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Neoplasias Pulmonares , Terapia Neoadjuvante , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/tratamento farmacológico , Terapia Neoadjuvante/métodos , Pneumonectomia/métodos , Masculino , Pessoa de Meia-Idade , Feminino , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , IdosoRESUMO
Relative apical longitudinal sparing (RALS) on echocardiography has become an increasingly used tool to evaluate for cardiac amyloidosis (CA), but the predictive value of this finding remains unclear. This is a retrospective analysis at a single tertiary care center across 3 years. Patients were included if they had RALS, defined by strain ratio ≥2.0 on echocardiography, and sufficient laboratory, imaging, or histopathologic workup to indicate their likelihood of CA. Patients were stratified by their likelihood of CA, and contributions of other co-morbidities previously shown to be associated with RALS. Of the 220 patients who had adequate workup to determine their likelihood of having CA, 50 (22.7%) had confirmed CA, 35 (15.9%) had suspicious CA, 83 (37.7%) had unlikely CA, and 52 (23.7%) had ruled-out CA. The positive predictive value of RALS for CA was 38.6% for confirmed or suspicious CA. The remaining 61.4% of patients who were unlikely or ruled out for CA had other co-morbidities such as hypertension, chronic kidney disease, malignancy, or aortic stenosis, 17.0% of this group had none of these co-morbidities. In our tertiary care cohort of patients with RALS pattern on echocardiography, we found that fewer than half of patients with RALS were likely to have CA. Given the increasing use of strain technology, further studies are warranted to determine the optimal strategy for assessing CA in a patient with RALS.
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Amiloidose , Cardiomiopatias , Humanos , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/complicações , Estudos Retrospectivos , Função Ventricular Esquerda , Amiloidose/diagnóstico por imagem , Amiloidose/complicações , Ecocardiografia/métodosRESUMO
Grounded in hydrodynamic theory, proximal isovelocity surface area (PISA) is a simplistic and practical technique widely used to quantify valvular regurgitation flow. PISA provides a relatively reasonable, though slightly underestimated flow rate for circular orifices. However, for elliptical orifices frequently seen in functional mitral regurgitation, PISA underestimates the flow rate. Based on data obtained with computational fluid dynamics (CFD) and in vitro experiments using systematically varied orifice parameters, we hypothesized that flow rate underestimation for elliptical orifices by PISA is predictable and within a clinically acceptable range. We performed 45 CFD simulations with varying orifice areas 0.1, 0.3 and 0.5 cm2, orifice aspect ratios 1:1, 2:1, 3:1, 5:1, and 10:1, and peak velocities (Vmax) 400, 500 and 600 cm/s. The ratio of computed effective regurgitant orifice area to true effective area (EROAC/EROA) against the ratio of aliasing velocity to peak velocity (VA/Vmax) was analyzed for orifice shape impact. Validation was conducted with in vitro imaging in round and 3:1 elliptical orifices. Plotting EROAC/EROA against VA/Vmax revealed marginal flow underestimation with 2:1 and 3:1 elliptical axis ratios against a circular orifice (< 10% for 8% VA/Vmax), rising to ≤ 35% for 10:1 ratio. In vitro modeling confirmed CFD findings; there was a 8.3% elliptical EROA underestimation compared to the circular orifice estimate. PISA quantification for regurgitant flow through elliptical orifices produces predictable, but generally small, underestimation deemed clinically acceptable for most regurgitant orifices.
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Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Humanos , Hidrodinâmica , Velocidade do Fluxo Sanguíneo , Valor Preditivo dos Testes , Ecocardiografia Doppler em Cores/métodosRESUMO
All-solid-state batteries have recently gained considerable attention due to their potential improvements in safety, energy density, and cycle-life compared to conventional liquid electrolyte batteries. Sodium all-solid-state batteries also offer the potential to eliminate costly materials containing lithium, nickel, and cobalt, making them ideal for emerging grid energy storage applications. However, significant work is required to understand the persisting limitations and long-term cyclability of Na all-solid-state-based batteries. In this work, we demonstrate the importance of careful solid electrolyte selection for use against an alloy anode in Na all-solid-state batteries. Three emerging solid electrolyte material classes were chosen for this study: the chloride Na2.25Y0.25Zr0.75Cl6, sulfide Na3PS4, and borohydride Na2(B10H10)0.5(B12H12)0.5. Focused ion beam scanning electron microscopy (FIB-SEM) imaging, X-ray photoelectron spectroscopy (XPS), and electrochemical impedance spectroscopy (EIS) were utilized to characterize the evolution of the anode-electrolyte interface upon electrochemical cycling. The obtained results revealed that the interface stability is determined by both the intrinsic electrochemical stability of the solid electrolyte and the passivating properties of the formed interfacial products. With appropriate material selection for stability at the respective anode and cathode interfaces, stable cycling performance can be achieved for Na all-solid-state batteries.
