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Since the full development of the ex vivo dual perfusion model of the human placenta cotyledon, the technique has provided essential insight into how nutrients, lipids, gases, immunoglobulins, endocrine agents, pharma-ceuticals, chemicals, nanoparticles, micro-organisms and parasites might traverse the maternofetal barrier. Additionally, the model has been instrumental in gaining a better understanding of the regulation of vascular tone, endocrinology and metabolism within this organ. The human placenta is unique amongst species in its anatomy and transfer modalities. This orthologous diversity therefore requires an appropriate consideration of placental transfer rates of compounds, particles and micro-organisms specific to humans. Different research centres have adapted this model with a wide variation in perfusion parameters, including in the establishment of perfusion, perfusate composition, gassing regime, cannulation method, flow rates, perfused tissue mass, and also in the application of quality control measures. The requirement to harmonise and stan-dardise perfusion practice between centres is largely driven by the need to obtain consistency in our under -standing of placental function, but also in the qualification of the model for acceptance by regulatory agencies in drug and toxicology testing. A pilot study is proposed, aiming to describe how existing inter-centre variation in perfusion methodology affects placental metabolism, protein synthesis, oxygen consumption, the materno-fetal transfer of key molecular markers, and placental structure.

Since the full development of the ex vivo dual perfusion model of the human placenta cotyledon, the technique has provided essential insight into how nutrients, lipids, gases, immunoglobulins, endocrine agents, pharma-ceuticals, chemicals, nanoparticles, micro-organisms and parasites might traverse the maternofetal barrier. Additionally, the model has been instrumental in gaining a better understanding of the regulation of vascular tone, endocrinology and metabolism within this organ. The human placenta is unique amongst species in its anatomy and transfer modalities. This orthologous diversity therefore requires an appropriate consideration of placental transfer rates of compounds, particles and micro-organisms specific to humans. Different research centres have adapted this model with a wide variation in perfusion parameters, including in the establishment of perfusion, perfusate composition, gassing regime, cannulation method, flow rates, perfused tissue mass, and also in the application of quality control measures. The requirement to harmonise and stan-dardise perfusion practice between centres is largely driven by the need to obtain consistency in our under -standing of placental function, but also in the qualification of the model for acceptance by regulatory agencies in drug and toxicology testing. A pilot study is proposed, aiming to describe how existing inter-centre variation in perfusion methodology affects placental metabolism, protein synthesis, oxygen consumption, the materno-fetal transfer of key molecular markers, and placental structure.

This systematic review evaluated which outcome variables and cut-off values of pretreatment exercise tests are associated with treatment complications in patients with stage I-III non-small cell lung cancer (NSCLC). PRISMA and Cochrane guidelines were followed. A total of 38 studies with adult patients undergoing treatment for stage I-III NSCLC who completed pretreatment exercise tests, and of whom treatment-related complications were recorded were included. A lower oxygen uptake at peak exercise amongst several other variables on the cardiopulmonary exercise test and a lower performance on field tests, such as the incremental shuttle walk test, stair-climb test, and 6-minute walk test, were associated with a higher risk for postoperative complications and/ or postoperative mortality. Cut-off values were reported in a limited number of studies and were inconsistent. Due to the variety in outcomes, further research is needed to evaluate which outcomes and cut-off values of physical exercise tests are most clinically relevant.

This systematic review evaluated which outcome variables and cut-off values of pretreatment exercise tests are associated with treatment complications in patients with stage I-III non-small cell lung cancer (NSCLC). PRISMA and Cochrane guidelines were followed. A total of 38 studies with adult patients undergoing treatment for stage I-III NSCLC who completed pretreatment exercise tests, and of whom treatment-related complications were recorded were included. A lower oxygen uptake at peak exercise amongst several other variables on the cardiopulmonary exercise test and a lower performance on field tests, such as the incremental shuttle walk test, stair-climb test, and 6-minute walk test, were associated with a higher risk for postoperative complications and/ or postoperative mortality. Cut-off values were reported in a limited number of studies and were inconsistent. Due to the variety in outcomes, further research is needed to evaluate which outcomes and cut-off values of physical exercise tests are most clinically relevant.

