The extended lipid panel assay: a clinically-deployed high-throughput nuclear magnetic resonance method for the simultaneous measurement of lipids and Apolipoprotein B.

BACKGROUND: Standard lipid panel assays employing chemical/enzymatic methods measure total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C), from which are calculated estimates of low-density lipoprotein cholesterol (LDL-C). These lipid measures are used universally to guide management of atherosclerotic cardiovascular disease risk. Apolipoprotein B (apoB) is generally acknowledged to be superior to LDL-C for lipid-lowering therapeutic decision-making, but apoB immunoassays are performed relatively infrequently due to the added analytic cost. The aim of this study was to develop and validate the performance of a rapid, high-throughput, reagent-less assay producing an "Extended Lipid Panel" (ELP) that includes apoB, using the Vantera® nuclear magnetic resonance (NMR) analyzer platform already deployed clinically for lipoprotein particle and other testing. METHODS: Partial least squares regression models, using as input a defined region of proton NMR spectra of plasma or serum, were created to simultaneously quantify TC, TG, HDL-C, and apoB. Large training sets (n > ~ 1000) of patient sera analyzed independently for lipids and apoB by chemical methods were employed to ensure prediction models reflect the wide lipid compositional diversity of the population. The analytical performance of the NMR ELP assay was comprehensively evaluated. RESULTS: Excellent agreement was demonstrated between chemically-measured and ELP assay values of TC, TG, HDL-C and apoB with correlation coefficients ranging from 0.980 to 0.997. Within-run precision studies measured using low, medium, and high level serum pools gave coefficients of variation for the 4 analytes ranging from 1.0 to 3.8% for the low, 1.0 to 1.7% for the medium, and 0.9 to 1.3% for the high pools. Corresponding values for within-lab precision over 20 days were 1.4 to 3.6%, 1.2 to 2.3%, and 1.0 to 1.9%, respectively. Independent testing at three sites over 5 days produced highly consistent assay results. No major interference was observed from 38 endogenous or exogenous substances tested. CONCLUSIONS: Extensive assay performance evaluations validate that the NMR ELP assay is efficient, robust, and substantially equivalent to standard chemistry assays for the clinical measurement of lipids and apoB. Routine reporting of apoB alongside standard lipid measures could facilitate more widespread utilization of apoB for clinical decision-making.

Detecting Intracranial Hemorrhage Using Automatic Tube Current Modulation With Advanced Modeled Iterative Reconstruction in Unenhanced Head Single- and Dual-Energy Dual-Source CT.

OBJECTIVE: The purpose of our study was to determine diagnostic accuracy, image quality, and radiation dose of low-dose single- and dual-energy unenhanced third-generation dual-source head CT for detection of intracranial hemorrhage (ICH). MATERIALS AND METHODS: A total of 123 patients with suspected ICH were examined using a dual-source 192-MDCT scanner. Standard-dose 120-kVp single-energy CT (SECT; n = 36) and 80-kVp and 150-kVp dual-energy CT (DECT; n = 30) images were compared with low-dose SECT (n = 32) and DECT (n = 25) images obtained using automated tube current modulation (ATCM). Advanced modeled iterative reconstruction (ADMIRE) was used for all protocols. Detection of ICH was performed by three readers who were blinded to the image acquisition parameters of each image series. Image quality was assessed both quantitatively and qualitatively. Interobserver agreement was calculated using the Fleiss kappa. Radiation dose was measured as dose-length product (DLP). RESULTS: Detection of ICH was excellent (sensitivity, 94.9-100%; specificity, 94.7-100%) in all protocols (p = 1.00) with perfect interobserver agreement (0.83-0.96). Qualitative ratings showed significantly better ratings for both standard-dose protocols regarding gray matter-to-white matter contrast (p ≤ 0.014), whereas highest gray matter-to-white matter contrast-to-noise ratio was observed with low-dose DECT images (p ≥ 0.057). The lowest posterior fossa artifact index was measured for standard-dose DECT, which showed significantly lower values compared with low-dose protocols (p ≤ 0.034). Delineation of ventricular margins and sharpness of subarachnoidal spaces were rated excellent in all protocols (p ≥ 0.096). Low-dose techniques lowered radiation dose by 26% for SECT images (DLP, 575.0 ± 72.3 mGy · cm vs 771.5 ± 146.8 mGy · cm; p < 0.001) and by 24% in DECT images (DLP, 587.0 ± 103.2 mGy · cm vs 770.6 ± 90.2 mGy · cm; p < 0.001). No significant difference was observed between the low-dose protocols (p = 1.00). CONCLUSION: Low-dose unenhanced head SECT and DECT using ATCM and ADMIRE provide excellent diagnostic accuracy for detection of ICH with good quantitative and qualitative image quality in third-generation dual-source CT while allowing significant radiation dose reduction.

