Search

Background: Response to ursodeoxycholic acid (UDCA) in primary biliary cholangitis (PBC) has been traditionally assessed 1 to 2 years after treatment initiation. With the development of new drugs, some patients may benefit from an earlier introduction of second-line therapies., Aims: This study aims to identify whether well-validated response criteria could correctly identify individuals likely to benefit from add-on second-line therapy at 6 months., Methods: Analysis of a multicenter retrospective cohort which included only patients with clear-cut PBC., Results: 206 patients with PBC (96.6% women; mean age 54 ± 12 years) were included. Kappa concordance was substantial for Toronto (0.67), Rotterdam (0.65), Paris 1 (0.63) and 2 (0.63) criteria at 6 and 12 months, whereas Barcelona (0.47) and POISE trial (0.59) criteria exhibited moderate agreement. Non-response rates to UDCA was not statistically different when assessed either at 6 or 12 months using Toronto, Rotterdam or Paris 2 criteria. Those differences were even smaller or absent in those subjects with advanced PBC. Mean baseline alkaline phosphatase was 2.73 ± 1.95 times the upper limit of normal (× ULN) among responders versus 5.05 ± 3.08 × ULN in non-responders (p < 0.001)., Conclusions: After 6 months of treatment with UDCA, the absence of response by different criteria could properly identify patients who could benefit from early addition of second-line therapies, especially in patients with advanced disease or high baseline liver enzymes levels., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease in which anti-mitochondrial antibodies (AMA) are the diagnostic hallmark. Whether AMA-negative PBC patients represent a different phenotype of disease is highly debated., Aims: The purpose of our study was to compare AMA-positive and AMA-negative PBC patients in a large non-white admixed Brazilian cohort., Methods: The Brazilian Cholestasis Study Group multicentre database was reviewed to assess demographics, clinical features and treatment outcomes of Brazilian PBC patients, stratifying data according to AMA status., Results: A total of 464 subjects (95.4% females, mean age 56 ± 5 years) with PBC were included. Three hundred and eighty-four (83%) subjects were AMA-positive, whereas 80 (17%) had AMA-negative PBC. Subjects with AMA-negative PBC were significantly younger (52.2 ± 14 vs. 59.6 ± 11 years, p = 0.001) and had their first symptom at an earlier age (43.2 ± 13 vs. 49.5 ± 12 years, p = 0.005). Frequency of type 2 diabetes was significantly increased in subjects with AMA-negative PBC (22.5% vs. 12.2%, p = 0.03). Lower IgM (272.2 ± 183 vs. 383.2 ± 378 mg/dL, p = 0.01) and triglycerides (107.6 ± 59.8 vs.129.3 ± 75.7 mg/dL, p = 0.025) and higher bilirubin (3.8 ± 13.5 vs. 1.8 ± 3.4 mg/dL, p = 0.02) levels were also observed in this subgroup. Response to ursodeoxycholic acid varied from 40.5 to 63.3% in AMA-positive and 34 to 62.3% in AMA-negative individuals, according to different response criteria. Outcomes such as development of liver-related complications, death and requirement for liver transplantation were similar in both groups., Conclusions: AMA-negative PBC patients are similar to their AMA-positive counterparts with subtle differences observed in clinical and laboratory features., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: Up to 40% of patients with primary biliary cholangitis (PBC) will have a suboptimal biochemical response to ursodeoxycholic acid (UDCA), which can be improved by the addition of fibrates. This exploratory study aims to evaluate the long-term real-life biochemical response of different fibrates, including ciprofibrate, in subjects with UDCA-unresponsive PBC. Methods: The Brazilian Cholestasis Study Group multicenter database was reviewed to assess the response rates to UDCA plus fibrates in patients with UDCA-unresponsive PBC 1 and 2 years after treatment initiation by different validated criteria. Results: In total, 27 patients (100% women, mean age 48.9 ± 9.2 years) with PBC were included. Overall response rates to fibrates by each validated criterion varied from 39 to 60% and 39-76% at 12 and 24 months after treatment combination, respectively. Combination therapy resulted in a significant decrease in ALT and ALP only after 2 years, while GGT significantly improved in the first year of treatment. Treatment response rates at 1 and 2 years appear to be comparable between ciprofibrate and bezafibrate using all available criteria. Conclusion: Our findings endorse the efficacy of fibrate add-on treatment in PBC patients with suboptimal response to UDCA. Ciprofibrate appears to be at least as effective as bezafibrate and should be assessed in large clinical trials as a possibly new, cheaper, and promising option for treatment of UDCA-unresponsive PBC patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Cançado, Couto, Guedes, Braga, Terrabuio, Cançado, Ferraz, Villela-Nogueira, Nardelli, Faria, Oliveira, Rotman, Mazo, Borges, Mendes, Codes, Pessoa, Signorelli, Levy and Bittencourt.)

