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Replacement of the sluggish anodic reaction in water electrocatalysis by a thermodynamically favorable urea oxidation reaction (UOR) offers the prospect of energy-saving H

Subjective cognitive decline (SCD) is a preclinical asymptomatic stage of Alzheimer’s disease (AD). Accurate diagnosis of SCD represents the greatest challenge for current clinical practice. The multimodal magnetic resonance imaging (MRI) features of 7 brain networks and 90 regions of interests from Chinese and ANDI cohorts were calculated. Machine learning (ML) methods based on support vector machine (SVM) were used to classify SCD plus and normal control. To assure the robustness of ML model, above analyses were repeated in amyloid β (Aβ) and apolipoprotein E (APOE) ɛ4 subgroups. We found that the accuracy of the proposed multimodal SVM method achieved 79.49% and 83.13%, respectively, in Chinese and ANDI cohorts for the diagnosis of the SCD plus individuals. Furthermore, adding Aβ pathology and ApoE ɛ4 genotype information can further improve the accuracy to 85.36% and 82.52%. More importantly, the classification model exhibited the robustness in the crossracial cohorts and different subgroups, which outperforms any single and 2 modalities. The study indicates that multimodal MRI imaging combining with ML classification method yields excellent and powerful performances at categorizing SCD due to AD, suggesting potential for clinical utility.

Exploring individual brain atrophy patterns is of great value in precision medicine for Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, the current individual brain atrophy detection models are deficient. Here, we proposed a framework called generative adversarial network constrained multiple loss autoencoder (GANCMLAE) for precisely depicting individual atrophy patterns. The GANCMLAE model was trained using normal controls (NCs) from the Alzheimer's Disease Neuroimaging Initiative cohort, and the Xuanwu cohort was employed to validate the robustness of the model. The potential of the model for identifying different atrophy patterns of MCI subtypes was also assessed. Furthermore, the clinical application potential of the GANCMLAE model was investigated. The results showed that the model can achieve good image reconstruction performance on the structural similarity index measure (0.929 ± 0.003), peak signal-to-noise ratio (31.04 ± 0.09), and mean squared error (0.0014 ± 0.0001) with less latent loss in the Xuanwu cohort. The individual atrophy patterns extracted from this model are more precise in reflecting the clinical symptoms of MCI subtypes. The individual atrophy patterns exhibit a better discriminative power in identifying patients with AD and MCI from NCs than those of the t-test model, with areas under the receiver operating characteristic curve of 0.867 (95%: 0.837-0.897) and 0.752 (95%: 0.71-0.790), respectively. Similar findings are also reported in the AD and MCI subgroups. In conclusion, the GANCMLAE model can serve as an effective tool for individualised atrophy detection.

Background. Subjective cognitive decline (SCD) is the earliest symptom stage of Alzheimer’s disease (AD). Previous studies have shown that the study setting is an important influence factor of SCD. However, the effect of this factor among a Chinese population with SCD is not clear. Here, we aim to compare the clinical characteristics of SCD between a convenience and a population-based sample in China. Methods. We included a convenience sample of 212 SCD subjects and a population-based sample of 110 SCD subjects. We performed univariate analysis to evaluate the between-group differences in sociodemographic characteristics, neuropsychological performance, psychiatric conditions, different cognitive domains, and the SCD-plus criteria. Multiple linear regression model was established, adjusted for sex, age, and education, and compared the neuropsychological performance between the groups. Results. The convenience sample had more years of education, a higher family history of dementia, and higher neuropsychological and anxiety depression score than the population-based sample. Using sex, age, education, group as the independent variables, and neuropsychological score as the dependent variable, multiple linear regression model was established; a statistically significant neuropsychological score difference (MoCA-B, AVLT-H-N4, AVLT-H-N5, AVLT-H-N7, AFT, and STT-B) was found between the two samples. In the SCD cognitive domains, the population-based sample had more complaints about declines in their language and planning domains. For SCD-plus criteria in memory domain, the convenience sample had more complaints, worry, and cognitive decline within the last 5 years, along with medical help-seeking. Conclusion. There were some different characteristics among SCD individuals between convenience samples and population-based samples in China.

