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The proposed study is devoted to highlighting the importance of mixed oxides preparation through the layered double hydroxide route for undesirable gas pollutants abatement. Different series of Cu/Al/Ce mixed oxides with similar or different stoichiometrics were prepared and compared for toluene and/or CO oxidation. Catalyst synthesis methods influence material properties and activity for oxidation reactions. The high activity for the oxidation reactions of mixed oxides derived from LDH is explained by the Cu/Ce synergy. The presence of CO in the CO/toluene mixture does not affect the total toluene oxidation, and the toluene does not affect the total oxidation of CO conversion at low temperatures. The most effective catalytic material (Cu6Al1.2Ce0.8) presents a long lifetime stability for total toluene oxidation and resistance to CO poisoning in mixtures. [ABSTRACT FROM AUTHOR]

Transition metal oxides have garnered attention for the methanol electro‐oxidation reaction owing to their easy availability, high catalytic applicability, and multiple oxidation capabilities. Bimetal‐based catalysts further enhance the performance of the methanol oxidation reaction. In this context, a chrysanthemum‐flower‐like MoO2/WO3 is synthesized through a solvothermal and annealing strategy. The morphology attests to the rough surface and pores in the catalyst, augmenting its surface area for reactions and enhancing catalytic applicability. Electrochemical oxidation of methanol yields an optimal current density of 0.99 mA cm−2 and 2.07 mA mg−1 at a potential of 0.57 V versus Ag/AgCl. The catalyst exhibits a remarkably low Tafel slope of 37.45 mV dec−1, affirming its rapid reaction kinetics. Electrochemical impedance spectroscopy (EIS) reveals an equivalent electronic circuit of R(Q(R(QR)Q(RW))), confirming low charge transfer resistance (Rct) and diffusion‐controlled kinetics attributable to the pores in the sample. The sample also demonstrates an electrochemically active surface area (ECSA) value equal to 0.122 mF cm−2 and long‐term stability over continuous 5000 s, exhibiting no change and high resistance to CO poisoning. All these characterizations and obtained results collectively affirm that the chrysanthemum‐flower‐like MoO2/WO3 serves as a highly suitable electrocatalyst for the electrochemical oxidation of methanol. [ABSTRACT FROM AUTHOR]

Despite established exposure limits and safety standards, and the availability of carbon monoxide (CO) alarms, each year an estimated 50,000 people in the United States visit emergency departments for CO poisoning. Carbon monoxide poisoning can occur from brief exposures to high levels of CO or from longer exposures to lower levels. If the CO exposure is sufficiently high, unconsciousness and death occur quickly, and without symptoms. With non-lethal exposures to CO, common symptoms include headaches, nausea and vomiting, dizziness, general malaise, and altered mental status. Some patients may have chest pain, shortness of breath, and myocardial ischemia, and may require mechanical ventilation and treatment of shock. Individuals poisoned by CO often develop brain injury. As with brain injury from non-CO causes such as traumatic brain injury, the clinical expression of brain injury caused by CO poisoning includes the domains of cognition, affect, neurological, and somatic. Common problems are neurological: imbalance, motor weakness, neuropathies, hearing loss, tinnitus, Parkinson's-like syndrome, vestibular, gaze, auditory processing, cognitive, anxiety and depression, posttraumatic stress, personality change, persistent headaches, dizziness, sleep problems, and others. In addition, some will have cardiac or other problems. While breathing oxygen hastens the removal of carboxyhemoglobin (COHb), hyperbaric oxygen (HBO2) hastens COHb elimination and favorably modulates inflammatory processes instigated by CO poisoning, an effect not observed with breathing normobaric oxygen. Hyperbaric oxygen improves mitochondrial function, inhibits lipid peroxidation transiently, impairs leukocyte adhesion to injured microvasculature, and reduces brain inflammation caused by CO-induced adduct formation of myelin basic protein. Based upon supportive randomized clinical trials in humans and considerable evidence from animal studies, HBO² should be considered for all cases of acute symptomatic CO poisoning. Hyperbaric oxygen is indicated for CO poisoning complicated by cyanide poisoning, often concomitantly with smoke inhalation. [ABSTRACT FROM AUTHOR]

This document provides summaries of various studies and initiatives related to Hyperbaric Oxygen Therapy (HBO2). One study found that adjunctive treatments with NBP or DXM were more effective than HBO2 alone for treating DNS from CO poisoning. Another study examined the prevention of middle ear barotrauma during HBO2 and found diverse practices among facilities. A physiological model for decompression sickness (DCS) presentations was also proposed. Additionally, the text discusses the use of HBO2 for soft tissue radiation injury and the potential benefits for treating sexual dysfunction. Lastly, a care process model and text alert system were implemented to increase the consultation rate for HBO2 treatment of carbon monoxide poisoning. [Extracted from the article]

In clinical management of carbon monoxide (CO) poisoning, serum cardiac enzyme biomarkers and electrocardiogram (ECG) are both highly recommended emergency check-ups to evaluate myocardial injuries. Medical imaging - including head CT or MRI - are not routine for CO poisoning emergency management. We herein report on a comatose patient who was diagnosed with cerebral infarction secondary to 24 hours previous acute CO poisoning, warned by a typical cerebral-type T waves on ECG in advance, and confirmed by a head MRI. Fortunately, the patient made a full recovery based on a timely treatment with medications and hyperbaric oxygen (HBO2) therapy. We would like to propose that a vital, stable, conscious CO poisoning patient who remains a higher risk for hemorrhagic or ischemic stroke should be closely monitored for potential neurological abnormalities, and a continuous ECG monitoring should be reinforced throughout the treatment. A head MRI or CT is a priority in evaluating the secondary cerebral stroke and should be arranged immediately in the event of an abnormal ECG or if unusual new symptoms are apparent. [ABSTRACT FROM AUTHOR]

World War II was approaching its end in Italy in 1944 when one of the worst train disasters in world history occurred near the small town of Balvano in the Apennine Mountains. The train did not derail or crash into something as in most major train disasters. Instead, it entered a mountainous railway tunnel, and when it emerged, over 500 passengers were dead from carbon monoxide poisoning. The event was not allowed to be publicized for almost two decades. This manuscript reconstructs the story of possibly the most significant incident of carbon monoxide mortality ever recorded. [ABSTRACT FROM AUTHOR]

