Identification and verification of novel ferroptosis biomarkers predicts the prognosis of hepatocellular carcinoma.

BACKGROUND: Big data mining and experiments are widely used to mine new prognostic markers. METHODS: Candidate genes were identified from CROEMINE and FerrDb. Kaplan-Meier survival and Cox regression analysis were applied to assess the association of genes with Overall survival time (OS) and Disease-free survival time (DFS) in two HCC cohorts. Real-time quantitative polymerase chain reaction (RT-qPCR) and Immunohistochemistry were performed in HCC samples. RESULTS: 21 and 15 genes that can predict OS and DFS, which had not been reported before, were identified from 719 genes, respectively. Survival analysis showed elevated mRNA expression of GLMP, SLC38A6, and WDR76 were associated with poor prognosis, and three genes combination signature was an independent prognostic factor in HCC. RT-qPCR and Immunohistochemistry confirmed the results. CONCLUSIONS: We established a novel computational process, which identified the expression levels of GLMP, SLC38A6, and WDR76 as potential ferroptosis-related biomarkers indicating the prognosis of HCC.

Simultaneous co-Photocatalytic CO2 Reduction and Ethanol Oxidation towards Synergistic Acetaldehyde Synthesis.

Photocatalytic conversion of CO2 is of great interest but it often suffers sluggish oxidation half reaction and undesired by-products. Here, we report for the first the simultaneous co-photocatalytic CO2 reduction and ethanol oxidation towards one identical value-added CH3 CHO product on a rubidium and potassium co-modified carbon nitride (CN-KRb). The CN-KRb offers a record photocatalytic activity of 1212.3 µmol h-1 g-1 with a high selectivity of 93.3 % for CH3 CHO production, outperforming all the state-of-art CO2 photocatalysts. It is disclosed that the introduced Rb boosts the *OHCCHO fromation and facilitates the CH3 CHO desorption, while K promotes ethanol adsorption and activation. Moreover, the H+ stemming from ethanol oxidation is confirmed to participate in the CO2 reduction process, endowing near ideal overall atomic economy. This work provides a new strategy for effective use of the photoexcited electron and hole for high selective and sustainable conversion of CO2 paired with oxidation reaction into identical product.

Correlations of serum cystatin C level and gene polymorphism with vascular cognitive impairment after acute cerebral infarction.

BACKGROUND: The aim of this study was to explore the possible correlations of serum cystatin C level and cystatin C gene (CST3) polymorphism with vascular cognitive impairment in patients who had acute cerebral infarction. METHODS: A total of 152 patients with acute cerebral infarction were recruited in this case-control study. Patients were divided into vascular cognitive impairment (VCI) group (n = 71) and cognitive impairment no dementia (CIND) group (n = 81). The serum concentrations of cystatin C were measured with immunoturbidimetric assay while the gene polymorphisms of CST3 were determined by technique polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: In the VCI group, serum cystatin C level was significantly higher than that in the control group. The frequency of the B allele was found to be higher in the VCI group as compared with that of the CIND group (18.5% vs 7.7%, p = 0.006). In logistic regression analysis, significant associations of VCI with high serum cystatin C level (OR 3.837 (1.176-12.520), p = 0.026) and CST3 B allele (OR 2.038 (1.048-3.963), p = 0.036) were also found. CONCLUSIONS: A high cystatin C level and CST3 B allele confer risks for VCI after acute cerebral infarction. It is probable that measurement of the serum cystatin C level and detection of CST3 gene polymorphism would aid in the early diagnosis of VCI, but further studies are warranted.

Evaluation of individual metal contribution on active sites tailoring in multimetallic oxygen evolution catalytic system.