The relationship of cognitive reserve and measures of reserve with longitudinal cognitive change and the duration of preclinical, prodromal, and mild Alzheimer disease (AD) dementia remains to be fully characterized. In our study, 660 β-amyloid-positive participants staged with preclinical AD, prodromal AD, and dementia due to AD from the Alzheimer's Disease Neuroimaging Initiative were selected. Cognitive reserve and brain reserve were defined by conventional proxies or the residual method at baseline. We evaluated the utility of these reserves in predicting longitudinal cognitive change by mixed effects models and used a multi-state model to estimate stage duration stratified by reserve groups. Corrected for age, sex, and APOE-ε4 status, reserve was associated with cognitive decline, and the effects changed depending on the specific measures of reserve and the stage of AD. Reserves defined by the residual method were stronger predictors of cognitive change than those defined by conventional proxies. The estimated time from preclinical to mild AD dementia varied from 15-24 years based on the different reserve groups, and we observed a linear trend for the longest duration in individuals with high cognitive reserve/high brain reserve, followed by those with high cognitive reserve/low brain reserve, low cognitive reserve/high brain reserve, and low cognitive reserve/low brain reserve. This study showed a reduced risk of cognitive decline for individuals with higher level of reserve regardless of methods for measuring reserve. Interindividual differences in reserve may be important for clinical practice and trial design.

Exploring highly efficient, robust, and stable catalysts for urea electrolysis is intensively desirable for hydrogen production but remains a challenging task. In this work, novel, well-aligned, self-supported NiS/Ni

Background To identify the effect of hemodynamic fluctuations on severe postoperative complications in patients undergoing surgery for pheochromocytoma and paraganglioma (PPGL). Methods Patients with PPGL confirmed by postoperative pathologic examination in Fujian Provincial Hospital from January 2015 to January 2021 were enrolled. Demographic characteristics, comorbidities, preoperative examinations, preoperative preparation, intraoperative data, and postoperative complications were collected. Receiver operating characteristic curve was used to calculate the cutoff point of intraoperative standard deviation of systolic blood pressure for prediction of severe postoperative complication. According to the cutoff point, patients were divided into fluctuation and nonsevere fluctuation groups. Incidence of postoperative complication, intensive care unit (ICU) admission, length of stay after the operation, and length of ICU stay between the 2 groups was compared. The cumulative incidence and hazard ratio of postoperative complications were evaluated by Kaplan�Meier method and Cox regression analysis. Results A total of 126 patients were included in the study with 41 and 85 cases in the severe fluctuation and nonsevere fluctuation groups, respectively. Compared with the nonsevere fluctuation group, the incidence of postoperative complications (58.5% vs. 16.5%, P < 0.001), ICU admission rate (26.8% vs. 10.6%, P = 0.019), postoperative hospital stay, and ICU stay (P < 0.05) were higher in the severe fluctuation group. The Kaplan–Meier curve showed a higher incidence of postoperative complications in patients with severe blood pressure fluctuations (P < 0.05). The Cox regression analysis also showed that patients in the severe fluctuation group were more susceptible to postoperative complications (hazard ratio = 3.010, 95% confidence interval 1.334–6.806). Conclusions For patients with PPGL, the intraoperative hemodynamic fluctuations are associated with an increased risk of severe postoperative complications.

Background: Subjective cognitive decline (SCD) is considered as the first symptomatic manifestation of Alzheimer’s disease (AD), which is also affected by different cultural backgrounds. Establishing cross-cultural prediction models of SCD is challenging. Objective: To establish prediction models of SCD available for both the Chinese and European populations. Methods: In this project, 330 SCD from China and 380 SCD from Germany are intended to be recruited. For all participants, standardized assessments, including clinical, neuropsychological, apolipoprotein E (APOE) genotype, blood, and multi-parameter magnetic resonance imaging (MRI) at baseline will be conducted. Participants will voluntarily undergo amyloid positron emission tomography (PET) and are classified into amyloid-β (Aβ) positive SCD (SCD+) and Aβ negative SCD (SCD-). First, baseline data of all SCD individuals between the two cohorts will be compared. Then, key features associated with brain amyloidosis will be extracted in SCD+ individuals, and the diagnosis model will be established using the radiomics method. Finally, the follow-up visits will be conducted every 12 months and the primary outcome is the conversion to mild cognitive impairment or dementia. After a 4-year follow-up, we will extract factors associated with the conversion risk of SCD using Cox regression analysis. Results: At present, 141 SCD from China and 338 SCD from Germany have been recruited. Initial analysis showed significant differences in demographic information, neuropsychological tests, and regional brain atrophy in SCD compared with controls in both cohorts. Conclusion: This project may be of great value for future implications of SCD studies in different cultural backgrounds. Trial registration: ClinicalTrials.gov, NCT04696315. Registered 3 January 2021.

