI: -0.92 ± 0.46%, lasting 1.9 ± 0.8 s), followed by a longer-lasting decrease in cerebral oxygenation (TOI: -0.79 ± 0.37%, lasting 5.2 ± 0.9 s, p < 0.01). The recovery of the TOI was generally followed by an overshoot (+1.06 ± 0.12%). These effects were progressively attenuated in response to R-R intervals of a shorter duration. Conclusions: Long R-R intervals cause a detectable and consistent cerebral hemodynamic response which concerns both cerebral blood volume and oxygenation and outlasts the duration of the systemic perturbation. These effects are compatible with the activation of dynamic autoregulatory mechanisms in response to the hypotensive stimulus.

A review of multiscale 0D-1D computational modeling of coronary circulation with applications to cardiac arrhythmias.

Computational hemodynamics is becoming an increasingly important tool in clinical applications and surgical procedures involving the cardiovascular system. Aim of this review is to provide a compact summary of state of the art 0D-1D multiscale models of the arterial coronary system, with particular attention to applications related to cardiac arrhythmias, whose effects on the coronary circulation remain so far poorly understood. The focus on 0D-1D models only is motivated by the competitive computational cost, the reliability of the outcomes for the whole cardiovascular system, and the ability to directly account for cardiac arrhythmias. The analyzed studies show that cardiac arrhythmias by their own are able to promote significant alterations of the coronary hemodynamics, with a worse scenario as the mean heart rate (HR) increases. The present review can stimulate future investigation, both in computational and clinical research, devoted to the hemodynamic effects induced by cardiac arrhythmias on the coronary circulation.

Increased beat-to-beat variability of cerebral microcirculatory perfusion during atrial fibrillation: a near-infrared spectroscopy study.

AIMS: Atrial fibrillation (AFib) is associated with cognitive decline/dementia, independently from clinical strokes or transient ischaemic attacks (TIA). Recent in silico data suggested that AFib may induce transient critical haemodynamic events in the cerebral microcirculation. The aim of this study is to use non-invasive spatially resolved cerebral near-infrared spectroscopy (SRS-NIRS) to investigate in vivo beat-to-beat microcirculatory perfusion during AFib and after sinus rhythm (SR) restoration. METHODS AND RESULTS: Cerebral SRS-NIRS with high-frequency sampling (20 Hz) and non-invasive systemic haemodynamic monitoring were recorded before and after elective electrical cardioversion (ECV) for AFib or atrial flutter (AFL). To assess beat-to-beat effects of the rhythm status, the frequency distribution of inter-beat differences in tissue haemoglobin index (THI), a proxy of microcirculatory cerebral perfusion, was compared before and after SR restoration. Fifty-three AFib/AFL patients (mean age 69 ± 8 years, 79% males) were ultimately enrolled. Cardioversion was successful in restoring SR in 51 (96%) patients. In front of a non-significant decrease in arterial blood pressure extreme events between pre- and post-ECV measurements, a significant decrease of both hypoperfusive and hyperperfusive/hypertensive microcirculatory events was observed after SR restoration (P < 0.001 and P = 0.041, respectively). CONCLUSION: The present is the first in vivo demonstration that SR restoration by ECV significantly reduces the burden of extreme single-beat haemodynamic events in cerebral microcirculation. Future studies are needed to assess whether SR maintenance might slow long-term AFib-correlated cognitive decline/dementia.

Stochastic ice stream dynamics.

Ice streams are narrow corridors of fast-flowing ice that constitute the arterial drainage network of ice sheets. Therefore, changes in ice stream flow are key to understanding paleoclimate, sea level changes, and rapid disintegration of ice sheets during deglaciation. The dynamics of ice flow are tightly coupled to the climate system through atmospheric temperature and snow recharge, which are known exhibit stochastic variability. Here we focus on the interplay between stochastic climate forcing and ice stream temporal dynamics. Our work demonstrates that realistic climate fluctuations are able to (i) induce the coexistence of dynamic behaviors that would be incompatible in a purely deterministic system and (ii) drive ice stream flow away from the regime expected in a steady climate. We conclude that environmental noise appears to be crucial to interpreting the past behavior of ice sheets, as well as to predicting their future evolution.