BackgroundThe importance of concurrent exercise order for improving endurance and resistance adaptations remains unclear, particularly when sessions are performed a few hours apart. We investigated the effects of concurrent training (in alternate orders, separated by ~3 hours) on endurance and resistance training adaptations, compared to resistance-only training.Materials and methodsTwenty-nine healthy, moderately-active men (mean ± SD; age 24.5 ± 4.7 y; body mass 74.9 ± 10.8 kg; height 179.7 ± 6.5 cm) performed either resistance-only training (RT, n = 9), or same-day concurrent training whereby high-intensity interval training was performed either 3 hours before (HIIT+RT, n = 10) or after resistance training (RT+HIIT, n = 10), for 3 d.wk-1 over 9 weeks. Training-induced changes in leg press 1-repetition maximal (1-RM) strength, countermovement jump (CMJ) performance, body composition, peak oxygen uptake (), aerobic power (), and lactate threshold () were assessed before, and after both 5 and 9 weeks of training.ResultsAfter 9 weeks, all training groups increased leg press 1-RM (~24–28%) and total lean mass (~3-4%), with no clear differences between groups. Both concurrent groups elicited similar small-to-moderate improvements in all markers of aerobic fitness ( ~8–9%; ~16-20%; ~14-15%). RT improved CMJ displacement (mean ± SD, 5.3 ± 6.3%), velocity (2.2 ± 2.7%), force (absolute: 10.1 ± 10.1%), and power (absolute: 9.8 ± 7.6%; relative: 6.0 ± 6.6%). HIIT+RT elicited comparable improvements in CMJ velocity only (2.2 ± 2.7%). Compared to RT, RT+HIIT attenuated CMJ displacement (mean difference ± 90%CI, -5.1 ± 4.3%), force (absolute: -8.2 ± 7.1%) and power (absolute: -6.0 ± 4.7%). Only RT+HIIT reduced absolute fat mass (mean ± SD, -11.0 ± 11.7%).ConclusionsIn moderately-active males, concurrent training, regardless of the exercise order, pr

Wave-induced surge conditions are found in shallow marine ecosystems worldwide; yet, few studies have quantified how cyclical surges may affect free swimming animals. Here, we used a recently adapted respirometry technique to compare the energetic costs of a temperate fish species (Cymatogaster aggregata) swimming against a steady flow versus cyclical unidirectional and bidirectional surges in which unsteady swimming (such as accelerating, decelerating and turning) occurs. Using oxygen uptake (O-2) as an estimate of energetic costs, our results reveal that fish swimming in an unsteady (i.e. cyclical) unidirectional flow showed no clear increase in costs when compared to a steady flow of the same average speed, suggesting that costs and savings from cyclical acceleration and coasting are near equal. Conversely, swimming in a bidirectional cyclical flow incurred significantly higher energetic costs relative to a steady, constant flow, likely due to the added cost of turning around to face the changing flow direction. On average, we observed a 50% increase in O-2 of fish station holding within the bidirectional flow (227.8 mg O-2 kg(-1) h(-1)) compared to a steady, constant flow (136.1 mg O-2 kg(-1) h(-1)) of the same mean velocity. Given wave-driven surge zones are prime fish habitats in the wild, we suggest the additional costs fish incur by station holding in a bidirectional cyclical flow must be offset by favourable conditions for foraging and reproduction. With current and future increases in abiotic stressors associated with climate change, we highlight the importance of incorporating additional costs associated with swimming in cyclical water flow in the construction of energy budgets for species living in dynamic, coastal habitats.