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PURPOSE: The purpose of this study was to evaluate the accuracy of four-dimensional (4D) flow MRI for direct assessment of peak velocity, flow volume, and momentum of a mitral regurgitation (MR) flow jets using an in vitro pulsatile jet flow phantom. We systematically investigated the impact of spatial resolution and quantification location along the jet on flow quantities with Doppler ultrasound as a reference for peak velocity. METHODS: Four-dimensional flow MRI data of a pulsatile jet through a circular, elliptical, and 3D-printed patient-specific MR orifice model was acquired with varying spatial resolution (1.5-5 mm isotropic voxel). Flow rate and momentum of the jet were quantified at various axial distances (x = 0-50 mm) and integrated over time to calculate Voljet and MTIjet . In vivo assessment of Voljet and MTIjet was performed on 3 MR patients. RESULTS: Peak velocities were comparable to Doppler ultrasound (3% error, 1.5 mm voxel), but underestimated with decreasing spatial resolution (-40% error, 5 mm voxel). Voljet was similar to regurgitant volume (RVol) within 5 mm, and then increased linearly with the axial distance (19%/cm) because of flow entrainment. MTIjet remained steady throughout the jet (2%/cm) as theoretically predicted. Four and 9 voxels across the jet were required to measure flow volume and momentum-time-integral within 10% error, respectively. CONCLUSION: Four-dimensional flow MRI detected accurate peak velocity, flow rate, and momentum for in vitro MR-mimicking flow jets. Spatial resolution significantly impacted flow quantitation, which otherwise followed predictions of flow entrainment and momentum conservation. This study provides important preliminary information for accurate in vivo MR assessment using 4D flow MRI.
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Doenças das Valvas Cardíacas , Insuficiência da Valva Mitral , Velocidade do Fluxo Sanguíneo , Humanos , Imageamento por Ressonância Magnética , Insuficiência da Valva Mitral/diagnóstico por imagem , Fluxo Pulsátil , UltrassonografiaRESUMO
By using temperature-dependent neutron powder diffraction combined with maximum entropy method analysis, a previously unreported Li lattice site was discovered in the argyrodite Li6PS5Cl solid-state electrolyte. This new finding enables a more complete description of the Li diffusion model in argyrodites, providing structural guidance for designing novel high-conductivity solid-state electrolytes.
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The development of silicon anodes for lithium-ion batteries has been largely impeded by poor interfacial stability against liquid electrolytes. Here, we enabled the stable operation of a 99.9 weight % microsilicon anode by using the interface passivating properties of sulfide solid electrolytes. Bulk and surface characterization, and quantification of interfacial components, showed that such an approach eliminates continuous interfacial growth and irreversible lithium losses. Microsilicon full cells were assembled and found to achieve high areal current density, wide operating temperature range, and high areal loadings for the different cells. The promising performance can be attributed to both the desirable interfacial property between microsilicon and sulfide electrolytes and the distinctive chemomechanical behavior of the lithium-silicon alloy.
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Rechargeable solid-state sodium-ion batteries (SSSBs) hold great promise for safer and more energy-dense energy storage. However, the poor electrochemical stability between current sulfide-based solid electrolytes and high-voltage oxide cathodes has limited their long-term cycling performance and practicality. Here, we report the discovery of the ion conductor Na3-xY1-xZrxCl6 (NYZC) that is both electrochemically stable (up to 3.8 V vs. Na/Na+) and chemically compatible with oxide cathodes. Its high ionic conductivity of 6.6 × 10-5 S cm-1 at ambient temperature, several orders of magnitude higher than oxide coatings, is attributed to abundant Na vacancies and cooperative MCl6 rotation, resulting in an extremely low interfacial impedance. A SSSB comprising a NaCrO2 + NYZC composite cathode, Na3PS4 electrolyte, and Na-Sn anode exhibits an exceptional first-cycle Coulombic efficiency of 97.1% at room temperature and can cycle over 1000 cycles with 89.3% capacity retention at 40 °C. These findings highlight the immense potential of halides for SSSB applications.
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All-solid-state batteries (ASSBs) have attracted enormous attention as one of the critical future technologies for safe and high energy batteries. With the emergence of several highly conductive solid electrolytes in recent years, the bottleneck is no longer Li-ion diffusion within the electrolyte. Instead, many ASSBs are limited by their low Coulombic efficiency, poor power performance, and short cycling life due to the high resistance at the interfaces within ASSBs. Because of the diverse chemical/physical/mechanical properties of various solid components in ASSBs as well as the nature of solid-solid contact, many types of interfaces are present in ASSBs. These include loose physical contact, grain boundaries, and chemical and electrochemical reactions to name a few. All of these contribute to increasing resistance at the interface. Here, we present the distinctive features of the typical interfaces and interphases in ASSBs and summarize the recent work on identifying, probing, understanding, and engineering them. We highlight the complicated, but important, characteristics of interphases, namely the composition, distribution, and electronic and ionic properties of the cathode-electrolyte and electrolyte-anode interfaces; understanding these properties is the key to designing a stable interface. In addition, conformal coatings to prevent side reactions and their selection criteria are reviewed. We emphasize the significant role of the mechanical behavior of the interfaces as well as the mechanical properties of all ASSB components, especially when the soft Li metal anode is used under constant stack pressure. Finally, we provide full-scale (energy, spatial, and temporal) characterization methods to explore, diagnose, and understand the dynamic and buried interfaces and interphases. Thorough and in-depth understanding on the complex interfaces and interphases is essential to make a practical high-energy ASSB.
