Capturing contact in mitral valve dynamic closure with fluid-structure interaction simulation.

PURPOSE: Realistic fluid-structure interaction (FSI) simulation of the mitral valve opens the way toward planning for surgical repair. In the literature, blood leakage is identified by measuring the flow rate, but detailed information about closure efficiency is missing. We present in this paper an FSI model that improves the detection of blood leakage by building a map of contact. METHODS: Our model is based on the immersed boundary method that captures a map of contact and perfect closure of the mitral valve, without the presence of orifice holes, which often appear with existing methods. We also identified important factors influencing convergence issues. RESULTS: The method is demonstrated in three typical clinical situations: mitral valve with leakage, bulging, and healthy. In addition to the classical ways of evaluating MV closure, such as stress distribution and flow rate, the contact map provides easy detection of leakage with identification of the sources of leakage and a quality assessment of the closure. CONCLUSIONS: Our method significantly improves the quality of the simulation and allows the identification of regurgitation as well as a spatial evaluation of the quality of valve closure. Comparably fast simulation, ability to simulate large deformation, and capturing detailed contact are the main aspects of the study.

Automatic extraction of the mitral valve chordae geometry for biomechanical simulation.

PURPOSE: Mitral valve computational models are widely studied in the literature. They can be used for preoperative planning or anatomical understanding. Manual extraction of the valve geometry on medical images is tedious and requires special training, while automatic segmentation is still an open problem. METHODS: We propose here a fully automatic pipeline to extract the valve chordae architecture compatible with a computational model. First, an initial segmentation is obtained by sub-mesh topology analysis and RANSAC-like model-fitting procedure. Then, the chordal structure is optimized with respect to objective functions based on mechanical, anatomical, and image-based considerations. RESULTS: The approach has been validated on 5 micro-CT scans with a graph-based metric and has shown an [Formula: see text] accuracy rate. The method has also been tested within a structural simulation of the mitral valve closed state. CONCLUSION: Our results show that the chordae architecture resulting from our algorithm can give results similar to experienced users while providing an equivalent biomechanical simulation.

Multi-scale impact of chronic exposure to environmental concentrations of chlordecone in freshwater cnidarian, Hydra circumcincta.

Chlordecone (CLD) is an organochlorine pesticide widely used in the past to control pest insects in banana plantations in the French West Indies. Due to its persistence in the environment, CLD has contaminated the soils where it has been spread, as well as the waters, and is still present in them. The objective of our study was to evaluate the effects of chronic exposure to environmentally relevant CLD concentrations in an animal model, the freshwater hydra (Hydra circumcincta). In a multi-marker approach, we have studied the expression of some target stress genes, the morphology, and the asexual reproduction rates. Our data showed that exposure to low concentrations of chlordecone leads to (i) a modulation of the expression of target genes involved in oxidative stress, detoxification, and neurobiological processes, and (ii) morphological damages and asexual reproduction impairment. We have observed non-monotonic dose-response curves, which agree with endocrine-disrupting chemical effects. Thus, "U-shaped" dose-response curves were observed for SOD, GRed, Hym355, and potentially GST gene expressions; inverted "U-shaped" curves for GPx and CYP1A gene expressions and reproductive rates; and a biphasic dose-response curve for morphological damages. Therefore, in the range of environmental concentrations tested, very low concentrations of CLD can produce equally or more important deleterious effects than higher ones. Finally, to our knowledge, this study is the first one to fill the lack of knowledge concerning the effects of CLD in Hydra circumcincta and confirms that this diploblastic organism is a pertinent freshwater model in the risk assessment.

Modeling Culicoides abundance in mainland France: implications for surveillance.