Spatial Distribution of the International Food Prices: Unexpected Heterogeneity and Randomness.

Global food prices are typically analysed in a time-series framework. We complement this approach by focusing on the spatial price dispersion of the country-pair bilateral trade in the international food trade network (IFTN), for ten relevant commodities. The main purposes are to verify if the Law of One Price (LOP) holds and to investigate the emergence of randomness in the price-formation mechanism. We distinguish between the "internal" variance, which indicates the magnitude of price discrimination, and the "external" variance, that is a measure of price dispersion. We find that, for some commodities, spatial price dispersion is remarkable and persistent over time (i.e., failure of the LOP) and that there exists a strict correlation between price spikes and peaks in spatial price variability. We test whether the price distribution can be replicated through a stochastic process of extraction. Surprisingly, the actual distribution of prices, for several commodities, is well described by a random distribution. Then, the process of data aggregation is not neutral because the information at the micro-level scale might be lost at the macro-scale, due to the complexity of the IFTN. Finally, we discuss some possible economic explanations of these outcomes and the main methodological, environmental, and policy consequences.

Impact of seasonal forcing on reactive ecological systems.

Our focus is on the short-term dynamics of reactive ecological systems which are stable in the long term. In these systems, perturbations can exhibit significant transient amplifications before asymptotically decaying. This peculiar behavior has attracted increasing attention. However, reactive systems have so far been investigated assuming that external environmental characteristics remain constant, although environmental conditions (e.g., temperature, moisture, water availability, etc.) can undergo substantial changes due to seasonal cycles. In order to fill this gap, we propose applying the adjoint non-modal analysis to study the impact of seasonal variations of environmental conditions on reactive systems. This tool allows the transient dynamics of a perturbation affecting non-autonomous ecological systems to be described. To show the potential of this approach, a seasonally forced prey-predator model with a Holling II type functional response is studied as an exemplifying case. We demonstrate that seasonalities can greatly affect the transient dynamics of the system.

From time-series to complex networks: Application to the cerebrovascular flow patterns in atrial fibrillation.

A network-based approach is presented to investigate the cerebrovascular flow patterns during atrial fibrillation (AF) with respect to normal sinus rhythm (NSR). AF, the most common cardiac arrhythmia with faster and irregular beating, has been recently and independently associated with the increased risk of dementia. However, the underlying hemodynamic mechanisms relating the two pathologies remain mainly undetermined so far; thus, the contribution of modeling and refined statistical tools is valuable. Pressure and flow rate temporal series in NSR and AF are here evaluated along representative cerebral sites (from carotid arteries to capillary brain circulation), exploiting reliable artificially built signals recently obtained from an in silico approach. The complex network analysis evidences, in a synthetic and original way, a dramatic signal variation towards the distal/capillary cerebral regions during AF, which has no counterpart in NSR conditions. At the large artery level, networks obtained from both AF and NSR hemodynamic signals exhibit elongated and chained features, which are typical of pseudo-periodic series. These aspects are almost completely lost towards the microcirculation during AF, where the networks are topologically more circular and present random-like characteristics. As a consequence, all the physiological phenomena at the microcerebral level ruled by periodicity-such as regular perfusion, mean pressure per beat, and average nutrient supply at the cellular level-can be strongly compromised, since the AF hemodynamic signals assume irregular behaviour and random-like features. Through a powerful approach which is complementary to the classical statistical tools, the present findings further strengthen the potential link between AF hemodynamic and cognitive decline.

Indicators of collapse in systems undergoing unsustainable growth.

