Scalable synthesis of coordinatively unsaturated metal-nitrogen sites for large-scale CO2 electrolysis.

Practical electrochemical CO2-to-CO conversion requires a non-precious catalyst to react at high selectivity and high rate. Atomically dispersed, coordinatively unsaturated metal-nitrogen sites have shown great performance in CO2 electroreduction; however, their controllable and large-scale fabrication still remains a challenge. Herein, we report a general method to fabricate coordinatively unsaturated metal-nitrogen sites doped within carbon nanotubes, among which cobalt single-atom catalysts can mediate efficient CO2-to-CO formation in a membrane flow configuration, achieving a current density of 200 mA cm-2 with CO selectivity of 95.4% and high full-cell energy efficiency of 54.1%, outperforming most of CO2-to-CO conversion electrolyzers. By expanding the cell area to 100 cm2, this catalyst sustains a high-current electrolysis at 10 A with 86.8% CO selectivity and the single-pass conversion can reach 40.4% at a high CO2 flow rate of 150 sccm. This fabrication method can be scaled up with negligible decay in CO2-to-CO activity. In situ spectroscopy and theoretical results reveal the crucial role of coordinatively unsaturated metal-nitrogen sites, which facilitate CO2 adsorption and key *COOH intermediate formation.

Isolation of Highly Reactive Cobalt Phthalocyanine via Electrochemical Activation for Enhanced CO2 Reduction Reaction.

Electrochemical CO2 -to-CO conversion offers an attractive and efficient route to recycle CO2 greenhouse gas. Molecular catalysts, like CoPc, are proved to be possible replacement for precious metal-based catalysts. These molecules, a combination of metal center and organic ligand molecule, may evolve into single atom structure for enhanced performance; besides, the manipulation of molecules' behavior also plays an important role in mechanism research. Here, in this work, the structure evolution of CoPc molecules is investigated via electrochemical-induced activation process. After numbers of cyclic voltammetry scanning, CoPc molecular crystals become cracked and crumbled, meanwhile the released CoPc molecules migrate to the conductive substrate. Atomic-scale HAADF-STEM proves the migration of CoPc molecules, which is the main reason for the enhancement in CO2 -to-CO performance. The as-activated CoPc exhibits a maximum FECO of 99% in an H-type cell and affords a long-term durability at 100 mA cm-2 for 29.3 h in a membrane electrode assembly reactor. Density-functional theory (DFT) calculation also demonstrates a favorable CO2 activation energy with such an activated CoPc structure. This work provides a different perspective for understanding molecular catalysts as well as a reliable and universal method for practical utilization.

Synergistic Cr2 O3 @Ag Heterostructure Enhanced Electrocatalytic CO2 Reduction to CO.

The electrocatalytic CO2 RR to produce value-added chemicals and fuels has been recognized as a promising means to reduce the reliance on fossil resources; it is, however, hindered due to the lack of high-performance electrocatalysts. The effectiveness of sculpturing metal/metal oxides (MMO) heterostructures to enhance electrocatalytic performance toward CO2 RR has been well documented, nonetheless, the precise synergistic mechanism of MMO remains elusive. Herein, an in operando electrochemically synthesized Cr2 O3 -Ag heterostructure electrocatalyst (Cr2 O3 @Ag) is reported for efficient electrocatalytic reduction of CO2 to CO. The obtained Cr2 O3 @Ag can readily achieve a superb FECO of 99.6% at -0.8 V (vs RHE) with a high JCO of 19.0 mA cm-2 . These studies also confirm that the operando synthesized Cr2 O3 @Ag possesses high operational stability. Notably, operando Raman spectroscopy studies reveal that the markedly enhanced performance is attributable to the synergistic Cr2 O3 -Ag heterostructure induced stabilization of CO2 •- /*COOH intermediates. DFT calculations unveil that the metallic-Ag-catalyzed CO2 reduction to CO requires a 1.45 eV energy input to proceed, which is 0.93 eV higher than that of the MMO-structured Cr2 O3 @Ag. The exemplified approaches in this work would be adoptable for design and development of high-performance electrocatalysts for other important reactions.

Association Between Long-Term HbA1c Variability and Functional Limitation in Individuals Aged Over 50 Years: A Retrospective Cohort Study.

