Translating the potential of the urine steroid metabolome to stage NAFLD (TrUSt-NAFLD): study protocol for a multicentre, prospective validation study.

INTRODUCTION: Non-alcoholic fatty liver disease (NAFLD) affects approximately one in four individuals and its prevalence continues to rise. The advanced stages of NAFLD with significant liver fibrosis are associated with adverse morbidity and mortality outcomes. Currently, liver biopsy remains the 'gold-standard' approach to stage NAFLD severity. Although generally well tolerated, liver biopsies are associated with significant complications, are resource intensive, costly, and sample only a very small area of the liver as well as requiring day case admission to a secondary care setting. As a result, there is a significant unmet need to develop non-invasive biomarkers that can accurately stage NAFLD and limit the need for liver biopsy. The aim of this study is to validate the use of the urine steroid metabolome as a strategy to stage NAFLD severity and to compare its performance against other non-invasive NAFLD biomarkers. METHODS AND ANALYSIS: The TrUSt-NAFLD study is a multicentre prospective test validation study aiming to recruit 310 patients with biopsy-proven and staged NAFLD across eight centres within the UK. 150 appropriately matched control patients without liver disease will be recruited through the Oxford Biobank. Blood and urine samples, alongside clinical data, will be collected from all participants. Urine samples will be analysed by liquid chromatography-tandem mass spectroscopy to quantify a panel of predefined steroid metabolites. A machine learning-based classifier, for example, Generalized Matrix Relevance Learning Vector Quantization that was trained on retrospective samples, will be applied to the prospective steroid metabolite data to determine its ability to identify those patients with advanced, as opposed to mild-moderate, liver fibrosis as a consequence of NAFLD. ETHICS AND DISSEMINATION: Research ethical approval was granted by West Midlands, Black Country Research Ethics Committee (REC reference: 21/WM/0177). A substantial amendment (TrUSt-NAFLD-SA1) was approved on 26 November 2021. TRIAL REGISTRATION NUMBER: ISRCTN19370855.

Intraductal fully covered self-expanding metal stents in the management of post-liver transplant anastomotic strictures: a UK wide experience.

Background: Fully covered intraductal self-expanding metal stents (IDSEMS) have been well described in the management of post-liver transplant (LT) anastomotic strictures (ASs). Their antimigration waists and intraductal nature make them suited for deployment across the biliary anastomosis. Objectives: We conducted a multicentre study to analyse their use and efficacy in the management of AS. Design: This was a retrospective, multicentre observational study across nine tertiary centres in the United Kingdom. Methods: Consecutive patients who underwent endoscopic retrograde cholangiopancreatography with IDSEMS insertion were analysed retrospectively. Recorded variables included patient demographics, procedural characteristics, response to therapy and follow-up data. Results: In all, 162 patients (100 males, 62%) underwent 176 episodes of IDSEMS insertion for AS. Aetiology of liver disease in this cohort included hepatocellular carcinoma (n = 35, 22%), followed by alcohol-related liver disease (n = 29, 18%), non-alcoholic steatohepatitis (n = 20, 12%), primary biliary cholangitis (n = 15, 9%), acute liver failure (n = 13, 8%), viral hepatitis (n = 13, 8%) and autoimmune hepatitis (n = 12, 7%). Early AS occurred in 25 (15%) cases, delayed in 32 (20%) cases and late in 95 (59%) cases. Age at transplant was 54 years (range, 12-74), and stent duration was 15 weeks (range, 3 days-78 weeks). In total, 131 (81%) had complete resolution of stricture at endoscopic re-evaluation. Stricture recurrence was observed in 13 (10%) cases, with a median of 19 weeks (range, 4-88 weeks) after stent removal. At removal, there were 21 (12%) adverse events, 5 (3%) episodes of cholangitis and 2 (1%) of pancreatitis. In 11 (6%) cases, the removal wires unravelled, and 3 (2%) stents migrated. All were removed endoscopically. Conclusion: IDSEMS appears to be safe and highly efficacious in the management of post-LT AS, with low rates of AS recurrence.

Remarkable stability of a molecular ruthenium complex in PEM water electrolysis.

The dinuclear Ru diazadiene olefin complex, [Ru2(OTf)(µ-H)(Me2dad)(dbcot)2], is an active catalyst for hydrogen evolution in a Polymer Exchange Membrane (PEM) water electrolyser. When supported on high surface area carbon black and at 80 °C, [Ru2(OTf)(µ-H)(Me2dad)(dbcot)2]@C evolves hydrogen at the cathode of a PEM electrolysis cell (400 mA cm-2, 1.9 V). A remarkable turn over frequency (TOF) of 7800 molH2 molcatalyst -1 h-1 is maintained over 7 days of operation. A series of model reactions in homogeneous media and in electrochemical half cells, combined with DFT calculations, are used to rationalize the hydrogen evolution mechanism promoted by [Ru2(OTf)(µ-H)(Me2dad)(dbcot)2].

