INTRODUCTION:Definitive management of non-compressible intra-abdominal hemorrhage (NCIAH) currently requires a surgeon and operating room capable of performing damage control surgery. In a wartime scenario or a geographically remote environment, these may not be readily available. In this study, we sought to test the safety of 2 emerging injectable hemostatic agents (CounterFlow and Fast Onset Abdominal Management, or FOAM, poloxamer component) versus normal saline control over a prolonged monitoring duration following administration by a non-surgical provider. MATERIALS AND METHODS:The Institutional Animal Care and Use Committee approved all research conducted in this study. We randomized male New Zealand white rabbits into 2 monitoring cohorts of 24 hours and 2 weeks. Each cohort contained 3 treatment groups (n = 4 rabbits/group): CounterFlow, the testable poloxamer component of FOAM, and normal saline control. We injected each treatment intraperitoneally in the left lower abdominal quadrant. Doses were 15 mL/kg for CounterFlow, 6.3 mL/kg for the poloxamer component of FOAM, and 15 mL/kg for normal saline. We conducted all injections under isoflurane anesthesia monitored by trained veterinary staff. Animals were euthanized at each cohort end point, and a veterinary pathologist blinded to treatment type performed necropsy. The primary outcome was incidence of intra-abdominal adhesions at necropsy. Quantitatively, adhesions when present were graded by the veterinary pathologist on a 1 to 4 scale, where "1" represented adhesions involving from 1 to 25% of the examined abdomen, "2" represented from 26 to 50%, "3" represented from 51 to 75%, and "4" represented from 76 to 100%. Qualitatively, adhesions present were graded by degree ("1" = minimal, "2" = mild, "3" = moderate, and "4" = severe) and chronicity ("1" = acute, "2" = subacute, and "3" = chronic). We also drew d-dimer blood values and measured body weights for each animal. Statistical analysis included either repeated measures 2-way ANOVA or a mixed-effects model (in the case of missing data) with Geisser-Greenhouse correction. We adjusted multiple comparisons using Tukey statistical hypothesis tests. RESULTS:In the 2-week cohort, 3 CounterFlow animals showed adhesions judged to be "1" quantitatively. Qualitatively, 2 of these were assessed as "1" for degree of adhesions and the other demonstrated a "2." On the chronicity of adhesions scale, 1 animal demonstrated a "2" and 2 demonstrated a "3." No animals in other groups (FOAM and control) demonstrated adhesions. CounterFlow-treated animals showed a statistically significant rise in d-dimer values in the 24-hour cohort only. In the 2-week cohort, CounterFlow-treated animals showed a decrease in body weight at 24 hours after injection but returned to their baseline (normal) body weights at 7 days. CONCLUSIONS:Findings from this study demonstrate that the tested ingredients of FOAM poloxamer component are safe for intraperitoneal injection and hold potential for further study directed toward prehospital non-compressible intra-abdominal hemorrhage management by non-surgical providers. Although CounterFlow produced abdominal adhesions in 3 of 4 rabbits in the 2-week cohort, these were determined to be "minimal" or "mild" in degree.

Background Evaluating the impact of ionizing radiation on stored blood is relevant since blood banks are major assets in emergency conditions such as radiation incident/attack. This study aimed to fill our knowledge gap of combined radiation and storage effects on blood. Methods Blood collected from 16 anesthetized rats was anticoagulated, aliquoted into storage bags, and assigned to 8 groups using protocols combining storage (1-day vs 3-day 4 o C) plus irradiation (75 Gy vs 0 Gy - control). Bags were positioned inside an X-ray irradiator (MultiRad-350). Complete blood count, differential white blood cell count, biochemistry, and hemostasis were analyzed (≥7 bags/group). Results Na + , bicarbonate, glucose, and pH significantly reduced, while K + , Cl − , and lactate increased by storage. Coagulation measures were not significantly altered after radiation. White blood cell count and most cell types were numerically reduced after radiation, but changes were statistically significant only for monocytes. No significant alterations were noted in aggregation or rotational thromboelastometry parameters between irradiated and control. Conclusions Evaluating cellular/biochemical parameters aids in assessing stored blood adequacy after radiation. Data suggest that fresh or cold-stored blood can sustain up to 75 Gy without major critical parameter changes and may remain suitable for use in critically ill patients in military/civilian settings.