The inefficiency of ethanol oxidation reaction (EOR) presents a significant obstacle in harnessing renewable biofuels with high energy density into electricity. Despite efforts, most Pt-based catalysts still suffer from drawbacks such as poor activity and susceptibility to CO poisoning, particularly in acidic conditions. Herein, we employed a physical laser-assisted approach to synthetize a PtPd alloy with a 1:1 atomic ratio. This alloy demonstrates remarkable performance in acidic EOR, boasting a high mass activity of 1.86 A·mgPt−1 and competitive resistance to poisoning. Combining in situ synchrotron radiation infrared spectroscopy with theoretical calculations, we reveal that the synergic interaction between Pt and Pd enhances both the adsorption of OH* intermediate and the dehydrogenation ability of ethanol. This work will prove the feasibility of synthesizing bimetallic alloys by a physical laser-assisted strategy and promote the development of advanced alloy electrocatalysts. [ABSTRACT FROM AUTHOR]

Proton exchange membrane (PEM) fuel cells require high-purity hydrogen. Carbon monoxide (CO) is a common impurity in hydrogen that significantly reduces the performance of PEM fuel cells. Currently, there are two main methods to eliminate the effect of CO: direct removal of CO and increasing the CO tolerance of PEM fuel cells. Each method has its advantages and disadvantages. It is important to consider the specific application when choosing between these methods. This review summarizes the mechanism of CO poisoning and its effect on the operation and durability of PEM fuel cells, as well as hydrogen purification and CO-tolerant techniques. Then analyzes the advantages and disadvantages of commonly used techniques and predicts future research directions for PEM fuel cells using impure hydrogen containing CO, aiming to expand the application scenarios, and promote the large-scale application of PEM fuel cells. • Mechanisms of CO poisoning on PEM fuel cells are summarized. • Impacts on potential oscillation and durability are reviewed. • Various hydrogen purifications techniques are compared. • CO-tolerant techniques for PEM fuel cells are discussed. • Futher directions for research on eliminating CO effect are presented. [ABSTRACT FROM AUTHOR]

Total blood carbon monoxide (TBCO) showed promising results in improving accuracy of CO determinations in blood and presenting better stability to different storage conditions. Therefore, it was proposed as an alternative biomarker to carboxyhemoglobin (COHb) for CO poisoning diagnosis. However, given that current interpretation reference values exist for COHb only, it is difficult to implement TBCO analysis in routine. Therefore, we aimed at determining TBCO reference values for postmortem CO poisoning cases. A previously validated method for TBCO analysis via gas chromatography–mass spectrometry was applied to cardiac, peripheral, cranial and spleen blood samples collected from 92 autopsies. Autopsy cases included 21 non-CO-related and 71 CO-related cases with varying postmortem intervals (PMIs). Statistical analyses were performed using statistical software R Studio. When comparing lower to higher PMIs for non-CO-related cases, no significant differences were found, which suggests that CO formation or degradation at low PMIs does not occur. Spleen blood showed potential as an alternative matrix to CO determinations in cases with sample availability issues but needs to be evaluated for CO-positive cases. Results for cardiac blood in CO-related autopsies showed a positive correlation between COHb and TBCO values (R  = 0.78). This value is lower than what is found in the literature, suggesting that even though COHb and TBCO are correlated, a potential underestimation of the true CO exposure might occur if only COHb values are taken into consideration. Samples were divided into CO exposure groups based on COHb concentrations, and with the data obtained, classification into the following TBCO concentration groups is proposed: no significant CO exposure case <6 µmol/mL, medium CO exposure case 6–20 µmol/mL and high CO exposure case >20 µmol/mL. Even if a higher number of samples in each group would enable to increase the confidence, these results are very promising and highlight the importance of TBCO measurement. [ABSTRACT FROM AUTHOR]

Carbon monoxide poisoning is one of the leading causes of mortality and morbidity by poisoning in the world. Signs and symptoms are nonspecific and related to impaired oxygen delivery to tissues, with the brain being the most affected organ due to its high oxygen demand. CO-Hb is a poor indicator of severity and long-term outcome, with clinicians relying more on clinical features such as level of consciousness and need for intubation, organ dysfunction and shock and also pH level. A 45-year-old female was found unconscious in her home with the fireplace lit and smoke all over the house. She was last seen well 18 hours before. She was brought to the emergency department and was admitted to the ICU in coma and cardiogenic shock, with a metabolic acidosis with hyperlactacidemia and a CO-Hb level of 15.5%. Laboratorial investigation revealed hepatic cytolysis, acute renal failure, rhabdomyolysis and a troponin I level of 338 ng/L. ECG showed no acute myocardial ischemia. Echocardiogram revealed diffuse hypokinesia with an ejection fraction of 25%. Head CT scan showed bilateral and symmetrical hypodensities of the globus pallidus. The patient underwent hyperbaric oxygen treatment with full neurological and cardiac recovery, allowing extubation 48 hours after admission. This rare severe case of coma due to carbon monoxide intoxication with globus pallidus injury and cardiogenic shock was successfully treated with hyperbaric oxygen, showing that it can be the right treatment choice in these cases, with an excellent impact on neurological and cardiac outcome. [ABSTRACT FROM AUTHOR]

Fire-related deaths are usually a consequence of carbon monoxide (CO) poisoning or shock from thermal injuries. In humans, high levels of carboxyhemoglobin (COHb) concentrations in the blood can support a diagnosis of CO poisoning. In veterinary medicine, few studies investigated the pathological changes and blood COHb% in fire victims, and no data are available on post-mortem changes in blood gas composition due to fire. This study aims to investigate the pathological changes and COHb levels in both animal victims of fire and cadavers experimentally exposed to fire. For this purpose, dogs were selected and subdivided into three groups. Group A comprised 9 adult dogs, and Group B comprised 7 puppies that died under fire-related conditions. Group C was represented by 4 dog cadavers experimentally exposed to heat and smoke. A complete macroscopic, histological, and COHb evaluation were performed on each animal. Animals in Groups A and B showed cherry-red discoloration, thermal-injuries and soot deposits along the respiratory tract. Animals in Group C showed thermal injuries and soot deposits limited to the upper respiratory tract. The mean COHb% values in cadavers in Group C were lower than those observed in the other groups but higher compared to the values detected before the heat and smoke treatment. These findings suggest that both pathological changes and COHb analysis are valid tools for investigating fire-related deaths in dogs. However, the increase of COHb levels in cadavers exposed postmortem to heat and smoke highlights how the COHb analysis should always be evaluated together with macroscopical and microscopical findings to avoid significant misjudgments in investigating fire-related fatalities in veterinary forensic practice. [ABSTRACT FROM AUTHOR]