Solid-state electrolytes are a promising family of materials for the next generation of high-energy rechargeable lithium batteries. Polymer electrolytes (PEs) have been widely investigated due to their main advantages, which include easy processability, high safety, good mechanical flexibility, and low weight. This review presents recent scientific advances in the design of versatile polymer-based electrolytes and composite electrolytes, underlining the current limitations and remaining challenges while highlighting their technical accomplishments. The recent advances in PEs as a promising application in structural batteries are also emphasized.

Introduction and Objectives: Little is known about primary biliary cholangitis (PBC) in non-whites. The purpose of this study was to evaluate clinical features and outcomes of PBC in a highly admixed population., Material and Methods: The Brazilian Cholestasis Study Group multicentre database was reviewed to assess demographics, clinical features and treatment outcomes of Brazilian patients with PBC., Results: 562 patients (95% females, mean age 51 ± 11 years) with PBC were included. Concurrent autoimmune diseases and overlap with autoimmune hepatitis (AIH) occurred, respectively, in 18.9% and 14%. After a mean follow-up was 6.2 ± 5.3 years, 32% had cirrhosis, 7% underwent liver transplantation and 3% died of liver-related causes. 96% were treated with ursodeoxycholic acid (UDCA) and 12% required add-on therapy with fibrates, either bezafibrate, fenofibrate or ciprofibrate. Response to UDCA and to UDCA/fibrates therapy varied from 39%-67% and 42-61%, respectively, according to different validated criteria. Advanced histological stages and non-adherence to treatment were associated with primary non-response to UDCA, while lower baseline alkaline phosphatase (ALP) and aspartate aminotransferase (AST) levels correlated with better responses to both UDCA and UDCA/fibrates., Conclusions: Clinical features of PBC in highly admixed Brazilians were similar to those reported in Caucasians and Asians, but with inferior rates of overlap syndrome with AIH. Response to UDCA was lower than expected and inversely associated with histological stage and baseline AST and ALP levels. Most of patients benefited from add-on fibrates, including ciprofibrate. A huge heterogeneity in response to UDCA therapy according to available international criteria was observed and reinforces the need of global standardization., Competing Interests: Conflicts of interest None., (Copyright © 2021 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)

The transition to a sustainable society is paramount and requires the electrification of vehicles, the grid, industry, data banks, wearables, and IoT. Here, we show an all-solid-state structural battery where a Na + -based ferroelectric glass electrolyte is combined with metallic electrodes/current collectors (no traditional cathode present at fabrication) and thin-ply carbon-fiber laminates to obtain a coaxial multifunctional beam. This new concept aims to optimize the volume of any hollow beam-like structure by integrating an electrochemical system capable of both harvesting thermal and storing electrical energy while improving its mechanical performance. The coaxial cell is a coaxial cable where the dielectric is ferroelectric. The electrochemical results demonstrated the capability of performing three-minute charges to one-day discharges (70 cycles) and long-lasting discharges (>40 days at 1 mA) showing an energy density of 56.2 Wh·L -1 and specific energy of 38.0 Wh·kg -1 , including the whole volume and weight of the structural cell. This is the highest specific energy among safe structural cells, while no Na + -based structural cells were found in the literature. The mechanical tests, instead, highlighted the coaxial cell capabilities to withstand severe inelastic deformation without compromising its functionalities, while increasing the flexural strength of the hosting structure. Moreover, the absence of alkali metals and liquid electrolytes together with its enhanced thermal properties makes this coaxial structural battery a valid and safe alternative as an energy reservoir for all the applications where traditional lithium-ion batteries are not suitable.

