Mechanisms of PVP-functionalized silver nanoparticle toxicity in fish: Intravascular exposure disrupts cardiac pacemaker function and inhibits Na+/K+-ATPase activity in heart, but not gill.

Polyvinylpyrrolidone-functionalized silver nanoparticles (nAgPVP) are popular in consumer products for their colloidal stability and antimicrobial activity. Whole lake additions of nAgPVP cause long term, ecosystem-scale changes in fish populations but the mechanisms underlying this effect are unclear. We have previously shown that in fish, nAgPVP impairs cardiac contractility and Na+/K+-ATPase (NKA) activity in vitro, raising the possibility that heart dysfunction could underlie population-level exposure effects. The goal of this study was to determine if nAgPVP influences the control of heart rate (fh), blood pressure, or cardiac NKA activity in vivo. First, a dose-response curve for the effects of 5 nm nAgPVP on contractility was completed on isometrically contracting ventricular muscle preparations from Arctic char (Salvelinus alpinus) and showed that force production was lowest at 500 µg L-1 and maximum pacing frequency increased with nAgPVP concentration. Stroke volume, cardiac output, and power output were maintained in isolated working heart preparations from brook char (Salvelinus fontinalis) exposed to 700 µg L-1 nAgPVP. Both fh and blood pressure were elevated after 24 h in brook char injected with 700 µg kg body mass-1 nAgPVP and fh was insensitive to modulation with blockers of ß-adrenergic and muscarinic cholinergic receptors. Na+/K+-ATPase activity was significantly lower in heart, but not gill of nAgPVP injected fish. The results indicate that nAgPVP influences cardiac function in vivo by disrupting regulation of the pacemaker and cardiomyocyte ionoregulation. Impaired fh regulation may prevent fish from appropriately responding to environmental or social stressors and affect their ability to survive.

Calcitonin Related Polypeptide Alpha Mediates Oral Cancer Pain.

Oral cancer patients suffer pain at the site of the cancer. Calcitonin gene related polypeptide (CGRP), a neuropeptide expressed by a subset of primary afferent neurons, promotes oral cancer growth. CGRP also mediates trigeminal pain (migraine) and neurogenic inflammation. The contribution of CGRP to oral cancer pain is investigated in the present study. The findings demonstrate that CGRP-immunoreactive (-ir) neurons and neurites innervate orthotopic oral cancer xenograft tumors in mice. Cancer increases anterograde transport of CGRP in axons innervating the tumor, supporting neurogenic secretion as the source of CGRP in the oral cancer microenvironment. CGRP antagonism reverses oral cancer nociception in preclinical oral cancer pain models. Single-cell RNA-sequencing is used to identify cell types in the cancer microenvironment expressing the CGRP receptor components, receptor activity modifying protein 1 Ramp1 and calcitonin receptor like receptor (CLR, encoded by Calcrl). Ramp1 and Calcrl transcripts are detected in cells expressing marker genes for Schwann cells, endothelial cells, fibroblasts and immune cells. Ramp1 and Calcrl transcripts are more frequently detected in cells expressing fibroblast and immune cell markers. This work identifies CGRP as mediator of oral cancer pain and suggests the antagonism of CGRP to alleviate oral cancer pain.

The effect of operative time on surgical-site infection following total shoulder arthroplasty.

BACKGROUND: Many factors contribute to the risk of surgical-site infection (SSI) following total shoulder arthroplasty (TSA). Operative time is a modifiable factor that may contribute to SSI occurrence after TSA. This study aimed to determine the correlation between operative time and SSI following TSA. MATERIALS AND METHODS: By use of the American College of Surgeons National Surgical Quality Improvement Program database, a total of 33,987 patient records were queried from 2006 to 2020 and sorted by operative time and the development of an SSI in the 30-day postoperative period. Odds ratios for the development of an SSI were calculated based on operative time. RESULTS: An SSI developed in the 30-day postoperative period in 169 of the 33,470 patients in this study, resulting in an overall SSI rate of 0.50%. A positive correlation was identified between operative time and the SSI rate. An inflection point was identified at an operative time of 180 minutes, with a significant increase in the rate of SSI occurrence for operative times >180 minutes. DISCUSSION AND CONCLUSION: Increased operative time was shown to be strongly correlated with an increased risk of SSI within 30 days following surgery, with a significant inflection point at 180 minutes. The target operative time for TSA should be <180 minutes to reduce the risk of SSI.