Background: As mean HbA1c provides incomplete information regarding glycemic variability, there has been considerable interest in the emerging association between glycemic variability and macrovascular events and with microvascular complications and mortality in adults with and without diabetes. However, the association between long-term glycemic variability, represented by visit-to-visit HbA1c variability, and functional limitations has not been clarified in previous literature. The present study aimed to explore the longitudinal association between long-term glycemic variability, represented by visit-to-visit HbA1c variability and functional limitations. Methods: This cohort study included adults aged over 50 years who participated in the 2006 to 2016 waves of the Health and Retirement Study. Physical functions, including mobility, large muscle function, activities of daily living (ADLs), and instrumental ADLs (IADLs), were assessed at baseline and every 2 years, and HbA1c levels were assessed at baseline and every 4 years. Visit-to-visit HbA1c variability was calculated using the HbA1c variability score (HVS) during the follow-up period. Generalized estimating equation models were used to evaluate the longitudinal association between HbA1c variability and functional limitations with adjustment for a series of confounders. Results: A total of 5,544 participants having three HbA1c measurements from 2006 to 2016, having two or more physical function measures (including one at baseline), and age over 50 years were included in this analysis. The mean age at baseline was 66.13 ± 8.39 years. A total of 916 (16.5%) participants had an HVS = 100, and 35.1% had an HVS = 50. The highest HVS category (HVS =100) was associated with increased functional status score (ß = 0.093, 95% CI: 0.021-0.165) in comparison with the lowest HVS category (HVS = 0). Sensitivity analyses using the CV and SD of HbA1c as measures of variability showed similar associations between HbA1c variability and functional limitation. An incremental increase in HbA1c-CV (ß = 0.630, 95% CI: 0.127-1.132) or HbA1c-SD (ß = 0.078, 95% CI: 0.006-0.150) was associated with an increase in functional limitation in the fully adjusted model. Conclusions: HbA1c variability was associated with heightened difficulty in performing functional activities over time after adjusting for mean HbA1c levels and multiple demographics and comorbidities. This study provides further evidence regarding the detrimental effect of HbA1c variability and highlights the significance of steady glycemic control.

The Association between Diabetes Complications, Diabetes Distress, and Depressive Symptoms in Patients with Type 2 Diabetes Mellitus.

This study investigated the association between diabetes complications, diabetes distress, and depressive symptoms in patients with type 2 diabetes mellitus. A total of 600 patients with type 2 diabetes mellitus were included in this study. Data were collected using the Diabetes Distress Scale and the nine-item Patient Health Questionnaire. The results showed that both diabetes complications and diabetes distress were positively associated with depressive symptoms, and diabetes distress attenuated the association between diabetes complications and depressive symptoms. The Sobel test confirmed the mediating effect of diabetes distress. Patients with both diabetes complications and diabetes distress had a higher risk of depressive symptoms than those with diabetes complications or diabetes distress alone. This study indicates that the positive association between diabetes complications and depressive symptoms is persistent and mediated by diabetes distress, and the comorbidity of diabetes complications and diabetes distress has an additive interaction effect on depressive symptoms.

Perinatal depression: Data-driven subtypes derived from life history and mindfulness and personality.

BACKGROUND: Perinatal depression is the most prevalent mental disorder during the perinatal period, and research suggests that it presents heterogeneously. We aimed to explore how subtypes of perinatal depression present in terms of multivariate patterns of stable characteristics. METHODS: A cohort study was conducted from March 2016 to March 2018 with Chinese women in the prenatal period (n = 3186). Of the participants, 682 (21.41%) women with Edinburgh Postnatal Depression Scale scores ≥10, indicating probable depression, were included, with the remaining 2504 (78.59%) representing the control group. We assessed mood distress, cognition, life history, emotional regulation, and personality, and used latent class analysis and latent transition analysis to identify perinatal depression subtypes. Of the 682 women with probable depression, only 598 were included in the full analyses, as they completed at least 10 questionnaires. A second, non-overlapping sample and a follow-up cohort were used. RESULTS: We identified four subtypes: 1) a highly distressed type characterized by distress across all domains, high levels of rumination and neuroticism, and reduced trait mindfulness; 2) two moderately distressed types: one with high trauma and low perceived social support, and another with low trauma, high perceived social support, and expressive suppression; and 3) a slightly distressed subtype. LIMITATIONS: We only collected cost and time spent in hospital from medical records. We only had a small follow-up sample. CONCLUSIONS: This multidimensional subtyping of women with perinatal depression could help reduce the apparent heterogeneity of perinatal depression. Distinguishing the subtype characteristics facilitates identifying underlying causes of perinatal depression.

