Efficacy of high-intensity interval- or continuous aerobic-training on insulin resistance and muscle function in adults with metabolic syndrome: a clinical trial.

PURPOSE: We carried out a randomized, clinical trial in adults of both sexes with metabolic syndrome (MS) to assess the efficacy of high-intensity, low-volume interval training (HIIT) compared to moderate-intensity continuous training (MICT) on insulin resistance (IR), muscle mass, muscle activation, and serum musclin. METHODS: Fasting glycemia, insulinemia, and glycated haemoglobin were determined by conventional methods, IR by Homeostatic model assessment (HOMA), lean mass by Dual-Energy X-ray Absorptiometry, muscle activation through carnosine by Proton Magnetic Resonance Spectroscopy, and musclin by Enzyme-Linked ImmunoSorbent Assay before and after a supervised, three-times/week, 12-week treadmill programme. HIIT (n = 29) consisted of six intervals with one-minute, high-intensity phases at 90% of peak oxygen consumption (VO2peak). MICT (n = 31) trained at 60% of VO2peak for 30 min. RESULTS: Patients had a mean age of 50.8 ± 6.0 years, body mass index of 30.6 ± 4.0 kg/m2, and VO2peak of 29.0 ± 6.3 mL.kg-1.min-1. Compared to MICT, HIIT was not superior at reducing Ln HOMA-IR (adjusted mean difference: 0.083 [95%CI - 0.092 to 0.257]), carnosine or musclin or at increasing thigh lean mass. HIIT increased carnosine by 0.66 mmol/kg.ww (95% CI 0.08-1.24) after intervention. Both interventions reduced IR, body fat percentage and increased total lean mass/height2 and VO2peak. Musclin showed a non-significant reduction with a small effect size after both interventions. CONCLUSION: Compared to MICT, HIIT is not superior at reducing IR, carnosine or musclin or at increasing skeletal muscle mass in adults with MS. Both training types improved IR, muscle mass and body composition. NCT03087721, March 22nd, 2017. TRIAL REGISTRATION NUMBER: NCT03087721. Registered March 22nd, 2017.

Physical and Cognitive Function Assessment to Predict Postoperative Outcomes of Abdominal Surgery.

BACKGROUND: Current evaluation methods to assess physical and cognitive function are limited and often not feasible in emergency settings. The upper-extremity function (UEF) test to assess physical and cognitive performance using wearable sensors. The purpose of this study was to examine the (1) relationship between preoperative UEF scores with in-hospital outcomes; and (2) association between postoperative UEF scores with 30-d adverse outcomes among adults undergoing emergent abdominal surgery. METHODS: We performed an observational, longitudinal study among adults older than 40 y who presented with intra-abdominal symptoms. The UEF tests included a 20-sec rapid repetitive elbow flexion (physical function), and a 60-sec repetitive elbow flexion at a self-selected pace while counting backwards by threes (cognitive function), administered within 24-h of admission and within 24-h prior to discharge. Multiple logistic regression models assessed the association between UEF and outcomes. Each model consisted of the in-hospital or 30-d post-discharge outcome as the dependent variable, preoperative UEF physical and cognitive scores as hypothesis covariates, and age and sex as adjuster covariates. RESULTS: Using UEF physical and cognitive scores to predict in-hospital outcomes, an area under curve (AUC) of 0.76 was achieved, which was 17% more sensitive when compared to age independently. For 30-d outcomes, the AUC increased to 0.89 when UEF physical and cognitive scores were included in the model with age and sex. DISCUSSION: Sensor-based measures of physical and cognitive function enhance outcome prediction providing an objective practicable tool for risk stratification in emergency surgery settings among aging adults presenting with intra-abdominal symptoms.

Natural Killer T (NKT) Cells and Periodontitis: Potential Regulatory Role of NKT10 Cells.