Wave-induced surge conditions are found in shallow marine ecosystems worldwide; yet, few studies have quantified how cyclical surges may affect free swimming animals. Here, we used a recently adapted respirometry technique to compare the energetic costs of a temperate fish species (Cymatogaster aggregata) swimming against a steady flow versus cyclical unidirectional and bidirectional surges in which unsteady swimming (such as accelerating, decelerating and turning) occurs. Using oxygen uptake (O-2) as an estimate of energetic costs, our results reveal that fish swimming in an unsteady (i.e. cyclical) unidirectional flow showed no clear increase in costs when compared to a steady flow of the same average speed, suggesting that costs and savings from cyclical acceleration and coasting are near equal. Conversely, swimming in a bidirectional cyclical flow incurred significantly higher energetic costs relative to a steady, constant flow, likely due to the added cost of turning around to face the changing flow direction. On average, we observed a 50% increase in O-2 of fish station holding within the bidirectional flow (227.8 mg O-2 kg(-1) h(-1)) compared to a steady, constant flow (136.1 mg O-2 kg(-1) h(-1)) of the same mean velocity. Given wave-driven surge zones are prime fish habitats in the wild, we suggest the additional costs fish incur by station holding in a bidirectional cyclical flow must be offset by favourable conditions for foraging and reproduction. With current and future increases in abiotic stressors associated with climate change, we highlight the importance of incorporating additional costs associated with swimming in cyclical water flow in the construction of energy budgets for species living in dynamic, coastal habitats.

Aerobic scope represents an animal’s capacity to increase its aerobic metabolic rate above maintenance levels (i.e. the difference between standard (SMR) and maximum (MMR) metabolic rates). Aerobic scope data can be presented in absolute or factorial terms (AAS or FAS, respectively). However, the robustness of these calculations to noise or variability in measures of metabolic rate can influence subsequent interpretations of patterns in the data. We explored this issue using simple models and we compared the predictions from these models to experimental data from the literature. First, we investigated the robustness of aerobic scope calculations as a function of varying SMR when MMR is fixed, and vice versa. While FAS is unexpectedly robust to variability in SMR, even in species with low aerobic scopes, AAS is less sensitive to variation in SMR than is FAS. However, where variation in MMR is the main concern, FAS is more robust than AAS. Our findings highlight the equal importance of minimising variability in MMR, rather than just the variability in SMR, to obtain robust aerobic scope estimates. Second, we analysed metabolic rate accounting for locomotor speed and body mass for swimming fish. The interactions among these factors in relation to AAS and FAS are complex and the appropriate metric is dependent on the specific eco-physiological context of the research question. We conclude with qualified recommendations for using and interpreting AAS and FAS.

Flipper strokes have been proposed as proxies to estimate the energy expended by marine vertebrates while foraging at sea, but this has never been validated on free-ranging otariids (fur seals and sea lions). Our goal was to investigate how well flipper strokes correlate with energy expenditure in 33 foraging northern and Antarctic fur seals equipped with accelerometers, GPS, and time-depth recorders. We concomitantly measured field metabolic rates with the doubly-labelled water method and derived activity-specific energy expenditures using fine-scale time-activity budgets for each seal. Flipper strokes were detected while diving or surface transiting using dynamic acceleration. Despite some inter-species differences in flipper stroke dynamics or frequencies, both species of fur seals spent 3.79 ± 0.39 J/kg per stroke and had a cost of transport of ~1.6-1.9 J/kg/m while diving. Also, flipper stroke counts were good predictors of energy spent while diving (R(2) = 0.76) and to a lesser extent while transiting (R(2) = 0.63). However, flipper stroke count was a poor predictor overall of total energy spent during a full foraging trip (R(2) = 0.50). Amplitude of flipper strokes (i.e., acceleration amplitude × number of strokes) predicted total energy expenditure (R(2) = 0.63) better than flipper stroke counts, but was not as accurate as other acceleration-based proxies, i.e. Overall Dynamic Body Acceleration.