Light-triggered cardiac microphysiological model.

Light is recognized as an accurate and noninvasive tool for stimulating excitable cells. Here, we report on a non-genetic approach based on organic molecular phototransducers that allows wiring- and electrode-free tissue modulation. As a proof of concept, we show photostimulation of an in vitro cardiac microphysiological model mediated by an amphiphilic azobenzene compound that preferentially dwells in the cell membrane. Exploiting this optical based stimulation technology could be a disruptive approach for highly resolved cardiac tissue stimulation.

Power laws prevail in medical ultrasound.

Major topics in medical ultrasound rest on the physics of wave propagation through tissue. These include fundamental treatments of backscatter, speed of sound, attenuation, and speckle formation. Each topic has developed its own rich history, lexicography, and particular treatments. However, there is ample evidence to suggest that power law relations are operating at a fundamental level in all the basic phenomena related to medical ultrasound. This review paper develops, from literature over the past 60 years, the accumulating theoretical basis and experimental evidence that point to power law behaviors underlying the most important tissue-wave interactions in ultrasound and in shear waves which are now employed in elastography. The common framework of power laws can be useful as a coherent overview of topics, and as a means for improved tissue characterization.

Reverberant shear wave phase gradients for elastography.

Reverberant shear wave fields are produced when multiple sources and multiple reflections establish a complex three-dimensional wave field within an organ. The expected values are assumed to be isotropic across all directions and the autocorrelation functions for velocity are expressed in terms of spherical Bessel functions. These results provide the basis for adroit implementations of elastography from imaging systems that can map out the internal velocity or displacement of tissues during reverberant field excitations. By examining the phase distribution of the reverberant field, additional estimators can be derived. In particular, we demonstrate that the reverberantphase gradientis shown to be proportional to the local value of wavenumber. This phase estimator is less sensitive to imperfections in the reverberant field distribution and requires a smaller support window, relative to earlier estimators based on autocorrelation. Applications are shown in simulations, phantoms, andin vivoliver.

The quantification of liver fat from wave speed and attenuation.

A framework is developed for estimating the volume fraction of fat in steatotic livers from viscoelastic measures of shear wave speed and attenuation. These measures are emerging on clinical ultrasound systems' elastography options so this approach can become widely available for assessing and monitoring steatosis. The framework assumes a distribution of fat vesicles as spherical inhomogeneities within the liver and uses a composite rheological model (Christensen 1969J. Mech. Phys. Solids1723-41) to determine the shear modulus as a function of increasing volume of fat within the liver. We show that accurate measurements of shear wave speed and attenuation provide the necessary and sufficient information to solve for the unknown fat volume and the underlying liver stiffness. Extension of the framework to compression wave measurements is also possible. Data from viscoelastic phantoms, human liver studies, and steatotic animal livers are shown to provide reasonable estimates of the volume fraction of fat.

Systematic analysis of goal-related movement sequences during maternal behaviour in a female mouse model for Rett syndrome.