Electronic structure optimization and architecture modulation are widely regarded as rational strategies to enhance the electrocatalysts catalytic performance. Herein, a hybridization of ZIF-67-derived CoP nanoparticles embedded in P, N co-doped carbon matrix (PNC) and anchored on P-doped carbonized wood fibers (PCWF) is constructed using a simple simultaneous phosphorization and carbonization strategy. Benefiting from the optimized surface/interface electronic structures, abundant exposed active sites, and outstanding conductivity, the CoP@PNC/PCWF can drive the urea oxidation reaction (UOR) with greater activity and better stability than most recently reported electrocatalysts, in which a potential as low as 1.32 V (vs reversible hydrogen electrode, RHE) is needed to reach 50 mA cm

Background: Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer’s disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. Objective: This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. Methods: The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration’s tool. The Hedges’ g of change was analyzed. Results: Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges’ g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges’ g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges’ g = 0.49, p = 0.0003) and psychological well-being (Hedges’ g = 0.27, p = 0.03). Conclusion: Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.

Background: Visual rating scales for medial temporal lobe atrophy (MTA) and posterior atrophy (PA) have been reported to be useful for Alzheimer’s disease diagnosis in routine clinical practice. Objective: To investigate the efficacy of combined MTA and PA visual rating scales to discriminate amnestic mild cognitive impairment (aMCI) patients from healthy controls. Methods: This study included T1-weighted MRI images from two different cohorts. In the first cohort, we recruited 73 patients with aMCI and 48 group-matched cognitively normal controls for training and validation. Visual assessments of MTA and PA were carried out for each participant. Global gray matter volume and density were estimated using voxel-based morphometry analysis as the objective reference. We investigated the discriminative power of a single visual rating scale and the combination of the MTA and PA rating scales for identifying aMCI. The second cohort, consisting of 33 aMCI patients and 45 controls, was used to verify the reliability of the visual assessments. Results: Compared with the single visual rating scale, the combination of the MTA and PA exhibited the best discriminative power, with an AUC of 0.818±0.041, which was similar to the diagnostic accuracy of the gray matter volumetric measures. The discriminative power of the combined MTA and PA was verified in the second cohort (AUC 0.824±0.058). Conclusion: The combined MTA and PA rating scales demonstrated practical diagnostic value for distinguishing aMCI patients from controls, suggesting its potential to serve as a convenient and reproducible method to assess the degree of atrophy in clinical settings.

Background Clinical research has demonstrated that brain reserve (BR) could exert positive effects on cognition for patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, the effects of BR on cognition in individuals with subjective cognitive decline (SCD) are not clear. Objective To examine cross-sectional effects of BR on cognition in SCD populations. Methods One hundred forty-nine subjects were studied from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Head circumference was used as a proxy of BR. Cognition was assessed across four domains (memory, executive, language, and general cognitive functions). Multiple linear regression models were conducted to examine effects of BR on cognitive scores. Furthermore, we addressed the question that whether the degree of self-perception of cognitive decline modified the effect of BR on cognitive performance in SCD subjects. Results We found a positive effect of BR on language cognition in subjects with SCD. Furthermore, the positive effect of BR on language cognition survived in SCD participants with a low degree of self-perception of cognitive decline while disappeared in SCD participants with a high degree of self-perception of cognitive decline. Conclusion This study suggests that BR has the potential to delay or slow down cognitive decline in SCD individuals, especially for mild SCD.

