Publications by authors named "Jiang He"

896 Publications

Modulating Tri-mode Emission for Single-component White Organic Afterglow.

Angew Chem Int Ed Engl 2021 Sep 15. Epub 2021 Sep 15.

IAM: Nanjing University of Posts and Telecommunications Institute of Advanced Materials, Materials Science and Engineering, CHINA.

Achieving single-component white organic afterglow remains a great challenge owing to the difficulties in simultaneously supporting long-lived emissions from varied excited states of a molecule for complementary afterglow. Here, an extraordinary tri-mode emission from the radiative decays of singlet (S 1 ), triplet (T 1 ) and stabilized triplet (T 1 * ) excited states was proposed to afford white afterglow through modulating the singlet-triplet splitting energy (Δ E ST ) and exciton trapping depth ( E TD ). Low-lying T 1 * for yellow afterglow was constructed by H-aggregation engineering with large E TD and trace isomer doping, while high-lying T 1 and S 1 for blue afterglow with thermally activated emission feature was realized by reducing Δ E ST through donor-acceptor molecular design. Therefore, the single-component white afterglow with high efficiency of 14.1% and lifetime of 0.61 s was achieved by rationally regulating the afterglow intensity ratios of complementary emissions from S 1 , T 1 and T 1 * .
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http://dx.doi.org/10.1002/anie.202109229DOI Listing
September 2021

Cost-effectiveness of a Multicomponent Intervention for Hypertension Control in Low-Income Settings in Argentina.

JAMA Netw Open 2021 Sep 1;4(9):e2122559. Epub 2021 Sep 1.

Department of Health Policy and Management, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.

Importance: Hypertension is highly prevalent in low- and middle-income countries, and it is an important preventable risk factor for cardiovascular diseases (CVDs). Understanding the economic benefits of a hypertension control program is valuable to decision-makers.

Objective: To evaluate the long-term cost-effectiveness of a multicomponent hypertension management program compared with usual care among patients with hypertension receiving care in public clinics in Argentina from a health care system perspective.

Design, Setting, And Participants: This economic evaluation used a Markov model to estimate the cost-effectiveness of a hypertension management program among adult patients with uncontrolled hypertension in a low-income setting. Patient-level data (743 individuals for multicomponent intervention; 689 for usual care) from the Hypertension Control Program in Argentina trial (HCPIA) were used to estimate treatment effects and the risk of CVD. Three health states were included in each strategy: (1) low risk of CVD, (2) high risk of CVD, and (3) death. The total time horizon was the lifetime, and each cycle lasted 6 months.

Main Outcomes And Measures: Model inputs were based on trial data and other published sources. Cost and utilities were discounted at a rate of 5% annually. The incremental cost-effectiveness ratio (ICER) between the multicomponent intervention and usual care was calculated using the difference in costs in 2017 international dollars (INT $) divided by the difference in effectiveness in quality-adjusted life-years (QALYs). One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the uncertainty and robustness of the results.

Results: In the original trial, the 743 participants in the intervention group (349 [47.0%] men) had a mean (SD) age of 56.2 (12.0) years, and the 689 participants in the control group (311 [45.1%] men) had a mean (SD) age of 56.2 (11.7) years. In the base-case analysis, the HCPIA program yielded 8.42 discounted QALYs and accrued INT $3096 discounted costs, while usual care yielded 8.29 discounted QALYs and accrued INT $2473 discounted costs. The ICER for the HCPIA program was INT $4907/QALY gained. The model results remained robust in sensitivity analyses, and the model was most sensitive to parameters of program costs.

Conclusions And Relevance: In this study, the HCPIA multicomponent intervention vs usual care was a cost-effective strategy to improve hypertension management and reduce the risk of associated CVD among patients with hypertension who received services at public clinics in Argentina. This intervention program is likely transferable to other settings in Argentina or other lower- and middle-income countries.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.22559DOI Listing
September 2021

Association between annual household income and adverse outcomes in patients who had ischaemic stroke.

J Epidemiol Community Health 2021 Sep 7. Epub 2021 Sep 7.

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.

Background And Purpose: The association between annual household income and prognosis of ischaemic stroke remains debatable. We aimed to prospectively investigate the relationship between annual household income and prognosis at 3 months after ischaemic stroke.

Methods: We included 3975 participants from the China Antihypertensive Trial in Acute Ischemic Stroke. All participants were categorised into three groups according to annual household income per capita: <¥10 000 (Chinese Yuan Renminbi (RMB)), ¥10 000-19 999 and ≥¥20 000. The primary outcome was a composite outcome of death and major disability (modified Rankin Scale score ≥3) at 3 months after stroke onset, and secondary outcomes included major disability, death, and vascular events. A meta-analysis was conducted to incorporate the results of the current study and previous studies on the association of income level with outcomes after stroke.

Results: Within 3 months after ischaemic stroke, 1002 participants (25.20%) experienced primary outcome (880 major disabilities and 122 deaths). After multivariate adjustment, low annual household income level was associated with increased risk of the primary outcome (OR 1.60; 95% CI: 1.12 to 2.31; P=0.034) when two extreme groups were compared. The meta-analysis confirmed the significant association between income level and death or major disability after stroke (pooled relative risk for lowest vs highest income level, 1.31 (95% CI: 1.18 to 1.45)).

Conclusions: Low annual household income per capita was significantly associated with increased risks of adverse clinical outcomes at 3 months after ischaemic stroke, independently of established risk factors. Further studies from other samples are needed to replicate our findings due to a reason for excluding some patients who had a severe stroke in this study.

Trial Registration Number: ClinicalTrials.gov (http://wwwclinicaltrialsgov) Registry (NCT01840072).
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http://dx.doi.org/10.1136/jech-2021-216481DOI Listing
September 2021

Learning From Negative Links.

Authors:
He Jiang Haibo He

IEEE Trans Cybern 2021 Sep 6;PP. Epub 2021 Sep 6.

