The design and use of a simple device for the MRI assessment of changes in cardiovascular function by lower-body negative-pressure-simulated reduction of central blood volume.

AIM: To use a locally designed and simple lower-body negative-pressure (LBNP) device and 1.5 T magnetic resonance imaging (MRI) to demonstrate the ability to assess changes in cardiovascular function during preload reduction. These effects were evaluated on ventricular volumes and great vessel flow in healthy volunteers, for which there are limited published data. MATERIAL AND METHODS: After ethical review, 14 volunteers (mean age 33.9 ± 7 years, mean body mass index [BMI] 23.1 ± 2.5) underwent LBNP prospectively at 0, -5, -10, and -20 mmHg pressure, using a locally designed LBNP box. Expiratory breath-hold biventricular volumes, and free-breathing flow imaging of the ascending aorta and main pulmonary artery were acquired at each level of LBNP. RESULTS: At -5 mmHg, there was no change in aortic flow or left ventricular volumes versus baseline. Right ventricular output (p=0.013) and pulmonary net flow (p=0.026) decreased. At -20 mmHg, aortic and pulmonary net flow (p<0.001) decreased, as were left and right ventricular end diastolic volume (p<0.001) and left and right end systolic volumes (p=0.038 and p=0.003 respectively). CONCLUSIONS: Use of a MRI-compatible LBNP device is feasible to measure changes in ventricular volume and great arterial flow in the same experiment. This may enhance further research into the effects of preload reduction by MRI in a wide range of important cardiovascular pathologies.

Emergent behavioural phenotypes of swarming models revealed by mimicking a frustrated anti-ferromagnet.

Self-propelled particle (SPP) models are often compared with animal swarms. However, the collective animal behaviour observed in experiments often leaves considerable unconstrained freedom in the structure of a proposed model. Essentially, multiple models can describe the observed behaviour of animal swarms in simple environments. To tackle this degeneracy, we study swarms of SPPs in non-trivial environments as a new approach to distinguish between candidate models. We restrict swarms of SPPs to circular (periodic) channels where they polarize in one of two directions (like spins) and permit information to pass through windows between neighbouring channels. Co-alignment between particles then couples the channels (anti-ferromagnetically) so that they tend to counter-rotate. We study channels arranged to mimic a geometrically frustrated anti-ferromagnet and show how the effects of this frustration allow us to better distinguish between SPP models. Similar experiments could therefore improve our understanding of collective motion in animals. Finally, we discuss how the spin analogy can be exploited to construct universal logic gates, and therefore swarming systems that can function as Turing machines.

Transcatheter and endovascular stent graft management of coarctation-related pseudoaneurysms.

OBJECTIVE: Surgical correction of congenital aortic coarctation can lead to a number of important problems including late pseudoaneurysm formation. Redo surgery has a significant risk. Endovascular stent graft repair is increasingly used but there are limited data regarding this indication. We describe the experience of two UK congenital referral centres. DESIGN: Retrospective analysis of patients treated with endovascular aortic stent grafting for late pseudoaneurysms. SETTING: Two UK congenital heart centres, Bristol Heart Institute and Leeds General Infirmary. PATIENTS: 17 patients were treated 2006-2012. This represents all patients treated with this technique. MAIN OUTCOME MEASURES: Procedural and postprocedure success and complications. RESULTS: The average time from index repair to endovascular repair of pseudoaneurysm was 24.6 years. The majority (70.6%) had patch aortoplasty as the original surgical procedure and 41.2% were not under follow-up or discharged. Stent grafting procedural success rate was 100%. Median hospital stay postprocedure was 3 days. There was no procedural mortality or immediate complication. There were four minor early and three minor late complications. Imaging follow-up was available for an average of 31.6 months (range 6-65 months). All patients have demonstrated positive remodelling of the pseudoaneurysm with no incidence of continued expansion or stent graft failure up to 5 years following implant. CONCLUSIONS: Endovascular stent graft treatment of pseudoaneurysms show promising results in a population who have a high risk of surgical re-intervention. Complication rates appear to be low and recovery is quick. Longer-term data remain essential to scrutinise stent graft performance in this situation.

