An electrocardiographic sign of ischemic preconditioning

Localization of magnetocardiographic sources for myocardial infarction cases using deterministic and Bayesian approaches

In this paper, the inverse problems of cardiac sources using analytical and probabilistic methods are solved and discussed. The standard Tikhonov regularization technique is solved initially to estimate the under-determined heart surface potentials from Magnetocardiographic (MCG) signals. The results of the deterministic method subjected to noise in the measurements are discussed and compared with the probabilistic models. Hierarchical Bayesian modeling with fixed Gaussian prior is employed to quantify the uncertainties in source reconstructions. A novel application of Variational Bayesian inference approach has been presented to estimate the heart sources. The reconstruction results of Variational Bayesian model with non-stationary priors are compared with solutions of simplistic Bayesian approach; and the performances are evaluated using Root Mean Square Error (RMSE) and correlation co-efficient metrics. The Bayesian solutions in the study are also extended to localize the MCG sources for two types of Myocardial infarction cases.

Optical neural stimulation using the thermoplasmonic effect of gold nano-hexagon

The use of nanoparticle photothermal effect as adjuvants in neuromodulation has recently received much attention, with many open questions about new nanostructures' effect on the action potential. The photothermal properties of hexagonal gold nanoparticles are investigated in this work, including the absorption peak wavelength and light-heat conversion rate, using both experimental and simulation methods. Furthermore, the ability to use these nanostructures in axonal neural stimulation and cardiac stimulation by measuring temperature changes of gold nano-hexagons under 532 nm laser irradiation is studied. In addition, their thermal effect on neural responses is investigated by modeling small-diameter unmyelinated axons and heart pacemaker cells. The results show that the increase in temperature caused by these nano-hexagons can successfully stimulate the small diameter axon and produce an action potential. Experiments have also demonstrated that the heat created by gold nano-hexagons affects toad cardiac rhythm and increases T wave amplitude. An increase in T wave amplitude on toad heart rhythm shows the thermal effect of nano hexagons heat on heart pacemaker cells and intracellular ion flows. This work demonstrates the feasibility of utilizing these nanostructures to create portable and compact medical devices, such as optical pacemakers or cardiac stimulation.

Effect of Ischemic Preconditioning and Postconditioning on Exosome-Rich Fraction microRNA Levels, in Relation with Electrophysiological Parameters and Ventricular Arrhythmia in Experimental Closed-Chest Reperfused Myocardial Infarction

We investigated the antiarrhythmic effects of ischemic preconditioning (IPC) and postconditioning (PostC) by intracardiac electrocardiogram (ECG) and measured circulating microRNAs (miRs) that are related to cardiac conduction. Domestic pigs underwent 90-min. percutaneous occlusion of the mid left anterior coronary artery, followed by reperfusion. The animals were divided into three groups: acute myocardial infarction (AMI, n = 7), ischemic preconditioning-acute myocardial infarction (IPC-AMI) (n = 9), or AMI-PostC (n = 5). IPC was induced by three 5-min. episodes of repetitive ischemia/reperfusion cycles (rI/R) before AMI. PostC was induced by six 30-s rI/R immediately after induction of reperfusion 90 min after occlusion. Before the angiographic procedure, a NOGA endocardial mapping catheter was placed again the distal anterior ventricular endocardium to record the intracardiac electrogram (R-amplitude, ST-Elevation, ST-area under the curve (AUC), QRS width, and corrected QT time (QTc)) during the entire procedure. An arrhythmia score was calculated. Cardiac MRI was performed after one-month. IPC led to significantly lower ST-elevation, heart rate, and arrhythmia score during ischemia. PostC induced a rapid recovery of R-amplitude, decrease in QTc, and lower arrhythmia score during reperfusion. Slightly higher levels of miR-26 and miR-133 were observed in AMI compared to groups IPC-AMI and AMI-PostC. Significantly lower levels of miR-1, miR-208, and miR-328 were measured in the AMI-PostC group as compared to animals in group AMI and IPC-AMI. The arrhythmia score was not significantly associated with miRNA plasma levels. Cardiac MRI showed significantly smaller infarct size in the IPC-AMI group when compared to the AMI and AMI-PostC groups. Thus, IPC led to better left ventricular ejection fraction at one-month and it exerted antiarrhythmic effects during ischemia, whereas PostC exhibited antiarrhythmic properties after reperfusion, with significant downregulaton of ischemia-related miRNAs.

The Maastricht-Duke bridge: An era of mentoring in clinical research - A model for mentoring in clinical research - A tribute to Dr. Galen Wagner

OBJECTIVE

With the passing of Dr. Galen Wagner, an exceptional collaboration between Maastricht University Medical Center, The Netherlands, and Duke Clinical Research Institute, USA, has come to an end. This article focuses on the background of what Galen coined the Maastricht-Duke bridge (MD-bridge), its merits, limitations and development throughout the years, and his special role.

METHODS

Between 2004 and 2015, 23 Maastricht University medical students and post-graduate students were enrolled in the 4-month research elective, mentored by Galen and the Maastricht co-mentor. They were asked to complete a survey about their MD-bridge experience.

RESULTS

Sixteen out of the 23 students responded. None but 1 participant had prior research experience. Following their MD bridge-program most participants published 1 or more manuscripts and/or presented their research in an international setting. They felt they had full responsibility as a leader of their project with all participants developing meaningful skills useful in their current job. Fourteen out of 16 would recommend the MD-bridge experience to others. Participants considered the program of great value for their personal growth and independence, giving a feeling of achievement. In addition, for some participants it led to careers in foreign countries including medical practice and research, or obtaining PhDs.

CONCLUSIONS

With Galen's impressive career of mentoring students, including the 23 MD-bridge participants, he has left behind an amazing concept of self-development in research and personal life. The successes of the MD-bridge prove that it is possible for students to be young investigators during or just after medical school with the potential to contribute to developing meaningful skills and noteworthy careers. Collaborations between international universities, such as the MD-bridge, are feasible and should be embraced by other institutions.