Unsustainable growth is typical of systems that rely on a finite pool of non-renewable resources that are tapped until they are depleted. The decrease in resource availability eventually leads these systems to a decline. Here we investigate the dynamics of systems that exhibit unsustainable growth and are prone to a collapse to an alternative ("degraded") state. For these systems the possible imminent occurrence of a collapse is difficult to avert because they keep growing as they approach the transition point. It is therefore important to identify some early warning signs that can be used to predict whether the system is approaching a critical and likely irreversible transition to an undesired and degraded state. This study evaluates whether existing theories of precursors of phase transitions based on the critical slowing down phenomenon are applicable as leading indicators of state shift in unsustainable growth dynamics. It is found that such indicators fail to serve as reliable early warning signs of the system's collapse.

Can diversity in root architecture explain plant water use efficiency? A modeling study.

Drought stress is a dominant constraint to crop production. Breeding crops with adapted root systems for effective uptake of water represents a novel strategy to increase crop drought resistance. Due to complex interaction between root traits and high diversity of hydrological conditions, modeling provides important information for trait based selection. In this work we use a root architecture model combined with a soil-hydrological model to analyze whether there is a root system ideotype of general adaptation to drought or water uptake efficiency of root systems is a function of specific hydrological conditions. This was done by modeling transpiration of 48 root architectures in 16 drought scenarios with distinct soil textures, rainfall distributions, and initial soil moisture availability. We find that the efficiency in water uptake of root architecture is strictly dependent on the hydrological scenario. Even dense and deep root systems are not superior in water uptake under all hydrological scenarios. Our results demonstrate that mere architectural description is insufficient to find root systems of optimum functionality. We find that in environments with sufficient rainfall before the growing season, root depth represents the key trait for the exploration of stored water, especially in fine soils. Root density, instead, especially near the soil surface, becomes the most relevant trait for exploiting soil moisture when plant water supply is mainly provided by rainfall events during the root system development. We therefore concluded that trait based root breeding has to consider root systems with specific adaptation to the hydrology of the target environment.

Effect of water table fluctuations on phreatophytic root distribution.

The vertical root distribution of riparian vegetation plays a relevant role in soil water balance, in the partition of water fluxes into evaporation and transpiration, in the biogeochemistry of hyporheic corridors, in river morphodynamics evolution, and in bioengineering applications. The aim of this work is to assess the effect of the stochastic variability of the river level on the root distribution of phreatophytic plants. A function describing the vertical root profile has been analytically obtained by coupling a white shot noise representation of the river level variability to a description of the dynamics of root growth and decay. The root profile depends on easily determined parameters, linked to stream dynamics, vegetation and soil characteristics. The riparian vegetation of a river characterized by a high variability turns out to have a rooting system spread over larger depths, but with shallower mean root depths. In contrast, a lower river variability determines root profiles with higher mean root depths.

Linking cerebral hemodynamics and ocular microgravity-induced alterations through an in silico-in vivo head-down tilt framework.

Head-down tilt (HDT) has been widely proposed as a terrestrial analog of microgravity and used also to investigate the occurrence of spaceflight-associated neuro-ocular syndrome (SANS), which is currently considered one of the major health risks for human spaceflight. We propose here an in vivo validated numerical framework to simulate the acute ocular-cerebrovascular response to 6° HDT, to explore the etiology and pathophysiology of SANS. The model links cerebral and ocular posture-induced hemodynamics, simulating the response of the main cerebrovascular mechanisms, as well as the relationship between intracranial and intraocular pressure to HDT. Our results from short-term (10 min) 6° HDT show increased hemodynamic pulsatility in the proximal-to-distal/capillary-venous cerebral direction, a marked decrease (-43%) in ocular translaminar pressure, and an increase (+31%) in ocular perfusion pressure, suggesting a plausible explanation of the underlying mechanisms at the onset of ocular globe deformation and edema formation over longer time scales.

Role of the vessel morphology on the lenticulostriate arteries hemodynamics during atrial fibrillation: A CFD-based multivariate regression analysis.

