Different Features of a Metabolic Connectivity Map and the Granger Causality Method in Revealing Directed Dopamine Pathways: A Study Based on Integrated PET/MR Imaging

BACKGROUND AND PURPOSE

Exploring the directionality of neural information in the brain is important for understanding brain mechanisms and neurodisease development. Granger causality analysis and the metabolic connectivity map can be used to investigate directional transmission of information between brain regions, but their differences in depicting functional effective connectivity are not clear.

MATERIALS AND METHODS

Using the Monash rs-PET/MR imaging data set, we conducted Granger causality and metabolic connectivity map analyses of the dopamine reward circuit in the brain. The dopamine reward circuit is a well-known system consisting primarily of the bilateral orbital frontal cortex, caudate, nucleus accumbens, thalamus, and substantia nigra. We validated these circuit pathways using Granger causality and the metabolic connectivity map for identifying effective connectivities against a priori knowledge by testing the significance of directed pathways (P < .05, false discovery rate-corrected).

RESULTS

We found 3 types of effective connectivities in the dopamine reward circuit: long-range, neighborhood, and symmetric. Granger causality analysis revealed long-range connections in the orbital frontal cortex-caudate and orbital frontal cortex-nucleus accumbens regions. Metabolic connectivity map analysis revealed neighborhood connections in the nucleus accumbens-caudate, substantia nigra-thalamus, and thalamus-caudate regions. Metabolic connectivity map analysis also found symmetric connections in each of the bilateral nucleus accumbens, caudate, thalamus, and orbital frontal cortex-caudate regions. Different patterns in directional networks of the dopamine reward circuit were revealed by Granger causality and metabolic connectivity map analyses.

CONCLUSIONS

Granger causality analysis primarily identified bidirectional cortico-nucleus connections, while the metabolic connectivity map primarily identified direct connections among neighborhood and symmetric regions. The results of this study indicated that investigations of effective connectivities should use an appropriate analysis method depending on the purpose of the study.

[The epidemiology and screening of hepatitis D]

Hepatitis D virus (HDV) is a defective RNA virus with 8 genotypes, which requires hepatitis B virus (HBV) for its replication both in co-infection (HDV infection occurs when people become infected with both hepatitis B and D simultaneously) and super-infection (HDV infection after infected with hepatitis B). Due to persistency of anti-HDV in the superinfected patient, the most epidemiology data of HDV infection suggests HBV/HDV super-infection. Because of inadequate awareness and effective HBV vaccination programme, HDV infection screen was not specific recommended, except for risk population recommended by AASLD. However, the disease burden of HDV infection was not fully understood and might be underestimated. This review summarized the anti-HDV and HDV genotype epidemiology and the screening of HDV infection.

[The influence of meteorological factors on SARS-CoV-2 transmission: evidence from laboratory and epidemiological studies]

SARS-CoV-2 has infected more than 600 million people worldwide and caused more than 6 million deaths. The emerging novel variants have made the epidemic rebound in many places. Meteorological factors can affect the epidemic spread by changing virus activity, transmission dynamic parameters and host susceptibility. This paper systematically analyzed the currently available laboratory and epidemiological studies on the association between the meteorological factors and COVID-19 incidence, in order to provide scientific evidence for future epidemic control and prevention, as well as developing early warning system.

Chromosome-level genome assembly of Fragaria pentaphylla using PacBio and Hi-C technologies

Fragaria pentaphylla, a wild diploid quinquefoliolate species of Fragaria, is native to Southwest China. It has two morphs of red and white fruit color in nature and has characteristics of unique fragrance and resistance, which made it not only a valuable breeding material but also a potential model plant for molecular function researches. Here, we generate a high-quality chromosome-level genome assembly of a F. pentaphylla accession, BAAFS-FP039 employing a combination of PacBio Long-Read Sequencing, Illumina Short-Read Sequencing, and Hi-C Sequencing. The assembled genome contained 256.74 Mb and a contig N50 length of 32.38 Mb, accounting for 99.9% of the estimated genome (256.77 Mb). Based on Hi-C data, seven pseudo-chromosomes of F. pentaphylla-FP039 genome were assembled, covering 99.39% of the genome assembly. The genome was composed of 44.61% repetitive sequences and 29,623 protein-coding genes, 97.62% of protein-coding genes could be functionally annotated. Phylogenetic and chromosome syntenic analysis revealed that F. pentaphylla-FP039 was closely related to F. nubicola. This high-quality genome could provides fundamental molecular resources for evolutionary studies, breeding efforts, and exploring the unique biological characteristics of F. pentaphylla.

