First Order Alignment Transition in an Interfaced Active Nematic Fluid.

We investigate experimentally the dynamic phase transition of a two-dimensional active nematic layer interfaced with a passive liquid crystal. Under a temperature ramp that leads to the transition of the passive liquid into a highly anisotropic lamellar smectic-A phase, and in the presence of a magnetic field, the coupled active nematic reorganizes its flow and orientational patterns from the turbulent into a quasilaminar regime aligned perpendicularly to the field. Remarkably, while the phase transition of the passive fluid is known to be continuous, or second order, our observations reveal intermittent dynamics of the order parameter and the coexistence of aligned and turbulent regions in the active nematic, a signature of discontinuous, or first order, phase transitions, similar to what is known to occur in relation to flocking in dry active matter. Our results suggest that alignment transitions in active systems are intrinsically discontinuous, regardless of the symmetry and momentum-damping mechanisms.

Traveling fronts in vibrated polar disks: At the crossroad between polar ordering and jamming.

We investigate experimentally the collective motion of polar vibrated disks in an annular geometry, varying both the packing fraction and the amplitude of the angular noise. For low enough noise and large enough density, an overall collective motion takes place along the tangential direction. The spatial organization of the flow reveals the presence of polar bands of large density, as expected from the commonly accepted picture of the transition to collective motion in systems of aligning polar active particles. However, in our case, the low density phase is also polar, consistent with what is observed when jamming takes place in a very high density flock. Interestingly, while in that case the particles in the high density bands are arrested, resulting in an upstream propagation at a constant speed, in our case the bands travel downstream with a density-dependent speed. We demonstrate from local measurements of the packing fraction, alignment, and flow speeds that the bands observed here result both from a polar ordering process and a motility induced phase separation mechanism.

Central carbon metabolism exhibits unique characteristics during the handling of fungal patterns by monocyte-derived dendritic cells.

Monocyte-derived dendritic cells (MDDCs) are key players in the defense against fungal infection because of their outstanding capacity for non-opsonic phagocytosis and phenotypic plasticity. Accordingly, MDDCs rewire metabolism to meet the energetic demands for microbial killing and biomass synthesis required to restore homeostasis. It has been commonplace considering the metabolic reprogramming a mimicry of the Warburg effect observed in tumor cells. However, this may be an oversimplification since the offshoots of glycolysis and the tricarboxylic acid (TCA) cycle are connected in central carbon metabolism. Zymosan, the external wall of Saccharomyces cerevisiae, contains ß-glucan and α-mannan chains that engage the C-type lectin receptors dectin-1/2 and Toll-like receptors. This makes it an optimal fungal surrogate for experimental research. Using real-time bioenergetic assays and [U-13C]glucose labeling, central hubs connected to cytokine expression were identified. The pentose phosphate pathway (PPP) exhibited a more relevant capacity to yield ribose-5-phosphate than reducing equivalents of NADPH, as judged from the high levels of isotopologues showing 13C-labeling in the ribose moiety and the limited contribution of the oxidative arm of the PPP to the production of ROS by NADPH oxidases (NOX). The finding of 13C-label in the purine ring and in glutathione unveiled the contribution of serine-derived glycine to purine ring and glutathione synthesis. Serine synthesis also supported the TCA cycle. Zymosan exhausted NAD+ and ATP, consistent with intracellular consumption and/or extracellular export. Poly-ADP-ribosylated proteins detected in the nuclear fractions of MDDCs did not show major changes upon zymosan stimulation, which suggests its dependence on constitutive Fe(II)/2-oxoglutarate-dependent demethylation of 5-methylcytosine by TET translocases and/or demethylation of histone H3 lysine 27 by JMJD demethylases rather than on NOX activities. These results disclose a unique pattern of central carbon metabolism following fungal challenge, characterized by the leverage of glycolysis offshoots and an extensive recycling of NAD+ and poly(ADP-ribose).

Active many-particle systems and the emergent behavior of dense ant collectives.

This article discusses recent work with fire ants,Solenopisis invicta, to illustrate the use of the framework of active matter as a base to rationalize their complex collective behavior. We review much of the work that physicists have done on the group dynamics of these ants, and compare their behavior to two minimal models of active matter, and to the behavior of the synthetic systems that have served to test and drive these models.