Skeletal muscle mitochondria play a specific role in many disease pathologies. As such, the measurement of oxygen consumption as an indicator of mitochondrial function in this tissue has become more prevalent. Although many technologies and assays exist that measure mitochondrial respiratory pathways in a variety of cells, tissue and species, there is currently a void in the literature in regards to the compilation of these assays using isolated mitochondria from mouse skeletal muscle for use in microplate based technologies. Importantly, the use of microplate based respirometric assays is growing among mitochondrial biologists as it allows for high throughput measurements using minimal quantities of isolated mitochondria. Therefore, a collection of microplate based respirometric assays were developed that are able to assess mechanistic changes/adaptations in oxygen consumption in a commonly used animal model. The methods presented herein provide step-bystep instructions to perform these assays with an optimal amount of mitochondrial protein and reagents, and high precision as evidenced by the minimal variance across the dynamic range of each assay.

Skeletal muscle mitochondria play a specific role in many disease pathologies. As such, the measurement of oxygen consumption as an indicator of mitochondrial function in this tissue has become more prevalent. Although many technologies and assays exist that measure mitochondrial respiratory pathways in a variety of cells, tissue and species, there is currently a void in the literature in regards to the compilation of these assays using isolated mitochondria from mouse skeletal muscle for use in microplate based technologies. Importantly, the use of microplate based respirometric assays is growing among mitochondrial biologists as it allows for high throughput measurements using minimal quantities of isolated mitochondria. Therefore, a collection of microplate based respirometric assays were developed that are able to assess mechanistic changes/adaptations in oxygen consumption in a commonly used animal model. The methods presented herein provide step-bystep instructions to perform these assays with an optimal amount of mitochondrial protein and reagents, and high precision as evidenced by the minimal variance across the dynamic range of each assay.

Sustained swimming at moderate speeds is considered beneficial in terms of the productive performance of salmonids, but the causative mechanisms have yet to be unequivocally established. In the present study, the effects of moderate exercise on the bioenergetics of rainbow trout were assessed during a 15 week growth experiment, in which fish were reared at three different current speeds: 1 BL s(-1), 0.5 BL s(-1) and still water (approximate to 0 BL s(-1)). Randomly selected groups of 100 fish were distributed among twelve 600 L tanks and maintained on a restricted diet regime. Specific growth rate (SGR) and feed conversion ratio (FCR) were calculated from weight and length measurements every 3 weeks. Routine metabolic rate (RMR) was measured every hour as rate of oxygen consumption in the tanks, and was positively correlated with swimming speed. Total ammonia nitrogen (TAN) excretion rates showed a tendency to decrease with increasing swimming speeds, yet neither they nor the resulting nitrogen quotients (NQ) indicated that swimming significantly reduced the fraction of dietary protein used to fuel metabolism. Energetic budgets revealed a positive correlation between energy expenditure and the current speed at which fish were reared, fish that were forced to swim and were fed restrictively consequentially had poorer growth and feed utilization. The results show that for rainbow trout, water current can negatively affect growth despite promoting minor positive changes in substrate utilization. We hypothesize that this may be the result of either a limited dietary energy supply from diet restriction being insufficient for both covering the extra costs of swimming and supporting enhanced growth.

Standard metabolic rate (SMR) and maximal metabolic rate (MMR) are fundamental measures in ecology and evolution because they set the scope within which animals can perform activities that directly affect fitness. In ectotherms, both SMR and MMR are repeatable over time when measured at a single ambient temperature (Ta). Many ectotherms encounter variable Ta from day to day and over their lifetime, yet it is currently unknown whether individual differences hold across an ecologically relevant range of Ta (i.e. thermal repeatability; RT). Moreover, it is possible that thermal sensitivity of SMR and MMR are important individual attributes, and correlated with one another, but virtually nothing is known about this at present. We measured SMR and MMR across an ecologically relevant Ta gradient (i.e. from 10 to 25 °C) in wild-caught salamanders (Plethodon albagula) and found that RT was significant in both traits. SMR and MMR were also positively correlated, resulting in a lower RT in absolute and factorial aerobic scopes (AAS and FAS). We found significant individual differences in thermal sensitivity for both SMR and MMR, but not for AAS and FAS. The intercept (at Ta = 0 °C) and the slope of the thermal reaction norms were negatively correlated; individuals with low MR at low Ta had a higher thermal sensitivity. Finally, individuals with a high thermal sensitivity for SMR also had high thermal sensitivity for MMR. Our results suggest that natural selection occurring over variable Ta may efficiently target the overall level of - and thermal sensitivity in - SMR and MMR. However, this may not be the case for metabolic scopes, as the positive correlation between SMR and MMR, in addition to their combined changes in response to Ta, yielded little individual variation in AAS and FAS. Our results support the idea that organisms with low metabolism at low Ta have a high metabolic thermal sensitivity as a compensatory mechanism to benefit in periods of warmer environme