Suicidality among young adults: Unique and cumulative roles of 14 different adverse childhood experiences.

BACKGROUND: College students with suicidal ideation (SI) are at high risk of suicide. Adverse childhood experiences (ACEs) are important risk factors for suicidal behavior. Most research in this area has been restricted to 10 conventional ACEs and suggests negative long-term developmental effects from other common childhood adversities such as peer victimization, peer isolation/rejection, exposure to community violence, and low socioeconomic status. OBJECTIVE: To test the unique and cumulative associations of 14 different ACEs with SI among young adults. PARTICIPANTS AND SETTING: Participants were 989 college students from two universities in China's provincial-leveled Hui Autonomous Region. METHODS: Associations between ACEs and SI were analyzed by logistic regression. A Chi-square trend test was used to examine the association between cumulative ACEs and SI. RESULTS: The rates of suicidal ideation, plans, and attempts among the cohort were 11.9%, 3.7%, and 1.6%, respectively; 43.9% had experienced at least one ACE. The strongest predictor of SI in adulthood was peer isolation/rejection, followed by emotional neglect, then low socioeconomic status. There was a cumulative effect of ACEs and SI, whereby the greater the number of ACEs, the greater the likelihood of SI. CONCLUSION: Peer isolation/rejection, emotional neglect, and low socioeconomic status were associated with increased risk of SI in adulthood. Two (peer isolation/rejection and low socioeconomic status) of the three factors that emerged from the analysis are not typically included in ACEs research. There was a cumulative effect of 14 kinds of ACEs on SI among young adults. Early recognition of risk factors is therefore important.

Gender differences in factors associated with depression in infertility patients.

AIMS: To clarify gender differences in the demographic variables and infertility problems associated with depression among men and women undergoing infertility treatment. DESIGN: A cross-sectional study. METHODS: We surveyed 380 women and 360 men undergoing infertility treatment at the reproductive medicine center of a hospital in China's Ningxia Province from March - September 2016. RESULTS: For women, ethnicity, the number of clinic visits, social concern, and sexual concern were factors linked with depression symptoms. For men, treatment cost pressure and social concern were significantly associated with depression symptoms. CONCLUSION: Psychological counseling and intervention programs should be integrated into in-vitro fertilization treatments and interventions should be targeted based on gender differences. IMPACT: The provision of treatment-related sexual knowledge by nurses is indispensable for infertile participants. Mental health policies should be developed to facilitate the implementation of psychological services. Psychological counseling and intervention programs should be integrated into in vitro fertilization treatment to help men and women with infertility cope with psychological distress.

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis.

AIMS: To investigate clinically relevant subtypes of perinatal depressive symptoms. DESIGN: Cross-sectional study. METHODS: A sample of 2,783 women at different prenatal and postnatal periods was recruited between August 2015 - August 2017. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Data analyses consisted of latent class analysis (LCA), analysis of variance and multinomial logistic regression. RESULTS: (a) Five latent subtypes (Classes 5/4/3/1/2) were identified: 'no symptoms', 'mild physio-somatic symptoms', 'severe physio-somatic symptoms and moderate anhedonia', 'moderate-to-severe symptoms' and 'severe symptoms'; (b) Postpartum women were more likely to belong to the severe depressive symptoms group, whereas pregnant women were likely to report severe physio-somatic symptoms; and (c) History of abortion and perinatal complications increased the likelihood of belonging to all moderate-to-severe classes. Lower levels of education increased the probability of belonging to Class 2. Younger women were more likely to be categorized into Classes 1 and 2. CONCLUSIONS: This is the first study to examine heterogeneity of perinatal depressive symptoms and delineate the characteristics of subtypes at different prenatal and postnatal periods via the PHQ-9, using LCA in a Chinese general population. IMPACT: This research details the heterogeneity of perinatal depressive symptoms and delineates the characteristics of subtypes at different prenatal and postnatal periods in a Chinese general population.

Effectiveness of two guided self-administered interventions for psychological distress among women with infertility: a three-armed, randomized controlled trial.