BACKGROUND AND OBJECTIVE: Atrial fibrillation (AF) is the most common cardiac arrhythmia, inducing accelerated and irregular beating. Beside well-known disabling symptoms - such as palpitations, reduced exercise tolerance, and chest discomfort - there is growing evidence that an alteration of deep cerebral hemodynamics due to AF increases the risk of vascular dementia and cognitive impairment, even in the absence of clinical strokes. The alteration of deep cerebral circulation in AF represents one of the least investigated among the possible mechanisms. Lenticulostriate arteries (LSAs) are small perforating arteries mainly departing from the middle cerebral artery (MCA) and susceptible to small vessel disease, which is one of the mechanisms of subcortical vascular dementia development. The purpose of this study is to investigate the impact of different LSAs morphologies on the cerebral hemodynamics during AF. METHODS: By combining a computational fluid dynamics (CFD) analysis of LSAs with 7T high-resolution magnetic resonance imaging (MRI), we performed different CFD-based multivariate regression analyses to detect which geometrical and morphological vessel features mostly affect AF hemodynamics in terms of wall shear stress. We exploited 17 cerebral 7T-MRI derived LSA vascular geometries extracted from 10 subjects and internal carotid artery data from validated 0D cardiovascular-cerebral modeling as inflow conditions. RESULTS: Our results revealed that few geometrical variables - namely the size of the MCA and the bifurcation angles between MCA and LSA - are able to satisfactorily predict the AF impact. In particular, the present study indicates that LSA morphologies exhibiting markedly obtuse LSA-MCA inlet angles and small MCA size downstream of the LSA-MCA bifurcation may be more prone to vascular damage induced by AF. CONCLUSIONS: The present MRI-based computational study has been able for the first time to: (i) investigate the net impact of LSAs vascular morphologies on cerebral hemodynamics during AF events; (ii) detect which combination of morphological features worsens the hemodynamic response in the presence of AF. Awaiting necessary clinical confirmation, our analysis suggests that the local hemodynamics of LSAs is affected by their geometrical features and some LSA morphologies undergo greater hemodynamic alterations in the presence of AF.

Inter-species competition-facilitation in stochastic riparian vegetation dynamics.

Riparian vegetation is a highly dynamic community that lives on river banks and which depends to a great extent on the fluvial hydrology. The stochasticity of the discharge and erosion/deposition processes in fact play a key role in determining the distribution of vegetation along a riparian transect. These abiotic processes interact with biotic competition/facilitation mechanisms, such as plant competition for light, water, and nutrients. In this work, we focus on the dynamics of plants characterized by three components: (1) stochastic forcing due to river discharges, (2) competition for resources, and (3) inter-species facilitation due to the interplay between vegetation and fluid dynamics processes. A minimalist stochastic bio-hydrological model is proposed for the dynamics of the biomass of two vegetation species: one species is assumed dominant and slow-growing, the other is subdominant, but fast-growing. The stochastic model is solved analytically and the probability density function of the plant biomasses is obtained as a function of both the hydrologic and biologic parameters. The impact of the competition/facilitation processes on the distribution of vegetation species along the riparian transect is investigated and remarkable effects are observed. Finally, a good qualitative agreement is found between the model results and field data.

Arterial wave dynamics preservation upon orthostatic stress: a modelling perspective.

Pressure-flow travelling waves are a key topic for understanding arterial haemodynamics. However, wave transmission and reflection processes induced by body posture changes have not been thoroughly explored yet. Current in vivo research has shown that the amount of wave reflection detected at a central level (ascending aorta, aortic arch) decreases during tilting to the upright position, despite the widely proved stiffening of the cardiovascular system. It is known that the arterial system is optimized when in the supine position, i.e. propagation of direct waves is enabled and reflected waves are trapped, protecting the heart; however, it is not known whether this is preserved with postural changes. To shed light on these aspects, we propose a multi-scale modelling approach to inquire into posture-induced arterial wave dynamics elicited by simulated head-up tilting. In spite of remarkable adaptation of the human vasculature following posture changes, our analysis shows that, upon tilting from supine to upright: (i) vessel lumens at arterial bifurcations remain well matched in the forward direction, (ii) wave reflection at central level is reduced due to the backward propagation of weakened pressure waves produced by cerebral autoregulation, and (iii) backward wave trapping is preserved.

