Biochemical origin of (near-) linear curvature constant (W')- V ˙ O 2 slow component ( Δ V ˙ O 2 sc ) and critical power (CP)- V ˙ O 2 transition time (t0.63) relationship in skeletal muscle.

PURPOSE: The biochemical background of the (near-)linear direct relationship between the curvature constant (W') of the power-duration curve and the magnitude ( Δ V ˙ O 2sc ) of the slow component of the V ˙ O 2 on-kinetics ( V ˙ O 2sc ) as well as reverse relationship between critical power (CP) and the characteristic transition time (t0.63, analogous to τp) of the primary phase II of the V ˙ O 2 on-kinetics encountered in experimental studies is studied. METHODS: A computer model of the bioenergetic system in skeletal muscle, involving the each-step-activation mechanism of work transitions and Pi double-threshold mechanism of muscle fatigue, is used. RESULTS: The activity (rate constant) (kadd) of the additional ATP usage, underlying the slow component, determines to a large extent the (near-)linear direct W'- Δ V ˙ O 2sc relationship, as an increase in kadd increases markedly both W' and Δ V ˙ O 2sc . t0.63 is a derivative of the changes in metabolite (M = PCr or Cr or Pi) concentrations between rest and the steady-state of the phase II M on-kinetics after the onset of exercise. The oxidative phosphorylation (OXPHOS) activity (kOX) mostly determines the (near)-linear inverse CP-t0.63 relationship, as an increase in kOX markedly decreases ΔM and t0.63, and elevates CP. CONCLUSIONS: The V ˙ O 2 on-kinetics (e.g., V ˙ O 2sc or t0.63) cannot cause anything in the system, as it is an emergent property of the system functioning on the biochemical level. Physiological variables: muscle V ˙ O 2sc and W' as well as t0.63 and CP, and relationships between them, are determined by biochemical parameters, mainly kadd and kOX, respectively.

How we diagnose Myelodysplastic syndromes.

The Myelodysplastic syndromes (MDS) are a heterogenous group of clonal bone marrow (BM) stem cell myeloid neoplasms, characterized by ineffective hematopoiesis that results in dysplasia in hematopoietic cells and peripheral cytopenias, especially anemia, and a propensity to leukemic transformation. The suspicion of MDS is raised by a typical but not specific clinical picture and routine laboratory findings, but the gold standard for MDS diagnosis is still BM examination with the presence of uni-or multi-lineage dysplasia and increased blast percentage, together with exclusion of other reasons. Cytogenetics is also an essential part of the diagnostic and prognostic processes. Flow cytometry and full genetic characterization are helpful but not mandatory for MDS diagnosis. This review summarizes the current steps of diagnostic approach for a patient suspected of having MDS. We also express our hopes that within the near future, non-invasive technologies, especially digital and peripheral blood genetics, will mature and be introduced into practice.

Impact of Effective Refractory Period Personalisation on Arrhythmia Vulnerability in Patient-Specific Atrial Computer Models.

BACKGROUND AND AIMS: The effective refractory period (ERP) is one of the main electrophysiological properties governing arrhythmia, yet ERP personalisation is rarely performed when creating patient-specific computer models of the atria to inform clinical decision-making. This study evaluates the impact of integrating clinical ERP measurements into personalised in silico models on arrhythmia vulnerability. METHODS: Clinical ERP measurements were obtained in seven patients from multiple locations in the atria. Atrial geometries from the electroanatomical mapping system were used to generate personalised anatomical atrial models. The Courtemanche cellular model was adjusted to reproduce patientspecific ERP. Four modelling approaches were compared: homogeneous (A), heterogeneous (B), regional (C), and continuous (D) ERP distributions. Non-personalised approaches (A, B) were based on literature data, while personalised approaches (C, D) were based on patient measurements. Modelling effects were assessed on arrhythmia vulnerability and tachycardia cycle length, with sensitivity analysis on ERP measurement uncertainty. RESULTS: Mean vulnerability was 3.4±4.0%, 7.7±3.4%, 9.0±5.1%, 7.0±3.6% for scenarios A to D, respectively. Mean tachycardia cycle length was 167.1±12.6 ms, 158.4±27.5 ms, 265.2±39.9 ms, and 285.9±77.3 ms for scenarios A to D, respectively. Incorporating perturbations to the measured ERP in the range of 2, 5, 10, 20, and 50ms changed the vulnerability of the model to 5.8±2.7%, 6.1±3.5%, 6.9±3.7%, 5.2±3.5%, 9.7±10.0% respectively. CONCLUSION: Increased ERP dispersion had a greater effect on reentry dynamics than on vulnerability. Inducibility was higher in personalised scenarios compared to scenarios with uniformly reduced ERP; however, this effect was reversed when incorporating fibrosis informed by low voltage areas.ERP measurement uncertainty up to 20 ms slightly influenced vulnerability. Electrophysiological personalisation of atrial in silico models appears essential and requires confirmation in larger cohorts.