Rodent dams seek and gather scattered pups back to the nest (pup retrieval), an essential aspect of maternal care. Systematic analysis of the dynamic sequences of goal-related movements that comprise the entire behavioural sequence, which would be ultimately essential for understanding the underlying neurobiology, is not well-characterized. Here, we present such analysis across 3 days in alloparental female mice (Surrogates or Sur) of two genotypes; Mecp2Heterozygotes (Het), a female mouse model for Rett syndrome and their wild type (WT) siblings. We analysed CBA/CaJ and C57BL/6J WT surrogates for within-strain comparisons. Frame-by-frame analysis over different phases was performed manually using DataVyu software. We previously showed that surrogate Het are inefficient at pup retrieval, by end-point analysis such as latency index and errors. Here, the sequence of searching, pup-approach and successful retrieval streamlines over days for WT, while Het exhibits variations in this pattern. Goal-related movements between Het and WT are similar in other phases, suggesting context-driven atypical patterns in Het during the pup retrieval phase. We identified proximal pup approach and pup grooming as atypical tactile interactions between pups and Het. Day-by-day analysis showed dynamic changes in goal-related movements in individual animals across genotypes and strains. Overall, our approach (1) highlights natural variation in individual mice on different days, (2) establishes a "gold-standard" manually curated dataset to help build behavioural repertoires using machine learning approaches, and (3) suggests atypical tactile sensory processing and possible regression in a female mouse model for Rett syndrome.

Contribution of Noncanonical Antigens to Virulence and Adaptive Immunity in Human Infection with Enterotoxigenic E. coli.

Enterotoxigenic Escherichia coli (ETEC) contributes significantly to the substantial burden of infectious diarrhea among children living in low- and middle-income countries. In the absence of a vaccine for ETEC, children succumb to acute dehydration as well as nondiarrheal sequelae related to these infections, including malnutrition. The considerable diversity of ETEC genomes has complicated canonical vaccine development approaches defined by a subset of ETEC pathovar-specific antigens known as colonization factors (CFs). To identify additional conserved immunogens unique to this pathovar, we employed an "open-aperture" approach to capture all potential conserved ETEC surface antigens, in which we mined the genomic sequences of 89 ETEC isolates, bioinformatically selected potential surface-exposed pathovar-specific antigens conserved in more than 40% of the genomes (n = 118), and assembled the representative proteins onto microarrays, complemented with known or putative colonization factor subunit molecules (n = 52) and toxin subunits. These arrays were then used to interrogate samples from individuals with acute symptomatic ETEC infections. Surprisingly, in this approach, we found that immune responses were largely constrained to a small number of antigens, including individual colonization factor antigens and EtpA, an extracellular adhesin. In a Bangladeshi cohort of naturally infected children <2 years of age, both EtpA and a second antigen, EatA, elicited significant serologic responses that were associated with protection from symptomatic illness. In addition, children infected with ETEC isolates bearing either etpA or eatA genes were significantly more likely to develop symptomatic disease. These studies support a role for antigens not presently targeted by vaccines (noncanonical) in virulence and the development of adaptive immune responses during ETEC infections. These findings may inform vaccine design efforts to complement existing approaches.

Fat and fibrosis as confounding cofactors in viscoelastic measurements of the liver.

Elastography provides significant information on staging of fibrosis in patients with liver disease and may be of some value in assessing steatosis. However, there remain questions as to the role of steatosis and fibrosis as cofactors influencing the viscoelastic measurements of liver tissues, particularly shear wave speed (SWS) and shear wave attenuation (SWA). In this study, by employing the theory of composite elastic media as well as two independent experimental measurements on oil-in-gelatin phantoms and also finite element simulations, it is consistently shown that fat and fibrosis jointly influence the SWS and SWA measurements. At a constant level of fat, fibrosis stages can influence the SWA by factors of 2-4. Moreover, the rate of increase in SWA with increasing fat is strongly influenced by the stages of fibrosis; softer background cases (low fibrosis stages) have higher rate of SWA increase with fat than those with stiffer moduli (higher fibrosis stages). Meanwhile, SWS results are influenced by the presence of fat, however the degree of variability is more subtle. The results indicate the importance of jointly considering fat and fibrosis as contributors to SWS and SWA measurements in complex liver tissues and in the design and interpretation of clinical trials.

Elastography imaging: the 30 year perspective.