Combined transcriptomic and metabolomic analysis reveals a role for adenosine triphosphate-binding cassette transporters and cell wall remodeling in response to salt stress in strawberry

Strawberry (Fragaria × ananassa Duch) are sensitive to salt stress, and breeding salt-tolerant strawberry cultivars is the primary method to develop resistance to increased soil salinization. However, the underlying molecular mechanisms mediating the response of strawberry to salinity stress remain largely unknown. This study evaluated the salinity tolerance of 24 strawberry varieties, and transcriptomic and metabolomic analysis were performed of 'Sweet Charlie' (salt-tolerant) and 'Benihoppe' (salt-sensitive) to explore salt tolerance mechanisms in strawberry. Compared with the control, we identified 3412 differentially expressed genes (DEGs) and 209 differentially accumulated metabolites (DAMs) in 'Benihoppe,' and 5102 DEGs and 230 DAMs in 'Sweet Charlie.' DEGs Gene Ontology (GO) enrichment analyses indicated that the DEGs in 'Benihoppe' were enriched for ion homeostasis related terms, while in 'Sweet Charlie,' terms related to cell wall remodeling were over-represented. DEGs related to ion homeostasis and cell wall remodeling exhibited differential expression patterns in 'Benihoppe' and 'Sweet Charlie.' In 'Benihoppe,' 21 ion homeostasis-related DEGs and 32 cell wall remodeling-related DEGs were upregulated, while 23 ion homeostasis-related DEGs and 138 cell wall remodeling-related DEGs were downregulated. In 'Sweet Charlie,' 72 ion homeostasis-related DEGs and 275 cell wall remodeling-related DEGs were upregulated, while 11 ion homeostasis-related DEGs and 20 cell wall remodeling-related DEGs were downregulated. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses showed only four KEGG enriched pathways were shared between 'Benihoppe' and 'Sweet Charlie,' including flavonoid biosynthesis, phenylalanine metabolism, phenylpropanoid biosynthesis and ubiquinone, and other terpenoid-quinone biosynthesis. Integrating the results of transcriptomic and metabolomics analyses showed that adenosine triphosphate-binding cassette (ABC) transporters and flavonoid pathway genes might play important roles in the salt stress response in strawberry, and DAMs and DEGs related to ABC transporter and flavonoid pathways were differentially expressed or accumulated. The results of this study reveal that cell wall remodeling and ABC transporters contribute to the response to salt stress in strawberry, and that related genes showed differential expression patterns in varieties with different salt tolerances. These findings provide new insights into the underlying molecular mechanism of strawberry response to salt stress and suggest potential targets for the breeding of salt-tolerant strawberry varieties.

Effects of weight loss on bone turnover, inflammatory cytokines, and adipokines in Chinese overweight and obese adults

PURPOSE

Plenty of studies have examined the long term effect of weight loss on bone mineral density. This study aimed to explore the effects of 10% weight loss on early changes in bone metabolism as well as the possible influencing factors.

METHODS

Overweight and obese outpatients (BMI > 24.0 kg/m²) were recruited from the nutrition clinic and followed a calorie-restricted, high-protein, low-carbohydrate diet program. Dietary intake, body composition, serum procollagen type I N-propeptide (PINP), β-Crosslaps, PTH, 25(OH) VitD, a series of inflammatory cytokines and adipokines were measured for the participants before starting to lose weight and after 10% weight loss (NCT04207879).

RESULTS

A total of 75 participants were enrolled and 37 participants achieved a weight loss of at least 10%. It was found that PINP decreased (p = 0.000) and the β-Crosslaps increased (p = 0.035) in female participants. Decreases in PTH (p = 0.001), serum IL-2 (p = 0.013), leptin (p = 0.001) and increases in 25(OH) VitD (p = 0.001), serum ghrelin (p = 0.033) were found in 37 participants after 10% of their weight had been lost. Change in PINP was detected to be significantly associated with change in lean body mass (r = 0.418, p = 0.012) and change in serum ghrelin(r = - 0.374, p = 0.023).

CONCLUSIONS

Bone formation was suppressed and bone absorption was increased in female subjects after a 10% weight loss. Bone turnover was found to be associated with lean body mass and affected by the circulating ghrelin level.