Global energy demand is rapidly increasing due to population and economic growth, especially in large emerging countries, which will account for 90% of energy demand growth to 2035. Electric vehicles (EVs) play a paramount role in the electrification revolution towards the reduction of the carbon footprint. Here, we review all the major trends in Li-ion batteries technologies used in EVs. We conclude that only five types of cathodes are used and that most of the EV companies use Nickel Manganese Cobalt oxide (NMC). Most of the Li-ion batteries anodes are graphite-based. Positive and negative electrodes are reviewed in detail as well as future trends such as the effort to reduce the Cobalt content. The electrolyte is a liquid/gel flammable solvent usually containing a LiFeP6 salt. The electrolyte makes the battery and battery pack unsafe, which drives the research and development to replace the flammable liquid by a solid electrolyte.

Coherence is a major caveat in quantum computing. While phonons and electrons are weakly coupled in a glass, topological insulators strongly depend on the electron-phonon coupling. Knowledge of the electron-phonon interaction at conducting surfaces is relevant from a fundamental point of view as well as for various applications, such as two-dimensional and quasi-1D superconductivity in nanotechnology. Similarly, the electron-phonon interaction plays a relevant role in other transport properties e.g., thermoelectricity, low-dimensional systems as layered Bi and Sb chalcogenides, and quasi-crystalline materials. Glass-electrolyte ferroelectric energy storage cells exhibit self-charge and self-cycling related to topological superconductivity and electron-phonon coupling; phonon coherence is therefore important. By recurring to ab initio molecular dynamics, it was demonstrated the tendency of the Li 3 ClO, Li 2.92 Ba 0.04 ClO, Na 3 ClO, and Na 2.92 Ba 0.04 ClO ferroelectric-electrolytes to keep phonon oscillation coherence for a short lapse of time in ps. Double-well energy potentials were obtained while the electrolyte systems were thermostatted in a heat bath at a constant temperature. The latter occurrences indicate ferroelectric type behavior but do not justify the coherent self-oscillations observed in all types of cells containing these families of electrolytes and, therefore, an emergent type phenomenon where the full cell works as a feedback system allowing oscillations coherence must be realized. A comparison with amorphous SiO 2 was performed and the specific heats for the various species were calculated.

Structural power composites stand out as a possible solution to the demands of the modern transportation system of more efficient and eco-friendly vehicles. Recent studies demonstrated the possibility to realize these components endowing high-performance composites with electrochemical properties. The aim of this paper is to present a systematic review of the recent developments on this more and more sensitive topic. Two main technologies will be covered here: (1) the integration of commercially available lithium-ion batteries in composite structures, and (2) the fabrication of carbon fiber-based multifunctional materials. The latter will be deeply analyzed, describing how the fibers and the polymeric matrices can be synergistically combined with ionic salts and cathodic materials to manufacture monolithic structural batteries. The main challenges faced by these emerging research fields are also addressed. Among them, the maximum allowable curing cycle for the embedded configuration and the realization that highly conductive structural electrolytes for the monolithic solution are noteworthy. This work also shows an overview of the multiphysics material models developed for these studies and provides a clue for a possible alternative configuration based on solid-state electrolytes.

Electrostatic gating of two-dimensional (2D) materials with ionic liquids (ILs), leading to the accumulation of high surface charge carrier densities, has been often exploited in 2D devices. However, the intrinsic liquid nature of ILs, their sensitivity to humidity, and the stress induced in frozen liquids inhibit ILs from constituting an ideal platform for electrostatic gating. Here we report a lithium-ion solid electrolyte substrate, demonstrating its application in high-performance back-gated n-type MoS 2 and p-type WSe 2 transistors with sub-threshold values approaching the ideal limit of 60 mV/dec and complementary inverter amplifier gain of 34, the highest among comparable amplifiers. Remarkably, these outstanding values were obtained under 1 V power supply. Microscopic studies of the transistor channel using microwave impedance microscopy reveal a homogeneous channel formation, indicative of a smooth interface between the TMD and underlying electrolytic substrate. These results establish lithium-ion substrates as a promising alternative to ILs for advanced thin-film devices.