Natural killer T (NKT) cells constitute a unique subset of T lymphocytes characterized by specifically interacting with antigenic glycolipids conjugated to the CD1d receptor on antigen-presenting cells. Functionally, NKT cells are capable of performing either effector or suppressor immune responses, depending on their production of proinflammatory or anti-inflammatory cytokines, respectively. Effector NKT cells are subdivided into three subsets, termed NKT1, NKT2, and NKT17, based on the cytokines they produce and their similarity to the cytokine profile produced by Th1, Th2, and Th17 lymphocytes, respectively. Recently, a new subgroup of NKT cells termed NKT10 has been described, which cooperates and interacts with other immune cells to promote immunoregulatory responses. Although the tissue-specific functions of NKT cells have not been fully elucidated, their activity has been associated with the pathogenesis of different inflammatory diseases with immunopathogenic similarities to periodontitis, including osteolytic pathologies such as rheumatoid arthritis and osteoporosis. In the present review, we revise and discuss the pathogenic characteristics of NKT cells in these diseases and their role in the pathogenesis of periodontitis; particularly, we analyze the potential regulatory role of the IL-10-producing NKT10 cells.

Analysis of socioeconomic and demographic factors and imaging exam characteristics associated with missed appointments in pediatric radiology.

BACKGROUND: Missed appointments can have an adverse impact on health outcomes by delaying appropriate imaging, which can be critical in influencing treatment decisions. OBJECTIVE: To assess for socioeconomic and imaging exam factors associated with missed appointments among children scheduled for diagnostic imaging. MATERIALS AND METHODS: We retrospectively analyzed children (<18 years) scheduled for outpatient diagnostic imaging during a 12-month period. In doing so, we obtained socioeconomic and radiology exam characteristics (modality, intravenous contrast administration, radiation and use of sedation) data from the electronic medical record. We employed multivariate logistic regression to assess the association of socioeconomic, demographic and imaging exam characteristics with imaging missed appointments. RESULTS: In total, 7,275 children met inclusion criteria. The mean age was 8.8 years (standard deviation [SD] = 6.2 years) and the study population consisted of 52% female gender, 69% White race, 38% adolescent age group and 32% with a median household income by ZIP-code category of <$50,000. Logistic regression showed increased likelihood of missed appointments among children of Black/African-American race (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.4-2.5); with insurance categories including Medicaid (OR=2.0; 95% CI=1.6-2.4), self-pay (OR=2.1; 95% CI=1.3-3.6) and other (OR=2.7; 95% CI=1.3-5.4); with <$50,000 median household income by ZIP-code category (OR=1.7; 95% CI=1.4-2.0); and with examination wait time of 7-21 days (OR=2.7; 95% CI=2.1-3.5) and >21 days (OR=3.7; 95% CI=2.9-4.8). The use of radiation, intravenous contrast agent or sedation was not associated with increased likelihood of missed appointments. CONCLUSION: Expanding our knowledge of how different socioeconomic and imaging-related factors influence missed appointments among children can serve as a foundational step to better understand existing and emerging disparities and inform strategies to advance health equity efforts in radiology.

Abbreviated MRI for Hepatocellular Carcinoma Screening and Surveillance.

To detect potentially curable hepatocellular carcinoma (HCC), clinical practice guidelines recommend semiannual surveillance US of the liver in adult patients at risk for developing this malignancy, such as those with cirrhosis and some patients with chronic hepatitis B infection. However, cirrhosis and a large body habitus, both of which are increasingly prevalent in the United States and the rest of the world, may impair US visualization of liver lesions and reduce the sensitivity of surveillance with this modality. The low sensitivity of US for detection of early-stage HCC contributes to delayed diagnosis and increased mortality. Abbreviated MRI, a shortened MRI protocol tailored for early-stage detection of HCC, has been proposed as an alternative surveillance option that provides high sensitivity and specificity. Abbreviated MRI protocols include fewer sequences than a complete multiphase MRI examination and are specifically designed to identify small potentially curable HCCs that may be missed at US. Three abbreviated MRI strategies have been studied: (a) nonenhanced, (b) dynamic contrast material-enhanced, and (c) hepatobiliary phase contrast-enhanced abbreviated MRI. Retrospective studies have shown that simulated abbreviated MRI provides high sensitivity and specificity for early-stage HCC, mostly in nonsurveillance cohorts. If it is supported by scientific evidence in surveillance populations, adoption of abbreviated MRI could advance clinical practice by increasing early detection of HCC, allowing effective treatment and potentially prolonging life in the growing number of individuals with this cancer. Online supplemental material is available for this article. ©RSNA, 2020.