Efficacy of percutaneous closure of patent foramen ovale: comparison among three commonly used occluders.

BACKGROUND: Percutaneous closure of patent foramen ovale (PFO) is standard treatment for patients with paradoxical embolism but studies examining the efficacy of the various occluders are lacking. OBJECTIVE: To evaluate short- and medium-term closure rates of three common occluders. METHODS: One hundred and sixty-six adults (47±12 (18-81 years)) were evaluated with transthoracic bubble echocardiography before and after PFO closure. Only patients with large PFOs were included (>30 bubbles in the left heart after Valsalva). RESULTS: Three occluders were used: Amplatzer (AGA Medical Corporation) (n=80, 48%), Gore Helex (n=48, 29%) and Premere TM (St Jude Medical) (n=38, 23%). One (0.6%) neurological event occurred during follow-up. At 6 months significant residual shunting after Valsalva was highest in the group that received the Helex (58.3%), and lower for Premere (39.5%) and Amplatzer (32.5%). At final follow-up residual shunting remained higher in patients with the Helex (33.3%) than in Premere (18.5%) and Amplatzer (11%). Amplatzer had a significantly lower residual shunt rate than Helex (p<0.05 at 6 months and final follow-up). The Premere had an intermediate residual shunt rate. Septal aneurysm also predicted residual shunting (RR=24.7, 95% CI: 8.2 to 74.4, p<0.0001). CONCLUSIONS: Percutaneous PFO closure is an efficacious progressive treatment but closure rates also depend on the presence of aneurysm and differ between occluders.

Volatile sulfur compounds produced by probiotic bacteria in the presence of cysteine or methionine.

AIMS: To investigate the abilities of various probiotic bacteria to produce volatile sulfur compounds (VSCs) relevant to food flavour and aroma. METHODS AND RESULTS: Probiotic strains (Lactobacillus acidophilus NCFM, Lactobacillus plantarum 299v, Lactobacillus rhamnosus GG, Lactobacillus reuteri ATCC55730 and L. reuteri BR11), Lactobacillus delbrueckii ATCC4797, L. plantarum ATCC14917 and Lactococcus lactis MG1363 were incubated with either cysteine or methionine. Volatile compounds were captured, identified and quantified using a sensitive solid-phase microextraction (SPME) technique combined with gas chromatography coupled to a pulsed flame photometric detector (SPME/GC/PFPD). Several VSCs were identified including H(2)S, methanethiol, dimethyldisulfide and dimethyltrisulfide. The VSC profiles varied substantially for different strains of L. plantarum and L. reuteri and it was found that L. reuteri ATCC55730 and L. lactis MG1363 produced the lowest levels of VSCs (P < 0.05). Levels of VSCs generated by bacteria were found to be equivalent to, or higher than, that found in commercial cheeses. CONCLUSIONS: Several probiotic strains are able to generate considerable levels of VSCs and substantial variations in VSC generating potential exists between different strains from the same species. SIGNIFICANCE AND IMPORTANCE OF THE STUDY: This study demonstrates that probiotic bacteria are able to efficiently generate important flavour and aroma compounds and therefore has implications for the development of probiotic containing foods.

Two-point heterogeneous connections in a continuum neural field model.

We examine a novel heterogeneous connection scheme in a 1D continuum neural field model. Multiple two-point connections are added to a local connection function in order to model the "patchy" connections seen in, for example visual cortex. We use a numerical approach to solve the equations, choosing the locations of the two-point connections stochastically. We observe self-sustained persistent fluctuations of activity which can be classified into two types (one of which is similar to that seen in network models of discrete excitable neurons, the other being particular to this model). We study the effect of parameters such as system size and the range, number and strength of connections, on the probability that a particular realisation of the connections is able to exhibit persistent fluctuations.

Persistent fluctuations of activity in undriven continuum neural field models with power-law connections.