Local blood flow/oxygen partial pressure (Po2) distributions and flow-Po2 relationships are physiologically relevant. They affect the pathophysiology and treatment of conditions like hemorrhagic shock (HS), but direct noninvasive measures of flow, Po2, and their heterogeneity during prolonged HS are infrequently presented. To fill this void, we report the first quantitative evaluation of flow-Po2 relationships and heterogeneities in normovolemia and during several hours of HS using noninvasive, unbiased, automated acquisition. Anesthetized rats were subjected to tracheostomy, arterial/venous catheterizations, cremaster muscle exteriorization, hemorrhage (40% total blood volume), and laparotomy. Control animals equally instrumented were not subjected to hemorrhage/laparotomy. Every 0.5 h for 4.5 h, noninvasive laser speckle contrast imaging and phosphorescence quenching were employed for nearly 7,000 flow/Po2 measurements in muscles from eight animals, using an automated system. Precise alignment of 16 muscle areas allowed overlapping between flow and oxygenation measurements to evaluate spatial heterogeneity, and repeated measurements were used to estimate temporal heterogeneity. Systemic physiological parameters and blood chemistry were simultaneously assessed by blood samplings replaced with crystalloids. Hemodilution was associated with local hypoxia, but increased flow prevented major oxygen delivery decline. Adding laparotomy and prolonged HS resulted in hypoxia, ischemia, decreased tissue oxygen delivery, and logarithmic flow/Po2 relationships in most regions. Flow and Po2 spatial heterogeneities were higher than their respective temporal heterogeneities, although this did not change significantly over the studied period. This quantitative framework establishes a basis for evaluating therapies aimed at restoring muscle homeostasis, positively impacting outcomes of civilian and military trauma/HS victims.NEW & NOTEWORTHY This is the first study on flow-Po2 relationships during normovolemia, hemodilution, and prolonged hemorrhagic shock using noninvasive methods in multiple skeletal muscle areas of monitored animals. Automated flow/Po2 measurements revealed temporal/spatial heterogeneities, hypoxia, ischemia, and decreased tissue oxygen delivery after trauma/severe hemorrhage. Hemodilution was associated with local hypoxia, but hyperemia prevented a major decline in oxygen delivery. This framework provides a quantitative basis for testing therapeutics that positively impacts muscle homeostasis and outcomes of trauma/hemorrhagic shock victims.

Studies evaluating blood flow and oxygen partial pressure (PO 2 ) may not directly measure both parameters and may depend on investigator's selection of measuring sites. In addition, relevant systemic parameters may not be simultaneously recorded. Therefore, we implemented a new automated system for blood flow and PO 2 acquisition in large tissue areas while collecting systemic information. In 10 animals anesthetized with isoflurane, cardio‐respiratory parameters were continuously recorded, in experiments lasting up to 4 h. Other data were collected at baseline, and after laparotomy and 30 min hemorrhage (40% of total blood volume). A cremaster muscle was spread over a thermostatically‐controlled pedestal fixed to a motorized stage. Sixteen noninvasive PO 2 measurements using oxygen‐dependent phosphorescence quenching and fiber‐optics were performed during a computer‐controlled tissue scan. In the same areas used for PO 2 measurements, microvascular blood flow was estimated employing laser speckle contrast imaging. Blood was sampled for extensive biochemistry and coagulation profiles. The system was used successfully by different operators. One set of flow and PO 2 measurements was completed in less than 90 s. Changes in muscle flow correlated with local PO 2 but several systemic parameters did not correlate with blood flow and PO 2 , emphasizing the importance of performing both local and systemic evaluations. System advantages include integration between local and multiple systemic parameters, unbiased data collection/analysis, easy implementation, improved performance, no need for customized programming, and simplified training compared to intravital microscopy. Support or Funding Information Supported by US Army Medical Research and Materiel Command. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .

BACKGROUND Many studies evaluating blood flow and oxygen partial pressure (P o 2 ) do not directly measure both parameters, are confined to few locations/microvessels, and depend on investigator's selection of measuring sites. Moreover, clinically/physiologically relevant systemic parameters are not simultaneously recorded. We implemented an automated system for prolonged blood flow/P o 2 acquisition in large areas while collecting relevant systemic information. METHODS In anesthetized animals, cardiorespiratory parameters were continuously recorded. Other data were collected at baseline and hourly after 4 hours of hemorrhagic shock. A cremaster muscle was spread over a pedestal fixed to a motorized stage. One 2-dimensional tissue scan allowed 16 noninvasive P o 2 measurements using oxygen-dependent phosphorescence quenching and fiber optics. Blood flow was estimated using laser speckle contrast imaging in the same areas used for P o 2 measurements. At each timepoint, blood was sampled for extensive biochemistry/coagulation profile. RESULTS The system was used successfully by different operators. A set of flow/P o 2 measurements was completed in less than 90 seconds. Muscle flow and P o 2 correlated with some but not several systemic parameters, emphasizing the importance of performing both local and systemic evaluations. CONCLUSION System advantages include integration between local and over 40 systemic parameters, unbiased data collection/analysis, improved performance/sampled area, easy expansion, implementation and maintenance, no customized programming, and simplified training. Combining this system with trauma/prolonged HS models will enhance our ability to investigate tissue stability and select better resuscitation strategies to improve outcomes and survival. LEVEL OF EVIDENCE Diagnostic test, level V.