During winter concrete curing, workers maintain temperature and humidity for quality control. However, in this process, carbon monoxide poisoning and fire accidents occur. Therefore, this study develops a system to prevent accidents and control quality by monitoring the environment at the concrete curing site in winter. The environmental information measurement sensor module is connected to the ESP32 board, and the collected information is transmitted to the database and automation service via Wi-Fi. The information is output to the visualization tool in the database for real-time monitoring, and notifications are delivered when the values fall outside a certain range. In addition, temperature and humidity information is recorded in the automation service. This allows us to monitor the concrete working environment for quality control and recognize dangerous situations to ensure safe work. [ABSTRACT FROM AUTHOR]

Direct methanol fuel cells (DMFCs) have received a lot of attention in recent years as promising technology for generating clean and efficient energy. In DMFC, the anode catalyst is a vital component because it is involved in the oxidation of methanol, which produces electrons that can be used as an energy source. Cyclic voltammetry (CV) is commonly used to test the characteristics of the electrode materials before they are employed in the actual fuel cell. Interestingly in the case of DMFCs CV also is a useful technique to obtain vital information about the performance and expected efficiency of the electrodes. In general, the CV of methanol electrooxidation for Pt‐based catalysts has two peaks, If in the forward scan (anodic scan) and Ib in the backward scan (cathodic scan). The ratio of these two peaks (If/Ib) is the most commonly used criterion for investigating CO poisoning in catalysts. However, there is a great deal of ambiguity surrounding this criterion, owing to the genesis of Ib. Addressing this we present here a new criterion to evaluate the efficiency of the catalyst using the same CV technique. We validate this newly proposed criterion with commercial Pt/C (comm. Pt/C) and other commercially available alloy catalysts. [ABSTRACT FROM AUTHOR]

Background and Objectives: Carbon monoxide (CO) intoxication is one of the most common causes of poisoning-related deaths and complications. Myocardial injury is an important complication of CO poisoning. In our study, we aimed to evaluate the relationship between the presence and prevalence of fragmented QRS (fQRS) and myocardial injury in patients with CO intoxication. Materials and Methods: We retrospectively evaluated patients who presented to the emergency department of our tertiary care center with CO intoxication between January 2020 and December 2023. In our study, we performed subgroup analyses according to the presence of myocardial injury and fQRS. We evaluated the parameters and risk factors associated with myocardial injury. Results: Myocardial injury was detected in 44 patients, and fQRS was detected in 38 patients. In the myocardial injury (+) group, the fQRS rate was 38.6%, and the median number of leads with fQRS was 3 (2–6) and was significantly higher than in the myocardial injury (−) group (p < 0.001). We found that carboxyhemoglobin had a significant positive correlation with troponin (p = 0.001) and pro-B-type natriuretic peptide (proBNP) (p = 0.009). As a result of multivariate analysis, we determined that age, creatinine, proBNP, fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury. Conclusions: Myocardial injury in CO intoxication patients is associated with proBNP, the presence of fQRS, and the number of leads with fQRS. Age, creatinine level, proBNP, the presence of fQRS, and ≥3 leads with fQRS are independent risk factors for myocardial injury in patients with CO intoxication. [ABSTRACT FROM AUTHOR]

Cases of carbon monoxide (CO) poisoning complicated with massive cerebral infarction are rare. A chinese female patient with carotid atherosclerotic plaque was found unconscious during bathing. The patient was diagnosed as carbon monoxide poisoning complicated with massive acute cerebral infarction by carbon monoxide hemoglobin (COHb) detection and imaging examination. The patient regained consciousness after treatment with hyperbaric oxygen, antiplatelet, and atorvastatin. This case suggests that patients with carotid atherosclerotic plaque may be more susceptible to develop acute cerebral infarction when CO poisoning occurs.

Previous studies have suggested a possible association between carbon monoxide poisoning (COP) and hypothyroidism, but the evidence is limited. Therefore, the aim of this study was to further investigate this relationship. Using data from the Taiwan National Health Research Database, we identified 32,162 COP patients and matched with 96,486 non-COP patients by age and index date for an epidemiological study. The risk of hypothyroidism was compared between the two cohorts until 2018. Independent predictors of hypothyroidism were analyzed using competing risk analysis. An animal study was also conducted to support the findings. COP patients had an increased risk of hypothyroidism compared to non-COP patients in the overall analysis (adjusted hazard ratio [AHR]= 3.88; 95 % confidence interval [CI]: 3.27−4.60) and in stratified analyses by age, sex, and comorbidities. The increase in the overall risk persisted even after more than six years of follow-up (AHR= 4.19; 95 % CI: 3.18−5.53). Independent predictors of hypothyroidism, in addition to COP, included age ≥65 years, female sex, hyperlipidemia, and mental disorder. The animal study showed damages in the hypothalamus, pituitary gland, and thyroid, as well as altered hormone levels 28 days after COP exposure. The epidemiological results showed an increased risk of hypothyroidism in COP patients, which was further supported by the animal study. These findings suggest the need for close monitoring of thyroid function in COP patients, especially in those who are age ≥65 years, female, and have hyperlipidemia or mental disorder.

The use of metal composites based on plasmonic nanostructures partnered with catalytic counterparts has recently emerged as a promising approach in the field of plasmon-enhanced electrocatalysis. Here, we report on the role of the surface morphology, size, and anchored site of Pd catalysts coupled to plasmonic metasurfaces formed by periodic arrays of multimetallic Ni/Au nanopillars for formic acid electro-oxidation reaction (FAOR). We compare the activity of two kinds of metasurfaces differing in the positioning of the catalytic Pd nanoparticles. In the first case, the Pd nanoparticles have a polyhedron crystal morphology with exposed (200) facets and were deposited over the Ni/Au metasurfaces in a site-selective fashion by limiting their growth at the electromagnetic hot spots (Ni/Au–Pd@W). In contrast, the second case consists of spherical Pd nanoparticles grown in solution, which are homogeneously deposited onto the Ni/Au metasurface (Ni/Au–Pd@M). Ni/Au–Pd@W catalytic metasurfaces demonstrated higher light-enhanced FAOR activity (61%) in comparison to the Ni/Au–Pd@M sample (42%) for the direct dehydrogenation pathway. Moreover, the site-selective Pd deposition promotes the growth of nanoparticles favoring a more selective catalytic behavior and a lower degree of CO poisoning on Pd surface. The use of cyclic voltammetry, energy-resolved incident photon to current conversion efficiency, open circuit potential, and electrochemical impedance spectroscopy highlights the role of plasmonic near fields and hot holes in driving the catalytic enhancement under light conditions. [ABSTRACT FROM AUTHOR]