Re-entry in models of cardiac ventricular tissue with scar represented as a Gaussian random field.

Introduction: Fibrotic scar in the heart is known to act as a substrate for arrhythmias. Regions of fibrotic scar are associated with slowed or blocked conduction of the action potential, but the detailed mechanisms of arrhythmia formation are not well characterised and this can limit the effective diagnosis and treatment of scar in patients. The aim of this computational study was to evaluate different representations of fibrotic scar in models of 2D 10 × 10 cm ventricular tissue, where the region of scar was defined by sampling a Gaussian random field with an adjustable length scale of between 1.25 and 10.0 mm. Methods: Cellular electrophysiology was represented by the Ten Tusscher 2006 model for human ventricular cells. Fibrotic scar was represented as a spatially varying diffusion, with different models of the boundary between normal and fibrotic tissue. Dispersion of activation time and action potential duration (APD) dispersion was assessed in each sample by pacing at an S1 cycle length of 400 ms followed by a premature S2 beat with a coupling interval of 323 ms. Vulnerability to reentry was assessed with an aggressive pacing protocol. In all models, simulated fibrosis acted to delay activation, to increase the dispersion of APD, and to generate re-entry. Results: A higher incidence of re-entry was observed in models with simulated fibrotic scar at shorter length scale, but the type of model used to represent fibrotic scar had a much bigger influence on the incidence of reentry. Discussion: This study shows that in computational models of fibrotic scar the effects that lead to either block or propagation of the action potential are strongly influenced by the way that fibrotic scar is represented in the model, and so the results of computational studies involving fibrotic scar should be interpreted carefully.

Human induced pluripotent stem cell-derived atrial cardiomyocytes recapitulate contribution of the slowly activating delayed rectifier currents IKs to repolarization in the human atrium.

AIMS: Human induced pluripotent stem cell-derived atrial cardiomyocytes (hiPSC-aCM) could be a helpful tool to study the physiology and diseases of the human atrium. To fulfil this expectation, the electrophysiology of hiPSC-aCM should closely resemble the situation in the human atrium. Data on the contribution of the slowly activating delayed rectifier currents (IKs) to repolarization are lacking for both human atrium and hiPSC-aCM. METHODS AND RESULTS: Human atrial tissues were obtained from patients with sinus rhythm (SR) or atrial fibrillation (AF). Currents were measured in human atrial cardiomyocytes (aCM) and compared with hiPSC-aCM and used to model IKs contribution to action potential (AP) shape. Action potential was recorded by sharp microelectrodes. HMR-1556 (1 µM) was used to identify IKs and to estimate IKs contribution to repolarization. Less than 50% of hiPSC-aCM and aCM possessed IKs. Frequency of occurrence, current densities, activation/deactivation kinetics, and voltage dependency of IKs did not differ significantly between hiPSC-aCM and aCM, neither in SR nor AF. ß-Adrenoceptor stimulation with isoprenaline did not increase IKs neither in aCM nor in hiPSC-aCM. In tissue from SR, block of IKs with HMR-1556 did not lengthen the action potential duration, even when repolarization reserve was reduced by block of the ultra-rapid repolarizing current with 4-aminopyridine or the rapidly activating delayed rectifier potassium outward current with E-4031. CONCLUSION: I Ks exists in hiPSC-aCM with biophysics not different from aCM. As in adult human atrium (SR and AF), IKs does not appear to relevantly contribute to repolarization in hiPSC-aCM.

