Enhanced echocardiographic assessment of intracardiac flow in congenital heart disease

BACKGROUND

4D flow magnetic resonance imaging (4D flow MRI) can assess and measure the complex flow patterns of the right ventricle (RV) in congenital heart diseases, but its limited availability makes the broad application of intracardiac flow assessment challenging. Color Doppler imaging velocity reconstruction from conventional echocardiography is an emerging alternative, but its validity against 4D flow MRI needs to be established.

OBJECTIVE

To compare intracardiac flow parameters measured by color Doppler velocity reconstruction (DoVeR) against parameters measured from 4D flow MRI.

METHODS

We analyzed 20 subjects, including 7 normal RVs and 13 abnormal RVs (10 with repaired Tetralogy of Fallot, and 3 with atrial-level shunts). Intracardiac flow parameters such as relative pressure difference, vortex strength, total kinetic energy, and viscous energy loss were quantified using DoVeR and 4D flow MRI. The agreement between the two methods was determined by comparing the spatial fields and quantifying the cross-correlation and normalized difference between time-series measurements.

RESULTS

The hemodynamic parameters obtained from DoVeR and 4D flow MRI showed similar flow characteristics and spatial distributions. The time evolutions of the parameters were also in good agreement between the two methods. The median correlation coefficient between the time-series of any parameter was between 0.87 and 0.92, and the median L2-norm deviation was between 10% to 14%.

CONCLUSIONS

Our study shows that DoVeR is a reliable alternative to 4D flow MRI for quantifying intracardiac hemodynamic parameters in the RV.

An experimentally validated cavitation inception model for spring-driven autoinjectors

Cavitation, the formation and collapse of vapor-filled bubbles, poses a problem in spring-driven autoinjectors (AIs). It occurs when the syringe accelerates abruptly during activation, causing pressure fluctuations within the liquid. These bubbles expand and then collapse, generating shock waves that can harm both the device and the drug molecules. This issue stems from the syringe's sudden acceleration when the driving rod hits the plunger. To better understand cavitation in AIs, we explore how design factors like drive spring force, air gap size, and fluid viscosity affect its likelihood and severity. We use a dynamic model for spring-driven autoinjectors to predict and analyze the factors contributing to cavitation initiation and severity. This model predicts the motion of AI components, such as the displacement and velocity of the syringe barrel, and allows us to investigate pressure wave propagation and the subsequent dynamics of cavitation under various operating conditions. We investigated different air gap heights (from 1 to 4 mm), drive spring forces (from 8 to 30 N), and drug solution viscosities (from 1 to 18 cp) to assess cavitation inception based on operational parameters. Results reveal that AI dynamics and cavitation onset and severity strongly depend upon AI operating parameters, namely drive spring force and air gap height. The maximum syringe acceleration increases with spring stiffness and decreases with air gap height; increases in air gap height prolong the time interval of syringe acceleration but diminish the maximum syringe acceleration. From actuation to injection, air gap pressure peaks twice, first due to impact with the rod/plunger and secondly due to the deacceleration event upon injection. The maximum air gap pressure increases with spring stiffness and decreases with air gap height. Results show that maximum cavitation bubble radii and collapse-driven extension rates occur with higher driver spring forces, smaller air gap heights, and less viscous solutions. A cavitation criterion is developed for cavitation in autoinjectors that concludes that cavitation in autoinjectors depends on the peak syringe acceleration.

Mechanistic Computational Modeling of Implantable, Bioresorbable Drug Release Systems

Implantable, bioresorbable drug delivery systems offer an alternative to current drug administration techniques; allowing for patient-tailored drug dosage, while also increasing patient compliance. Mechanistic mathematical modeling allows for the acceleration of the design of the release systems, and for prediction of physical anomalies that are not intuitive and may otherwise elude discovery. This study investigates short-term drug release as a function of water-mediated polymer phase inversion into a solid depot within hours to days, as well as long-term hydrolysis-mediated degradation and erosion of the implant over the next few weeks. Finite difference methods are used to model spatial and temporal changes in polymer phase inversion, solidification, and hydrolysis. Modeling reveals the impact of non-uniform drug distribution, production and transport of H+ ions, and localized polymer degradation on the diffusion of water, drug, and hydrolyzed polymer byproducts. Compared to experimental data, the computational model accurately predicts the drug release during the solidification of implants over days and drug release profiles over weeks from microspheres and implants. This work offers new insight into the impact of various parameters on drug release profiles, and is a new tool to accelerate the design process for release systems to meet a patient specific clinical need.

Computational modeling of the effect of skin pinch and stretch on subcutaneous injection of monoclonal antibodies using autoinjector devices

Subcutaneous injection of monoclonal antibodies (mAbs) has experienced unprecedented growth in the pharmaceutical industry due to its benefits in patient compliance and cost-effectiveness. However, the impact of different injection techniques and autoinjector devices on the drug's transport and uptake is poorly understood. Here, we develop a biphasic large-deformation chemomechanical model that accounts for the components of the extracellular matrix that govern solid deformation and fluid flow within the subcutaneous tissue: interstitial fluid, collagen fibers and negatively charged proteoglycan aggregates. We use this model to build a high-fidelity representation of a virtual patient performing a subcutaneous injection of mAbs. We analyze the impact of the pinch and stretch methods on the injection dynamics and the use of different handheld autoinjector devices. The results suggest that autoinjector base plates with a larger device-skin contact area cause significantly lower tissue mechanical stress, fluid pressure and fluid velocity during the injection process. Our simulations indicate that the stretch technique presents a higher risk of intramuscular injection for autoinjectors with a relatively long needle insertion depth.

Interpenetrating Networks of Collagen and Hyaluronic Acid That Serve as In Vitro Tissue Models for Assessing Macromolecular Transport

High-fidelity preclinical in vitro tissue models can reduce the failure rate of drugs entering clinical trials. Collagen and hyaluronic acid (HA) are major components of the extracellular matrix of many native tissues and affect therapeutic macromolecule diffusion and recovery through tissues. Although collagen and HA are commonly used in tissue engineering, the physical and mechanical properties of these materials are variable and depend highly on processing conditions. In this study, HA was chemically modified and crosslinked via hydrazone bonds to form interpenetrating networks of crosslinked HA (HAX) with collagen (Col). These networks enabled a wide range of mechanical properties, including stiffness and swellability, and microstructures, such as pore morphology and size, that can better recapitulate diverse tissues. We utilized these interpenetrating ColHAX hydrogels as in vitro tissue models to examine macromolecular transport and recovery for early-stage drug screening. Hydrogel formulations with varying collagen and HAX concentrations imparted different gel properties based on the ratio of collagen to HAX. These gels were stable and swelled up to 170% of their original mass, and the storage moduli of the ColHAX gels increased over an order of magnitude by increasing collagen and HA concentration. Interestingly, when HAX concentration was constant and collagen concentration increased, both the pore size and spatial colocalization of collagen and HA increased. HA in the system dominated the ζ-potentials of the gels. The hydrogel and macromolecule properties impacted the mass transport and recovery of lysozyme, β-lactoglobulin, and bovine serum albumin (BSA) from the ColHAX gels─large molecules were largely impacted by mesh size, whereas small molecules were influenced primarily by electrostatic forces. Overall, the tunable properties demonstrated by the ColHAX hydrogels can be used to mimic different tissues for early-stage assays to understand drug transport and its relationship to matrix properties.

