Incident heart failure in chronic kidney disease: proteomics informs biology and risk stratification.

BACKGROUND AND AIMS: Incident heart failure (HF) among individuals with chronic kidney disease (CKD) incurs hospitalizations that burden patients and health care systems. There are few preventative therapies, and the Pooled Cohort equations to Prevent Heart Failure (PCP-HF) perform poorly in the setting of CKD. New drug targets and better risk stratification are urgently needed. METHODS: In this analysis of incident HF, SomaScan V4.0 (4638 proteins) was analysed in 2906 participants of the Chronic Renal Insufficiency Cohort (CRIC) with validation in the Atherosclerosis Risk in Communities (ARIC) study. The primary outcome was 14-year incident HF (390 events); secondary outcomes included 4-year HF (183 events), HF with reduced ejection fraction (137 events), and HF with preserved ejection fraction (165 events). Mendelian randomization and Gene Ontology were applied to examine causality and pathways. The performance of novel multi-protein risk models was compared to the PCP-HF risk score. RESULTS: Over 200 proteins were associated with incident HF after adjustment for estimated glomerular filtration rate at P < 1 × 10-5. After adjustment for covariates including N-terminal pro-B-type natriuretic peptide, 17 proteins remained associated at P < 1 × 10-5. Mendelian randomization associations were found for six proteins, of which four are druggable targets: FCG2B, IGFBP3, CAH6, and ASGR1. For the primary outcome, the C-statistic (95% confidence interval [CI]) for the 48-protein model in CRIC was 0.790 (0.735, 0.844) vs. 0.703 (0.644, 0.762) for the PCP-HF model (P = .001). C-statistic (95% CI) for the protein model in ARIC was 0.747 (0.707, 0.787). CONCLUSIONS: Large-scale proteomics reveal novel circulating protein biomarkers and potential mediators of HF in CKD. Proteomic risk models improve upon the PCP-HF risk score in this population.

Fitting the Cox proportional hazards model to big data.

The semiparametric Cox proportional hazards model, together with the partial likelihood principle, has been widely used to study the effects of potentially time-dependent covariates on a possibly censored event time. We propose a computationally efficient method for fitting the Cox model to big data involving millions of study subjects. Specifically, we perform maximum partial likelihood estimation on a small subset of the whole data and improve the initial estimator by incorporating the remaining data through one-step estimation with estimated efficient score functions. We show that the final estimator has the same asymptotic distribution as the conventional maximum partial likelihood estimator using the whole dataset but requires only a small fraction of computation time. We demonstrate the usefulness of the proposed method through extensive simulation studies and an application to the UK Biobank data.

Evaluating treatment efficacy in hospitalized COVID-19 patients, with applications to Adaptive COVID-19 Treatment Trials.

BACKGROUND: The current endpoints for therapeutic trials of hospitalized COVID-19 patients capture only part of the clinical course of a patient and have limited statistical power and robustness. METHODS: We specify proportional odds models for repeated measures of clinical status, with a common odds ratio of lower severity over time. We also specify the proportional hazards model for time to each level of improvement or deterioration of clinical status, with a common hazard ratio for overall treatment benefit. We apply these methods to Adaptive COVID-19 Treatment Trials. RESULTS: For remdesivir versus placebo, the common odds ratio was 1.48 (95% confidence interval (CI) = 1.23-1.79; p < 0.001), and the common hazard ratio was 1.27 (95% CI = 1.09-1.47; p = 0.002). For baricitinib plus remdesivir versus remdesivir alone, the common odds ratio was 1.32 (95% CI = 1.10-1.57; p = 0.002), and the common hazard ratio was 1.30 (95% CI = 1.13-1.49; p < 0.001). For interferon beta-1a plus remdesivir versus remdesivir alone, the common odds ratio was 0.95 (95% CI = 0.79-1.14; p = 0.56), and the common hazard ratio was 0.98 (95% CI = 0.85-1.12; p = 0.74). CONCLUSIONS: The proposed methods comprehensively characterize the treatment effects on the entire clinical course of a hospitalized COVID-19 patient.

Betaine Alleviates High-Fat Diet Induced Excessive Lipid Deposition in Gibel Carp Hepatopancreas and L8824 Cells by Enhancing VLDL Secretion through HNF4α/MTTP Pathway.