Carbon monoxide (CO) is a gas that has no odor or color, making it difficult to detect until exposure leads to coma or death. CO poisoning is one of the most common and deadly poisonings around the world. CO poisoning is a common and often fatal form of poisoning worldwide. A toxic effect of CO is tissue hypoxia, which leads to systemic complications. Additionally, there may be severe neurological symptoms and delayed complications following CO poisoning. However, peripheral neuropathy is relatively rare after CO poisoning. Previously, only one case of unilateral plexopathy after CO poisoning, accompanied by rhabdomyolysis and cognitive dysfunction, has been reported. In this report, an isolated unilateral brachial plexopathy following CO intoxication is described. A key mechanism in this case may be CO-induced spinal cord ischemia. Immediate administration of hyperbaric oxygen therapy (HBOT) is crucial to prevent peripheral neuropathy after acute CO intoxication. Hyperbaric oxygen therapy (HBOT) should be administered immediately after acute CO intoxication to prevent peripheral neuropathy. Additionally, peripheral neuropathy following acute CO intoxication may benefit from consistent rehabilitation training. [ABSTRACT FROM AUTHOR]

Background: Carbon monoxide (CO) poisoning is now one of the leading causes of poisoning-related mortality worldwide. The central nervous system is the most vulnerable structure in acute CO poisoning. MRI is of great significance in the diagnosis and prognosis of CO toxic encephalopathy. The imaging features of CO poisoning are diverse. We report atypical hippocampal lesions observed on MRI in four patients after acute CO exposure. Case presentations: We report four patients who presented to the emergency department with loss of consciousness. The diagnosis of CO poisoning was confirmed on the basis of their detailed history, physical examination and laboratory tests. Brain MRI in all of these patients revealed abnormal signal intensity in hippocampi bilaterally. They all received hyperbaric oxygen therapy. The prognosis of all four patients was poor. Conclusion: Hippocampi, as a relatively rare lesion on MRI of CO poisoning, is of important significance both in the early and delayed stages of acute CO poisoning. In this article, we summarize the case reports of hippocampal lesions on MRI in patients with CO poisoning in recent years, in order to provide reference for the diagnosis and prognosis of CO poisoning. [ABSTRACT FROM AUTHOR]

Developing formic acid (FA) as a promising hydrogen (H 2) carrier relies on the exploration of efficient dehydrogenation catalyst. In this work, well-dispersed Pd-B x nanoparticles on XC-72 carbon were synthesized and investigated for FA dehydrogenation, wherein the B doping content can be varied by changing solvothermal temperature, B source concentration, and reaction time. With sodium formate as the additive, the optimized Pd–B 0.2 /C exhibits a low apparent activation energy of 27.6 kJ mol−1 for FA dehydrogenation, enabling the CO-free H 2 production with a high initial turnover frequency of 1146 h−1 and a H 2 generation rate of 315.79 L h−1 g Pd −1 at 343 K. System investigations suggest that the strain and electronic effects induced by B doping collaboratively contribute to the superior catalytic activity by promoting the dissociation of the O–H bond in FA molecule and weakening the possible CO adsorption. [Display omitted] • Pd–B 0.2 /C exhibits high activity for formic acid dehydrogenation. • B doping brings in the strain and electronic effects. • B doping promotes the dissociation of O–H bond and increases CO poisoning resistance. [ABSTRACT FROM AUTHOR]

Carbon monoxide poisoning remains a leading cause of accidental poisoning worldwide (both at home and at work), and it is also a cause of suicidal poisoning. Such poisoning can arise following prolonged exposure to low levels of CO or following brief exposure to high concentrations of the gas. In fact, despite exposure limits, high safety standards, and the availability of CO alarms, nearly 50,000 people in the United States visit the emergency department each year due to poisoning. Additionally, CO poisoning in the United States causes up to 500 deaths each year. Despite the widespread nature of this form of poisoning, known about for centuries and whose damage mechanisms have been recognized (or rather hypothesized about) since the 1800s, early recognition, especially of late complications, and treatment remain a medical challenge. A well-designed therapeutic diagnostic process is necessary so that indication for hyperbaric or normobaric therapy is correctly made and so that patients are followed up even after acute exposure to diagnose late complications early. Furthermore, it is necessary to consider that in the setting of emergency medicine, CO poisoning can be part of a differential diagnosis along with other more frequent conditions, making its recognition difficult. The last thirty years have been marked by a significant increase in knowledge regarding the toxicity of CO, as well as its functioning and its importance at physiological concentrations in mammalian systems. This review, taking into account the significant progress made in recent years, aims to reconsider the pathogenicity of CO, which is not trivially just poisonous to tissues. A revision of the paradigm, especially as regards treatment and sequelae, appears necessary, and new studies should focus on this new point of view. [ABSTRACT FROM AUTHOR]

Considering the structural and compositional advantages of high‐entropy alloy (HEA) as high‐efficient electrocatalysts, we here present a facile method to prepare high‐entropy alloy nanowires with seven elements in an aqueous solution. The as‐synthesized PdPtCuAgAuPbCo nanowires possess dispersed one‐dimensional morphology and exhibit enhanced electrocatalytic performance with the mass activity of 9.9 A mgPd+Pt−1 toward ethanol electrooxidation. The HEA nanowires also perform superior stability, resistance to CO poisoning, and good electrocatalytic activities toward other alcohols (e. g. ethylene glycol and methanol) oxidation. The synthesis strategy is easy to operate with low cost and has wide application prospects for preparing desired electrocatalysts for fuel cells. [ABSTRACT FROM AUTHOR]