Novel coumarin-pyridazine hybrids as selective MAO-B inhibitors for the Parkinson's disease therapy.

The 3-pyridazinylcoumarin scaffold was previously reported as an efficient core for the discovery of reversible and selective inhibitors of MAO-B, a validated drug target for PD therapy which also plays an important role in the AD progress. Looking for its structural optimization, novel compounds of hybrid structure coumarin-pyridazine, differing in polarizability and lipophilicity properties, were synthesized and tested against the two MAO isoforms, MAO-A and MAO-B (compounds 17a-f and 18a-f). All the designed compounds selectively inhibited the MAO-B isoenzyme, exhibiting many of them IC50 values ranging from sub-micromolar to nanomolar grade and lacking neuronal toxicity. The 7-bromo-3-(6-bromopyridazin-3-yl)coumarin (18c), the most potent compound of these series (IC50 = 60 nM), was subjected to further in vivo studies in a reserpine-induced mouse PD model. The obtained results suggest a promising potential for 18c as antiparkinsonian agent. Molecular modeling studies also provided valuable information about the enzyme-drug interactions and the potential pharmacokinetic profile of the novel compounds.

CFD model to characterize the physical processes of energy transfer in a secondary facultative lagoon.

In this paper, the energy transfer phenomena of a secondary facultative lagoon and its relationship with environmental conditions such as wind and solar radiation were studied. To this end, a three-dimensional computational fluid dynamics model was constructed within a conventional facultative lagoon located in the municipality of Ginebra-Valle del Cauca, Colombia. The model included the transport of suspended solids from inlet to outlet, the penetration of incident solar radiation into the body of water, surface wind, the transfer of heat through lateral walls and the temperature profiles of the wastewater. The model was validated using tracer studies and experimental temperature data. This demonstrated that simulated data of temperature and solar radiation penetration have an acceptable degree of consistency compared with the experimental data. The model demonstrated that temperature profiles were significantly affected by the wind at 0.45 m and 1.40 m depth, while no effect on the surface was obtained.

Preliminary investigation of 6,7-dihydropyrazolo[1,5-a]pyrazin-4-one derivatives as a novel series of mGlu5 receptor positive allosteric modulators with efficacy in preclinical models of schizophrenia.

As part of our efforts to identify a suitable back-up compound to our recently disclosed mGlu5 positive allosteric modulator (PAM) clinical candidate VU0490551/JNJ-46778212, this letter details the investigation and challenges of a novel series of 6,7-dihydropyrazolo[1,5-a]pyrazin-4-one derivatives. From these efforts, compound 4k emerged as a potent and selective mGlu5 PAM displaying overall attractive in vitro (pharmacological and ADMET) and PK profiles combined with in vivo efficacy in preclinical models of schizophrenia. However, further advancement of the compound was precluded due to severely limiting CNS-related side-effects confirming the previously reported association between excessive mGlu5 activation and target-related toxicities.

Biocatalytic reduction of racemic 2-arenoxycycloalkanones by yeasts P. glucozyma and C. glabrata: one way of achieving chiral 2-arenoxycycloalcohols.