Synergistic effects among different metals have positioned multimetallic electrocatalysts as promising facilitators for enhancing the oxygen evolution reaction (OER), though understanding their precise mechanisms has remained elusive. Delving into the unique contributions of individual metals is crucial for comprehending the complex synergy within multimetallic systems. In this study, we employed quinary (Co, Ce, Fe, Cu, and Mn) molybdates as a model to systematically investigate the role of each metal species in tailoring active sites. Our systematic analyses unveiled the presence of crucial oxygen vacancies, which can be considered as the active sites in OER. Comparative analyses of the top-performing quinary molybdates and their quaternary counterparts highlighted distinct electronic interactions and varying densities of oxygen vacancies, indicative of the diverse electron and vacancy engineering capabilities inherent to different metals. Mott-schottky plots demonstrated the predominant contribution of Mn to specific catalytic activity, followed by Ce, Fe, Cu, and Co. Leveraging an in-situ methanol probing method, it was found that the introduction of Cu, Ce, Fe, and Mn weakened intermediate adsorption, with Mn and Ce having the most significant effects, whereas Co strengthened adsorption. This work can advance our comprehension of the role played by individual metals within multimetallic catalysts, thereby promoting a more profound understanding of synergistic effects.

NiFe codoping-regulated amorphous/crystalline heterostructured Co-based hydroxides/tungstate with rich oxygen vacancies for efficient water oxidation catalysis.

Oxygen evolution reaction (OER) is a crucial half-reaction in water splitting, generating hydrogen for sustainable development, but it is often subject to sluggish kinetics. Abundant transition metal-based OER electrocatalysts have been utilized to expedite the process. However, traditional amorphous catalysts suffer from low conductivity, while the activity of crystalline catalysts is also unsatisfactory. Herein, an amorphous/crystalline heterostructured Co-based hydroxide/tungstate was meticulously constructed and further tailored using a NiFe codoping method (NiFeCoW). Following NiFe codoping, the electronic structure had been modulated, subsequently altering the adsorption toward intermediates. From the electrochemical measurements, the NiFeCoW catalyst demonstrated superior electrocatalytic activity for OER in alkaline media, with a minimal overpotential of 297 mV at 10 mA cm-2 and a cell voltage of 1.57 V for water splitting. This study provides valuable guidance for regulating the amorphous/crystalline heterophase in catalysts through bimetallic modulating engineering.

Correlation between urinary rare earth elements and liver function in a Zhuang population aged 35-74 years in Nanning.

BACKGROUND: Animal studies have shown that exposure to REEs can cause severe liver damage, but evidence from population studies is still lacking. Therefore, we investigated the relationship between REEs concentrations in urine and liver function in the population. METHODS: We conducted a cross-sectional study on 1024 participants in Nanning, China. An inductively coupled plasma mass spectrometer (ICP-MS) was used to detect the concentrations of 12 REEs in urine. The relationship between individual exposure to individual REE and liver function was analyzed by multiple linear regression. Finally, the effects of co-exposure to 5 REEs on liver function were assessed by a weighted sum of quartiles (WQS) regression model and a Bayesian kernel machine regression (BKMR) model. RESULTS: The detection rate of 5 REEs, lanthanum (La), cerium (Ce), praseodymium (Pr), neodymium (Nd), and dysprosium (Dy), is greater than 60%. After multiple factor correction, La, Ce, Pr, Nd, and Dy were positively correlated with serum ALP, Ce, Pr, and Nd were positively correlated with serum AST, while Ce was negatively correlated with serum TBIL and DBIL. Both WQS and BKMR results indicate that the co-exposure of the 5 REEs is positively correlated with serum ALP and AST, while negatively correlated with serum DBIL. There were potential interactions between La and Ce, La and Dy in the association of co-exposure of the 5 REEs with serum ALP. CONCLUSIONS: The co-exposure of the 5 REEs was positively correlated with serum ALP and AST, and negatively correlated with serum DBIL.

A nomogram based on inflammation and nutritional biomarkers for predicting the survival of breast cancer patients.