Recently, graph convolutional networks (GCNs) and their variants have achieved remarkable successes for the graph-based semisupervised node classification problem. With a GCN, node features are locally smoothed based on the information aggregated from their neighborhoods defined by the graph topology. In most of the existing methods, the graph typologies only contain positive links which are deemed as descriptions for the feature similarity of connected nodes. In this article, we develop a novel GCN-based learning framework that improves the node representation inference capability by including negative links in a graph. Negative links in our method define the inverse correlations for the nodes connected by them and are adaptively generated through a neural-network-based generation model. To make the generated negative links beneficial for the classification performance, this negative link generation model is jointly optimized with the GCN used for class inference through our designed training algorithm. Experiment results show that the proposed learning framework achieves better or matched performance compared to the current state-of-the-art methods on several standard benchmark datasets.
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http://dx.doi.org/10.1109/TCYB.2021.3104246DOI Listing
September 2021

Hypertension in Guatemala's Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework.

BMC Health Serv Res 2021 Sep 3;21(1):908. Epub 2021 Sep 3.

INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala.

Background: Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted a needs assessment to define short- and long-term needs and opportunities for hypertension services within the public health system.

Methods: We conducted a multi-method, multi-level assessment of needs related to hypertension within Guatemala's public system using the World Health Organization's health system building blocks framework. We conducted semi-structured interviews with stakeholders at national (n = 17), departmental (n = 7), district (n = 25), and community (n = 30) levels and focus groups with patients (3) and frontline auxiliary nurses (3). We visited and captured data about infrastructure, accessibility, human resources, reporting, medications and supplies at 124 health posts and 53 health centers in five departments of Guatemala. We conducted a thematic analysis of transcribed interviews and focus group discussions supported by matrix analysis. We summarized quantitative data observed during visits to health posts and centers.

Results: Major challenges for hypertension service delivery included: gaps in infrastructure, insufficient staffing and high turnover, limited training, inconsistent supply of medications, lack of reporting, low prioritization of hypertension, and a low level of funding in the public health system overall. Key opportunities included: prior experience caring for patients with chronic conditions, eagerness from providers to learn, and interest from patients to be involved in managing their health. The 5 departments differ in population served per health facility, accessibility, and staffing. All but 7 health posts had basic infrastructure in place. Enalapril was available in 74% of health posts whereas hydrochlorothiazide was available in only 1 of the 124 health posts. With the exception of one department, over 90% of health posts had a blood pressure monitor.

Conclusions: This multi-level multi-method needs assessment using the building blocks framework highlights contextual factors in Guatemala's public health system that have been important in informing the implementation of a hypertension control trial. Long-term needs that are not addressed within the scope of this study will be important to address to enable sustained implementation and scale-up of the hypertension control approach.
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http://dx.doi.org/10.1186/s12913-021-06889-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8414027PMC
September 2021

Donor-Acceptor Competition via Halide Vacancy Filling for Oxygen Detection of High Sensitivity and Stability by All-Inorganic Perovskite Films.

Small 2021 Sep 3:e2102733. Epub 2021 Sep 3.

School of Physics, Sun Yat-sen University, Guangzhou, 510275, China.

Oxygen detection by organic-inorganic halide perovskites (OIHPs) has demonstrated advantages in operating temperature, response time, and reversibility over traditional materials. However, OIHPs can only sense O in light and the unavoidable O exposure during detection easily induces the degradation of OIHPs. The trade-off between sensitivity and stability makes the OIHP-based oxygen sensors impractical. By replacing organic groups with Cs, the compact films of all-inorganic halide perovskites (AIHPs) that can adsorb O at grain boundaries in dark are developed. AIHPs show conductance increase of 1875.5% from 1 × 10 to 700 Torr of O pressure, associated with full reversibility and long-term stability. Combining experiments and modeling, this work reveals the donor-acceptor competition via halide vacancy filling leading to the modulation of carrier concentration and mobility. This work offers understandings on oxygen sensing by perovskite materials and paves the way for further optimization of AIHPs as promising oxygen sensors with high sensitivity and stability.
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http://dx.doi.org/10.1002/smll.202102733DOI Listing
September 2021

Synthetic Circuit-Driven Expression of Heterologous Enzymes for Disease Detection.

ACS Synth Biol 2021 Aug 31. Epub 2021 Aug 31.

Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, United States.

The integration of nanotechnology and synthetic biology could lay the framework for new classes of engineered biosensors that produce amplified readouts of disease states. As a proof-of-concept demonstration of this vision, here we present an engineered gene circuit that, in response to cancer-associated transcriptional deregulation, expresses heterologous enzyme biomarkers whose activity can be measured by nanoparticle sensors that generate amplified detection readouts. Specifically, we designed an AND-gate gene circuit that integrates the activity of two ovarian cancer-specific synthetic promoters to drive the expression of a heterologous protein output, secreted Tobacco Etch Virus (TEV) protease, exclusively from within tumor cells. Nanoparticle probes were engineered to carry a TEV-specific peptide substrate in order to measure the activity of the circuit-generated enzyme to yield amplified detection signals measurable in the urine or blood. We applied our integrated sense-and-respond system in a mouse model of disseminated ovarian cancer, where we demonstrated measurement of circuit-specific TEV protease activity both using exogenously administered nanoparticle sensors and using quenched fluorescent probes. We envision that this work will lay the foundation for how synthetic biology and nanotechnology can be meaningfully integrated to achieve next-generation engineered biosensors.
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http://dx.doi.org/10.1021/acssynbio.1c00133DOI Listing
August 2021

Blood Pressure and Left Ventricular Geometric Changes: A Directionality Analysis.

Hypertension 2021 Aug 30:HYPERTENSIONAHA12118035. Epub 2021 Aug 30.

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (Y.Y., Y.G., C.F., L.B., J.H., W.C.).