We study the effect of random inhomogeneous connections on a continuous field description of neural tissue. We focus on a regime in which persistent random fluctuations in activity arise spontaneously in the absence of either time-varying or spatially inhomogeneous input. While present in real tissue and network models of discrete neurons, such behavior has not been reported in continuum models of this type. The activity contains frequencies similar to those seen experimentally. We consider a power-law envelope r(-alpha) for the inhomogeneity and present evidence that the statistical coherence (a measure of two-point correlation) rapidly percolates across the system as alpha is reduced below alphac approximately 1,2 in one and two dimensions, respectively.

Diffusion on membrane tubes: a highly discriminatory test of the Saffman-Delbruck theory.

The efficient transport of membrane proteins is vital in maintaining life. In this work, we investigate the transport of such membrane proteins along long thin membrane tubes or tethers. We calculate the diffusion constant to leading order in the low Reynolds number regime to be D = (4 pi eta)-1 log(r/a), with r and a being the tube and protein radii, respectively, and eta being the membrane viscosity. Thus we propose an exact limiting form for the controversial logarithmic correction, such as originally introduced by Saffman and Delbruck, that involves the tube radius rather than some "frame size". Our work suggests a test of this logarithmic correction could be achieved by measuring diffusion on membrane tubes, exploiting the fact that the equilibrium tube radius can be controlled by the membrane tension and varied over several orders of magnitude. We analyze the time taken for a protein to transit a membrane tube between cells and find that this can vary by an order of magnitude over physiological tensions. This is a strong effect in biological terms and suggests a possible regulatory coupling between membrane tension and signaling.

Random fluctuations of the firing rate function in a continuum neural field model.

We incorporate a source of noise into a continuum neural field model by allowing the firing threshold to fluctuate noisily about a mean value, and examine traveling wave front solutions. Under certain conditions we are able to calculate the first and second moments of the distributions of the resulting time varying front speed and shape. This is then compared with more complete numerical solutions. Fluctuations in the wave front speed and in the shape (i.e., fluctuations in activity at particular coordinate positions across the wave front) were found to increase as the magnitude of the fluctuations in firing threshold increased. The mean speed was found to increase as the magnitude of the fluctuations increases. The role of the correlation time for the threshold variation is also investigated. We also study the role of threshold fluctuations in the failure of front propagation, both in the fast and slow varying noise limits.

Clinical impact of selective serotonin reuptake inhibitors therapy with bleeding risks.

The selective serotonin reuptake inhibitors (SSRIs) are extensively used for the treatment of multiple psychiatric conditions. In vitro and ex vivo data with these agents indicate they may have varying degrees of antiplatelet activity via multiple receptors. Reports of bleeding in patients receiving SSRIs appeared soon after their introduction. A review of the literature suggests SSRI therapy may increase the risk of bleeding especially with concomitant aspirin or nonsteroidal anti-inflammatory agents. Clinicians should exercise caution when prescribing these agents in high risk patients and maintain awareness of the potential contribution of SSRIs to unexplained bleeding episodes.

Stall, spiculate, or run away: The fate of fibers growing towards fluctuating membranes.

We study the dynamics of a growing semiflexible fiber approaching a membrane at an angle. At late times we find three regimes: fiber stalling, when growth stops, runaway, in which the fiber bends away from the membrane, and another regime in which spicules form. We discuss which regions of the resulting "phase diagram" are explored by (i) single and bundled actin fibers in living cells, (ii) sickle hemoglobin fibers, and (iii) microtubules inside vesicles. We complement our analysis with 3D stochastic simulations.

Fiber depolymerization.

Depolymerization is, by definition, a crucial process in the reversible assembly of various biopolymers. It may also be an important factor in the pathology of sickle cell disease. If sickle hemoglobin fibers fail to depolymerize fully during passage through the lungs then they will reintroduce aggregates into the systemic circulation and eliminate or shorten the protective delay (nucleation) time for the subsequent growth of fibers. We study how depolymerization depends on the rates of end- and side-depolymerization, k(end) and k(side), which are, respectively, the rates at which fiber length is lost at each end and the rate at which new breaks appear per unit fiber length. We present both an analytic mean field theory and supporting simulations showing that the characteristic fiber depolymerization time tau= square root 1/k(end)k(side) depends on both rates, but not on the fiber length L, in a large intermediate regime 1 << k(side)L(2)/k(end) << (L/d)(2), with d the fiber diameter. We present new experimental data which confirms that both mechanisms are important and shows how the rate of side depolymerization depends strongly on the concentration of CO, acting as a proxy for oxygen. Our theory remains rather general and could be applied to the depolymerization of an entire class of linear aggregates, not just sickle hemoglobin fibers.

