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Background Diabetes mellitus is associated with increased rates of mortality in patients with less severe (stage C) heart failure (HF). The prevalence of diabetes and its complications in advanced (stage D) HF and their contributions to mortality risk are unknown. Methods and Results We conducted a retrospective population-based cohort study of all adult residents of Olmsted County, Minnesota, who had advanced HF between 2007 and 2017. Patients with diabetes were identified by using the criteria of the Healthcare Effectiveness Data and Information Set. Diabetes complications were captured by using the Diabetes Complications Severity Index. Of 936 patients with advanced HF, 338 (36.1%) had diabetes. Overall, median survival time after development of advanced HF was 13.1 (3.9–33.1) months; mortality did not vary by diabetes status (aHR 1.06, 95% CI 0.90–1.25; P = 0.45) or by glycated hemoglobin levels in those with diabetes (aHR 1.01 per 1% increase, 95% CI 0.93–1.10; P = 0.82). However, patients with diabetes and 4 (aHR 1.24, 95% CI 0.92–1.67) or 5–7 (aHR 1.49, 95% CI 1.09–2.03) diabetes complications were at increased risk of mortality compared to those with ≤ 3 complications. Conclusions More than one-third of patients with advanced HF have diabetes. In advanced HF, overall prognosis is poor, but we found no evidence that diabetes is associated with a significantly higher mortality risk.

PURPOSE Androgen receptor (AR) signaling is important in prostate cancer progression, and therapies that target this pathway have been the mainstay of treatment for advanced disease for over 70 years. Tumors eventually progress despite castration through a number of well-characterized mechanisms; however, little is known about what determines the magnitude of response to short-term pathway inhibition. METHODS We evaluated a novel combination of AR-targeting therapies (degarelix, abiraterone, and bicalutamide) and noted that the objective patient response to therapy was highly variable. To investigate what was driving treatment resistance in poorly responding patients, as a secondary outcome we comprehensively characterized pre- and post-treatment samples using both whole-genome and RNA sequencing. RESULTS We find that resistance following short-term treatment differs molecularly from typical progressive castration-resistant disease, associated with transcriptional reprogramming, to a transitional epithelial-to-mesenchymal transition (EMT) phenotype rather than an upregulation of AR signaling. Unexpectedly, tolerance to therapy appears to be the default state, with treatment response correlating with the prevalence of tumor cells deficient for SNAI2, a key regulator of EMT reprogramming. CONCLUSION We show that EMT characterizes acutely resistant prostate tumors and that deletion of SNAI2, a key transcriptional regulator of EMT, correlates with clinical response.

Identification of low-dose, low-molecular-weight, drug-like inhibitors of protein-protein interactions (PPIs) is a challenging area of research. Despite the challenges, the therapeutic potential of PPI inhibition has driven significant efforts toward this goal. Adding to recent success in this area, we describe herein our efforts to optimize a novel purine carboxylic acid-derived inhibitor of the HDM2-p53 PPI into a series of low-projected dose inhibitors with overall favorable pharmacokinetic and physical properties. Ultimately, a strategy focused on leveraging known binding hot spots coupled with biostructural information to guide the design of conformationally constrained analogs and a focus on efficiency metrics led to the discovery of MK-4688 (compound 56), a highly potent, selective, and low-molecular-weight inhibitor suitable for clinical investigation.

In this study, NMR and molecular dynamics simulations were employed to study IgG1 FC binding to multimodal surfaces. Gold nanoparticles functionalized with two multimodal cation-exchange ligands (Capto and Nuvia) were synthesized and employed to carry out solution-phase NMR experiments with the FC. Experiments with perdeuterated 15N-labeled FC and the multimodal surfaces revealed micromolar residue-level binding affinities as compared to millimolar binding affinities with these ligands in free solution, likely due to cooperativity and avidity effects. The binding of FC with the Capto ligand nanoparticles was concentrated near an aliphatic cluster in the CH2/CH3 interface, which corresponded to a focused hydrophobic region. In contrast, binding with the Nuvia ligand nanoparticles was more diffuse and corresponded to a large contiguous positive electrostatic potential region on the side face of the FC. Results with lower-ligand-density nanoparticles indicated a decrease in binding affinity for both systems. For the Capto ligand system, several aliphatic residues on the FC that were important for binding to the higher-density surface did not interact with the lower-density nanoparticles. In contrast, no significant difference was observed in the interacting residues on the FC to the high- and low-ligand density Nuvia surfaces. The binding affinities of FC to both multimodal-functionalized nanoparticles decreased in the presence of salt due to the screening of multiple weak interactions of polar and positively charged residues. For the Capto ligand nanoparticle system, this resulted in an even more focused hydrophobic binding region in the interface of the CH2 and CH3 domains. Interestingly, for the Nuvia ligand nanoparticles, the presence of salt resulted in a large transition from a diffuse binding region to the same focused binding region determined for Capto nanoparticles at 150 mM salt. Molecular dynamics simulations corroborated the NMR results and provided important insights into the molecular basis of FC binding to these different multimodal systems containing clustered (observed at high-ligand densities) and nonclustered ligand surfaces. This combined biophysical and simulation approach provided significant insights into the interactions of FC with multimodal surfaces and sets the stage for future analyses with even more complex biotherapeutics.