This study assessed the temporal relationship of elevated blood pressure (BP) with left ventricular hypertrophy (LVH) and geometric changes in a longitudinal cohort of adults. Left ventricular mass index (LVMI), relative wall thickness (RWT), and BP were measured at 2 time points 4.1 to 14.9 years apart between 2000 and 2016 among 984 adults (677 White and 307 Black people; 41.1% men; age range, 24.2-56.7 years) in the Bogalusa Heart Study cohort. Cross-lagged path analysis models were used to examine the temporal relationship of BP with LVMI and RWT in subjects who did not take antihypertensive medications (n=693). The cross-lagged path coefficients did not differ significantly between race and sex groups. In the combined sample, the path coefficients from baseline systolic BP to follow-up LVMI/RWT were significantly greater than the path coefficients from baseline LVMI/RWT to follow-up systolic BP (0.111 versus -0.005 for LVMI, =0.010 for difference; 0.146 versus 0.004 for RWT, =0.002 for difference). Hypertensive subjects at baseline had a significantly higher incidence rate of concentric LVH at follow-up compared with normotensive subjects (19.4% versus 9.7%, <0.001 for difference), but incident eccentric LVH did not show such a difference between hypertensive and normotensive subjects (5.4% versus 4.4%, =0.503 for difference). Diastolic BP showed similar results to those of systolic BP. In conclusion, the findings on these one-directional paths provide strong and fresh evidence that elevated BP precedes the development of LVH, especially concentric LVH, during the young-to-midlife adult age period.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.121.18035DOI Listing
August 2021

Validation and comparison of prognostic scales in Chinese patients with ischemic stroke: a prospective study from CATIS.

Neurol Res 2021 Aug 25:1-8. Epub 2021 Aug 25.

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

Background: : Various tools are currently available to quantify the risks of adverse clinical outcomes after an ischemic stroke. This study aimed to validate and compare prognostic scales among Chinese patients with ischemic stroke.

Methods: : We compared three stroke prognostic scales (Stroke Prognostication using Age and the National Institutes of Health Stroke Scale-100 [SPAN-100], Totaled Health Risks in Vascular Events [THRIVE], and Acute Stroke Registry and Analysis of Lausanne [ASTRAL]) in 3870 Chinese patients with ischemic stroke from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The 2-year primary outcome was a combination of death and major disability (modified Rankin Scale score ≥3).

Results: : Among all the scales, the ASTRAL score had the best accuracy for predicting 2-year prognosis in Chinese patients with ischemic stroke. The C-statistic of the ASTRAL score for the 2-year primary outcome was 0.79 (95% confidence interval [CI]: 0.78-0.80), and the Hosmer-Lemeshow goodness-of-fit test showed that the ASTRAL score fitted Chinese patients with ischemic stroke well (χ = 9.83, = 0.277). The incidences of the primary outcome in the <5%, 5%-9.9%, 10%-19.9%, and ≥20% risk groups based on the ASTRAL scores were 3.93%, 7.55%, 14.29%, and 41.81%, respectively (odds ratio: 1.23; 95% CI: 1.21-1.26; < 0.001).

Conclusion: : The ASTRAL score had higher efficacy than the SPAN-100 and THRIVE scores in predicting 2-year adverse outcomes among Chinese patients with ischemic stroke, suggesting that it could be a valuable risk assessment tool for the 2-year prognosis of such patients.
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http://dx.doi.org/10.1080/01616412.2021.1959775DOI Listing
August 2021

Zeolite-Tailored Active Site Proximity for the Efficient Production of Pentanoic Biofuels.

Angew Chem Int Ed Engl 2021 Aug 19. Epub 2021 Aug 19.

Dalian Institute of Chemical Physics, State Key Laboratory of Catalysis, 457 Zhongshan Road, 116023, 116023, Dalian, CHINA.

Biofuel production can be a viable option for alleviating current heavy reliance on fossil resources and the related carbon dioxide emission issue. Hydrodeoxygenation refers collectively to a series of important biorefinery processes to produce biofuels. Here, we show that well-dispersed and ultra-small Ru metal nanoclusters (~ 1 nm), confined within the micropores of zeolite Y, provide the required active site intimacy, which significantly boosts the chemoselectivity towards the production of pentanoic biofuels in the direct, one-pot hydrodeoxygenation (HDO) of neat ethyl levulinate. Crucial for improving catalyst stability is the addition of La, which upholds the confined proximity by preventing zeolite lattice deconstruction during catalysis. Furthermore, we have established and extended an understanding of the 'intimacy criterion' in catalytic biomass valorization. These findings bring fundamental new understanding of HDO reactions over confined proximity sites, and may facilitate a new application potential for the practical production of pentanoic biofuels in biomass conversion.
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http://dx.doi.org/10.1002/anie.202108170DOI Listing
August 2021

Population sequencing data reveal a compendium of mutational processes in the human germ line.

Science 2021 08 12;373(6558):1030-1035. Epub 2021 Aug 12.

Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.

Biological mechanisms underlying human germline mutations remain largely unknown. We statistically decompose variation in the rate and spectra of mutations along the genome using volume-regularized nonnegative matrix factorization. The analysis of a sequencing dataset (TOPMed) reveals nine processes that explain the variation in mutation properties between loci. We provide a biological interpretation for seven of these processes. We associate one process with bulky DNA lesions that are resolved asymmetrically with respect to transcription and replication. Two processes track direction of replication fork and replication timing, respectively. We identify a mutagenic effect of active demethylation primarily acting in regulatory regions and a mutagenic effect of long interspersed nuclear elements. We localize a mutagenic process specific to oocytes from population sequencing data. This process appears transcriptionally asymmetric.
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http://dx.doi.org/10.1126/science.aba7408DOI Listing
August 2021

Plasma osteopontin levels and adverse clinical outcomes after ischemic stroke.

Atherosclerosis 2021 Sep 30;332:33-40. Epub 2021 Jul 30.

Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.

Background And Aims: Osteopontin is implicated in atherosclerosis, and its expression is upregulated in response to brain injury. The aim of this study was to prospectively investigate the associations between plasma osteopontin levels and adverse clinical outcomes in ischemic stroke patients.

Methods: We measured baseline plasma osteopontin levels in 3545 ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS). The primary outcome was the composite outcome of death and major disability (modified Rankin scale score ≥3) at 1 year after ischemic stroke, and secondary outcomes included major disability, death, and the composite outcome of death and vascular events.

Results: During 1 year of follow-up, patients in the fourth quartile of plasma osteopontin had the highest risks of primary outcome, major disability, death, and the composite outcome of death and vascular events. After multivariate adjustment, the odds ratios or hazard ratios (95 % confidence intervals) associated with each standard deviation increase in log-transformed osteopontin were 1.20 (1.09-1.33) for primary outcome, 1.11 (1.00-1.23) for major disability, 1.29 (1.10-1.52) for death, and 1.15 (1.01-1.30) for the composite outcome of death and vascular events. The addition of plasma osteopontin to conventional risk factors significantly improved the risk reclassification for the primary outcome (net reclassification improvement: 16.91%, p < 0.001; integrated discrimination improvement: 0.43%, p = 0.002).

