Constant Energy Supply Research Articles

Numerical simulation of seasonal underground hydrogen storage: Role of the initial gas amount on the round-trip hydrogen recovery efficiency

Subterranean structures such as aquifers and depleted gas reservoirs (DGRs) offer a scalable, high-pressure, secure, cost-efficient, and ecologically friendly means of hydrogen (H2) storage. Underground H2 storage (UHS) has emerged as a potential solution to alleviate the imbalance between the fluctuating renewable energy generation and the demand for a constant energy supply. Quantifying the recovery efficiency is of paramount importance in the effort toward large-scale UHS. In this numerical simulation study, we employed a high-resolution grid for the discretization of a synthetic (but realistic) heterogeneous anticline intended as a H2 storage facility, and we assessed the H2 recovery efficiency, and the purity of produced gas associated with UHS in natural reservoirs involving different pre-existing gases and their quantities. All of these studies included an initial phase of cushion gas injection, followed by 4 cycles of H2 storage operations composed of injection-idle-withdrawal periods. The simulation results indicated that the H2 round-trip recovery efficiency RH increased (a) with an increasing number of storage cycles, routinely exceeding 90% and providing evidence of a self-enhancement or self-optimization H2 recovery mechanism and (b) with an increasing amount of pre-existing gas in the storage zone prior to the H2 injections — at the end of the 4-cycle test, the highest RH is associated with a DGR with a pre-existing gas consisting of residual CH4 and additional injected N2, and the lowest RH corresponds to an aquifer with no cushion gas. Conversely, the H2 mass fraction of the produced gas FHQ (a) increased with an increasing number of storage cycles, but (b) decreased rapidly with an increasing amount of pre-existing gas. The presence of a pre-existing gas inevitably leads to severe contamination of the produced H2, which never exceeds 40% in the produced gas, can be as low as 4% in early cycles, and cannot be used as a H2 fuel without gas separation. Aquifer storage without a cushion gas may exhibit the lowest H2 recovery (about 75% in the long run), but yields practically pure H2 that does not require further processing before use. A positive conclusion is that, under the conditions of this study, total H2 losses (including H2 escaping into the caprock, and inaccessible H2 dissolved in the aqueous phase of the formation or remaining in the gas storage zone) are limited and manageable, indicating the technical feasibility of geologic H2 storage.

Chemiosmotic nutrient transport in synthetic cells powered by electrogenic antiport coupled to decarboxylation

Cellular homeostasis depends on the supply of metabolic energy in the form of ATP and electrochemical ion gradients. The construction of synthetic cells requires a constant supply of energy to drive membrane transport and metabolism. Here, we provide synthetic cells with long-lasting metabolic energy in the form of an electrochemical proton gradient. Leveraging the L-malate decarboxylation pathway we generate a stable proton gradient and electrical potential in lipid vesicles by electrogenic L-malate/L-lactate exchange coupled to L-malate decarboxylation. By co-reconstitution with the transporters GltP and LacY, the synthetic cells maintain accumulation of L-glutamate and lactose over periods of hours, mimicking nutrient feeding in living cells. We couple the accumulation of lactose to a metabolic network for the generation of intermediates of the glycolytic and pentose phosphate pathways. This study underscores the potential of harnessing a proton motive force via a simple metabolic network, paving the way for the development of more complex synthetic systems.

Alternative Energy in Nigeria: Prospects and Limitations

Energy is a major driving ingredient to the development of any country and determines the quality of life a person lives. Accessibility to constant energy supply is a major challenge in this part of the world because the demand for energy is more than the supply, and since the nation’s major source of energy is fossil fuel, it’s only an eye-opener that our overdependence on this energy source doesn’t meet the demands since energy drives forward an economy, Nigeria could as well not be developed for a couple of number of years. Alternative energy sources are examined in this review especially the renewable source of energy in Nigeria. A delve into other (alternative) sources of energy were also looked into. This review also presents the projections and limits of the alternative sources of energy in Nigeria and the way forward. Policies that can be enacted to promote the use of alternative energy were also identified and some of the limitations were stretched out. Alternative energy sources should be considered priority in the country’s agenda since more than 60% of the nation’s population has access to the national grid of which constitutes more than half of the nation’s populace.

Multiple Self-Powered Sensor-Integrated Mobile Manipulator for Intelligent Environment Detection.