An approach for evaluating spectra from ground state probability amplitudes (GSPA) obtained from diffusion Monte Carlo (DMC) simulations is extended to improve the description of excited state energies and allow for coupling among vibrational excited states. This approach is applied to studies of the protonated water trimer and tetramer, and their deuterated analogs. These ions provide models for solvated hydronium, and analysis of these spectra provides insights into spectral signatures of proton transfer in aqueous environments. In this approach, we obtain a separable set of internal coordinates from the DMC ground state probability amplitude. A basis is then developed from products of the DMC ground state wave function and low-order polynomials in these internal coordinates. This approach provides a compact basis in which the Hamiltonian and dipole moment matrix are evaluated and used to obtain the spectrum. The resulting spectra are in good agreement with experiment and in many cases provide comparable agreement to the results obtained using much larger basis sets. In addition, the compact basis allows for interpretation of the spectral features and how they evolve with cluster size and deuteration.

We report the fabrication and measurement of an ab -plane Josephson junction created in an 80-nm thick thin-film-like exfoliated Bi $_{2}$ Sr $_{2}$ CaCu $_{2}$ O $_{8+x}$ single crystal flake. The junctions are formed using ion irradiation from a focused helium ion beam which locally converts the material from a superconductor to an insulator. Current-voltage characteristics show the device to be a weak link with I $_\text{C}$ R $_\text{N}$ product of 40 $\mu$ A. The critical current exhibits a well-behaved Fraunhofer pattern with magnetic field applied perpendicular to the film confirming the DC Josephson effect. Simulations reveal a large amount of ion straggle deep into the film which is likely influencing the electrical properties. Combination of these devices with the intrinsic junctions could provide a method for multi-dimensional Josephson devices.

In Mississippi, rice reproduction and ripening often overlaps with soybean maturation, creating potential for herbicide exposure onto rice from desiccants applied to soybeans. Six independent studies were conducted concurrently at the Delta Research and Extension Center in Stoneville, MS, from 2016 to 2018 to determine the response of rice to sublethal concentrations of soybean desiccants during rice reproductive and ripening growth stages. Studies included the desiccants paraquat, glyphosate, saflufenacil, sodium chlorate, paraquat + saflufenacil, and paraquat + sodium chlorate applied at a rate equal to 1/10th of Mississippi recommendations. Treatments were applied at five different rice growth stages, beginning at 50% heading––defined as 0 d after heading (DAH)––with subsequent applications at 1-wk intervals (0, 7, 14, 21, and 28 DAH), up to harvest. Injury was observed 7 d after application (DAA), with five of six desiccants at all application timings. No injury was observed with glyphosate application across all rating intervals. Rough rice grain yield following all glyphosate applications was reduced by >6%. In the studies evaluating paraquat, injury ranged from 5% to 18% at all evaluations, regardless of application timing. Rough rice grain yield was reduced >12% 0 to 21 DAH, following paraquat application. Similar trends were observed with paraquat + saflufenacil and paraquat + sodium chlorate, with rice exhibiting yield decreases >6% following an application 0 to 14 and 0 to 21 DAH, respectively. In studies evaluating saflufenacil and sodium chlorate, rough rice grain yield was >95% of the untreated across all application timings Yield component trends closely resembled reductions observed in rough rice grain yield. Reductions in head rice yield were >5% following applications of paraquat or paraquat + saflufenacil 0 to 14 and 0 to 21 DAH, respectively. Late-season exposure to sublethal concentrations of desiccant from 50% heading (0 DAH) to 28 DAH has an impact on rough rice grain yield, yield components, and head rice yield.

Background Atopic dermatitis (AD) is a common and chronic inflammatory skin disease that erupts periodically. Although the negative impact of the disorder on overall quality of life has been well established, new treatments for AD are still needed. Various studies have reported on cannabidiol's effectiveness in relieving pain and easing inflammation while not presenting major health risks. Aims In this communication, we aim to demonstrate the effectiveness of a novel cannabidiol (CBD) and aspartame formulation, JW-100, in relieving signs and symptoms of AD. Patients/methods We conducted a double-blinded placebo-controlled interventional study randomizing patients to one of three treatment groups: JW-100 (CBD plus aspartame), CBD only, or placebo topical formulations. The Investigator's Static Global Assessment (ISGA) score was used to document any changes in AD resulting from the applied interventions at 14 days. Results Fifty-seven patients completed the trial and were included in the final analysis. The ISGA score of the patients at baseline was 2.56, 2.24, and 2.24, for the JW-100, CBD, and placebo groups, respectively. After two weeks of treatment, the ISGA score reduced by 1.28, 0.81, and 0.71, for the JW-100, CBD, and placebo groups, respectively. The JW-100 cohorts demonstrated statistically significant ISGA score reduction (p = 0.042). 50% of patients in the JW-100 group achieved ISGA score of clear or almost clear (0 or 1) with at least a 2-grade improvement from baseline after treatment (p = 0.028). Only 20% and 15% of patients in the CBD only and placebo groups reported ISGA score of clear or almost clear (0 or 1). Conclusions JW-100, a novel topical formulation containing CBD and aspartame, was demonstrated to produce statistically significant improvements in AD following 14 days of topical application.

