Scroll-Wave Dynamics in Human Cardiac Tissue: Lessons from a Mathematical Model with Inhomogeneities and Fiber Architecture

Cardiac arrhythmias, such as ventricular tachycardia (VT) and ventricular fibrillation (VF), are among the leading causes of death in the industrialized world. These are associated with the formation of spiral and scroll waves of electrical activation in cardiac tissue; single spiral and scroll waves are believed to be associated with VT whereas their turbulent analogs are associated with VF. Thus, the study of these waves is an important biophysical problem. We present a systematic study of the combined effects of muscle-fiber rotation and inhomogeneities on scroll-wave dynamics in the TNNP (ten Tusscher Noble Noble Panfilov) model for human cardiac tissue. In particular, we use the three-dimensional TNNP model with fiber rotation and consider both conduction and ionic inhomogeneities. We find that, in addition to displaying a sensitive dependence on the positions, sizes, and types of inhomogeneities, scroll-wave dynamics also depends delicately upon the degree of fiber rotation. We find that the tendency of scroll waves to anchor to cylindrical conduction inhomogeneities increases with the radius of the inhomogeneity. Furthermore, the filament of the scroll wave can exhibit drift or meandering, transmural bending, twisting, and break-up. If the scroll-wave filament exhibits weak meandering, then there is a fine balance between the anchoring of this wave at the inhomogeneity and a disruption of wave-pinning by fiber rotation. If this filament displays strong meandering, then again the anchoring is suppressed by fiber rotation; also, the scroll wave can be eliminated from most of the layers only to be regenerated by a seed wave. Ionic inhomogeneities can also lead to an anchoring of the scroll wave; scroll waves can now enter the region inside an ionic inhomogeneity and can display a coexistence of spatiotemporal chaos and quasi-periodic behavior in different parts of the simulation domain. We discuss the experimental implications of our study

Global Soil Moisture Patterns Observed by Space Borne Microwave Radiometers and Scatterometers

Within the scope of the upcoming launch of a new water related satellite mission (SMOS) a global evaluation study was performed on two available global soil moisture products. ERS scatterometer surface wetness data was compared to AMSR-E soil moisture data. This study pointed out a strong similarity between both products in sparse to moderate vegetated regions with an average correlation coefficient of 0.83. Low correlations were found in densely vegetated areas and deserts. The low values in the vegetated regions can be explained by the limited soil moisture retrieval capabilities over dense vegetation covers. Soil emission is attenuated by the canopy and tends to saturate the microwave signal with increasing vegetation density, resulting in a decreased sensor sensitivity to soil moisture variations. It is expected that the new low frequency satellite mission (SMOS) will obtain soil moisture products with a higher quality in these regions. The low correlations in the desert regions are likely due to volume scattering or to the dielectric dynamics within the soil. The volume scattering in dry soils causes a higher backscatter under very dry conditions than under conditions when the sub-surface soil layers are somewhat wet. In addition, at low moisture levels the dielectric constant has a reduced sensitivity in response to changes in the soil moisture content. At a global scale the spatial correspondence of both products is high and both products clearly distinguish similar regions with high seasonal and inter annual variations. Based on the global analyses we concluded that the quality of both products was comparable and in the sparse to moderate vegetated regions both products may be beneficial for large scale validation of SMOS soil moisture. Some limitations of the studied products are different, pointing to significant potential for combining both products into one superior soil moisture data set. © The Author(s) 2008

Auriculotherapy for Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

OBJECTIVES: Side-effects of standard pain medications can limit their use. Therefore, nonpharmacologic pain relief techniques such as auriculotherapy may play an important role in pain management. Our aim was to conduct a systematic review and meta-analysis of studies evaluating auriculotherapy for pain management. DESIGN: MEDLINE,(®) ISI Web of Science, CINAHL, AMED, and Cochrane Library were searched through December 2008. Randomized trials comparing auriculotherapy to sham, placebo, or standard-of-care control were included that measured outcomes of pain or medication use and were published in English. Two (2) reviewers independently assessed trial eligibility, quality, and abstracted data to a standardized form. Standardized mean differences (SMD) were calculated for studies using a pain score or analgesic requirement as a primary outcome. RESULTS: Seventeen (17) studies met inclusion criteria (8 perioperative, 4 acute, and 5 chronic pain). Auriculotherapy was superior to controls for studies evaluating pain intensity (SMD, 1.56 [95% confidence interval (CI): 0.85, 2.26]; 8 studies). For perioperative pain, auriculotherapy reduced analgesic use (SMD, 0.54 [95% CI: 0.30, 0.77]; 5 studies). For acute pain and chronic pain, auriculotherapy reduced pain intensity (SMD for acute pain, 1.35 [95% CI: 0.08, 2.64], 2 studies; SMD for chronic pain, 1.84 [95% CI: 0.60, 3.07], 5 studies). Removal of poor quality studies did not alter the conclusions. Significant heterogeneity existed among studies of acute and chronic pain, but not perioperative pain. CONCLUSIONS: Auriculotherapy may be effective for the treatment of a variety of types of pain, especially postoperative pain. However, a more accurate estimate of the effect will require further large, well-designed trials