Quantifying Numerical Uncertainty in Background-Oriented Schlieren

Our study presents and evaluates a method for computing the numerical uncertainty in Background Oriented Schlieren (BOS). We use Richardson extrapolation to assess the uncertainty of numerical integration of density gradients, based on residuals of density results across two grid levels. By integrating this numerical uncertainty with the existing random uncertainty, we obtain the final uncertainty of the density field. We assess the method's effectiveness using synthetic fields with artificial noise. Our error analysis shows that the sharpness of the density gradient significantly affects bias error and the prediction of numerical uncertainty. The prediction of numerical uncertainty corresponds to variations in bias error, particularly when the noise level and wavelength of the flow field are altered. By accounting for the numerical uncertainty, our method achieves up to 91% accuracy in predicting total uncertainty, as measured against the root-mean-square of the total error. We further demonstrate the utility of our methodology by applying it to experimental BOS images. Our proposed approach offers a more accurate understanding of uncertainty estimation in the BOS technique, with implications for future experiments.

Automatic 4D Flow MRI Segmentation Using the Standardized Difference of Means Velocity

We present a method to automatically segment 4D flow magnetic resonance imaging (MRI) by identifying net flow effects using the standardized difference of means (SDM) velocity. The SDM velocity quantifies the ratio between the net flow and observed flow pulsatility in each voxel. Vessel segmentation is performed using an F-test, identifying voxels with significantly higher SDM velocity values than background voxels. We compare the SDM segmentation algorithm against pseudo-complex difference (PCD) intensity segmentation of 4D flow measurements in in vitro cerebral aneurysm models and 10 in vitro Circle of Willis (CoW) datasets. We also compared the SDM algorithm to convolutional neural network (CNN) segmentation in 5 thoracic vasculature datasets. The in vitro flow phantom geometry is known, while the ground truth geometries for the CoW and thoracic aortas are derived from high-resolution time-of-flight (TOF) magnetic resonance angiography and manual segmentation, respectively. The SDM algorithm demonstrates greater robustness than PCD and CNN approaches and can be applied to 4D flow data from other vascular territories. The SDM to PCD comparison demonstrated an approximate 48% increase in sensitivity in vitro and 70% increase in the CoW, respectively; the SDM and CNN sensitivities were similar. The vessel surface derived from the SDM method was 46% closer to the in vitro surfaces and 72% closer to the in vitro TOF surfaces than the PCD approach. The SDM and CNN approaches both accurately identify vessel surfaces. The SDM algorithm is a repeatable segmentation method, enabling reliable computation of hemodynamic metrics associated with cardiovascular disease.

Material properties of skin in the flying snake Chrysopelea ornata

In snakes, the skin serves for protection, camouflage, visual signaling, locomotion, and its ability to stretch facilitates large prey ingestion. The flying snakes of the genus Chrysopelea are capable of jumping and gliding through the air, requiring additional functional demands: its skin must accommodate stretch in multiple directions during gliding and, perhaps more importantly, during high-speed, direct-impact landing. Is the skin of flying snakes specialized for gliding? Here, we characterized the material properties of the skin of Chrysopelea ornata and compared them with two nongliding species of colubrid snakes, Thamnophis sirtalis and Pantherophis guttatus, as well as with previously published values. The skin was examined using uniaxial tensile testing to measure stresses, and digital image correlation methods to determine strains, yielding metrics of strength, elastic modulus, strain energy, and extensibility. To test for loading orientation effects, specimens were tested from three orientations relative to the snake's long axis: lateral, circumferential, and ventral. Specimens were taken from two regions of the body, pre- and pos-tpyloric, to test for regional effects related to the ingestion of large prey. In comparison with T. sirtalis and P. guttatus, C. ornata exhibited higher post-pyloric and lower pre-pyloric extensibility in circumferential specimens. However, overall there were few differences in skin material properties of C. ornata compared to other species, both within and across studies, suggesting that the skin of flying snakes is not specialized for gliding locomotion. Surprisingly, circumferential specimens demonstrated lower strength and extensibility in pre-pyloric skin, suggesting less regional specialization related to large prey.

Complex hemolymph circulation patterns in grasshopper wings

An insect's living systems-circulation, respiration, and a branching nervous system-extend from the body into the wing. Wing hemolymph circulation is critical for hydrating tissues and supplying nutrients to living systems such as sensory organs across the wing. Despite the critical role of hemolymph circulation in maintaining healthy wing function, wings are often considered "lifeless" cuticle, and flows remain largely unquantified. High-speed fluorescent microscopy and particle tracking of hemolymph in the wings and body of the grasshopper Schistocerca americana revealed dynamic flow in every vein of the fore- and hindwings. The global system forms a circuit, but local flow behavior is complex, exhibiting three distinct types: pulsatile, aperiodic, and "leaky" flow. Thoracic wing hearts pull hemolymph from the wing at slower frequencies than the dorsal vessel; however, the velocity of returning hemolymph (in the hindwing) is faster than in that of the dorsal vessel. To characterize the wing's internal flow mechanics, we mapped dimensionless flow parameters across the wings, revealing viscous flow regimes. Wings sustain ecologically important insect behaviors such as pollination and migration. Analysis of the wing circulatory system provides a template for future studies investigating the critical hemodynamics necessary to sustaining wing health and insect flight.

Multi-feature-Based Robust Cell Tracking

Cell tracking algorithms have been used to extract cell counts and motility information from time-lapse images of migrating cells. However, these algorithms often fail when the collected images have cells with spatially and temporally varying features, such as morphology, position, and signal-to-noise ratio. Consequently, state-of-the-art algorithms are not robust or reliable because they require manual inputs to overcome the cell feature changes. To address these issues, we present a fully automated, adaptive, and robust feature-based cell tracking algorithm for the accurate detection and tracking of cells in time-lapse images. Our algorithm tackles measurement limitations twofold. First, we use Hessian filtering and adaptive thresholding to detect the cells in images, overcoming spatial feature variations among the existing cells without manually changing the input thresholds. Second, cell feature parameters are measured, including position, diameter, mean intensity, area, and orientation, and these parameters are simultaneously used to accurately track the cells between subsequent frames, even under poor temporal resolution. Our technique achieved a minimum of 92% detection and tracking accuracy, compared to 16% from Mosaic and Trackmate. Our improved method allows for extended tracking and characterization of heterogeneous cell behavior that are of particular interest for intravital imaging users.

Modeling large-volume subcutaneous injection of monoclonal antibodies with anisotropic porohyperelastic models and data-driven tissue layer geometries

Subcutaneous injection of therapeutic monoclonal antibodies (mAbs) has become one of the fastest-growing fields in the pharmaceutical industry. The transport and mechanical processes behind large volume injections are poorly understood. Here, we leverage a large-deformation poroelastic model to study high-dose, high-speed subcutaneous injection. We account for the anisotropy of subcutaneous tissue using of a fibril-reinforced porohyperelastic model. We also incorporate the multi-layer structure of the skin tissue, generating data-driven geometrical models of the tissue layers using histological data. We analyze the impact of handheld autoinjectors on the injection dynamics for different patient forces. Our simulations show the importance of considering the large deformation approach to model large injection volumes. This work opens opportunities to better understand the mechanics and transport processes that occur in large-volume subcutaneous injections of mAbs.

Investigation of macromolecular transport through tunable collagen hyaluronic acid matrices

Therapeutic macromolecules possess properties such as size and electrostatic charge that will dictate their transport through subcutaneous (SC) tissue and ultimate bioavailability and efficacy. To improve therapeutic design, platforms that systematically measure the transport of macromolecules as a function of both drug and tissue properties are needed. We utilize a Transwell chamber with tunable collagen-hyaluronic acid (ColHA) hydrogels as an in vitro model to determine mass transport of macromolecules using non-invasive UV spectroscopy. Increasing hyaluronic acid (HA) concentration from 0 to 2 mg/mL within collagen gels decreases the mass transport of five macromolecules independent of size and charge and results in a maximum decrease in recovery of 23.3% in the case of bovine immunoglobulin G (IgG). However, in a pure 10 mg/mL HA solution, negatively-charged macromolecules bovine serum albumin (BSA), β-lactoglobulin (BLg), dextran (Dex), and IgG had drastically increased recovery by 20-40% compared to their performance in ColHA matrices. This result was different from the positively-charged macromolecule Lysozyme (Lys), which, despite its small size, showed reduced recovery by 3% in pure HA. These results demonstrate two distinct regimes of mass transport within our tissue model. In the presence of both collagen and HA, increasing HA concentrations decrease mass transport; however, in the absence of collagen, the high negative charge of HA sequesters and increases residence time of positively-charged macromolecules and decreases residence time of negatively-charged macromolecules. Through our approach, ColHA hydrogels serve as a platform for the systematic evaluation of therapeutic macromolecule transport as a function of molecular characteristics.