Background: We aim to develop a new prognostic model that incorporates inflammation, nutritional parameters and clinical-pathological features to predict overall survival (OS) and disease free survival (DFS) of breast cancer (BC) patients. Methods: The study included clinicopathological and follow-up data from a total of 2857 BC patients between 2013 and 2021. Data were randomly divided into two cohorts: training (n=2001) and validation (n=856) cohorts. A nomogram was established based on the results of a multivariate Cox regression analysis from the training cohorts. The predictive accuracy and discriminative ability of the nomogram were evaluated by the concordance index (C-index) and calibration curve. Furthermore, decision curve analysis (DCA) was performed to assess the clinical value of the nomogram. Results: A nomogram was developed for BC, incorporating lymphocyte, platelet count, hemoglobin levels, albumin-to-globulin ratio, prealbumin level and other key variables: subtype and TNM staging. In the prediction of OS and DFS, the concordance index (C-index) of the nomogram is statistically greater than the C-index values obtained using TNM staging alone. Moreover, the time-dependent AUC, exceeding the threshold of 0.7, demonstrated the nomogram's satisfactory discriminative performance over different periods. DCA revealed that the nomogram offered a greater overall net benefit than the TNM staging system. Conclusion: The nomogram incorporating inflammation, nutritional and clinicopathological variables exhibited excellent discrimination. This nomogram is a promising instrument for predicting outcomes and defining personalized treatment strategies for patients with BC.

Remote ischemic conditioning in the treatment of acute cerebral infarction: A case control study.

Objective: This paired case-control study aimed to evaluate the efficacy and safety of remote ischemic conditioning (RIC) in patients with acute cerebral infarction (CI) and explore potential serological markers of RIC. Methods: Patients with acute CI (<72 h) were matched 1:1 according to age, sex, and CI conditions and were divided into the RIC group and the control group. The RIC group received RIC intervention for 7 days on top of routine treatment, while the control group received a sham RIC. The curative effects and adverse reactions were observed. Result: A total of 66 patients (mean age 60.00 ± 11.37 years; mean time of acute CI onset 32.91 ± 17.94 h) completed the study. The National Institute of Health stroke scale score on day 7, modified Rankin Scale scores on day 7 and day 90 were significantly lower than the baseline in the RIC group (P < 0.001, P = 0.003, P = 0.004, respectively) but not in the control group (P = 0.056, P = 0.169, P = 0.058, respectively). RIC was well-tolerated, and no adverse events were reported. Both plasma hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor increased in the RIC group from day 0 to day 7, while they decreased in the control group. The changes in plasma HIF-1α in the RIC group were statistically different from those in the control group (P = 0.006). Conclusion: Early and short-term RIC treatment was well-tolerated and effective in improving the prognosis in acute CI. HIF-1α can be recognized as a biomarker for evaluating the efficacy of RIC treatment.

Iron/cobalt-decorated nitrogen-rich 3D layer-stacked porous biochar as high-performance oxygen reduction air-cathode catalyst in microbial fuel cell.

Developing low-cost and high-efficiency oxygen reduction reaction (ORR) catalysts is crucial to the commercial application of microbial fuel cell (MFC). Herein, Fe/Co-decorated nitrogen-rich three-dimensional (3D) layer-stacked porous biochar (Fe/Co-NC-x) have been synthesized from silk gel through secondary carbonization of activated carbons which firstly adsorbed metal ions. The multilayer porous structure of Fe/Co-NC-3 contributes to construction of high specific surface area (576 m2 g-1), large pore volume (1.27 cm3 g-1) and many defect structure (ID/IG = 1.004). As expected, with Fe/Co synergistic effect, Fe/Co-NC-3 exhibits excellent ORR performance through 4e- pathway with good methanol resistance. In addition, the performance of MFC using Fe/Co-NC-3 as air-cathode catalyst is more prominent with higher maximum power density (1059.62 ± 30.00 mW m-2) compared to that using NC (668.19 ± 9.84 mW m-2) and commercial Pt/C catalyst (957.33 ± 10.50 mW m-2). Therefore, Fe/Co-NC-3 should be a prospective catalyst in the practical application of fuel cells and other energy devices.

Resveratrol Suppresses Bupivacaine-Induced Spinal Neurotoxicity in Rats by Inhibiting Endoplasmic Reticulum Stress via SIRT1 Modulation.