BACKGROUND: Biting midges of the genus Culicoides Latreille (Diptera: Ceratopogonidae) are involved in the transmission of several viruses affecting humans and livestock, particularly bluetongue (BTV). Over the last decade, Culicoides surveillance has been conducted discontinuously and at various temporal and spatial scales in mainland France following the BTV epizootics in 2008-2009 and its reemergence and continuous circulation since 2015. The ability to predict seasonal dynamics and spatial abundance of Culicoides spp. is a key element in identifying periods and areas at high risk of transmission in order to strengthen surveillance for early detection and to establish seasonally disease-free zones. The objective of this study was to model the abundance of Culicoides spp. using surveillance data. METHODS: A mixed-effect Poisson model, adjusted for overdispersion and taking into account temperature data at each trap location, was used to model the weekly relative abundance of Culicoides spp. over a year in 24 vector zones, based on surveillance data collected during 2009-2012. Vector zones are the spatial units used for Culicoides surveillance since 2016 in mainland France. RESULTS: The curves of the predicted annual abundance of Culicoides spp. in vector zones showed three different shapes: unimodal, bimodal or plateau, reflecting the temporal variability of the observed counts between zones. For each vector zone, the model enabled to identify periods of vector activity ranging from 25 to 51 weeks. CONCLUSIONS: Although the data were collected for surveillance purposes, our modeling approach integrating vector data with daily temperatures, which are known to be major drivers of Culicoides spp. activity, provided areas-specific predictions of Culicoides spp. abundance. Our findings provide decisions makers with essential information to identify risk periods in each vector zone and guide the allocation of resources for surveillance and control. Knowledge of Culicoides spp. dynamics is also of primary importance for modeling the risk of establishment and spread of midge-borne diseases in mainland France.

Autoclavable and Injectable Cryogels for Biomedical Applications.

Prior to any clinical application, terminal sterilization of biomaterials is a critical process imposed by the Food and Drug Administration. Of all the methods available for sterilization, high-pressure steam sterilization such as autoclaving is the most widely used. While autoclave sterilization minimizes pathogen contamination, it can dramatically impact both structural and biological properties of biomaterials. It has recently been reported that injectable cryogels with shape memory properties hold great promises as 3D macroporous biomimetic scaffolds for biomedical applications including tissue engineering. In this study, the impact of autoclave sterilization on properties of a series of cryogels is measured. Unlike conventional hydrogels, cryogels made of natural polymers demonstrate a strong resilience to autoclave sterilization. This process does not alter either their macrostructural or unique physical properties including syringe injectability. The scaffolds' bioactive sites are preserved and autoclaved cryogels retain their excellent cytological compatibility post-autoclaving. Furthermore, autoclaved cryogels do not trigger a notable activation of primary murine bone marrow-derived dendritic cells suggesting a minimal risk for biomaterial-induced inflammation, which is further confirmed by an in vivo histologic analysis. In summary, these results further demonstrate the huge potential of cryogels in the biomedical field and their capacity to be translated into clinical applications.

A Low Molecular Weight Protein from the Sea Anemone Anemonia viridis with an Anti-Angiogenic Activity.

Sea anemones are a remarkable source of active principles due to a decentralized venom system. New blood vessel growth or angiogenesis is a very promising target against cancer, but the few available antiangiogenic compounds have limited efficacy. In this study, a protein fraction, purified from tentacles of Anemonia viridis, was able to limit endothelial cells proliferation and angiogenesis at low concentration (14 nM). Protein sequences were determined with Edman degradation and mass spectrometry in source decay and revealed homologies with Blood Depressing Substance (BDS) sea anemones. The presence of a two-turn alpha helix observed with circular dichroism and a trypsin activity inhibition suggested that the active principle could be a Kunitz-type inhibitor, which may interact with an integrin due to an Arginine Glycin Aspartate (RGD) motif. Molecular modeling showed that this RGD motif was well exposed to solvent. This active principle could improve antiangiogenic therapy from existing antiangiogenic compounds binding on the Vascular Endothelial Growth Factor (VEGF).

In Vitro Cocktail Effects of PCB-DL (PCB118) and Bulky PCB (PCB153) with BaP on Adipogenesis and on Expression of Genes Involved in the Establishment of a Pro-Inflammatory State.

(1) Objective: Highlight the in vitro effects of 3T3-L1 cell exposure to polychlorinated biphenyls (PCB118 and 153) or benzo(a)pyrene (BaP) alone or as a cocktail on adipogenesis (ADG) by focusing on changes in lipid metabolism and inflammatory-related genes expression (INFG) and ADG-related genes expression (ADGG); (2) Results: Treatment from the early stage of cell differentiation by BaP alone or in combination with PCBs decreased the expression of some of the ADGG (PPARγGlut-4, FAS, Lipin-1a, Leptin, and Adiponectin). BaP enhanced the INFG, especially MCP-1 and TNFα. Co-exposure to BaP and PCB153 showed a synergistic effect on TNFα and IL6 expression. Treatment with BaP and PCBs during only the maturation period up-regulated the INFG (IL6, TNFα, CXCL-10 & MCP-1). PCB118 alone also enhanced TNFα, CXCL-10, and PAI-1 expression. The change in MCP-1 protein expression was in agreement with that of the gene. Finally, the BaP-induced up-regulation of the xenobiotic responsive element (XRE)-controlled luciferase activity was impaired by PCB153 but not by PCB118; (3) Conclusion: BaP and PCBs down-regulate a part of ADGG and enhance INFG. The direct regulatory effect of PCBs on both ADGG and INFG is usually rather lower than that of BaP and synergistic or antagonistic cocktail effects are clearly observed.

