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Understanding the electronic properties resulting from soft-hard material interfacial contact has elevated the utility of functional polymers in advanced materials and nanoscale structures, such as in work function engineering of two-dimensional (2D) materials to produce new types of high-performance devices. In this paper, we describe the electronic impact of functional polymers, containing both zwitterionic and fluorocarbon components in their side chains, on the work function of monolayer graphene through the preparation of negative-tone photoresists, which we term "fluorozwitterists." The zwitterionic and fluorinated groups each represent dipole-containing moieties capable of producing distinct surface energies as thin films. Kelvin probe force microscopy revealed these polymers to have a p-doping effect on graphene, which contrasts the work function decrease typically associated with polymer-to-graphene contact. Copolymerization of fluorinated zwitterionic monomers with methyl methacrylate and a benzophenone-substituted methacrylate produced copolymers that were amenable to photolithographic fabrication of fluorozwitterist structures. Consequently, spatial alteration of zwitterion coverage across graphene yielded stripes that resemble a lateral p-i-n diode configuration, with local increase or decrease of work function. Overall, this polymeric fluorozwitterist design is suitable for enabling simple, solution-based surface patterning and is anticipated to be useful for spatial work function modulation of 2D materials integrated into electronic devices.

Abstract: The future of coastal wetlands will depend on the combined effects of climate change and human impacts from urbanization and coastal management. Disentangling the effects of these factors is difficult, but satellite imagery archives provide a way to track biological and physical changes in wetlands over recent decades to reveal how coastal wetlands have been changing in response to climate and human drivers. In this study, we used Landsat to monitor the conditions of 32 coastal wetlands in southern California from 1984 to 2019 and identify environmental and human drivers of these trends. Wetland conditions were characterized by vegetation greenness, using the normalized difference vegetation index (NDVI), and by habitat composition, derived from areal estimates of wetland and subtidal habitats. Overall, wetlands displayed three types of long‐term response: greening and gaining wetland (10), greening and losing wetland (16), and browning and losing wetland (6). Regional environmental drivers with overall positive effects on wetland NDVI were sea level, wave height, and precipitation, whereas stream discharge, vapor pressure deficit, and air temperature had negative or nonlinear effects. Wetland area change was primarily correlated with sea level, but response was highly contextual among sites. Negative trends in wetland NDVI and area were more common in larger sites with low elevations and in sites with open inlets. Restoration had mixed effects, with only half of the restored sites showing positive changes in NDVI and wetland area post‐restoration. The important work of managing and restoring urban coastal wetlands is complicated by variability and context and requires us to account for the influence of humans and climate as we build a regional understanding of historic, present, and future wetland health.

Matters of sound and listening are increasingly being attended to across the social sciences and humanities, reflecting what has been termed a ‘sonic turn’ since the early 2000s. In urban ethnographic research, scholars are starting to pay attention to the role of sound in social relations, in expressions of identity and senses of belonging, as well as in processes of othering. In this paper, we explore the theoretical and methodological opportunities of sonic urban ethnography, that is, an urban ethnography that foregrounds sound and listening in theoretical and methodological ways. We argue that the promise of sonic urban ethnography lies in its ability to interrupt the predominant focus on text and the visual by developing expanded practices of listening for alternative ways of knowing and engaging with the urban. We share four empirical vignettes from Shanghai, Berlin and London that illustrate, in their different ways, the power exercised through sound in the urban environment. Our discussion of the empirical cases highlights three key ‘lessons’ for doing sonic urban ethnography.

Globally, many solar power plants and other types of renewable energy are being located in water-scarce regions. Many projects rely on groundwater resources whose sustainability is uncertain. In the Chuckwalla Basin in California, quantification of recharge and trans-valley underflow is needed to estimate the impacts of solar project withdrawals on the water table.However, such estimates are highly challenging due to data scarcity, heterogeneous soils and long residence times. Conventional assessment employs isolated groundwater models configured with crude and uniform estimates of recharge. Here, we employ a data-constrained surface subsurface processes model, PAWS+CLM, to provide an ensemble of recharges and underflows with perturbed parameters. Then, the Parameter Estimation (PEST) package is used to calibrate MODFLOW aquifer conductivity and filter out implausible recharges. The novel dual-model approach, potentially applicable in other arid regions, can effectively assimilate groundwater head observations, reject unrealistic parameters, and narrow the range of estimated drawdowns.Simulated recharge concentrates along alluvial fans at the mountain fronts and ephemeral washes where run-off water infiltrates. If an evenly distributed recharge was assumed, it resulted in under-estimated drawdown and larger uncertainty bounds. The withdrawals are approaching total inflow, suggesting the system will be nearing, if not exceeding, its sustainable groundwater production capacity, and a boom of such projects will not be sustainable. Especially, the cost/benefit of pumped-storage projects is called into question as the initial-fill phase depletes entire area’s recharge. Our study highlights the stress on groundwater resources of solar development, and that the speed of groundwater recovery does not indicate sustainability.