Carbon monoxide (CO) poisoning is a leading cause of poison-related morbidity and mortality worldwide. By binding to hemoglobin and other heme-containing proteins, CO reduces oxygen delivery and produces tissue damage. Prompt treatment of CO-poisoned patients is necessary to prevent acute and long-term complications. Oxygen therapy is the only available treatment. Visible light has been shown to selectively dissociate CO from hemoglobin with high efficiency without affecting oxygen affinity. Pulmonary phototherapy has been shown to accelerate the rate of CO elimination in CO poisoned mice and rats when applied directly to the lungs or via intra-esophageal or intra-pleural optical fibers. The extracorporeal removal of CO using a membrane oxygenator with optimal characteristic for blood exposure to light has been shown to accelerate the rate of CO illumination in rats with or without lung injury and in pigs. The development of non-invasive techniques to apply pulmonary phototherapy and the development of a compact, highly efficient membrane oxygenator for the extracorporeal removal of CO in humans may provide a significant advance in the treatment of CO poisoning. • Visible light selectively dissociates CO from hemoglobin without affecting oxygen binding. • Pulmonary phototherapy has been shown to accelerate the rate of CO elimination in mice and rats. • The extracorporeal removal of CO using phototherapy (ECCOR-P) accelerates CO elimination in small and large animals. • Pulmonary phototherapy and ECCOR-P development may provide a significant advance for treating CO poisoning. [ABSTRACT FROM AUTHOR]

This study presents the facile synthesis of CoO/PtPd and CoO/PtPd/reduced‐graphene oxide (r‐GO) nanocomposites, highlighting their significant role in methanol fuel cells. To create a CoO/PtPd thin film at the toluene/water interface, we employed NaBH4 to effectively reduce PtCl2(COD), PdCl2(COD), and Co (acac)3 (COD = cis,cis‐1,5‐ cyclooctadiene, acac = acetylacetonate). The two nanocomposites were analyzed using XRD, FE‐SEM, AFM, XPS, BET, and TEM techniques. In the electrooxidation of methanol in the anodic part of fuel cell, cobalt (II) oxide can serve as an oxygen source in the catalytic oxidation of carbon monoxide (CO) or it can play a role in producing the HO‐CoO intermediate to facilitate the oxidation of CO‐PtPd to carbon dioxide (CO2). This reaction can help eliminate CO, which is a common poison for Pt‐based catalysts in methanol oxidation. Our research reveals significant improvements in current densities and catalyst tolerance when using the CoO/PtPd/r‐GO nanocomposite thin film. The observed current density for CoO/PtPd/r‐GO is 263.33 mA.cm−2, surpassing the reported value of 30.00 mA.cm−2 for PtPd/r‐GO. The jf/jb ratios, commonly used to evaluate catalyst tolerance, are approximately 2.80 for CoO/PtPd and 4.98 for CoO/PtPd/r‐GO, in contrast to ratios larger than 0.99 for ETEK Pt and 0.58 for other types of commercial Pt/C. These findings indicate that the CoO/PtPd/r‐GO thin film exhibits enhanced catalytic performance and improved tolerance to CO poisoning. Furthermore, the power output calculated for CoO/PtPd/r‐GO is 104.5 mW·cm−2, which is comparable to the reported value of 48.03 mW·cm−2 for commercial Pt/C. These results demonstrate the potential of the CoO/PtPd/r‐GO nanocomposite thin film as a promising alternative to traditional catalyst materials in methanol fuel cells. [ABSTRACT FROM AUTHOR]

[Display omitted] The platinum catalysts based on carbon black and carbon nanotubes supports have been obtained via pulse alternating current technique. The synthesized Pt/C catalysts showed better electric transport characteristics and the carbon monoxide poisoning resistance in comparison with the commercial Pt/C owing to both the size of the platinum nanoparticles and their agglomeration on the support surface, and the morphology of the carbon support. [ABSTRACT FROM AUTHOR]

CO and H 2 S poisoning of Pt-based catalysts for hydrogen oxidation reaction (HOR) stands as one of the long-standing hindrances to the widespread commercialization of proton exchange membrane fuel cells. In this paper, a Ru/Ti 4 O 7 catalyst is successfully synthesized by the microwave-thermal method. This Ru/Ti 4 O 7 catalyst shows a much higher noble metal mass activity than those of commercial PtRu/C and conventional Ru/C catalysts. The performance of the Ru/Ti 4 O 7 catalyst under the exist of CO or H 2 S shows insignificant current decay, which is far superior to commercial PtRu/C and Pt/C catalysts. In this Ru/Ti 4 O 7 catalyst, the electron transfer between Ru and Ti to form d-p orbital hybridization is considered to be responsible for the favorable catalytic HOR performance and the corresponding CO and H 2 S tolerance. The interaction mechanism formed by electron transfer may open a promising way for the subsequent development of anti-poisoning catalysts for PEM fuel cell hydrogen oxidation reaction. [Display omitted] • Ru/Ti 4 O 7 catalyst shows a superior noble metal mass activity than those of commercial Pt–Ru/C based catalysts. • Ru/Ti 4 O 7 catalyst exhibits excellent resistance to CO poisoning. • The catalyst is extremely resistant to H 2 S while remaining CO-tolerant. • MSI of Ru/Ti 4 O 7 ensures catalytic activity and anti-poisoning properties. [ABSTRACT FROM AUTHOR]

Despite the coexistence of CO and H2S in reformed hydrogen, studies on the interaction between impurities are lacking. In this study, the co‐poisoning effect of CO and H2S on a polymer electrolyte membrane fuel cell (PEMFC) is systematically investigated using a hydrogen reference electrode inserted into a membrane electrode assembly (MEA). Notably, when CO and H2S are present simultaneously, the poisoning rate is accelerated and is higher than the simple sum of the poisoning by the individual gases, suggesting a complex synergic effect between the two gases. This phenomenon can be attributed to the potential‐dependent behavior of H2S poisoning, whereas CO poisoning remains independent of the potential but depends on the total poisoning time. Therefore, the potential of the anode rises over time due to the time‐dependent CO poisoning, which accelerates the potential‐dependent H2S poisoning. As a result, the cell voltage decreases more rapidly in the CO and H2S mixture. [ABSTRACT FROM AUTHOR]

With the increasing consumption of fossil fuels, there is an urgent need to develop a new green and clean energy source. Fuel cells have been extensively studied as a clean alternative to fossil fuels. As a green energy source, direct methanol fuel cells (DMFCs) have high energy density; however, their commercialization is restricted by the poor stability and slow kinetics of methanol oxidation reactions (MORs). One of the key strategies to overcome these problems is to develop efficient, economic and green catalysts for energy storage and conversion devices. Thus far, Pt-based electrocatalysts have been extensively used to enhance the oxidation process of CH3OH. However, since Pt-based electrocatalysts are limited by high cost and susceptibility to CO poisoning, researchers have been motivated to search for a cost-effective, highly active and durable catalytic material. In recent years, Co-based spinel oxides have been found to exhibit good potential as fuel cell electrode materials, they can be modified by defect engineering, alloying and heteroatom doping, or more active sites can be exposed by morphology regulation or carrier regulation, so as to improve their electrocatalytic performance. This review provides a comprehensive introduction to the recent development of Co-based spinel electrocatalysts for emerging MORs involved in DMFCs, and the future development of low-cost and high-performance Co-based spinel oxide catalytic materials is prospected. [ABSTRACT FROM AUTHOR]