Determining compositional trends among individual minerals is key to understanding the thermodynamic conditions under which they formed and altered, and is also essential to maximizing the scientific value of small extraterrestrial samples, including returned samples and meteorites. Here we report the chemical compositions of Fe-sulfides, focusing on the pyrrhotite-group sulfides, which are ubiquitous in chondrites and are sensitive indicators of formation and alteration conditions in the protoplanetary disk and in small Solar System bodies. Our data show that while there are trends with the at.% Fe/S ratio of pyrrhotite with thermal and aqueous alteration in some meteorite groups, there is a universal trend between the Fe/S ratio and degree of oxidation. Relatively reducing conditions led to the formation of troilite during: (1) chondrule formation in the protoplanetary disk (i.e., pristine chondrites) and (2) parent body thermal alteration (i.e., LL4 to LL6, CR1, CM, and CY chondrites). Oxidizing and sulfidizing conditions led to the formation of Fe-depleted pyrrhotite with low Fe/S ratios during: (1) aqueous alteration (i.e., CM and CI chondrites), and (2) thermal alteration (i.e., CK and R chondrites). The presence of troilite in highly aqueously altered carbonaceous chondrites (e.g., CY, CR1, and some CM chondrites) indicates they were heated after aqueous alteration. The presence of troilite, Fe-depleted pyrrhotite, or pyrite in a chondrite can provide an estimate of the oxygen and sulfur fugacities at which it was formed or altered. The data reported here can be used to estimate the oxygen fugacity of formation and potentially the aqueous and/or thermal histories of sulfides in extraterrestrial samples, including those returned by the Hayabusa2 mission and due to be returned by the OSIRIS-REx mission in the near future.

Growth differentiation factor 8 (GDF8), a.k.a. myostatin, is a member of the larger TGFβ superfamily of signaling ligands. GDF8 has been well characterized as a negative regulator of muscle mass. After synthesis, GDF8 is held latent by a noncovalent complex between the N-terminal prodomain and the signaling ligand. Activation of latent GDF8 requires proteolytic cleavage of the prodomain at residue D99 by a member of the tolloid family of metalloproteases. While tolloid proteases cleave multiple substrates, they lack a conserved consensus sequence. Here, we investigate the tolloid cleavage site of the GDF8 prodomain to determine what residues contribute to tolloid recognition and subsequent proteolysis. Using sequential alanine mutations, we identified several residues adjacent to the scissile bond, including Y94, that when mutated, abolish tolloid-mediated activation of latent GDF8. Using the astacin domain of Tll1 (Tolloid Like 1) we determined that prodomain mutants were more resistant to proteolysis. Purified latent complexes harboring the prodomain mutations, D92A and Y94A, impeded activation by tolloid but could be fully activated under acidic conditions. Finally, we show that co-expression of GDF8 WT with prodomain mutants that were tolloid resistant, suppressed GDF8 activity. Taken together our data demonstrate that residues towards the N-terminus of the scissile bond are important for tolloid-mediated activation of GDF8 and that the tolloid-resistant version of the GDF8 prodomain can function dominant negative to WT GDF8.

Criegee intermediates (CIs) play a vital role in the atmosphere-known most prominently for enhancing the oxidizing capacity of the troposphere. Knowledge of their electronic absorption spectra is of vital importance for two reasons: (1) to aid experimentalists in detecting CIs and (2) in deciding if their removal is affected by solar photolysis. In this article we report a simple and efficient method based on the nuclear ensemble method that may be effectively used to compute the electronic absorption spectra of Criegee intermediates without the need for extensive computation of preparing the initial configurations of the starting geometry. We use this method to benchmark several excited-state electronic structure methods and their efficacy in reproducing the electronic absorption spectra of two well-known cases of CI: CH2OO and CH3CHOO. The success and computational feasibility of the methodology are crucial for its applicability to CIs of increasing molecular complexity, which have no known experimentally measured electronic absorption spectra, allowing a guide for experimentalists. Application of the methodology to more complex CIs (e.g., those with extended conjugation or those derived from endocyclic alkenes) will also reveal if solar photolysis becomes a competitive removal process when compared to unimolecular decay or bimolecular chemistry.

