Simultaneous Improvements in Performance and Durability of an Octahedral PtNix/C Electrocatalyst for Next-Generation Fuel Cells by Continuous, Compressive, and Concave Pt Skin Layers

Simultaneous improvements in oxygen reduction reaction (ORR) activity and long-term durability of Pt-based cathode catalysts are indispensable for the development of next-generation polymer electrolyte fuel cells but are still a major dilemma. We present a robust octahedral core–shell PtNix/C electrocatalyst with high ORR performance (mass activity and surface specific activity 6.8–16.9 and 20.3–24.0 times larger than those of Pt/C, respectively) and durability (negligible loss after 10000 accelerated durability test (ADT) cycles). The key factors of the robust octahedral nanostructure (core–shell Pt73Ni27/C) responsible for the remarkable activity and durability were found to be three continuous Pt skin layers with 2.0–3.6% compressive strain, concave facet arrangements (concave defects and high coordination), a symmetric Pt/Ni distribution, and a Pt67Ni33 intermetallic core, as found by STEM-EDS, in situ XAFS, XPS, etc. The robust core–shell Pt73Ni27/C was produced by the partial release of the stress, Pt/Ni rearrangement, and dimension reduction of an as-synthesized octahedral Pt50Ni50/C with 3.6–6.7% compressive Pt skin layers by Ni leaching during the activation process. The present results on the tailored synthesis of the PtNix structure and composition and the better control of the robust catalytic architecture renew the current knowledge and viewpoint for instability of octahedral PtNix/C samples to provide a new insight into the development of next-generation PEFC cathode catalysts

Key Structural Transformations and Kinetics of Pt Nanoparticles in PEFC Pt/C Electrocatalysts by a Simultaneous Operando Time-Resolved QXAFS–XRD Technique

This account article treats with the key structural transformations and kinetics of Pt nanoparticles in Pt/C cathode catalysts under transient voltage operations (0.4 VRHE→1.4 VRHE→0.4 VRHE) by simultaneous operando time-resolved QXAFS–XRD measurements, summarizing and analyzing our previous kinetic data in more detail and discussing on the key reaction steps and rate constants for the performance and durability of polymer electrolyte fuel cells (PEFC). The time-resolved QXAFS–XRD measurements were conducted at each acquisition time of 20 ms, while measuring the current/charge of the PEFC. The rate constants for the transient responses of Pt valence, CN(Pt–O) (CN: coordination number), CN(Pt–Pt), and Pt metallic-phase core size under the transient voltage operations were determined by the combined time-resolved QXAFS‒XRD technique. The relationship of the structural kinetics with the performance and durability of the PEFC Pt/C was also documented as key issues for the development of next-generation PEFCs. The present account emphasizes the time-resolved QXAFS and XRD techniques to be a powerful technique to analyze directly the structural and electronic change of metal nanoparticles inside PEFC under the operating conditions

Polymorphic ventricular tachycardia in a patient with hypertrophic cardiomyopathy and digitalis intoxication

SummaryWe report the case of a 74-year-old woman who presented with recurrent episodes of polymorphic ventricular tachycardia (PVT) with a normal QT interval due to digitalis intoxication (serum digoxin concentration, 5.0 ng/mL) and severe hyperkalemia (serum potassium level, 8.3 mEq/L). In addition, laboratory data showed elevated levels of blood urea nitrogen (54 mg/dL) and serum creatinine (1.57 mg/dL), suggesting dehydration. She had been treated with a combination of digoxin and eplerenone for atrial fibrillation and heart failure. The PVT resolved after treatment for hyperkalemia. Cardiac magnetic resonance imaging and left ventriculography showed left ventricular hypertrophy predominantly in the apex, suggesting apical hypertrophic cardiomyopathy (HCM). We presume that the presence of HCM was related to the occurrence of PVT in this patient with digitalis intoxication and hyperkalemia.<Learning objective: PVT with a normal QT interval caused by digitalis intoxication with hyperkalemia was observed in a patient with HCM treated with digoxin and eplerenone for atrial fibrillation and heart failure. The presence of HCM may be related to the occurrence of PVT. Combination therapy with digoxin and aldosterone receptor antagonist may predispose severe hyperkalemia, and monitoring of serum digitalis concentration and potassium level should be done strictly.

