Importance of circulating platelet aggregates and haemodynamic changes in ophthalmic artery and progression of visual field loss at pseudoexfoliation glaucoma

The aim of this work is to examine the role of circulating platelet aggregates (CPA) at pseudoexfoliation glaucoma (PXG), haemodynamic changes in the ophthalmic artery by ultrasonic color Doppler, searching for visual field progression. Vascular component at PXG and its role in VF progression dynamics has not been sufficiently explained, as well as CPA influence to ischaemic events related to optic nerve damage and VF progression. The examination included 80 patients, where of 35 (44%) men average age 68.3 +/- 7.0 and 45 (56%) women average age 65.7 +/- 7.0 (t = 1.66; p = 0.101). Forthy of them suffered from primary open angle glaucoma (POAG) as a control group (healthy), and 40 from pseudoexfoliative glaucoma (PXG) as an experimental group. All the examinees underwent complete ophthalmological examination: visual acuity, ocular fundus, intraocular pressure measured, anterior eye segment biomicroscopy with gonioscopy performed. Also VF examination was performed three times at 6 months intervals. Laboratory testing of CPA proportion values was performed by means of Wu an Hoak method and ultrasonic measurement of blood perfusion in the carotid tree, particularly concerning ophthalmic artery by means of color Doppler. Obtained decreased values of CPA proportion resulted in hypercoagulability of blood in PXG group. At PXG were also found increased blood flow resistivity indexes in ophthalmic artery (RI AO) and internal carotid artery (RI ACI), resulting with ischemia and hypoxia and finally progression of the visual filed damage. In conclusion, our study shows that examining CPA and ultrasonic monitoring of vascular parameters in ophthalmic artery with color Doppler may be the way of better understanding the vascular role in PXG prognosis.     

Insight into the transfer function,gain, and oscillation onset for the pupil light reflex using nonlinear delay-differential equations

Analogies are drawn between a physiologically relevant nonlinear delay-differential equation (DDE) model for the pupil light reflex and servo control analytic approaches. This DDE is shown to be consistent with the measured open loop transfer function and hence physiological insight can be obtained into the gain of the reflex and its properties. A Hopf bifurcation analysis of the DDE shows that a limit cycle oscillation in pupil area occurs when the first mode of the characteristic equation becomes unstable. Its period agrees well with experimental measurements. Beyond the point of instability onset, more modes become unstable corresponding to multiple encirclings of (-1, 0) on the Nyquist plot. These modes primarily influence the shape of the oscillation. Techniques from dynamical systems theory, e.g. bifurcation analysis, can augment servo control analytic methods for the study of oscillations produced by nonlinear neural feedback mechanisms.     

Ventilatory frequency indicates visual recognition of an allopatric predator in nai;ve Nile tilapia

Perceiving a possible predator may promote physiological changes to support prey ‘fight or flight’. In this case, an increase in ventilatory frequency (VF) may be expected, because this is a way to improve oxygen uptake for escape tasks. Therefore, changes in VF may be used as a behavioral tool to evaluate visual recognition of a predator threat. Thus, we tested the effects of predator visual exposure on VF in the fish Nile tilapia, Oreochromis niloticus. For this, we measured tilapia VF before and after the presentation of three stimuli: an aquarium with a harmless fish or a predator or water (control). Nile tilapia VF increased significantly in the group visually exposed to a predator compared with the other two, which were similar to each other. Hence, we conclude that Nile tilapia may recognize an allopatric predator; consequently VF is an effective tool to indicate visual recognition of predator threat in fish.     

Detection of Progression of Glaucomatous Visual Field Damage Using the Point-Wise Method with the Binomial Test

Purpose

To compare the performance of newly proposed point-wise linear regression (PLR) with the binomial test (binomial PLR) against mean deviation (MD) trend analysis and permutation analyses of PLR (PoPLR), in detecting global visual field (VF) progression in glaucoma.