Surface Reconstruction of Co4N Coupled with CeO2 toward Enhanced Alkaline Oxygen Evolution Reaction

Constructing the active interface in a heterojunction electrocatalyst is critical for the electron transfer and intermediate adsorption (O*, OH*, and HOO*) in alkaline oxygen evolution reaction (OER) but still remains challenging. Herein, a CeO₂/Co₄N heterostructure is rationally synthesized through the direct calcination of Ce[Co(CN)₆], followed by thermal nitridation. The in situ electrochemically generated CoOOH on the surface of Co₄N serves as the active site for the OER, and the coupled CeO₂ with oxygen vacancy can optimize the energy barrier of intermediate reactions of the OER, which simultaneously boosts the OER performance. Besides, electrochemical measurement results demonstrate that oxygen vacancies in CeO₂ and optimized absorption free energy originating from the electron transfer between CeO₂ and CoOOH contribute to enhanced OER kinetics. This work provides new insight into regulating the interface heterostructure to rationally design efficient OER electrocatalysts under alkaline conditions.

[Comparison of tolerance to decentration and tilt in the early postoperative period between the continuous range and bifocal intraocular lens implantation in myopic eyes]

Objective: To compare decentration and tilt tolerances between continuous range intraocular lens (IOL) and bifocal IOL in myopia during the early stages post intraocular implantation. Method: A retrospective cohort study was conducted using follow-up data of 145 patients (145 eyes) who underwent phacoemulsification combined with IOL implantation in the Eye & ENT Hospital of Fudan University from January 2018 to December 2020. According to whether the axial length was less than 24.5 mm, patients were divided into non-myopic and myopic groups. According to IOL type, patients were divided into extend depth of focus (EDOF) ZXR00 IOL group (myopic 38 eyes, non-myopic 41 eyes) and bifocal ZMB00 IOL group (myopic 23 eyes, non-myopic 43 eyes). The distance and near visual acuity (log of the minimum angle of resolution visual acuity), IOL tilt and decentration, intraocular high-order aberration (HOA), coma, trefoil, spherical aberrations, modulation transfer function (MTF), as well as VF-14 index and the incidence of dysphotopsia were compared between the 2 groups at 3 months after surgery. Statistics were performed using Student's t-test, χ² test, Pearson correlation analysis and multiple linear regression analysis. Results: In either the myopic or non-myopic group, no significant differences were found in age, gender, eye laterality, axial length and IOL degree between eyes with the two different types of IOLs (all P>0.05). At 3 months after surgery, there was no significant difference in uncorrected and best-corrected distance visual acuity between the ZXR00 IOL group and the ZXR00 IOL group, while uncorrected near visual acuity was better in the ZMB00 IOL group than the ZXR00 IOL group (t=10.41, P<0.01). The total postoperative IOL decentration in the ZXR00 IOL group and ZMB00 IOL group in myopic eyes were (0.32±0.17) and (0.38±0.16) mm, respectively, which were greater than those in non-myopic eyes [(0.22±0.12), (0.28±0.12) mm; t=3.16, 2.57; both P<0.05]. However, there were no significant differences in IOL tilt between myopic and non-myopic eyes in the 2 groups (both P>0.05). There were no significant differences in postoperative IOL tilt and decentration between the 2 groups regardless of myopia or non-myopia (all P>0.05). In myopic eyes, HOA, coma aberration and spherical aberration in the ZXR00 IOL group were significantly lower than those in the ZMB00 IOL group, while the total ocular MTF (38.15±10.12) was significantly higher than that in the ZMB00 IOL group (30.46±10.53) (all P<0.05). Pearson correlation analysis and multiple linear regression analysis showed a positive correlation between postoperative HOA and both IOL tilt and decentration in the ZMB00 IOL group (r=0.627, 0.726; β=0.446, 0.587; all P<0.01). However, no such relationship was found in the ZXR00 IOL group (all P>0.05). In myopic eyes, when the IOL tilt aberration and decentration were greater than the median, the HOAs in the ZXR00 IOL group [(0.33±0.14), (0.27±0.11) μm] were lower than those in the ZMB00 IOL group [(0.88±0.56), (0.96±0.45) μm], while the total ocular MTF (42.87±10.97, 40.22±9.30) were higher than those in the ZMB00 IOL group (25.02±8.99, 29.87±10.19) (all P<0.05). In myopic eyes, the proportion of patients with visual interference symptoms in the ZXR00 IOL group [42.11% (16/38)] was significantly lower than that in the ZMB00 IOL group [78.26%(18/23), χ²=7.59, P<0.05]. Conclusion: During the early stages after IOL implantation in myopic eyes, EDOF IOL is more tolerant to decentration and tilt than bifocal IOL.