One-dimensional supramolecular surface structures: 1,4-diisocyanobenzene on Au(111) surfaces.

One-dimensional supramolecular structures formed by adsorbing low coverages of 1,4-diisocyanobenzene on Au(111) at room temperature are obtained and imaged by scanning tunneling microscopy (STM) under ultrahigh vacuum (UHV) conditions. The structures originate from step edges or surface defects and arrange predominantly in a straight fashion on the substrate terraces along the <110> directions. They are proposed to consist of alternating units of 1,4-diisocyanobenzene molecules and gold atoms with a unit cell in registry with the substrate corresponding to four times the lattice interatomic distance. Their long 1-D chains and high thermal stability offer the potential to use them as conductors in nanoelectronic applications.

High Betaine, a Trimethylamine N-Oxide Related Metabolite, Is Prospectively Associated with Low Future Risk of Type 2 Diabetes Mellitus in the PREVEND Study.

BACKGROUND: Gut microbiota-related metabolites, trimethylamine-N-oxide (TMAO), choline, and betaine, have been shown to be associated with cardiovascular disease (CVD) risk. Moreover, lower plasma betaine concentrations have been reported in subjects with type 2 diabetes mellitus (T2DM). However, few studies have explored the association of betaine with incident T2DM, especially in the general population. The goals of this study were to evaluate the performance of a newly developed betaine assay and to prospectively explore the potential clinical associations of betaine and future risk of T2DM in a large population-based cohort. METHODS: We developed a high-throughput, nuclear magnetic resonance (NMR) spectroscopy procedure for acquiring spectra that allow for the accurate quantification of plasma/serum betaine and TMAO. Assay performance for betaine quantification was assessed and Cox proportional hazards regression was employed to evaluate the association of betaine with incident T2DM in 4336 participants in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study. RESULTS: Betaine assay results were linear (y = 1.02X - 3.75) over a wide range of concentrations (26.0-1135 µM). The limit of blank (LOB), limit of detection (LOD) and limit of quantitation (LOQ) were 6.4, 8.9, and 13.2 µM, respectively. Coefficients of variation for intra- and inter-assay precision ranged from 1.5-4.3% and 2.5-5.5%, respectively. Deming regression analysis of results produced by NMR and liquid chromatography coupled to tandem mass spectrometry(LC-MS/MS) revealed an R2 value of 0.94 (Y = 1.08x - 1.89) and a small bias for higher values by NMR. The reference interval, in a cohort of apparently healthy adult participants (n = 501), was determined to be 23.8 to 74.7 µM (mean of 42.9 ± 12.6 µM). In the PREVEND study (n = 4336, excluding subjects with T2DM at baseline), higher betaine was associated with older age and lower body mass index, total cholesterol, triglycerides, and hsCRP. During a median follow-up of 7.3 (interquartile range (IQR), 5.9-7.7) years, 224 new T2DM cases were ascertained. Cox proportional hazards regression models revealed that the highest tertile of betaine was associated with a lower incidence of T2DM. Hazard ratio (HR) for the crude model was 0.61 (95% CI: 0.44-0.85, p = 0.004). The association remained significant even after adjusting for multiple clinical covariates and T2DM risk factors, including fasting glucose. HR for the fully-adjusted model was 0.50 (95% CI: 0.32-0.80, p = 0.003). CONCLUSIONS: The newly developed NMR-based betaine assay exhibits performance characteristics that are consistent with usage in the clinical laboratory. Betaine levels may be useful for assessing the risk of future T2DM.