Anisotropy in sickle hemoglobin fibers from variations in bending and twist.

We have studied the variations of twist and bend in sickle hemoglobin fibers. We find that these variations are consistent with an origin in equilibrium thermal fluctuations, which allows us to estimate the bending and torsional rigidities and effective corresponding material moduli. We measure bending by electron microscopy of frozen hydrated fibers and find that the bending persistence length, a measure of the length of fiber required before it starts to be significantly bent due to thermal fluctuations, is 130microm, somewhat shorter than that previously reported using light microscopy. The torsional persistence length, obtained by re-analysis of previously published experiments, is found to be only 2.5microm. Strikingly this means that the corresponding torsional rigidity of the fibers is only 6x10(-27)Jm, much less than their bending rigidity of 5x10(-25)Jm. For (normal) isotropic materials, one would instead expect these to be similar. Thus, we present the first quantitative evidence of a very significant material anisotropy in sickle hemoglobin fibers, as might arise from the difference between axial and lateral contacts within the fiber. We suggest that the relative softness of the fiber with respect to twist deformation contributes to the metastability of HbS fibers: HbS double strands are twisted in the fiber but not in the equilibrium crystalline state. Our measurements inform a theoretical model of the thermodynamic stability of fibers that takes account of both bending and extension/compression of hemoglobin (double) strands within the fiber.

Deforming biological membranes: how the cytoskeleton affects a polymerizing fiber.

We give a theoretical treatment of the force exerted by a fluctuating membrane on a polymer rod tip, taking into account the effects of an underlying biological cytoskeleton by way of a simple harmonic dependence on displacement. We also consider theoretically and experimentally the dynamics of a growing fiber tip under the influence of such a fluctuation-induced membrane force, including the effects of an underlying cytoskeletal network. We compare our model with new experimental data for the growth of hemoglobin fibers within red blood cells, revealing a good agreement. We are also able to estimate the force and membrane/cytoskeletal displacement required to stall growth of, or buckle, a growing fiber. We discuss the significance of our results in a biological context, including how the properties of the membrane and cytoskeleton relate to the thermodynamics of rod polymerization.

Spicules and the effect of rigid rods on enclosing membrane tubes.

Membrane tubes (spicules) arise in cells, or artificial membranes, in the nonlinear deformation regime due to, e.g., the growth of microtubules, actin filaments, or sickle hemoglobin fibers towards a membrane. We calculate the axial force f exerted by the tube, and its average radius, taking into account steric interactions between the fluctuating membrane and the enclosed rod. We find a smooth crossover of the axial force between f approximately square root of (sigma) and f approximately sigma as the membrane tension sigma increases and the tube radius shrinks. This crossover occurs around the most physiologically relevant membrane tensions. Our work may be important in (i) interpreting experiments in which axial force is related to the tube radius or membrane tension, and (ii) constructing dynamical theories for biopolymer growth in narrow tubes where these fluctuation effects control the tube radius.

Modelling genetic networks with noisy and varied experimental data: the circadian clock in Arabidopsis thaliana.

Circadian clocks in all organisms include feedback loops that generate rhythmic expression of key genes. We model the first such loop proposed for the clock of Arabidopsis thaliana, the experimental model species for circadian timing in higher plants. As for many biological systems, there are no experimental values for the parameters in our model, and the data available for parameter fitting is noisy and varied. To tackle this we constructed a cost function, which quantifies the agreement between our model and various key experimental features. We then undertook an efficient global search of parameter space, to test whether the proposed circuit can fit the experimental data. Using this approach we show that circadian clock models can function well with low cooperativity in transcriptional regulation, whereas high cooperativity has been a feature of previous (hand-fitted) clock models in other species. Our optimized solution for the Arabidopsis clock model fits several, but not all, of the key experimental features. We test the predicted effects of well-characterized mutations in the clock circuit and show the phases of the circadian cycle where additional components that are yet to be identified experimentally must be present to complete the circadian feedback loop.

