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Copper-based materials are promising electrocatalysts for CO 2 reduction. Prior studies show that the mixture of copper (I) and copper (0) at the catalyst surface enhances multi-carbon products from CO 2 reduction; however, the stable presence of copper (I) remains the subject of debate. Here we report a copper on copper (I) composite that stabilizes copper (I) during CO 2 reduction through the use of copper nitride as an underlying copper (I) species. We synthesize a copper-on-nitride catalyst that exhibits a Faradaic efficiency of 64 ± 2% for C 2+ products. We achieve a 40-fold enhancement in the ratio of C 2+ to the competing CH 4 compared to the case of pure copper. We further show that the copper-on-nitride catalyst performs stable CO 2 reduction over 30 h. Mechanistic studies suggest that the use of copper nitride contributes to reducing the CO dimerization energy barrier—a rate-limiting step in CO 2 reduction to multi-carbon products. While multi-carbon (C 2+ ) products present high-value species attainable from emitted carbon dioxide, it is challenging to prepare stable, C 2+ selective catalysts. Here, authors support copper on copper nitride to improve copper’s electrocatalytic stability and selectivity toward C 2+ synthesis.

The electroreduction of C 1 feedgas to high-energy-density fuels provides an attractive avenue to the storage of renewable electricity. Much progress has been made to improve selectivity to C 1 and C 2 products, however, the selectivity to desirable high-energy-density C 3 products remains relatively low. We reason that C 3 electrosynthesis relies on a higher-order reaction pathway that requires the formation of multiple carbon-carbon (C-C) bonds, and thus pursue a strategy explicitly designed to couple C 2 with C 1 intermediates. We develop an approach wherein neighboring copper atoms having distinct electronic structures interact with two adsorbates to catalyze an asymmetric reaction. We achieve a record n -propanol Faradaic efficiency (FE) of (33 ± 1)% with a conversion rate of (4.5 ± 0.1) mA cm −2 , and a record n -propanol cathodic energy conversion efficiency (EE cathodic half-cell ) of 21%. The FE and EE cathodic half-cell represent a 1.3× improvement relative to previously-published CO-to- n -propanol electroreduction reports. Catalysts for CO electroreduction have focused on Cu, and their main products have been C 2 chemicals. Here authors use the concept of asymmetric active sites to develop a class of doped Cu catalysts for C-C coupling, delivering record selectivity to n -propanol.

Background Non-insulin-based insulin resistance (NI-IR) indices have been reported to have an association with prevalent hypertension, however, no cohort studies to date have compared their prediction of hypertension among young adults. Methods A total of 2,448 military men and women, aged 18–39 years, without baseline hypertension in Taiwan were followed for incident hypertension events from 2014 until the end of 2020. All subjects underwent annual health examinations including measurements of blood pressure (BP) in mmHg. Systolic BP (SBP) 130–139/diastolic BP (DBP) < 80, SBP < 130/DBP 80–89, and SBP 130–139/DBP 80–89 were respectively defined as stage I isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined hypertension (CH). The cut-off levels of stage II hypertension for SBP and DBP were 140–159 and 90–99, respectively. Four NI-IR indices included the ratio of serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C), TyG index defined as ln[TG* fasting glucose (FG)/2], Metabolic Score for IR (METS-IR) defined as ln[(2* FG) + TG)* body mass index (BMI)/(ln(HDL-C))], and ZJU index defined as BMI + FG + TG + 3* alanine transaminase/aspartate transaminase (+ 2 if female). Multivariable Cox regression analysis was performed with adjustments for baseline age, sex, body mass index, BP, substance use, family history for early onset cardiovascular diseases or hypertension, low-density lipoprotein cholesterol, kidney function, serum uric acid and physical activity to determine the associations. Results During a median follow-up of 6.0 years, there were 920 hypertension events (37.6%). Greater TyG, TG/HDL-C and METS-IR indices were associated with a higher risk of stage I IDH (hazard ratios (HRs) and 95% confidence intervals: 1.376 (1.123–1.687), 1.082 (1.039–1.127) and 3.455 (1.921–6.214), respectively), whereas only greater ZJU index was associated with a higher risk of stage II IDH [HRs: 1.011 (1.001–1.021)]. In addition, greater ZJU index was associated with a higher risk of stage II ISH [HR: 1.013 (1.003–1.023)], and greater TyG index was associated with a higher risk of stage II CH [HR: 2.821 (1.244–6.395)]. Conclusion Insulin resistance assessed by various NI-IR indices was associated with a higher risk of hypertension in young adults, while the assessment ability for specific hypertension category may differ by NI-IR indices.