Methods

15 VFs (Humphrey Field Analyzer, SITA standard, 24-2) were collected from 96 eyes of 59 open angle glaucoma patients (6.0 ± 1.5 [mean ± standard deviation] years). Using the total deviation of each point on the 2^nd to 16^th VFs (VF2-16), linear regression analysis was carried out. The numbers of VF test points with a significant trend at various probability levels (p<0.025, 0.05, 0.075 and 0.1) were investigated with the binomial test (one-side). A VF series was defined as “significant” if the median p-value from the binomial test was <0.025. Similarly, the progression analysis was carried out using only second to sixth VFs (VF2-6). The performance of each method was evaluated using the ‘consistency measures’; proportion both significant (PBS): both VF series (VF2-6 and VF2-16) were “significant”, proportion both were not significant (PBNS): both were “not significant”, proportion inconsistently significant (PIS): VF2-16 was “not significant” but VF2-6 was “significant”. A similar analysis was carried out using VF2-7 and VF2-15 series, and the performance was compared with MD trend analysis and PoPLR.

Results

The PBS of the binomial PLR method (0.14 to 0.86) was significantly higher than MD trend analysis (0.04 to 0.89) and PoPLR (0.09 to 0.93). The PIS of the proposed method (0.0 to 0.17) was significantly lower than the MD approach (0.0 to 0.67) and PoPLR (0.07 to 0.33). The PBNS of the three approaches were not significantly different.

Conclusions

The binomial BLR method gives more consistent results than MD trend analysis and PoPLR, hence it will be helpful as a tool to ‘flag’ possible VF deterioration.     

Use of time‐lapse photography and digital image analysis to estimate breeding success of a cliff‐nesting seabird

Development of new methods for obtaining basic demographic data from difficult‐to‐access breeding colonies and easily disturbed species is an important challenge in studies of seabirds. We describe a method that can generate data concerning annual breeding success of cliff‐nesting seabirds or other colonial birds with open nests. Our method requires only a single visit to a colony every second or third year, and is based on the use of automated time‐lapse photography. To test our method, we used time‐lapse photos to examine the breeding success of Thick‐billed Murres (Uria lomvia) in two breeding colonies in Greenland during the years 2011, 2012, and 2014. Based on the analysis of time‐lapse photos, we found that hatching success during the 3 yr of our study ranged from 60% to 81%, fledging success from 89% to 95%, and breeding success from 53% to 74% (Table 1). Use of digital image analysis made it possible to differentiate between breeding and non‐breeding birds and determine if and when breeding attempts failed or succeeded. The key to making our method a realistic long‐term monitoring technique is the use of an automated, formal image analysis to process the thousands of photos from the time‐lapse cameras and, more specifically, to reduce a large number of photos to a manageable number. Using our method, we needed 12–22 h per study plot, depending on the number of breeding sites per plot (range = 47–127) and whether it was the first or the second time the plot was analyzed, to obtain our estimates of hatching, fledging, and breeding success. This included time for data preparation, image analyses, visual inspections, and summarizing data in a spreadsheet. We found that our estimates of breeding success were comparable to those obtained by direct observation in the field. An important aspect of using time‐lapse technology is to foresee potential reasons why time‐lapse cameras might stop taking pictures, for example, equipment failure (camera, timer, or battery) or interference by visitors (e.g., vandalism or theft). As such, thorough testing of time‐lapse systems and selecting camera locations less likely to be disturbed are most important. We believe that use of time‐lapse photography in combination with digital image analysis to estimate breeding success can be useful for determining the breeding success of other cliff‐nesting seabirds and, more generally, other birds that breed in colonies, especially those located in remote areas and where direct observation may disturb birds.     

Open-thorax guinea pig model for defibrillation

BACKGROUND AND PURPOSE: Guinea pigs are used as models for study of ventricular tachyarrhythmias (VT); however, the tachyarrhythmia often is transient and does not persist. We developed an open-thorax guinea pig model of sustained ventricular fibrillation (VF). METHODS: Bilateral thoracotomy was performed on eight guinea pigs weighing 865 to 1,464 g, and two sutures were positioned in the right ventricular apex for the purpose of pacing. Two methods were used to induce VF: a 50-Hz burst (normal pacing), and an initial 15 beats at 70% of the R-R interval followed by a 100-Hz burst for 84 beats (rapid pacing). Fifteen attempts at inducing VF were performed by use of each method. Blood pressure was recorded before and after development of VF, which was defined as VT with mean blood pressure consistently <10 mm Hg. A final observation was obtained using the normal pacing method without defibrillation. RESULTS: Use of both methods successfully induced VF. A significant relationship between body weight >1,021 g and ability to sustain and survive VF was detected. CONCLUSION: The guinea pig is a useful rodent model for the study of VF and defibrillation.     