The IrRh@C ZIF-8 catalysts capable of oxidizing H 2 , CO, or a combination of the two is fabricated through the secondary high temperature annealing. Benefiting from the closely located single atom sites to the nanoparticles, CO on the metal nanoparticles could be efficiently removed, thus conferring the catalysts with excellent H 2 oxidation performance in CO presence that has not been possible before. This work opens up a new avenue to conquer the formidable poisoning issue of PEMFCs. [Display omitted] Nanosized Pt catalysts are the catalyst-of-choice for proton exchange membrane fuel cell (PEMFC) anode, but are limited by their extreme sensitivity to CO in parts per million (ppm) level, thereby making the use of ultrapure H 2 a prerequisite to ensure acceptable performance. Herein, we confront the CO poisoning issue by bringing the Ir/Rh single atom sites to synergistically working with their metallic counterparts. In presence of 1000 ppm CO, the catalyst represents not only undisturbed H 2 oxidation reaction (HOR) catalytic behavior in electrochemical cell, but also unparalleled peak power density at 643 mW cm−2 in single cell, 27-fold in mass activity of the best PtRu/C catalysts available. Pre-poisoning experiments and surface-enhanced Raman scattering spectroscopy (SERS) and calculation results in combine suggest the presence of adjacent Ir/Rh single atom sites (SASs) to the nanoparticles (NPs) as the origin for this prominent catalytic behavior. The single sites not only exhibit superb CO oxidation performance by themselves, but can also scavenge the CO adsorbed on approximated NPs via supplying reactive OH* species. We open up a new route here to conquer the formidable CO poisoning issue through single atom and nanoparticle synergistic catalysis, and pave the way towards a more robust PEMFC future. [ABSTRACT FROM AUTHOR]

MoP nanofiber-coupled Pd nanoparticles were demonstrated as efficient catalysts for formic acid-assisted water splitting in hydrogen generation. The theoretical calculations indicated that the OH on the surface of MoP through d–p bonding promoted the oxidation of CO at the Pd sites, and improved the ability to resist CO poisoning. As a result, enhanced catalytic performance was indicated. [ABSTRACT FROM AUTHOR]

Gray matter (GM) atrophy and white matter (WM) lesions may contribute to cognitive decline in patients with delayed neurological sequelae (DNS) after carbon monoxide (CO) poisoning. However, there is currently a lack of evidence supporting this relationship. This study aimed to investigate the volume of GM, cortical thickness, and burden of WM lesions in 33 DNS patients with dementia, 24 DNS patients with mild cognitive impairment, and 51 healthy controls. Various methods, including voxel‐based, deformation‐based, surface‐based, and atlas‐based analyses, were used to examine GM structures. Furthermore, we explored the connection between GM volume changes, WM lesions burden, and cognitive decline. Compared to the healthy controls, both patient groups exhibited widespread GM atrophy in the cerebral cortices (for volume and cortical thickness), subcortical nuclei (for volume), and cerebellum (for volume) (p <.05 corrected for false discovery rate [FDR]). The total volume of GM atrophy in 31 subregions, which included the default mode network (DMN), visual network (VN), and cerebellar network (CN) (p <.05, FDR‐corrected), independently contributed to the severity of cognitive impairment (p <.05). Additionally, WM lesions impacted cognitive decline through both direct and indirect effects, with the latter mediated by volume reduction in 16 subregions of cognitive networks (p <.05). These preliminary findings suggested that both GM atrophy and WM lesions were involved in cognitive decline in DNS patients following CO poisoning. Moreover, the reduction in the volume of DMN, VN, and posterior CN nodes mediated the WM lesions‐induced cognitive decline. [ABSTRACT FROM AUTHOR]

Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a relatively rare inflammatory-associated neurometabolic complication. In this article, we present a case report of a 50-year-old male patient with a history of carbon monoxide poisoning. This acute poisoning, although successfully controlled during a stay in the intensive care unit of a local hospital, later led to persistent neurological symptoms. The patient was then treated in the inpatient unit of the rehabilitation clinic, where cognitive deterioration began to develop 20 days after admission. Subsequent examination using EEG and magnetic resonance imaging confirmed severe encephalopathy later complicated by SARS-CoV-2 infection with fatal consequences due to bronchopneumonia. Because currently there are no approved guidelines for the management of DEACMP, we briefly discuss the existing challenges for future studies, especially the application of rational immunosuppressive therapy already in the acute treatment phase of CO poisoning, which could prevent the development of a severe form of DEACMP. [ABSTRACT FROM AUTHOR]

No definitive prognostic biomarkers for carbon monoxide (CO) poisoning have been proposed. The aim of this study is to investigate, through a systematic literature review and pooled analysis, whether red blood cell distribution width (RDW) can predict disease severity in CO-poisoned patients. We performed an electronic search in Scopus and PubMed using the keywords: 'red blood cell distribution width' OR 'RDW' AND 'carbon monoxide' AND 'poisoning,' with no time or language restrictions (i.e. through August 2023) to find clinical studies that examined the value of RDW in patients with varying severity of CO poisoning. The analysis was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 reporting checklist. We identified 29 articles, seven of which were included in our analysis, with a total of 1979 CO-poisoned patients, 25.9% of whom were severely ill. In all but one of the studies, the RWD mean or median value was higher in CO-poisoned patients with severe disease. The weighted mean difference (WMD) of RDW was 0.36 (95% confidence interval (CI), 0.26–0.47)%. In the three articles in which the severity of illness in CO-poisoned patients was defined as cardiac injury, the WMD of the RDW was 1.26 (95%CI, 1.02–1.50)%. These results suggest that monitoring RDW in CO-poisoned patients may help to determine the severity of disease, particularly cardiac injury. [ABSTRACT FROM AUTHOR]