Objective: To develop natural language processing (NLP) solutions for identifying patients’ unmet social needs to enable timely intervention. Patients and Methods: Design: A retrospective cohort study with review and annotation of clinical notes to identify unmet social needs, followed by using the annotations to develop and evaluate NLP solutions. Participants: A total of 1103 primary care patients seen at a large academic medical center from June 1, 2019, to May 31, 2021 and referred to a community health worker (CHW) program. Clinical notes and portal messages of 200 age and sex-stratified patients were sampled for annotation of unmet social needs. Systems: Two NLP solutions were developed and compared. The first solution employed similarity-based classification on top of sentences represented as semantic embedding vectors. The second solution involved designing of terms and patterns for identifying each domain of unmet social needs in the clinical text. Measures: Precision, recall, and f1-score of the NLP solutions. Results: A total of 5675 clinical notes and 475 portal messages were annotated, with an inter-annotator agreement of 0.938. The best NLP solution achieved an f1-score of 0.95 and was applied to the entire CHW-referred cohort (n=1103), of whom >80% had at least 1 unmet social need within the 6 months before the first CHW referral. Financial strain and health literacy were the top 2 domains of unmet social needs across most of the sex and age strata. Conclusion: Clinical text contains rich information about patients’ unmet social needs. The NLP can achieve good performance in identifying those needs for CHW referral and facilitate data-driven research on social determinants of health.

Fracture injection/shut-in tests are commonly used to measure the state of stress in the subsurface. Injection creates a hydraulic fracture (or in some cases, opens a preexisting fracture), and then the pressure after shut-in is monitored to identify fracture closure. Different interpretation procedures have been proposed for estimating closure, and the procedures sometimes yield significantly different results. In this study, direct, in-situ strain measurements are used to observe fracture reopening and closure. The tests were performed as part of the EGS Collab project, a mesoscale project performed at 1.25 and 1.5 km depth at the Sanford Underground Research Facility. The tests were instrumented with the SIMFIP tool, a double-packer probe with a high-resolution three-dimensional borehole displacement sensor. The measurements provide a direct observation of the fracture closure signature, enabling a high-fidelity estimate of the fracture closure stress (ie, the normal stress on the fracture). In two of the four tests, injection created an opening mode fracture, and so the closure stress can be interpreted as the minimum principal stress. In the other two tests, injection probably opened preexisting natural fractures, and so the closure stress can be interpreted as the normal stress on the fractures. The strain measurements are compared against different proposed methods for estimating closure stress from pressure transients. The shut-in transients are analyzed with two techniques that are widely used in the field of petroleum engineering – the ‘tangent’ method and the ‘compliance’ method. In three of the four tests, the tangent method significantly underestimates the closure stress. The compliance method is reasonably accurate in all four tests. Closure stress is also interpreted using two other commonly-used methods – ‘first deviation from linearity’ and the method of (Hayashi and Haimson, 1991). In comparison with the SIMFIP data, these methods tend to overestimate the closure stress, evidently because they identify closure from early-time transient effects, such as near-wellbore tortuosity. In two of the tests, microseismic imaging provides an independent estimate of the size of the fracture created by injection. When combined with a simple mass balance calculation, the SIMFIP stress measurements yield predictions of fracture size that are reasonably consistent with the estimates from microseismic. The calculations imply an apparent fracture toughness 2-3x higher than typical laboratory-derived values.