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Thin film solid oxide fuel cells (TF-SOFCs) are attracting attention due to their ability to operate at comparatively lower temperatures (400-650 °C) that are unattainable for conventional anode-supported SOFCs (650-800 °C). However, limited cathode performance and cell scalability remain persistent issues. Here, we report a new approach of fabricating yttria-stabilized zirconia (YSZ)-based TF-SOFCs via a scalable magnetron sputtering process. Notable is the development and deposition of a porous La0.6Sr0.4Co0.2Fe0.8O2.95(LSCF)-based cathode with a unique fibrous nanostructure. This all-sputtered cell shows an open-circuit voltage of â¼1.0 V and peak power densities of â¼1.7 and â¼2.5 W/cm2 at 600 and 650 °C, respectively, under hydrogen fuel and air along with showing stable performance in short-term testing. The power densities obtained in this work are the highest among YSZ-based SOFCs at these low temperatures, which demonstrate the feasibility of fabricating exceptionally high-performance TF-SOFC cells with distinctive dense or porous nanostructures for each layer, as desired, by a sputtering process. This work illustrates a new, potentially low-cost, and scalable platform for the fabrication of next-generation TF-SOFCs with excellent power output and stability.
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Enabling long cyclability of high-voltage oxide cathodes is a persistent challenge for all-solid-state batteries, largely because of their poor interfacial stabilities against sulfide solid electrolytes. While protective oxide coating layers such as LiNbO3 (LNO) have been proposed, its precise working mechanisms are still not fully understood. Existing literature attributes reductions in interfacial impedance growth to the coating's ability to prevent interfacial reactions. However, its true nature is more complex, with cathode interfacial reactions and electrolyte electrochemical decomposition occurring simultaneously, making it difficult to decouple each effect. Herein, we utilized various advanced characterization tools and first-principles calculations to probe the interfacial phenomenon between solid electrolyte Li6PS5Cl (LPSCl) and high-voltage cathode LiNi0.85Co0.1Al0.05O2 (NCA). We segregated the effects of spontaneous reaction between LPSCl and NCA at the interface and quantified the intrinsic electrochemical decomposition of LPSCl during cell cycling. Both experimental and computational results demonstrated improved thermodynamic stability between NCA and LPSCl after incorporation of the LNO coating. Additionally, we revealed the in situ passivation effect of LPSCl electrochemical decomposition. When combined, both these phenomena occurring at the first charge cycle result in a stabilized interface, enabling long cyclability of all-solid-state batteries.
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In this work, we investigated the interface between the sodium anode and the sulfide-based solid electrolytes Na3SbS4 (NAS), Na3PS4 (NPS), and Cl-doped NPS (NPSC) in all-solid-state-batteries (ASSBs). Even though these electrolytes have demonstrated high ionic conductivities in the range of 1 mS cm-1 at ambient temperatures, sulfide sold-state electrolytes (SSEs) are known to be unstable with Na metal, though the exact reaction mechanism and kinetics of the reaction remain unclear. We demonstrate that the primary cause of capacity fade and cell failure is a chemical reaction spurred on by electrochemical cycling that takes place at the interface between the Na anode and the SSEs. To investigate the properties of the Na-solid electrolyte interphase (SSEI) and its effect on cell performance, the SSEI was predicted computationally to be composed of Na2S and Na3Sb for NAS and identified experimentally via X-ray photoelectron spectroscopy (XPS). These two compounds give the SSEI mixed ionic- and electronic-conducting properties, which promotes continued SSEI growth, which increases the cell impedance at the expense of cell performance and cycle life. The SSEI for NPS was similarly found to be comprised of Na2S and Na3P, but XPS analysis of Cl-doped NPS (NPSC) showed the presence of an additional compound at the SSEI, NaCl, which was found to mitigate the decomposition of NPS. The methodologies presented in this work can be used to predict and optimize the electrochemical behavior of an all-solid-state cell. Such joint computational and experimental efforts can inform strategies for engineering a stable electrolyte and SSEI to avoid such reactions. Through this work, we call for more emphasis on SSE compatibility with both anodes and cathodes, essential for improving the electrochemical properties, longevity, and practicality of Na-based ASSBs.