Chiral ß-aryloxy alcohols are interesting building blocks that form part of drugs like ß adrenergic antagonists. Acquiring cyclic rigid analogs to obtain more selective drugs is interesting. Thus, we used whole cells of yeast strains Pichia glucozyma and Candida glabrata to catalyze the reduction of several 2-arenoxycycloalkanones to produce chiral 2-arenoxycycloalcohols with good/excellent enantioselectivity. In both cases, the alcohol configuration that resulted from the carbonyl group reduction was S. Yeast P. glucozyma allowed the conversion of both enantiomers of the starting material to produce 2-arenoxycycloalcohols with configuration (1S, 2R) and (1S, 2S). The reaction with C. glabrata nearly always allowed the kinetic resolution of the starting ketone, recovering 2-arenoxycycloalkanone with configuration S and (1S, 2R)-2-arenoxycycloalcohol.All the four possible stereoisomers of 2-phenoxycyclohexanol and the two enantiomers of 2-phenoxycyclohexanone were obtained by combining the biocatalyzed reaction with the oxidation/reduction of the chiral compounds with standard reagents. This is a simple approach for the synthesis of the rigid chiral moiety 2-arenoxycycloalcohols contained in putative ß-blockers 2-arenoxycycloalkanepropanolamines.

A computational musculoskeletal arm model for assessing muscle dysfunction in chronic obstructive pulmonary disease.

Computational models have been used extensively to assess diseases and disabilities effects on musculoskeletal system dysfunction. In the current study, we developed a two degree-of-freedom subject-specific second-order task-specific arm model for characterizing upper-extremity function (UEF) to assess muscle dysfunction due to chronic obstructive pulmonary disease (COPD). Older adults (65 years or older) with and without COPD and healthy young control participants (18 to 30 years) were recruited. First, we evaluated the musculoskeletal arm model using electromyography (EMG) data. Second, we compared the computational musculoskeletal arm model parameters along with EMG-based time lag and kinematics parameters (such as elbow angular velocity) between participants. The developed model showed strong cross-correlation with EMG data for biceps (0.905, 0.915) and moderate cross-correlation for triceps (0.717, 0.672) within both fast and normal pace tasks among older adults with COPD. We also showed that parameters obtained from the musculoskeletal model were significantly different between COPD and healthy participants. On average, higher effect sizes were achieved for parameters obtained from the musculoskeletal model, especially for co-contraction measures (effect size = 1.650 ± 0.606, p < 0.001), which was the only parameter that showed significant differences between all pairwise comparisons across the three groups. These findings suggest that studying the muscle performance and co-contraction, may provide better information regarding neuromuscular deficiencies compared to kinematics data. The presented model has potential for assessing functional capacity and studying longitudinal outcomes in COPD.

Analysis of Geographic Accessibility of Breast, Lung, and Colorectal Cancer Screening Centers Among American Indian and Alaskan Native Tribes.

PURPOSE: To evaluate geographic accessibility of ACR mammographic screening (MS), lung cancer screening (LCS), and CT colorectal cancer screening (CTCS) centers among US federally recognized American Indian and Alaskan Native (AI/AN) tribes. METHODS: Distances from AI/AN tribes' ZIP codes to their closest ACR-accredited LCS and CTCS centers were recorded using tools from the ACR website. The FDA's database was used for MS. Persistent adult poverty (PPC-A), persistent child poverty (PPC-C), and rurality indexes (rural-urban continuum codes) were from the US Department of Agriculture. Logistic and linear regression analyses were used to assess distances to screening centers and relationships among rurality, PPC-A, and PPC-C. RESULTS: Five hundred ninety-four federally recognized AI/AN tribes met the inclusion criteria. Among all closest MS, LCS, or CTCS center to AI/AN tribes, 77.8% (1,387 of 1,782) were located within 200 miles, with a mean distance of 53.6 ± 53.0 miles. Most tribes (93.6% [557 of 594]) had MS centers within 200 miles, 76.4% (454 of 594) had LCS centers within 200 miles, and 63.5% (376 of 594) had CTCS centers within 200 miles. Counties with PPC-A (odds ratio [OR], 0.47; P < .001) and PPC-C (OR, 0.19; P < .001) were significantly associated with decreased odds of having a cancer screening center within 200 miles. PPC-C was associated with decreased likelihood of having an LCS center (OR, 0.24; P < .001) and an CTCS center (OR, 0.52; P < .001) within the same state as the tribe's location. No significant association was found between PPC-A and PPC-C and MS centers. CONCLUSIONS: AI/AN tribes experience distance barriers to ACR-accredited screening centers, resulting in cancer screening deserts. Programs are needed to increase equity in screening access among AI/AN tribes.