A multiple self-powered sensor-integrated mobile manipulator (MSIMM) system was proposed to address challenges in existing exploration devices, such as the need for a constant energy supply, limited variety of sensed information, and difficult human-computer interfaces. The MSIMM system integrates triboelectric nanogenerator (TENG)-based self-powered sensors, a bionic manipulator, and wireless gesture control, enhancing sensor data usability through machine learning. Specifically, the system includes a tracked vehicle platform carrying the manipulator and electronics, including a storage battery and a microcontroller unit (MCU). An integrated sensor glove and terminal application (APP) enable intuitive manipulator control, improving human-computer interaction. The system responds to and analyzes various environmental stimuli, including the droplet and fall height, temperature, pressure, material type, angles, angular velocity direction, and acceleration amplitude and direction. The manipulator, fabricated using 3D printing technology, integrates multiple sensors that generate electrical signals through the triboelectric effect of mechanical motion. These signals are classified using convolutional neural networks for accurate environmental monitoring. Our database shows signal recognition and classification accuracy exceeding 94%, with specific accuracies of 100% for pressure sensors, 99.55% for angle sensors, and 98.66, 95.91, 96.27, and 94.13% for material, droplet, temperature, and acceleration sensors, respectively.

Implantable Triboelectric Nanogenerators in the Biomedical Field

Implantable Triboelectric Nanogenerators (TENGs) have revolutionized the biomedical field by providing innovative power solutions for medical devices and enhancing diagnostic and therapeutic applications. Internally implanted TENG transforms kinetic energy from the body into electrical power, providing a constant energy supply for Implantable Medical Devices (IMD). Their ability to generate high voltage and low current makes them particularly effective for applications in biosensing, patient monitoring, and therapeutic interventions. Therapeutically, TENGs power cardiac pacemakers, promote wound healing, enhance bone regeneration, and support muscle and nerve stimulation. They also enable controlled drug release, particularly in targeted cancer treatments.

Interactions of binary mixtures of metals on rainbow trout (Oncorhynchus mykiss) heart mitochondrial H2O2 homeodynamics

For continuous pumping of blood, the heart needs a constant supply of energy (ATP) that is primarily met via oxidative phosphorylation in the mitochondria of cardiomyocytes. However, sustained high rates of electron transport for energy conversion redox reactions predisposes the heart to the production of reactive oxygen species (ROS) and oxidative stress. Mitochondrial ROS are fundamental drivers of responses to environmental stressors including metals but knowledge of how combinations of metals alter mitochondrial ROS homeodynamics remains sparse. We explored the effects and interactions of binary mixtures of copper (Cu), cadmium (Cd), and zinc (Zn), metals that are common contaminants of aquatic systems, on ROS (hydrogen peroxide, H2O2) homeodynamics in rainbow trout (Oncorhynchus mykiss) heart mitochondria. Isolated mitochondria were energized with glutamate-malate or succinate and exposed to a range of concentrations of the metals singly and in equimolar binary concentrations. Speciation analysis revealed that Cu was highly complexed by glutamate or Tris resulting in Cu2+ concentrations in the picomolar to nanomolar range. The concentration of Cd2+ was 7.2–7.5 % of the total while Zn2+ was 15 % and 21 % of the total during glutamate-malate and succinate oxidation, respectively. The concentration-effect relationships for Cu and Cd on mitochondrial H2O2 emission depended on the substrate while those for Zn were similar during glutamate-malate and succinate oxidation. Cu + Zn and Cu + Cd mixtures exhibited antagonistic interactions wherein Cu reduced the effects of both Cd and Zn, suggesting that Cu can mitigate oxidative distress caused by Cd or Zn. Binary combinations of the metals acted additively to reduce the rate constant and increase the half-life of H2O2 consumption while concomitantly suppressing thioredoxin reductase and stimulating glutathione peroxidase activities. Collectively, our study indicates that binary mixtures of Cu, Zn, and Cd act additively or antagonistically to modulate H2O2 homeodynamics in heart mitochondria.

Comprehensive Metabolomic Analysis of Human Heart Tissue Enabled by Parallel Metabolite Extraction and High-Resolution Mass Spectrometry.