NMR quantification of trimethylamine-N-oxide in human serum and plasma in the clinical laboratory setting.

BACKGROUND AND OBJECTIVES: Trimethylamine-N-oxide (TMAO) produced by gut microbiota metabolism of dietary choline and carnitine has been shown to be associated with increased risk of cardiovascular disease (CVD) and to provide incremental clinical prognostic utility beyond traditional risk factors for assessing a patient's CVD risk. The aim of this study was to develop an automated nuclear magnetic resonance (NMR) spectroscopy assay for quantification of TMAO concentration in serum and plasma using a high-throughput NMR clinical analyzer. METHODS: Key steps in assay development included: (i) shifting the TMAO analyte peak to a less crowded region of the spectrum with a pH buffer/reagent, (ii) attenuating the broad protein background signal in the spectrum and (iii) using a non-negative least squares algorithm for peak deconvolution. Assay performance was evaluated according to Clinical and Laboratory Standards Institute guidelines. A method comparison study was performed to compare TMAO concentrations quantified by NMR and mass spectrometry (MS). RESULTS: The within-run and within-lab imprecision ranged from 4.3 to 14.5%. Under the acquisition method employed, the NMR assay had a limit of blank, detection and quantitation of 1.6, 3.0 and 3.3µM, respectively. Linearity was demonstrated within the reportable range of 3.3 to 3000µM. TMAO measurements using the NMR assay, which involves minimal sample preparation, compared well with values obtained with the MS-based assay (R2=0.98). CONCLUSIONS: The NMR based assay provides a simple and accurate measurement of circulating TMAO levels amenable to the high-throughput demands of the clinical chemistry laboratory. Moreover, assay performance enables the levels of TMAO to be quantified in serum or plasma at clinically actionable concentrations for the assessment of cardiovascular disease risks and individualized dietary monitoring.

Enantiospecific Formation of Trans 1,3-Disubstituted Tetrahydro-beta-carbolines by the Pictet-Spengler Reaction and Conversion of Cis Diastereomers into Their Trans Counterparts by Scission of the C-1/N-2 Bond.

The factors which effect the stereoselective formation of trans-1-alkyl-2-benzyl-3-(alkoxycarbonyl)-1,2,3,4-tetrahydro-beta-carbolines and trans-3-(alkoxycarbonyl)-1-alkyl-2-(diphenylmethyl)-1,2,3,4-tetrahydro-beta-carbolines by the Pictet-Spengler cyclization were examined by heating tryptophan derivatives with aldehydes of varied steric bulk under aprotic and acidic conditions, followed by determination of the ratio of cis to trans diastereomers so formed. The presence of a benzyl group at the N(b)-nitrogen atom alters the diastereochemical outcome of this condensation to provide 100% trans stereoselectivity when the cyclization is carried out with cyclohexanecarboxaldehyde. Furthermore, when N(b)-(diphenylmethyl)tryptophan isopropyl ester was condensed with aldehydes of any size, trans diastereomers are formed with 100% stereoselectively. The trans N(b)-substituted diastereomers are thermodynamically more stable than their cis congeners as shown by equilibration experiments in TFA. Conversion of the cis diastereomers into the more stable trans diastereomers is believed to occur under acidic conditions by cleavage of the carbon (C-1)-nitrogen (N-2) bond with complete retention of configuration at the C-3 stereocenter. Evidence from deuterium exchange experiments as well as optical rotations support this model for epimerization. In addition, when cis diastereomer 66a was allowed to stir in CF(3)COOD, the trans isomer 66b was isolated in 90% yield, while treatment of cis 66a with CF(3)COOH/NaBH(4) provided a mixture of the ring cleaved [scission across C(1)-N(2) bond] product 67 and the trans isomer 66b. Treatment of 66b (control experiment) with NaBH(4)/CF(3)COOH under the same conditions returned only starting trans 66b in excellent yield. The Pictet-Spengler reaction of substrates with sufficiently large substituents, followed by treatment with acid, permits the 100% enantiospecific formation of trans-1,3-disubstituted-1,2,3,4-tetrahydro-beta-carbolines for alkaloid total synthesis.