Wall Shear Stress Estimation for 4D Flow MRI Using Navier-Stokes Equation Correction

This study introduces a novel wall shear stress (WSS) estimation method for 4D flow MRI. The method improves the WSS accuracy by using the reconstructed pressure gradient and the flow-physics constraints to correct velocity gradient estimation. The method was tested on synthetic 4D flow data of analytical Womersley flow and flow in cerebral aneurysms and applied to in vivo 4D flow data acquired in cerebral aneurysms and aortas. The proposed method's performance was compared to the state-of-the-art method based on smooth-spline fitting of velocity profile and the WSS calculated from uncorrected velocity gradient. The proposed method improved the WSS accuracy by as much as 100% for the Womersley flow and reduced the underestimation of mean WSS by 39 to 50% for the synthetic aneurysmal flow. The predicted mean WSS from the in vivo aneurysmal data using the proposed method was 31 to 50% higher than the other methods. The predicted aortic WSS using the proposed method was 3 to 6 times higher than the other methods and was consistent with previous CFD studies and the results from recently developed methods that take into account the limited spatial resolution of 4D flow MRI. The proposed method improves the accuracy of WSS estimation from 4D flow MRI, which can help predict blood vessel remodeling and progression of cardiovascular diseases.

The Air Entrainment and Hydrodynamic Shear of the Liquid Slosh in Syringes

Understanding the interface motion and hydrodynamic shear induced by the liquid sloshing during the insertion stage of an autoinjector can help improve drug product administration. We perform experiments to investigate the interfacial motion and hydrodynamic shear due to the acceleration and deceleration of syringes. The goal is to explore the role of fluid properties, air gap size, and syringe acceleration on the interface dynamics caused by autoinjector activation. We used a simplified autoinjector platform to record the syringe and liquid motion without any view obstruction. Water and silicone oil with the same viscosity are used as the model fluids. Particle Image Velocimetry (PIV) is employed to measure the velocity field. Simultaneous shadowgraph visualization captures the air entrainment. Our in-house PIV and image processing algorithms are used to quantify the hydrodynamic stress and interfacial area to investigate the effects of various autoinjector design parameters and fluid types on liquid sloshing. The results indicate that reducing the air gap volume and syringe acceleration/deceleration mitigate the interface area and effective shear. Moreover, the interfacial area and induced hydrodynamic stress decrease with the Fr=U/aD, where U is the interface velocity, a is the maximum syringe acceleration, and D is the syringe diameter.

Cavitation in a soft porous material

We study the collapse and expansion of a cavitation bubble in a deformable porous medium. We develop a continuum-scale model that couples compressible fluid flow in the pore network with the elastic response of a solid skeleton. Under the assumption of spherical symmetry, our model can be reduced to an ordinary differential equation that extends the Rayleigh-Plesset equation to bubbles in soft porous media. The extended Rayleigh-Plesset equation reveals that finite-size effects lead to the breakdown of the universal scaling relation between bubble radius and time that holds in the infinite-size limit. Our data indicate that the deformability of the porous medium slows down the collapse and expansion processes, a result with important consequences for wide-ranging phenomena, from drug delivery to spore dispersion.

Assessment of Cavitation Intensity in Accelerating Syringes of Spring-Driven Autoinjectors

PURPOSE

Cavitation is an undesired phenomenon that may occur in certain types of autoinjectors (AIs). Cavitation happens because of rapid changes of pressure in a liquid, leading to the formation of small vapor-filled cavities, which upon collapsing, can generate an intense shock wave that may damage the device container and the protein drug molecules. Cavitation occurs in the AI because of the syringe-drug relative displacement as a result of the syringe's sudden acceleration during needle insertion and the ensuing pressure drop at the bottom of the container. Therefore, it's crucial to analyze the potential effect of cavitation on AI. The goal of the current study is to investigate the effects of syringe and AI design parameters such as air gap size, syringe filling volume, fluid viscosity, and drive spring force (syringe acceleration) on the risk and severity of cavitation.

METHODS

A model autoinjector platform is built to record the syringe and cavitation dynamics which we use to estimate the cavitation intensity in terms of extension rate and to study the effects of design parameters on the severity of cavitation.

RESULTS

Our results show the generation of an intense shock wave and a high extension rate upon cavitation collapse. The induced extension rate increases with syringe acceleration and filling volume and decreases with viscosity and air gap size.

CONCLUSION

The most severe cavitation occurred in an AI device with the larger drive spring force and the syringe of a smaller air gap size filled with a less viscous fluid and a larger filling volume.

Modeling Bias Error in 4D Flow MRI Velocity Measurements

We present a model to estimate the bias error of 4D flow magnetic resonance imaging (MRI) velocity measurements. The local instantaneous bias error is defined as the difference between the expectation of the voxel's measured velocity and actual velocity at the voxel center. The model accounts for bias error introduced by the intra-voxel velocity distribution and partial volume (PV) effects. We assess the intra-voxel velocity distribution using a 3D Taylor Series expansion. PV effects and numerical errors are considered using a Richardson extrapolation. The model is applied to synthetic Womersley flow and in vitro and in vivo 4D flow MRI measurements in a cerebral aneurysm. The bias error model is valid for measurements with at least 3.75 voxels across the vessel diameter and signal-to-noise ratio greater than 5. All test cases exceeded this diameter to voxel size ratio with diameters, isotropic voxel sizes, and velocity ranging from 3-15mm, 0.5-1mm, and 0-60cm/s, respectively. The model accurately estimates the bias error in voxels not affected by PV effects. In PV voxels, the bias error is an order of magnitude higher, and the accuracy of the bias error estimation in PV voxels ranges from 67.3% to 108% relative to the actual bias error. The bias error estimated for in vivo measurements increased two-fold at systole compared to diastole in partial volume and non-partial volume voxels, suggesting the bias error varies over the cardiac cycle. This bias error model quantifies 4D flow MRI measurement accuracy and can help plan 4D flow MRI scans.

A multi-modality approach for enhancing 4D flow magnetic resonance imaging via sparse representation

This work evaluates and applies a multi-modality approach to enhance blood flow measurements and haemodynamic analysis with phase-contrast magnetic resonance imaging (4D flow MRI) in cerebral aneurysms (CAs). Using a library of high-resolution velocity fields from patient-specific computational fluid dynamic simulations and in vitro particle tracking velocimetry measurements, the flow field of 4D flow MRI data is reconstructed as the sparse representation of the library. The method was evaluated with synthetic 4D flow MRI data in two CAs. The reconstruction enhanced the spatial resolution and velocity accuracy of the synthetic MRI data, leading to reliable pressure and wall shear stress (WSS) evaluation. The method was applied on in vivo 4D flow MRI data acquired in the same CAs. The reconstruction increased the velocity and WSS by 6-13% and 39-61%, respectively, suggesting that the accuracy of these quantities was improved since the raw MRI data underestimated the velocity and WSS by 10-20% and 40-50%, respectively. The computed pressure fields from the reconstructed data were consistent with the observed flow structures. The results suggest that using the sparse representation flow reconstruction with in vivo 4D flow MRI enhances blood flow measurement and haemodynamic analysis.