The IRE1α-XBP1 arm of the unfolded protein response is a host factor activated in SARS-CoV-2 infection.

SARS-CoV-2 infection can cause severe pneumonia, wherein exacerbated inflammation plays a major role. This is reminiscent of the process commonly termed cytokine storm, a condition dependent on a disproportionated production of cytokines. This state involves the activation of the innate immune response by viral patterns and coincides with the biosynthesis of the biomass required for viral replication, which may overwhelm the capacity of the endoplasmic reticulum and drive the unfolded protein response (UPR). The UPR is a signal transduction pathway composed of three branches that is initiated by a set of sensors: inositol-requiring protein 1 (IRE1), protein kinase RNA-like ER kinase (PERK), and activating transcription factor 6 (ATF6). These sensors control adaptive processes, including the transcriptional regulation of proinflammatory cytokines. Based on this background, the role of the UPR in SARS-CoV-2 replication and the ensuing inflammatory response was investigated using in vivo and in vitro models of infection. Mice and Syrian hamsters infected with SARS-CoV-2 showed a sole activation of the Ire1α-Xbp1 arm of the UPR associated with a robust production of proinflammatory cytokines. Human lung epithelial cells showed the dependence of viral replication on the expression of UPR-target proteins branching on the IRE1α-XBP1 arm and to a lower extent on the PERK route. Likewise, activation of the IRE1α-XBP1 branch by Spike (S) proteins from different variants of concern was a uniform finding. These results show that the IRE1α-XBP1 system enhances viral replication and cytokine expression and may represent a potential therapeutic target in SARS-CoV-2 severe pneumonia.

Collective chemomechanical oscillations in active hydrogels.

We report on the collective response of an assembly of chemomechanical Belousov-Zhabotinsky (BZ) hydrogel beads. We first demonstrate that a single isolated spherical BZ hydrogel bead with a radius below a critical value does not oscillate, whereas an assembly of the same BZ hydrogel beads presents chemical oscillation. A BZ chemical model with an additional flux of chemicals out of the BZ hydrogel captures the experimentally observed transition from oxidized nonoscillating to oscillating BZ hydrogels and shows this transition is due to a flux of inhibitors out of the BZ hydrogel. The model also captures the role of neighboring BZ hydrogel beads in decreasing the critical size for an assembly of BZ hydrogel beads to oscillate. We finally leverage the quorum sensing behavior of the collective to trigger their chemomechanical oscillation and discuss how this collective effect can be used to enhance the oscillatory strain of these active BZ hydrogels. These findings could help guide the eventual fabrication of a swarm of autonomous, communicating, and motile hydrogels.

Innate IRE1α-XBP1 activation by viral single-stranded RNA and its influence on lung cytokine production during SARS-CoV-2 pneumonia.

The utilization of host-cell machinery during SARS-CoV-2 infection can overwhelm the protein-folding capacity of the endoplasmic reticulum and activate the unfolded protein response (UPR). The IRE1α-XBP1 arm of the UPR could also be activated by viral RNA via Toll-like receptors. Based on these premises, a study to gain insight into the pathogenesis of COVID-19 disease was conducted using nasopharyngeal exudates and bronchioloalveolar aspirates. The presence of the mRNA of spliced XBP1 and a high expression of cytokine mRNAs were observed during active infection. TLR8 mRNA showed an overwhelming expression in comparison with TLR7 mRNA in bronchioloalveolar aspirates of COVID-19 patients, thus suggesting the presence of monocytes and monocyte-derived dendritic cells (MDDCs). In vitro experiments in MDDCs activated with ssRNA40, a synthetic mimic of SARS-CoV-2 RNA, showed induction of XBP1 splicing and the expression of proinflammatory cytokines. These responses were blunted by the IRE1α inhibitor MKC8866, the TLR8 antagonist CU-CPT9a, and knockdown of TLR8 receptor. In contrast, the IRE1α-XBP1 activator IXA4 enhanced these responses. Based on these findings, the TLR8/IRE1α system seems to play a significant role in the induction of the proinflammatory cytokines associated with severe COVID-19 disease and might be a druggable target to control cytokine storm.

Poly(N-isopropylacrylamide) microgel swelling behavior and suspension structure studied with small-angle neutron scattering.