C 1-Symmetric {cyclopentadienyl/indenyl}-metallocene catalysts: synthesis, structure, isospecific polymerization of propylene and stereocontrol mechanism.

A series of new Me2Si-bridged cyclopentadiene/indene proligands {Me2Si(R2',5'2-R3',4'2-Cp)(R2,R4,R5,R6-Ind)H2} (1a-j) with various substitutions both on the indene and cyclopentadiene moieties was prepared. The corresponding C1-symmetric group 4 ansa-metallocene complexes (M = Zr, Hf), namely, {Me2Si(Me4Cp)(Ind)}ZrCl2 (2a-Zr), {Me2Si(Me4Cp)(2-Me,4-Ph-Ind)}MCl2 (2b-M), {Me2Si(Me4Cp)(2-Me,4-Ph,6-tBu-Ind)}ZrCl2 (2c-Zr), {Me2Si(Me4Cp)(2-Me,4-Ph,5-OMe,6-tBu-Ind)}MCl2 (2d-M), {Me2Si(Me4Cp)(2-R',4-(3',5'-tBu2,4'-OMe-C6H2),5-OMe,6-tBu-Ind)}ZrCl2, R' = Me (2e-Zr), R' = Et (2f-Zr), {Me2Si(2,5-Ph2-3,4-Me2-Cp)(2-Me,4-(3',5'-tBu2,4'-OMe-C6H2),5-OMe,6-tBu-Ind)}ZrCl2 (2g-Zr), {Me2Si(Me4Cp)(2-Me,4-(3',6'-tBu2-carbazol-4'-yl)-Ind)}ZrCl2 (2h-Zr), {Me2Si(2,5-Me2,3,4-iPr2-Cp)(2-Me,4-Ph-Ind)}ZrCl2 (2i-Zr), {Me2Si(2,5-Me2,3,4-iPr2-Cp)(2-Me,4-Ph,6-tBu-Ind)}ZrCl2 (2j-Zr) and {Me2Si(Me4Cp)(2-Me-4,5-[a]anthracene-Ind)}MCl2 (2k-Zr) were synthesized and characterized by NMR spectroscopy and mass spectrometry. The solid-state molecular structures of 2b-Zr, 2d-Zr, 2e-Zr, 2f-Zr, 2j-Zr and 2k-Zr were determined by X-ray crystallography. The zirconocene complexes, once activated with MAO in toluene solution, exhibited propylene polymerization activities at 60 °C up to 161 000 kg(PP) mol(Zr)-1 h-1, affording highly isotactic polypropylenes (iPP) with [m]4 up to 96.5% and Tm up to 157 °C. Also, metallocene complexes 2b-e-Zr were supported on SiO2-MAO and evaluated in slurry bulk propylene polymerization at 70 °C, producing iPPs with [m]4 = 91.7-96.6 mol% and low regiodefects (0.2-0.3 mol%) content, with productivities up to 636 000 kg(PP) mol(Zr)-1 h-1. DFT calculations allowed rationalizing a polymerization reaction mechanism occurring through "chain-stationary" enchainment with preference for 1,2-insertions.

Active and durable R2MnRuO7 pyrochlores with low Ru content for acidic oxygen evolution.