Conclusions: Elevated plasma osteopontin levels at baseline were associated with increased risks of adverse clinical outcomes at 1 year after ischemic stroke, suggesting that osteopontin is a promising prognostic biomarker for ischemic stroke.
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http://dx.doi.org/10.1016/j.atherosclerosis.2021.07.010DOI Listing
September 2021

Iron status, fibroblast growth factor 23 and cardiovascular and kidney outcomes in chronic kidney disease.

Kidney Int 2021 Jul 30. Epub 2021 Jul 30.

Division of Nephrology, Department of Medicine, and Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA.

Disordered iron and mineral homeostasis are interrelated complications of chronic kidney disease that may influence cardiovascular and kidney outcomes. In a prospective analysis of 3747 participants in the Chronic Renal Insufficiency Cohort Study, we investigated risks of mortality, heart failure, end-stage kidney disease (ESKD), and atherosclerotic cardiovascular disease according to iron status and tested for mediation by C-terminal fibroblast growth factor 23 (FGF23), hemoglobin and parathyroid hormone. Study participants were agnostically categorized based on quartiles of transferrin saturation and ferritin as "Iron Replete" (27.1% of participants; referent group for all outcomes analyses), "Iron Deficiency" (11.1%), "Functional Iron Deficiency" (7.6%), "Mixed Iron Deficiency" (iron indices between the Iron Deficiency and Functional Iron Deficiency groups; 6.3%), "High Iron" (9.2%), or "Non-Classified" (the remaining 38.8% of participants). In multivariable-adjusted Cox models, Iron Deficiency independently associated with mortality (hazard ratio 1.28, 95% confidence interval 1.04-1.58) and heart failure (1.34, 1.05- 1.72). Mixed Iron Deficiency associated with mortality (1.61, 1.27-2.04) and ESKD (1.33, 1.02-1.73). High Iron associated with mortality (1.54, 1.24-1.91), heart failure (1.58, 1.21-2.05), and ESKD (1.41, 1.13-1.77). Functional Iron Deficiency did not significantly associate with any outcome, and no iron group significantly associated with atherosclerotic cardiovascular disease. Among the candidate facilitators, FGF23 most significantly mediated the risks of mortality and heart failure conferred by Iron Deficiency. Thus, alterations in iron homeostasis associated with adverse cardiovascular and kidney outcomes in patients with chronic kidney disease.
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http://dx.doi.org/10.1016/j.kint.2021.07.013DOI Listing
July 2021

"Hands" teaching method in Circle of Willis: A useful model.

Asian J Surg 2021 Jul 29. Epub 2021 Jul 29.

Department of Gastrointestinal Surgery, Binzhou Medical University Hospital, Binzhou, Shandong Province, 256600, China.

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http://dx.doi.org/10.1016/j.asjsur.2021.06.048DOI Listing
July 2021

A Prognostic Model to Assess Long-Term Survival of Patients on Antiretroviral Therapy: A 15-Year Retrospective Cohort Study in Southwestern China.

Open Forum Infect Dis 2021 Jul 12;8(7):ofab309. Epub 2021 Jun 12.

Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.

Background: Because there is no assessment tool for survival of people with human immunodeficiency virus (PWH) who received antiretroviral therapy (ART) in rural southwestern China, we aimed to formulate and validate a simple-to-use model to predict long-term overall survival at the initiation of ART.

Methods: In total, 36 268 eligible participants registered in the Guangxi autonomous region between December 2003 and December 2018 were enrolled and randomized into development and validation cohorts. Predictive variables were determined based on Cox hazard models and specialists' advice. Discrimination, calibration, and clinical utility were measured, respectively.

Results: The prognostic combined 14 variables: sex, age, marital status, infectious route, opportunistic infection, acquired immunodeficiency syndrome (AIDS)-related symptoms, body mass index, CD4 T lymphocyte count, white blood cell, platelet, hemoglobin, serum creatinine, aspartate transaminase, and total bilirubin. Age, aspartate transaminase, and serum creatinine were assigned higher risk scores than that of CD4 T lymphocytopenia count and having opportunistic infections or AIDS-related symptoms. At 3 time points (1, 3, and 5 years), the area under the curve ranged from 0.75 to 0.81 and the Brier scores ranged from 0.03 to 0.07. The decision curve analysis showed an acceptable clinical net benefit.

Conclusions: The prognostic model incorporating routine baseline data can provide a useful tool for early risk appraisal and treatment management in ART in rural southwestern China. Moreover, our study underscores the role of non-AIDS-defining events in long-term survival in ART.
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http://dx.doi.org/10.1093/ofid/ofab309DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314953PMC
July 2021

Upper Reference Limits for High-Sensitivity Cardiac Troponin T and N-Terminal Fragment of the Prohormone Brain Natriuretic Peptide in Patients With CKD.

Am J Kidney Dis 2021 Jul 19. Epub 2021 Jul 19.

Division of Nephrology, School of Medicine, University of Maryland, Baltimore, Maryland.

Rationale & Objective: The utility of conventional upper reference limits (URL) for N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hsTnT) in chronic kidney disease (CKD) remains debated. We analyzed the distribution of hsTnT and NT-proBNP in people with CKD in ambulatory settings to examine the diagnostic value of conventional URL in this population.

Study Design: Observational study.

Setting & Participants: We studied participants of the Chronic Renal Insufficiency Cohort (CRIC) with CKD and no self-reported history of cardiovascular disease.

Exposure: Estimated glomerular filtration rate (eGFR).

Outcome: NT-proBNP and hsTnT at baseline.

Analytical Approach: We described the proportion of participants above the conventional URL for NT-proBNP (125pg/mL) and hsTnT (14ng/L) overall and by eGFR. We then estimated 99th percentile URL for NT-proBNP and hsTnT. Using quantile regression of the 99th percentile, we modeled the association of eGFR with NT-proBNP and hsTnT.