Background: Up to 50% of all long-term catheterized individuals experience recurrent episodes of urinary catheter infections and blockages, leading to urine retention, pyelonephritis and septicaemia if the catheter is left in situ. We have previously reported the synergistic activity of weak organic acid (WOA) combinations against nosocomial uropathogens. Aim: To investigate the efficacy of selected WOAs, citric acid and propionic acid, alone and in combination, on prevention of crystalline biofilm formation and catheter blockages. Methods: Static crystallization assays and dynamic in vitro bladder model assays, with scanning electron microscopy, were performed for determination of bacterial viability, urinary pH and time to catheter blockage. Findings: The rate of encrustation around the catheter eyeholes was reduced in the presence of the citric acid/propionic acid combination, extending the time to blockage three-fold. Conclusion: Synergistic WOA combinations identified herein represent promising alternatives to antibiotics to combat the global healthcare burden of catheter-associated urinary tract infections and related blockages.

Extracellular vesicles (EVs) are an important intercellular communication system facilitating the transfer of macromolecules between cells. Delivery of exogenous cargo tethered to the EV surface or packaged inside the lumen are key strategies for generating therapeutic EVs. We identified two "scaffold" proteins, PTGFRN and BASP1, that are preferentially sorted into EVs and enable high-density surface display and luminal loading of a wide range of molecules, including cytokines, antibody fragments, RNA binding proteins, vaccine antigens, Cas9, and members of the TNF superfamily. Molecules were loaded into EVs at high density and exhibited potent in vitro activity when fused to full-length or truncated forms of PTGFRN or BASP1. Furthermore, these engineered EVs retained pharmacodynamic activity in a variety of animal models. This engineering platform provides a simple approach to functionalize EVs with topologically diverse macromolecules and represents a significant advance toward unlocking the therapeutic potential of EVs.

A population of Haemonchus contortus that was highly resistant to benzimidazoles and avermectin/milbemycins with a subpopulation that was resistant to levamisole, was replaced with a susceptible laboratory isolate of H. contortus in a flock of sheep. The anthelmintic susceptibility and population genetics of the newly established population were evaluated for 3.5 years using in vivo, in vitro, and molecular methods. Successful replacement of the resistant population with a susceptible population was confirmed using phenotypic and genotypic measurements; larval development assay indicated full anthelmintic susceptibility; albendazole treatment yielded 98.7% fecal egg count reduction; pyrosequence genotyping of single nucleotide polymorphisms in positions 167 and 200 of the isotype-1 beta tubulin gene were present at 0.0 and 1.7%, respectively; microsatellite genotyping indicated the background haplotype was similar to the susceptible isolate; and haplotypes of the isotype-1 beta tubulin gene were similar to the susceptible isolate. To sustain the susceptibility of the new population, targeted selective treatment was implemented using albendazole. Surprisingly, within 1.5 years post-replacement, the population reverted to a resistant phenotype. Resistance to albendazole, ivermectin, and moxidectin was confirmed via fecal egg count reduction test, larval development assay, and pyrosequencing-based genotyping. Targeted selective treatment was then carried out using levamisole. However, within one year, resistance was detected to levamisole. Population genetics demonstrated a gradual change in the genetic structure of the population until the final population was similar to the initial resistant population. Genetic analyses showed a lack of diversity in the susceptible isolate, suggesting the susceptible isolate had reduced environmental fitness compared to the resistant population, providing a possible explanation for the rapid reversion to resistance. This work demonstrates the power of combining molecular, in vitro, and in vivo assays to study phenotypic and genotypic changes in a field population of nematodes, enabling improved insights into the epidemiology of anthelmintic resistance., Graphical abstract Image 1

Although the fibrous plant material called Affenhaar from the middle Eocene lignites of Geiseltal in Germany has been repeatedly studied for over 172 years, modern imaging and chemical analyses have enabled a deeper understanding of its chemical composition and preservation within the parent plant. Known in English as “monkeyhair,” the fibrous material represents a very rare case of fossil laticifers, the latex-bearing ducts of plants. Here we use high-resolution X-ray microcomputed tomography (micro-CT) for the first time to elucidate the anatomy of tissues and their differential degradation within the monkeyhair tree. Even in large, fairly intact stem axes, the center cylinder of secondary xylem inside the trunks or branches is completely absent, presumably due to diagenetic degradation. Nevertheless, there is a moderately well-preserved outer layer of bark and mats of excellently preserved laticifers in the extraxylary zone beneath the bark. Previous chemical analyses revealed that the latex in these laticifers was dominated by natural rubber (cis-1,4-polyisoprene), but also included various triterpenoids. These fossil laticifers also contained large amounts of organic sulfur, suggesting the rubber may have been naturally vulcanized. Pyrolysis GC/MS is also applied to the fossil laticifers for the first time to identify the organic sulfur constituents of this ancient latex. The chemical analysis yields 12 major sulfur compounds, mostly thiophenes, consistent with vulcanized rubber. The vulcanization of these laticifers most likely occurred during early diagenesis, before the degradation of the wood, at low temperatures, and may have been facilitated with other compounds that served as accelerators, activators, and fillers.