STUDY QUESTION: What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI? SUMMARY ANSWER: A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables. WHAT IS KNOWN ALREADY: Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress. STUDY DESIGN, SIZE, DURATION: A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children. PARTICIPANTS/MATERIALS, SETTING, METHODS: Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (T1), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude. MAIN RESULTS AND THE ROLE OF CHANCE: Participants of the BMG showed decreased depression (mean difference (MD) = -1.69, [-3.01, -0.37], d = 0.44) and improved sleep quality (MD = -1.24, [-1.95, -0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between T1 and T3 and no reduction between T2 and T3. There were no significant effects on any of the variables for the GJG. LIMITATIONS, REASONS FOR CAUTION: The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population. WIDER IMPLICATIONS OF THE FINDINGS: The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the National Social Science Foundation (17BSH054). The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-16008452. TRIAL REGISTRATION DATE: 9 May 2016. DATE OF FIRST PATIENT'S ENROLMENT: 15 May 2016.

A non-linear relationship between the cumulative exposure to occupational stressors and nurses' burnout and the potentially emotion regulation factors.

BACKGROUND: Stressful situations can increase the likelihood of nurses experiencing negative emotions, especially burnout. AIMS: To explore the association of cumulative exposure to occupational stressors and emotion regulation strategies with nurses' burnout. METHODS: Participants were 602 nurses from three general hospitals in Jinan, China. Social demographic characteristics, occupational stress, burnout, and emotion regulation strategies (cognitive reappraisal, expressive suppression, and rumination), were assessed. RESULTS: Nearly 70% of nurses reported that they were burnt out. Those with a moderate level and high level of stressors were 3.203 times and 26.444 times more likely to have burnout, respectively (x2trend = 62.732). Logistic regression revealed that nurses had higher cognitive reappraisal score (odds ratios (OR) = 0.941), scored lower for burnout. Those who had higher expressive suppression score (OR = 1.054), higher rumination score (OR = 1.037), and a higher level of stressors (OR = 2.779-18.259) scored higher for burnout. The results of sensitivity analysis were similar. CONCLUSIONS: A non-linear relationship exists between the cumulative exposure to occupational stressors and nurses' burnout. Those who less frequently use cognitive reappraisal, more frequently use rumination and expressive suppression, and have a high level of stressors may be more likely to experience burnout.

Disrupted Executive Function and Aggression in Individuals With a History of Adverse Childhood Experiences: An Event-Related Potential Study.

Here, we explored the functional and neural mechanisms underlying aggression related to adverse childhood experiences. We assessed behavioral performance and event-related potentials during a go/no-go and N-back paradigm. The participants were 15 individuals with adverse childhood experiences and high aggression (ACE + HA), 13 individuals with high aggression (HA), and 14 individuals with low aggression and no adverse childhood experiences (control group). The P2 latency (initial perceptual processing) was longer in the ACE + HA group for the go trials. The HA group had a larger N2 (response inhibition) than controls for the no-go trials. Error-related negativity (error processing) in the ACE + HA and HA groups was smaller than that of controls for false alarm go trials. Lastly, the ACE + HA group had shorter error-related negativity latencies than controls for false alarm trials. Overall, our results reveal the neural correlates of executive function in aggressive individuals with ACEs.

Predictors of occupational burnout among nurses: a dominance analysis of job stressors.

AIMS AND OBJECTIVES: To quantitatively compare dimensions of job stressors' effects on nurses' burnout. BACKGROUND: Nurses, a key group of health service providers, often experience stressors at work. Extensive research has examined the relationship between job stressors and burnout; however, less has specifically compared the effects of job stressor domains on nurses' burnout. DESIGN: A quantitative cross-sectional survey examined three general hospitals in Jinan, China. METHOD: Participants were 602 nurses. We compared five potential stressors' ability to predict nurses' burnout using dominance analysis and assuming that each stressor was intercorrelated. RESULTS: Strong positive correlations were found between all five job stressors and burnout. Interpersonal relationships and management issues most strongly predicted participants' burnout (11·3% of average variance). CONCLUSION: Job stressors, and particularly interpersonal relationships and management issues, significantly predict nurses' job burnout. RELEVANCE TO CLINICAL PRACTICE: Understanding the relative effect of job stressors may help identify fruitful areas for intervention and improve nurse recruitment and retention.

Association between child maltreatment and prospective and retrospective memory in adolescents: The mediatory effect of neuroticism.