Here we show the electrochemical data for a Ferroelectric Electrolyte Battery (FEB) Li/ferroelectric Li-glass electrolyte (Li 2·99 Ba 0·005 ClO) in cellulose/γ-MnO 2 pouch-cell with (2.5 × 2.5 cm 2 ) discharged with a green LED load. The Li 2·99 Ba 0·005 ClO electrolyte was synthesized and ground in ethanol. A cellulose matrix was dipped into the Li-glass/ethanol slurry. The γ-MnO 2 based cathode was doctor bladed onto a carbon-coated aluminum foil current collector. The cell was assembled in an Ar-filled glove-box and it was not sealed and, therefore, it remained inside the glove-box while discharging with a green LED at approximately 24 °C for 334 days (>11 months) corresponding to 764 mAhg -1 of the active cathode and to 224 mAhg -1 of the electrolyte. The maximum capacity of γ-MnO 2 is 209 mAhg -1 and of the MnO 2 in the commercial cell is 308 mAhg -1 , corresponding to LiMnO 2 ; therefore, the capacity of the FEB is 370% the capacity of the γ-MnO 2 and 250% the capacity of the MnO 2 in the commercial cell. Moreover, the experimental capacity of the electrolyte minus the maximum capacity of the γ-MnO 2 is 163 mAhg -1 of the electrolyte. The potential difference between anode and cathode in a diode is non-linear and dependent on the input current and, therefore, the plateaus in the potential vs time curves do not correspond to thermodynamic equilibria of the electrochemical cell energy source. Nevertheless, the maximum output current as well as the FEB cell's discharge profile may be determined with an LED and compared with traditional battery cells' profiles. The present data might be used by the electrochemical (in particular, battery), electrostatic and ferroelectric materials researchers and industrials for comparative analysis. Furthermore, it can be reused to calculate the maximum energy stored electrostatically in these devices., (© 2020 The Author(s).)

Here we show the electrochemical raw data for a Li/ferroelectric Li-glass electrolyte/plasticizer/Li-rich, F doped LNMO coin cell where the plasticizer is succinonitrile-SN. The nominal composition of the active oxide-host cathode particles is Li 1.36 Ni 0.49 Mn 1.15 O 3.28 F 0.36 (LNMO) that disproportionated into 78 wt% spinel phase LiNi 1/2 Mn 3/2 O 3.8 F 0.2 and 22 wt% Li-rich, F-doped layered phase containing Li 2 MnO 3 planes separated by Li + and Ni 2+ ions. The Li 2.99 Ba 0.005 OCl electrolyte was synthesized and ground in ethanol. A cellulose matrix was dipped into the glass/ethanol slurry. This cell has been cycling for two years and six months. The electrochemical performance was firstly published in graphs after cycling the cell for about one year and three months [1]. The Li//LNMO CR2032 coin cell was assembled in an argon-filled glove box and electrochemically tested in a battery testing analyzer (LAND) at room temperature and at constant specific current densities and potentials between 2.5 and 4.8 V. Moreover, the cell's cycling current is 23 mA g -1 (active cathode). The data might be used by the electrochemical (in particular, battery), electrostatic and ferroelectric researchers and industrials for comparative analysis. Furthermore, it can be reused by anyone interested in solid-state devices that wants to calculate the maximum energy stored electrostatically in these devices., (© 2020 The Authors.)

The Ag-Li system was analysed using first-principles calculations 10.1016/j.jallcom.2019.152811 [1]. The method included using density functional theory to optimize the crystal structure of the phases constituting the binary phase diagram by relaxing atomic positions, volume, and shape. The optimized structures were subsequently used to calculate thermodynamic properties at different temperatures; by determining the zero-point energy, the vibrational internal energy, and the entropy, the heat capacity at constant volume was obtained as well as the phases' stability limits. Furthermore, optimized structures were used to calculate the XRD patterns and to compare them with experimental data. All the referred data are now accessible to researchers and industrials demanding to work with binary and higher-order systems that include Ag and Li, for example, for energy storage. Binaries should be well assessed prior to higher-order phase diagrams and in that resides additional usefulness to this data., (© 2019 The Authors.)