Fast image-based mitral valve simulation from individualized geometry.

BACKGROUND: Common surgical procedures on the mitral valve of the heart include modifications to the chordae tendineae. Such interventions are used when there is extensive leaflet prolapse caused by chordae rupture or elongation. Understanding the role of individual chordae tendineae before operating could be helpful to predict whether the mitral valve will be competent at peak systole. Biomechanical modelling and simulation can achieve this goal. METHODS: We present a method to semi-automatically build a computational model of a mitral valve from micro CT (computed tomography) scans: after manually picking chordae fiducial points, the leaflets are segmented and the boundary conditions as well as the loading conditions are automatically defined. Fast finite element method (FEM) simulation is carried out using Simulation Open Framework Architecture (SOFA) to reproduce leaflet closure at peak systole. We develop three metrics to evaluate simulation results: (i) point-to-surface error with the ground truth reference extracted from the CT image, (ii) coaptation surface area of the leaflets and (iii) an indication of whether the simulated closed leaflets leak. RESULTS: We validate our method on three explanted porcine hearts and show that our model predicts the closed valve surface with point-to-surface error of approximately 1 mm, a reasonable coaptation surface area, and absence of any leak at peak systole (maximum closed pressure). We also evaluate the sensitivity of our model to changes in various parameters (tissue elasticity, mesh accuracy, and the transformation matrix used for CT scan registration). We also measure the influence of the positions of the chordae tendineae on simulation results and show that marginal chordae have a greater influence on the final shape than intermediate chordae. CONCLUSIONS: The mitral valve simulation can help the surgeon understand valve behaviour and anticipate the outcome of a procedure.

Development and validation of real-time simulation of X-ray imaging with respiratory motion.

We present a framework that combines evolutionary optimisation, soft tissue modelling and ray tracing on GPU to simultaneously compute the respiratory motion and X-ray imaging in real-time. Our aim is to provide validated building blocks with high fidelity to closely match both the human physiology and the physics of X-rays. A CPU-based set of algorithms is presented to model organ behaviours during respiration. Soft tissue deformation is computed with an extension of the Chain Mail method. Rigid elements move according to kinematic laws. A GPU-based surface rendering method is proposed to compute the X-ray image using the Beer-Lambert law. It is provided as an open-source library. A quantitative validation study is provided to objectively assess the accuracy of both components: (i) the respiration against anatomical data, and (ii) the X-ray against the Beer-Lambert law and the results of Monte Carlo simulations. Our implementation can be used in various applications, such as interactive medical virtual environment to train percutaneous transhepatic cholangiography in interventional radiology, 2D/3D registration, computation of digitally reconstructed radiograph, simulation of 4D sinograms to test tomography reconstruction tools.

The Transcriptional Effects of PCB118 and PCB153 on the Liver, Adipose Tissue, Muscle and Colon of Mice: Highlighting of Glut4 and Lipin1 as Main Target Genes for PCB Induced Metabolic Disorders.

Epidemiological studies have associated environmental exposure to polychlorinated biphenyls (PCBs) with an increased risk of type 2 diabetes; however, little is known about the underlying mechanisms involved in the metabolic side-effects of PCB. Our study evaluated the transcriptional effects of a subchronic exposure (gavage at Day 0 and Day 15 with 10 or 100 µmol/Kg bw) to PCB118 (dioxin-like PCB), PCB153 (non-dioxin-like PCB), or an equimolar mixture of PCB118 and PCB153 on various tissues (liver, visceral adipose tissue, muscle, and colon) in mice. Our results showed that a short-term exposure to PCB118 and/or PCB153 enhanced circulating triglyceride levels but did not affect glycemia. Among the studied tissues, we did not observe any modification of the expression of inflammation-related genes, such as cytokines or chemokines. The main transcriptional effects were observed in visceral adipose and liver tissues. We found a downregulation of lipin1 and glut4 expression in these two target organs. In adipose tissue, we also showed a downregulation of Agpat2, Slc25a1, and Fasn. All of these genes are involved in lipid metabolism and insulin resistance. In muscles, we observed an induction of CnR1 and Foxo3 expression, which may be partly involved in PCB metabolic effects. In summary, our results suggest that lipin1 and glut4, notably in adipose tissue, are the main targeted genes in PCB-induced metabolic disorders, however, further studies are required to fully elucidate the mechanisms involved.