Evaluation of Glaucomatous Damage via Functional Magnetic Resonance Imaging,and Correlations Thereof with Anatomical and Psychophysical Ocular Findings

PurposeTo evaluate the functional magnetic resonance imaging (fMRI) response to binocular visual stimulation and the association thereof with structural ocular findings and psychophysical test results in patients with glaucoma, and controls.MethodsCross-sectional study. Participants underwent a complete ophthalmic examination, including Humphrey 24-2 visual field (VF) testing and optical coherence tomography. Binocular VF in each quadrant was determined using an integrated method. Patients with glaucoma were assigned to three subgroups: initial, asymmetrical and severe glaucoma. Regions of interest (ROIs) were determined anatomically. fMRI (3 T) was performed using a bilaterally presented polar angle stimulus, and the accompanying changes in blood oxygen level-dependent (BOLD) signals were obtained from the occipital poles and calcarine ROIs. We used generalized estimation equation models to compare anatomical and functional data between the groups.ResultsA total of 25 subjects were enrolled, of whom 17 had glaucoma and 8 were controls. Significant associations between quadrant binocular VF sensitivities and fMRI responses were found in the occipital pole ROIs (p = 0.033) and the calcarine ROIs (p = 0.045). In glaucoma severity subgroup analysis, retinal nerve fiber layer (RNFL) thickness was associated with the BOLD response of the calcarine and occipital pole ROIs (p = 0.002 and 0.026, respectively). The initial and asymmetrical glaucoma subgroups had similar binocular VF sensitivities and RNFL thicknesses, but distinct BOLD responses.ConclusionsThe response of the visual cortex to binocular stimulation was associated with binocular VF sensitivity. RNFL thickness was associated with the BOLD response of the calcarine and occipital pole ROIs.     

Measuring Visual Field Progression in the Central 10 Degrees Using Additional Information from Central 24 Degrees Visual Fields and ‘Lasso Regression’

Purpose

To measure progression of the visual field (VF) mean deviation (MD) index in longitudinal 10-2 VFs more accurately, by adding information from 24-2 VFs using Lasso regression.

Methods

A training dataset consisted of 138 eyes from 97 patients with glaucoma or ocular hypertension and a testing dataset consisted of 40 eyes from 34 patients with glaucoma or ocular hypertension. The Lasso method was used to predict total deviation (TD) values in training patients’ 10-2 VFs based on information from their 24-2 VFs (52 TD values, foveal sensitivity and mean deviation MD). Then, the MD of each patient’s 10-2 VF was estimated as the average of these Lasso-predicted TD values (10-2 VF ‘Lasso MD’; LMD). Finally, linear regression was applied to each testing patient’s series of longitudinal 10-2 VF MDs with and without additional Lasso-derived LMDs in order to predict future MDs not included in the regression analysis. Absolute prediction errors were compared when only actual 10-2 MDs were regressed against when a combination of actual 10-2 MDs and LMDs were regressed.

Results

The average absolute prediction error was significantly smaller for the novel method incorporating LMDs (range: 1.6 to 1.8 dB) compared with the standard approach (range: 1.7 to 3.4 dB) (p<0.05, ANOVA test).

Conclusions

Deriving 10-2 VF MD values from 24-2 VFs improves the prediction accuracy of progression. This approach will help clinicians to predict patients’ visual function in the parafoveal area.     