Materials having a high dielectric constant are needed for a variety of electrical applications from transistors to capacitors. Ferroelectric amorphous-oxide (glass) alkali-ion electrolytes of composition A 2.99 Ba 0.005 ClO (A = Li, Na) are shown by two different types of measurement and different consistent analyses to have extraordinarily high dielectric constants, varying from 10 9 at 25 °C to 10 10 at 220 °C if the glass is properly conditioned. These anomalously high dielectric properties coexist with alkali-ion conductivities at 25 °C that are equivalent to those of the best organic-liquid electrolytes of a Li-ion cell, and cyclic voltammetry (CV) in a Au/glass electrolyte/Au cell is stable from -10 to +10 V. A model to interpret microscopically all the key features of the CV curves shows that the electric-double-layer capacitors that form at the gold/electrolyte interfaces in the Au/glass electrolyte/Au heterojunction reverse polarization at an applied voltage V = ±2.1 V, resulting in three almost equivalent discharging capacitances for a single physical capacitor from -10 to +10 V.

A room-temperature all-solid-state rechargeable battery cell containing a tandem electrolyte consisting of a Li + -glass electrolyte in contact with a lithium anode and a plasticizer in contact with a conventional, low cost oxide host cathode was charged to 5 V versus lithium with a charge/discharge cycle life of over 23,000 cycles at a rate of 153 mA·g -1 of active material. A larger positive electrode cell with 329 cycles had a capacity of 585 mAh·g -1 at a cutoff of 2.5 V and a current of 23 mA·g -1 of the active material; the capacity rose with cycle number over the 329 cycles tested during 13 consecutive months. Another cell had a discharge voltage from 4.5 to 3.7 V over 316 cycles at a rate of 46 mA·g -1 of active material. Both the Li + -glass electrolyte and the plasticizer contain electric dipoles that respond to the internal electric fields generated during charge by a redistribution of mobile cations in the glass and by extraction of Li + from the active cathode host particles. The electric dipoles remain oriented during discharge to retain an internal electric field after a discharge. The plasticizer accommodates to the volume changes in the active cathode particles during charge/discharge cycling and retains during charge the Li + extracted from the cathode particles at the plasticizer/cathode-particle interface; return of these Li + to the active cathode particles during discharge only involves a displacement back across the plasticizer/cathode interface and transport within the cathode particle. A slow motion at room temperature of the electric dipoles in the Li + -glass electrolyte increases with time the electric field across the EDLC of the anode/Li + -glass interface to where Li + from the glass electrolyte is plated on the anode without being replenished from the cathode, which charges the Li + -glass electrolyte negative and consequently the glass side of the Li + -glass/plasticizer EDLC. Stripping back the Li + to the Li + -glass during discharge is enhanced by the negative charge in the Li + -glass. Since the Li + -glass is not reduced on contact with metallic lithium, no passivating interface layer contributes to a capacity fade; instead, the discharge capacity increases with cycle number as a result of dipole polarization in the Li + -glass electrolyte leading to a capacity increase of the Li + -glass/plasticizer EDLC. The storage of electric power by both faradaic electrochemical extraction/insertion of Li + in the cathode and electrostatic stored energy in the EDLCs provides a safe and fast charge and discharge with a long cycle life and a greater capacity than can be provided by the cathode host extraction/insertion reaction. The cell can be charged to a high voltage versus a lithium anode because of the added charge of the EDLCs.