From the development of x-ray imaging in the late 19th century, the field of medical imaging developed an impressive array of modalities. These can measure and image a variety of physical parameters from absorption coefficients to spin-spin relaxations. However, throughout most of the 20th century, the intrinsic biomechanical properties of tissues remained hidden from conventional radiology. This changed around 1990 when it was demonstrated that medical ultrasound systems with their fast pulse repetition rate and high sensitivity to motion could create images related to the stiffness of tissues and their shear wave properties. From there, vigorous development efforts towards imaging the elastic properties of tissues were launched across different modalities. These progressed from the research phase, through implementation on clinical scanners, through extensive clinical trials of selected diagnostic tasks, to government approvals, payer approvals, international standards statements, and into routine clinical practice around the globe. This review covers highlights of some major topics of the technical and clinical developments over the last 30 years with brief pointers to some of the remaining issues for the next decade of development.

Canonical Notch signaling is required for bone morphogenetic protein-mediated human osteoblast differentiation.

Osteoblast differentiation of bone marrow-derived human mesenchymal stem cells (hMSC) can be induced by stimulation with canonical Notch ligand, Jagged1, or bone morphogenetic proteins (BMPs). However, it remains elusive how these two pathways lead to the same phenotypic outcome. Since Runx2 is regarded as a master regulator of osteoblastic differentiation, we targeted Runx2 with siRNA in hMSC. This abrogated both Jagged1 and BMP2 mediated osteoblastic differentiation, confirming the fundamental role for Runx2. However, while BMP stimulation increased Runx2 and downstream Osterix protein expression, Jagged1 treatment failed to upregulate either, suggesting that canonical Notch signals require basal Runx2 expression. To fully understand the transcriptomic profile of differentiating osteoblasts, RNA sequencing was performed in cells stimulated with BMP2 or Jagged1. There was common upregulation of ALPL and extracellular matrix genes, such as ACAN, HAS3, MCAM, and OLFML2B. Intriguingly, genes encoding components of Notch signaling (JAG1, HEY2, and HES4) were among the top 10 genes upregulated by both stimuli. Indeed, ALPL expression occurred concurrently with Notch activation and inhibiting Notch activity for up to 24 hours after BMP administration with DAPT (a gamma secretase inhibitor) completely abrogated hMSC osteoblastogenesis. Concordantly, RBPJ (recombination signal binding protein for immunoglobulin kappa J region, a critical downstream modulator of Notch signals) binding could be demonstrated within the ALPL and SP7 promoters. As such, siRNA-mediated ablation of RBPJ decreased BMP-mediated osteoblastogenesis. Finally, systemic Notch inhibition using diabenzazepine (DBZ) reduced BMP2-induced calvarial bone healing in mice supporting the critical regulatory role of Notch signaling in BMP-induced osteoblastogenesis.

CTRP3 Regulates Endochondral Ossification and Bone Remodeling During Fracture Healing.

C1q/TNF-related protein 3 (CTRP3) is a cytokine known to regulate a variety of metabolic processes. Though previously undescribed in the context of bone regeneration, high throughput gene expression experiments in mice identified CTRP3 as one of the most highly upregulated genes in fracture callus tissue. Hypothesizing a positive regulatory role for CTRP3 in bone regeneration, we phenotyped skeletal development and fracture healing in CTRP3 knockout (KO) and CTRP3 overexpressing transgenic (TG) mice relative to wild-type (WT) control animals. CTRP3 KO mice experienced delayed endochondral fracture healing, resulting in abnormal mineral distribution, the presence of periosteal marrow compartments, and a nonunion-like state. Decreased osteoclast number was also observed in CTRP3 KO mice, whereas CTRP3 TG mice underwent accelerated callus remodeling. Gene expression profiling revealed a broad impact on osteoblast/osteoclast lineage commitment and metabolism, including arrested progression toward mature skeletal lineages in the KO group. A single systemic injection of CTRP3 protein at the time of fracture was insufficient to phenocopy the chronic TG healing response in WT mice. By associating CTRP3 levels with fracture healing progression, these data identify a novel protein family with potential therapeutic and diagnostic value. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:00-19966, 2020.

Non-invasive assessment of ventriculo-arterial coupling using aortic wave intensity analysis combining central blood pressure and phase-contrast cardiovascular magnetic resonance.