ABSTRACT: The Ly α forest (LAF) at z > 5 probes the thermal and reionization history of the intergalactic medium (IGM) and the nature of dark matter, but its interpretation requires comparison to cosmological hydrodynamical simulations. At high-z, convergence of these simulations is more exacting since transmission is dominated by underdense voids that are challenging to resolve. With evidence mounting for a late end to reionization, small structures down to the sub-kpc level may survive to later times than conventionally thought due to the reduced time for pressure smoothing to impact the gas, further tightening simulation resolution requirements. We perform a suite of simulations using the Eulerian cosmological hydrodynamics code Nyx, spanning domain sizes of 1.25 − 10 h−1 Mpc  and 5 − 80 h−1 kpc  cells, and explore the interaction of these variables with the timing of reionization on the properties of the matter distribution and the simulated LAF at z = 5.5. In observable Ly α power, convergence within 10 per cent is achieved for k < 0.1 s km–1, but larger k shows deviation of up to 20 per cent. While a later reionization retains more small structure in the density field, because of the greater thermal broadening there is little difference in the convergence of LAF power between early (z = 9) and later (z = 6) reionizations. We conclude that at z ∼ 5.5, resolutions of 10 kpc are necessary for convergence of LAF power at k < 0.1 s km–1, while higher-k modes require higher resolution, and that the timing of reionization does not significantly impact convergence given realistic photoheating.

Abstract This study explores the geochemical reactions that can cause permeability loss in hydraulically fractured reservoirs. The experiments involved the reaction of powdered-rock samples with produced brines in batch reactor system at temperature of 95 °C and atmospheric pressure for 7-days and 30-days respectively. Results show changes in mineralogy and chemistry of rock and fluid samples respectively, therefore confirming chemical reactions between the two during the experiments. The mineralogical changes of the rock included decreases of pyrite and feldspar content, whilst carbonate and illite content showed an initial stability and increase respectively before decreasing. Results from analyses of post-reaction fluids generally corroborate the results obtained from mineralogical analyses. Integrating the results obtained from both rocks and fluids reveal a complex trend of reactions between rock and fluid samples which is summarized as follows. Dissolution of pyrite by oxygenated fluid causes transient and localized acidity which triggers the dissolution of feldspar, carbonates, and other minerals susceptible to dissolution under acidic conditions. The dissolution of minerals releases high concentrations of ions, some of which subsequently precipitate secondary minerals. On the field scale, the formation of secondary minerals in the pores and flow paths of hydrocarbons can cause significant reduction in the permeability of the reservoir, which will culminate in rapid productivity decline. This study provides an understanding of the geochemical rock–fluid reactions that impact long term permeability of shale reservoirs.

Abstract Background Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation. The objective of the present study was to determine if a combination of several echocardiographic and clinical parameters may be used to evaluate LV filling pressure in patients with atrial fibrillation. Results In a multicentre study of 148 atrial fibrillation patients, several echocardiographic parameters were tested against invasively measured LV filling pressure as the reference method. No single parameter had sufficiently strong association with LV filling pressure to be recommended for clinical use. Based on univariate regression analysis in the present study, and evidence from existing literature, we developed a two-step algorithm for differentiation between normal and elevated LV filling pressure, defining values ≥ 15 mmHg as elevated. The parameters in the first step included the ratio between mitral early flow velocity and septal mitral annular velocity (septal E/e’), mitral E velocity, deceleration time of E, and peak tricuspid regurgitation velocity. Patients who could not be classified in the first step were tested in a second step by applying supplementary parameters, which included left atrial reservoir strain, pulmonary venous systolic/diastolic velocity ratio, and body mass index. This two-step algorithm classified patients as having either normal or elevated LV filling pressure with 75% accuracy and with 85% feasibility. Accuracy in EF ≥ 50% and EF

Abstract Background Quality smoking data is crucial for assessing smoking-related health risk and eligibility for interventions related to that risk. Smoking information collected in primary care practices (PCPs) is a major data source; however, little is known about the PCP smoking data quality. This project compared PCP smoking data to that collected in the Māori and Pacific Abdominal Aortic Aneurysm (AAA) screening programme. Methods A two stage review was conducted. In Stage 1, data quality was assessed by comparing the PCP smoking data recorded close to AAA screening episodes with the data collected from participants at the AAA screening session. Inter-rater reliability was analysed using Cohen’s kappa scores. In Stage 2, an audit of longitudinal smoking status was conducted, of a subset of participants potentially misclassified in Stage 1. Data were compared in three groups: current smoker (smoke at least monthly), ex-smoker (stopped > 1 month ago) and never smoker (smoked