Studying semblances of a true killer: experimental model of human ventricular fibrillation

It is unknown whether ventricular fibrillation (VF) studied in experimental models represents in vivo human VF. First, we examined closed chest in vivo VF induced at defibrillation threshold testing (DFT) in four patients with ischemic cardiomyopathy pretransplantation. We examined VF in these same four hearts in an ex vivo human Langendorff posttransplantation. VF from DFT was compared with VF from the electrodes from a similar region in the right ventricular endocardium in the Langendorff using two parameters: the scale distribution width (extracted from continuous wavelet transform) and VF mean cycle length (CL). In a second substudy group where multielectrode phase mapping could be performed, we examined early VF intraoperatively (in vivo open chest condition) in three patients with left ventricular cardiomyopathy. We investigated early VF in the hearts of three patients in an ex vivo Langendorff and compared findings with intraoperative VF using two metrics: dominant frequency (DF) assessed by the Welch periodogram and the number of phase singularities (lasting >480 ms). Wavelet analysis (P = 0.9) and VF CL were similar between the Langendorff and the DFT groups (225 ± 13, 218 ± 24 ms; P = 0.9), indicating that wave characteristics and activation rate of VF was comparable between the two models. Intraoperative DF was slower but comparable with the Langendorff DF over the endocardium (4.6 ± 0.1, 5.0 ± 0.4 Hz; P = 0.9) and the epicardium (4.5 ± 0.2, 5.2 ± 0.4 Hz; P = 0.9). Endocardial phase singularity number (9.6 ± 5, 12.1 ± 1; P = 0.6) was lesser in number but comparable between in vivo and ex vivo VF. VF dynamics in the limited experimental human studies approximates human in vivo VF.     

Vibrational dynamics and heat capacity in polyglycine II

The earlier works on the vibrational dynamics of polyglycine II (PG II) suffer from several infirmities, which not only suppress the dynamical nature of normal modes, but also lead to several incorrect assignments and interactive constants of the potential field. In this study, we have re-examined the phonon dispersion profiles of PG II using Higgs method for evaluation of phase-related normal modes and have attempted to remove the infirmities, as far as possible. The Wilson's GF matrix method combined with the Urey-Bradley force field has been used for normal mode analysis. This potential field leads to correct assignments of Raman, infrared and inelastic neutron scattering frequencies. Characteristic features of the dispersion curve (v versus delta/pi plot), such as repulsion and regions of high density-of-states have been interpreted. In addition, the heat capacity as a function of temperature has been obtained via density-of-states. It agrees well with the experimental data and is being reported for the first time.     

The influence of taste stimuli and illumination on electrogastrogram measurements

An electrogastrogram (EGG) is considered to be an index to the autonomic nervous system of the digestive organs. In the present study, we attempted to clarify whether or not an EGG can be used to evaluate the influence of illumination, and what kinds of effect taste stimuli and illumination have on the autonomic nervous system. In this study, we used the ratio of the normal wave component of the EGG (EGG-NR: 2-4.5 cpm power/1-10 cpm power) and the amplitude of a normal wave (EGG-NI: integrated EGG of 2-4.5 cpm). Thirteen healthy males participated in 16 experimental conditions (4 lighting conditionsx4 taste stimuli). The four lighting conditions were set by combinations of illuminance levels of 200 and 1500 lx and color temperatures of 3000 and 7500 K. The four taste stimuli were sweet (glucose), salty (salt), sour (acetic acid), and bitter (quinine). The changes in EGG-NR and EGG-NI were compared for different taste conditions. The results showed that EGG-NI was not significantly affected by the different taste conditions. However, the main effect of taste on EGG-NR was significant: sweet and salty tastes were significantly higher than the bitter taste. EGG-NR and EGG-NI in different lighting conditions were also compared. The main effect of different color temperatures was also significant, but the illuminance level did not affect EGG-NR. EGG-NR increased significantly at the lower color temperature. On the other hand, EGG-NI significantly increased at the lower illuminance. These results suggest that parasympathetic nervous activity has a predominant effect on gastric activity in different lighting environments. Therefore, EGG measurements may be useful indicators for illumination environment studies.     