Biofouling of surfaces is a major cause of infection and leads to significant patient morbidity and mortality within healthcare settings. With ever-increasing concerns over antibiotic resistance and associated challenges in eradicating surface-attached biofilm communities, efficacious antifouling materials are urgently required. We herein describe the development of an inherently antiadherent polymer system with the capacity for on-demand cleavage of surface-localized surfactant moieties. The nonionic surfactant, Triton X-100, was linked to hydrogel monomers via hydrolytically labile ester bonds. Synthesized copolymers exhibited pH-dependent switching of surfactant release, with elution triggered under the alkaline conditions characteristic of catheter-associated urinary tract infections and subsequently slowed down as the pH decreased, representing eradication of infection. In addition, the materials demonstrated complete resistance to adherence of Staphylococcus aureus following 24 h incubation in infected artificial urine, with reductions in adherence of Proteus mirabilis of up to 89% also observed. This dual-pronged approach with active, infection-responsive cleavage of surfactant to enhance the antiadherent properties of the surfactant-modified surfaces represents a promising self-cleaning strategy without associated concerns over bacterial resistance.

Background The prognostic value of tumor‐associated dendritic cells (DC) in colon cancer remains poorly understood. This may be in part due to the interchangeable expression of immunostimulatory and immunoinhibitory molecules on DC. Here we investigated the prognostic impact of CD11c+ DC co–expressing the immunoinhibitory molecule PD‐L1 and their spatial relationship with CD8+ T‐cells in patients treated for stage III colon cancer. Methods Tissue microarrays containing representative cores of central tumor, leading edge, and adjacent normal tissue from 221 patients with stage III colon cancer were immunostained for CD8, CD11c, PD‐L1, and cytokeratin using immunofluorescent probes. Cells were quantified using StrataQuest digital image analysis software, with intratumoral and stromal regions analyzed separately. Kaplan‐Meier estimates and Cox regression were used to assess survival. Results Intratumoral CD8+ cell density (HR = .52, 95% confidence interval [CI] .33‐.83, P = .007), stromal CD11c+ cell density (HR = .52, 95% CI .33‐.83, P = .006), intratumoral CD11c+PD‐L1+ cell density (HR = .57, 95% CI .35‐.92, P = .021), and stromal CD11c+PD‐L1+ cell density (HR = .48, 95% CI .30‐.77, P = .003) on leading‐edge cores were all significantly associated with good survival. CD8+ cell density was positively correlated with both CD11c+ cell density and CD11c+PD‐L1+ cell density in tumor epithelium and stromal compartments. Conclusion Here we showed that PD‐L1‐expressing DC in the tumor microenvironment are associated with improved survival in stage III colon cancer and likely reflect an immunologically “hot” tumor microenvironment. Further investigation into the expression of immunomodulatory molecules by tumor‐associated DC may help to further elucidate their prognostic value., In this study, using immunofluorescence analysis of fixed surgical samples, we demonstrate that PD‐L1 expressing dendritic cells are associated with good prognosis in stage III colon cancer. However, densities of PD‐L1 expressing dendritic cells were correlated to CD8 T cell density, indicating that they may represent an immunologically “hot” tumor microenvironment. Further investigation into the expression of immunomodulatory molecules by DC is required.

The ability to kill infecting microbes is an essential facet of our immune response to an infection. However, phagocytic ability is often overlooked as a part of immunological profile in infected patients' diagnosis, as the understanding of phagocytic capabilities in disease states is incomplete. In this work, we have evaluated for the first time the relationship between blood lactate level and the neutrophil phagocytic activity at a single-cell level. Blood samples (N = 19) were grouped on the basis of their blood lactate levels i.e., below (control) or above 2 mmol L−1 (high-risk) (i.e., 2 mmol L−1 is a common clinical lactate threshold used for patients' triage). Neutrophils were isolated from whole blood and then incubated with fluorescent IgG coated beads for 40 minutes, and the ability of each neutrophil to internalize beads was quantified. Single-cell phagocytic activity analysis has shown interesting findings such as: (i) a single neutrophil was able to internalize up to 7 beads, (ii) for a control group, 39.76% cells didn't internalize any beads, while for a high-risk group, 30.65% cells didn't show any phagocytic activity, (iii) similarly, 30.46% cells internalize only 1 bead in a control group, while for a high-risk group the activity is slightly higher with only 31.73% cells showing single bead internalization, and (iv) 7 bead internalization activity was much higher for samples in a high-risk group (0.6% cells) compared to a control group (0.17% cells). We used multiple statistical tests to compare these differences. For a two-tailed T-test, we used the mean phagocytic activity of the cells (i.e., the average number of beads internalized by cells) isolated from the blood samples in the two groups (1.14 vs. 1.35) and found the p-value to be 0.08. We also used principal component analysis (PCA) on this high dimensional phagocytic activity distribution data and performed dimension reduction. However, the first 3 principal components didn't show a clear distinction between groups. Next, we developed machine learning models using artificial neural networks (ANNs) to differentiate between the distribution of phagocytic activity in neutrophil populations of the two groups. Our models yielded area under curve (AUC) values below 0.7 for receiver operator characteristic curves. Although our study highlighted interesting phagocytic activity findings at a single cell level, it further highlights the need for integration of an individual patient's medical record to get more personalized insights into individual phagocytic activity in the future.