Background Kidney disease is common in heart failure with preserved ejection fraction (HFpEF). However, the biologic correlates and prognostic significance of kidney injury (KI), in HFpEF, beyond the estimated glomerular filtration rate (eGFR), are unclear. Methods and Results Using baseline plasma samples from the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial, we measured the following KI biomarkers: cystatin‐C, fatty acid‐binding protein‐3, Beta‐2 microglobulin, neutrophil gelatinase‐associated lipocalin, and kidney‐injury molecule‐1. Factor analysis was used to extract the common variability underlying these biomarkers. We assessed the relationship between the KI‐factor score and the risk of death or HF‐related hospital admission in models adjusted for the Meta‐Analysis Global Group in Chronic Heart Failure risk score and eGFR. We also assessed the relationship between the KI factor score and ~5000 plasma proteins, followed by pathway analysis. We validated our findings among HFpEF participants in the Penn Heart Failure Study. KI was associated with the risk of death or HF‐related hospital admission independent of the Meta‐Analysis Global Group in Chronic Heart Failure risk score and eGFR. Both the risk score and eGFR were no longer associated with death or HF‐related hospital admission after adjusting for the KI factor score. KI was predominantly associated with proteins and biologic pathways related to complement activation, inflammation, fibrosis, and cholesterol homeostasis. KI was associated with 140 proteins, which reproduced across cohorts. Findings regarding biologic associations and the prognostic significance of KI were also reproduced in the validation cohort. Conclusions KI is associated with adverse outcomes in HFpEF independent of baseline eGFR. Patients with HFpEF and KI exhibit a plasma proteomic signature indicative of complement activation, inflammation, fibrosis, and impaired cholesterol homeostasis.

Recent progress in satellite observations has provided unprecedented opportunities to monitor vegetation activity at global scale. However, a major challenge in fully utilizing remotely sensed data to constrain land surface models (LSMs) lies in inconsistencies between simulated and observed quantities. For example, gross primary productivity (GPP) and transpiration (T) that traditional LSMs simulate are not directly measurable from space, although they can be inferred from spaceborne observations using assumptions that are inconsistent with those LSMs. In comparison, canopy reflectance and fluorescence spectra that satellites can detect are not modeled by traditional LSMs. To bridge these quantities, we presented an overview of the next generation land model developed within the Climate Modeling Alliance (CliMA), and simulated global GPP, T, and hyperspectral canopy radiative transfer (RT; 400–2,500 nm for reflectance, 640–850 nm for fluorescence) at hourly time step and 1° spatial resolution using CliMA Land. CliMA Land predicts vegetation indices and outgoing radiances, including solar-induced chlorophyll fluorescence (SIF), normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and near infrared reflectance of vegetation (NIRv) for any given sun-sensor geometry. The spatial patterns of modeled GPP, T, SIF, NDVI, EVI, and NIRv correlate significantly with existing data-driven products (mean R2 = 0.777 for 9 products). CliMA Land would be also useful in high temporal resolution simulations, for example, providing insights into when GPP, SIF, and NIRv diverge.

Abstract Interest continues to grow in Arctic megafaunal ecological engineering, but, since the mass extinction of megafauna ~ 12–15 ka, key physiographic variables and available forage continue to change. Here we sought to assess the extent to which contemporary Arctic ecosystems are conducive to the rewilding of megaherbivores, using a woolly mammoth (M. primigenius) proxy as a model species. We first perform a literature review on woolly mammoth dietary habits. We then leverage Oak Ridge National Laboratories Distributive Active Archive Center Global Aboveground and Belowground Biomass Carbon Density Maps to generate aboveground biomass carbon density estimates in plant functional types consumed by the woolly mammoth at 300 m resolution on Alaska’s North Slope. We supplement these analyses with a NASA Arctic Boreal Vulnerability Experiment dataset to downgrade overall biomass estimates to digestible levels. We further downgrade available forage by using a conversion factor representing the relationship between total biomass and net primary productivity (NPP) for arctic vegetation types. Integrating these estimates with the forage needs of woolly mammoths, we conservatively estimate Alaska’s North Slope could support densities of 0.0–0.38 woolly mammoth km−2 (mean 0.13) across a variety of habitats. These results may inform innovative rewilding strategies.