Lycopene modulates THP1 and Caco2 cells inflammatory state through transcriptional and nontranscriptional processes.

We revisited the action of a carotenoid, the lycopene, on the expression of proinflammatory genes, reactive oxygen species (ROS) production, and metalloprotease (MMP9) activity. THP1 and Caco2 cell lines were used as in vitro models for the two main cell types found in intestine tissue, that is, monocytes and epithelial cells. Proinflammatory condition was induced using either phorbol ester acetate (PMA), lipopolysaccharide (LPS) or tumor necrosis factor (TNF). In THP1 cells, short term pretreatment (2 h) with a low concentration (2 µM) of lycopene reinforce proinflammatory gene expression. The extent of the effect of lycopene is dependent on the proinflammtory stimulus (PMA, LPS or TNF) used. Lycopene enhanced MMP9 secretion via a c-AMP-dependent process, and reduced ROS production at higher concentrations than 2 µM. Cell culture media, conditioned by PMA-treated monocytes and then transferred on CaCo-2 epithelial cells, induced a proinflammatory state in these cells. The extent of this inflammatory effect was reduced when cells has been pretreated (12 h) with lycopene. At low concentration (2 µM or less), lycopene appeared to promote an inflammatory state not correlated with ROS modulation. At higher concentration (5 µM-20 µM), an anti-inflammatory effect takes place as a decrease of ROS production was detected. So, both concentration and time have to be considered in order to define the exact issue of the effect of carotenoids present in meals.

Toward a realistic simulation of organ dissection.

Whilst laparoscopic surgical simulators are becoming increasingly realistic they can not, as yet, fully replicate the experience of live surgery. In particular tissue dissection in one task that is particularly challenging to replicate. Limitation of current attempts to simulate tissue dissection include: poor visual rendering; over simplification of the task and; unrealistic tissue properties. In an effort to generate a more realistic model of tissue dissection in laparoscopic surgery we propose a novel method based on task analysis. Initially we have chosen to model only the basic geometrics of this task rather than a whole laparoscopic procedure. Preliminary work has led to the development of a real time simulator performing organ dissection with a haptic thread at 1000Hz. A virtual cutting tool, manipulated through a haptic device, in combination with 1D and 2D soft-tissue models accuratelyreplicatetheprocessoflaparoscopictissuedissection.

SP-Designer: a user-friendly program for designing species-specific primer pairs from DNA sequence alignments.

SP-Designer is an open-source program providing a user-friendly tool for the design of specific PCR primer pairs from a DNA sequence alignment containing sequences from various taxa. SP-Designer selects PCR primer pairs for the amplification of DNA from a target species on the basis of several criteria: (i) primer specificity, as assessed by interspecific sequence polymorphism in the annealing regions, (ii) the biochemical characteristics of the primers and (iii) the intended PCR conditions. SP-Designer generates tables, detailing the primer pair and PCR characteristics, and a FASTA file locating the primer sequences in the original sequence alignment. SP-Designer is Windows-compatible and freely available from http://www2.sophia.inra.fr/urih/sophia_mart/sp_designer/info_sp_designer.php.

Tuning of patient-specific deformable models using an adaptive evolutionary optimization strategy.

We present and analyze the behavior of an evolutionary algorithm designed to estimate the parameters of a complex organ behavior model. The model is adaptable to account for patient's specificities. The aim is to finely tune the model to be accurately adapted to various real patient datasets. It can then be embedded, for example, in high fidelity simulations of the human physiology. We present here an application focused on respiration modeling. The algorithm is automatic and adaptive. A compound fitness function has been designed to take into account for various quantities that have to be minimized. The algorithm efficiency is experimentally analyzed on several real test cases: 1) three patient datasets have been acquired with the "breath hold" protocol, and 2) two datasets corresponds to 4-D CT scans. Its performance is compared with two traditional methods (downhill simplex and conjugate gradient descent): a random search and a basic real-valued genetic algorithm. The results show that our evolutionary scheme provides more significantly stable and accurate results.

A method to compute respiration parameters for patient-based simulators.