Digital twins for cardiac electrophysiology: state of the art and future challenges.

Cardiac arrhythmias remain a major cause of death and disability. Current antiarrhythmic therapies are effective to only a limited extent, likely in large part due to their mechanism-independent approach. Precision cardiology aims to deliver targeted therapy for an individual patient to maximize efficacy and minimize adverse effects. In-silico digital twins have emerged as a promising strategy to realize the vision of precision cardiology. While there is no uniform definition of a digital twin, it typically employs digital tools, including simulations of mechanistic computer models, based on patient-specific clinical data to understand arrhythmia mechanisms and/or make clinically relevant predictions. Digital twins have become part of routine clinical practice in the setting of interventional cardiology, where commercially available services use digital twins to non-invasively determine the severity of stenosis (computed tomography-based fractional flow reserve). Although routine clinical application has not been achieved for cardiac arrhythmia management, significant progress towards digital twins for cardiac electrophysiology has been made in recent years. At the same time, significant technical and clinical challenges remain. This article provides a short overview of the history of digital twins for cardiac electrophysiology, including recent applications for the prediction of sudden cardiac death risk and the tailoring of rhythm control in atrial fibrillation. The authors highlight the current challenges for routine clinical application and discuss how overcoming these challenges may allow digital twins to enable a significant precision medicine-based advancement in cardiac arrhythmia management.

Groundwater modelling reports fail to comply with guideline recommendations for model reproducibility.

Computer models are routinely used to underpin critical decision-making for projects that impact groundwater systems. Modelling results are communicated through technical reports, which advise regulators and other stakeholders of groundwater impacts, thereby informing approvals, project restrictions and monitoring requirements. Several guidelines and texts are available to instruct groundwater model development and reporting. In seven of the eight guidelines/texts reviewed, it is recommended that modelling reports (or a model archive) contain sufficient information for an external party to rebuild the model. This study examined that expectation (assumed to be "best practice") by reviewing 25 groundwater modelling reports from eight countries and assessing whether the information contained therein was sufficient (or an archive was provided) to rebuild the model on which the report was based. The reports were characterised based on 18 model components (e.g., aquifer properties, boundary conditions, etc.), and the availability of sufficient information in the report to rebuild each one. The "rebuildability" of model components was classified as: (a) reproducible (from the report), (b) reproducible but assumptions needed, and (c) not reproducible. The Analytical Hierarchical Process was employed to rank the reports based on the reproducibility of the models they describe. Only one of the 25 reports provided adequate information to rebuild the model, while one other report was accompanied by a model archive, resulting in two cases of model reproducibility, contrary to guideline recommendations. This outcome reflects problems with reproducibility in the wider scientific community. We conclude that modelling reports need to provide more detailed information to be compliant with best practice or model archives ought to be made available. Addressing this issue will ensure that stakeholders have access to the information needed to properly assess whether future groundwater impacts have been reliably evaluated.

A computational model predicts sex-specific responses to calcium channel blockers in mammalian mesenteric vascular smooth muscle.

The function of the smooth muscle cells lining the walls of mammalian systemic arteries and arterioles is to regulate the diameter of the vessels to control blood flow and blood pressure. Here, we describe an in silico model, which we call the 'Hernandez-Hernandez model', of electrical and Ca2+ signaling in arterial myocytes based on new experimental data indicating sex-specific differences in male and female arterial myocytes from murine resistance arteries. The model suggests the fundamental ionic mechanisms underlying membrane potential and intracellular Ca2+ signaling during the development of myogenic tone in arterial blood vessels. Although experimental data suggest that KV1.5 channel currents have similar amplitudes, kinetics, and voltage dependencies in male and female myocytes, simulations suggest that the KV1.5 current is the dominant current regulating membrane potential in male myocytes. In female cells, which have larger KV2.1 channel expression and longer time constants for activation than male myocytes, predictions from simulated female myocytes suggest that KV2.1 plays a primary role in the control of membrane potential. Over the physiological range of membrane potentials, the gating of a small number of voltage-gated K+ channels and L-type Ca2+ channels are predicted to drive sex-specific differences in intracellular Ca2+ and excitability. We also show that in an idealized computational model of a vessel, female arterial smooth muscle exhibits heightened sensitivity to commonly used Ca2+ channel blockers compared to male. In summary, we present a new model framework to investigate the potential sex-specific impact of antihypertensive drugs.