Betaine, a methyl donor, plays a crucial role in lipid metabolism. Previous studies have shown that appropriate betaine supplementation in a high-fat diet reduces triglycerides (TG) of serum and hepatopancreas in fish. However, the underlying mechanism remains unclear. This study examined whether betaine can enhance the secretion of very low-density lipoprotein (VLDL) and sought to identify the specific mechanisms through which this enhancement occurs. A lipid accumulation model was established in gibel carp and L8824 cells using a high-fat diet and oleic acid, respectively. Different doses of betaine (1, 4, and 16 g/kg in the diet; 400 µmol in cell culture) were administered, and measurements were taken for lipid deposition, gene expression of HNF4α, MTTP, and ApoB, as well as the regulation of Mttp and Apob promoters by HNF4α. The results showed that betaine supplementation mitigated lipid droplet accumulation, TG levels, and VLDL production induced by the high-fat diet in gibel carp hepatopancreas and L8824 cells. Moreover, betaine not only increased VLDL content in the cell culture supernatant but also reversed the inhibitory effects of the high-fat diet on protein expression of MTTP, ApoB, and HNF4α in both gibel carp hepatopancreas and L8824 cells. Additionally, HNF4α exhibits transactivating activity on the promoter of Mttp in gibel carp. These findings suggest that betaine supplementation exerts its effects through the HNF4α/MTTP/ApoB pathway, promoting the assembly and secretion of VLDL and effectively reducing lipid accumulation in the hepatopancreas of farmed gibel carp fed a high-fat diet.

Migration and transformation of Pb, Cu, and Zn during co-combustion of high-chlorine-alkaline coal and Si/Al dominated coal.

Shaerhu (SEH) coal is abundant in Xinjiang, China. The utilization of SEH suffers from severe ash deposition, slagging, and fouling problems due to its high-chlorine-alkaline characteristics. The co-combustion of high-alkaline coal and other type coals containing high Si/Al oxides has been proven to be a simple and effective method that will alleviate ash-related problems, but the risk of heavy metals (HMs) contamination in this process is nonnegligible. Hence, the volatilization rates and chemical speciation of Pb, Cu, and Zn in co-combusting SEH and a high Si/Al oxides coal, i.e., Yuanbaoshan (YBS) coal were investigated in this study. The results showed that the addition of SEH increased the volatilization rates of Pb, Cu, and Zn during the co-combustion at 800°C from 23.70%, 23.97%, and 34.98% to 82.31%, 30.01%, and 44.03%, respectively, and promoted the extractable state of Cu and Zn. In addition, the interaction between SEH and YBS inhibited the formation of the Pb residue state. SEM-EDS mapping results showed that compared to Zn and Cu, the signal intensity of Pb was extremely weak in regions where some of the Si and Al signal distributions overlap. The DFT results indicated that the O atoms of the metakaolin (Al2O3⋅2SiO2) (001) surface were better bound to the Zn and Cu than Pb atoms after adsorption of the chlorinated HMs. These results contribute to a better understanding of the effects of high-alkaline coal blending combustion on Pb, Cu, and Zn migration and transformation.

Ultrahigh sensitive and rapid-response self-powered flexible pressure sensor based on sandwiched piezoelectric composites.

Flexible sensors and actuators are the basis for realizing the Internet of Everything. This study identifies specific interfacial polarization and filler dispersion challenges in flexible sensors. A novel sandwich-structured flexible sensor with polydimethylsiloxane (PDMS)-filled Nb2CTx as the interlayer and poly(vinylidene fluoride-trifluoroethylene) [P(VDF-TrFE)]-filled barium titanate (BTO) as the upper and lower layers was designed and fabricated. The thickness of the interlayer was optimized to be 6.2 µm, resulting in an ultrahigh sensitivity of 16.05 V/N and ultrashort response time of 626 µs. The interlayer achieved an oriented arrangement of the dipoles in the upper and lower piezoelectric films through interfacial polarization, enhancing the piezoelectric output and sensitivity. The proposed mechanism was confirmed by the dielectric properties, local piezoelectric response, cross-sectional potential simulation, and interfacial electrical calculations. Additionally, the sensor effectively distinguishes various body movements, facial micro-expressions, and throat vibrations during vocalization, and can be applied to ultrahigh-sensitive self-powered flexible piezoelectric pressure sensors.

Characterization of dissolved organic matter in rivers impacted by acid mine drainage: Components and complexation with metals.