Bupivacaine (BUP) may cause neurotoxic effects after spinal anesthesia. Resveratrol (RSV), a natural agonist of Silent information regulator 1 (SIRT1), protects various tissues and organs from damage by regulating endoplasmic reticulum (ER) stress. The aim of this study is to explore whether RSV could alleviate the neurotoxicity induced by bupivacaine via regulating ER stress. We established a model of bupivacaine-induced spinal neurotoxicity in rats using intrathecal injection of 5% bupivacaine. The protective effect of RSV was evaluated by injecting intrathecally with 30 µg/µL RSV in total of 10 µL per day for 4 consecutive days. On day 3 after bupivacaine administration, tail-flick latency (TFL) tests and the Basso, Beattie, and Bresnahan (BBB) locomotor scores were assessed to neurological function, and the lumbar enlargement of the spinal cord was obtained. H&E and Nissl staining were used to evaluate the histomorphological changes and the number of survival neurons. TUNEL staining was conducted to determine apoptotic cells. The expression of proteins was detected by IHC, immunofluorescence, and western blot. The mRNA level of SIRT1 was determined by RT-PCR. Bupivacaine caused spinal cord neurotoxicity by inducing cell apoptosis and triggering ER stress. RSV treatment promoted the recovery of neurological dysfunction after bupivacaine administration by suppressing neuronal apoptosis and ER stress. Furthermore, RSV upregulated SIRT1 expression and inhibited PERK signaling pathway activation. In summary, resveratrol suppresses bupivacaine-induced spinal neurotoxicity in rats by inhibiting endoplasmic reticulum stress via SIRT1 modulation.

Ferrostatin-1 ameliorates Bupivacaine-Induced spinal neurotoxicity in rats by inhibiting ferroptosis.

Bupivacaine (BUP) has previously been shown to trigger neurotoxicity after spinal anesthesia. Further, ferroptosis has been implicated in the pathological processes associated with various central nervous system diseases. Although the impact of ferroptosis on BUP-induced neurotoxicity in the spinal cord has not been fully understood, this research aims to investigate this relationship in rats. Additionally, this study aims to determine whether ferrostatin-1 (Fer-1), a potent inhibitor of ferroptosis, can provide protection against BUP-induced spinal neurotoxicity. The experimental model for BUP-induced spinal neurotoxicity involved the administration of 5% bupivacaine through intrathecal injection. Then, the rats were randomized into the Control, BUP, BUP + Fer-1, and Fer-1 groups. BBB scores, %MPE of TFL, and H&E and Nissl stainings showed that intrathecal Fer-1 administration improved functional recovery, histological outcomes, and neural survival in BUP-treated rats. Moreover, Fer-1 has been found to alleviate the BUP-induced alterations related to ferroptosis, such as mitochondrial shrinkage and disruption of cristae, while also reducing the levels of malondialdehyde (MDA), iron, and 4-hydroxynonenal (4HNE). Fer-1 also inhibits the accumulation of reactive oxygen species (ROS) and restores the normal levels of glutathione peroxidase 4 (GPX4), cystine/glutamate transporter (xCT), and glutathione (GSH). Furthermore, double-immunofluorescence staining revealed that GPX4 is primarily localized in the neurons instead of microglia or astroglia in the spinal cord. In summary, we demonstrated that ferroptosis play a pivotal role in mediating BUP-induced spinal neurotoxicity, and Fer-1 ameliorated BUP-induced spinal neurotoxicity by reversing the underlying ferroptosis-related changes in rats.

circELMOD3 increases and stabilizes TRIM13 by sponging miR-6864-5p and direct binding to inhibit HCC progression.

Many circular RNAs (circRNAs) have been identified to be associated with hepatocellular carcinoma (HCC) progression. We aim to explore the diagnostic potential, functions, and mechanism of circELMOD3 in HCC. Differentially expressed circRNAs in HCC and its paired adjacent tissues were identified by RNA sequencing. circELMOD3 was downregulated in HCC tissues and was related to clinicopathological characteristics of HCC patients. Additionally, plasma circELMOD3 was shown to be a highly sensitive and non-invasive biomarker to distinguish HCC from healthy controls. Functional assays showed that circELMOD3 inhibited proliferation and induced apoptosis of HCC cells both in vitro and in vivo. Mechanistically, RNA antisense purification (RAP) and luciferase reporter assays verified that circELMOD3 functioned as a sponge for miR-6864-5p leading to increased expression of its target gene TRIM13. Interestingly, RNA stability test demonstrated that circELMOD3 overexpression led to enhanced stability of its directly bound TRIM13 mRNA, which in turn co-activated the p53 signaling pathway.