Bis(1,2-bis(diphenylphosphino)ethane)tungsten(0) Complexes Containing Electron-Saturated Metal Centers and Singly-Coordinated Bridging Ligands.

Reaction of 1,4-diisocyanobenzene or 4-isocyanobenzonitrile with trans-W(N(2))(2)(DPPE)(2) (DPPE = 1,2-bis(diphenylphosphino)ethane) produced cis-WL(2)(DPPE)(2), where L = 1,4-diisocyanobenzene or 4-isocyanobenzonitrile. cis-(CNC(6)H(4)NC)(2)W(DPPE)(2) crystallizes in the triclinic space group P&onemacr;, with a = 12.848(3) Å, b = 13.596(3) Å, c = 19.072(3) Å, alpha = 78.99(2) degrees, beta = 70.66(2) degrees, gamma = 65.26(2) degrees, V = 2849.8(11) Å(3), and Z = 2. cis-(NCC(6)H(4)NC)(2)W(DPPE)(2) crystallizes in the triclinic space group P&onemacr;, with a = 12.712(3) Å, b = 13.700(3) Å, c = 19.109(3) Å, alpha = 77.91(2) degrees, beta = 70.63(2) degrees, gamma = 64.76(2) degrees, V = 2830.7(13) Å(3), and Z = 2. Both compounds possess a distorted octahedral geometry about the metal center, with the two isocyanide ligands cis to one another. The isocyanide ligands are substantially bent along the CNC axis of the isocyanide group coordinated to tungsten. For the complex containing the symmetric ligand, CNC(6)H(4)NC, the mean CNC angle for the coordinated end of the isocyanide is 139.1(11) degrees, the average W-C bond length is 1.86(1) Å, and the C&tbd1;N bond lengths have a mean value of 1.30(2) Å. These data indicate substantial back-donation from an electron-saturated tungsten atom. This is supported spectroscopically, with substantial shifts to lower wavenumbers for the C-N stretching frequencies of the coordinated isocyanide groups. Similar trends are observed in cis-(NCC(6)H(4)NC)(2)W(DPPE)(2). Both compounds contain electron-rich metals surrounded by large ligands which apparently protect the metals from atmospheric oxidation. The isocyanide ligands in both complexes contain a second coordinating group pointing away from the metal into the environment surrounding the molecules, providing the potential for polymetallic complexes containing metals in a variety of oxidation states.

Determination of Adsorbate Structures from 1,4-Phenylene Diisocyanide on Gold.

The structure of the 1-D oligomer chains that form on a Au(111) surface following adsorption of 1,4-phenylene diisocyanide (PDI) is explored using reflection-absorption infrared spectroscopy and scanning tunneling microscopy (STM). The experimental work is complemented by first-principles density functional theory calculations, which indicate that the previously proposed gold-PDI oligomer chains in which the PDI molecule bridged gold adatoms are thermodynamically stable. In addition, the calculated vibrational modes for this structure are in excellent agreement with the experimental infrared data. The linkage of the PDI units by gold adatoms is confirmed by comparing STM images collected as a function of tip bias with images for the calculated structure by the Bardeen method.

Linking gold nanoparticles with conductive 1,4-phenylene diisocyanide-gold oligomers.

It is demonstrated that 1,4-phenylene diisocyanide (PDI)-gold oligomers can spontaneously bridge between gold nanoparticles on mica, thereby providing a strategy for electrically interconnecting nanoelectrodes. The barrier height of the bridging oligomer is 0.10 ± 0.02 eV, within the range of previous single-molecule measurements of PDI.