BACKGROUND: Wave intensity analysis (WIA) in the aorta offers important clinical and mechanistic insight into ventriculo-arterial coupling, but is difficult to measure non-invasively. We performed WIA by combining standard cardiovascular magnetic resonance (CMR) flow-velocity and non-invasive central blood pressure (cBP) waveforms. METHODS AND RESULTS: Two hundred and six healthy volunteers (age range 21-73 years, 47% male) underwent sequential phase contrast CMR (Siemens Aera 1.5 T, 1.97 × 1.77 mm2, 9.2 ms temporal resolution) and supra-systolic oscillometric cBP measurement (200 Hz). Velocity (U) and central pressure (P) waveforms were aligned using the waveform foot, and local wave speed was calculated both from the PU-loop (c) and the sum of squares method (cSS). These were compared with CMR transit time derived aortic arch pulse wave velocity (PWVtt). Associations were examined using multivariable regression. The peak intensity of the initial compression wave, backward compression wave, and forward decompression wave were 69.5 ± 28, -6.6 ± 4.2, and 6.2 ± 2.5 × 104 W/m2/cycle2, respectively; reflection index was 0.10 ± 0.06. PWVtt correlated with c or cSS (r = 0.60 and 0.68, respectively, P < 0.01 for both). Increasing age decade and female sex were independently associated with decreased forward compression wave (-8.6 and -20.7 W/m2/cycle2, respectively, P < 0.01) and greater wave reflection index (0.02 and 0.03, respectively, P < 0.001). CONCLUSION: This novel non-invasive technique permits straightforward measurement of wave intensity at scale. Local wave speed showed good agreement with PWVtt, and correlation was stronger using the cSS than the PU-loop. Ageing and female sex were associated with poorer ventriculo-arterial coupling in healthy individuals.

Presence and diversity of mixed avian Plasmodium spp. infections in introduced birds whose distribution overlapped with threatened New Zealand endemic birds.

Aims: To determine the presence of infection and co-infection of Plasmodium lineages in introduced birds at translocation sites for the North Island saddleback (Philesturnus rufusater), to investigate their role as Plasmodium spp. reservoirs.Methods: Blood samples were collected from introduced bird species, with a special focus on blackbirds (Turdus merula) and song thrushes (Turdus philomelos), at six locations in the North Island of New Zealand that were the origin, or translocation sites, for North Island saddleback. Where available, blood smears were examined, and blood samples were tested using nested PCR with subsequent sequence analysis, for the presence of Plasmodium spp.Results: Of the 55 samples tested using PCR analysis, 39 (71%) were positive for Plasmodium spp., and 28/40 (62%) blood smears were positive for Plasmodium spp. Overall, 31 blood samples were from blackbirds with 28/31 (90%) samples positive for Plasmodium spp. Six distinct avian Plasmodium lineages were identified, including three cosmopolitan lineages; Plasmodium vaughani SYAT05 was detected in 16 samples, Plasmodium matutinum Linn1 in 10 samples and Plasmodium elongatum GRW6 in eight samples. Mixed infections with more than one lineage were detected in 12 samples. Samples from two Australian magpies (Gymnorhina tibicen) were positive for Plasmodium. sp. lineage MYNA02, previously not identified in New Zealand.Conclusions and clinical relevance: This is the first report from New Zealand in which specific Plasmodium spp. mixed infections have been found in introduced birds. Co-infections with several cosmopolitan Plasmodium lineages were identified, as well as the first report in New Zealand of an exotic avian Plasmodium sp. lineage, in Australian magpies. Whilst the role of introduced birds in maintaining and spreading pathogenic avian malaria in New Zealand is unclear, there is a potential infection risk to native birds, especially where distributions overlap.

Towards a consensus on rheological models for elastography in soft tissues.