Melatonin ameliorates bupivacaine-induced spinal neurotoxicity in rats by suppressing neuronal NLRP3 inflammasome activation.

Bupivacaine is a common local anesthetic that causes neurotoxicity when used at clinical concentrations. Melatonin (MT), is a potent neuroprotective molecule. The study aimed to characterize the neuroprotective effects of MT on spinal neurotoxicity induced by bupivacaine in rats. It showed that bupivacaine, by intrathecal injection, induced spinal injury, and that the protein levels of Nod-like receptor protein 3 (NLRP3), cleaved caspase-1, and the N-terminal region of gasdermin D (GSDMD-N) were significantly increased. NLRP3 was expressed mainly in neurons and microglia. MT treatment ameliorated bupivacaine-induced spinal cord injury in rats by suppressing activation of neuronal NLRP3 inflammasomes.

Hollow N-doped bimetal carbon spheres with superior ORR catalytic performance for microbial fuel cells.

Herein, we report the fabrication of bimetal ZIF-derived Cu/Co/N co-doped hollow spheres as effective oxygen reduction reaction (ORR) catalysts by the pyrolysis of core-shell polystyrene@Cu/Co-ZIFs (PS@Cu/Co-ZIFs) composite precursors. As a thermally degradable template, PS spheres are a key to determine the catalyst size. The bimetal ZIF hollow spheres were synthesized via a simple carbonization reaction, where ZIFs shells formed on PS spheres after the addition of metal sources, (Co(NO3)2 and Cu(NO3)2), and organic ligand 2-methylimidazole. Benefiting from the hollow structural and abundant catalytic sites, the as-prepared Cu/Co/N-doped hollow spheres showed superior electrocatalytic performances and excellent durability than commercial Pt/C catalysts. The on-set and half-wave potentials of the Cu/Co/N-HS-3 catalyst were 0.25 and 0.13 V (vs Ag/AgCl), respectively, which were greater than those of 20% Pt/C catalysts (0.24 and 0.12 V). Moreover, the Cu/Co/N-HS-3 catalyst-based air-cathode microbial fuel cells (MFCs) exhibited maximum output voltage and power density of 620 mV and 1016 mW/m2, respectively, demonstrating superiority to commercial Pt/C catalyst-based MFCs (586 mV and 908 mW/m2).

A pyridine-Fe gel with an ultralow-loading Pt derivative as ORR catalyst in microbial fuel cells with long-term stability and high output voltage.

A low-cost and high-efficiency oxygen reduction reaction (ORR) catalyst was fabricated using a pyridine-Fe gel with ultralow-loading of Pt nanoparticles and subsequently applied to air-cathode microbial fuel cells (MFCs). This novel catalyst (N3/Fe/C-Pt) exhibited excellent electrocatalytic activity with a positive onset potential of 0.19 V (vs Ag/AgCl) and half-wave potential of 0.03 V (vs Ag/AgCl), which is comparable to commercial PtC catalysts. More importantly, N3/Fe/C-Pt shows remarkable oxygen reduction activity in MFCs with a distinct output voltage (568 mV) and power density (504 mW m-2) for 400 h when it is fed with a culture medium containing 5 g L-1 sucrose in the phosphate buffer solution. This strategy, incorporating Pt nanoparticles uniformly into a conductive gel demonstrates significance for broadening the development and research of gel-based catalysts for applications in batteries.

The Treatment of Topical Drugs for Postherpetic Neuralgia: A Network Meta-Analysis.