Sensorimotor Learning of Acupuncture Needle Manipulation Using Visual Feedback

Objective

Humans can acquire a wide variety of motor skills using sensory feedback pertaining to discrepancies between intended and actual movements. Acupuncture needle manipulation involves sophisticated hand movements and represents a fundamental skill for acupuncturists. We investigated whether untrained students could improve their motor performance during acupuncture needle manipulation using visual feedback (VF).

Methods

Twenty-one untrained medical students were included, randomly divided into concurrent (n = 10) and post-trial (n = 11) VF groups. Both groups were trained in simple lift/thrusting techniques during session 1, and in complicated lift/thrusting techniques in session 2 (eight training trials per session). We compared the motion patterns and error magnitudes of pre- and post-training tests.

Results

During motion pattern analysis, both the concurrent and post-trial VF groups exhibited greater improvements in motion patterns during the complicated lifting/thrusting session. In the magnitude error analysis, both groups also exhibited reduced error magnitudes during the simple lifting/thrusting session. For the training period, the concurrent VF group exhibited reduced error magnitudes across all training trials, whereas the post-trial VF group was characterized by greater error magnitudes during initial trials, which gradually reduced during later trials.

Conclusions

Our findings suggest that novices can improve the sophisticated hand movements required for acupuncture needle manipulation using sensorimotor learning with VF. Use of two types of VF can be beneficial for untrained students in terms of learning how to manipulate acupuncture needles, using either automatic or cognitive processes.     

Telephonocardiography: The Transmission of Electrocardiograms by Telephone

Transmission of electrocardiograms via long-distance telephone (telephonocardiography) from Wingham to London, Ontario, was carried out over a period of three months, early in 1964. The object of this study was to ascertain whether or not the telephonocardiogram was a practical and reliable method of interpreting such tracings for outlying areas. During this period 102 tracings were recorded on 71 patients. Thirty-one (30%) of the tracings were normal and 71 (70%) abnormal. Analysis of the clinical data revealed that the telephonocardiogram was extremely valuable in five of 71 patients (7%) and was also of considerable value to 11 other patients (16%) in providing immediate diagnosis and thereby indicating definite treatment. The trial also demonstrated that the method was practical, accurate and easy to perform.     

Cross-Modal and Intra-Modal Characteristics of Visual Function and Speech Perception Performance in Postlingually Deafened,Cochlear Implant Users

Evidence of visual-auditory cross-modal plasticity in deaf individuals has been widely reported. Superior visual abilities of deaf individuals have been shown to result in enhanced reactivity to visual events and/or enhanced peripheral spatial attention. The goal of this study was to investigate the association between visual-auditory cross-modal plasticity and speech perception in post-lingually deafened, adult cochlear implant (CI) users. Post-lingually deafened adults with CIs (N = 14) and a group of normal hearing, adult controls (N = 12) participated in this study. The CI participants were divided into a good performer group (good CI, N = 7) and a poor performer group (poor CI, N = 7) based on word recognition scores. Visual evoked potentials (VEP) were recorded from the temporal and occipital cortex to assess reactivity. Visual field (VF) testing was used to assess spatial attention and Goldmann perimetry measures were analyzed to identify differences across groups in the VF. The association of the amplitude of the P1 VEP response over the right temporal or occipital cortex among three groups (control, good CI, poor CI) was analyzed. In addition, the association between VF by different stimuli and word perception score was evaluated. The P1 VEP amplitude recorded from the right temporal cortex was larger in the group of poorly performing CI users than the group of good performers. The P1 amplitude recorded from electrodes near the occipital cortex was smaller for the poor performing group. P1 VEP amplitude in right temporal lobe was negatively correlated with speech perception outcomes for the CI participants (r = -0.736, P = 0.003). However, P1 VEP amplitude measures recorded from near the occipital cortex had a positive correlation with speech perception outcome in the CI participants (r = 0.775, P = 0.001). In VF analysis, CI users showed narrowed central VF (VF to low intensity stimuli). However, their far peripheral VF (VF to high intensity stimuli) was not different from the controls. In addition, the extent of their central VF was positively correlated with speech perception outcome (r = 0.669, P = 0.009). Persistent visual activation in right temporal cortex even after CI causes negative effect on outcome in post-lingual deaf adults. We interpret these results to suggest that insufficient intra-modal (visual) compensation by the occipital cortex may cause negative effects on outcome. Based on our results, it appears that a narrowed central VF could help identify CI users with poor outcomes with their device.     