Dissolved organic matter (DOM), a ubiquitous and active ingredient, is extensively involved in the transformation and migration of environmental pollutants in aquatic ecosystems. However, its chemical composition in acid mine drainage (AMD)-impacted rivers remains poorly characterized, hindering our understanding of its role in the biogeochemistry of key elements in contaminated fluvial environments. Here, we investigated the concentration of dissolved organic carbon (DOC) and spectroscopic and molecular characteristics of DOM in a headwater river contaminated with polymetallic mine-derived AMD in southern China. Terrestrial humic-like (C1) and typically groundwater-supplied aromatic protein/tyrosine-like (C2) substances which were partially from AMD, were identified as the predominant fluorescent components in the river water. Notably, tryptophan-like (C3) substances originating from tailings pond spills were only occasionally detected in the river. Although DOM biogeochemical transformations and degradation occurred in the lateral soil-water riparian interface and longitudinal in-stream transport processes, the molecular compositions identified by FT-ICR MS showed a core set of molecular formulae in the lignin/saturated compound/tannin region of the van Krevelen diagram of the water samples across the rivers. The complexation of DOM with typical metals in AMD was investigated using fluorescence quenching experiments. The results showed that the highest binding ability of Fe(III) to C2 followed by C1, with both detected in the experimental water samples. Mg(II) and Ca(II) strengthened the binding of DOM-Fe(III) when the ferric/DOM ratio was low, while Cu(II) weakened the binding of DOM-Fe(III) due to competition. Ca(II) inhibited the binding of Fe(III) to C1 but promoted the binding of the complex to C2 when both Cu(II) and Mg(II) were present. Since DOM-Fe(III) complexation was associated with the cotransport of AMD-derived metals/metalloids in diverse aqueous environments with multiple co-existing ions (typically Ca(II) input for remediation), our study on the composition of DOM and its complexation with metals can contribute to managing and remediating AMD-impacted rivers.

Antimony(V) behavior during the Fe(II)-induced transformation of Sb(V)-bearing natural multicomponent secondary iron mineral under acidic conditions.

Fe(II)-induced phase transformations of secondary iron minerals have attracted considerable attention due to their influence on antimony (Sb) mobility. However, Fe(II)-induced natural multicomponent secondary iron mineral (nmSIM) transformations and the corresponding repartitioning of Sb on nmSIM under acidic conditions upon Fe(II) exposure have not been systematically examined. Herein, we investigated the effect of Fe(II) on nmSIM mineralogy and Sb mobility in Sb(V)-bearing nmSIM at pH 3.8 and 5.6 at various Fe(II) concentrations over 15 d. The Sb(V)-bearing nmSIM phase transformation occurred under both strongly and weakly acidic conditions without Fe(II) exposure, while the presence of Fe(II) significantly intensified the transformation, and substantial amounts of intermediary minerals, including jarosite, ferrihydrite, lepidocrocite and fougerite, formed during the initial reaction stage, especially at pH 5.6. X-ray diffraction (XRD) analyses confirmed that goethite and hematite were the primary final-stage transformation products of Sb(V)-bearing nmSIM, regardless of Fe(II) exposure. Throughout the Sb(V)-bearing nmSIM transformation at pH 3.8, Sb release was inversely related to the Fe(II) concentration in the initial stage, and after maximum release was achieved, Sb was gradually repartitioned onto the nmSIM. No Sb repartitioning occurred in the absence of Fe(II) at pH 5.6, but the introduction of Fe(II) suppressed Sb release and improved Sb repartitioning on nmSIM. This transformation was conducive to Sb reimmobilization on Sb(V)-bearing nmSIM due to the structural incorporation of Sb into the highly crystalline goethite and hematite generated by the Sb(V)-bearing nmSIM transformation, and no reduction of Sb(V) occurred. These results imply that Fe(II) can trigger mineralogical changes in Sb(V)-bearing nmSIM and have important impacts on Sb partitioning under acidic conditions. These new insights are essential for assessing the mobility and availability of Sb in acid mine drainage areas.

Novel process for organic wastewater treatment using aerobic composting technology: Shifting from pollutant removal towards resource recovery.

In this study, an organic wastewater treatment process based on aerobic composting technology was developed in order to explore the transition of wastewater treatment from pollutants removal to resource recovery. The novelty of the process focuses towards the microbial metabolic heat that is often ignored during the composting, and taking advantage of this heat for wastewater evaporation to achieve zero-discharge treatment. Meanwhile, this process can retain the wastewater's nutrients in the composting substrate to realize the recovery of resources. This study determined the optimum condition for the process (initial water content of 50 %, C/N ratio of 25:1, ventilation rate of 3 m3/h), and 69.9 % of the total heat generated by composting was used for wastewater treatment under the condition. The HA/FA ratio of composting substrate increased from 0.07 to 0.53 after wastewater treatment, and the retention ratio of TOC and TN was 52.3 % and 61.7 %, respectively, which proved the high recycling value of the composting products. Thermoduric and thermophilic bacteria accounted for 44.3 % of the community structure at the maturation stage, which played a pivotal role in both pollutant removal and resource recovery.

MXene Hollow Spheres Supported by a C-Co Exoskeleton Grow MWCNTs for Efficient Microwave Absorption.