The dependence of modern society on the energy stored in a fossil fuel is not sustainable. An immediate challenge is to eliminate the polluting gases emitted from the roads of the world by replacing road vehicles powered by the internal combustion engine with those powered by rechargeable batteries. These batteries must be safe and competitive in cost, performance, driving range between charges, and convenience. The competitive performance of an electric car has been demonstrated, but the cost of fabrication, management to ensure safety, and a short cycle life have prevented large-scale penetration of the all-electric road vehicle into the market. Low-cost, safe all-solid-state cells from which dendrite-free alkali-metal anodes can be plated are now available; they have an operating temperature range from -20 °C to 80 °C and they permit the design of novel high-capacity, high-voltage cathodes providing fast charge/discharge rates. Scale-up to large multicell batteries is feasible.

A family of hydrides, including the high capacity MgH2 and LiH, is reported. The disadvantages these hydrides normally display (high absorption/desorption temperatures and poor kinetics) are mitigated by Cu-hydride catalysis. This paper reports on the synthesis of novel CuLi0.08Mg1.42H4 and CuLi0.08Mg1.92H5 hydrides, which are structurally and thermodynamically characterized for the first time. The CuLi0.08Mg1.42H4 hydride structure in nanotubes is able to hold molecular H2, increasing the gravimetric and volumetric capacity of this compound. The catalytic effect these compounds show on hydride formation and decomposition of CuMg2 and Cu2Mg/MgH2, Li and LiH, Mg and MgH2 is analyzed. The Gibbs energy, decomposition temperature, and gravimetric capacity of the reactions occurring within the Cu-Li-Mg-H system are presented for the first time. First principles and phonon calculations are compared with experiments, including neutron spectroscopy. It is demonstrated that the most advantageous sample contains CuLi0.08Mg1.92 and (Li) ∼ Li2Mg3; it desorbs/absorbs hydrogen according to the reaction, 2CuLi0.08Mg1.42H4 + 2Li + 4MgH2 ↔ 2CuLi0.08Mg1.92 + Li2Mg3 + 8H2 at 114 °C (5.0 wt%) - 1 atm, falling within the proton exchange membrane fuel cell applications window. Finally the reaction 2CuLi0.08Mg1.42H4 + MgH2 ↔ 2CuLi0.08Mg1.92 + 5H2 at 15 °C (4.4 wt%) - 1 atm is found to be the main reaction of the samples containing CuLi0.08Mg1.92 that were analyzed in this study.

Objective: To describe published cases of cerebral mansoni schistosomiasis and three others and discuss the diagnosis and treatment of cerebral pseudotumoral schistosomiasis., Case Descriptions: In case 1, a 20-year-old man presented with occipital headache, intense dizziness, visual alterations, nausea, decreased appetite, and asthenia. Cranial computed tomography (CT) revealed an expansive cerebellar lesion in the right hemisphere with no contrast enhancement. The patient had complete resection of the lesion. Anatomicopathological examination revealed a schistosomal granuloma. In case 2, a 22-year-old man presented with generalized tonic-clonic seizure. Cranial CT and magnetic resonance imaging (MRI) revealed an expansive bilateral middle frontal lesion, with contrast uptake close to the cingulate gyrus and corpus callosum. The patient underwent left frontal craniotomy, and an interhemispheric approach was used to resect part of the lesion. In case 3, a 32-year-old man presented with generalized tonic-clonic seizures. Cranial CT showed a hyperdense intense intracranial expansive lesion that presented contrast uptake in the left temporal region. The patient had complete resection of the lesion., Conclusions: A surgical approach with lesion resection or stereotaxic biopsy is warranted to determine the diagnosis definitively. Antiparasitic drugs must be administered to complete treatment., (Copyright © 2011. Published by Elsevier Inc.)

Objective: To determine the causes of early shunt complications in 46 children with hydrocephalus., Method: A retrospective study was conducted on 46 children submitted to ventriculoperitoneal shunt surgery between February 2005 and February 2007., Results: Thirteen (28%) patients presented complications, which were due to infection in 9 (69%) and to malfunction of the shunt system in 4 (31%).The mean number of surgical procedures performed on patients who presented complications was 2.8 per patient, with a total of 46 surgeries in this group. All patients with infectious complications were identified during their hospital stay., Conclusions: Infection was the most common complication. The infection rate was proportional to the length of hospital stay. All patients with hydrocephalus due to tumors or myelomeningocele presented complications. A higher incidence of infections was observed in children older than 2 years.