The purpose of this study was to examine the relationship between child maltreatment and prospective and retrospective memory in children/adolescents by investigating the mediating role of neuroticism. In total, 662 children/adolescents aged 10-16 years were recruited from a middle school in China, and they completed questionnaires comprising the Childhood Trauma Questionnaire, Prospective and Retrospective Memory Questionnaire, and the Neuroticism subscale of the NEO Five-Factor Inventory. The severity of maltreatment was positively associated with the severity of impairment of memory (prospective and retrospective considered together) in children/adolescents. Children/adolescents exposed to maltreatment tended to display higher levels of neuroticism. Neuroticism partially mediated the association between child maltreatment and memory in all the subjects. The results of multigroup analyses showed neuroticism fully mediated the relationship between child maltreatment and memory for boys, in which the effect size of indirect effect was 0.52, and partially mediated the association for girls with 0.44 effect size of indirect effect. Early intervention aimed to reduce neuroticism might contribute to a better prognosis in children/adolescences with poor memory function.

Comparison of two types of colectomy in treating slow transit constipation with or without melanosis coli.

AIM: To compare the follow-up outcomes of ileosigmoidal anastomosis (ISA) and caecorectal anastomosis (CRA) in patients with slow transit constipation (STC) with or without melanosis coli (MC). METHODS: We collected the clinical data of 48 STC patients with or without MC from May 2002 to May 2007. Twenty-six patients underwent CRA (14 with MC) and 22 cases received ISA (14 with MC). A 3-year postoperative follow-up was conducted. RESULTS: CRA improved the quality of life [evaluated by the gastrointestinal quality of life index (GIQLI)] in patients without MC, but was inferior to ISA in stool frequency and Wexner and GIQLI scores for MC patients. In the CRA group, patients with MC suffered worse outcomes than those without MC. CONCLUSION: CRA is more suitable for STC patients without MC; however, for STC patients with MC, ISA is a better choice.

[Effects of methyl jasmonate on accumulation and release of main tropane alkaloids in liquid cultures of Datura stramonium hairy root].

OBJECTIVE: To study the effects of methyl jasmonate (MJ) on the accumulation and release of main secondary metabolites i. e. scopolamine and hyoscyamine in liquid cultures of Datura stramonium hairy roots. METHOD: After 18 days liquid culture of D. stramonium hairy roots induced by agrobacterium rhizogenes C58C1, the chemical elicitor methyl jasmonate was added into 1/2 MS liquid cultures and scopolamine and hyoscyamine on the day 0, 3, 6, 9 and 12, after dealing with MJ, was determined by HPLC. RESULT: After dealing with MJ on the day 3, 6, 9 and 12,the concentration of scopolamine reached to 0.419, 0.439, 0.431, 0.374 mg x g(-1), respectively, the increase of scopolamine were 1.36, 1.42, 1.17 and 1.12 fold higher than that of the control, respectively. And hyoscyamine reached 1.493, 0.817, 0.723 and 0.698 mg x g(-1), respectively, the increase of hyoscyamine were 2.28, 1.11, 0.63 and 0.70 fold higher than that of the control, respectively. CONCLUSION: MJ could stimulate the accumulation of scopolamine and hyoscyamine (3,6 d) in D. stramonium hairy root and have released them into the culture medium.

[Scopolamine and hyoscyamine synthesis in hair roots culture of Datura metel].

OBJECTIVE: To establish the hair roots culture system of Datura metel and study the hair roots growth and biosynthesis of scopolamine and hyoscyamine in hair roots culturing system. METHOD: Direct degermed cotyledon of wild D. metel was infected by Agrobacterium tumefaciens strain C58C1 to obtain hair roots. Growth curves and scopolamine and hyoscyamine biosynthesis curves were determined. The scopolamine and hyoscyamine from different hair roots lines were examined by HPLC. RESULT: Hair roots induction rate reached 70%. After 25 days cultured in 1/2 MS liquid nutrient medium, the hair roots weight, content of scopolamine and hyoscyamine reached maximum, tow high efficient accumulation hyoscyamine and scopolamine hair roots lines M1 and M2 were obtained. The medial accumulation coefficient of hyoscyamine and scopolamine were 2.53 times and 5.37 times compared with the leaves of wild D. metel respectively. CONCLUSION: The established hair roots induction and culture system of D. metel provided a foundation for further obtaining scopolamine and hyoscyamine.