Measuring forces between protein fibers by microscopy.

We propose a general scheme for measuring the attraction between mechanically frustrated semiflexible fibers by measuring their thermal fluctuations and shape. We apply this analysis to a system of sickle hemoglobin (HbS) fibers that laterally attract one another. These fibers appear to "zip" together before reaching mechanical equilibrium due to the existence of cross-links into a dilute fiber network. We are also able to estimate the rigidities of the fibers. These rigidities are found to be consistent with sickle hemoglobin "single" fibers 20 nm in diameter, despite recent experiments indicating that fiber bundling sometimes occurs. Our estimate of the magnitude of the interfiber attraction for HbS fibers is in the range 8 +/- 7 kBT/microm, or 4 +/- 3 k(B)T/microm if the fibers are assumed, a priori to be single fibers (such an assumption is fully consistent with the data). This value is sufficient to bind the fibers, overcoming entropic effects, although extremely chemically weak. Our results are compared to models for the interfiber attraction that include depletion and van der Waals forces. This technique should also facilitate a similar analysis of other filamentous protein assembles in the future, including beta-amyloid, actin, and tubulin.

Left ventricular pacing minimizes diastolic ventricular interaction, allowing improved preload-dependent systolic performance.

BACKGROUND: Left ventricular (LV) pacing improves hemodynamics in patients with heart failure. We hypothesized that at least part of this benefit occurs by minimization of external constraint to LV filling from ventricular interaction. METHODS AND RESULTS: We present median values (interquartile ranges) for 13 heart failure patients with LV pacing systems implanted for New York Heart Association class III/IV limitation. We used the conductance catheter method to measure LV pressure and volume simultaneously. External constraint was measured from the end-diastolic pressure-volume relation recorded during inferior vena caval occlusion, during LV pacing, and while pacing was suspended. External constraint to LV filling was reduced by 3.0 (4.6 to 0.6) mm Hg from 4.8 (0.6 to 7.5) mm Hg (P<0.01) in response to LV pacing; effective filling pressure (LV end-diastolic pressure minus external constraint) increased by 4.0 (2.2 to 5.8) mm Hg from 17.7 (13.3 to 22.6; P<0.01). LV end-diastolic volume increased by 10 (3 to 11) mL from 238 (169 to 295) mL (P=0.01), whereas LV end-systolic volume did not change significantly (-1 [-2 to 3] mL from 180 [124 to 236] mL, P=0.97), which resulted in an increase in stroke volume of 11 (5 to 13) mL from 49 (38 to 59) mL (P<0.01). LV stroke work increased by 720 (550 to 1180) mL . mm Hg from 3400 (2110 to 4480) mL . mm Hg (P=0.01), and maximum dP/dt increased by 120 (2 to 161) mm Hg/s from 635 (521 to 767) mm Hg/s (P=0.03). CONCLUSIONS: This study suggests a potentially important mechanism by which LV pacing may produce hemodynamic benefit. LV pacing minimizes external constraint to LV filling, resulting in an increase in effective filling pressure; the consequent increase in LV end-diastolic volume increases stroke volume via the Starling mechanism.

The force generated by biological membranes on a polymer rod and its response: statics and dynamics.

We propose a theory for the force exerted by a fluctuating membrane on a polymer rod tip. Using statistical mechanical methods, the expression for the generated force is written in terms of the distance of the rod tip from the membrane "frame." We apply the theory in calculating the stall force and membrane displacement required to cease the growth of a growing fiber induced by membrane fluctuations, as well as the membrane force and membrane displacement required for rod/fiber buckling. We also consider the dynamics of a growing fiber tip under the influence of a fluctuation-induced membrane force. We discuss the importance of our results in various biological contexts. Finally, we present a method to simultaneously extract both the rigidity of the semiflexible rod and the force applied by, e.g., the membrane from the measurements of the bending fluctuations of the rod. Such a measurement of the force would give information about the thermodynamics of the rod polymerization that involves the usual Brownian ratchet mechanism.