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Emergency hyperbaric oxygen treatment capability is limited in the United States, and there is little documentation of calls received by centers available 24 hours a day, seven days a week, 365 days a year. Our study aimed to calculate the number of calls received for urgent hyperbaric oxygen (HBO2). We logged calls from two HBO2 chambers on the East Coast of the United States that serve a densely populated region in 2021. The total number of emergency calls was 187 at the University of Maryland (UMD) and 127 at the University of Pennsylvania (UPenn). There were calls on 180/365 (46%) days during the study period at UMD and 239/365 (63%) days at UPenn. The most common indication was carbon monoxide toxicity. The peak month of calls was March. Emergency HBO2 calls are common, and more centers must accept emergency cases. Data from geographically diverse centers would add generalizability to these results and capture more diving-related emergencies. [ABSTRACT FROM AUTHOR]

The direct methanol fuel cells (DMFCs) are impeded by the sluggish methanol oxidation reaction (MOR) induced by CO poisoning. In this work, we report the synthesis of PtPd alloy nanoparticles (3.2 nm) on molybdenum carbide nanosheets (PtPd@Mo 2 C). The XPS investigation indicates that Pd atoms accept electrons from Pt and Mo atoms resulting in a slight percentage of oxidized Pt capable of anchoring OH− species from water dissociation; thereby, the CO poisoned Pt is re-activated. Therefore, PtPd@Mo 2 C exhibits 8.1-fold higher mass activity than commercial PtRu/C. Ascribing to the strong electronic interaction between PtPd and Mo 2 C substrate, a superior stability is achieved for PtPd@Mo 2 C with MOR activity only decreased by 6 % after 10,000 cycles. Additionally, the operando electrochemical impedance spectroscopy measurement indicates a similar MOR kinetics to PtRu/C and a better structural stability. [Display omitted] • PdPt alloyed nanoparticles (3.2 nm) are deposited on molybdenum carbide nanosheets. • PtPd@Mo 2 C shows 8.1-fold higher mass activity toward MOR than PtRu/C. • MOR activity only decreased by 6 % is achieved for PtPd@Mo 2 C after 10,000 cycles. [ABSTRACT FROM AUTHOR]

Sulforaphane (SFN) has attracted much attention due to its ability on antioxidant, anti‐inflammatory, and anti‐apoptotic properties, while its functional targets and underlying mechanism of action on brain injury caused by acute carbon monoxide poisoning (ACOP) have not been fully elucidated. Herein, we used a systematic network pharmacology approach to explore the mechanism of SFN in the treatment of brain damage after ACOP. In this study, the results of network pharmacology demonstrated that there were a total of 81 effective target genes of SFN and 36 drug–disease targets, which were strongly in connection with autophagy–animal signaling pathway, drug metabolism, and transcription disorders in cancer. Upon the further biological function and KEGG signaling pathway enrichment analysis, a large number of them were involved in neuronal death, reactive oxygen metabolic processes and immune functions. Moreover, based on the results of bioinformatics prediction associated with multiple potential targets and pathways, the AMP‐activated protein kinase (AMPK) signaling pathway was selected to elucidate the molecular mechanism of SFN in the treatment of brain injury caused by ACOP. The following molecular docking analysis also confirmed that SFN can bind to AMPKα well through chemical bonds. In addition, an animal model of ACOP was established by exposure to carbon monoxide in a hyperbaric oxygen chamber to verify the predicted results of network pharmacology. We found that the mitochondrial ultrastructure of neurons in rats with ACOP was seriously damaged, and apoptotic cells increased significantly. The histopathological changes were obviously alleviated, apoptosis of cortical neurons was inhibited, and the number of Nissl bodies was increased in the SFN group as compared with the ACOP group (p <.05). Besides, the administration of SFN could increase the expressions of phosphorylated P‐AMPK and MFN2 proteins and decrease the levels of DRP1, Caspase3, and Casapase9 proteins in the brain tissue of ACOP rats. These findings suggest that network pharmacology is a useful tool for traditional Chinese medicine (TCM) research, SFN can effectively inhibit apoptosis, protect cortical neurons from the toxicity of carbon monoxide through activating the AMPK pathway and may become a potential therapeutic strategy for brain injury after ACOP. [ABSTRACT FROM AUTHOR]

Objective: This study aims to provide an updated overview of the relationship between carbon monoxide poisoning (COP) and cardiovascular disease. Methods: A systematic literature search was conducted in PubMed, Embase, Cochrane, and Web of Science databases up to September 2023. The association between COP patients and cardiovascular adverse events was examined and summarized. The outcomes included arrhythmia, coronary heart disease, heart failure, myocardial infarction, major adverse cardiovascular events (MACE), carboxyhaemoglobin percent (COHB%), Pondus Hydrogenii (PH) electrocardiography (ECG) parameters. Results: Eight eligible articles, involving a total of 251,971 patients, were included for evidence synthesis. The analysis revealed a heightened incidence of MACE in patients with COP. Additionally, COP exhibited an impact on specific ECG parameters. The incidence of MACE after COP was found to be similar in Korean and Chinese populations, and there was no significant effect of gender or underlying diseases on MACE incidence following COP. The incidence of MACE after COP did not differ significantly in individuals aged 50 years and older. Conclusions: Considering the observed heterogeneity and potential biases in the selected studies, emergency physicians should be aware of the increased likelihood of cardiovascular events in patients diagnosed with COP.

Abstract Background Delayed neuropsychiatric sequelae (DNS) is a syndrome that appears days to weeks after acute carbon monoxide (CO) poisoning. DNS shows various neuropsychiatric symptoms, such as mental deterioration and parkinsonism. Case Presentation Our case was a 37‐year‐old male with schizophrenia. He attempted suicide by CO poisoning and was brought to our emergency department (Day 0). He was ventilated with normobaric oxygen therapy for 3 days and moved to the psychiatric ward with clear consciousness. We restarted antipsychotics, and he gradually presented akinesia and rigidity. Additionally, around Day 32, he showed disorganized behaviors, mental deterioration, incontinence, and gait disturbance. Brain magnetic resonance imaging (MRI) showed slightly abnormal findings on Day 35. Although we suspected DNS on the clinical course and the MRI findings, catatonia and side‐effects of antipsychotics were also considered. Finally, electroencephalography (EEG) on Day 38 with apparent abnormalities, including diffuse slow waves, resulted in our diagnosis of DNS, and he underwent hyperbaric oxygen therapy. His condition was dramatically improved, and his diffuse slow waves on EEG disappeared on Day 83. We also followed his clinical presentations and brain MRI until 33 months. Throughout the whole follow‐up, his cognition, movement, and psychiatric symptoms remained stable. However, his brain MRI showed progressive atrophy in bilateral frontal lobes and increasing white matter lesions throughout the whole course. Conclusion EEG, as well as brain MRI, may be crucial in the differential diagnosis of DNS in patients with complex conditions involving medications and severe mental illnesses.

