Urinary Tubular Injury Biomarkers Are Associated With ESRD and Death in the REGARDS Study.

IntroductionUrinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary kidney injury molecule-1 (uKIM-1) are established markers of subclinical acute kidney injury. In persons with reduced estimated glomerular filtration rate (eGFR) and albuminuria who are at high risk for end-stage renal disease (ESRD) and death, the associations of these urinary markers with incident ESRD or death is an area of active investigation.MethodsAmong 1472 black and white participants from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study with eGFR ≤60 ml/min per 1.73 m2 (Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI] cystatin, 2012) and albumin-to-creatinine ratio (ACR) ≥30 mg/g, we evaluated the associations of baseline uNGAL and uKIM-1 with progression to ESRD and all-cause death. Cox models were sequentially adjusted for urinary creatinine, traditional risk factors, C-reactive protein, ACR, and eGFR.ResultsThere were 257 ESRD events and 819 deaths over a median follow-up of 5.7 and 6.5 years, respectively. In demographic adjusted models, higher levels of uNGAL were associated with increased risk of ESRD and death, but these associations were attenuated in fully adjusted models including baseline eGFR for both ESRD (hazard ratio [HR] = 1.06 per doubling, 95% confidence interval [CI] 0.98-1.14) and death (HR = 1.04, 95% CI = 1.00-1.08). Higher levels of uKIM-1 were associated with increased risk of ESRD and death in demographic-adjusted models, and although attenuated in fully adjusted models, remained statistically significant for both ESRD (HR = 1.24 per doubling, 95% CI = 1.08-1.42) and death (HR = 1.10, 95% CI =1.03-1.19).ConclusionIn this cohort of high-risk patients with baseline eGFR ≤60 ml/min per 1.73 m2 and albuminuria, renal tubular injury is associated with higher mortality and progression to ESRD. Further studies are necessary to investigate the mechanism underlying this increased risk

Nuclear magnetic resonance spectroscopy: An experimentally accessible paradigm for quantum computing

We present experimental results which demonstrate that nuclear magnetic resonance spectroscopy is capable of efficiently emulating many of the capabilities of quantum computers, including unitary evolution and coherent superpositions, but without attendant wave-function collapse. Specifically, we have: (1) Implemented the quantum XOR gate in two different ways, one using Pound-Overhauser double resonance, and the other using a spin-coherence double resonance pulse sequence; (2) Demonstrated that the square root of the Pound-Overhauser XOR corresponds to a conditional rotation, thus obtaining a universal set of gates; (3) Devised a spin-coherence implementation of the Toffoli gate, and confirmed that it transforms the equilibrium state of a four-spin system as expected; (4) Used standard gradient-pulse techniques in NMR to equalize all but one of the populations in a two-spin system, so obtaining the pseudo-pure state that corresponds to |00>; (5) Validated that one can identify which basic pseudo-pure state is present by transforming it into one-spin superpositions, whose associated spectra jointly characterize the state; (6) Applied the spin-coherence XOR gate to a one-spin superposition to create an entangled state, and confirmed its existence by detecting the associated double-quantum coherence via gradient-echo methods.Comment: LaTeX + epsfig + amsmath packages, 27 pages, 12 figures, to appear in Physica D; revision updates list of authors and reference

Acetic acid ketonization over Fe3O4/SiO2 for pyrolysis bio-oil upgrading

A family of silica supported, magnetite nanoparticle catalysts was synthesized and investigated for continuous flow acetic acid ketonization as a model pyrolysis bio-oil upgrading reaction. Physicochemical properties of Fe3O4/SiO2 catalysts were characterized by HRTEM, XAS, XPS, DRIFTS, TGA and porosimetry. Acid site densities were inversely proportional to Fe3O4 particle size, although acid strength and Lewis character were size invariant, and correlated with the specific activity for vapor phase acetic ketonization to acetone. A constant activation energy (~110 kJ.mol-1), turnover frequency (~13 h-1) and selectivity to acetone of 60 % were observed for ketonization across the catalyst series, implicating Fe3O4 as the principal active component of Red Mud waste

Association of urinary uromodulin with kidney function decline and mortality: the health ABC study .

BackgroundUrine uromodulin (uUMOD) is a protein secreted by the kidney tubule. Recent studies have suggested that higher uUMOD may be associated with improved kidney and mortality outcomes.MethodsUsing a case-cohort design, we evaluated the association between baseline uUMOD levels and ≥ 30% estimated glomerular filtration rate (eGFR) decline, incident chronic kidney disease (CKD), rapid kidney function decline, and mortality using standard and modified Cox proportional hazards regression.ResultsThe median value of uUMOD was 25.8 µg/mL, mean age of participants was 74 years, 48% were women, and 39% were black. Persons with higher uUMOD had lower prevalence of diabetes and coronary artery disease (CAD), and had lower systolic blood pressure. Persons with higher uUMOD also had higher eGFR, lower urinary albumin to creatinine ratio (ACR), and lower C-reactive protein (CRP). There was no association of uUMOD with > 30% eGFR decline. In comparison to those in the lowest quartile of uUMOD, those in the highest quartile had a significantly (53%) lower risk of incident CKD (CI 73%, 18%) and a 51% lower risk of rapid kidney function decline (CI 76%, 1%) after multivariable adjustment. Higher uUMOD was associated with lower risk of mortality in demographic adjusted models, but not after multivariable adjustment.ConclusionHigher levels of uUMOD are associated with lower risk of incident CKD and rapid kidney function decline. Additional studies are needed in the general population and in persons with advanced CKD to confirm these findings.