Genome-Wide Analysis of Ascorbic Acid Metabolism Related Genes in Fragaria × ananassa and Its Expression Pattern Analysis in Strawberry Fruits

Ascorbic acid (AsA) is an important antioxidant for scavenging reactive oxygen species and it is essential for human health. Strawberry (Fragaria × ananassa) fruits are rich in AsA. In recent years, strawberry has been regarded as a model for non-climacteric fruit ripening. However, in contrast to climacteric fruits, such as tomato, the regulatory mechanism of AsA accumulation in strawberry fruits remains largely unknown. In this study, we first identified 125 AsA metabolism-related genes from the cultivated strawberry "Camarosa" genome. The expression pattern analysis using an available RNA-seq data showed that the AsA biosynthetic-related genes in the D-mannose/L-galactose pathway were downregulated remarkably during fruit ripening which was opposite to the increasing AsA content in fruits. The D-galacturonate reductase gene (GalUR) in the D-Galacturonic acid pathway was extremely upregulated in strawberry receptacles during fruit ripening. The FaGalUR gene above belongs to the aldo-keto reductases (AKR) superfamily and has been proposed to participate in AsA biosynthesis in strawberry fruits. To explore whether there are other genes in the AKR superfamily involved in regulating AsA accumulation during strawberry fruit ripening, we further implemented a genome-wide analysis of the AKR superfamily using the octoploid strawberry genome. A total of 80 FaAKR genes were identified from the genome and divided into 20 subgroups based on phylogenetic analysis. These FaAKR genes were unevenly distributed on 23 chromosomes. Among them, nine genes showed increased expression in receptacles as the fruit ripened, and notably, FaAKR23 was the most dramatically upregulated FaAKR gene in receptacles. Compared with fruits at green stage, its expression level increased by 142-fold at red stage. The qRT-PCR results supported that the expression of FaAKR23 was increased significantly during fruit ripening. In particular, the FaAKR23 was the only FaAKR gene that was significantly upregulated by abscisic acid (ABA) and suppressed by nordihydroguaiaretic acid (NDGA, an ABA biosynthesis blocker), indicating FaAKR23 might play important roles in ABA-mediated strawberry fruit ripening. In a word, our study provides useful information on the AsA metabolism during strawberry fruit ripening and will help understand the mechanism of AsA accumulation in strawberry fruits.

AB0891 Deucravacitinib Efficacy in Psoriatic Arthritis by Baseline DMARD Use: Exploratory Analysis From a Phase 2 Study

Background

Psoriatic arthritis (PsA) treatment guidelines recommend that patients (pts) inadequately responding to conventional synthetic DMARDs (csDMARDs) can be treated with targeted synthetic DMARDs with or without background use of csDMARDs. Deucravacitinib (DEUC) is a novel, oral, selective, allosteric inhibitor of tyrosine kinase 2 (TYK2) that binds to the unique TYK2 regulatory domain, thereby suppressing signaling of key cytokines (eg, IL-23) involved in PsA pathogenesis. In a Phase 2 trial in pts with active PsA, DEUC was well tolerated and significantly more efficacious than placebo (PBO) after 16 weeks of treatment.1

Objectives

This analysis further evaluated the effect of DEUC in this Phase 2 trial in pts treated with and without background csDMARDs for 16 weeks.

Methods

This double-blind trial (NCT03881059) enrolled pts with active PsA who had either failed or were intolerant to ≥1 nonsteroidal anti-inflammatory drug, corticosteroid, csDMARD, and/or 1 TNF inhibitor (TNFi; up to 30%). Pts were randomised 1:1:1 to DEUC 6 mg once daily (QD) or 12 mg QD, or PBO. A post hoc subgroup analysis in pts with and without background csDMARD use assessed improvements in select clinical outcomes (ACR 20 response, and change from baseline in ACR components, Psoriasis Area and Severity Index total score, and Psoriatic Arthritis Disease Activity Score) at Week 16.