We propose a method to automatically tune a patient-based virtual environment training simulator for abdominal needle insertion. The key attributes to be customized in our framework are the elasticity of soft-tissues and the respiratory model parameters. The estimation is based on two 3D Computed Tomography (CT) scans of the same patient at two different time steps. Results are presented on four patients and show that our new method leads to better results than our previous studies with manually tuned parameters.

CYP1A1 induction in the colon by serum: involvement of the PPARα pathway and evidence for a new specific human PPREα site.

BACKGROUND: We previously showed that blood serum induced cytochrome P450 1A1 (CYP1A1) monooxygenase expression in vitro. OBJECTIVE: Our purpose was (i) to identify the molecular mechanism involved and (ii) to characterize the inducer compound(s) in serum involved at least in part. METHODS: Serum was fractionated on hydrophobic columns. PPARα involvement was demonstrated by gene reporter assays, DNA mutagenesis and EMSA. Gene expression was evaluated by qRT-PCR. Serum samples were analyzed using HS-SPME-GC-MS. RESULTS: The inductive effect of serum did not depend on the AhR pathway and was enhanced by cotransfection of PPARα cDNA. Mutations in the PPAR response elements of the CYP1A1 gene promoter suppressed this effect. One of the PPRE sites appeared highly specific for human PPARα, an unreported PPRE property. A link was found between CYP1A1 inducibility and serum hydrophobic compounds. Characterization of sera showed that hexanal, a metabolite produced by peroxidation of linoleic acid, was involved in CYP1A1 induction by serum, possibly along with other serum entities. CONCLUSION: We demonstrate that serum induces CYP1A1 via the PPARα pathway and that hexanal is one of the serum inducers. The two PPRE sites within the CYP1A1 promoter are functional and one of them is specific for PPARα.

Open surgery simulation of inguinal hernia repair.

Inguinal hernia repair procedures are often one of the first surgical procedures faced by junior surgeons. The biggest challenge in this procedure for novice trainees is understanding the 3D spatial relations of the complex anatomy of the inguinal region, which is crucial for the effective and careful handling of the present anatomical structures in order to perform a successful and lasting repair. Such relationships are difficult to illustrate and comprehend through standard learning material. This paper presents our work in progress to develop a simulation-based teaching tool allowing junior surgeons to train the Lichtenstein tension-free open inguinal hernia repair technique for direct and indirect hernias, as well as to enforce their understanding of the spatial relations of the involved anatomy.

Polycyclic aromatic hydrocarbons potentiate high-fat diet effects on intestinal inflammation.

We demonstrate that intestinal inflammation caused by high-fat diet is increased by the environmental contaminant benzo[a]pyrene. Our in vivo results indicate that a high-fat diet (HFD) induces a pre-diabetic state in mice compared with animals fed normal chow. HFD increased IL-1betamRNA concentration in the jejunum, colon, and liver, and TNFalpha was increased in the colon and strongly increased in the liver. HFD also increased the expression of other genes related to type 2 diabetes, such as the uncoupling protein UCP2, throughout the bowel and liver, but not in the colon. The treatment of HFD with BaP enhanced the expression of IL-1beta in the liver and TNFalpha throughout the bowel and in the liver. Adding BaP to the diet also caused a significant decrease in the expression of the incretin glucagon-like peptide 1, which plays an important role in insulin secretion. Our results suggest that intestinal inflammation may be involved in the onset of type 2 diabetes and that chronic exposure to environmental polycyclic aromatic hydrocarbons can increase the risk of type 2 diabetes by inducing pro-inflammatory cytokine production.

Developing an immersive ultrasound guided needle puncture simulator.

We present an integrated system for training ultrasound guided needle puncture. Our aim is to provide a cost effective and validated training tool that uses actual patient data to enable interventional radiology trainees to learn how to carry out image-guided needle puncture. The input data required is a computed tomography scan of the patient that is used to create the patient specific models. Force measurements have been made on real tissue and the resulting data is incorporated into the simulator. Respiration and soft tissue deformations are also carried out to further improve the fidelity of the simulator.

Haptic simulation of the liver with respiratory motion.

During a standard procedure of liver biopsy, the motion due to respiration may be difficult to handle. The patient is often requested to hold his breath or to breathe shallowly. Ideally, this physiological behaviour should be taken into account in a virtual reality biopsy simulator. This paper presents a framework that accurately simulates respiratory motion, allowing for the fine tuning of relevant parameters in order to produce a patient-specific breathing pattern that can then be incorporated into a simulation with real-rime haptic interaction. This work has been done as part of the CRaIVE collaboration [1], which aims to build interventional radiology simulators.