Results: Among 2,312 CKD participants, 40% and 43% had levels of NT-proBNP and hsTnT above the conventional URL, respectively. In those with eGFR <30mL/min/1.73m, 71% and 68% of participants had concentrations of NT-proBNP and hsTnT above the conventional URL, respectively. Among all CKD participants, the 99th percentile for NT-proBNP was 3,592 (95% CI, 2,470-4,849) pg/mL and for hsTnT it was 126 (95% CI, 100-144) ng/L. Each 15mL/min/1.73m decrement in eGFR was associated with a ~40% higher threshold for the 99th percentile of NT-proBNP (1.43 [95% CI, 1.21-1.69]) and hsTnT (1.45 [95% CI, 1.31-1.60]).

Limitations: Study included ambulatory patients, and we could not test the accuracy of the URL of NT-proBNP and hsTnT in the acute care setting.

Conclusions: In this ambulatory CKD population with no self-reported history of cardiovascular disease, a range of 40%-88% of participants had concentrations of NT-proBNP and hsTnT above the conventional URL, depending on eGFR strata. Developing eGFR-specific thresholds for these commonly used cardiac biomarkers in the setting of CKD may improve their utility for evaluation of suspected heart failure and myocardial infarction.
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http://dx.doi.org/10.1053/j.ajkd.2021.06.017DOI Listing
July 2021

Corrigendum: Identification of a Potential miRNA-mRNA Regulatory Network Associated With the Prognosis of HBV-ACLF.

Front Mol Biosci 2021 29;8:705683. Epub 2021 Jun 29.

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

[This corrects the article DOI: 10.3389/fmolb.2021.657631.].
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http://dx.doi.org/10.3389/fmolb.2021.705683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276013PMC
June 2021

Pangenomic Analysis of Strains Related to the Outbreak of Blackleg and Soft Rot of Potato in USA.

Plant Dis 2021 Jul 2. Epub 2021 Jul 2.

University of Maine, Plant, Soil & Environmental Sciences, 5735 Hitchner Hall, Room 174, Orono, Maine, United States, 04473.

has caused an outbreak of blackleg and soft rot of potato in the eastern half of the USA since 2015. To investigate genetic diversity of the pathogen, a comparative analysis was conducted on genomes of strains. Whole genomes of 16 strains from the USA outbreak were assembled and compared to 16 previously sequenced genomes of isolated from potato or carnation. Among the 32 strains, eight distinct clades were distinguished based on phylogenomic analysis. The outbreak strains were grouped into three clades, with the majority of the strains in clade I. Clade I strains were unique and homogeneous, suggesting a recent incursion of this strain into potato production from alternative hosts or environmental sources. Pangenome of the 32 strains contained 6693 genes, 3377 of which were core genes. By screening primary protein subunits associated with virulence from all USA strains, we found many virulence-related gene clusters, such as plant cell wall degrading enzyme genes, flagellar and chemotaxis related genes, two-component regulatory genes, and type I/II/III secretion system genes were highly conserved but type IV and type VI secretion system genes varied. The virulent clade I strains encoded two clusters of type IV secretion systems, while clade II and III strains encoded only one cluster. Clade I and II strains encoded one more VgrG/PAAR spike protein than clade III. Thus, we predicted that the presence of additional virulence-related genes may have enabled the unique clade I strain to become predominant source in the USA outbreak.
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http://dx.doi.org/10.1094/PDIS-03-21-0587-REDOI Listing
July 2021

Psychological Factors Affecting Risk Perception of COVID-19: Evidence from Peru and China.

Int J Environ Res Public Health 2021 06 17;18(12). Epub 2021 Jun 17.

Instituto de Investigación Ambiente Comportamiento y Sociedad, Cusco 08002, Peru.

COVID-19 has spread around the world, causing a global pandemic, and to date is impacting in various ways in both developed and developing countries. We know that the spread of this virus is through people's behavior despite the perceived risks. Risk perception plays an important role in decision-making to prevent infection. Using data from the online survey of participants in Peru and China ( = 1594), data were collected between 8 July 31 and August 2020. We found that levels of risk perception are relatively moderate, but higher in Peru compared to China. In both countries, anxiety, threat perception, self-confidence, and sex were found to be significant predictors of risk perception; however, trust in the information received by government and experts was significant only in Peru, whereas self-confidence had a significant negative effect only for China. Risk communication should be implemented through information programs aimed at reducing anxiety and improving self-confidence, taking into consideration gender differences. In addition, the information generated by the government should be based on empirical sources. Finally, the implications for effective risk communication and its impacts on the health field are discussed.
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http://dx.doi.org/10.3390/ijerph18126513DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296494PMC
June 2021

Hyperlipidemia Influences the Accuracy of Glucometer-Measured Blood Glucose Concentrations in Genetically Diverse Mice.

Am J Med Sci 2021 Jun 29. Epub 2021 Jun 29.

Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, VA, USA; Biochemistry & Molecular Genetics, University of Virginia, Charlottesville, VA, USA. Electronic address:

Background: Glucometers are widely used in animal research due to simplicity and ease of utilization, but their accuracy in blood glucose assessment for hyperlipidemic mice is unknown.

Methods: Here, we compared blood glucose levels measured by a glucometer with plasma glucose levels measured by a standard enzymatic assay for 325 genetically diverse F2 mice derived from LP and BALB/c (BALB) Apoe mice. Non-fasting glucose levels were measured before initiation of a Western diet and after 11 weeks on the diet.

Results: On chow diet, lab-measured plasma glucose levels were 279.5 ± 42.6 mg/dl (mean ± SD), while blood glucose values measured by glucometer were 138.7 ± 16.6 mg/dl. The two measures had no correlation (R = 0.006, p = 0.167). On the Western diet, plasma glucose levels rose to 351.1 ± 121.6 mg/dl, while glucometer-measured blood glucose fell to 128.7 ± 27.9 mg/dl. The two measures showed a moderate correlation (R = 0.111, p = 3.1E-9). Lab-measured plasma glucose showed strong positive correlations with plasma triglyceride and non-high-density lipoprotein cholesterol levels, while glucometer-measured blood glucose showed an inverse correlation with non-high-density lipoprotein levels on the chow diet.