Tetranuclear group 7/8 mixed-metal and open trinuclear group 7 metal carbonyl clusters bearing bridging 2-mercapto-1-methylimidazole ligands.

The reactivity of group 7 metal dinuclear carbonyl complexes [M(2)(CO)(6)(mu-SN(2)C(4)H(5))(2)] (1, M = Re; 2, M = Mn) toward group 8 metal trinuclear carbonyl clusters were examined. Reactions of 1 and 2 with [Os(3)(CO)(10)(NCMe)(2)] in refluxing benzene furnished the tetranuclear mixed-metal clusters [Os(3)Re(CO)(13)(mu(3)-SN(2)C(4)H(5))] (3) and [Os(3)Mn(CO)(13)(mu(3)-SN(2)C(4)H(5))] (4), respectively. Similar treatment of 1 and 2 with Ru(3)(CO)(12) yielded the ruthenium analogs [Ru(3)Re(CO)(13)(mu(3)-SN(2)C(4)H(5))] (5), and [Ru(3)Mn(CO)(13)(mu(3)-SN(2)C(4)H(5))] (6), but in the case of 2 a secondary product [Mn(3)(CO)(10)(mu-Cl)(mu(3)-SN(2)C(4)H(5))(2)] (7) was also formed. Compounds have a butterfly core of four metal atoms with the M (Mn or Re) at a wingtip of the butterfly and containing a noncrystallographic mirror plane of symmetry. This result provides a potential method for the synthesis of a series of new group 7/8 mixed metal complexes containing a bifunctional heterocyclic ligand. Compound 7 is a unique example of a 54-electron trimanganese complex having bridging 2-mercapto-1-methylimidazolate and chloride ligands. Interestingly, the reaction of 1 with Fe(3)(CO)(12) at 70-75 degrees C furnished the tri- and dirhenium complexes [Re(3)(CO)(10)(mu-H)(mu(3)-SN(2)C(4)H(5))(2)] (8) and [Re(2)(CO)(6)(N(2)C(4)H(5))(mu-SN(2)C(4)H(5))(2)] (9), respectively instead of the expected formation of the mixed-metal clusters. The former is an interesting example of a 52-electron trirhenium-hydridic complex containing bridging 2-mercapto-1-methylimidazolate ligand, while the latter can be viewed as a 1-methylimidazole adduct of 1 . No mixed Fe-Re complexes were produced in this reaction. The molecular structures of the new compounds and were established by single-crystal X-ray diffraction analyses and the DFT studies of compounds , and are reported.

The surprisingly elusive crystal structure of sodium metabisulfite.

The crystal structure of Na2S2O5, a simple and common ionic compound, is reported here for the first time. The crystals form non-merohedral twins, with the twin domains related by a twofold axis which bisects the angle between the a and c axes of each unit cell. The structure was determined from a single-crystal fragment of a twinned crystal that had undergone cleavage along the twin boundary. In addition to the problems associated with twinning, space-group determination proved difficult as well, with the structure initially determined in the P2(1) space group appearing to be disordered with two rotational conformers of the metabisulfite ion occupying equivalent sites in the lattice. An analysis at low temperature provided new weak reflections which were inconsistent with the original unit cell, but indexed to the correct unit cell, allowing for space group and crystal structure determination. The apparent structure, which appeared disordered in P2(1), seems to have resulted from an apparently fortuitous superposition of two conformationally inequivalent S2O5(2-) anions in the asymmetric unit of the correct structure in the P2(1)/n space group. The metabisulfite ions in this structure do not adopt the C(s) geometry observed in previously determined crystal structures containing S2O5(2-). The structures of both ions in the asymmetric unit are effectively conformational mirror images of one another with two of the O atoms on each S atom in the ion approaching an eclipsed geometry. This observation provides further evidence that the structures of sulfur-oxy anions in the solid state are dictated mainly by interionic coulombic forces rather than by intraionic bonding interactions