High blood pressure is a major risk factor for heart disease, which is one of the leading causes of death worldwide. While drugs are available to control blood pressure, male and female patients can respond differently to treatment. However, the biological mechanisms behind this sex difference are not fully understood. Blood pressure is controlled by cells lining the artery walls called smooth muscle cells which alter the width of blood vessels. On the surface of smooth muscle cells are potassium and calcium channels which control the cell's electrical activity. When calcium ions enter the cell via calcium channels, this generates an electrical signal that causes the smooth muscle to contract and narrow the blood vessel. Potassium ions then flood out of the cell via potassium channels to dampen the rise in electrical activity, causing the muscle to relax and widen the artery. There are various sub-types of potassium and calcium channels in smooth muscle cells. Here, Hernandez-Hernandez et al. set out to find how these channels differ between male and female mice, and whether these sex differences could alter the response to blood pressure medication. The team developed a computational model of a smooth muscle cell, incorporating data from laboratory experiments measuring differences in cells isolated from the arteries of male and female mice. The model predicted that the sub-types of potassium and calcium channels in smooth muscle cells varied between males and females, and how the channels impacted electrical activity also differed. For instance, the potassium channel Kv2.1 was found to have a greater role in controlling electrical activity in female mice, and this sex difference impacted blood vessel contraction. The model also predicted that female mice were more sensitive than males to calcium channel blockers, a drug commonly prescribed to treat high blood pressure. The findings by Hernandez-Hernandez et al. provide new insights into the biological mechanisms underlying sex differences in response to blood pressure medication. They also demonstrate how computational models can be used to predict the effects of drugs on different individuals. In the future, these predictions may help researchers to identify better, more personalized treatments for blood pressure.

Dynamic modulation of transthylakoid electric potential by chloroplast ATP synthases.

The light-induced transthylakoid membrane potential (ΔΨm) can function as a driving force to help catalyzing the formation of ATP molecules, proving a tight connection between ΔΨm and the ATP synthase. Naturally, a question can be raised on the effects of altered functioning of ATP synthases on regulating ΔΨm, which is attractive in the area of photosynthetic research. Lots of findings, when making efforts of solving this difficulty, can offer an in-depth understanding into the mechanism behind. However, the functional network on modulating ΔΨm is highly interdependent. It is difficult to comprehend the consequences of altered activity of ATP synthases on adjusting ΔΨm because parameters that have influences on ΔΨm would themselves be affected by ΔΨm. In this work, a computer model was applied to check the kinetic changes in polarization/depolarization across the thylakoid membrane (TM) regulated by the modified action of ATP synthases. The computing data revealed that under the extreme condition by numerically "switching off" the action of the ATP synthase, the complete inactivation of ATP synthase would markedly impede proton translocation at the cytb6f complex. Concurrently, the KEA3 (CLCe) porter, actively pumping protons into the stroma, further contributes to achieving a sustained low level of ΔΨm. Besides, the quantitative consequences on every particular component of ΔΨm adjusted by the modified functioning of ATP synthases were also explored. By employing the model, we bring evidence from the theoretical perspective that the ATP synthase is a key factor in forming a transmembrane proton loop thereby maintaining a propriate steady-state ΔΨm to meet variable environmental conditions.

Calibrating GESPECOR model of computing the full-energy peak efficiency of coaxial high-purity germanium detectors by Monte Carlo simulation.

In this work, a classical approach was used for calibrating the GESPECOR detector model for computing the full-energy peak efficiency of p-type coaxial HPGe detectors that is based on the use of linear least squares optimization. The key element of the work is the multiplicative model developed for approximating the values of the full-energy peak efficiency provided by GESPECOR code. It was linearized using the logarithmic transformation to allow an easy use of the linear least squares optimization. A procedure was also developed to estimate the optimal values of the parameters, describing the p-type coaxial HPGe detectors. Its application to a Canberra detector GC3018 showed that it is possible to determine accurate values of the full-energy peak efficiency computed by GESPECOR code using the optimized parameter values.