The effects of oxygen nonstoichiometry on material formation, geometrical structure, and electronic structures together with carrier conductions of CaMnO3 perovskite are comprehensively studied in detail. Specifically, the formation energy of oxygen nonstoichiometry in CaMnO3 perovskite is 8.01 eV. It has formation enthalpy of −7.10 eV. The MnO6 octahedron is diminished along b and c, it is expanded along a. All Mn–O bindings tend to tilt and the MnO6 octahedron is distorted. The strength of Mn–O bindings parallel to the a–c plane is enhanced; the strength of Mn–O bindings parallel to the b direction is weakened. The band gaps are 0.804 eV and 0.065 eV for the CaMnO3 and CaMnO2.75, respectively. The work functions are 4.69 eV and 2.58 eV, respectively. The p orbital electrons form the upper valance bands and the d orbital electrons form the lower conduction bands. The Ca s, Mn d and O p electrons contribute to carrier conductions for CaMnO2.75 perovskite.

The continuous demand for high-speed, low-power consumption and multi-functionality of new generation electronic products has led to an exponential increase for high-yield and high-reliability packaging technologies, which has promoted the application of the 7nm node process technology to promote higher I/Os and smaller bump pitches. The advantages of copper pillar bump, which was widely used in high-density packaging, include fine pitch, high strength, low interconnection resistance, excellent electromigration performance, and lead-free packaging solutions. The low-k/ultra-low-k (LK/ULK) material medium used in back-end of the line (BEOL) can effectively reduce the parasitic capacitance without reducing the wiring density. Therefore, to improve thermomechanical and electrical performance, chips with a 42nm node and beyond usually integrate LK/ULK structure and metal line in BEOL. However, the encapsulation of the chip exceeding the 28nm node would lead to a sharp increment in the number of BEOL interconnection layers (vertical) and high-density copper traces (horizontal). The thermomechanical stress caused by the mismatch of the CTE of wafer and packaging material may cause LK/ULK delamination, bump cracks, and UBM peeling failures. Therefore, the accurate analysis and calculation of the thermomechanical stress in the film structure has always been the focus of engineering and academia. The integrity of the bumps and microstructure of BEOL can be evaluated effectively by shear test method, which was suitable for structural inspection. In this work, the shear test simulation was applied for single bump to characterize the failures of BEOL structures, e.g., fractures of ULK/LK. Owing to the fragile characteristics of LK/ULK, BEOL was susceptible to external loads. When the copper pillar bumps above BEOL were subjected to shearing forces caused by thermal mismatch, the failure would occur in some microstructures within BEOL, especially in ULK/LK interfaces. Because the bumps near die corner suffered a critical shear load, so the single bump of the aforementioned area was investigated by a shear simulation model. Studies had shown that the shear rate had less effect on the maximum shear stress, but the increment of the shear height brought about more fractures of LK, which showed that reducing the bump height helps to reduce the risk of BEOL damage under thermomechanical loads. Generally, the shear test of copper pillar bumps could effectively evaluate the strength and adhesion of the BEOL film interfaces. As an early evaluation under extreme conditions, this simulation was designed to check the integrity of ULK/LK stack film and the strength of the bump structure through the chip package interaction without underfill protection and finally find the optimal packaging solution.