Results

Baseline (BL) demographics, clinical characteristics, and disease activity were generally similar among pts with and without background csDMARD use. At BL, background csDMARD use was 64.3%, 64.2%, and 66.7% and methotrexate use was 50.0%, 55.2%, and 59.1% in the DEUC 6 mg QD, 12 mg QD, and PBO groups, respectively. Pts with and without background csDMARD use showed similar improvements at Week 16 with DEUC treatment versus PBO on most clinical measures, pt-reported outcomes, and composite measures (Table 1 and Figure 1). No clinically meaningful differences in adverse events (AEs) were observed in pts with or without background csDMARD use.

Table 1.

Adjusted mean (SE) change from baseline at Week 16 in clinical outcomes by csDMARD use

PBO w/o csDMARD (n=22)PBO w csDMARD (n=44)DEUC 6 mg QD w/o csDMARD (n=25)DEUC 6 mg QD w csDMARD (n=45)DEUC 12 mg QD w/o csDMARD (n=24)DEUC 12 mg QD w csDMARD (n=43)Swollen joint count-4.7 (1.4)-5.0 (0.9)-7.4 (1.4)-6.8 (0.9)-8.4 (1.3)-7.7 (1.0)Tender joint count-5.3 (2.2)-6.6 (1.3)-6.4 (2.2)-11.3 (1.3)-11.5 (2.0)-11.6 (1.4)Physician’s Global Assessment of Disease Activity-20.6 (5.6)-20.6 (3.7)-29.1 (5.8)-32.6 (3.5)-30.1 (5.3)-32.1 (3.9)Patients’ Global Assessment of Disease Activity-14.9 (5.8)-13.4 (3.9)-23.0 (5.9)-28.4 (3.8)-28.2 (5.4)-24.9 (4.2)Pain-14.7 (5.6)-14.6 (3.9)-22.7 (5.7)-26.2 (3.7)-25.5 (5.3)-25.5 (4.2)HAQ-DI-0.23 (0.11)-0.04 (0.09)-0.31 (0.11)-0.38 (0.08)-0.48 (0.10)-0.34 (0.09)hsCRP12.0 (5.3)-4.4 (2.1)-10.1 (5.3)-13.3 (2.0)-4.9 (4.9)-10.0 (2.2)PASI total score2.5 (1.4)-2.3 (0.7)-3.7 (1.4)-4.0 (0.6)-4.0 (1.3)-4.9 (0.7)PASDAS-0.9 (0.4)-1.2 (0.3)-1.8 (0.4)-2.1 (0.2)-2.2 (0.3)-2.1 (0.3)

The number of patients with data available for individual endpoints may vary.

csDMARD, conventional synthetic disease-modifying antirheumatic drug; DEUC, deucravacitinib; HAQ-DI, Health Assessment Questionnaire-Disability Index; hsCRP, high-sensitivity C-reactive protein; PASDAS, Psoriatic Arthritis Disease Activity Score; PASI, Psoriasis Area and Severity Index; PBO, placebo; QD, once daily; SE, standard error; w, with; w/o, without.

Conclusion

These analyses demonstrate that the efficacy of DEUC for the treatment of PsA was similar in pts with and without background csDMARD use. The AE profile of DEUC treatment with and without csDMARD use was consistent with findings from the overall Phase 2 PsA trial population.

References

[1]Mease PJ et al. Efficacy and Safety of Selective TYK2 Inhibitor, Deucravacitinib, in a Phase 2 Trial in Psoriatic Arthritis. Ann Rheum Dis. (In Press)

Acknowledgements

This study was sponsored by Bristol Myers Squibb. Professional medical writing assistance was provided by Julianne Hatfield, PhD at Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, USA, and funded by Bristol Myers Squibb.