Conclusions: Our results indicate that hyperlipidemia affects the accuracy of glucometers in measuring blood glucose levels of mice.
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http://dx.doi.org/10.1016/j.amjms.2021.06.014DOI Listing
June 2021

Designing an Electron-Deficient Pd/NiCoO Bifunctional Electrocatalyst with an Enhanced Hydrodechlorination Activity to Reduce the Consumption of Pd.

Environ Sci Technol 2021 07 1;55(14):10087-10096. Epub 2021 Jul 1.

College of Environment, Zhejiang University of Technology, Hangzhou 310032, People's Republic of China.

Reducing the Pd loading on electrodes is critical in the electrocatalytic hydrodechlorination (EHDC) of chlorinated organic compounds (COCs). The EHDC reaction of COCs on Pd involves three steps: H* formation, H* adsorption, and dechlorination. It has been established that the initial hydrogen evolution reaction (HER) occurs on Pd and the dechlorination steps occur on Pd. A strategy is proposed to design new electrodes by adding a reducible HER-active interlayer to replace Pd, fulfilling the responsibility of producing hydrogen, and to facilitate the formation of more Pd for following C-Cl bond cleavage. Keeping the atomic hydrogen adsorption energy on the Pd/interlayer similar to that on pure Pd is also necessary for H* adsorption as well as to maintain a high EHDC activity. For the first time, the NiCoO-interlayer-modified Pd/Ni-foam electrode was applied in the EHDC of COCs, which enhanced the EHDC efficiency to 100% within 90 min and reduced 88.6% of Pd consumption. The Pd/NiCoO/Ni-foam electrode with enhanced EHDC activity was also observed with almost 100% product selectivity and good stability. A synergistic mechanism is proposed for the enhanced EHDC activity on the Pd/NiCoO/Ni-foam. This work offers a simple and useful strategy to design robust electrocatalysts for the EHDC of COCs.
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http://dx.doi.org/10.1021/acs.est.1c01922DOI Listing
July 2021

Plasma Metabolomic Signatures of Healthy Dietary Patterns in the Chronic Renal Insufficiency Cohort (CRIC) Study.

J Nutr 2021 Jun 30. Epub 2021 Jun 30.

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA.

Background: In individuals with chronic kidney disease (CKD), healthy dietary patterns are inversely associated with CKD progression. Metabolomics, an approach that measures many small molecules in biofluids, can identify biomarkers of healthy dietary patterns.

Objectives: We aimed to identify known metabolites associated with greater adherence to 4 healthy dietary patterns in CKD patients.

Methods: We examined associations between 486 known plasma metabolites and Healthy Eating Index (HEI)-2015, Alternative Healthy Eating Index (AHEI)-2010, the Dietary Approaches to Stop Hypertension (DASH) diet, and alternate Mediterranean diet (aMED) in 1056 participants (aged 21-74 y at baseline) in the Chronic Renal Insufficiency Cohort (CRIC) Study. Usual dietary intake was assessed using a semiquantitative FFQ. We conducted multivariable linear regression models to study associations between healthy dietary patterns and individual plasma metabolites, adjusting for sociodemographic characteristics, health behaviors, and clinical factors. We used principal component analysis to identify groups of metabolites associated with individual food components within healthy dietary patterns.

Results: After Bonferroni correction, we identified 266 statistically significant diet-metabolite associations (HEI: n = 60; AHEI: n = 78; DASH: n = 77; aMED: n = 51); 78 metabolites were associated with >1 dietary pattern. Lipids with a longer acyl chain length and double bonds (unsaturated) were positively associated with all 4 dietary patterns. A metabolite pattern low in saturated diacylglycerols and triacylglycerols, and a pattern high in unsaturated triacylglycerols was positively associated with intake of healthy food components. Plasmalogens were negatively associated with the consumption of nuts and legumes and healthy fat, and positively associated with the intake of red and processed meat.

Conclusions: We identified many metabolites associated with healthy dietary patterns, indicative of food consumption. If replicated, these metabolites may be considered biomarkers of healthy dietary patterns in patients with CKD.
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http://dx.doi.org/10.1093/jn/nxab203DOI Listing
June 2021

Association of fine particulate matter air pollution and its constituents with lung function: The China Pulmonary Health study.

Environ Int 2021 11 26;156:106707. Epub 2021 Jun 26.

Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China; National Center of Gerontology, Beijing, China.

The associations of long-term exposure to various constituents of fine particulate matter (≤2.5 μm in aerodynamic diameter, PM) air pollution with lung function were not clearly elucidated in developing countries. The aim was to evaluate the associations of long-term exposure to main constituents of PM with lung function in China. This is a nationwide, cross-sectional analysis among 50,991 study participants from the China Pulmonary Health study. Multivariable linear regression models were used to obtain differences of forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC, peak expiratory flow (PEF), and forced expiratory flow at 25-75% of exhaled FVC (FEF) associated with an interquartile range (IQR) change of PM or its constituents. Residential annual PM levels varied from 26 μg/m to 92 μg/m (average: 53 μg/m). An IQR increase of PM concentrations was associated with lower FEV (19.82 mL, 95% CI: 11.30-28.33), FVC (17.45 mL, 95% CI: 7.16-27.74), PEF (86.64 mL/s, 95% CI: 59.77-113.52), and FEF (31.93 mL/s, 95% CI: 16.64-47.22). Black carbon, organic matter, ammonium, sulfate, and nitrate were negatively associated with most lung function indicators, with organic matter and nitrate showing consistently larger magnitude of associations than PM mass. This large-scale study provides first-hand epidemiological evidence that long-term exposure to ambient PM and some constituents, especially organic matter and nitrate, were associated with lower large- and small- airway function.
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http://dx.doi.org/10.1016/j.envint.2021.106707DOI Listing
November 2021

Plasma Kidney Injury Molecule 1 in CKD: Findings From the Boston Kidney Biopsy Cohort and CRIC Studies.

Am J Kidney Dis 2021 Jun 24. Epub 2021 Jun 24.

Section of Nephrology, Department of Medicine, Boston University School of Medicine, Boston Medical Center, Boston, MA; Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address:

Rationale & Objective: Plasma kidney injury molecule-1 (KIM-1) is a sensitive marker of proximal tubule injury, but its association with risks of adverse clinical outcomes across a spectrum of kidney diseases is unknown.

Study Design: Prospective, observational cohort study.