Delayed neuropsychiatric sequelae (DNS) significantly impact the quality of life in patients following acute carbon monoxide poisoning (COP). This systematic review and meta-analysis aimed to assess the relationship between serum neuron-specific enolase (NSE) levels at admission and the risk of DNS in adults after acute COP. Relevant observational studies with longitudinal follow-up were identified through searches in PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases. The random-effects model was used to aggregate results, accounting for potential heterogeneity. Nine cohort studies, including 1501 patients, were analyzed, with 254 (16.9%) developing DNS during follow-up. The pooled data indicated that elevated serum NSE in the early phase was linked to a higher risk of subsequent DNS (odds ratio per 1 ng/mL increase in NSE: 1.10, 95% confidence interval: 1.06 to 1.15, P < 0.001). Moderate heterogeneity (I2 = 46%) among the studies was entirely attributed to one study with the longest follow-up duration (22.3 months; I2 = 0% after excluding this study). Subgroup analyses based on country, study design, sample size, age, sex, admission carboxyhemoglobin levels, DNS incidence, follow-up duration, and quality score yielded consistent results (P for subgroup differences all > 0.05). In summary, high serum NSE levels in the early phase of acute COP are associated with an increased risk of developing DNS during follow-up.

The article discusses the development of quality indicators (QIs) for the care of patients with acute poisoning in emergency departments. The authors highlight the importance of nursing staff and emergency technicians in providing initial care to poisoned patients. They mention that Spain has already developed 24 QIs for the emergency care of poisoned patients, which include aspects measurable by nurses. The authors emphasize the need for further research and validation of QIs to improve the quality of care for poisoned patients. [Extracted from the article]

Objective: Carbon monoxide (CO) poisoning is a condition which oxygen transport is reduced and presentation is impaired. Red cell distribution width (RDW) is associated with many diseases. Although there are many studies on RDW in the literature, there are very few studies evaluating the relationship between CO poisoning and RDW. The aim of our study is to investigate whether relationship between CO poisoning and RDW. Methods: Patients who applied to the emergency service, CO poisoning was diagnosed, their age 18 years and over, their blood gas measurements showed a carboxyhemoglobin (COHb) level of ≥5%, were taken in this retrospective study. It was recorded that research participants' age, sex, COHb levels in blood gases, hemogram, consultation due to CO poisoning and effects, whether taken hyperbaric oxygen (HBO) and its outcomes. Whether there was a change that could be attributed to CO poisoning at the RDW levels was investigated. Results: Fifty-nine cases were included in the study. The mean RDW of the study group (13.61+-1.12) was higher than that of the control group (12.99+-0.59) (p

Background: One emergency that occurs frequently and has high morbidity is carbon monoxide poisoning. After a time of lucidity, some victims who recover from the incident of acute carbon monoxide exposure may later suffer delayed neuropsychiatric sequelae (DNS), which can include cognitive impairments, a wide range of neurological abnormalities, and affective disorders. Below, we report the first documented incident of DNS after carbon monoxide poisoning in Ethiopia. Case presentation: A 40-year-old male patient who developed a coma after he was exposed to burning charcoal in a closed room was admitted to Debre Tabor Comprehensive Specialized Hospital in the northwest region of Ethiopia. He stayed for 12 days during his first admission and was discharged with improvement. One month after discharge, he developed delayed neuropsychiatric sequelae, which manifested as bizarre behavior, being unable to walk unsupported, loss of concentration, and failure to control urine and feces. Brain MRI showed bilateral periventricular and frontoparietal deep white matter subcortical abnormal T1 and T2 prolongation with no restriction of diffusivity, possibly due to demyelinating disorders. He was managed with fluid therapy, benzhexol, risperidone, and rehabilitation therapy. He stayed for two weeks in our hospital and was discharged with improvement. Conclusion: Despite the paucity of delayed neuropsychiatric sequelae from carbon monoxide poisoning, physicians should be highly suspicious in the right situations. The precise mechanisms of delayed toxic effects, prevention measures, and treatment modalities have not yet been determined; therefore, more research and attention are required.

Despite recent technological progress, carbon monoxide poisoning is still one of the leading causes of domestic and industrial morbidity and mortality. The brain is particularly vulnerable to CO toxicity, and thus the majority of survivors develop delayed movement and cognitive complications. CO binds to haemoglobin in erythrocytes, preventing oxygen delivery to tissues, and additionally inhibits mitochondrial respiration. This renders the effect of CO to be closely related to hypoxia reperfusion injury. Oxygen deprivation, as well as CO poisoning and re-oxygenation, are shown to be able to activate the production of reactive oxygen species and to induce oxidative stress. Here, we review the role of reactive oxygen species production and oxidative stress in the mechanism of neuronal cell death induced by carbon monoxide and re-oxygenation. We discuss possible protective mechanisms used by brain cells with a specific focus on the inhibition of CO-induced ROS production and oxidative stress.

The high catalytic activity of Pt is accompanied by a high affinity for CO, making it extremely susceptible to poisoning. Such CO poisoning limits the use of proton exchange membrane fuel cells. In this work, using global minima search techniques and exhaustive electronic structure characterization, the dopant concentration is pinpointed as a crucial factor to improve the CO tolerance of Pt catalysts. By investigating the PtGe nanoclusters of different sizes and compositions, we found that, for those clusters with roughly the same amount of Pt and Ge, the binding to CO is weakened significantly. The uniqueness of the PtGe equimolar clusters is traced down to the electronic effects. The strong covalency and electrostatic stabilization arising from the advantageous Pt–Ge mixing make the equimolar clusters highly resistant toward CO poisoning and therefore more durable. Importantly, the novel catalysts not only are more resistant to deactivation but also remain catalytically active toward hydrogen oxidation. Representative clusters are additionally deposited on graphene with a pentagon–octagon–pentagon (5-8-5) reconstructed divacancy. The remarkable results of free-standing clusters hold true for surface mounted clusters, in which the interaction with CO is dramatically weakened for those compounds with a Pt:Ge ratio of 1:1. Our results demonstrate that Ge can be a promising alloying agent to mitigate the deactivation of Pt and that the dopant concentration is a critical factor in the design of advanced catalysts. [ABSTRACT FROM AUTHOR]