胃电的非线性动力学分析

我们用非线性动力学的方法分析了两例健康人的胃电图（Ｅｌｅｃｔｒｏｇａｓｔｒｏｇｒａｍ,简称ＥＧＧ）,得出它的功率谱、计算了它的关联维数和最大Ｌｙａｐｕｎｏｖ指数。结果显示：它的功率谱为一有尖峰的连续谱;其关联维数介于６和７之间;它的最大Ｌｖａａｕｎｏｖ指数大于０。由此,我们可以初步推知ＥＧＧ不是随机噪声,它服从确定性的动力学规律。     

A system for parallel measurement of glottis opening and larynx position

The simultaneous assessment of glottal dynamics and larynx position can be beneficial for the diagnosis of disordered voice or speech production and swallowing. Up to now, methods either concentrate on assessment of the glottis opening using optical, acoustical or electrical (electroglottography, EGG) methods, or on visualisation of the larynx position using ultrasound, computer tomography or magnetic resonance imaging techniques.The method presented here makes use of a time-multiplex measurement approach of space-resolved transfer impedances through the larynx. The fast sequence of measurements allows a quasi simultaneous assessment of both larynx position and EGG signal using up to 32 transmit–receive signal paths. The system assesses the dynamic opening status of the glottis as well as the vertical and back/forward motion of the larynx.Two electrode-arrays are used for the measurement of the electrical transfer impedance through the neck in different directions. From the acquired data the global and individual conductivity is calculated as well as a 2D point spatial representation of the minimum impedance.The position information is shown together with classical EGG signals allowing a synchronous visual assessment of glottal area and larynx position. A first application to singing voice analysis is presented that indicate a high potential of the method for use as a non-invasive tool in the diagnosis of voice, speech, and swallowing disorders.     

Voice disorders assessed by (cross-) Sample Entropy of electroglottogram and microphone signals

The quantitative analysis of vocal disorders by nonlinear signal processing methods has been extensively used in the last two decades. In this work, two algorithms for nonlinear time-series analysis, Sample Entropy and cross-Sample Entropy, are used on electroglottogram (EGG) and microphone (MIC) signals recorded from 51 normal and 80 dysphonic subjects, to obtain summary measures of voice disorders through SampEn and cross-SampEn indices. Such parameters quantify, respectively, the degree of irregularity (in the sense of self-dissimilarity) within a time-series and of asynchrony (in the sense of cross-dissimilarity) between two distinct time-series. The aims of this work are: to determine if statistically significant differences in terms of signal irregularity quantified by SampEn occur between normal and pathological subjects, investigating whether or not such differences can be equally seen in EGG and MIC; to assess if cross-SampEn reveals different degrees of asynchrony between EGG and MIC signals in the two groups. Results show that SampEn in pathological subjects is higher than in normal subjects for both EGG and MIC time-series, with a statistically significant difference detectable from both signals (Pe < 10^?4 for EGG and Pe < 10^?7 for MIC). Cross-SampEn exhibits a statistically significant difference too, showing a higher degree of cross-dissimilarity between EGG and MIC time-series for pathological subjects (Pe < 10^?4). In conclusion, SampEn and cross-SampEn well quantify the increase of complexity of both EGG and MIC signals and the decrease of their cross-similarity in presence of vocal disorders. Thanks to the complementarity of nonlinear indicators to the traditionally considered linear ones, SampEn and cross-SampEn appear as suitable candidates to enter the pool of approaches to investigate speech pathologies and to obtain potentially new insights on their nature.     

Comparison of Macular Integrity Assessment (MAIA ?), MP-3, and the Humphrey Field Analyzer in the Evaluation of the Relationship between the Structure and Function of the Macula

Purpose

This study was conducted in order to compare relationships between the macular visual field (VF) mean sensitivity measured by MAIA^TM (Macular Integrity Assessment), MP-3, or Humphry field analyzer (HFA) and the ganglion cell and inner plexiform layer (GCA) thicknesses.