We used phase resetting methods to predict firing patterns of rat subthalamic nucleus (STN) neurons when their rhythmic firing was densely perturbed by noise. We applied sequences of contiguous brief (0.5-2 ms) current pulses with amplitudes drawn from a Gaussian distribution (10-100 pA standard deviation) to autonomously firing STN neurons in slices. Current noise sequences increased the variability of spike times with little or no effect on the average firing rate. We measured the infinitesimal phase resetting curve (PRC) for each neuron using a noise-based method. A phase model consisting of only a firing rate and PRC was very accurate at predicting spike timing, accounting for more than 80% of spike time variance and reliably reproducing the spike-to-spike pattern of irregular firing. An approximation for the evolution of phase was used to predict the effect of firing rate and noise parameters on spike timing variability. It quantitatively predicted changes in variability of interspike intervals with variation in noise amplitude, pulse duration and firing rate over the normal range of STN spontaneous rates. When constant current was used to drive the cells to higher rates, the PRC was altered in size and shape and accurate predictions of the effects of noise relied on incorporating these changes into the prediction. Application of rate-neutral changes in conductance showed that changes in PRC shape arise from conductance changes known to accompany rate increases in STN neurons, rather than the rate increases themselves. Our results show that firing patterns of densely perturbed oscillators cannot readily be distinguished from those of neurons randomly excited to fire from the rest state. The spike timing of repetitively firing neurons may be quantitatively predicted from the input and their PRCs, even when they are so densely perturbed that they no longer fire rhythmically.

Injecting white noise currents has been shown to increase mean firing rate in several types of neuron. This speed up is generally attributed to the fact that depolarizing currents on the tails of the noise distribution push cells past spike threshold sooner than they would have otherwise. As part of a larger effort to understand the dynamic properties of rat subthalamic (STN) neurons, we have performed perforated patch recordings of these tonically active neurons in brain slices, exposing them to contiguous sequences of brief current pulses drawn from a Gaussian distribution. Pulsed noise disrupted firing pattern with no significant change in rate over a wide range of noise amplitudes, so long as the pulse durations were brief (<2 ms). With longer pulse durations, neurons increased their firing rate with noise, with greater increases for pulses of larger magnitude and longer duration. However, individual neurons displayed varying degrees of noise-induced speed up. We used phase resetting methods to understand the noise-induced changes in the mean and variance of the recorded interspike interval distributions. For each cell, a phase response curves (PRC) was derived by using linear interpolation to estimate the phase of the neuron between spikes, followed by a linear regression to estimate the sensitivity of the cell to input perturbations at each phase. We then compared Monte Carlo simulations of a one-dimensional phase model to predict the response patterns of individual neurons. Surprisingly, simulation results produced a good match to experimental mean and variances even at noise levels leading to autocorrelation histograms with no visible periodicity (CVs ~ 0.4). We then investigated simulations results in detail to understand the dynamic mechanism that underlies the noise-induced speed up in these neurons. Plots of the mean phase as a function of time revealed that the noise-induced phase advance occurred early in an interspike interval, well before trajectories approach the time of the next spike. This phase advance can be understood as ‘noise-induced drift’ in the Stratanovich interpretation of stochastic differential equations, with possible supralinear contributions for pulses of finite duration. Current research uses artificially constructed PRCs to examine how the increasing spread of the phase distribution during each intervals leads to an asymmetric sampling of the noise-induced drift, preventing the early noise-induced speed up from being canceled by an expected noise-induced slowing as the PRC approaches zero near the time of the next spike.

Intrinsic heterogeneity in networks of interconnected cells has profound effects on synchrony and spike-time reliability of network responses. Projection neurons of the globus pallidus (GPe) are interconnected by GABAergic inhibitory synapses and in vivo fire continuously but display significant rate and firing pattern heterogeneity. Despite being deprived of most of their synaptic inputs, GPe neurons in slices also fire continuously and vary greatly in their firing rate (1-70 spikes/s) and in regularity of their firing. We asked if this rate and pattern heterogeneity arises from separate cell types differing in rate, local synaptic interconnections, or variability of intrinsic properties. We recorded the resting discharge of GPe neurons using extracellular methods both in vivo and in vitro. Spike-to-spike variability (jitter) was measured as the standard deviation of interspike intervals. Firing rate and jitter covaried continuously, with slow firing being associated with higher variability than faster firing, as would be expected from heterogeneity arising from a single physiologically distinct cell type. The relationship between rate and jitter was unaffected by blockade of GABA and glutamate receptors. When the firing rate of individual neurons was altered with constant current, jitter changed to maintain the rate-jitter relationship seen across neurons. Long duration (30-60 min) recordings showed slow and spontaneous bidirectional drift in rate similar to the across-cell heterogeneity. Paired recordings in vivo and in vitro showed that individual cells wandered in rate independently of each other. Input conductance and rate wandered together, in a manner suggestive that both were due to fluctuations of an inward current.