The heart contracts incessantly and requires a constant supply of energy, utilizing numerous metabolic substrates, such as fatty acids, carbohydrates, lipids, and amino acids, to supply its high energy demands. Therefore, a comprehensive analysis of various metabolites is urgently needed for understanding cardiac metabolism; however, complete metabolome analyses remain challenging due to the broad range of metabolite polarities, which makes extraction and detection difficult. Herein, we implemented parallel metabolite extractions and high-resolution mass spectrometry (MS)-based methods to obtain a comprehensive analysis of the human heart metabolome. To capture the diverse range of metabolite polarities, we first performed six parallel liquid-liquid extractions (three monophasic, two biphasic, and one triphasic) of healthy human donor heart tissue. Next, we utilized two complementary MS platforms for metabolite detection: direct-infusion ultrahigh-resolution Fourier-transform ion cyclotron resonance (DI-FTICR) and high-resolution liquid chromatography quadrupole time-of-flight tandem MS (LC-Q-TOF-MS/MS). Using DI-FTICR MS, 9644 metabolic features were detected where 7156 were assigned a molecular formula and 1107 were annotated by accurate mass assignment. Using LC-Q-TOF-MS/MS, 21,428 metabolic features were detected where 285 metabolites were identified based on fragmentation matching against publicly available libraries. Collectively, 1340 heart metabolites were identified in this study, which span a wide range of polarities including polar (benzenoids, carbohydrates, and nucleosides) as well as nonpolar (phosphatidylcholines, acylcarnitines, and fatty acids) compounds. The results from this study will provide critical knowledge regarding the selection of appropriate extraction and MS detection methods for the analysis of the diverse classes of human heart metabolites.

Managing the low carbon transition pathways through solid waste electricity

The potential of solid waste as an energy source is clear, owing to its wide availability and renewable properties, which provide a critical answer for energy security. This can be especially effective in reducing the environmental impact of fossil fuels. Countries that rely heavily on coal should examine alternatives such as electricity from solid waste to provide a constant energy supply while also contributing to atmospheric restoration. In this regards, Low Emissions Analysis Platform (LEAP) is used for simulation the entire energy system in Pakistan and forecasted its capital cost and future CO2 emissions in relation to the use of renewable and fossil fuel resources under the different growth rates of solid waste projects like 20%, 30% and 40% for the study period 2023–2053. The results revealed that, 1402.97 TWh units of energy are generated to meet the total energy demand of 1193.93 TWh until 2053. The share of solid waste based electricity in total energy mix is increasing from a mere 0.81% in 2023 to around 9.44% by 2053 under the 20% growth rate, which then increase to 39.67% by 2053 under the 30% growth rate and further increases to 78.33% by 2053 under the 40% growth rate. It is suggested that 40% growth rate for solid waste based electricity projects is suitable for Pakistan until 2053 because under this condition, renewable sources contributes 95.2% and fossil fuels contributed 4.47% in the total energy mix of Pakistan. Hence, CO2 emissions are reduced from 148.26 million metric tons to 35.46 million metric tons until 2053 but capital cost is increased from 13.23 b$ in 2023 to 363.11 b$ by 2053.

Fintech, human development and energy poverty in sub-Saharan Africa

Studies have highlighted the important role of financial technology (fintech) in enhancing socio-economic conditions of nations. However, despite the efforts of governments to improve the latter, the rating of African countries still remains manifestly inadequate. Given that access to electricity is imperative for fintech, and fundamental to improving socioeconomic conditions, we provide novel evidence by investigating the degree to which the prevailing energy poverty in Africa mediates the relationship between the duo. Our baseline results confirm that fintech has a significant positive impact on socioeconomic conditions, proxied by human development, and the impact becomes increasingly significant in the face of constant energy supply. However, when we split our sample based on regions and income classification proposed by the World Bank, our results show that the impact of fintech on human development, in the absence of access to electricity, is notably limited to some African regions. Considering the current state of human development in Africa, our study advocates for more investment in energy infrastructure for the rapid realization of the gains of fintech.

A vesicular Warburg effect: Aerobic glycolysis occurs on axonal vesicles for local NAD+ recycling and transport.