Divergence-Free Constrained Phase Unwrapping and Denoising for 4D Flow MRI Using Weighted Least-Squares

A novel divergence-free constrained phase unwrapping method was proposed and evaluated for 4D flow MRI. The unwrapped phase field was obtained by integrating the phase variations estimated from the wrapped phase data using weighted least-squares. The divergence-free constraint for incompressible blood flow was incorporated to regulate and denoise the resulting phase field. The proposed method was tested on synthetic phase data of left ventricular flow and in vitro 4D flow measurement of Poiseuille flow. The method was additionally applied to in vivo 4D flow measurements in the thoracic aorta from 30 human subjects. The performance of the proposed method was compared to the state-of-the-art 4D single-step Laplacian algorithm. The synthetic phase data were completely unwrapped by the proposed method for all the cases with velocity encoding (venc) as low as 20% of the maximum velocity and signal-to-noise ratio as low as 5. The in vitro Poiseuille flow data were completely unwrapped with a 60% increase in the velocity-to-noise ratio. For the in-vivo aortic datasets with venc ratio less than 0.4, the proposed method significantly improved the success rate by as much as 40% and reduced the velocity error levels by a factor of 10 compared to the state-of-the-art method. The divergence-free constrained method exhibits reliability and robustness on phase unwrapping and shows improved accuracy of velocity and hemodynamic quantities by unwrapping the low-venc 4D flow MRI data.

Automated peak prominence-based iterative Dijkstras algorithm for segmentation of B-mode echocardiograms

We present a user-initialized, automated segmentation method for use with echocardiograms (echo). The method uses an iterative Dijkstra's algorithm, a strategic node selection, and a novel cost matrix formulation based on intensity peak prominence, termed the Prominence Iterative Dijkstras algorithm, or ProID. ProID is initialized with three user-input clicks per time-series scan. ProID was tested using artificial echo images representing five different systems. Results showed accurate LV contours and volume estimations as compared to the ground-truth for all systems. Using the CAMUS dataset, we demonstrate ProID maintained similar Dice similarity scores to other automated methods. ProID was then used to analyze a clinical cohort of 66 pediatric patients, including normal and diseased hearts. Output segmentations, end-diastolic, end-systolic volumes, and ejection fraction were compared against manual segmentations from two expert readers. ProID maintained an average Dice score of 0.93 when comparing against manual segmentation. Comparing the two expert readers, the manual segmentations maintained a score of 0.93 which increased to 0.95 when they used ProID. Thus, ProID reduced the inter-operator variability across the expert readers. Overall, this work demonstrates ProID yields accurate boundaries across age groups, disease states, and echo platforms with low computational cost and no need for training data.

Modeling cavitation bubble dynamics in an autoinjector and its implications on drug molecules

The collapse of cavitation bubbles induced by abrupt acceleration of the syringe in an autoinjector device can lead to protein aggregation. The details of bubble dynamics are investigated using an axisymmetric, three-dimensional simulation with passive tracers to illustrate the transport of protein molecules. When a bubble near the syringe wall collapses, protein molecules are concentrated in the re-entrant jet, pushed towards the syringe wall, and then spread across the wall, potentially leading to protein adsorption on the syringe wall and aggregation. This phenomenon is more prominent for bubbles positioned closer to the bottom wall, growing to a larger maximum radius. The bubble's maximum radius decreases with the bubble's distance from the syringe wall and air gap pressure, and increases with an increase in liquid column height and nucleus size. The strain rate induced by the bubble collapse is not large enough to unfold the proteins. When the re-entrant jet impacts the bubble surface or syringe wall, the bubble breaks up, generating smaller bubbles with high surface concentration of protein molecules, potentially inducing aggregation in the bulk. The bubble dynamics are influenced by dimensionless distance of the nucleus from the wall, normalized by maximum bubble radius (γ). The re-entrant jet velocity increases with γ, while the maximum liquid pressure, typically 100∼1000 bar, first decreases and then increases with γ. For a cloud of cavitation bubbles, i.e., closely clustered bubbles, coalescence of bubbles can occur, leading to a higher peak pressure at collapse.

Haemodynamic dependence of mechano-genetic evolution of the cardiovascular system in Japanese medaka

The progression of cardiac gene expression-wall shear stress (WSS) interplay is critical to identifying developmental defects during cardiovascular morphogenesis. However, mechano-genetics from the embryonic to larval stages are poorly understood in vertebrates. We quantified peak WSS in the heart and tail vessels of Japanese medaka from 3 days post fertilization (dpf) to 14 dpf using in vivo micro-particle image velocimetry flow measurements, and in parallel analysed the expression of five cardiac genes (fgf8, hoxb6b, bmp4, nkx2.5, smyd1). Here, we report that WSS in the atrioventricular canal (AVC), ventricular outflow tract (OFT), and the caudal vessels in medaka peak with inflection points at 6 dpf and 10-11 dpf instead of a monotonic trend. Retrograde flows are captured at the AVC and OFT of the medaka heart for the first time. In addition, all genes were upregulated at 3 dpf and 7 dpf, indicating a possible correlation between the two, with the cardiac gene upregulation preceding WSS increase in order to facilitate cardiac wall remodelling.

Stable Thermally-Modulated Nanodroplet Ultrasound Contrast Agents

Liquid perfluorocarbon-based nanodroplets are stable enough to be used in extravascular imaging, but provide limited contrast enhancement due to their small size, incompressible core, and small acoustic impedance mismatch with biological fluids. Here we show a novel approach to overcoming this limitation by using a heating-cooling cycle, which we will refer to as thermal modulation (TM), to induce echogenicity of otherwise stable but poorly echogenic nanodroplets without triggering a transient phase shift. We apply thermal modulation to high-boiling point tetradecafluorohexane (TDFH) nanodroplets stabilized with a bovine serum albumin (BSA) shell. BSA-TDFH nanodroplets with an average diameter under 300 nanometers showed an 11.9 ± 5.4 mean fold increase in echogenicity on the B-mode and a 13.9 ± 6.9 increase on the nonlinear contrast (NLC) mode after thermal modulation. Once activated, the particles maintained their enhanced echogenicity (p < 0.001) for at least 13 h while retaining their nanoscale size. Our data indicate that thermally modulated nanodroplets can potentially serve as theranostic agents or sensors for various applications of contrast-enhanced ultrasound.

The aerodynamics of flying snake airfoils in tandem configuration

Flying snakes flatten their body to form a roughly triangular cross-sectional shape, enabling lift production and horizontal acceleration. While gliding, they also assume an S-shaped posture, which could promote aerodynamic interactions between the fore and the aft body. Such interactions have been studied experimentally; however, very coarse models of the snake's cross-sectional shape were used, and the effects were measured only for the downstream model. In this study, the aerodynamic interactions resulting from the snake's posture were approximated using two-dimensional anatomically accurate airfoils positioned in tandem to mimic the snake's geometry during flight. Load cells were used to measure the lift and drag forces, and flow field data were obtained using digital particle image velocimetry (DPIV). The results showed a strong dependence of the aerodynamic performance on the tandem arrangement, with the lift coefficients being generally more influenced than the drag coefficients. Flow field data revealed that the tandem arrangement modified the separated flow and the wake size, and enhanced the lift in cases in which the wake vortices formed closer to the models, producing suction on the dorsal surface. The downforce created by the flow separation from the ventral surface of the models at 0 deg angle of attack was another significant factor contributing to lift production. A number of cases showing large variations of aerodynamic performance included configurations close to the most probable posture of airborne flying snakes, suggesting that small postural variations could be used to control the glide trajectory.