The production of green hydrogen in water electrolyzers is limited by the oxygen evolution reaction (OER). State-of-the-art electrocatalysts are based on Ir. Ru electrocatalysts are a suitable alternative provided their performance is improved. Here we show that low-Ru-content pyrochlores (R2MnRuO7, R = Y, Tb and Dy) display high activity and durability for the OER in acidic media. Y2MnRuO7 is the most stable catalyst, displaying 1.5 V at 10 mA cm-2 for 40 h, or 5000 cycles up to 1.7 V. Computational and experimental results show that the high performance is owed to Ru sites embedded in RuMnOx surface layers. A water electrolyser with Y2MnRuO7 (with only 0.2 mgRu cm-2) reaches 1 A cm-2 at 1.75 V, remaining stable at 200 mA cm-2 for more than 24 h. These results encourage further investigation on Ru catalysts in which a partial replacement of Ru by inexpensive cations can enhance the OER performance.

Influence of photoperiod on carbon dioxide and methane emissions from two pilot-scale stabilization ponds.

Greenhouse gas (GHG) emissions (CO(2), CH(4)) from pilot-scale algal and duckweed-based ponds (ABP and DBP) were measured using the static chamber methodology. Daylight and nocturnal variations of GHG and wastewater characteristics (e.g. chemical oxygen demand (COD), pH) were determined via sampling campaigns during midday (12:30-15:30) and midnight (00:30-03:30) periods. The results showed that under daylight conditions in ABP median emissions were -232 mg CO(2) m(-2) d(-1) and 9.9 mg CH(4) m(-2) d(-1), and in DBP median emissions were -1,654.5 mg CO(2) m(-2) d(-1) and 71.4 mg CH(4) m(-2) d(-1), respectively. During nocturnal conditions ABP median emissions were 3,949.9 mg CO(2) m(-2) d(-1), 12.7 mg CH(4) m(-2) d(-1), and DBP median emissions were 5,116 mg CO(2) m(-2) d(-1), 195.2 mg CH(4) m(-2) d(-1), respectively. Once data measured during daylight were averaged together with nocturnal data the median emissions for ABP were 1,566.8 mg CO(2) m(-2) d(-1) and 72.1 mg CH(4) m(-2) d(-1), whilst for DBP they were 3,016.9 mg CO(2) m(-2) d(-) and 178.9 mg CH(4) m(-2) d(-1), respectively. These figures suggest that there were significant differences between CO(2) emissions measured during daylight and nocturnal periods (p < 0.05). This shows a sink-like behaviour for both ABP and DBP in the presence of solar light, which indicates the influence of photosynthesis in CO(2) emissions. On the other hand, the fluxes of CH(4) indicated that DBP and ABP behave as net sources of CH(4) during day and night, although higher emissions were observed from DBP. Overall, according to the compound average (daylight and nocturnal emissions) both ABP and DBP systems might be considered as net sources of GHG.

Brain function complexity during dual-tasking is associated with cognitive impairment and age.

BACKGROUND AND PURPOSE: Early diagnosis of cognitive impairment is important because symptoms can be delayed through therapies. Synaptic disconnections are the key characteristics of dementia, and through nonlinear complexity analysis of brain function, it is possible to identify long-range synaptic disconnections in the brain. METHODS: We investigated the capability of a novel upper-extremity function (UEF) dual-task paradigm in the functional MRI (fMRI) setting, where the participant flexes and extends their arm while counting, to differentiate between cognitively normal (CN) and those with mild cognitive impairment (MCI). We used multiscale entropy (MSE) complexity analysis of the blood oxygen-level dependent time-series across neural networks and brain regions. Outside of the fMRI, we used the UEF dual-task test, while the elbow kinematics were measured using motion sensors, to record the motor function score. RESULTS: Results showed 34% lower MSE values in MCI compared to CN (p<.04 for all regions and networks except cerebellum when counting down by one; effect size = 1.35±0.15) and a negative correlation between MSE values and age (average r2 of 0.30 for counting down by one and 0.36 for counting backward by three). Results also showed an improvement in the logistic regression model sensitivity by 14-24% in predicting the presence of MCI when brain function measure was added to the motor function score (kinematics data). CONCLUSIONS: Current findings suggest that combining measures of neural network and motor function, in addition to neuropsychological testing, may provide an accurate tool for assessing early-stage cognitive impairment and age-related decline in cognition.