In neurons, fast axonal transport (FAT) of vesicles occurs over long distances and requires constant and local energy supply for molecular motors in the form of adenosine triphosphate (ATP). FAT is independent of mitochondrial metabolism. Indeed, the glycolytic machinery is present on vesicles and locally produces ATP, as well as nicotinamide adenine dinucleotide bonded with hydrogen (NADH) and pyruvate, using glucose as a substrate. It remains unclear whether pyruvate is transferred to mitochondria from the vesicles as well as how NADH is recycled into NAD+ on vesicles for continuous glycolysis activity. The optimization of a glycolytic activity test for subcellular compartments allowed the evaluation of the kinetics of vesicular glycolysis in the brain. This revealed that glycolysis is more efficient on vesicles than in the cytosol. We also found that lactate dehydrogenase (LDH) enzymatic activity is required for effective vesicular ATP production. Indeed, inhibition of LDH or the forced degradation of pyruvate inhibited ATP production from axonal vesicles. We found LDHA rather than the B isoform to be enriched on axonal vesicles suggesting a preferential transformation of pyruvate to lactate and a concomitant recycling of NADH into NAD+ on vesicles. Finally, we found that LDHA inhibition dramatically reduces the FAT of both dense-core vesicles and synaptic vesicle precursors in a reconstituted cortico-striatal circuit on-a-chip. Together, this shows that aerobic glycolysis is required to supply energy for vesicular transport in neurons, similar to the Warburg effect.

Strategies in Energy Supply: A Social Network Analysis on the Energy Trade of the European Union

As energy is vital in the sustainability of almost every part of daily life, energy security has become more crucial than ever before. One of the main threats to energy security is a possible disruption along the trade network, which jeopardizes the constant energy supply. The purpose of this research is to identify the relation ties between EU countries in order to clarify the characteristics of the network, such as its crucial actors, vulnerabilities, structural holes, etc., to help achieve some proposals for a more sustainable and secure energy supply. This will help identify the underlying causes of recurring energy crises in the EU and provide insight into developing management strategies for further studies. Following this purpose, we examined the trade network density to clarify typical characteristics of the network, applied degree centrality measures to identify the most central importer and exporter countries, and found the dominance and critical vulnerabilities of actors in the network by using domestic import data of the EU countries. Finally, we recommend some policies and management strategies according to the obtained results and previous literature for further discussion.

Mitochondrial thermogenesis in cancer cells

Abstract Organisms, following the laws of thermodynamics, require a constant supply of energy to maintain their daily activities. Catabolism, a controlled degradation process, not only releases Gibbs free energy and regenerates ATP but also dissipates excess energy as heat. Despite this, the molecular mechanisms governing heat production within cells remain elusive, and intracellular temperature remains a topic of inquiry. Numerous efforts have been made to develop thermosensors such as quantum dot-based nanoparticles, gold nanoclusters, and thermoresponsive probes, significantly advancing our ability to study intracellular temperature. Mitochondria, significant energy providers in the form of ATP, are strongly implicated in thermogenesis. In addition to energy production, mitochondria are pivotal in various signaling pathways, including calcium homeostasis, cellular redox state, and apoptosis. Simultaneously, they are central to various pathogenic processes, including cancer development. This dual role underscores the potential involvement of mitochondria in thermogenesis across cancer cells. Understanding this intersection is critical, as unraveling the mechanisms of mitochondrial thermogenesis in cancer cells may pave the way for innovative, targeted cancer therapies.

Does energy poverty moderate the impact of economic freedom on the quality of life in Africa? A panel quantile via moment approach

We examine the interactive effects of economic freedom and energy poverty across different conditional distributions on the quality of life in Africa. We find that free market economies with adequate supplies of electricity significantly improves the quality of life in the region. The effectiveness of economic freedom policy and access to electricity is more noticeable among countries with a lower quality of life, which suggests that if the qualities of institutions in poor African countries were strengthened and there were a constant supply of energy, the vast majority of Africans would prosper.

What Triggers the Dynamic Self-Assembly of Molecules and Materials?

Dynamic self-assembly has emerged as one of the reliable approaches to create complex materials with more life-like functions. In a typical dynamic self-assembly process, the external triggers activate the building blocks to initiate the assembly step to form transiently stable higher-order structures. These external triggers provide a constant supply of energy to maintain the transiently stable self-assembled states. The withdrawal or consumption of the trigger deactivates the building block in the aggregates, thereby initiating the disassembly step. A precise control over the interplay between the deterministic and nondeterministic forces is the key to achieving a dynamic self-assembly process. This demands the appropriate choice of building blocks as well as triggers, which has led to the development of a wide range of triggers in dynamic self-assembly. Through this Perspective, we intend to highlight the functional diversities, prospects, and challenges associated with different classes of "triggers" by bringing them under one platform. Such treatment will help us to identify the missing features and deduce a guideline for the development of ideal triggers. A few of the desirable features that a trigger should possess, along with probable ways to achieve them, are discussed, as well. In summary, the Perspective covers many intriguing aspects of triggers that can be helpful for researchers to achieve precise spatiotemporal control over various interparticle interactions, which is essential to obtaining the desired outcome from a dynamic self-assembly process.