An R&D perspective on international trade and sustainable development.

Research and Development (R&D) is the common denominator of innovation and technological progress, supporting sustainable development and economic growth. In light of the availability of new datasets and innovative indicators, in this work, we introduce a novel perspective to analyse the international trade of goods through the lenses of the nexus R&D-industrial activities of countries. We propose two new indices, RDE and RDI, summarizing the R&D content of countries' export and import baskets-respectively-and investigate their evolution in time, during the period 1995-2017, and space. We demonstrate the potential of these indices to shed new light on the evolution of R&D choices and trade, innovation, and development. In fact, compared to standard measures of countries' development and economic growth (e.g., the Human Development Index among the others tested), these indices provide complementary information. In particular, tracing the trajectories of countries along the RDE-HDI plane, different dynamics appear for countries with increased HDI, which we speculate can be reasoned with countries' availability of natural resources. Eventually, we identify two insightful applications of the indices to investigate further countries' environmental performances as related to their role in international trade.

Beat-to-beat finger photoplethysmography in atrial fibrillation patients undergoing electrical cardioversion.

Atrial fibrillation (AF)-induced peripheral microcirculatory alterations have poorly been investigated. The present study aims to expand current knowledge through a beat-to-beat analysis of non-invasive finger photoplethysmography (PPG) in AF patients restoring sinus rhythm by electrical cardioversion (ECV). Continuous non-invasive arterial blood pressure and left middle finger PPG pulse oximetry waveform (POW) signals were continuously recorded before and after elective ECV of consecutive AF or atrial flutter (AFL) patients. The main metrics (mean, standard deviation, coefficient of variation), as well as a beat-to-beat analysis of the pulse pressure (PP) and POW beat-averaged value (aPOW), were computed to compare pre- and post-ECV phases. 53 patients (mean age 69 ± 8 years, 79% males) were enrolled; cardioversion was successful in restoring SR in 51 (96%) and signal post-processing was feasible in 46 (87%) patients. In front of a non-significant difference in mean PP (pre-ECV: 51.96 ± 13.25, post-ECV: 49.58 ± 10.41 mmHg; p = 0.45), mean aPOW significantly increased after SR restoration (pre-ECV: 0.39 ± 0.09, post-ECV: 0.44 ± 0.06 a.u.; p < 0.001). Moreover, at beat-to-beat analysis linear regression yielded significantly different slope (m) for the PP (RR) relationship compared to aPOW(RR) [PP(RR): 0.43 ± 0.18; aPOW(RR): 1.06 ± 0.17; p < 0.001]. Long (> 95th percentile) and short (< 5th percentile) RR intervals were significantly more irregular in the pre-ECV phases for both PP and aPOW; however, aPOW signal suffered more fluctuations compared to PP (p < 0.001 in both phases). Present findings suggest that AF-related hemodynamic alterations are more manifest at the peripheral (aPOW) rather than at the upstream macrocirculatory level (PP). Restoring sinus rhythm increases mean peripheral microvascular perfusion and decreases variability of the microvascular hemodynamic signals. Future dedicated studies are required to determine if AF-induced peripheral microvascular alterations might relate to long-term prognostic effects.

Network-Based Characterization of Blood Large-Scale Coherent Motion in the Healthy Human Aorta With 4D Flow MRI.