[Patients' Perceptions of the Management of Idiopathic Pulmonary Fibrosis. Explora-IPF Project]. / Percepción de los pacientes en cuanto al manejo de la fibrosis pulmonar idiopática. Proyecto Explora-IPF.

Introduction: Idiopathic pulmonary fibrosis (IPF) impacts the life of patients and their families, so it is necessary to ascertain their perception in the approach to their disease. Methods: Observational study by means of a specific questionnaire that includes socio-demographic and clinical variables, perception of the impact of the disease (5-point Likert scale), preferences regarding the characteristics of the medication (degree of importance/concern 1-10) and satisfaction with treatment (SATMED-Q® scale 0-100). Results: 69 individuals participated (age: 66.5 ± 7.6 years; time until diagnosis: 16.5 ± 17.4 months; diagnosis time: 49.6 ± 42.3 months). The majority state that IPF limits them physically (90%) and emotionally (75%). The most highly valued features of the treatment were: slowing down progression of the disease (7.4 ± 2.8), stabilising lung capacity (6.9 ± 2.8) and improving quality of life (6.9 ± 2.8), above stabilising/improving symptoms (6.1 ± 2.8/6.3 ± 2.8) or avoiding hospitalisation (6.6 ± 2.7). The principal factors of concern were suffering gastric disorders (7.1 ± 2.9), photosensitivity (6.6 ± 3.0) or interaction with other drugs (6.0 ± 3.0). Overall satisfaction with the current treatment scored 61.1 points, with the highest scores being for medical follow-up (79.5) and overall opinion of the medicine (74.3). Conclusions: A study conducted in Spain on the perspective of IPF patients regarding the disease and its treatment. The results show a high level of awareness in terms of the seriousness of the disease on the part of patients, whose main concern is to slow down its progression. The information provided may help to optimise the management of IPF patients.

Highly active and stable OER electrocatalysts derived from Sr2MIrO6 for proton exchange membrane water electrolyzers.

Proton exchange membrane water electrolysis is a promising technology to produce green hydrogen from renewables, as it can efficiently achieve high current densities. Lowering iridium amount in oxygen evolution reaction electrocatalysts is critical for achieving cost-effective production of green hydrogen. In this work, we develop catalysts from Ir double perovskites. Sr2CaIrO6 achieves 10 mA cm-2 at only 1.48 V. The surface of the perovskite reconstructs when immersed in an acidic electrolyte and during the first catalytic cycles, resulting in a stable surface conformed by short-range order edge-sharing IrO6 octahedra arranged in an open structure responsible for the high performance. A proton exchange membrane water electrolysis cell is developed with Sr2CaIrO6 as anode and low Ir loading (0.4 mgIr cm-2). The cell achieves 2.40 V at 6 A cm-2 (overload) and no loss in performance at a constant 2 A cm-2 (nominal load). Thus, reducing Ir use without compromising efficiency and lifetime.

Effect of the Thermal Treatment of Fe/N/C Catalysts for the Oxygen Reduction Reaction Synthesized by Pyrolysis of Covalent Organic Frameworks.

A nitrogen-containing covalent organic framework obtained from the polymerization of 1,3-dicyanobenzene has been used as a starting material for the synthesis of Fe/N/C catalysts for the oxygen reduction reaction (ORR). In this work we report the effect of the thermal treatments on the nature and catalytic properties of the catalysts obtained after the thermal treatments. After the first thermal treatment, the catalysts obtained contain metallic iron and iron carbide particles, along with a minority fraction of inorganic FeN x sites. After acid leaching and a second thermal treatment, FeN x sites remain in the catalysts, along with a minor fraction of graphite-wrapped Fe3C particles. Both catalysts display high activity for the ORR, with the catalyst subjected to acid leaching and a second thermal treatment, 2HT-1,3DCB, displaying higher ORR activity and a lower production of H2O2. This observation suggests that iron particles, such as Fe3C, display ORR activity but mainly toward the two-electron pathway. On the contrary, FeN x ensembles promote the ORR via the four-electron pathway, that is, via H2O formation.