Contribution of the mix renewable energy potentials in delivering parts of the electric energy needs in the west region of Cameroon

The constant supply of energy remains a great challenge in many developing countries and Cameroon is no exception. It is necessary to explore other renewable energy sources that have environmental and energy potential. However, there is limited and sparse literature on the potential of renewable energy sources in Cameroon and its western part in particular. This limits investment and policy design that can lead to the exploitation of renewable energy sources. There is thus a need for more research on renewable energy development to better inform energy policies. This paper investigates the potential and extent to which available renewable energy sources can contribute to the electric power sector in the western part of Cameroon is on estimating the potential of hydroelectric, solar and biomass energy resources. A cross-sectional method, observations and literature review were used to determine the water flow and electrical energy potential of different biomass. The results show that the electrical potential of hydroelectricity is 11.68 GWh/year, for solar represents 44.12 GWh/year, and the energy of biomass 8586.42 GWh/year, 135.53 GWh/year and 13.05 GWh/year for agricultural, animal and forestry residues; they have a rate of access to electricity of 6.64%, 25.08%, 4881.46%, 77.05%, and 7.42% respectively. This potential can satisfy needs of 18 526 464 households. According to results obtained and in order to provide a sustainable solution by improving access to electricity, living standards and socio-economic conditions of populations; two hybrid cogeneration thermal-solar power plants can be installed at the limits of the decentralized areas of Bamboutos-Mifi-Menoua and Koung Khi, which are nearby areas with high population density. Hydroelectric plants can be installed to electrify villages that are far from the national network.

Cleaning of Thar coal by froth flotation and water washing

The demand for a constant supply of energy is increasing day by day. To meet these increasing demands the natural resources must be utilized smartly. Coal can be a promising fuel due to its large reserves available in Pakistan. About 175 billion tons of coal reserves are found in Thar region of Sindh province. The major issue is the pre-processing cleaning of coal after it is mined out. A number of methods have been adopted to clean coal.
 Presently, cleaning of Thar coal was carried out using froth flotation and water washing techniques. Three different particle sizes (-60#, -100# and -150#) were employed to study the effect of froth flotation on ash and sulfur reduction. Experiments were carried out in laboratory flotation cell and beakers under different set of conditions (i.e., flotation with and without collector and frother and by simple water washing). Kerosene oil was used as a collector and pine oil as a frother. Characterization of raw and treated Thar coal samples was carried out by ASTM standards. The results exhibited an inverse relationship of particle size towards efficiency of the cleaning process; thus, the optimal combustible recovery was attained at -150# particle size. Furthermore, FTIR results disclosed the presence of aromatic and aliphatic structure in treated coal samples. Thermo-gravimetric analysis was also made to determine the weight loss in raw and treated samples and observed increased combustion efficiency and reactivity of Coal.

Role of L-lactate as an energy substrate in primary rat podocytes under physiological and glucose deprivation conditions

Lactate has long been acknowledged to be a metabolic waste product, but it has more recently been found as a fuel energy source in mammalian cells. Podocytes are an important component of the glomerular filter, and their role in maintaining the structural integrity of this structure was established. These cells rely on a constant energy supply and reservoir. The utilization of alternative energy substrates to preserve energetic homeostasis is a subject of extensive research, and lactate appears to be one such candidate. Therefore, we investigated the role of lactate as an energy substrate and characterize the lactate transport system in cultured rat podocytes during sufficient and insufficient glucose supplies. The present study, for the first time, demonstrated the presence of lactate transporters in podocytes. Moreover, we observed modified the amount of these transporters in response to limited glucose availability and after l-lactate supplementation. Simultaneously, exposure to l-lactate preserved cell survival during insufficient glucose supply. Interestingly, during glucose deprivation, lactate exposure allowed the steady flow of glycolysis and prevented glycogen reserves depletion. Summarizing, podocytes utilize lactate as an energy substrate and possess a developed system that controls lactate homeostasis, suggesting that it plays an essential role in podocyte metabolism, especially during fluctuations of energy availability.