Remodelling of the extracellular matrix (ECM) and cell surface by matrix metalloproteinases (MMPs) is an important function of monocytes and macrophages. Recent work has emphasised the diverse roles of classically and alternatively activated macrophages but the consequent regulation of MMPs and their inhibitors has not been studied comprehensively. Classical activation of macrophages derived in vitro from un-fractionated CD16(+/-) or negatively-selected CD16(-) macrophages up-regulated MMP-1, -3, -7, -10, -12, -14 and -25 and decreased TIMP-3 steady-state mRNA levels. Bacterial lipopolysaccharide, IL-1 and TNFα were more effective than interferonγ except for the effects on MMP-25, and TIMP-3. By contrast, alternative activation decreased MMP-2, -8 and -19 but increased MMP -11, -12, -25 and TIMP-3 steady-state mRNA levels. Up-regulation of MMPs during classical activation depended on mitogen activated protein kinases, phosphoinositide-3-kinase and inhibitor of κB kinase-2. Effects of interferonγ depended on janus kinase-2. Where investigated, similar effects were seen on protein concentrations and collagenase activity. Moreover, activity of MMP-1 and -10 co-localised with markers of classical activation in human atherosclerotic plaques in vivo. In conclusion, classical macrophage activation selectively up-regulates several MMPs in vitro and in vivo and down-regulates TIMP-3, whereas alternative activation up-regulates a distinct group of MMPs and TIMP-3. The signalling pathways defined here suggest targets for selective modulation of MMP activity.

Recently, a significant reduction in ST-elevation myocardial infarction (STEMI) admission was reported from the United States and Europe where the coronavirus disease (COVID-19) caused a public health crisis.1,2 The door-to-device time of primary percutaneous coronary intervention (PPCI) was also delayed.3 The COVID-19 pandemic has a much less impact in Taiwan because early actions to prevent community outbreak were taken from January 2020 when mystery pneumonia in Wuhan, China was found.4 As to May 2020, there were only 443 confirmed cases in 23 million population in Taiwan and most patients were imported cases from February to April, 2020. [...]although there was no reduction of STEMI admission in Taiwan, a significant delay for medical help was found during the COVID-19 pandemic. [...]actions are necessary to avoid the negative impact of COVID-19 pandemic on care of STEMI.Disclosures The authors have no conflicts of interest to disclose. 2019 (Feb to Apr) (n = 1,092) 2020 (Feb to Apr) (n = 1,038) p value STEMI case number/hospital 27.3 ± 18.4 26.0 ± 16.7 0.27 Symptom onset-to-door time (min) 142 (75-338) 180 (84-460) <0.01 Door-to-device time (min) 65 (50-81) 66 (52-81) 0.20 Table 1 The case number and primary PCI for STEMI before and after COVID-19 outbreak in Taiwan

Understanding how the spatial arrangement of remnant green spaces in cities complements biodiversity provides an opportunity for synergy between urban development and biological conservation. However, the geography of urbanization is shifting from Europe and North America to Asia and Africa, and more research is needed for fast-growing regions. To understand how shifting urbanization shapes biodiversity patterns, we analyzed the contribution of landscape factors in explaining vertebrate species richness in urban areas across biogeographic realms. We used variation partitioning to quantify and compare the relative importance of landscape factors (composition and configuration) and environmental factors (climate, elevation, and latitude) in explaining vertebrate species richness in landscapes with at least a million inhabitants across biogeographic realms. Our results pointed out that in the Indo-Malayan, the Afrotropical, and the Neotropical realm (on average of 16.46%) and China and India (11.88%), the influence of landscape factors on vertebrate species richness are significantly higher than that of the Palearctic and Nearctic realms (6.48%). Our findings outline the importance of landscape composition and configuration in shaping biodiversity patterns in regions with fast urban growth during the next two decades, such as Africa, Latin America, and Southeastern Asia. We suggest improving land governance and urban planning to construct eco-friendly landscape structures to mitigate biodiversity loss due to urbanization.

Background: Treating an underactive bladder (UAB) is challenging. Previously, we introduced a more precise method of transvaginal ultrasound-guided botulinum toxin A (BoNT-A) injection into the external urethral sphincter as a treatment option for patients with UABs. Although many patients experience good results, those with an UAB and excessive residual urine still require catheterization. Therefore, we developed a new method that combines transvaginal ultrasound-guided BoNT-A injection with a transurethral bladder neck incision. Methods: A prospective study was conducted on 16 patients who experienced symptoms of UAB and chronic urine retention. The treatment consisted of a combination of transvaginal ultrasound-guided BoNT-A injection and a transurethral incision of the bladder neck (TUI-BN). The primary objective was to assess the efficacy of this combined treatment in improving symptoms in women with UABs. Results: Our study demonstrated significant improvements after treatment, including increased voiding volume, decreased post-void residual (PVR) urine, and improved voiding efficiency. The frequency of clean intermittent catheterization (CIC) decreased at 1 and 3 months post-surgery, along with improvements in the AUA symptoms score and the Patient Perception of Bladder Condition (PPBC) score. Conclusions: Our study showed significant improvements in the surgical treatment of UABs using a combination of transvaginal ultrasound-guided BoNT-A and TUI-BN.