A rising wave of technologies and instruments are enabling more labs and clinics to make a variety of measurements related to tissue viscoelastic properties. These instruments include elastography imaging scanners, rheological shear viscometers, and a variety of calibrated stress-strain analyzers. From these many sources of disparate data, a common step in analyzing results is to fit the measurements of tissue response to some viscoelastic model. In the best scenario, this places the measurements within a theoretical framework and enables meaningful comparisons of the parameters against other types of tissues. However, there is a large set of established rheological models, even within the class of linear, causal, viscoelastic solid models, so which of these should be chosen? Is it simply a matter of best fit to a minimum mean squared error of the model to several data points? We argue that the long history of biomechanics, including the concept of the extended relaxation spectrum, along with data collected from viscoelastic soft tissues over an extended range of times and frequencies, and the theoretical framework of multiple relaxation models which model the multi-scale nature of physical tissues, all lead to the conclusion that fractional derivative models represent the most succinct and meaningful models of soft tissue viscoelastic behavior. These arguments are presented with the goal of clarifying some distinctions between, and consequences of, some of the most commonly used models, and with the longer term goal of reaching a consensus among different sub-fields in acoustics, biomechanics, and elastography that have common interests in comparing tissue measurements.

Shapes and distributions of soft tissue scatterers.

What causes scattering of ultrasound from normal soft tissues such as the liver, thyroid, and prostate? Commonly, the answer is formulated around the properties of spherical scatterers, related to cellular shapes and sizes. However, an alternative view is that the closely packed cells forming the tissue parenchyma create the reference media, and the long cylindrical-shaped fluid vessels serve as the scattering sites. Under a weak scattering or Born approximation for the extracellular fluid in the vessels, and assuming an isotropic distribution of cylindrical channels across a wide range of diameters, consistent with a fractal branching pattern, some simple predictions can be made about the nature of backscatter as a function of frequency in soft tissues. Specifically, a number of plausible shapes would predict that backscatter increases as a power law of frequency, where the power law is determined by the function governing the number density of the vessels versus diameter. These results are compared with some historical models developed over the last 100 years in scattering theory and point to the need for higher spatial resolution and higher bandwidths to obtain more precise measures of the key parameters in normal tissues, and to better identify the dominant structures responsible for backscatter in everyday clinical imaging.

Bifidobacterium longum-fermented rice bran and rice bran supplementation affects the gut microbiome and metabolome.

This study investigated gut microbiota composition along with food, host, and microbial derived metabolites in the colon and systemic circulation of healthy mice following dietary rice bran and fermented rice bran intake. Adult male BALB/c mice were fed a control diet or one of two experimental diets containing 10% w/w rice bran fermented by Bifidobacterium longum or 10% w/w non-fermented rice bran for 15 weeks. Metabolomics was performed on the study diets (food), the murine colon and whole blood. These were analysed in concert with 16S rRNA amplicon sequencing of faeces, caecum, and colon microbiomes. Principal components analysis of murine microbiota composition displayed marked separation between control and experimental diets, and between faecal and tissue (caecum and colon) microbiomes. Colon and caecal microbiomes in both experimental diet groups showed enrichment of Roseburia, Lachnospiraceae, and Clostridiales related amplicon sequence variants compared to control. Bacterial composition was largely similar between experimental diets. Metabolite profiling revealed 530 small molecules comprising of 39% amino acids and 21% lipids that had differential abundances across food, colon, and blood matrices, and statistically significant between the control, rice bran, and fermented rice bran groups. The amino acid metabolite, N-delta-acetylornithine, was notably increased by B. longum rice bran fermentation when compared to non-fermented rice bran in food, colon, and blood. These findings support that dietary intake of rice bran fermented with B. longum modulates multiple metabolic pathways important to the gut and overall health.

The orthodontic-oral surgery interface. Part two: diagnosis and management of anomalies in eruption and transpositions.

The orthodontic-oral surgery interface is important for the multidisciplinary management of patients presenting with complex dental anomalies. This article provides an overview of anomalies of eruption and transpositions, their diagnosis, aetiology, presenting features and the different management options. It also highlights the role of the general dental practitioner (GDP) in identifying such anomalies and the importance of timely referral to specialist care.