High-performance microwave absorption (MA) materials must be studied immediately since electromagnetic pollution has become a problem that cannot be disregarded. A straightforward composite material, comprising hollow MXene spheres loaded with C-Co frameworks, was prepared to develop multiwalled carbon nanotubes (MWCNTs). A high impedance and suitable morphology were guaranteed by the C-Co exoskeleton, the attenuation ability was provided by the MWCNTs endoskeleton, and the material performance was greatly enhanced by the layered core-shell structure. When the thickness was only 2.04 mm, the effective absorption bandwidth was 5.67 GHz, and the minimum reflection loss (RLmin) was - 70.70 dB. At a thickness of 1.861 mm, the sample calcined at 700 °C had a RLmin of - 63.25 dB. All samples performed well with a reduced filler ratio of 15 wt%. This paper provides a method for making lightweight core-shell composite MA materials with magnetoelectric synergy.

Schlafen 11 triggers innate immune responses through its ribonuclease activity upon detection of single-stranded DNA.

Nucleic acids are major structures detected by the innate immune system. Although intracellular single-stranded DNA (ssDNA) accumulates during pathogen infection or disease, it remains unclear whether and how intracellular ssDNA stimulates the innate immune system. Here, we report that intracellular ssDNA triggers cytokine expression and cell death in a CGT motif-dependent manner. We identified Schlafen 11 (SLFN11) as an ssDNA-activated RNase, which is essential for the innate immune responses induced by intracellular ssDNA and adeno-associated virus infection. We found that SLFN11 directly binds ssDNA containing CGT motifs through its carboxyl-terminal domain, translocates to the cytoplasm upon ssDNA recognition, and triggers innate immune responses through its amino-terminal ribonuclease activity that cleaves transfer RNA (tRNA). Mice deficient in Slfn9, a mouse homolog of SLFN11, exhibited resistance to CGT ssDNA-induced inflammation, acute hepatitis, and septic shock. This study identifies CGT ssDNA and SLFN11/9 as a class of immunostimulatory nucleic acids and pattern recognition receptors, respectively, and conceptually couples DNA immune sensing to controlled RNase activation and tRNA cleavage.

Efficacy of infliximab, abatacept, and cenicriviroc for the treatment of adults hospitalized with COVID-19 pneumonia.

A randomized, double-blind, placebo-controlled clinical trial was conducted to investigate the efficacy of infliximab, abatacept, and cenicriviroc in treating patients hospitalized with COVID-19. The patient's clinical status was assessed daily on an 8-point ordinal scale. We evaluated the totality of evidence on the efficacy of the 3 immunomodulators by considering all possible changes in the clinical status of each patient over time. We demonstrated that infliximab accelerated improvement and reduced deterioration of clinical status when added to standard of care. There was also evidence for the benefit of abatacept. There was no evidence for the benefit of cenicriviroc.

Self-assembly and dynamic exchange of cuboctahedral metal-organic cages.

Due to their unique physical and chemical properties, metal-organic cage structures have great potential for applications in various fields. However, current studies have mainly focused on highly symmetric structures assembled from single metal ions and organic ligands, limiting their diversity and complexity, and there are still relatively few studies on the dynamic formation process of metal-organic cages. Herein, we constructed a series of metal-organic cages with different sizes assembled from the highly-stable coordination of 2,2':6',2''-terpyridine-based tetratopic ligands and various metals ions such as Zn, Cu, Co and Fe. Furthermore, the intermolecular exchange process between the metal-organic cages was explored through the dynamic exchange of ligands, and the formation of a series of hybrid supramolecular nanocages together with their final tendency to form a predominant structure of M24L14L28 was observed. In addition, the binding of metal-organic cages with 5,10,15,20-tetrakis(3,4,5-trimethoxyphenyl) porphyrin-Zn was also investigated. This study not only expands the complexity and diversity of metal-organic cages, but also provides a new perspective for studying the dynamic behaviour of metal-organic cages.

Enhancing homology-directed repair efficiency with HDR-boosting modular ssDNA donor.

Despite the potential of small molecules and recombinant proteins to enhance the efficiency of homology-directed repair (HDR), single-stranded DNA (ssDNA) donors, as currently designed and chemically modified, remain suboptimal for precise gene editing. Here, we screen the biased ssDNA binding sequences of DNA repair-related proteins and engineer RAD51-preferred sequences into HDR-boosting modules for ssDNA donors. Donors with these modules exhibit an augmented affinity for RAD51, thereby enhancing HDR efficiency across various genomic loci and cell types when cooperated with Cas9, nCas9, and Cas12a. By combining with an inhibitor of non-homologous end joining (NHEJ) or the HDRobust strategy, these modular ssDNA donors achieve up to 90.03% (median 74.81%) HDR efficiency. The HDR-boosting modules targeting an endogenous protein enable a chemical modification-free strategy to improve the efficacy of ssDNA donors for precise gene editing.