Training-Induced Increase in V·O2max and Critical Power, and Acceleration of V·O2 on-Kinetics Result from Attenuated Pi Increase Caused by Elevated OXPHOS Activity.

Computer simulations using a dynamic model of the skeletal muscle bioenergetic system, involving the Pi-double-threshold mechanism of muscle fatigue, demonstrate that the training-induced increase in V·O2max, increase in critical power (CP) and acceleration of primary phase II of the V·O2 on kinetics (decrease in t0.63) is caused by elevated OXPHOS activity acting through a decrease in and slowing of the Pi (inorganic phosphate) rise during the rest-to-work transition. This change leads to attenuation of the reaching by Pi of Pipeak, peak Pi at which exercise is terminated because of fatigue. The delayed (in time and in relation to V·O2 increase) Pi rise for a given power output (PO) in trained muscle causes Pi to reach Pipeak (in very heavy exercise) after a longer time and at a higher V·O2; thus, exercise duration is lengthened, and V·O2max is elevated compared to untrained muscle. The diminished Pi increase during exercise with a given PO can cause Pi to stabilize at a steady state less than Pipeak, and exercise can continue potentially ad infinitum (heavy exercise), instead of rising unceasingly and ultimately reaching Pipeak and causing exercise termination (very heavy exercise). This outcome means that CP rises, as the given PO is now less than, and not greater than CP. Finally, the diminished Pi increase (and other metabolite changes) results in, at a given PO (moderate exercise), the steady state of fluxes (including V·O2) and metabolites being reached faster; thus, t0.63 is shortened. This effect of elevated OXPHOS activity is possibly somewhat diminished by the training-induced decrease in Pipeak.

Corrigendum: Analysis of the approach angle to medial orbitotomy that avoids accidental neurotrauma in the mesaticephalic dog skull utilizing 3D computer models and virtual surgical planning.

[This corrects the article DOI: 10.3389/fvets.2023.1185454.].

MIL-CELL: a tool for multi-scale simulation of yeast replication and prion transmission.

The single-celled baker's yeast, Saccharomyces cerevisiae, can sustain a number of amyloid-based prions, the three most prominent examples being [URE3], [PSI+], and [PIN+]. In the laboratory, haploid S. cerevisiae cells of a single mating type can acquire an amyloid prion in one of two ways (i) spontaneous nucleation of the prion within the yeast cell, and (ii) receipt via mother-to-daughter transmission during the cell division cycle. Similarly, prions can be lost due to (i) dissolution of the prion amyloid by its breakage into non-amyloid monomeric units, or (ii) preferential donation/retention of prions between the mother and daughter during cell division. Here we present a computational tool (Monitoring Induction and Loss of prions in Cells; MIL-CELL) for modelling these four general processes using a multiscale approach describing both spatial and kinetic aspects of the yeast life cycle and the amyloid-prion behavior. We describe the workings of the model, assumptions upon which it is based and some interesting simulation results pertaining to the wave-like spread of the epigenetic prion elements through the yeast population. MIL-CELL is provided as a stand-alone GUI executable program for free download with the paper. MIL-CELL is equipped with a relational database allowing all simulated properties to be searched, collated and graphed. Its ability to incorporate variation in heritable properties means MIL-CELL is also capable of simulating loss of the isogenic nature of a cell population over time. The capability to monitor both chronological and reproductive age also makes MIL-CELL potentially useful in studies of cell aging.

Optimal design of aperiodic tri-slot antennas for the conformal ablation of liver tumors using an experimentally validated MWA computer model.

OBJECTIVE: This study aims to demonstrate that the conformal microwave ablation (MWA) of liver tumors could be attained by optimizing the structure of an aperiodic tri-slot coaxial antenna, its insertion depth, and input power. METHODS: A computational MWA model with an aperiodic tri-slot coaxial antenna operating at the frequency of 2.45 GHz was built and validated by both an ex vivo and a pilot in vivo experiment with porcine healthy livers. The validated in vivo computational MWA model implemented with a liver tumor was then used as a testbed to investigate the conformal ablation of liver tumors. Five liver tumors in different sizes and shapes were investigated. A genetic algorithm optimization method (NSGA-II) was used to optimize the structure of antenna, insertion depth of antenna, and microwave antenna input power for the conformal ablation of liver tumors. RESULTS: The validation results showed that a good agreement in both the spatiotemporal temperature distribution and ablation zone was found between the computer model and the ex vivo experiments at both 45 W, 5 min and 60 W, 3 min treatments and the in vivo experiment at 45 W, 5 min treatment. The optimized simulation results confirmed that five cases of liver tumors in different sizes and shapes can be conformally ablated by optimizing the aperiodic tri-slot coaxial antenna, antenna insertion depth, and microwave antenna input power. CONCLUSION: This paper demonstrates that the aperiodic tri-slot coaxial antenna can be optimized with the insertion depth and input power for the conformal ablation of liver tumors, regardless the size and shape of liver tumors.