A Wavelet Approach to the Estimation of Left Ventricular Early Filling Wave Propagation Velocity from Color M-Mode Echocardiograms

A new approach to calculating left ventricular (LV) early filling propagation velocity (VP) from color M-mode echocardiograms using wavelet analysis is described. Current methods for measuring VP do not account for the spatiotemporal variation in VP. They are confined by empirical assumptions and user inputs that hinder the accuracy of VP, limiting its clinical utility. We evaluated three methods for measuring LV early filling: conventional VP, the strength of propagation (VS) and wavelet propagation velocity (VW) determined from the most energetically significant wave (peak VW). Group A comprised 125 patients (n = 50 normal filling, n = 25 impaired relaxation, n = 25 pseudonormal filling and n = 25 restrictive filling), and group B comprised 69 patients (n = 32 normal, n = 15 dilated and n = 22 hypertrophic). Peak VW most accurately distinguished normal from diseased patients. For group A, the area under the receiver operating characteristic curve was 0.92 for peak VW versus 0.62 for VP, 0.63 for VS and 0.58 for intraventricular pressure difference. These correspond to a 50%-70% improvement in classification ability. Similar improvements were measured in group B. Peak VW may provide a more accurate evaluation of diastolic function than standard methods and enable better diagnostic classification of patients with diastolic dysfunction.

The Interface Motion and Hydrodynamic Shear of the Liquid Slosh in Syringes

PURPOSE

Interface motion and hydrodynamic shear of the liquid slosh during the insertion of syringes upon autoinjector activation may damage the protein drug molecules. Experimentally validated computational fluid dynamics simulations are used in this study to investigate the interfacial motion and hydrodynamic shear due to acceleration and deceleration of syringes. The goal is to explore the role of fluid viscosity, air gap size, syringe acceleration, syringe tilt angle, liquid-wall contact angle, surface tension and fill volume on the interface dynamics caused by autoinjector activation.

METHODS

A simplified autoinjector platform submerged in water is built to record the syringe and liquid motion without obstruction of view. The syringe kinematics is imported to the simulations based on OpenFOAM InterIsoFoam solver, which is used to study the effects of various physical parameters.

RESULTS

The simulations agree with experiments on the air-liquid interface profile and interface area. The interfacial area and the volume of fluid subject to high strain rate decrease with the solution viscosity, increase with the air gap height, syringe velocity, tilt angle and syringe wall hydrophobicity, and hardly change with the surface tension and liquid column height. The hydrodynamic shear mainly occurs near the syringe wall and entrained bubbles.

CONCLUSION

For a given dose of drug solution, the syringe with smaller radius and larger length will generate less liquid slosh. Reducing the air volume and syringe wall hydrophobicity are also helpful to reduce interface area and effective shear. The interface motion is reduced when the syringe axis is aligned with the gravitational direction.

Colour-Doppler echocardiography flow field velocity reconstruction using a streamfunction-vorticity formulation

We introduce a new method (Doppler Velocity Reconstruction or DoVeR), for reconstructing two-component velocity fields from colour Doppler scans. DoVeR employs the streamfunction-vorticity equation, which satisfies mass conservation while accurately approximating the flow rate of rotation. We validated DoVeR using artificial colour Doppler images generated from computational fluid dynamics models of left ventricle (LV) flow. We compare DoVeR against the conventional intraventricular vector flow mapping (iVFM_1D) and reformulated iVFM (iVFM_2D). LV model error analysis showed that DoVeR is more robust to noise and probe placement, with noise RMS errors (nRMSE) between 3.81% and 6.67%, while the iVFM methods delivered 4.16-24.17% for iVFM_1D and 4.06-400.21% for iVFM_2D. We test the DoVeR and iVFM methods using in vivo mouse LV ultrasound scans. DoVeR yielded more haemodynamically accurate reconstructions, suggesting that it can provide a more reliable approach for robust quantification of cardiac flow.

Estimation of the probability density function of random displacements from images

We introduce an image-based algorithm to find the probability density function (PDF) of particle displacements from a sequence of images. Conventionally methods based on cross correlation (CC) of image ensembles estimate the standard deviation of an assumed Gaussian PDF from the width of the CC peak. These methods are subject to limiting assumptions that the particle intensity profile and distribution of particle displacements are both Gaussian. Here, we introduce an approach to image-based probability estimation of displacement (iPED) without making any assumptions about the shape of particles' intensity profile or the PDF of the displacements. In addition, we provide a statistical convergence criterion for iPED to achieve an accurate estimate of the underlying PDF. We compare iPED's performance with the previous CC method for both Gaussian and non-Gaussian particle intensity profiles undergoing Gaussian or non-Gaussian processes. We validate iPED using synthetic images and show that it accurately resolves the PDF of particle displacements with no underlying assumptions. Finally, we demonstrate the application of iPED to real experimental data sets and evaluate its performance. In conclusion, this work presents a method for the estimation of the probability density function of random displacements from images. This method is generalized and independent of any assumptions about the underlying process and is applicable to any moving objects of any arbitrary shape.

Fibronectin-Expressing Mesenchymal Tumor Cells Promote Breast Cancer Metastasis

Simple Summary

For cancer to metastasize, tumor cells must not only invade the local tissue but must also grow and proliferate once they arrive. Tumor cell heterogeneity, the presence of multiple types of cancer cells within a tumor, can increase cell proliferation and invasion through cooperative interactions, increasing the potential for metastasis. We recently found that pro-invasion cancer cells express the protein fibronectin and increase metastasis for pro-growth cancer cells. We investigated this interaction by analyzing these two cell types’ migration and survival, both alone and in co-cultures. We find that pro-invasion cells have a protective effect on pro-growth cells, which otherwise die after two days in nutrient-starved conditions. Further, we find that adding soluble fibronectin to pro-growth cells in culture was sufficient to improve survival. However, their survival was higher for co-culturing conditions. These studies highlight the importance of cancer cell heterogeneity and the role of fibronectin in metastasis.

Abstract

Tumor metastasis is connected to epithelial-mesenchymal heterogeneity (EMH) and the extracellular matrix (ECM) within the tumor microenvironment. Mesenchymal-like fibronectin (FN) expressing tumor cells enhance metastasis within tumors that have EMH. However, the secondary tumors are primarily composed of the FN null population. Interestingly, during tumor cell dissemination, the invasive front has more mesenchymal-like characteristics, although the outgrowths of metastatic colonies consist of a more epithelial-like population of cells. We hypothesize that soluble FN provided by mesenchymal-like tumor cells plays a role in supporting the survival of the more epithelial-like tumor cells within the metastatic niche in a paracrine manner. Furthermore, due to a lower rate of proliferation, the mesenchymal-like tumor cells become a minority population within the metastatic niche. In this study, we utilized a multi-parametric cell-tracking algorithm and immunoblotting to evaluate the effect of EMH on the growth and invasion of an isogenic cell series within a 3D collagen network using a microfluidic platform. Using the MCF10A progression series, we demonstrated that co-culture with FN-expressing MCF10CA1h cells significantly enhanced the survival of the more epithelial MCF10CA1a cells, with a two-fold increase in the population after 5 days in co-culture, whereas the population of the MCF10CA1a cells began to decrease after 2.5 days when cultured alone (p < 0.001). However, co-culture did not significantly alter the rate of proliferation for the more mesenchymal MCF10CA1h cells. Epithelial tumor cells not only showed prolonged survival, but migrated significantly longer distances (350 µm compared with 150 µm, respectively, p < 0.01) and with greater velocity magnitude (4.5 µm/h compared with 2.1 µm/h, respectively, p < 0.001) under co-culture conditions and in response to exogenously administered FN. Genetic depletion of FN from the MCF10CA1h cells resulted in a loss of survival and migration capacity of the epithelial and mesenchymal populations. These data suggest that mesenchymal tumor cells may function to support the survival and outgrowth of more epithelial tumor cells within the metastatic niche and that inhibition of FN production may provide a valuable target for treating metastatic disease.