Free to read at publisher's site. Traditionally, physiologists have estimated the ability of organisms to withstand lower partial pressures of oxygen by estimating the partial pressure at which oxygen consumption begins to decrease (known as the critical P-O2 or P-c). For almost 30 years, the principal way in which P-c has been estimated has been via piecewise 'broken stick' regression (BSR). BSR was a useful approach when more sophisticated analyses were less available, but BSR makes a number of unsupported assumptions about the underlying form of the relationship between the rate of oxygen consumption and oxygen availability. The BSR approach also distils a range of values into a single point with no estimate of error. In accordance with more general calls to fit functions to continuous data, we propose the use of nonlinear regression (NLR) to fit various curvilinear functions to oxygen consumption data in order to estimate P-c. Importantly, our approach is back-compatible so that estimates using traditional methods in earlier studies can be compared with data estimates from our technique. When we compared the performance of our approach relative to the traditional BSR approach for real world and simulated data, we found that under realistic circumstances, NLR was more accurate and provided more powerful hypothesis tests. We recommend that future studies make use of NLR to estimate P-c, and also suggest that this approach might be more appropriate for a range of physiological studies that use BSR currently.

The purpose was to investigate the effects of acute normobaric hyperoxia at rest on cerebral, respiratory and leg muscle oxygenation. Ten healthy men were studied twice in a single-blinded counterbalanced crossover study protocol. On one occasion they breathed air and on the other 100% normobaric O-2 for a 2-hour time period. Oxygenated (Delta[O(2)Hb]), deoxygenated (Delta[HHb]) and total (Delta[tHb]) hemoglobin in the cerebral frontal cortex, and in the intercostal and vastus lateralis muscles were simultaneously monitored with near-infrared spectroscopy. The hyperoxic stimulus promptly increased Delta[O(2)Hb] (similar to 2 mu M) and decreased Delta[HHb] (similar to 3.6 mu M) in the frontal cortex. These cerebral responses were directly and fully countered by resumption of normoxic air breathing. In contrast, Delta[HHb] significantly decreased due to the acute hyperoxic stimulus in both intercostal and vastus lateralis muscles. The temporal changes in muscle oxygenation were slower compared to those in the cerebral area; and they only partially recovered during the 15-min normoxic-recovery period. Acute supplementation of normobaric O-2 at rest influences cerebral, leg and respiratory muscle oxygenation of healthy individuals, but not in the same manner. Namely, the frontal cortex seems to be more sensitive to hyperoxia than are the skeletal muscle regions., QC 20120914

Parasites can have detrimental effects on host fitness, and infection typically results in the stimulation of the immune system. While defending against infection, the immune system generates toxic oxidants; if these are not sufficiently counteracted by the antioxidant system, a state of oxidative stress can occur. Here, we investigated the relationship between parasitic infection-using malarial infection as a model-and oxidative status in a natural population of the Seychelles warbler, while taking into account potentially interacting environmental covariates. We found that malaria is associated with increased susceptibility to oxidative stress, but this depends on the breeding stage: only during the energetically demanding provisioning stage did infected birds have higher oxidative stress susceptibility than non-infected birds. The imbalance in oxidative status was caused by a marked increase in oxidant levels observed only in infected birds during provisioning and by an overall reduction in antioxidant capacity observed in all birds across the breeding cycle. This finding implies that higher workload while dealing with an infection could aggravate oxidative repercussions. Malarial infection was not associated with body condition loss, suggesting that even when conditional effects are not directly visible, detrimental effects may still manifest themselves over the longer term through the oxidative consequences.