Microgels are of high interest for applications and as model systems due to their volume response to external stimuli. We use small-angle neutron scattering to measure the form and structure factors of poly(N-isopropylacrylamide) microgels in dilute and concentrated suspensions and find that microgels keep a constant size up to a concentration, above which they deswell. This happens before random-close packing. We emphasize suspension polydispersity must be considered to obtain accurate form and structure factors. Our results are compatible with microgel deswelling triggered by the osmotic pressure set by counterions associated to charged groups in the microgel periphery, which sharply increases when the counterion clouds surrounding the microgels percolate throughout the suspension volume.

Measuring the counterion cloud of soft microgels using SANS with contrast variation.

The behavior of microgels and other soft, compressible colloids depends on particle concentration in ways that are absent in their hard-particulate counterparts. For instance, poly-N-isopropylacrylamide (pNIPAM) microgels can spontaneously deswell and reduce suspension polydispersity when concentrated enough. Despite the pNIPAM network in these microgels is neutral, the key to understanding this distinct behavior relies on the existence of peripheric charged groups, responsible for providing colloidal stability when deswollen, and the associated counterion cloud. When in close proximity, clouds of different particles overlap, effectively freeing the associated counterions, which are then able to exert an osmotic pressure that can potentially cause the microgels to decrease their size. Up to now, however, no direct measurement of such an ionic cloud exists, perhaps even also for hard colloids, where it is referred to as an electric double layer. Here, we use small-angle neutron scattering with contrast variation with different ions to isolate the change in the form factor directly related to the counterion cloud, and obtain its radius and width. Our results highlight that the modeling of microgel suspensions must unavoidably and explicitly consider the presence of this cloud, which exists for nearly all microgels synthesized today.

Physically informed data-driven modeling of active nematics.

A continuum description is essential for understanding a variety of collective phenomena in active matter. However, building quantitative continuum models of active matter from first principles can be extremely challenging due to both the gaps in our knowledge and the complicated structure of nonlinear interactions. Here, we use a physically informed data-driven approach to construct a complete mathematical model of an active nematic from experimental data describing kinesin-driven microtubule bundles confined to an oil-water interface. We find that the structure of the model is similar to the Leslie-Ericksen and Beris-Edwards models, but there are appreciable and important differences. Rather unexpectedly, elastic effects are found to play no role in the experiments considered, with the dynamics controlled entirely by the balance between active stresses and friction stresses.

Descripción de actividad asistencial en las Unidades de Hospitalización a Domicilio de Osakidetza – Servicio Vasco de Salud / Description of care activity in the Hospital at Home Units of Osakidetza - Servicio Vasco de Salud (Basque Health Service)

Introducción: Las Unidades de Hospitalización a Domicilio (HaD) presentan diferencias en su contenido y condiciones de asistencia. La Sociedad Vasca de HaD inició en 2018 un proyecto de investigación para definir indicadores que permitan comparar la actividad de equipos que tienen contenidos asistenciales diferentes. Una fase del proyecto implicó el registro de características de los episodios atendidos y la atención prestada. Dar a conocer el resultado del registro es de interés.Método: Entre 1 y 31 de mayo de 2021, 9 Uni-dades registraron ciertas características de los pacientes atendidos, así como tipo, frecuencia y duración de las visitas realizadas. Se muestran los descriptivos de estas variables en la serie global y en cada Unidad.Resultados: Se analizaron 1171 episodios y 8363 visitas en 14458 estancias. (82% de es-tancias reales). De media, en laborable se vi-sitó al 65% de los pacientes y en no laborable al 42%. El porcentaje de casos en cada tipo clínico varió según Unidades: patología aguda entre 12 y 48%; cuidados paliativos entre 20% y 40%; patología quirúrgica entre 2.3 y 30 %. Se apreciaron también diferencias en edad, sexo y dispersión geográfica. Mortalidad y reenvío al hospital variaron entre Unidades y también entre patologías. La duración de la atención direc-ta varió entre Unidades entre 24,4 y 35.9 min, y la del desplazamiento para cada visita entre 11.9 y 25 min, en probable relación con el tipo de patología y la dispersión geográfica respectivamente.Conclusiones: Se constata que existen diferencias en el contenido y condiciones de trabajo de las distintas Unidades de H a D. Es necesario analizar cómo influyen en las medidas de actividad y de resultado para disponer de indicadores ajustados. (AU)