ModEx: a general purpose computer model exploration system.

We present a general purpose visual analysis system that can be used for exploring parameters of a variety of computer models. Our proposed system offers key components of a visual parameter analysis framework including parameter sampling, deriving output summaries, and an exploration interface. It also provides an API for rapid development of parameter space exploration solutions as well as the flexibility to support custom workflows for different application domains. We evaluate the effectiveness of our system by demonstrating it in three domains: data mining, machine learning and specific application in bioinformatics.

Analysis of the approach angle to medial orbitotomy that avoids accidental neurotrauma in the mesaticephalic dog skull utilizing 3D computer models and virtual surgical planning.

This study was conducted to determine an approach angle to medial orbitotomy that avoids accidental neurotrauma in mesaticephalic dogs. Medical records of dogs with mesaticephalic skulls that were presented to the veterinary medical teaching hospital for head computed tomography (CT) between September 2021 and February 2022 were reviewed. Descriptive data were queried, and CT findings were analyzed. Dogs greater than 20 kg and possessing a disease-free orbitozygomaticomaxillary complex (OZMC) on at least one side of the skull were included in this study. Digital imaging and communications in medicine (DICOM) files of head CT studies were imported into medical modeling software, and the safe approach angle for medial orbitotomy was determined using three-dimensional (3D) computer models and virtual surgical planning (VSP) principles. Angles were measured along the ventral orbital crest (VOC) from the rostral cranial fossa (RCF) to the rostral alar foramen (RAF). The safe approach angle at four points from rostral to caudal along the VOC was measured. The results at each location were reported as mean, median, 95% CI, interquartile ranges, and distribution. The results were statistically different at each location and generally increased from rostral to caudal. The variances between subjects and the differences between locations were large enough to suggest a standard safe approach angle in mesaticephalic dogs cannot be determined and should be measured for each patient. A standardized approach angle to medial orbitotomy is not possible in the mesaticephalic dog. Computer modeling and VSP principles should be implemented as part of the surgical planning process to accurately measure the safe approach angle along the VOC.

Thalamic control of sensory processing and spindles in a biophysical somatosensory thalamoreticular circuit model of wakefulness and sleep.

Thalamoreticular circuitry plays a key role in arousal, attention, cognition, and sleep spindles, and is linked to several brain disorders. A detailed computational model of mouse somatosensory thalamus and thalamic reticular nucleus has been developed to capture the properties of over 14,000 neurons connected by 6 million synapses. The model recreates the biological connectivity of these neurons, and simulations of the model reproduce multiple experimental findings in different brain states. The model shows that inhibitory rebound produces frequency-selective enhancement of thalamic responses during wakefulness. We find that thalamic interactions are responsible for the characteristic waxing and waning of spindle oscillations. In addition, we find that changes in thalamic excitability control spindle frequency and their incidence. The model is made openly available to provide a new tool for studying the function and dysfunction of the thalamoreticular circuitry in various brain states.

Von Mises stress peak (VMSP) and laryngomalacia severity score (LSS) are extremely useful in the selection of treatment for laryngomalacia.