Development of electrochemical pathways to convert CO2 into fuels and feedstock is rapidly progressing over the past decade. Here we present a comparative cradle-to-gate life cycle assessment (LCA) of one and two-step electrochemical conversion of CO2 to eight major value-added products; wherein we consider CO2 capture, conversion and product separation in our process model. We measure the carbon intensity (i.e., global warming impact) of one and two-step electrochemical routes with its counterparts – thermochemical CO2 utilization and fossil-fuel based incumbent synthesis routes for those eight products. Here we show that due to inevitable carbonate formation or CO2 crossover in one-step CO2 electrolysis using neutral pH membrane electrode assembly, the two-step electrosynthesis pathways (i.e., CO2 to CO in solid oxide electrolysis cell followed by CO electroreduction in alkaline flow cell) would be distinctively compelling through the lens of climate benefits. This analysis further reveals that the carbon intensity of electrosynthesis products is due to significant energy requirement for conversion (77–83% of total energy consumption for gas products) and product separation (30–85% of total energy consumption for liquid products) phases. Global warming impact of electrochemical route is highly sensitive to the electricity emission intensity and is compelling over incumbent routes only when coupled with low emission intensity ( 20 wt%. It is our hope that this analysis will guide the CO2 electrosynthesis community to target achieving these technological goals, such that when coupled with low-carbon electricity, electrochemical route would bring climate benefits in near future.

Decoding the structural information contained in the interfacial vibrational spectrum of water requires understanding how the spectral signatures of individual water molecules respond to their local hydrogen bonding environments. In this study, we isolated the contributions for the five classes of sites that differ according to the number of donor (D) and acceptor (A) hydrogen bonds that characterize each site. These patterns were measured by exploiting the unique properties of the water cluster cage structures formed in the gas phase upon hydration of a series of cations M+·(H2O)n (M = Li, Na, Cs, NH4, CH3NH3, H3O, and n = 5, 20-22). This selection of ions was chosen to systematically express the A, AD, AAD, ADD, and AADD hydrogen bonding motifs. The spectral signatures of each site were measured using two-color, IR-IR isotopomer-selective photofragmentation vibrational spectroscopy of the cryogenically cooled, mass selected cluster ions in which a single intact H2O is introduced without isotopic scrambling, an important advantage afforded by the cluster regime. The resulting patterns provide an unprecedented picture of the intrinsic line shapes and spectral complexities associated with excitation of the individual OH groups, as well as the correlation between the frequencies of the two OH groups on the same water molecule, as a function of network site. The properties of the surrounding water network that govern this frequency map are evaluated by dissecting electronic structure calculations that explore how changes in the nearby network structures, both within and beyond the first hydration shell, affect the local frequency of an OH oscillator. The qualitative trends are recovered with a simple model that correlates the OH frequency with the network-modulated local electron density in the center of the OH bond.

BACKGROUND: Cystic fibrosis transmembrane conductance regulator (CFTR) modulators correct the basic defect caused by CFTR mutations. Improvements in health outcomes have been achieved with the combination of a CFTR corrector and potentiator in people with cystic fibrosis homozygous for the F508del mutation. The addition of elexacaftor (VX-445), a next-generation CFTR corrector, to tezacaftor plus ivacaftor further improved F508del-CFTR function and clinical outcomes in a phase 2 study in people with cystic fibrosis homozygous for the F508del mutation.METHODS: This phase 3, multicentre, randomised, double-blind, active-controlled trial of elexacaftor in combination with tezacaftor plus ivacaftor was done at 44 sites in four countries. Eligible participants were those with cystic fibrosis homozygous for the F508del mutation, aged 12 years or older with stable disease, and with a percentage predicted forced expiratory volume in 1 s (ppFEV1) of 40-90%, inclusive. After a 4-week tezacaftor plus ivacaftor run-in period, participants were randomly assigned (1:1) to 4 weeks of elexacaftor 200 mg orally once daily plus tezacaftor 100 mg orally once daily plus ivacaftor 150 mg orally every 12 h versus tezacaftor 100 mg orally once daily plus ivacaftor 150 mg orally every 12 h alone. The primary outcome was the absolute change from baseline (measured at the end of the tezacaftor plus ivacaftor run-in) in ppFEV1 at week 4. Key secondary outcomes were absolute change in sweat chloride and Cystic Fibrosis Questionnaire-Revised respiratory domain (CFQ-R RD) score. This study is registered with ClinicalTrials.gov, NCT03525548.FINDINGS: Between Aug 3 and Dec 28, 2018, 113 participants were enrolled. Following the run-in, 107 participants were randomly assigned (55 in the elexacaftor plus tezacaftor plus ivacaftor group and 52 in the tezacaftor plus ivacaftor group) and completed the 4-week treatment period. The elexacaftor plus tezacaftor plus ivacaftor group had improvements in the primary outcome of ppFEV1 (least squares mean [LSM] treatment difference of 10·0 percentage points [95% CI 7·4 to 12·6], pINTERPRETATION: Elexacaftor plus tezacaftor plus ivacaftor provided clinically robust benefit compared with tezacaftor plus ivacaftor alone, with a favourable safety profile, and shows the potential to lead to transformative improvements in the lives of people with cystic fibrosis who are homozygous for the F508del mutation.FUNDING: Vertex Pharmaceuticals.