1 population. 2 3 Running Head: Heterogeneity of Pallidal Neurons 4 5 Christopher A. Deister1, Ramana Dodla1, David Barraza1, Hitoshi Kita2 and Charles J. Wilson1 6 1 Department of Biology and Neurosciences Institute, University of Texas at San Antonio, 7 San Antonio, TX 78249 8 2 Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, 9 Memphis, TN 38163 10 11 12 Current Address: 13 Christopher A. Deister 14 Department of Neuroscience 15 Brown University 16 185 Meeting Street 17 Box G-LN 18 Providence, RI 02912 19 cdeister@brown.edu 20 21 22

Synchrony among neurons is seen throughout the mammalian CNS, in particular within networks of GABAergic neurons. The globus pallidus (GP) consists of GABAergic neurons that project to neurons throughout the basal ganglia in addition to each other via local axon collaterals. The GP does not display synchronous rhythms and there are no clear correlations between neurons in healthy mammals. In contrast, strong correlations among GP neurons emerge in Parkinson’s disease patients and MPTP treated primates. Why GP neurons show no correlations in healthy animals is not known. GP neurons are autonomous pacemakers and are thought to discharge at a constant frequency. Theoretical work shows that the degree of synchrony in interconnected networks depends on the amount of heterogeneity in firing rate. We have observed in cell-attached recordings of GP neurons, in slices, that their firing rates are not stationary, but instead visit a range of rates over a period of one hour in a non-stereotypical fashion. The fluctuations in rate are stable for periods of minutes, can vary as much as 30 Hz, and appear to be unaffected by blocking synaptic inputs. HCN channels are a critical component of the GP neuron’s pacemaking mechanism, and their availability is positively correlated with the firing rate of GP neurons. Paired recordings revealed that these fluctuations in rate were neuron-independent. We hypothesized that these slow non-stereotypical fluctuations in firing rate could be attributed to regulation of HCN channels by cAMP. cAMP alters HCN availability by shifting the channel’s activation curve to depolarized potentials. Consistent with this, up-regulation of cAMP levels by bath application of 50 μM Forskolin increased the firing rate of GP neurons from 12.7 ± 1.3 to 20.5 ± 1.5 Hz. After the Forskolin induced increase in firing rate stabilized, there was a marked decrease in the amount of variability in interspike intervals (ISIs) observed over a one hour period of recording in the cell-attached configuration. In control conditions the average coefficient of variation of ISIs (CV), measured over one hour, was 0.43 ± 0.22 and was 0.09 ± 0.02 after exposure to Forskolin. Thus, fluctuations in cAMP can create heterogeneity in firing rate among GP neurons by altering the availability of the voltage-gated ion channels necessary to drive pacemaking. By this mechanism, activity independent intracellular signaling could potentially contribute to the absence of synchrony in the GP.

Neurons of the subthalamic nucleus (STN) are very sensitive to applied currents, firing at 10-20/s during spontaneous activity, but increasing to peak firing rates of 200/s with applied currents <0.5 nA. They receive a powerful tonic excitatory input from neurons in the cerebral cortex, yet in vivo maintain an irregular firing rate only slightly higher than the autonomous firing rate seen in slices. Spike frequency adaptation acts to normalize background firing rate by removing slow trends in firing due to changes in average input. Subthalamic neurons have been previously described as showing little spike frequency adaptation, but this was based on tests using brief stimuli. We applied long-duration depolarizing current steps to STN neurons in slices and observed a very strong spike frequency adaptation with a time constant of 20 s and that recovered at a similar rate. This adaptation could return firing to near-baseline levels during prolonged current pulses that transiently drove the cells at high rates. The current responsible for adaptation was studied in voltage clamp during and after high-frequency driving of the cell and was determined to be a slowly accumulating K(+) current. This current was independent of calcium or sodium entry and could be induced with long-duration voltage steps after blockade of action potentials. In addition to the adaptation current, driven firing produced slow inactivation of the persistent Na(+) current, which also contributed to the reduced excitability of STN cells during and after driven firing.