Performance characterization of spring actuated autoinjector devices for Emgality and Aimovig

Objective: Autoinjectors are a convenient and efficient way to self-administer subcutaneous injections of biopharmaceuticals. Differences in device mechanical design can affect the autoinjector functionality and performance. This study investigates the performance differences of two single-spring-actuated autoinjectors.Methods: We compare the performance between Emgality (120 mg/mL) and Aimovig (140 mg/mL) autoinjector devices from an engineering point of view at two test conditions: room (25 C[Formula: see text]) and storage (5 C[Formula: see text]) temperatures. We employ a novel experimental procedure to simultaneously acquire the force and acoustic signals during operation, and high-speed imaging during the needle insertion and drug injection.Results: We perform 18 quantitative comparisons between Emgality and Aimovig, and we observe that 14 of these have statistically significant differences. For both test conditions, Emgality requires an 8 N activation force while Aimovig requires 14 N activation force, and the needle of Emgality has an insertion depth of 5 mm while Aimovig has an insertion depth of 7 mm. The injection speeds are significantly affected by temperature. Emgality has an injection speed of 0.40 mL/s and 0.28 mL/s at room and storage temperature condition, respectively; while Aimovig has an injection speed of 0.24 mL/s and 0.16 mL/s at those conditions. Lastly, confirmation "click" sound of Emgality occurs 0.75-1.53 s after dose completion, while in Aimovig, the confirmation "click" sound occurs 0.26-0.46 s before dose completion.Conclusions: This study revealed performance differences between Emgality and Aimovig autoinjector devices, despite the fact that the delivery principle of these single-spring-actuated autoinjectors are the same. These differences may result in different risk of intramuscular injection and premature device removal, both of which need to be further verified in clinical trials.

4D Flow MRI Pressure Estimation Using Velocity Measurement-Error-Based Weighted Least-Squares

This work introduces a 4D flow magnetic resonance imaging (MRI) pressure reconstruction method which employs weighted least-squares (WLS) for pressure integration. Pressure gradients are calculated from the velocity fields, and velocity errors are estimated from the velocity divergence for incompressible flow. Pressure gradient errors are estimated by propagating the velocity errors through Navier-Stokes momentum equation. A weight matrix is generated based on the pressure gradient errors, then employed for pressure reconstruction. The pressure reconstruction method was demonstrated and analyzed using synthetic velocity fields as well as Poiseuille flow measured using in vitro 4D flow MRI. Performance of the proposed WLS method was compared to the method of solving the pressure Poisson equation which has been the primary method used in the previous studies. Error analysis indicated that the proposed method is more robust to velocity measurement errors. Improvement on pressure results was found to be more significant for the cases with spatially-varying velocity error level, with reductions in error ranging from 50% to over 200%. Finally, the method was applied to flow in patient-specific cerebral aneurysms. Validation was performed with in vitro flow data collected using Particle Tracking Velocimetry (PTV) and in vivo flow measurement obtained using 4D flow MRI. Pressure calculated by WLS, as opposed to the Poisson equation, was more consistent with the flow structures and showed better agreement between the in vivo and in vitro data. These results suggest the utility of WLS method to obtain reliable pressure field from clinical flow measurement data.

Hydrodynamic attraction of bacteria to gas and liquid interfaces

Near an interface, the distribution of swimming microorganisms such as bacteria is distinguished from inert colloidal particles because of the interfacial hydrodynamics induced by swimming. In this work, we use nontumbling flagellated bacteria, Escherichia coli, to study cell distribution near gas and liquid interfaces and compare it to the case of a solid wall. For low-viscosity ratios such as gas interfaces, we observe a stronger cell accumulation compared to that near liquid and solid surfaces. This contradicts known theoretical predictions. Therefore, we develop a model based on Brownian dynamics, including hydrodynamic effects and short-range physiochemical interactions between bacteria and interfaces. This model explains our experimental findings and can predict cell distribution near clean and surfactant-contaminated interfaces. By considering higher order singularities, this study helps explain bacteria orientation, trajectories, and cell density.

Multi-modality cerebral aneurysm haemodynamic analysis: in vivo 4D flow MRI, in vitro volumetric particle velocimetry and in silico computational fluid dynamics

Typical approaches to patient-specific haemodynamic studies of cerebral aneurysms use image-based computational fluid dynamics (CFD) and seek to statistically correlate parameters such as wall shear stress (WSS) and oscillatory shear index (OSI) to risk of growth and rupture. However, such studies have reported contradictory results, emphasizing the need for in-depth multi-modality haemodynamic metric evaluation. In this work, we used in vivo 4D flow MRI data to inform in vitro particle velocimetry and CFD modalities in two patient-specific cerebral aneurysm models (basilar tip and internal carotid artery). Pulsatile volumetric particle velocimetry experiments were conducted, and the particle images were processed using Shake-the-Box, a particle tracking method. Distributions of normalized WSS and relative residence time were shown to be highly yet inconsistently affected by minor flow field and spatial resolution variations across modalities, and specific relationships among these should be explored in future work. Conversely, OSI, a non-dimensional parameter, was shown to be more robust to the varying assumptions, limitations and spatial resolutions of each subject and modality. These results suggest a need for further multi-modality analysis as well as development of non-dimensional haemodynamic parameters and correlation of such metrics to aneurysm risk of growth and rupture.

Diastolic Intra-Left Ventricular Pressure Difference During Exercise: Strong Determinant and Predictor of Exercise Capacity in Patients With Heart Failure

BACKGROUND

Although the enhancement of early-diastolic intra-left ventricular pressure difference (IVPD) during exercise is considered to maintain exercise capacity, little is known about their relationship in heart failure (HF).

METHODS AND RESULTS

Cardiopulmonary exercise testing and exercise-stress echocardiography were performed in 50 HF patients (left ventricular [LV] ejection fraction 39 ± 15%). Echocardiographic images were obtained at rest and submaximal and peak exercise. Color M-mode Doppler images of LV inflow were used to determine IVPD. Thirty-five patients had preserved exercise capacity (peak oxygen consumption [VO₂] ≥14 mL·kg^-1·min^-1; group 1) and 15 patients had reduced exercise capacity (group 2). During exercise, IVPD increased only in group 1 (group 1: 1.9 ± 0.9 mm Hg at rest, 4.1 ± 2.0 mm Hg at submaximum, 4.7 ± 2.1 mm Hg at peak; group 2: 1.9 ± 0.8 mm Hg at rest, 2.1 ± 0.9 mm Hg at submaximum, 2.1 ± 0.9 mm Hg at peak). Submaximal IVPD (r = 0.54) and peak IVPD (r = 0.69) were significantly correlated with peak VO₂. Peak IVPD determined peak VO₂ independently of LV ejection fraction. Moreover, submaximal IVPD could well predict the reduced exercise capacity.

CONCLUSION

Early-diastolic IVPD during exercise was closely associated with exercise capacity in HF. In addition, submaximal IVPD could be a useful predictor of exercise capacity without peak exercise in HF patients.

Density and Viscosity Matched Newtonian and non-Newtonian Blood-Analog Solutions with PDMS Refractive Index

Optical imaging is commonly used to investigate biological flows and cardiovascular disease using compliant silicone polydimethysiloxane (PDMS) Sylgard 184 geometries. However, selecting the working fluid with blood density and viscosity, and PDMS index of refraction (RI) for such experiments is challenging. Currently, water-glycerol is commonly used and sodium iodide (NaI) often added to increase the index of refraction without changing fluid viscosity. But the resulting fluid density is well above blood. Moreover, NaI is expensive, has safety and material discoloration concerns, and has been reported to affect non-Newtonian fluid behavior. Here, we present a new blood analog alternative based on urea. Urea is approximately five to fifteen times less expensive than NaI, safe and easy to handle, optically clear, and causes no discoloration. Water-glycerol-urea solutions, unlike those with NaI, simultaneously matched the density and viscosity of blood and RI of PDMS. Water-xylitol and water-xylitol-urea solutions are also possible blood analog solutions. Xanthan gum (XG)-water-glycerol non-Newtonian solutions maintained similar viscoelastic properties throughout the range of weight percent (about 15-25%) of urea and NaI used here. The results showed that the XG weight percent affected viscoelastic properties more than the weight percent of urea or NaI tested in this study. Overall, we demonstrate urea is useful for PDMS blood analog experiments and should also be considered as an inexpensive additive, and an alternative to NaI.