BACKGROUND: Postherpetic neuralgia (PHN) is a neuropathic pain that causes a reduction in patients' quality of life. There are many topical drugs for PHN, including topical lidocaine patch, topical application of capsaicin, and others. OBJECTIVES: This study aims to compare the efficacy and safety of topical drugs for PHN. STUDY DESIGN: Relevant studies were found by systemically searching for terms including "topical" and "Postherpetic neuralgia" in PubMed, Cochrane library, MEDLINE, and EMBASE databases (inception through June 12, 2019). The primary outcome was the percentage of change in the Numeric Rating Scale or the Visual Analog Scale scores from baseline. The secondary outcome was the number of adverse events. METHODS: The efficacy and safety of topical drugs for PHN was investigated by the pairwise meta-analysis and Bayesian network meta-analysis, applying Revman 5.3, the Stata 14.0 software, and GeMTC 0.14.3. RESULTS: Twelve studies met the inclusion criteria, and eligible studies were selected for the ultimate meta-analysis. Our meta-analysis displayed 6 topical drugs for PHN. Lidocaine, high-concentration capsaicin, and aspirin/diethyl ether (ADE) had a higher possibility of bringing pain relief than placebo. Among them, lidocaine had the highest possibility of being the most effective drug for PHN and had the statistical significances compared with diclofenac, high-concentration capsaicin, indomethacin, low-concentration capsaicin, and placebo, and lidocaine was significantly preferable than other effective drugs in the aspect of safety. LIMITATIONS: (1) The small number of included studies; (2) a small number of patients and short-term trials in progress, including lidocaine and ADE; (3) both randomized controlled trial and crossover randomized trial were included in our network meta-analysis; (4) only studies published in English were evaluated; (5) lack of head-to-head comparisons of some treatments; (6) different measurement methods were used in different trial, which may cause deviation; and (7) with the lack of cycles in the included trials, the inconsistency factors cannot be calculated, and node-splitting method cannot be performed in our network meta-analysis to check the inconsistency. CONCLUSIONS: Compared with other topical drugs, lidocaine was the most effective and most tolerable drug to be recommended for PHN.

Salt-induced silk gel-derived N and trace Fe co-doped 3D porous carbon as an oxygen reduction catalyst in microbial fuel cells.

Inexpensive and high-efficiency oxygen reduction reaction (ORR) catalysts play a significant role in achieving practical applications of microbial fuel cells (MFCs). Hence, herein, novel nitrogen (N) and trace iron (Fe) co-doped three-dimensional (3D) porous carbon (NFex-C) was synthesized as an excellent ORR catalyst from an interesting salt-induced silk gel, which was beneficial to the spontaneously formation of porosity and boosted the ORR activity. Among the series of NFex-C, NFe0.5-C (1.20% N-ORR/C, 0.07 at% Fe) possessed a higher specific surface area (538.94 m2 g-1) and pore volume (2.158 cm3 g-1). Note that NFe0.5-C exhibited a significantly higher positive initial potential (0.274 V vs. Ag/AgCl) and half-wave potential (0.095 V vs. Ag/AgCl) than other catalysts and commercial Pt/C (20 wt%); this implied that it possessed prominent ORR catalytic activity. In the MFC tests, the output-voltage and maximum power density of NFe0.5-C were enhanced to 517.37 ± 7.87 mV and 605.35 ± 15.39 mW m-2, respectively. Moreover, NFe0.5-C (0.15 $ g-1) exhibits excellent anti-poisoning ability and is thousands of times cheaper than commercial Pt/C (20 wt%, 220.04 $ g-1); therefore, NFe0.5-C should be a prospective catalyst to substitute precious commercial Pt/C in MFCs and even for application in other types of fuel cells.

Superiority of boron, nitrogen and iron ternary doped carbonized graphene oxide-based catalysts for oxygen reduction in microbial fuel cells.