Disclosure of Interests

Atul Deodhar Consultant of: Consulting and/or advisory boards: AbbVie, Amgen, Aurinia, Bristol Myers Squibb, Celgene, Eli Lilly, GlaxoSmithKline, Janssen, MoonLake, Novartis, Pfizer, UCB;, Grant/research support from: Research grants: AbbVie, Eli Lilly, GlaxoSmithKline, Novartis, Pfizer, UCB., Miroslawa Nowak Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, June Ye Shareholder of: Employees and shareholders of Bristol Myers Squibb, Employee of: Employees and shareholders of Bristol Myers Squibb, Thomas Lehman Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Lan Wei Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Subhashis Banerjee Shareholder of: Bristol Myers Squibb, Employee of: Bristol Myers Squibb, Philip J Mease Consultant of: Consulting and/or speaker fees: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN Pharma, UCB., Grant/research support from: Research grants: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN Pharma, UCB;

Low temperature inhibits anthocyanin accumulation in strawberry fruit by activating FvMAPK3-induced phosphorylation of FvMYB10 and degradation of Chalcone Synthase 1

Low temperature causes poor coloration of strawberry (Fragaria sp.) fruits, thus greatly reducing their commercial value. Strawberry fruits accumulate anthocyanins during ripening, but how low temperature modulates anthocyanin accumulation in plants remains largely unknown. We identified MITOGEN-ACTIVATED PROTEIN KINASE3 (FvMAPK3) as an important negative regulator of anthocyanin accumulation that mediates the poor coloration of strawberry fruits in response to low temperature. FvMAPK3 activity was itself induced by low temperature, leading to the repression of anthocyanin accumulation via two mechanisms. Activated FvMAPK3 acted as the downstream target of MAPK KINASE4 (FvMKK4) and SUCROSE NONFERMENTING1-RELATED KINASE2.6 (FvSnRK2.6) to phosphorylate the transcription factor FvMYB10 and reduce its transcriptional activity. In parallel, FvMAPK3 phosphorylated CHALCONE SYNTHASE1 (FvCHS1) to enhance its proteasome-mediated degradation. These results not only provide an important reference to elucidate the molecular mechanisms underlying low-temperature-mediated repression of anthocyanin accumulation in plants, but also offer valuable candidate genes for generating strawberry varieties with high tolerance to low temperature and good fruit quality.

The value of MRCP in children with biliary symptomatology - an essential adjunct for safe cholecystectomy

Congenital abnormalities of the biliary system are a consideration in children with biliary symptomatology. The preoperative diagnosis rate is still not satisfactory, despite progresses made in imaging technology, with the potential of biliary tract injury if surgery is indicated. The double gallbladder is a rare developmental abnormality of the biliary tract with several anatomical variations. This abnormality was accurately delineated in a 7-year-old child by MRI/MRCP, allowing the ductal anatomy to be accurately identified and safe laparoscopic cholecystectomies to be performed.

What can GP data tell us about the treatment of onychomycosis in the UK?

Background

Treatment of onychomycosis is challenging, and there is much literature on optimal treatment strategies. In contrast, information on how onychomycosis is actually treated in primary care is scarce. Information on practice is important as it can reveal much, such as, to what extent national guidelines are followed and which population groups seek/receive treatment or do not do so.

Objectives

To describe the pattern of onychomycosis treatment in primary care in the UK, by patient's gender and age.

Methods

A population‐based retrospective cross‐sectional study was conducted. The Health Improvement Network (THIN) database was used to calculate incidence rates of onychomycosis in the years 2001–2017. The prescription of oral and topical anti‐fungal drugs to patients with onychomycosis was reviewed.

Results

THIN data showed an onychomycosis incidence rate of about 50 per 100,000. More males than females (52% vs. 48%), and more people aged 50–59 years had received treatment for onychomycosis. Oral terbinafine was the most commonly prescribed drug, followed by topical amorolfine, although terbinafine was used more commonly by men and amorolfine by women. Patients with onychomycosis were also prescribed other antifungals, including itraconazole, griseofulvin, tioconazole, ketoconazole shampoo, fluconazole and clotrimazole. A greater proportion of women, compared to men, were prescribed fluconazole.

Conclusions

Onychomycosis treatment in primary care in the UK is broadly in concordance with national guidelines.

Optimizing the Interlayer Spacing of Heteroatom-Doped Carbon Nanofibers toward Ultrahigh Potassium-Storage Performances

Precise control over the interlayer spacing for K⁺ intercalation is an effective approach to boost the potassium-storage performances in carbonaceous materials. Herein, we first found that the optimal interlayer spacing for K⁺ intercalation is around 0.38 nm for N, O codoped carbon nanofibers (NOCNs), displaying a reversible capacity of 627 mAh g^-1 at 0.1 A g^-1 after 200 cycles, excellent rate capability (123 mAh g^-1 at 20 A g^-1), and ultrastable cycling stability (262 mAh g^-1 at 5 A g^-1 after 10 000 cycles). Such good potassium-storage performances have never been reported in carbonaceous materials. The theoretical calculations and electrochemical studies reveal that the optimal interlayer spacing and N, O heteroatom-induced active sites work together to provide an intercalation-adsorption mechanism for storing K⁺ in carbonaceous materials. This work facilitates the understanding of the role of the critical interlayer spacing for K⁺ intercalation in carbonaceous materials.