Evidence is building to suggest that both chronic and acute warm temperature exposure, as well as other anthropogenic perturbations, may select for small adult fish within a species. To shed light on this phenomenon, we investigated physiological and anatomical attributes associated with size-specific responses to an acute thermal challenge and a fisheries capture simulation (exercise+air exposure) in maturing male coho salmon (Oncorhynchus kisutch). Full-size females were included for a sex-specific comparison. A size-specific response in haematology to an acute thermal challenge (from 7 to 20 °C at 3 °C h(-1)) was apparent only for plasma potassium, whereby full-size males exhibited a significant increase in comparison with smaller males ('jacks'). Full-size females exhibited an elevated blood stress response in comparison with full-size males. Metabolic recovery following exhaustive exercise at 7 °C was size-specific, with jacks regaining resting levels of metabolism at 9.3 ± 0.5 h post-exercise in comparison with 12.3 ± 0.4 h for full-size fish of both sexes. Excess post-exercise oxygen consumption scaled with body mass in male fish with an exponent of b = 1.20 ± 0.08. Jacks appeared to regain osmoregulatory homeostasis faster than full-size males, and they had higher ventilation rates at 1 h post-exercise. Peak metabolic rate during post-exercise recovery scaled with body mass with an exponent of b~1, suggesting that the slower metabolic recovery in large fish was not due to limitations in diffusive or convective oxygen transport, but that large fish simply accumulated a greater 'oxygen debt' that took longer to pay back at the size-independent peak metabolic rate of ~6 mg min(-1) kg(-1). Post-exercise recovery of plasma testosterone was faster in jacks compared with full-size males, suggesting less impairment of the maturation trajectory of smaller fish. Supporting previous studies, these findings suggest that environmental cha

To obtain more knowledge about carbon requirements for growth by sponges, the growth rate, respiration rate, and clearance rate was measured in situ in Haliclona oculata. We found that only 34% of the particulate carbon pumped through the sponge was used for both respiration and growth. The net growth efficiency, being the ratio of carbon incorporated in biomass and the total carbon used by the sponge for respiration and growth, was found to be 0.099¿±¿0.013. Thus, about 10% of the total used carbon was fixed in biomass, and over 90% was used for generating energy for growth, maintenance, reproduction, and pumping. H. oculata had 2.5 µmol C available for every micromole O2 consumed. A value of 0.75 for respiratory quotient (RQ in micromole CO2 micromole O2-1) was used for H. oculata, which is the average value reported in literature for different marine invertebrates. Thus, carbon was available in excess to meet the respiratory demand. Oxygen was found not to be the limiting factor for growth, since only 3.3% of the oxygen pumped through the sponge body was used. Our results indicate that both oxygen and carbon availability are not limiting. The low growth efficiency agrees with the low growth rates found for the species used in this study

Understanding stopover decisions of long-distance migratory birds is crucial for conservation and management of these species along their migratory flyway. Recently, an increasing number of Barnacle geese breeding in the Russian Arctic have delayed their departure from their wintering site in the Netherlands by approximately one month and have reduced their staging duration at stopover sites in the Baltic accordingly. Consequently, this extended stay increases agricultural damage in the Netherlands. Using a dynamic state variable approach we explored three hypotheses about the underlying causes of these changes in migratory behavior, possibly related to changes in (i) onset of spring, (ii) potential intake rates and (iii) predation danger at wintering and stopover sites. Our simulations showed that the observed advance in onset of spring contradicts the observed delay of departure, whereas both increased predation danger and decreased intake rates in the Baltic can explain the delay. Decreased intake rates are expected as a result of increased competition for food in the growing Barnacle goose population. However, the effect of predation danger in the model was particularly strong, and we hypothesize that Barnacle geese avoid Baltic stopover sites as a response to the rapidly increasing number of avian predators in the area. Therefore, danger should be considered as an important factor influencing Barnacle goose migratory behavior, and receive more attention in empirical studies