OBJECTIVE: To analyze the judgment efficiency of a computer stress model and severity score in severity evaluation and treatment plan selection of laryngomalacia patients. METHODS: Twenty-two children (12 cases in the operation group and 10 cases in the follow-up group) with moderate to severe laryngomalacia were assessed by laryngomalacia severity score (LSS) which included visual analogue scale (VAS) and clinical score. A computer stress model of the laryngeal cavity was constructed for all children, with the von Mises stress peak (VMSP) of the model used as another quantitative evaluation method. The ROC curves of two quantitative evaluation methods, the LSS and the VMSP, were analyzed respectively, according to the clinical guideline which is regarded as the gold standard for judging whether surgery is needed. The diagnostic efficiency indexes such as sensitivity, specificity, and accuracy were calculated. The area under ROC curves (AUC) of the two methods were compared by a DeLong model. Spearman correlation analysis and Kappa test were used to test the correlation and consistency of the two quantitative evaluation methods. The independent sample t test was used to compare the difference of LSS and VMSP between operation group and follow-up group. RESULTS: The sensitivity, specificity, and accuracy of LSS in judging whether laryngomalacia was operated or not were 83.33%, 80.00% and 81.82%, respectively, and the area under ROC curve (AUC) was 0.825 (p < 0.05). The sensitivity, specificity, and accuracy of the computer stress model for laryngomalacia were 58.33%, 90.00% and 72.73%, respectively, and the AUC was 0.796 (p < 0.05). The spearman correlation coefficient between LSS and VMSP was 0.833, p < 0.001, which is statistically significant. LSS (t = 3.251, p = 0.004) and VMSP (t = 2.435, p = 0.024) of the two groups were statistically different. CONCLUSION: VMSP and LSS have high diagnostic efficacy in the quantitative evaluation of the severity of laryngomalacia and the selection of treatment plan. The consistency of the two quantitative evaluation methods is good, which has practical value for the evaluation of the severity of laryngomalacia and has guiding significance for surgery.

In silico analysis of the dynamic regulation of cardiac electrophysiology by Kv 11.1 ion-channel trafficking.

Cardiac electrophysiology is regulated by continuous trafficking and internalization of ion channels occurring over minutes to hours. Kv 11.1 (also known as hERG) underlies the rapidly activating delayed-rectifier K+ current (IKr ), which plays a major role in cardiac ventricular repolarization. Experimental characterization of the distinct temporal effects of genetic and acquired modulators on channel trafficking and gating is challenging. Computer models are instrumental in elucidating these effects, but no currently available model incorporates ion-channel trafficking. Here, we present a novel computational model that reproduces the experimentally observed production, forward trafficking, internalization, recycling and degradation of Kv 11.1 channels, as well as their modulation by temperature, pentamidine, dofetilide and extracellular K+ . The acute effects of these modulators on channel gating were also incorporated and integrated with the trafficking model in the O'Hara-Rudy human ventricular cardiomyocyte model. Supraphysiological dofetilide concentrations substantially increased Kv 11.1 membrane levels while also producing a significant channel block. However, clinically relevant concentrations did not affect trafficking. Similarly, severe hypokalaemia reduced Kv 11.1 membrane levels based on long-term culture data, but had limited effect based on short-term data. By contrast, clinically relevant elevations in temperature acutely increased IKr due to faster kinetics, while after 24 h, IKr was decreased due to reduced Kv 11.1 membrane levels. The opposite was true for lower temperatures. Taken together, our model reveals a complex temporal regulation of cardiac electrophysiology by temperature, hypokalaemia, and dofetilide through competing effects on channel gating and trafficking, and provides a framework for future studies assessing the role of impaired trafficking in cardiac arrhythmias. KEY POINTS: Kv 11.1 channels underlying the rapidly activating delayed-rectifier K+ current are important for ventricular repolarization and are continuously shuttled from the cytoplasm to the plasma membrane and back over minutes to hours. Kv 11.1 gating and trafficking are modulated by temperature, drugs and extracellular K+ concentration but experimental characterization of their combined effects is challenging. Computer models may facilitate these analyses, but no currently available model incorporates ion-channel trafficking. We introduce a new two-state ion-channel trafficking model able to reproduce a wide range of experimental data, along with the effects of modulators of Kv 11.1 channel functioning and trafficking. The model reveals complex dynamic regulation of ventricular repolarization by temperature, extracellular K+ concentration and dofetilide through opposing acute (millisecond) effects on Kv 11.1 gating and long-term (hours) modulation of Kv 11.1 trafficking. This in silico trafficking framework provides a tool to investigate the roles of acute and long-term processes on arrhythmia promotion and maintenance.