Externally-induced shear waves in the right ventricular free wall throughout the cardiac cycle

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): 1. NWO STW/Dutch Heart foundation 2. NWO Vidi TTW

Background

The right ventricular (RV) size and function have prognostic value, not only in right heart conditions (pulmonary hypertension, congenital heart disease), but also in left ventricular (LV) disease states. There is currently no noninvasive method for measuring the elastic properties of the RV walls. Increased RV diastolic stiffness however, as determined invasively, is linked to adverse prognosis in pulmonary arterial hypertension. In the LV, new high frame rate (HFR) echocardiography applications have been used in order to determine the propagation speed of naturally-occurring or externally-induced shear waves (SW) in the septum, which is related to myocardial stiffness.

Purpose

We show for the first time that SWs in the RV free wall (RVFW) can be externally induced and imaged transthoracically with ultrasound.

Methods

SW imaging was performed using a linear array with a programmable research ultrasound system, aimed at the parasternal long-axis view of a 5-weeks-old Yorkshire-Landrace pig (Fig. 1a). SWs were induced by a high intensity focused beam (f0 = 4.5 MHz) on the RVFW (Fig. 1a). This push beam generates a downwards force at the focus, which induces SWs that propagate left and right from the focus along the RVFW, visible on tissue Doppler images (TDI) shown in Figure 1b-c. SW propagation was imaged (f0 = 5.2 MHz) using HFR ultrasound (Fig. 1b, frame rate = 3 kHz). Three acquisitions of 1 second were performed, where 14 SWs were sequentially induced during each acquisition. ECG signal was captured simultaneously and synchronized offline. SW speeds were estimated using a custom, semi-automatic pipeline that includes TDI calculation, and SW speed estimation along a manually traced spline on the RVFW. This was repeated two times to include variability due to the manual processes. Up to four SW speed estimates were made after each push beam. SW speed estimation was repeated for all push pulses throughout the cardiac cycle, and the mean and standard deviation of the estimates were plotted (Fig. 2).

Results

At least 85% of the waves were tracked successfully for all acquisitions. Diastole and systole were identified using the ECG signal (Fig. 2a). The average SW speed was 0.6 ± 0.1 m/s at end-diastole (Fig. 2b). The measured speeds ranged from 0.5 ± 0.1 m/s during diastole to 1.9 ± 0.3 m/s during systole. The changes in SW speeds correspond to the expected variation in muscle stiffness during the heart cycle as the RV relaxes and contracts.

Conclusions

We demonstrate for the first time the induction and tracking of shear waves in the RVFW of a closed-chest pig. The possibility to noninvasively quantify RV wall stiffness opens a large field of translational research, with direct applications in pulmonary hypertension, congenital heart disease and heart failure in general. Pathological increase in stiffness should be further investigated in longitudinal case/control studies. Abstract Figure. Fig1: Induction and tracking of RV SW  Abstract Figure. Fig2: SW speeds during cardiac cycle

Unidirectional single-mode lasing realization and temperature-induced mode switching in asymmetric GaN coupled cavities

Effective lasing mode control and unidirectional coupling of semiconductor microlasers are vital to boost their applications in optical interconnects, on-chip communication, and bio-sensors. In this study, symmetric and asymmetric GaN floating microdisks and coupled cavities are designed based on the Vernier effect and then fabricated via electron beam lithography, dry-etching of GaN, and isotropic wet-etching of silicon (Si) support. The lasing properties, including model number, threshold, radiation direction, and mode switching method, are studied. Compared to its symmetrical structure, both experimental and simulated optical field distributions indicate that the lasing outgoing direction can be controlled with a vertebral angle on the disk. The whispering gallery mode (WGM) lasing of the structures, with a quasi-single-mode lasing at 374.36 nm, a dual-mode lasing at 372.36 nm, and 373.64 nm at coupled cavities, are obtained statically. More interestingly, a switching between dual-mode and single-mode can be achieved dynamically via a thermal-induced mode shifting.