Setting & Participants: 524 individuals undergoing clinically indicated native kidney biopsy with biopsy specimens adjudicated for semiquantitative scores of histopathology by two kidney pathologists enrolled into the Boston Kidney Biopsy Cohort (BKBC) Study and 3,800 individuals with common forms of chronic kidney disease (CKD) enrolled into the Chronic Renal Insufficiency Cohort (CRIC) Study.

Exposure: Histopathologic lesions and clinicopathologic diagnosis in cross-sectional analyses, baseline plasma KIM-1 in prospective analyses.

Outcomes: Baseline plasma KIM-1 in cross-sectional analyses, kidney failure (defined as initiation of kidney replacement therapy) and death in prospective analyses.

Analytical Approach: Multivariable-adjusted linear regression models tested associations of plasma KIM-1 with histopathologic lesions and clinicopathologic diagnoses. Cox proportional hazards models tested associations of plasma KIM-1 with future kidney failure and death.

Results: In the BKBC Study, higher plasma KIM-levels were associated with more severe acute tubular injury, tubulointerstitial inflammation, and more severe mesangial expansion after multivariable adjustment. Participants with diabetic nephropathy, glomerulopathies, and tubulointerstitial disease had significantly higher plasma KIM-1 levels after multivariable adjustment. In the BKBC Study, 124 participants progressed to kidney failure and 85 participants died during a median follow-up time of 5 years. In the CRIC Study, 1153 participants progressed to kidney failure and 1356 participants died during a median follow-up time of 11.5 years. In both cohorts, each doubling of plasma KIM-1 was associated with an increased risk of kidney failure after multivariable adjustment (BKBC: HR 1.19, 95% CI 1.03 to 1.38 and CRIC: HR 1.10, 95% CI 1.06 to 1.15). There was no statistically significant association of plasma KIM-1 with death in either cohort.

Limitations: Generalizability and unmeasured confounding.

Conclusions: Plasma KIM-1 is associated with underlying tubulointerstitial and mesangial lesions and progression to kidney failure in two cohort studies of individuals with kidney diseases.
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http://dx.doi.org/10.1053/j.ajkd.2021.05.013DOI Listing
June 2021

(Hetero)arene-fused boroles: a broad spectrum of applications.

Chem Sci 2020 Nov 24;12(1):128-147. Epub 2020 Nov 24.

Institute for Inorganic Chemistry and Institute for Sustainable Chemistry & Catalysis with Boron (ICB), Julius-Maximilians-Universität Würzburg Am Hubland 97074 Würzburg Germany

(Hetero)arene-fused boroles are a class of compounds containing a 5-membered boron diene-ring. Based on their molecular framework, the (hetero)arene-fused boroles can be considered as boron-doped polycyclic antiaromatic hydrocarbons and are thus of great interest. Due to the vacant p orbital on the 3-coordinate boron atom, the antiaromaticity and strain of the 5-membered borole ring, (hetero)arene-fused boroles possess strong electron accepting abilities and Lewis acidity. By functionalization, they can be tuned to optimize different properties for specific applications. Herein, we summarize synthetic methodologies, different strategies for their functionalization, and applications of (hetero)arene-fused boroles.
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http://dx.doi.org/10.1039/d0sc05676fDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178973PMC
November 2020

Plasma choline and betaine and risks of cardiovascular events and recurrent stroke after ischemic stroke.

Am J Clin Nutr 2021 Jun 22. Epub 2021 Jun 22.

Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.

Background: Choline and betaine have been suggested to play a pivotal role in neurotransmitter synthesis, cell membrane integrity, and methyl-group metabolism, exerting neuroprotective effects in patients with various neurological disorders. However, population-based evidence on choline and betaine with subsequent cardiovascular events after stroke is rare.

Objectives: We aimed to prospectively investigate the relationships of circulating choline and betaine with cardiovascular events and recurrent stroke in patients with ischemic stroke.

Methods: We performed a nested case-control study within the China Antihypertensive Trial in Acute Ischemic Stroke. A total of 323 cardiovascular events (including 264 recurrent strokes) and 323 controls (free of recurrent cardiovascular events) matched for age (±1 y), sex, and treatment group were included. The primary endpoint was a composite of cardiovascular events after ischemic stroke. Plasma choline and betaine were measured at baseline by ultra-high-performance LC-MS/MS. Conditional logistic regression models were applied, and discrimination, reclassification, and calibration of models with choline pathway metabolites were evaluated.

Results: Plasma choline and betaine were inversely associated with cardiovascular events and recurrent stroke after ischemic stroke. Specifically, in fully adjusted models, each additional SD of choline and betaine was associated with 35% (95% CI: 20%-48%) and 30% (95% CI: 14%-43%) decreased risks of subsequent cardiovascular events, respectively, and 34% (95% CI: 16%-48%) and 29% (95% CI: 12%-43%) decreased risks of recurrent stroke, respectively. In addition, both choline and betaine offered substantial risk discrimination and reclassification improvement for cardiovascular events and recurrent stroke beyond traditional risk factors, as evidenced by an increase in C statistics, the net reclassification index, and integrated discrimination improvement.

Conclusions: Plasma choline pathway metabolites, including choline and betaine, were associated with decreased risks of cardiovascular events and recurrent stroke and provided incremental value in risk discrimination and stratification in patients with ischemic stroke. This nested case-control study was based on the China Antihypertensive Trial in Acute Ischemic Stroke, which is registered at clinicaltrials.gov as NCT01840072.
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http://dx.doi.org/10.1093/ajcn/nqab199DOI Listing
June 2021

The engineered expression of secreted HSPB5-Fc in CHO cells exhibits cytoprotection in vitro.

BMC Biotechnol 2021 06 14;21(1):39. Epub 2021 Jun 14.

Joint National Laboratory for Antibody Drug Engineering, The First Affiliated Hospital of Henan University, School of Basic Medical Sciences, Henan University, Jin-Ming Road, Kaifeng, 475004, China.

Background: HSPB5 is an ATP-independent molecular chaperone that is induced by heat shock or other proteotoxic stresses. HSPB5 is cytoprotective against stress both intracellularly and extracellularly. It acts as a potential therapeutic candidate in ischemia-reperfusion and neurodegenerative diseases.