Background Cardiorespiratory fitness (CRF) could reduce the risk of metabolic syndrome (MetS) while the association between muscular endurance capacity (MEC) and incident MetS has rarely been investigated in young adults. Methods A total of 2890 military men and women, aged 18–39 years, free of baseline MetS in Taiwan, were followed for incident MetS from baseline (2014) until the end of 2020. All subjects received annual health examinations for assessment of MetS. Physical fitness was assessed by CRF (estimated maximal oxygen uptake, VO2 max [mL/kg/min], in a 3000‐m run) and MEC (numbers of 2‐min push‐ups). MetS was defined according to the International Diabetes Federation (IDF) criteria. Multiple Cox regression analysis was conducted with adjustments for baseline age, sex, substance use status and physical activity to determine the associations of CRF and MEC with incidences of new‐onset MetS and related features, for example, central obesity, hypertension, dyslipidaemia and prediabetes or diabetes. To examine the combined effects of CRF and MEC status on incidence of MetS, high and low levels of CRF and MEC were separately defined by over and under the sex‐specific median in each exercise test. Results During a median follow‐up of 5.8 years, there were 673 (23.3%) new‐onset MetS. Higher CRF was associated with a lower incidence of MetS (hazard ratio [HR] and 95% confidence interval: 0.905 [0.877–0.933]), and its components separately, except hypertension. No association was observed between MEC and incident MetS, and its components separately, except hypertension. When evaluating the combined effects of MEC and CRF status on the incidence of MetS, it was observed that compared with the low CRF/low MEC, the high CRF/high MEC (HR: 0.553 [0.439–0.697]) and the high CRF/low MEC (HR: 0.730 [0.580–0.918]) had a lower incidence of new‐onset MetS (P value for the intergroup difference = 0.04). There was no significant result for the low CRF/high MEC. Conclusions This study highlights that although the protective effects of MEC to reduce the incidence of MetS and most of its related features were mainly driven by CRF in young adults, there was an addictive effect of greater MEC on CRF to prevent the development of new‐onset MetS before midlife.

Background Previous studies have reported reduced acute exacerbation rates and improved symptom control in asthma patients treated using inhaled corticosteroids plus formoterol maintenance and reliever therapy (MART). Fluticasone furoate (FF) and vilanterol (VIL) also provide rapid bronchodilation and sustained anti-inflammatory effects, however no studies have investigated FF/VIL as MART for asthma control. Methods From October 1, 2021 to September 30, 2023, this retrospective study included asthma patients classified as step 3 or 4 according to the Global Initiative for Asthma guidelines, who were then divided into two groups. One group received BUD/FOR as MART, while the other received FF/VIL as MART. Pulmonary function tests, exacerbation rates, Asthma Control Test (ACT), fractional exhaled nitric oxide (FeNO) levels, and blood eosinophil counts were measured before and after 12 months of treatment. Results A total of 161 patients were included, of whom 36 received BUD/FOR twice daily as MART, and 125 received FF/VIL once daily as MART. After 12 months of treatment, the FF/VIL group showed a significant increase in ACT scores by 1.57 ( p  < 0.001), while the BUD/FOR group had an increase of 0.88 ( p  = 0.11). In terms of FeNO levels, the BUD/FOR group experienced a decline of -0.2 ppb ( p  = 0.98), whereas the FF/VIL group had a mild increase of + 0.8 ppb ( p  = 0.7). Notably, there was a significant difference in the change of FeNO between the two groups (∆ FeNO: -0.2 ppb in BUD/FOR; + 0.8 ppb in FF/VIL, p  < 0.001). There were no significant alterations observed in FEV1, blood eosinophil count, or acute exacerbation decline in either group. Conclusions In the current study, patients treated with FF/VIL as MART showed improvements in ACT scores, while those treated with BUD/FOR as MART exhibited a reduction in FeNO levels. However, the difference between the two treatment groups did not reach clinical significance. Thus, FF/VIL as MART showed similar effectiveness to BUD/FOR as MART.