Introduction: Hospitalization at Home (HaH) Units present differences in their content and conditions of care. The Basque HaH Society initiated a research project in 2018 to define useful indicators to compare the activity of teams with different care content. One phase of the project involved recording characteristics of episodes attended and care provided. It is of interest to disclose the results of the registry. Method: Between May 1 and May 31, 2021, 9 Units recorded certain characteristics of the patients seen, as well as type, frequency and duration of visits performed. Descriptive data on these variables are shown for the overall series and for each unit. Results: 1171 episodes and 8363 visits in 14458 stays were analysed (82% of actual stays). On average, 65% of patients received a visit during working days and 42% during non-working days. The percentage of cases in each clinical type varied according to Units: acute pathology between 12 and 48%; palliative care between 20% and 40%; surgical pathology between 2.3 and 30%. There were also differences in age, sex and geographical dispersion. Mortality and hospital referral varied between Units and also between pathologies. The duration of direct care varied between Units from 24.4 to 35.9 min, and the duration of travel for each visit from 11.9 to 25 min, probably related to the type of pathology and geographical dispersion, respectively. Conclusions: There are indeed differences in the content and working conditions of the different HaH Units. It is necessary to analyse how much they influence the activity and outcome measures in order to have adjusted indicators. (AU)

Long term phase separation dynamics in liquid crystal-enriched microdroplets obtained from binary fluid mixtures.

The dynamics of long term phase separation in binary liquid mixtures remains a subject of fundamental interest. Here, we study a binary liquid mixture, where the minority phase is confined to a liquid crystal (LC)-rich droplet, by investigating the evolution of size, defect and mesogen alignment over time. We track the binary liquid mixture evolving towards equilibrium by visualising the configuration of the liquid crystal droplet through polarisation microscopy. We compare our experimental findings with computational simulations and elucidate differences between bulk phases and confined droplets based on the respective thermodynamics of phase separation. Our work provides insights on how phase transitions on the microscale can deviate from bulk phase diagrams with relevance to other material systems, such as the liquid-liquid phase separation of polymer and protein solutions.

Ant waves-Spontaneous activity waves in fire-ant columns.

Active matter, which includes crowds of organisms, is composed of constituents that independently consume and dissipate energy. Some active matter systems have been shown to sustain the propagation of various types of waves, resulting from the interplay between density and alignment. Here, we examine a type of solitary wave in dense two-dimensional columns of Solenopsis invicta, fire ants, in which the local activity, density and alignment all play a key role. We demonstrate that these waves are nonlinear and that they are composed of aligned ants that are constrained at the top by the time it takes disordered ants to activate and align and at the bottom by a density minimum enforced by gravity. Our results suggest that intrinsically switchable activity can be a productive framework to understand and trigger a broad range of wave-like behaviors, including stampedes in crowds and herds.

Social interactions lead to motility-induced phase separation in fire ants.

Collections of fire ants are a form of active matter, as the ants use their internal metabolism to self-propel. In the absence of aligning interactions, theory and simulations predict that active matter with spatially dependent motility can undergo motility-induced phase separation. However, so far in experiments, the motility effects that drive this process have come from either crowding or an external parameter. Though fire ants are social insects that communicate and cooperate in nontrivial ways, we show that the effect of their interactions can also be understood within the framework of motility-induced phase separation. In this context, the slowing down of ants when they approach each other results in an effective attraction that can lead to space-filling clusters and an eventual formation of dynamical heterogeneities. These results illustrate that motility-induced phase separation can provide a unifying framework to rationalize the behavior of a wide variety of active matter systems.

Safety and efficacy of ribociclib plus letrozole in patients with HR+, HER2- advanced breast cancer: Results from the Spanish sub-population of the phase 3b CompLEEment-1 trial.