Methods

This cross-sectional study examined 73 glaucoma patients and 19 normal subjects. All subjects underwent measurements for GCA thickness by Cirrus HD-OCT and static threshold perimetry using MAIA^TM, MP-3, or HFA. VF and OCT in the retinal view were used to examine both the global relationship between the VF sensitivity and GCA thickness, and the superior hemiretina and inferior hemiretina. The relationship between the GCA thickness and macular sensitivity was examined by Spearman correlation analysis.

Results

For each instrument, statistically significant macular VF sensitivity (dB) and GCA thickness relationships were observed using the decibel scale (R = 0.547–0.687, all P < 0.001). The highest correlation for the global (R = 0.682) and the superior hemiretina (R = 0.594) GCA thickness-VF mean sensitivity was observed by the HFA. The highest correlation for the inferior hemiretina (R = 0.687) GCA thickness-VF mean sensitivity was observed by the MP-3. Among the three VF measurement instruments, however, no significant differences were found for the structure-function relationships.

Conclusions

All three VF measurement instruments found similar structure-function relationships in the central VF.     

Endocardial activation during ventricular fibrillation in normal and failing canine hearts

Because congestive heart failure (CHF) promotes ventricular fibrillation (VF), we compared VF in seven dogs with CHF induced by combined myocardial infarction and rapid ventricular pacing to VF in six normal dogs. A noncontact, multielectrode array balloon catheter provided full-surface real-time left ventricular (LV) endocardial electrograms and a dynamic color-coded display of endocardial activation projected onto a three-dimensional model of the LV. Fast Fourier transform (FFT) analysis of virtual electrograms showed no difference in peak or centroid frequency in CHF dogs compared with normals. The average number of simultaneous noncontiguous wavefronts present during VF was higher in normals (2.4 +/- 1.0 at 10 s of VF) than in CHF dogs (1.3 +/- 1.0, P < 0.005) and decreased in both over time. The wavefront "turnover" rate, estimated using FFT of the noncontiguous wavefront data, did not differ between normals and CHF and did not change over 5 min of VF. Thus the fundamental frequency characteristics of VF are unaltered by CHF, but dilated abnormal ventricles sustain fewer active wavefronts than do normal ventricles.     

Norovirus regulation of the innate immune response and apoptosis occurs via the product of the alternative open reading frame 4

Small RNA viruses have evolved many mechanisms to increase the capacity of their short genomes. Here we describe the identification and characterization of a novel open reading frame (ORF4) encoded by the murine norovirus (MNV) subgenomic RNA, in an alternative reading frame overlapping the VP1 coding region. ORF4 is translated during virus infection and the resultant protein localizes predominantly to the mitochondria. Using reverse genetics we demonstrated that expression of ORF4 is not required for virus replication in tissue culture but its loss results in a fitness cost since viruses lacking the ability to express ORF4 restore expression upon repeated passage in tissue culture. Functional analysis indicated that the protein produced from ORF4 antagonizes the innate immune response to infection by delaying the upregulation of a number of cellular genes activated by the innate pathway, including IFN-Beta. Apoptosis in the RAW264.7 macrophage cell line was also increased during virus infection in the absence of ORF4 expression. In vivo analysis of the WT and mutant virus lacking the ability to express ORF4 demonstrated an important role for ORF4 expression in infection and virulence. STAT1-/- mice infected with a virus lacking the ability to express ORF4 showed a delay in the onset of clinical signs when compared to mice infected with WT virus. Quantitative PCR and histopathological analysis of samples from these infected mice demonstrated that infection with a virus not expressing ORF4 results in a delayed infection in this system. In light of these findings we propose the name virulence factor 1, VF1 for this protein. The identification of VF1 represents the first characterization of an alternative open reading frame protein for the calicivirus family. The immune regulatory function of the MNV VF1 protein provide important perspectives for future research into norovirus biology and pathogenesis.