Abstract Excessive STAT3 signalling via gp130, the shared receptor subunit for IL-6 and IL-11, contributes to disease progression and poor survival outcomes in patients with colorectal cancer. Here, we provide evidence that bazedoxifene inhibits tumour growth via direct interaction with the gp130 receptor to suppress IL-6 and IL-11-mediated STAT3 signalling. Additionally, bazedoxifene combined with chemotherapy synergistically reduced cell proliferation and induced apoptosis in patient-derived colon cancer organoids. We elucidated that the primary mechanism of anti-tumour activity conferred by bazedoxifene treatment occurs via pro-apoptotic responses in tumour cells. Co-treatment with bazedoxifene and the SMAC-mimetics, LCL161 or Birinapant, that target the IAP family of proteins, demonstrated increased apoptosis and reduced proliferation in colorectal cancer cells. Our findings provide evidence that bazedoxifene treatment could be combined with SMAC-mimetics and chemotherapy to enhance tumour cell apoptosis in colorectal cancer, where gp130 receptor signalling promotes tumour growth and progression.

A key feature of unconventional shale reservoirs is low permeability. On average, only 10% of original oil in place and 25% of original gas in place is produced from these reservoirs. Understanding the mechanisms behind fracture conductivity past the first couple of years of shale production is still an ongoing research topic, as most such reservoirs report fast and massive production declines. Hydraulic fracturing is indispensable for stimulating low-permeability rocks for economical oil and gas production from unconventional reservoir rocks such as shales. In contrast, for subsurface sequestration and storage of fluids including supercritical CO2 (for carbon capture, utilization, and storage) and hydrogen gas, inadvertent creation of fractures can lead to breaching of shale caprock. The Caney Shale in southern Oklahoma is being evaluated as both a potential hydrocarbon-producing reservoir and a caprock for fluid sequestration. The Caney Shale is a Mississippian-age, organic-rich mudrock with intermittent calcareous laminae, that produces. But currently there is limited data reported regarding productivity of horizontally drilled wellbores. While many scholars have investigated fracture conductivity in shale reservoirs, the mechanisms of proppant embedment in relation to lithology are still under investigation. This study implemented a multi-scale approach towards investigating proppant embedment and fracture conductivity, from nano-scale instrumented micro/nano-indentation to millimeter (mm) scale, mono-layer propped fracture flow at reservoir temperature and pressure, and American Petroleum Institute (API)-RP19D conductivity tests using inch/cm-scale shale platens. At each scale, various material characterization tools were utilized, including Focused Ion Beam-Scanning Electron Microscopy (FIB-SEM), Energy Dispersive Spectroscopy (EDS), Raman spectroscopy, Laser profilometry, Computed X-ray Microscopy and X-ray Diffraction (XRD). The outcomes of the micro-indentation revealed variations in mechanical properties attributed to changing mineral composition and microstructures. Outcomes from API fracture conductivity testing and flow-through testing using a monolayer of proppant demonstrated: (1) a 50% impact on proppant embedment compared to ductile samples, (2) a significant decline in fracture conductivity with increasing stress and temperatures, and (3) conductivity that was also influenced by organic and inorganic content as well as internal sample architecture. Mineralogically, ductile samples contain about 25% more clay minerals compared to brittle regions. Heterogeneity in mineral composition causes the Caney Shale to show different responses at reservoir temperature and pressure, particularly in relation to creep and proppant embedment. Geomechanical and fluid-flow modeling have been conducted at several scales to help interpret laboratory results and apply findings to field-scale operation. The outcomes from this integration should aid geological and engineering predictions for the hydrocarbon production and caprock integrity of the Caney Shale.

IntroductionPatient and Public Involvement (PPI) can have a positive impact on research. PPI can make research more meaningful and appropriate as well as preventing research waste. For decades, patient advocates with HIV have played a key part in public health and research. This article presents the PPI activity undertaken during a doctoral study. The aim of this article is to demonstrate how PPI was embedded into a doctoral study that explored the feasibility of HIV testing in dental settings.MethodsPatients and the public were invited to be involved with the feasibility study through various organisations and charities. A comprehensive PPI activity strategy was devised, and appropriate funding was obtained. Patients and the public were predominantly consulted or collaboratively involved with several aspects of the study.FindingsPatients and the public positively contributed to the intervention development and the resources supporting its implementation. As a result, the study resources (i.e., questionnaire and information leaflets) were easier to read, and the intervention was more appropriate to the needs of patients. Furthermore, the training and focus groups conducted with dental patients and people with HIV benefitted from input of people with lived experience.ConclusionsPPI can be embedded within doctoral studies provided there is sufficient funding, flexibility, and supervisory support. However, PPI activity may be impacted by limited resource and a priori research protocol and funding agreements.