In-hospital Outcome in Octogenarians with Acute Coronary Syndrome Undergoing Emergent Coronary Angiography

金沢大学附属病院臨床試験管理センターVery elderly patients have higher mortality rates than younger patients after acute coronary syndrome (ACS). However, the mechanism by which increasing age contributes to such mortality remains unclear. In addition, the efficacy and safety of invasive coronary procedures for octogenarians with ACS have not been well established. We compared the clinical characteristics and in-hospital outcome of 193 octogenarians (mean age, 83 years) with those of 1,462 younger patients (mean age, 64 years) with ACS who underwent emergent coronary angiography. Octogenarians included a greater number of females, had higher rates of cerebrovascular disease and multivessel disease, a higher Killip class, a higher Forrester class, and lower rates of smoking, diabetes, and hypercholesterolemia than the younger subjects. Interventions, including percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG), were performed less frequently in octogenarians than in younger patients (88.0% versus 90.8%). The procedural success rate in octogenarians did not differ from that in younger patients. However, the in-hospital mortality rate for the octogenarians was about three times higher than for the younger patients (19.2% versus 6.9%). Multivariate analysis revealed that the predictors of in-hospital mortality in the octogenarians were a higher Killip class and a higher Forrester class. Octogenarians with ACS had fewer coronary risk factors and a similar success rate for the intervention, but had more greatly impaired hemodynamics and higher in-hospital mortality than the younger patients. Therefore, impaired myocardial reserve may contribute to a large portion of in-hospital deaths in octogenarians with ACS

Impact of functional studies on exome sequence variant interpretation in early-onset cardiac conduction system diseases

Aims The genetic cause of cardiac conduction system disease (CCSD) has not been fully elucidated. Whole-exome sequencing (WES) can detect various genetic variants; however, the identification of pathogenic variants remains a challenge. We aimed to identify pathogenic or likely pathogenic variants in CCSD patients by using WES and 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines as well as evaluating the usefulness of functional studies for determining them. Methods and Results We performed WES of 23 probands diagnosed with early-onset (&amp;lt;65 years) CCSD and analyzed 117 genes linked to arrhythmogenic diseases or cardiomyopathies. We focused on rare variants (minor allele frequency &amp;lt; 0.1%) that were absent from population databases. Five probands had protein truncating variants in EMD and LMNA which were classified as “pathogenic” by 2015 ACMG standards and guidelines. To evaluate the functional changes brought about by these variants, we generated a knock-out zebrafish with CRISPR-mediated insertions or deletions of the EMD or LMNA homologs in zebrafish. The mean heart rate and conduction velocities in the CRISPR/Cas9-injected embryos and F2 generation embryos with homozygous deletions were significantly decreased. Twenty-one variants of uncertain significance were identified in 11 probands. Cellular electrophysiological study and in vivo zebrafish cardiac assay showed that 2 variants in KCNH2 and SCN5A, 4 variants in SCN10A, and 1 variant in MYH6 damaged each gene, which resulted in the change of the clinical significance of them from “Uncertain significance” to “Likely pathogenic” in 6 probands. Conclusions Of 23 CCSD probands, we successfully identified pathogenic or likely pathogenic variants in 11 probands (48%). Functional analyses of a cellular electrophysiological study and in vivo zebrafish cardiac assay might be useful for determining the pathogenicity of rare variants in patients with CCSD. SCN10A may be one of the major genes responsible for CCSD. Translational Perspective Whole-exome sequencing (WES) may be helpful in determining the causes of cardiac conduction system disease (CCSD), however, the identification of pathogenic variants remains a challenge. We performed WES of 23 probands diagnosed with early-onset CCSD, and identified 12 pathogenic or likely pathogenic variants in 11 of these probands (48%) according to the 2015 ACMG standards and guidelines. In this context, functional analyses of a cellular electrophysiological study and in vivo zebrafish cardiac assay might be useful for determining the pathogenicity of rare variants, and SCN10A may be one of the major development factors in CCSD

An influential factor for external radiation dose estimation for residents after the Fukushima Daiichi Nuclear Power Plant accident-time spent outdoors for residents in Iitate Village

Many studies have been conducted on radiation doses to residents after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Time spent outdoors is an influential factor for external dose estimation. Since little information was available on actual time spent outdoors for residents, different values of average time spent outdoors per day have been used in dose estimation studies on the FDNPP accident. The most conservative value of 24 h was sometimes used, while 2.4 h was adopted for indoor workers in the UNSCEAR 2013 report. Fukushima Medical University has been estimating individual external doses received by residents as a part of the Fukushima Health Management Survey by collecting information on the records of moves and activities (the Basic Survey) after the accident from each resident. In the present study, these records were analyzed to estimate an average time spent outdoors per day. As an example, in Iitate Village, its arithmetic mean was 2.08 h (95% CI: 1.64-2.51) for a total of 170 persons selected from respondents to the Basic Survey. This is a much smaller value than commonly assumed. When 2.08 h is used for the external dose estimation, the dose is about 25% (23-26% when using the above 95% CI) less compared with the dose estimated for the commonly used value of 8 h