Diffusion Monte Carlo provides an effective and efficient approach for calculating ground state properties of molecular systems based on potential energy surfaces. The approach has been shown to require increasingly large ensembles when intra- and intermolecular vibrations are weakly coupled. We recently proposed a guided variant of diffusion Monte Carlo to address these challenges for water clusters [Lee, V. G. M.; McCoy, A. B. J. Phys. Chem. A 2019, 123, 8063-8070]. In the present study, we extend this approach and apply it to more strongly bound molecular ions, specifically CH5+ and H+(H2O)n=1-4. For the protonated water systems, we show that the guided DMC approach that was developed for studies of (H2O)n can be used to describe the OH stretches and HOH bends in the solvating water molecules, as well as the free OH stretches in the hydronium core. For the hydrogen bonded OH stretches in the H3O+ core of H+(H2O)n and the CH stretches in CH5+, we develop adaptive guiding functions based on the instantaneous structure of the ion of interest. Using these guiding functions, we demonstrate that we are able to obtain converged zero-point energies and ground state wave functions using ensemble sizes that are as small as 10% the size that is needed to obtain similar accuracy from unguided calculations.

Differential tolerance may be observed among rice cultivars with desiccant exposure events during rice reproduction and ripening. Five field studies were established at the Mississippi State University Delta Research and Extension Center in Stoneville, MS, to determine the effects of exposure to sublethal concentrations of common desiccants across multiple rice cultivars. Rice cultivars in the study were ‘CLXL745’, ‘XL753’, ‘CL163’, ‘Rex’, and ‘Jupiter’. Desiccant treatments included no desiccant, paraquat, or glyphosate and were applied at the 50% heading growth stage respective to cultivar. Differential injury estimates among cultivars and desiccant treatments was observed when glyphosate or paraquat was applied at 50% heading. Injury from glyphosate at 50% heading was nondetectable across all cultivars. However, injury following paraquat applications was >7% across all rating intervals and cultivars. Hybrid cultivars exhibited less injury with paraquat applications than the inbred cultivars in the study. Rice following exposure to glyphosate or paraquat at 50% heading growth stage produced rough rice grain yield decreases ranging from 0% to 20% and 9% to 21%, respectively. Rough rice grain yield decreases were observed across all cultivars following paraquat exposure, and all inbred cultivars following glyphosate exposure. Across desiccant treatment, head rice yield was reduced in three of five cultivars in the study. When pooled across cultivar, paraquat applications cause a head rice yield reduction of 10%, whereas rice yield following glyphosate application remained >95%. Although differential tolerance among cultivars to paraquat or glyphosate exposure was observed, impacts on grain quality coupled with yield reductions suggests extreme rice sensitivity to exposure to sublethal concentrations of these desiccants at the 50% heading growth stage.

Inosine modulates antitumor immunity Checkpoint blockade immunotherapy harnesses the immune system to kill cancer cells and has been used with great success to treat certain tumors, but not all cancer patients respond. The efficacy of checkpoint blockade immunotherapy has been shown to depend on the presence of distinct, beneficial bacteria residing in the gut of patients, but how the microbiome mediates such beneficial effects is unclear. Mager et al. found that specific bacteria produce a metabolite called inosine that enhances the effect of checkpoint blockade immunotherapy (see the Perspective by Shaikh and Sears). In mouse models, inosine, together with proinflammatory stimuli and immunotherapy, strongly enhanced the antitumor capacities of T cells in multiple tumor types, including colorectal cancer, bladder cancer, and melanoma. Science , this issue p. 1481 ; see also p. 1427