Pore-scale statistics of flow and transport through porous media

Flow in porous media is known to be largely affected by pore morphology. In this work, we investigate the effects of pore geometry on the transport and spatial correlations of flow through porous media in two distinct pore structures arising from three-dimensional assemblies of overlapping and nonoverlapping spheres. Using high-resolution direct numerical simulations (DNS), we perform Eulerian and Lagrangian analysis of the flow and transport characteristics in porous media. We show that the Eulerian velocity distributions change from nearly exponential to Gaussian distributions as porosity increases. A stretched exponential distribution can be used to represent this behavior for a wide range of porosities. Evolution of Lagrangian velocities is studied for the uniform injection rule. Evaluation of tortuosity and trajectory length distributions of each porous medium shows that the model of overlapping spheres results in higher tortuosity and more skewed trajectory length distributions compared to the model of nonoverlapping spheres. Wider velocity distribution and higher tortuosity for overlapping spheres model give rise to non-Fickian transport while transport in nonoverlapping spheres model is found to be Fickian. Particularly, for overlapping spheres model our analysis of first-passage time distribution shows that the transport is very similar to those observed for sandstone. Finally, using three-dimensional (3D) velocity field obtained by DNS at the pore-scale, we quantitatively show that despite the randomness of pore-space, the spatially fluctuating velocity field and the 3D pore-space distribution are strongly correlated for a range of porous media from relatively homogeneous monodisperse sphere packs to Castlegate sandstone.

B fibers are the best predictors of cardiac activity during Vagus nerve stimulation: Qing, vagal B fiber activation and cardiac effects

Background

Vagus nerve stimulation (VNS) is a promising therapy for many neurologic and psychiatric conditions. However, determining stimulus parameters for individual patients is a major challenge. The traditional method of titrating stimulus intensity based on patient perception produces highly variable responses. This study explores using the vagal response to measure stimulation dose and predict physiological effect. Clinicians are investigating the use of VNS for heart failure management, and this work aims to correlate cardiac measures with vagal fiber activity.

Results

By recording vagal activity during VNS in rats and using regression analysis, we found that cardiac activity across all animals was best correlated to the activation of a specific vagal fiber group. With conduction velocities ranging from 5 to 10 m/s, these fibers are classified as B fibers (using the Erlanger-Gasser system) and correspond to vagal parasympathetic efferents.

Conclusions

B fiber activation can serve as a standardized, objective measure of stimulus dose across all subjects. Tracking fiber activation provides a more systematic way to study the effects of VNS and in the future, may lead to a more consistent method of therapy delivery.

Development and Validation of a Phase-Filtered Moving Ensemble Correlation for Echocardiographic Particle Image Velocimetry

A new processing method for echocardiographic particle image velocimetry (EchoPIV) using moving ensemble (ME) correlation with dynamic phase correlation filtering was developed to improve velocity measurement accuracy for routine clinical evaluation of cardiac function. The proposed method was tested using computationally generated echocardiogram images. Error analysis indicated that ME EchoPIV yields a twofold improvement in bias and random error over the current standard correlation method (β_Pairwise = -0.15 vs. β_ME = -0.06; σ_Pairwise = 1.00 vs. σ_ME = 0.49). Subsequently a cohort of eight patients with impaired diastolic filling underwent similar evaluation. Comparison of patient EchoPIV velocity time series with corresponding color M-mode velocity time series revealed better agreement for ME EchoPIV compared with standard PIV processing (R_ME = 0.90 vs. R_Pairwise = 0.70). Further time series analysis was performed to measure filling propagation velocity and 1-D intraventricular pressure gradients. Comparison against CMM values indicated that both measurements are completely decorrelated for pairwise processing (R²_Vp = 0.15, R²_IVPD = 0.07), whereas ME processing correlates decently (R²_Vp = 0.69, R²_IVPD = 0.69). This new approach enables more robust processing of routine clinical scans and can increase the utility of EchoPIV for the assessment of left ventricular function.

Cardiac and respiratory-gated volumetric murine ultrasound

Current cardiovascular ultrasound mainly employs planar imaging techniques to assess function and physiology. These techniques rely on geometric assumptions, which are dependent on the imaging plane, susceptible to inter-observer variability, and may be inaccurate when studying complex diseases. Here, we developed a gated volumetric murine ultrasound technique to visualize cardiovascular motion with high spatiotemporal resolution and directly evaluate cardiovascular health. Cardiac and respiratory-gated cine loops, acquired at 1000 frames-per-second from sequential positions, were temporally registered to generate a four-dimensional (4D) dataset. We applied this technique to (1) evaluate left ventricular (LV) function from both healthy mice and mice with myocardial infarction and (2) characterize aortic wall strain of angiotensin II-induced dissecting abdominal aortic aneurysms in apolipoprotein E-deficient mice. Combined imaging and processing times for the 4D technique was approximately 2-4 times longer than conventional 2D approaches, but substantially more data is collected with 4D ultrasound and further optimization can be implemented to reduce imaging times. Direct volumetric measurements of 4D cardiac data aligned closely with those obtained from MRI, contrary to conventional methods, which were sensitive to transducer alignment, leading to overestimation or underestimation of estimated LV parameters in infarcted hearts. Green-Lagrange circumferential strain analysis revealed higher strain values proximal and distal to the aneurysm than within the aneurysmal region, consistent with published reports. By eliminating the need for geometrical assumptions, the presented 4D technique can be used to more accurately evaluate cardiac function and aortic pulsatility. Furthermore, this technique allows for the visualization of regional differences that may be overlooked with conventional 2D approaches.

Hemodynamics of Stent Implantation Procedures in Coronary Bifurcations: An In Vitro Study

Stent implantation in coronary bifurcations presents unique challenges and currently there is no universally accepted stent deployment approach. Despite clinical and computational studies, the effect of each stent implantation method on the coronary artery hemodynamics is not well understood. In this study the hemodynamics of stented coronary bifurcations under pulsatile flow conditions were investigated experimentally. Three implantation methods, provisional side branch (PSB), culotte (CUL), and crush (CRU), were investigated using time-resolved particle image velocimetry to measure the velocity fields. Subsequently, hemodynamic parameters including wall shear stress, oscillatory shear index (OSI), and relative residence time (RRT) were calculated. The pressure field through the vessel was non-invasively quantified and pressure wave speeds were computed. The effects of each stented case were evaluated and compared against an un-stented case. CRU provided the lowest compliance mismatch, but demonstrated detrimental stent interactions. PSB, the clinically preferred method, and CUL maintained many normal flow conditions. However, PSB provided about a 300% increase in both OSI and RRT. CUL yielded a 10 and 85% increase in OSI and RRT, respectively. The results of this study support the concept that different bifurcation stenting techniques result in hemodynamic environments that deviate from that of un-stented bifurcations, to varying degrees.