Background Plasma amyloid-β (Aβ) may facilitate identification of individuals with brain amyloidosis. Gut microbial dysbiosis in Alzheimer’s disease (AD) is increasingly being recognized. However, knowledge about alterations of gut microbiota in preclinical AD, as well as whether the combination of plasma Aβ and gut microbiota could identify preclinical AD, remains largely unknown. Methods This study recruited 34 Aβ-negative cognitively normal (CN−) participants, 32 Aβ-positive cognitively normal (CN+) participants, and 22 patients with cognitive impairment (CI), including 11 patients with mild cognitive impairment (MCI) and 11 AD dementia patients. All participants underwent neuropsychological assessments and fecal microbiota analysis through 16S ribosomal RNA (rRNA) Illumina Miseq sequencing technique. Meso Scale Discovery (MSD) kits were used to quantify the plasma Aβ40, Aβ42, and Aβ42/Aβ40 in CN− and CN+ participants. Using Spearman’s correlation analysis, the associations of global standard uptake value rate (SUVR) with altered gut microbiota and plasma Aβ markers were separately evaluated. Furthermore, the discriminative power of the combination of gut microbiota and plasma Aβ markers for identifying CN+ individuals was investigated. Results Compared with the CN− group, the CN+ group showed significantly reduced plasma Aβ42 (p = 0.011) and Aβ42/Aβ40 (p = 0.003). The relative abundance of phylum Bacteroidetes was significantly enriched, whereas phylum Firmicutes and class Deltaproteobacteria were significantly decreased in CN+ individuals in comparison with that in CN− individuals. Particularly, the relative abundance of phylum Firmicutes and its corresponding SCFA-producing bacteria exhibited a progressive decline tendency from CN− to CN+ and CI. Besides, the global brain Aβ burden was negatively associated with the plasma Aβ42/Aβ40 (r = −0.298, p = 0.015), family Desulfovibrionaceae (r = −0.331, p = 0.007), genus Bilophila (r = −0.247, p = 0.046), and genus Faecalibacterium (r = −0.291, p = 0.018) for all CN participants. Finally, the combination of plasma Aβ markers, altered gut microbiota, and cognitive performance reached a relatively good discriminative power in identifying individuals with CN+ from CN− (AUC = 0.869, 95% CI 0.782 ~ 0.955). Conclusions This study provided the evidence that the gut microbial composition was altered in preclinical AD. The combination of plasma Aβ and gut microbiota may serve as a non-invasive, cost-effective diagnostic tool for early AD screening. Targeting the gut microbiota may be a novel therapeutic strategy for AD. Trial registration This study has been registered in ClinicalTrials.gov (NCT03370744, https://www.clinicaltrials.gov) in November 15, 2017.

A robust algorithm in the form of a 3-D dynamic system is introduced to identify the frequency, the in-phase component, the orthogonal component, and the amplitude of a sinusoidal signal with unknown frequency. The condition for asymptotically convergent property of the dynamic system is analyzed sequentially by time scale change, variable transformation, slow integral manifold, averaging method, Lyapunov stability theorem, and stability theory of Mathieu equation. The robustness is embodied in two aspects: 1) the actual values of both frequency and amplitude slightly influence the convergent property and 2) two design parameters have independent effects on performance of both frequency identification and amplitude identification, respectively. Simulation results verify the validity.

The electrical and magnetic properties of Mn-doped GaN were investigated by the density functional theory of spin polarization. The results indicate that Mn-doped GaN is still a direct band...

Subjective cognitive decline (SCD), characterized by a very early and subtle cognitive decline prior to the appearance of objective cognitive impairment, is considered to be the preclinical manifestation of Alzheimer's disease (AD). Given the lack of significant abnormalities in standardized neuropsychological assessments for individuals with SCD, biochemical and neuroimaging biomarkers may be important indicators of the preclinical stage of AD. The application of various biomarkers derived from the cerebrospinal fluid and neuroimaging thus has the potential to make AD-related pathology detectable in vivo. In this review, we discuss the conceptual evolution of SCD as an entity and further elucidate characteristic cerebrospinal fluid and neuroimaging biomarkers of SCD.

Background: Evidence suggests that subjective cognitive decline (SCD) individuals with worry have a higher risk of cognitive decline. However, how SCD-related worry influences the functional brain network is still unknown. Objective: In this study, we aimed to explore the differences in functional brain networks between SCD subjects with and without worry. Methods: A total of 228 participants were enrolled from the Sino Longitudinal Study on Cognitive Decline (SILCODE), including 39 normal control (NC) subjects, 117 SCD subjects with worry, and 72 SCD subjects without worry. All subjects completed neuropsychological assessments, APOE genotyping, and resting-state functional magnetic resonance imaging (rs-fMRI). Graph theory was applied for functional brain network analysis based on both the whole brain and default mode network (DMN). Parameters including the clustering coefficient, shortest path length, local efficiency, and global efficiency were calculated. Two-sample T-tests and chi-square tests were used to analyze differences between two groups. In addition, a false discovery rate-corrected post hoc test was applied. Results: Our analysis showed that compared to the SCD without worry group, SCD with worry group had significantly increased functional connectivity and shortest path length (p = 0.002) and a decreased clustering coefficient (p = 0.013), global efficiency (p = 0.001), and local efficiency (p