The exploration of highly active and cost-effective catalysts for the oxygen reduction reaction is vitally important to facilitate the improvement of metal-air batteries and fuel cells. Herein, super-active catalysts made from an interesting metal-polymer network (MPN) that consist of Fe-Nx-C, B-N and Fe3O4/Fe3C alloys were prepared via facile one-pot carbonization. The achieved catalysts possessed an amazing porous structure that was derived from the MPN with the assistance of a "bubble-template". Remarkably, the content of highly active Fe-Nx-C can be regulated by introducing graphene, and the ORR activity of the catalyst was enhanced dramatically with an increase in the Fe3O4/Fe3C alloy content. The most active BNFe-C-G2 catalyst exhibited superior ORR activity/stability, and was then employed as an air cathode electrocatalyst in a microbial fuel cell. The results showed that the output voltage and power density of BNFe-C-G2 were significantly improved to 575 ± 11 mV and 1046.2 ± 35 mW m-2, respectively. These values are 4.5% and 44.44% higher than those of commercial Pt/C. Thus, due to the synergistic electrocatalysis of the Fe-Nx-C, B-N and Fe3O4/Fe3C alloys, the super-active and low-cost BNFe-C-G2 material should be a promising ORR catalyst for application in biofuel cells, and in many other energy conversion and storage devices.

Combination of Ewing test, heart rate variability, and heart rate turbulence analysis for early diagnosis of diabetic cardiac autonomic neuropathy.

The aim of this study was to compare and analyze Ewing test, heart rate variability (HRV), and heart rate turbulence (HRT) in the diagnosis of cardiac autonomic neuropathy (CAN) in diabetic patients.Ninety diabetic patients (age 18-78) and 20 nondiabetic control subjects were studied. Standard Ewing test and 24-hour Holter was performed in all participants to evaluate CAN. Patients with Ewing score ≥2 were classified as CAN+.The rate of CAN+ in diabetic patients [44.4% (40/90)] was higher than that in the controls [5% (1/20)] (P < .05). Using the HRV analysis and HRT analysis, rates of CAN+ in diabetic patients were 56.67% (51/90) and 52.22% (47/90), respectively. SD of all normal-to-normal (NN) intervals (SDNN), SD of the average NN intervals calculated over 5-minute periods of the entire recording (SDANN), low frequency power (LF), and turbulence slope (TS) were significantly correlated negatively with Ewing scores. TS (r = -0.68, P < .05) and SDNN (r = -0.58, P < .05) had the strongest correlation with Ewing scores among relevant factors. Combining TS with SDNN as diagnostic criteria for CAN, the diagnostic sensitivity can be increased to 98%.Parameters used for evaluating parasympathetic functions in Ewing test, HR variability, and HR turbulence were found to significantly decrease in CAN+ group. The combination of SDNN and TS showed greater diagnostic value than Ewing test, HRV analysis, or HRT analysis alone.

Gas-Flow Tailoring Fabrication of Graphene-like Co-Nx-C Nanosheet Supported Sub-10 nm PtCo Nanoalloys as Synergistic Catalyst for Air-Cathode Microbial Fuel Cells.

In this work, we presented a novel, facile, and template-free strategy for fabricating graphene-like N-doped carbon as oxygen reduction catalyst in sustainable microbial fuel cells (MFCs) by using an ion-inducing and spontaneous gas-flow tailoring effect from a unique nitrogen-rich polymer gel precursor which has not been reported in materials science. Remarkably, by introduction of trace platinum- and cobalt- precursor in polymer gel, highly dispersed sub-10 nm PtCo nanoalloys can be in situ grown and anchored on graphene-like carbon. The as-prepared catalysts were investigated by a series of physical characterizations, electrochemical measurements, and microbial fuel cell tests. Interestingly, even with a low Pt content (5.13 wt %), the most active Co/N codoped carbon supported PtCo nanoalloys (Co-N-C/Pt) exhibited dramatically improved catalytic activity toward oxygen reduction reaction coupled with superior output power density (1008 ± 43 mW m-2) in MFCs, which was 29.40% higher than the state of the art Pt/C (20 wt %). Notability, the distinct catalytic activity of Co-N-C/Pt was attributed to the highly efficient synergistic catalytic effect of Co-Nx-C and PtCo nanoalloys. Therefore, Co-N-C/Pt should be a promising oxygen reduction catalyst for application in MFCs. Further, the novel strategy for graphene-like carbon also can be widely used in many other energy conversion and storage devices.