Abstract 106: Characterizing Aortic Wall Dynamics in Murine Models of Abdominal Aortic Aneurysms Using Ultrasound Imaging

The objective of this study is to use non-invasive ultrasound imaging to characterize aortic wall dynamics in abdominal aortic aneurysms (AAAs). We induced AAAs (n=5) in apolipoprotein-E deficient mice by subcutaneously implanting an osmotic pump, which systemically delivers angiotensin II at a rate of 1000 ng/kg/min for 28 days, in the back of each mouse. Once aneurysm formations were confirmed using a high frequency small animal ultrasound system (Vevo2100, Visualsonics; 40 MHz central frequency), we implemented our cardiac- and respiratory-gated volumetric ultrasound technique to acquire 3D AAA geometries throughout a cardiac cycle. Figure 1 summarizes the results obtained from a representative mouse with a suprarenal AAA. A 3D volume rendering of an abdominal aorta, with the aneurysm positioned in the center, is illustrated next to a color bar, which provides position references for both the maximum circumferential Green-Lagrangian (GL) strain and the instantaneous strain plots. Qualitative inspections of both strain plots depicted in Figure 1 demonstrate that maximum GL circumferential strain occurs during systole and is smallest within the AAA. Quantitative assessments of GL circumferential strain for all five AAAs were performed with similar results indicating that maximum GL strain decreased significantly within the aneurysm (1.1±0.2%) compared to proximal (9.3±5.3%) and distal (4.0±2.1%) regions (p<0.05). This decrease in GL circumferential strain within the aneurysmal portion of the abdominal aorta corroborates the idea that an increase in vessel stiffness is associated with the degradation of elastin and increased collagen turnover in the AAA wall. Interestingly, in all five cases, we observed a stiffer distal region, when compared to regions proximal to the aneurysm, suggesting that AAA development may also contribute to extracellular matrix remodeling of the aortic wall downstream of the aneurysm site.

Flow shear stress regulates endothelial barrier function and expression of angiogenic factors in a 3D microfluidic tumor vascular model

Endothelial cells lining blood vessels are exposed to various hemodynamic forces associated with blood flow. These include fluid shear, the tangential force derived from the friction of blood flowing across the luminal cell surface, tensile stress due to deformation of the vessel wall by transvascular flow, and normal stress caused by the hydrodynamic pressure differential across the vessel wall. While it is well known that these fluid forces induce changes in endothelial morphology, cytoskeletal remodeling, and altered gene expression, the effect of flow on endothelial organization within the context of the tumor microenvironment is largely unknown. Using a previously established microfluidic tumor vascular model, the objective of this study was to investigate the effect of normal (4 dyn/cm(2)), low (1 dyn/cm(2)), and high (10 dyn/cm(2)) microvascular wall shear stress (WSS) on tumor-endothelial paracrine signaling associated with angiogenesis. It is hypothesized that high WSS will alter the endothelial phenotype such that vascular permeability and tumor-expressed angiogenic factors are reduced. Results demonstrate that endothelial permeability decreases as a function of increasing WSS, while co-culture with tumor cells increases permeability relative to mono-cultures. This response is likely due to shear stress-mediated endothelial cell alignment and tumor-VEGF-induced permeability. In addition, gene expression analysis revealed that high WSS (10 dyn/cm(2)) significantly down-regulates tumor-expressed MMP9, HIF1, VEGFA, ANG1, and ANG2, all of which are important factors implicated in tumor angiogenesis. This result was not observed in tumor mono-cultures or static conditioned media experiments, suggesting a flow-mediated paracrine signaling mechanism exists with surrounding tumor cells that elicits a change in expression of angiogenic factors. Findings from this work have significant implications regarding low blood velocities commonly seen in the tumor vasculature, suggesting high shear stress-regulation of angiogenic activity is lacking in many vessels, thereby driving tumor angiogenesis.

Tunable collagen I hydrogels for engineered physiological tissue micro-environments

Collagen I hydrogels are commonly used to mimic the extracellular matrix (ECM) for tissue engineering applications. However, the ability to design collagen I hydrogels similar to the properties of physiological tissues has been elusive. This is primarily due to the lack of quantitative correlations between multiple fabrication parameters and resulting material properties. This study aims to enable informed design and fabrication of collagen hydrogels in order to reliably and reproducibly mimic a variety of soft tissues. We developed empirical predictive models relating fabrication parameters with material and transport properties. These models were obtained through extensive experimental characterization of these properties, which include compression modulus, pore and fiber diameter, and diffusivity. Fabrication parameters were varied within biologically relevant ranges and included collagen concentration, polymerization pH, and polymerization temperature. The data obtained from this study elucidates previously unknown fabrication-property relationships, while the resulting equations facilitate informed a priori design of collagen hydrogels with prescribed properties. By enabling hydrogel fabrication by design, this study has the potential to greatly enhance the utility and relevance of collagen hydrogels in order to develop physiological tissue microenvironments for a wide range of tissue engineering applications.

Vortex formation time is not an index of ventricular function

The diastolic intraventricular ring vortex formation and pinch-off process may provide clinically useful insights into diastolic function in health and disease. The vortex ring formation time (FT) concept, based on hydrodynamic experiments dealing with unconfined (large tank) flow, has attracted considerable attention and popularity. Dynamic conditions evolving within the very confined space of a filling, expansible ventricular chamber with relaxing and rebounding, and viscoelastic muscular boundaries diverge from unconfined (large tank) flow and encompass rebounding walls' suction and myocardial relaxation. Indeed, clinical/physiological findings seeking validation in vivo failed to support the notion that FT is an index of normal/abnormal diastolic ventricular function. Therefore, FT as originally proposed cannot and should not be utilized as such an index. Evidently, physiologically accurate models accounting for coupled hydrodynamic and (patho)physiological myocardial wall interactions with the intraventricular flow are still needed to enhance our understanding and yield diastolic function indices useful and reliable in the clinical setting.

Review of collagen I hydrogels for bioengineered tissue microenvironments: characterization of mechanics, structure, and transport

Type I collagen hydrogels have been used successfully as three-dimensional substrates for cell culture and have shown promise as scaffolds for engineered tissues and tumors. A critical step in the development of collagen hydrogels as viable tissue mimics is quantitative characterization of hydrogel properties and their correlation with fabrication parameters, which enables hydrogels to be tuned to match specific tissues or fulfill engineering requirements. A significant body of work has been devoted to characterization of collagen I hydrogels; however, due to the breadth of materials and techniques used for characterization, published data are often disjoint and hence their utility to the community is reduced. This review aims to determine the parameter space covered by existing data and identify key gaps in the literature so that future characterization and use of collagen I hydrogels for research can be most efficiently conducted. This review is divided into three sections: (1) relevant fabrication parameters are introduced and several of the most popular methods of controlling and regulating them are described, (2) hydrogel properties most relevant for tissue engineering are presented and discussed along with their characterization techniques, (3) the state of collagen I hydrogel characterization is recapitulated and future directions are proposed. Ultimately, this review can serve as a resource for selection of fabrication parameters and material characterization methodologies in order to increase the usefulness of future collagen-hydrogel-based characterization studies and tissue engineering experiments.

A theoretical analysis of pitch stability during gliding in flying snakes

Flying snakes use their entire body as a continuously morphing 'wing' to produce lift and shallow their glide trajectory. Their dominant behavior during gliding is aerial undulation, in which lateral waves are sent posteriorly down the body. This highly dynamic behavior, which is unique among animal gliders, should have substantial effects on the flight dynamics and stability of the snakes, resulting from the continuous redistribution of mass and aerodynamic forces. In this study, we develop two-dimensional theoretical models to assess the stability characteristics of snakes in the pitch direction. Previously measured force coefficients are used to simulate aerodynamic forces acting on the models, and undulation is simulated by varying mass. Model 1 is a simple three-airfoil representation of the snake's body that possesses a passively stable equilibrium solution, whose basin of stability contains initial conditions observed in experimental gliding trajectories. Model 2 is more sophisticated, with more degrees of freedom allowing for postural changes to better represent the snake's real kinematics; in addition, a restoring moment is added to simulate potential active control. The application of static and dynamic stability criteria show that Model 2 is passively unstable, but can be stabilized with a restoring moment. Overall, these models suggest that undulation does not contribute to stability in pitch, and that flying snakes require a closed-loop control system formed around a passively stable dynamical framework.