Addressing Linguistic Barriers to Care: Evaluation of Breast Cancer Online Patient Educational Materials for Spanish-Speaking Patients.

PURPOSE: The purpose of this study was to evaluate the readability of breast cancer online patient educational materials (OPEM) written in Spanish and to compare to equivalent English-language OPEM. METHODS: The breast cancer-related terms cáncer de seno (breast cancer), detección de cáncer de seno (breast cancer screening), and biopsia de seno (breast biopsy) were queried using an online search engine. After each query, educational information related to the queried term was downloaded from each website appearing on the first five search engine result pages. Readability of Spanish-language OPEM was evaluated using the Crawford reading grade score. When available, equivalent English-language OPEM from the same website was then evaluated using the mean of five validated readability indices. Differences in readability, word count, and reading time between Spanish- and English-language OPEM were compared using an unpaired t test. The Fisher exact test was used to compare the proportion of websites meeting AMA recommendations for patient educational resources. RESULTS: Queries for cáncer de seno, detección de cáncer de seno, and biopsia de seno yielded 27, 31, and 30 results of term-specific OPEM. Equivalent English-language versions were available for 19 (70.4%), 18 (58.1%), and 20 (66.7%) websites, respectively. Spanish-language OPEM were written at a lower grade reading level than equivalent English-language versions overall (5.49 ± 0.50 versus 7.77 ± 1.95, P < .01). Spanish-language OPEM were also more likely than English-language OPEM to meet AMA recommendations (82.9% versus 40.4%, P < .01). CONCLUSIONS: Breast cancer-related Spanish-language OPEM were written at a significantly lower grade reading level compared with equivalent information written in English.

Musclin Is Related to Insulin Resistance and Body Composition, but Not to Body Mass Index or Cardiorespiratory Capacity in Adults.

BACKGROUND: We studied whether musclin function in humans is related to glycemic control, body composition, and cardiorespiratory capacity. METHODS: A cross-sectional study was performed in sedentary adults with or without metabolic syndrome (MS). Serum musclin was measured by enzyme-linked immunosorbent assay. Insulin resistance (IR) was evaluated by the homeostatic model assessment (HOMA-IR). Body composition was determined by dual-energy X-ray absorptiometry and muscle composition by measuring carnosine in the thigh, a surrogate of fiber types, through proton magnetic resonance spectroscopy. Cardiorespiratory capacity was assessed through direct ergospirometry. RESULTS: The control (n=29) and MS (n=61) groups were comparable in age (51.5±6.5 years old vs. 50.7±6.1 years old), sex (72.4% vs. 70.5% women), total lean mass (58.5%±7.4% vs. 57.3%±6.8%), and peak oxygen consumption (VO2peak) (31.0±5.8 mL O2./kg.min vs. 29.2±6.3 mL O2/kg.min). Individuals with MS had higher body mass index (BMI) (30.6±4.0 kg/m2 vs. 27.4± 3.6 kg/m2), HOMA-IR (3.5 [95% confidence interval, CI, 2.9 to 4.6] vs. 1.7 [95% CI, 1.1 to 2.0]), and musclin (206.7 pg/mL [95% CI, 122.7 to 387.8] vs. 111.1 pg/mL [95% CI, 63.2 to 218.5]) values than controls (P˂0.05). Musclin showed a significant relationship with HOMA-IR (ß=0.23; 95% CI, 0.12 to 0.33; P˂0.01), but not with VO2peak, in multiple linear regression models adjusted for age, sex, fat mass, lean mass, and physical activity. Musclin was significantly associated with insulin, glycemia, visceral fat, and regional muscle mass, but not with BMI, VCO2peak, maximum heart rate, maximum time of work, or carnosine. CONCLUSION: In humans, musclin positively correlates with insulinemia, IR, and a body composition profile with high visceral adiposity and lean mass, but low body fat percentage. Musclin is not related to BMI or cardiorespiratory capacity.