BACKGROUND: Breast cancer is the most common malignancy and the second leading cause of cancer-related mortality in Spanish women. Ribociclib in combination with endocrine therapy (ET) has shown superiority in prolonging survival in patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) vs. ET alone. METHODS: CompLEEment-1 is a single-arm, open-label phase 3b trial evaluating ribociclib plus letrozole in a broad population of patients with HR+, HER2- ABC. The primary endpoints were safety and tolerability. Here we report data for Spanish patients enrolled in CompLEEment-1. RESULTS: A total of 526 patients were evaluated (median follow-up: 26.97 months). Baseline characteristics showed a diverse population with a median age of 54 years. At study entry, 56.5% of patients had visceral metastases and 8.7% had received prior chemotherapy for advanced disease. Rates of all-grade and Grade ≥3 adverse events (AEs) were 99.0% and 76.2%, respectively; 21.3% of patients experienced a serious AE, and 15.8% of AEs led to treatment discontinuation. AEs of special interest of neutropenia, increased alanine aminotransferase, increased aspartate aminotransferase and QTcF prolongation occurred in 77.8%, 14.8%, 11.4% and 4.0% of patients, respectively. Patients aged >70 years experienced increased rates of all-grade and Grade ≥3 neutropenia and anemia. Efficacy results were consistent with the global study. CONCLUSIONS: Results from Spanish patients enrolled in CompLEEment-1 are consistent with global data showing efficacy and a manageable safety profile for ribociclib plus letrozole treatment in patients with HR+, HER2- ABC, including populations of interest (NCT02941926). TRIAL REGISTRATION: ClinicalTrials.gov NCT02941926.

The role of PAF in immunopathology: From immediate hypersensitivity reactions to fungal defense.

Platelet-activating factor (PAF, 1-alkyl-2-acetyl-sn-glycero-3-phosphorylcholine) was discovered when the mechanisms involved in the deposition of immune complex in tissues were being scrutinized in the experimental model of rabbit serum sickness. The initial adscription of PAF to IgE-dependent anaphylaxis was soon extended after disclosing its release from phagocytes stimulated by calcium mobilizing agents, formylated peptides, and phagocytosable particles. This explains why ongoing research in the field turned to the analysis of immune cell types and stimuli involved in PAF production with the purpose of establishing its role in pathology. This was spurred by the identification of the chemical structure of PAF and the enzymic mechanisms involved in its biosynthesis and degradation, which showed commonalities with those involved in eicosanoid production and the Lands' cycle of phospholipid fatty acid remodeling. The reassignment of PAF function in immunopathology is explained by the finding that the most robust mechanisms leading to PAF production are associated with opsonic and non-opsonic phagocytosis, depending on the cell type. While polymorphonuclear leukocytes exhibit opsonic phagocytosis, monocyte-derived dendritic cells show a marked preference for non-opsonic phagocytosis associated with C-type lectin receptors. This is particularly relevant to the defense against fungal invasion and explains why PAF exerts an autocrine feed-forwarding mechanism required for the selective expression of some cytokines.

Janssen effect in columns of fire ants.

We study fire-ant columns, an active version of passive granular columns, and find that, despite the inherent activity of the ants and their natural tendency to rearrange, the ants develop force-chain structures that help support the weight of the column. Hence, the apparent mass at the bottom of the column saturates with added mass in a Janssen-like fashion, reminiscent of what is seen in passive-grain columns in wide containers. Activity-induced rearrangements within the column, however, lead to changes in the force-chain structure that slightly reduce the supportive nature of the force-chains over time and to fluctuations in the pressure at the bottom of the column that scale like the law of large numbers. We capture the experimental results in simulations that include not only friction with the walls, but also a fluctuating force that introduces activity and that effectively affects the force-chain structure of the ant collective.

Onset and window of SARS-CoV-2 infectiousness and temporal correlation with symptom onset: a prospective, longitudinal, community cohort study.