Background Cognitive reserve (CR) and brain reserve (BR) could offer protective effects on cognition in the early stage of Alzheimer's disease (AD). However, the effects of CR or BR on cognition in individuals with subjective cognitive decline (SCD) are not clear. Objective To explore the effects of CR and BR on cognition in subjects with SCD. Methods We included 149 subjects from the Sino Longitudinal Study on Cognitive Decline (SILCODE) study. Education was used as a proxy for CR, and head circumference was used as a proxy for BR. Multiple linear regression models were conducted to examine the effects of CR and BR on cognitive scores. Furthermore, we assessed differences in effects between APOEɛ4 carriers with SCD (n = 35) and APOEɛ4 non-carriers with SCD (n = 114) and linear trends among 4 reserve levels (low BR/CR, high BR/low CR, low BR/high CR, and high BR/high CR). Results Both CR and BR had independent positive effects on multiple cognitive measures in SCD participants, and the effects of CR were greater than those of BR. CR has positive effects on cognitive measures in both APOEɛ4 carriers and non-carriers with SCD. However, the positive effects of BR on cognitive measures were observed in APOEɛ4 non-carriers with SCD but not in APOEɛ4 carriers with SCD. Furthermore, there was a linear trend toward better cognitive performance on all cognitive measures in the BR+/CR+ group, followed by the BR-/CR+, BR+/CR-, and BR-/CR-groups. Conclusion This study suggests that both CR and BR have the potential to delay or slow cognitive decline in individuals with SCD.

Sepsis-associated encephalopathy (SAE) is a clinical syndrome of brain dysfunction secondary to sepsis, which is characterized by long-term neurocognitive deficits such as memory, attention, and executive dysfunction. However, the mechanisms underlying SAE remain unclear. By using transcriptome sequencing approach, we showed that hippocampal S100A9 was significantly increased in sepsis induced by cecal ligation and puncture (CLP) or lipopolysaccharide (LPS) challenge. Thus, we used S100A9 inhibitor Paquinimod to study the role of S100A9 in cognitive impairments in CLP-induced and LPS-induced mice models of SAE. Sepsis survivor mice underwent behavioral tests or the hippocampal tissues subjected to Western blotting, real-time quantitative PCR, and immunohistochemistry. Our results showed that CLP-induced and LPS-induced memory impairments were accompanied with increased expressions of hippocampal microglia Iba1 and CD86 (M1 markers), but reduced expression of Arg1 (M2 marker). Notably, S100A9 inhibition significantly improved the survival rate and learning and memory impairments in sepsis survivors, with a shift from M1 to M2 phenotype. Taken together, our study suggests that S100A9 upregulation might contribute to learning and memory impairments by promoting microglia M1 polarization in sepsis survivors, whereas S100A9 inhibition might provide a potential therapeutic target for SAE.

We investigated the relationship between urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) levels and apolipoprotein epsilon 4 (ApoE ɛ4) alleles, as well as other factors that cause cognitive decline, in the cognitively normal population. We recruited 329 cognitively normal right-handed Han Chinese subjects who completed ApoE gene testing and urinary AD7c-NTP testing. There was no significant difference in urinary AD7c-NTP levels between the normal control and subjective cognitive decline groups. Urinary AD7c-NTP levels were significantly higher in subjects with ApoE ɛ3/4 and 4/4 [0.6074 (0.6541) ng/mL] than in subjects without ApoE ɛ4 [0.4368 (0.3392) ng/mL and 0.5287 (0.3656) ng/mL], and urinary AD7c-NTP levels positively correlated with ApoE genotype grade (r=0.165, p=0.003). There were significant differences in urinary AD7c-NTP levels between subjects with and without a history of coronary heart disease or diabetes. Urinary AD7c-NTP levels were not related to years of education, nature of work, family history of dementia, a history of hypertension, stroke, anemia, or thyroid dysfunction. Urinary AD7c-NTP levels were positively correlated with ApoE grade in the cognitively normal population. The relationship between risk factors of cognitive decline and urinary AD7c-NTP levels provides a new way for us to understand AD and urinary AD7c-NTP.