Background The phosphatidyl 3-inositol kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) pathway frequently is activated in patients with urothelial carcinoma (UC). In the current study, the authors performed a phase 2 study evaluating the efficacy of the pan-isoform class I PI3K inhibitor buparlisib in patients with platinum-refractory metastatic UC. Methods Two cohorts were recruited: an initial genetically unselected cohort and a subsequent expansion cohort of patients with PI3K/Akt/mTOR pathway-altered tumors. The primary endpoint was the 2-month progression-free survival rate. A rate of ≥80% was considered promising using a Simon 2-stage minimax design. Secondary endpoints included safety and correlation of markers of PI3K pathway activation with outcome. Results Six of 13 evaluable patients within the initial cohort demonstrated stable disease and 1 demonstrated a partial response, which was below the cutoff of 9 patients required to proceed to stage 2. Three of the patients with stable disease and the patient with a partial response harbored somatic TSC1 alterations. Four patients subsequently were recruited onto an expansion cohort: 3 patients with TSC1 alterations and 1 patient with a PIK3CA-activating mutation. No patient achieved disease control at 8 weeks and accrual was halted. Of the 19 patients evaluable for toxicity, 17 demonstrated treatment-related toxicities, 2 of whom had to discontinue therapy. Conclusions Buparlisib was found to demonstrate modest activity in patients with metastatic UC whose tumors harbored TSC1 loss of function alterations; however, this was not a robust predictor of response to buparlisib. The pattern of genetic coalterations likely influences drug sensitivity. Given the modest clinical activity and substantial toxicity of buparlisib, future trials of PI3K inhibitors in patients with UC should focus on isoform-selective PI3K inhibitors in genomically selected patients. Lay summary The phosphatidyl 3-inositol kinase (PI3K)/Akt/mechanistic target of rapamycin (mTOR) signaling pathway frequently is upregulated in patients with metastatic urothelial carcinoma (UC). This trial explored buparlisib, an inhibitor of the pathway, in patients with heavily pretreated metastatic UC. Although the drug was found to have modest efficacy, with 6 patients experiencing stable disease and 1 patient achieving a partial response at 8 weeks on therapy, significant side effects also were observed. Patients with specific genetic alterations responded to treatment. Further studies of PI3K pathway inhibition are warranted using newer agents that have superior toxicity profiles and are more selective inhibitors of the pathway.

Spontaneous formation of vesicles from the self-assembly of two specific surfactants, one zwitterionic (oleyl amidopropyl betaine, OAPB) and the other anionic (Aerosol-OT, AOT), is explored in water using small-angle scattering techniques. Two factors were found to be critical in the formation of vesicles: surfactant ratio, as AOT concentrations less than equimolar with OAPB result in cylindrical micelles or mixtures of micellar structures, and salt concentration, whereby increasing the amount of NaCl promotes vesicle formation by reducing headgroup repulsions. Small-angle neutron scattering measurements reveal that the vesicles are approximately 30-40 nm in diameter, depending on sample composition. Small-angle X-ray scattering measurements suggest preferential partitioning of OAPB molecules on the vesicle inner layer to support vesicular packing. Heating the vesicles to physiological temperature (37 °C) causes them to collapse into smaller ellipsoidal micelles (2-3 nm), with higher salt concentrations (≥10 mM) inhibiting this transition. These aggregates could serve as responsive carriers for loading or unloading of aqueous cargoes such as drugs and pharmaceuticals, with temperature changes serving as a simple release/uptake mechanism.

OBJECTIVE Previous trials evaluated the efficacy of lumacaftor/ivacaftor in Phe508del homozygotes. These trials are limited by manufacturer sponsorship and were conducted under strict protocol. Additionally, this therapy is costly and does not allow for reduction in daily cystic fibrosis therapies. This study assessed the efficacy of lumacaftor/ivacaftor therapy and its effect on health care utilization in a real-world setting. METHODS Retrospective chart review comparing the first 12 months of therapy to the 24 months prior was conducted to evaluate the impact of lumacaftor/ivacaftor on pulmonary function following a streamlined process for therapy introduction. The impact on body mass index and healthcare utilization were also evaluated. The following measurements were assessed: percent predicted forced expiratory volume in 1 second, body mass index and z-scores, number of admissions, length of stay, number of emergency department visits. RESULTS Mean ppFEV1 was improved for the first 12 months on lumacaftor/ivacaftor treatment when compared with the 24 months prior: 78.8 (95% CI: 72.6, 84.9) vs 76.2 (95% CI: 70.1, 82.3) (p = 0.03). Body mass index significantly improved (patients ≥20 years), but improvement in BMI z-score (patients CONCLUSIONS Lumacaftor/ivacaftor is effective for improving ppFEV1 and BMI and for reducing health care utilization. However, this small reduction does not overcome the financial cost of treatment. Long-term outcomes and use must be studied to determine the overall effect of this therapy on cystic fibrosis interventions and their costs.

The spectra for H5+ and D5+ are extended to cover the region between 4830 and 7300 cm-1. These spectra are obtained using mass-selected photodissociation spectroscopy. To understand the nature of the states that are accessed by the transitions in this and prior studies, we develop a four-dimensional model Hamiltonian. This Hamiltonian is expressed in terms of the two outer H2 stretches, the displacement of the shared proton from the center of mass of these two H2 groups, and the distance between the H2 groups. This choice is motivated by the large oscillator strength associated with the shared proton stretch and the fact that the spectral regions that have been probed correspond to zero, one, and two quanta of excitation in the H2 stretches. This model is analyzed using an adiabatic separation of the H2 stretches from the other two vibrations and includes the non-adiabatic couplings between H2 stretch states with the same total number of quanta of excitation in the H2 stretches. Based on the analysis of the energies and wave functions obtained from this model, we find that when there are one or more quanta of excitation in the H2 stretches the states come in pairs that reflect tunneling doublets. The states accessed by the transitions in the spectrum with the largest intensity are assigned to the members of the doublets with requisite symmetry that are localized on the lowest-energy adiabat for a given level of H2 excitation.