The Ratio Distribution of Evapotranspiration to Precipitation well Related With Soil Thickness in Karst Watershed of Southwest China

AbstractEvapotranspiration (ET) is predominant variable for water management in various types of ecosystems, and it has been intensively studied through in situ measuring and modeling methods. However, it is challenging to measure actual ET and upscale it to regional level for karst landscapes, where aquifers typically show remarkable and rapid responses to precipitation events. There is an urgent need to quantify water fluxes to provide reliable evidence for the protection and sustainable management of karst water resources. Therefore, in this study, five plots were built to observe actual ET based on Thermal Dissipation Probes, redesigned ventilated chamber and in‐site microlysimeters in a karst watershed in southwest China. Then, three models (Penman‐Monteith‐Leurning, PML; Remote Sensing‐Priestley and Taylor; and Hargreaves) were constructed to upscale ET estimation to the regional level based on Landsat‐8 images and MODIS data. The results showed that: (a) The PML model performed better than other models (p < 0.01) with higher R2 values (0.72 for MODIS images and 0.87 for Landsat‐8 images); (b) Daily ET exhibited significant seasonal variability and different spatial distribution, and yearly ET exhibited well related with soil thickness (R2 = 0.58); (c) Daily ET had a slightly positive correlation with DEM, however, had a negative correlation with ground temperature. This study is helpful to improve accuracy of measured and estimated ET by combining remote sensing data, and it has important implications for upscaling it to regional level. It suggests that ET is strongly regulated by constant supply of water, vegetation coverage, and available energy in karst catchments.

Obesity-Induced Brain Neuroinflammatory and Mitochondrial Changes.

Obesity is defined as abnormal and excessive fat accumulation, and it is a risk factor for developing metabolic and neurodegenerative diseases and cognitive deficits. Obesity is caused by an imbalance in energy homeostasis resulting from increased caloric intake associated with a sedentary lifestyle. However, the entire physiopathology linking obesity with neurodegeneration and cognitive decline has not yet been elucidated. During the progression of obesity, adipose tissue undergoes immune, metabolic, and functional changes that induce chronic low-grade inflammation. It has been proposed that inflammatory processes may participate in both the peripheral disorders and brain disorders associated with obesity, including the development of cognitive deficits. In addition, mitochondrial dysfunction is related to inflammation and oxidative stress, causing cellular oxidative damage. Preclinical and clinical studies of obesity and metabolic disorders have demonstrated mitochondrial brain dysfunction. Since neuronal cells have a high energy demand and mitochondria play an important role in maintaining a constant energy supply, impairments in mitochondrial activity lead to neuronal damage and dysfunction and, consequently, to neurotoxicity. In this review, we highlight the effect of obesity and high-fat diet consumption on brain neuroinflammation and mitochondrial changes as a link between metabolic dysfunction and cognitive decline.

Metabolic remodeling in takotsubo syndrome.

The heart requires a large and constant supply of energy that is mainly the result of an efficient metabolic machinery that converges on mitochondrial oxidative metabolism to maintain its continuous mechanical work. Perturbations in these metabolic processes may therefore affect energy generation and contractile function directly. Metabolism characteristics in takotsubo syndrome (TTS) reveals several metabolic alterations called metabolic remodeling, including the hyperactivity of sympathetic metabolism, derangements of substrate utilization, effector subcellular dysfunction and systemic metabolic disorders, ultimately contributing to the progression of the disease and the development of a persistent and long-term heart failure (HF) phenotype. In this review, we explore the current literature investigating the pathological metabolic alterations in TTS. Although the metabolic dysfunction in takotsubo hearts is initially recognized as a myocardial metabolic inflexibility, we suggest that the widespread alterations of systemic metabolism with complex interplay between the heart and peripheral tissues rather than just cardiometabolic disorders per se account for long-term maladaptive metabolic, functional and structural impairment under this condition. Therapeutic strategies with the recent evidence from small clinical and animal researches, especially for targeting substrate utilization and/or oxidative stress, might be promising tools to improve the outcome of patients with TTS beyond that achieved with traditional sympathetic inhibition and symptomatic therapies.