Because of its relatively low tolerance to elevated temperatures, Macoma balthica (L.) may be one of the first important marine species in temperate coastal areas to suffer from a warming climate. For the last few decades, the abundance of the species in the Dutch Wadden Sea has been seriously declining. At lower latitudes, the southern edge of its range recently shifted several 100s of km to the north. To understand changes in abundance related to high temperatures, we studied short-term population responses to warmer than average seasons using data from a long-term (>35 yr) sampling program in the western Wadden Sea. The observed relationships included reduction of reproductive output and recruitment in years starting with mild winter–spring periods, reduction of adult survival in years with warm summers, reduction of annual migration in ~8 mo olds to more favourable areas in mild winters, reduction of growth rates in warmer than average growing seasons, and enhancement of seasonal weight loss in milder than average winters. We conclude that elevated temperatures negatively affect population dynamics of M. balthica in a number of ways, i.e. via recruitment or mortality as well as growth. These negative influences were observed already far below the upper lethal temperature of the species and in populations living ~1000 km poleward of the warm edge of the species’ range. The outcome of M. balthica’s energy balance appears to be decisive for their continued existence by effects not only on individual weights but also on mortality as well as reproduction

Background: Relatively limited and conflicting data are available on the effects of cardiac resynchronization therapy (CRT) on coronary blood flow (CBF). Aims: To investigate changes in the left anterior descending coronary artery (LAD) flow under different CRT pacing modes by means of transthoracic Doppler echocardiography (TTE). Methods: Twenty-two responders to CRT (67 11 years) with idiopathic dilated cardiomyopathy underwent TTE assessment of LAD flow and Tissue Velocity Imaging during 4 programming modes: intrinsic conduction (IC), right ventricular pacing (RV), simultaneous biventricular pacing (BVP), BVP with left ventricular (LV) pre-activation. Results: Mean coronary flow velocity (CFV) was increased by simultaneous BVP (p = 0.0063 vs. IC) and BVP with LV pre-activation (p<0.0001 vs. IC; p=0.027 vs. simultaneous BVP). Peak CFV and LAD flow velocity/time integral were highest during BVP with LV pre-activation. A reduction in septal-to-lateral delay and an increase in peak systolic velocity in the basal septum were observed during simultaneous BVP and BVP with LV pre-activation. Conclusions: In CRT responders with idiopathic dilated cardiomyopathy, an increase in LAD flow, assessed by TTE, was observed during simultaneous BVP and BVP with LV pre-activation. This was associated with an improvement in regional myocardial contraction and a decrease in intraventricular dyssynchrony., QC 20100525

Pancreatic islets of Langerhans display complex intracellular calcium changes in response to glucose that include fast (seconds), slow (similar to 5 min), and mixed fast/slow oscillations; the slow and mixed oscillations are likely responsible for the pulses of plasma insulin observed in vivo. To better understand the mechanisms underlying these diverse patterns, we systematically analyzed the effects of glucose on period, amplitude, and plateau fraction ( the fraction of time spent in the active phase) of the various regimes of calcium oscillations. We found that in both fast and slow islets, increasing glucose had limited effects on amplitude and period, but increased plateau fraction. In some islets, however, glucose caused a major shift in the amplitude and period of oscillations, which we attribute to a conversion between ionic and glycolytic modes (i.e., regime change). Raising glucose increased the plateau fraction equally in fast, slow, and regime-changing islets. A mathematical model of the pancreatic islet consisting of an ionic subsystem interacting with a slower metabolic oscillatory subsystem can account for these complex islet calcium oscillations by modifying the relative contributions of oscillatory metabolism and oscillatory ionic mechanisms to electrical activity, with coupling occurring via KATP channels.