BACKGROUND: Knowledge of the window of SARS-CoV-2 infectiousness is crucial in developing policies to curb transmission. Mathematical modelling based on scarce empirical evidence and key assumptions has driven isolation and testing policy, but real-world data are needed. We aimed to characterise infectiousness across the full course of infection in a real-world community setting. METHODS: The Assessment of Transmission and Contagiousness of COVID-19 in Contacts (ATACCC) study was a UK prospective, longitudinal, community cohort of contacts of newly diagnosed, PCR-confirmed SARS-CoV-2 index cases. Household and non-household exposed contacts aged 5 years or older were eligible for recruitment if they could provide informed consent and agree to self-swabbing of the upper respiratory tract. The primary objective was to define the window of SARS-CoV-2 infectiousness and its temporal correlation with symptom onset. We quantified viral RNA load by RT-PCR and infectious viral shedding by enumerating cultivable virus daily across the course of infection. Participants completed a daily diary to track the emergence of symptoms. Outcomes were assessed with empirical data and a phenomenological Bayesian hierarchical model. FINDINGS: Between Sept 13, 2020, and March 31, 2021, we enrolled 393 contacts from 327 households (the SARS-CoV-2 pre-alpha and alpha variant waves); and between May 24, 2021, and Oct 28, 2021, we enrolled 345 contacts from 215 households (the delta variant wave). 173 of these 738 contacts were PCR positive for more than one timepoint, 57 of which were at the start of infection and comprised the final study population. The onset and end of infectious viral shedding were captured in 42 cases and the median duration of infectiousness was 5 (IQR 3-7) days. Although 24 (63%) of 38 cases had PCR-detectable virus before symptom onset, only seven (20%) of 35 shed infectious virus presymptomatically. Symptom onset was a median of 3 days before both peak viral RNA and peak infectious viral load (viral RNA IQR 3-5 days, n=38; plaque-forming units IQR 3-6 days, n=35). Notably, 22 (65%) of 34 cases and eight (24%) of 34 cases continued to shed infectious virus 5 days and 7 days post-symptom onset, respectively (survival probabilities 67% and 35%). Correlation of lateral flow device (LFD) results with infectious viral shedding was poor during the viral growth phase (sensitivity 67% [95% CI 59-75]), but high during the decline phase (92% [86-96]). Infectious virus kinetic modelling suggested that the initial rate of viral replication determines the course of infection and infectiousness. INTERPRETATION: Less than a quarter of COVID-19 cases shed infectious virus before symptom onset; under a crude 5-day self-isolation period from symptom onset, two-thirds of cases released into the community would still be infectious, but with reduced infectious viral shedding. Our findings support a role for LFDs to safely accelerate deisolation but not for early diagnosis, unless used daily. These high-resolution, community-based data provide evidence to inform infection control guidance. FUNDING: National Institute for Health and Care Research.

Resolving the different bulk moduli within individual soft nanogels using small-angle neutron scattering.

The bulk modulus, K, quantifies the elastic response of an object to an isotropic compression. For soft compressible colloids, knowing K is essential to accurately predict the suspension response to crowding. Most colloids have complex architectures characterized by different softness, which additionally depends on compression. Here, we determine the different values of K for the various morphological parts of individual nanogels and probe the changes of K with compression. Our method uses a partially deuterated polymer, which exerts the required isotropic stress, and small-angle neutron scattering with contrast matching to determine the form factor of the particles without any scattering contribution from the polymer. We show a clear difference in softness, compressibility, and evolution of K between the shell of the nanogel and the rest of the particle, depending on the amount of cross-linker used in their synthesis.

Fungal Patterns Induce Cytokine Expression through Fluxes of Metabolic Intermediates That Support Glycolysis and Oxidative Phosphorylation.

Cytokine expression is fine-tuned by metabolic intermediates, which makes research on immunometabolism suitable to yield drugs with a wider prospect of application than the biological therapies that block proinflammatory cytokines. Switch from oxidative phosphorylation (OXPHOS) to glycolysis has been considered a characteristic feature of activated immune cells. However, some stimuli might enhance both routes concomitantly. The connection between the tricarboxylic acid cycle and cytokine expression was scrutinized in human monocyte-derived dendritic cells stimulated with the fungal surrogate zymosan. Results showed that nucleocytosolic citrate and ATP-citrate lyase activity drove IL1B, IL10, and IL23A expression by yielding acetyl-CoA and oxaloacetate, with the latter one supporting glycolysis and OXPHOS by maintaining cytosolic NAD+ and mitochondrial NADH levels through mitochondrial shuttles. Succinate dehydrogenase showed a subunit-specific ability to modulate IL23A and IL10 expression. Succinate dehydrogenase A subunit activity supported cytokine expression through the control of the 2-oxoglutarate/succinate ratio, whereas C and D subunits underpinned cytokine expression by conveying electron flux from complex II to complex III of the electron transport chain. Fatty acids may also fuel the tricarboxylic acid cycle and influence cytokine expression. Overall, these results show that fungal patterns support cytokine expression through a strong boost of glycolysis and OXPHOS supported by the use of pyruvate, citrate, and succinate, along with the compartmentalized NAD(H) redox state maintained by mitochondrial shuttles.