OBJECTIVE: The need for distilling the hemodynamic complexity of aortic flows into clinically relevant quantities resulted in a loss of the information hidden in 4D aortic fluid structures. To reduce information loss, this study proposes a network-based approach to identify and characterize in vivo the large-scale coherent motion of blood in the healthy human aorta. METHODS: The quantitative paradigm of the aortic flow as a "social network" was applied on 4D flow MRI acquisitions performed on forty-one healthy volunteers. Correlations between the aortic blood flow rate waveform at the proximal ascending aorta (AAo), assumed as one of the drivers of aortic hemodynamics, and the waveforms of the axial velocity in the whole aorta were used to build "one-to-all" networks. The impact of the driving flow rate waveform and of aortic geometric attributes on the transport of large-scale coherent fluid structures was investigated. RESULTS: The anatomical length of persistence of large-scale coherent motion was the 29.6% of the healthy thoracic aorta length (median value, IQR 23.1%-33.9%). Such length is significantly influenced by the average and peak-to-peak AAo blood flow rate values, suggesting a remarkable inertial effect of the AAo flow rate on the transport of large-scale fluid structures in the distal aorta. Aortic geometric attributes such as curvature, torsion and arch shape did not influence the anatomical length of persistence. CONCLUSION: The proposed in vivo approach allowed to quantitatively characterize the transport of large-scale fluid structures in the healthy aorta, strengthening the definition of coherent hemodynamic structures and identifying flow inertia rather than geometry as one of its main determinants. SIGNIFICANCE: The findings on healthy aortas may be used as reference values to investigate the impact of aortic disease or implanted devices in disrupting/restoring the physiological spatiotemporal coherence of large-scale aortic flow.

Hydrodynamic-driven stability analysis of morphological patterns on stalactites and implications for cave paleoflow reconstructions.

A novel hydrodynamic-driven stability analysis is presented for surface patterns on speleothems, i.e., secondary sedimentary cave deposits, by coupling fluid dynamics to the geochemistry of calcite precipitation or dissolution. Falling film theory provides the solution for the flow-field and depth perturbations, the latter being crucial to triggering patterns known as crenulations. In a wide range of Reynolds numbers, the model provides the dominant wavelengths and pattern celerities, in fair agreement with field data. The analysis of the phase velocity of ridges on speleothems has a potential as a proxy of past film flow rates, thus suggesting a new support for paleoclimate analyses.

Numerical and experimental characterization of a novel modular passive micromixer.

This paper reports a new low-cost passive microfluidic mixer design, based on a replication of identical mixing units composed of microchannels with variable curvature (clothoid) geometry. The micromixer presents a compact and modular architecture that can be easily fabricated using a simple and reliable fabrication process. The particular clothoid-based geometry enhances the mixing by inducing transversal secondary flows and recirculation effects. The role of the relevant fluid mechanics mechanisms promoting the mixing in this geometry were analysed using computational fluid dynamics (CFD) for Reynolds numbers ranging from 1 to 110. A measure of mixing potency was quantitatively evaluated by calculating mixing efficiency, while a measure of particle dispersion was assessed through the lacunarity index. The results show that the secondary flow arrangement and recirculation effects are able to provide a mixing efficiency equal to 80 % at Reynolds number above 70. In addition, the analysis of particles distribution promotes the lacunarity as powerful tool to quantify the dispersion of fluid particles and, in turn, the overall mixing. On fabricated micromixer prototypes the microscopic-Laser-Induced-Fluorescence (µLIF) technique was applied to characterize mixing. The experimental results confirmed the mixing potency of the microdevice.

Stochastic resonance and coherence resonance in groundwater-dependent plant ecosystems.

Several studies have shown that non-linear deterministic dynamical systems forced by external random components can give rise to unexpectedly regular temporal behaviors. Stochastic resonance and coherence resonance, the two best known processes of this type, have been studied in a number of physical and chemical systems. Here, we explore their possible occurrence in the dynamics of groundwater-dependent plant ecosystems. To this end, we develop two eco-hydrological models, which allow us to demonstrate that stochastic and coherence resonance may emerge in the dynamics of phreatophyte vegetation, depending on their deterministic properties and the intensity of external stochastic drivers.