Advances in computational modelling for personalised medicine after myocardial infarction

Myocardial infarction (MI) is a leading cause of premature morbidity and mortality worldwide. Determining which patients will experience heart failure and sudden cardiac death after an acute MI is notoriously difficult for clinicians. The extent of heart damage after an acute MI is informed by cardiac imaging, typically using echocardiography or sometimes, cardiac magnetic resonance (CMR). These scans provide complex data sets that are only partially exploited by clinicians in daily practice, implying potential for improved risk assessment. Computational modelling of left ventricular (LV) function can bridge the gap towards personalised medicine using cardiac imaging in patients with post-MI. Several novel biomechanical parameters have theoretical prognostic value and may be useful to reflect the biomechanical effects of novel preventive therapy for adverse remodelling post-MI. These parameters include myocardial contractility (regional and global), stiffness and stress. Further, the parameters can be delineated spatially to correspond with infarct pathology and the remote zone. While these parameters hold promise, there are challenges for translating MI modelling into clinical practice, including model uncertainty, validation and verification, as well as time-efficient processing. More research is needed to (1) simplify imaging with CMR in patients with post-MI, while preserving diagnostic accuracy and patient tolerance (2) to assess and validate novel biomechanical parameters against established prognostic biomarkers, such as LV ejection fraction and infarct size. Accessible software packages with minimal user interaction are also needed. Translating benefits to patients will be achieved through a multidisciplinary approach including clinicians, mathematicians, statisticians and industry partners

Dementia, music and biometric gaming: Rising to the Dementia Challenge

In 2012, the U.K. government launched its Dementia Challenge, authorizing additional funding for dementia research and health care. The search for curative medicines is ongoing, but scientific research reveals evidence that music can play a positive role in general health, and in dementia and Alzheimer’s disease in particular. This article considers whether some of the challenges that dementia presents could be addressed through music therapy and proposes that biometric gaming might offer one means of channeling such associated health benefits to sufferers of dementia, even in the final stages of the disease

Flow velocity mapping using contrast enhanced high-frame-rate plane wave ultrasound and image tracking: methods and initial in vitro and in vivo evaluation

Ultrasound imaging is the most widely used method for visualising and quantifying blood flow in medical practice, but existing techniques have various limitations in terms of imaging sensitivity, field of view, flow angle dependence, and imaging depth. In this study, we developed an ultrasound imaging velocimetry approach capable of visualising and quantifying dynamic flow, by combining high-frame-rate plane wave ultrasound imaging, microbubble contrast agents, pulse inversion contrast imaging and speckle image tracking algorithms. The system was initially evaluated in vitro on both straight and carotid-mimicking vessels with steady and pulsatile flows and in vivo in the rabbit aorta. Colour and spectral Doppler measurements were also made. Initial flow mapping results were compared with theoretical prediction and reference Doppler measurements and indicate the potential of the new system as a highly sensitive, accurate, angle-independent and full field-of-view velocity mapping tool capable of tracking and quantifying fast and dynamic flows

Diabetes, hypertension, and cardiovascular disease: clinical insights and vascular mechanisms

Hypertension and type 2 diabetes are common comorbidities. Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes. Moreover, patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals. The major cause of morbidity and mortality in diabetes is cardiovascular disease, which is exacerbated by hypertension. Accordingly, diabetes and hypertension are closely interlinked because of similar risk factors, such as endothelial dysfunction, vascular inflammation, arterial remodelling, atherosclerosis, dyslipidemia, and obesity. There is also substantial overlap in the cardiovascular complications of diabetes and hypertension related primarily to microvascular and macrovascular disease. Common mechanisms, such as upregulation of the renin-angiotensin-aldosterone system, oxidative stress, inflammation, and activation of the immune system likely contribute to the close relationship between diabetes and hypertension. In this article we discuss diabetes and hypertension as comorbidities and discuss the pathophysiological features of vascular complications associated with these conditions. We also highlight some vascular mechanisms that predispose to both conditions, focusing on advanced glycation end products, oxidative stress, inflammation, the immune system, and microRNAs. Finally, we provide some insights into current therapies targeting diabetes and cardiovascular complications and introduce some new agents that may have vasoprotective therapeutic potential in diabetes

System on fabrics architecture using distributed computing

This paper describes a novel, distributed sensor network with parallel processing capability based on the Instruction Systolic Array (ISA). A new computing paradigm is introduced where spatially distributed sensors are closely coupled to processing elements and the whole array forms a parallel computer. This may find applications in wearable devices for sensing the position and other metrics of a human body and rapidly processing that data. A new programming model to implement the distributed computer on fabrics is described. The fabric-based distributed computing concept has been validated using a number of parallel applications including a real-time shape sensing and reconstruction application. The exemplar wearable system based on the ISA concept has been realized using off-the-shelf microcontrollers and sensors. Results show that the application executes on the prototype ISA implementation in real time thus confirming the viability of the proposed architecture for fabric-resident computing devices

Confocal and multiphoton imaging of intracellular Ca²⁺

This chapter compares the imaging capabilities of a range of systems including multiphoton microscopy in regard to measurements of intracellular Ca<sup>2+</sup> within living cells. In particular, the excitation spectra of popular fluorescent Ca<sup>2+</sup> indicators are shown during 1P and 2P excitation. The strengths and limitations of the current indicators are discussed along with error analysis which highlights the value of matching the Ca<sup>2+</sup> affinity of the dye to a particular aspect of Ca<sup>2+</sup> signaling. Finally, the combined emission spectra of Ca<sup>2+</sup> and voltage sensitive dyes are compared to allow the choice of the optimum combination to allow simultaneous intracellular Ca<sup>2+</sup> and membrane voltage measurement

Non-invasive imaging in congenital heart disease

The care of the adult patient with congenital heart disease is becoming increasingly complex. In many of these patients re-intervention, heart failure and arrhythmias are inevitable consequences of successful repair in childhood. Specialist imaging is integral to accurate diagnosis and in establishing optimal management plans for these long-term complications. Fortunately there are now a whole series of imaging techniques available to the clinician – each with its own inherent strengths and limitations. These modalities are complementary and offer fresh insight into the unique anatomy and physiology of these conditions. This paper reviews the most commonly employed imaging techniques and their contribution to assessing a patient with a congenital heart lesion

Polymer optical fiber sensors in human life safety

The current state of research into polymer optical fiber (POF) sensors linked to safety in human life is summarized in this paper. This topic is directly related with new solutions for civil aircraft, structural health monitoring, healthcare and biomedicine fields. In the last years, the properties of polymers have been explored to identify situations offering potential advantages over conventional silica fiber sensing technology, replacing, in some cases, problematic electronic technology used in these mentioned fields, where there are some issues to overcome. POFs could preferably replace their silica counterparts, with improved performance and biocompatibility. Finally, new developments are reported which use the unique properties of POF