Results: In this paper, we constructed a recombinant plasmid that expresses and extracellularly secrets a HSPB5-Fc fusion protein (sHSPB5-Fc) at 0.42 μg/ml in CHO-K1 cells. This sHSPB5-Fc protein contains a Fc-tag at the C-terminal extension of HSPB5, facilitating protein-affinity purification. Our study shows that sHSPB5-Fc inhibits heat-induced aggregation of citrate synthase in a time and dose dependent manner in vitro. Administration of sHSPB5-Fc protects lens epithelial cells against cisplatin- or UVB-induced cell apoptosis. It also decreases GFP-Htt-Q74 insolubility, and reduces the size and cytotoxicity of GFP-Htt-Q74 aggregates in PC-12 cells.

Conclusion: This recombinant sHSPB5-Fc exhibits chaperone activity to protect cells against proteotoxicity.
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http://dx.doi.org/10.1186/s12896-021-00700-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204567PMC
June 2021

Suppression of DLBCL Progression by the E3 Ligase Trim35 Is Mediated by CLOCK Degradation and NK Cell Infiltration.

J Immunol Res 2021 24;2021:9995869. Epub 2021 May 24.

Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha 410008, China.

The majority of diffuse large B-cell lymphoma (DLBCL) patients develop relapsed or refractory disease after standard ruxolitinib, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy, which is partly related to a dysregulated tumor immune microenvironment. However, how the infiltration of immune cells is appropriately regulated is poorly understood. Herein, we show that the E3 ubiquitin ligase Trim35 is expressed at low levels in human DLBCL tissues. We also show that overexpression of Trim35 suppresses DLBCL cell proliferation and correlates with inferior survival in DLBCL patients. Our mechanistic study shows that Trim35 functions as an E3 ligase to mediate the ubiquitination and degradation of CLOCK, a key regulator of circadian rhythmicity. High expression of Trim35 correlates with NK cell infiltration in DLBCL, partly due to the degradation of CLOCK. Consistently, patients with high expression of CLOCK show poor overall survival. Overall, these findings suggest that Trim35 suppresses the progression of DLBCL by modulating the tumor immune microenvironment, indicating that it may be a promising diagnostic and prognostic biomarker in DLBCL.
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http://dx.doi.org/10.1155/2021/9995869DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8166485PMC
May 2021

Structural insights into two distinct nanobodies recognizing the same epitope of green fluorescent protein.

Biochem Biophys Res Commun 2021 Aug 4;565:57-63. Epub 2021 Jun 4.

Department of Physiology and Biophysics, School of Life Sciences, Fudan University, Shanghai, 200438, China. Electronic address:

Green fluorescent protein (GFP) and its derivatives are widely used in biomedical research, and the manipulation of GFP-tagged proteins by GFP-specific binders is highly desired. However, structural information on how these binders bind with GFP is still lacking. In this study, we determined the crystal structure of the nanobody Nb2 complexed with superfolder GFP (sfGFP) at a resolution of 2.2 Å. Interestingly, although the complementarity-determining regions (CDRs) of Nb2 and LaG16 sequences were only 29.7% identical, they both bound to the same epitope of GFP and existed in the same orientation. Structural analysis indicated that they achieved similar binding characteristics through different mechanisms. We further verified the kinetics and thermodynamics of binding by biolayer interferometry (BLI) and isothermal titration calorimetry (ITC). Nb2 showed a slightly higher binding affinity for sfGFP than LaG16. The stability of GFP-specific nanobodies was verified by nano differential scanning fluorimetry (nanoDSF). Nb2 exhibited the highest melting temperature (Tm); thus, Nb2 is a promising GFP nanobody candidate for use in applications requiring harsh testing conditions. We also compared the binding sites of available GFP nanobodies and showed that some of them can simultaneously bind with GFP and assemble into multifunctional complexes to manipulate GFP-tagged target proteins. Our results provide atomic-scale binding information for Nb2-sfGFP, which is important for the further development of GFP-nanobody based fusion protein manipulation techniques.
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http://dx.doi.org/10.1016/j.bbrc.2021.05.089DOI Listing
August 2021

Early Contributors to Healthy Arterial Aging Versus Premature Atherosclerosis in Young Adults: The Bogalusa Heart Study.

J Am Heart Assoc 2021 Jun 5;10(12):e020774. Epub 2021 Jun 5.

Department of Medicine Tulane University School of Medicine New Orleans LA.

Background Early identification of healthy arterial aging versus premature atherosclerosis is important for optimal atherosclerotic cardiovascular disease risk stratification and prevention. We sought to identify predictors for the long-term absence of carotid plaque among young adults. Methods and Results We included 508 participants from the Bogalusa Heart Study without clinical atherosclerotic cardiovascular disease who were free of carotid plaque at baseline (2001-2002) and underwent ultrasound imaging at follow-up (2013-2016). Modified Poisson regression estimated the persistent absence of plaque over 12.8 years. Participants were on average age 36.2 years at baseline, 64% were women, and 29% were Black. Although nearly all participants (97%) had a 10-year atherosclerotic cardiovascular disease risk <7.5%, there were 162 people (32%) who developed premature atherosclerosis. Aside from younger age (risk ratio [RR], 1.21; 95% CI, 1.07-1.36, per 10 years) and a total cholesterol/high-density lipoprotein cholesterol ratio <3.5 (RR, 1.15; 95% CI, 1.01-1.30), normal values of traditional risk factors did not predict long-term absence of plaque. Independent from traditional markers including glomerular filtration rate, serum calcium-phosphate product (RR, 1.07; 95% CI, 1.01-1.14, per 1-SD lower), phosphate (RR, 1.15; 95% CI, 1.03-1.29, per 1 mg/dL lower), and dietary sodium <2300 mg/day (RR, 1.20; 95% CI, 1.02-1.41) were significantly associated with the non-development of plaque. Conclusions Nearly one third of young adults with a low burden of traditional risk factors developed premature atherosclerosis. Beyond younger age and an ideal lipoprotein profile, lower calcium-phosphate homeostasis and low sodium intake were associated with long-term absence of carotid plaque. These results suggest that dietary and intrinsic minerals are early contributors to the development of arterial aging phenotypes.
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http://dx.doi.org/10.1161/JAHA.121.020774DOI Listing
June 2021
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