Abstract Fires were historically rare in tropical forests of West and Central Africa, where dense vegetation, rapid decomposition, and high moisture limit available fuels. However, increasing heat and drought combined with forest degradation and fragmentation are making these areas more susceptible to wildfires. We evaluated historical patterns of Moderate Resolution Imaging Spectroradiometer active fires in African tropical forests from 2003 to 2021. Trends were mostly positive, particularly in the northeastern and southern Congo Basin, and were concentrated in areas with high deforestation. Year‐to‐year variation of fires was synchronized with increasing temperature and vapor pressure deficit. There was anomalously high fire activity across the region during the 2015–2016 El Niño. These results contrast with the drier African woodlands and savannas, where fire has been decreasing. Further attention to fires in African tropical forests is needed to understand their global impacts on carbon dynamics and their local implications for biodiversity and human livelihoods.

Background The relationship of serial NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) measurements with changes in cardiac features and outcomes in heart failure (HF) remains incompletely understood. We determined whether common clinical covariates impact these relationships. Methods and Results In 2 nationwide observational populations with HF, the relationship of serial NT‐proBNP measurements with serial echocardiographic parameters and outcomes was analyzed, further stratified by HF with reduced versus preserved left ventricular ejection fraction, inpatient versus outpatient enrollment, age, obesity, chronic kidney disease, atrial fibrillation, and attainment of ≥50% guideline‐recommended doses of renin‐angiotensin system inhibitors and β‐blockers. Among 1911 patients (mean±SD age, 65.1±13.4 years; 26.6% women; 62% inpatient and 38% outpatient), NT‐proBNP declined overall, with more rapid declines among inpatients, those with obesity, those with atrial fibrillation, and those attaining ≥50% guideline‐recommended doses. Each doubling of NT‐proBNP was associated with increases in left ventricular volume (by 6.1 mL), E/e′ (transmitral to mitral annular early diastolic velocity ratio) (by 1.4 points), left atrial volume (by 3.6 mL), and reduced left ventricular ejection fraction (by −2.1%). The effect sizes of these associations were lower among patients with HF with preserved ejection fraction, atrial fibrillation, or advanced age (Pinteraction

Background Although several studies have addressed plasma proteomics in heart failure with preserved ejection fraction, limited data are available on the prognostic value of urinary proteomics. The objective of our study was to identify urinary proteins/peptides associated with death and heart failure admission in patients with heart failure with preserved ejection fraction. Methods and Results The study population included participants enrolled in TOPCAT (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist Trial). The relationship between urine protein levels and the risk of death or heart failure admission was assessed using Cox regression, in both nonadjusted analyses and adjusting for urine creatinine levels, and the MAGGIC (Meta‐Analysis Global Group in Chronic Heart Failure) score. A total of 426 (12.4%) TOPCAT participants had urinary protein data and were included. There were 40 urinary proteins/peptides significantly associated with death or heart failure admission in nonadjusted analyses, 21 of which were also significant adjusted analyses. Top proteins in the adjusted analysis included ANGPTL2 (angiopoietin‐like protein 2) (hazard ratio [HR], 0.5731 [95% CI, 0.47–0.7]; P=3.13E‐05), AMY2A (α amylase 2A) (HR, 0.5496 [95% CI, 0.44–0.69]; P=0.0001), and DNASE1 (deoxyribonuclease‐1) (HR, 0.5704 [95% CI, 0.46–0.71]; P=0.0002). Higher urinary levels of proteins involved in fibrosis (collagen VI α‐1, collagen XV α‐1), metabolism (pancreatic α‐amylase 2A/B, mannosidase α class 1A member 1), and inflammation (heat shock protein family D member 1, inducible T cell costimulatory ligand) were associated with a lower risk of death or heart failure admission. Conclusions Our study identifies several novel associations between urinary proteins/peptides and outcomes in heart failure with preserved ejection fraction. Many of these associations are independent of clinical risk scores and may aid in risk stratification in this patient population.