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We follow a formal homogenization approach to investigate the effects of mechanical deformations in electrophysiology models relying on a bidomain description of ionic motion at the microscopic level. To that purpose, we extend these microscopic equations to take into account the mechanical deformations, and proceed by recasting the problem in the framework of classical two-scale homogenization in periodic media, and identifying the equations satisfied by the first coefficients in the formal expansions. The homogenized equations reveal some interesting effects related to the microstructure — and associated with a specific cell problem to be solved to obtain the macroscopic conductivity tensors — in which mechanical deformations play a nontrivial role, i.e. they do not simply lead to a standard bidomain problem posed in the deformed configuration. We then present detailed numerical illustrations of the homogenized model with coupled cardiac electrical–mechanical simulations — all the way to ECG simulations — albeit without taking into account the abundantly-investigated effect of mechanical deformations in ionic models, in order to focus here on other effects. And in fact our numerical results indicate that these other effects are numerically of a comparable order, and therefore cannot be disregarded.
A central concern in simulation studies is the adequation, or inadequation, of a designed model with respect to its intended goal. Models of cardiac electrical activity may differ in complexity, level of description and representation. Depending on the events to be be simulated, analytical, cellular automatas and qualitative models can be used. Their advantages and shortcomings can be put forth by comparing the space and time complexities, and if factors clinically relevant for studying arrhythmias and ischemias are taken into account in the respective models. In this paper, the factors under scrutiny are those characterizing impulse formation and conduction. If and how they are represented and computed constitutes a means of comparison between the models. The simplifying assumptions built into each can thus be put forth. Through illustrative examples, we then show that qualitative models can assume the explanatory and a predictive role usually devolved to numerical models. Such models can be used as a primer to quantification in a multi-stage process. A possibly useful development would be to integrate the analytical, cellular and qualitative models within a single computational framework. Central to this task is qualification. All piece of knowledge that is implicit in the mathematical or procedural representations has to be made explicit. Semantic links can thereafter be established between the models. This knowledge could be the starting point of a system emulating the reasoning of a theoretician working at different levels of detail. Its role would be to help researchers select, instantiate and interpret results of their most detailed cellular automata and/or analytical models.
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For the month of October 2020, our editorial theme focuses on artificial intelligence technologies. An overview of how artificial intelligence is helping in the fight against the COVID-19 pandemic is covered by an article contribution in the Features section. Discover how artificial intelligence is enhancing the drug discovery process. In the Spotlights section, explore new research and discoveries on one of our vital organs, the Heart. Gain insights to what it takes to develop a COVID-19 vaccine during this pandemic.
For the month of May 2021, APBN discovers how the used of digital technology and innovative new methods can help treatment, prevention and management of diseases. In the Columns section, we have a contribution by Son Pham, Country Manager for GE Healthcare Vietnam and the CEO for GE Vietnam on how technology has helped healthcare systems in Vietnam during the COVID-19 pandemic. In the Spotlights section, read about a research study by the National Heart Centre Singapore (NHCS) and its international partners affirm the use of intravenous iron to help heart failure patients improve health outcomes.
In this issue, APBN looks at the technology that have improved our understanding of the human body and paved the way for future treatments and therapies.
First off, we learn about pneumococcal vaccination and how it offers protection against bacterial pneumonia with Dr Chew Huck Chin, respiratory physician and intensivist at Mount Elizabeth Novena Hospital. Then, we hear from Yutaka Shimokawa, Founder and CEO of KINS, about how gut microbes can improve women's hormonal health.
In Spotlights, we bring you the highlights from the recent Asia Summit on Global Health as well as an interview with Dr Tan Hong Chang, Senior Consultant at the Singapore General Hospital, and Associate Professor Liu Yu-Chi, Clinician Scientist at the Singapore National Eye Centre, on how a cholesterol drug was repurposed as a new treatment for diabetic corneal neuropathy.
In Columns, Dr Jane Leong, Vice President, Medical Affairs Asia Pacific for Moderna, shares how recent developments in mRNA technology could change the way we approach cancer other diseases.
Virtual reality (VR) has applications in cardiology to create enhancement, thereby improving the quality of associated planning, treatment and surgery. The need is to study different applications of this technology in the field of cardiology. We have studied research papers on VR and its applications in cardiology through a detailed bibliometric analysis. The study identified five significant steps for proper implementation of this technology in cardiology. Some challenges are to be undertaken by using this technology, and they can provide some benefits; thus, authors contemplate extensive research and development. This study also identifies 10 major VR technology applications in cardiology and provided a brief description. This innovative technology helps a heart surgeon to perform complex heart surgery effectively. Thus, VR applications have the potential for improving decision-making, which helps save human life. VR plays a significant role in the development of a surgical procedure. This technology undertakes 3D heart model information in full colour, which helps to analyze the overall heart vane, blockage and blood flow. With the help of this digital technology, a surgeon can improve the accuracy of heart surgery, and he can simulate the surgery. A surgeon can undertake surgery in a virtual environment on a virtual patient. The unique purpose of this technology is to practice pre-operatively on the specific circumstance. A cardiologist can also check the proper status of inner and outer heart wall layer. Thus, by using this 3D information, the surgeon can now interact with heart data/information without any physical touch. This technology opens a new opportunity to improve the heart surgery and development in cardiovascular treatment to improve patient outcome.
Single photon emission computed tomography (SPECT) is a non-invasive technique used in the visualization and analysis of the distribution of radioactive counts, for instance within the myocardium and surrounding structures. In the last two decades, a number of techniques have been developed to aid in the classification of the SPECT images. The strength and availability of these quantitative tools have in many ways provided a competitive advantage to nuclear cardiology, compared with other higher-resolution non-invasive imaging modalities for the detection of coronary artery disease (CAD). The first efforts in this area involved the quantification of planar images of patients with low probability of CAD. It allowed the construction of normality databases and the definition of mean and variance limits for normal patients. With the definition of these values, objective abnormality thresholds were defined. These tools were continuously expanded providing LV perfusion and function parameters in 2D, 3D and 4D. Some of them were incorporated and commercially offered with the scanners available nowadays. In such scenario, the comparison of the different techniques is a difficult task due to the diversity of approaches, image acquisition protocol and the lack of a “gold standard” to compare the results. Therefore, the search for robust methods to analyze automatically the complete series of images is yet an open study area.