Reshaping the Cathodic Catalyst Layer for Anion Exchange Membrane Fuel Cells: From Heterogeneous Catalysis to Homogeneous Catalysis.

In anion exchange membrane fuel cells, catalytic reactions occur at a well-defined three-phase interface, wherein conventional heterogeneous catalyst layer structures exacerbate problems, such as low catalyst utilization and limited mass transfer. We developed a structural engineering strategy to immobilize a molecular catalyst tetrakis(4-methoxyphenyl)porphyrin cobalt(II) (TMPPCo) on the side chains of an ionomer (polyfluorene, PF) to obtain a composite material (PF-TMPPCo), thereby achieving a homogeneous catalysis environment inside ion-flow channels, with greatly improved mass transfer and turnover frequency as a result of 100 % utilization of the catalyst molecules. The unique structure of the homogeneous catalysis system comprising interconnected nanoreactors exhibits advantages of low overpotential and high fuel-cell power density. This strategy of reshaping of the catalyst layer structure may serve as a new platform for applications of many molecular catalysts in fuel cells.

Electrochemical CO2 reduction in water at carbon cloth electrodes functionalized with a fac-Mn(apbpy)(CO)3Br complex.

The organometallic complex (fac-Mn(apbpy)(CO)3Br) (apbpy = 4-(4-aminophenyl)-2,2'-bipyridine) grafted electrochemically onto carbon cloth serves as an electrocatalyst in the aqueous reduction of CO2 to syngas. A faradaic efficiency of around 60% for CO and 40% for H2 at -1.35 V is achieved together with a productivity rate higher than 870 NlCO h-1 gMn-1 at turnover numbers of up to 33 200 during 10 hours of operation.

Heat treated carbon supported iron(ii)phthalocyanine oxygen reduction catalysts: elucidation of the structure-activity relationship using X-ray absorption spectroscopy.

This paper focuses on studying the influence of the heat treatment on the structure and activity of carbon supported Fe(ii)phthalocyanine (FePc/C) oxygen reduction reaction (ORR) catalysts under alkaline conditions. The FePc macrocycle was deposited onto ketjen black carbon and heated treated for 2 hours under inert atmosphere (Ar) at different temperatures (400, 500, 600, 700, 800, 900 and 1000 °C). The atomic structure of Fe in each sample has been determined by XAS and correlated to the activity and ORR mechanisms determined in electrochemical half cells and in a complete H2/O2 anion exchange membrane fuel cells (AEM-FC). The results show that the samples prepared at 600 and 700 °C have the highest electrochemical catalytic activity for the ORR, consistent with the findings that the FeN4 active sites are thermally stable up to 700 °C, confirmed by both XANES linear combination fittings and EXAFS fittings. Upon annealing at temperatures above 800 °C, the FeN4 structure partially decomposes to small iron nanoparticles. The transition from the FeN4 structure to metallic Fe results in a significant loss in ORR activity and an increase in the production of undesirable HO2- during catalysis.

A Pd/C-CeO2 Anode Catalyst for High-Performance Platinum-Free Anion Exchange Membrane Fuel Cells.

One of the biggest obstacles to the dissemination of fuel cells is their cost, a large part of which is due to platinum (Pt) electrocatalysts. Complete removal of Pt is a difficult if not impossible task for proton exchange membrane fuel cells (PEM-FCs). The anion exchange membrane fuel cell (AEM-FC) has long been proposed as a solution as non-Pt metals may be employed. Despite this, few examples of Pt-free AEM-FCs have been demonstrated with modest power output. The main obstacle preventing the realization of a high power density Pt-free AEM-FC is sluggish hydrogen oxidation (HOR) kinetics of the anode catalyst. Here we describe a Pt-free AEM-FC that employs a mixed carbon-CeO2 supported palladium (Pd) anode catalyst that exhibits enhanced kinetics for the HOR. AEM-FC tests run on dry H2 and pure air show peak power densities of more than 500 mW cm(-2) .

Direct alcohol fuel cells: toward the power densities of hydrogen-fed proton exchange membrane fuel cells.

A 2 µm thick layer of TiO2 nanotube arrays was prepared on the surface of the Ti fibers of a nonwoven web electrode. After it was doped with Pd nanoparticles (1.5 mgPd cm(-2) ), this anode was employed in a direct alcohol fuel cell. Peak power densities of 210, 170, and 160 mW cm(-2) at 80 °C were produced if the cell was fed with 10 wt % aqueous solutions of ethanol, ethylene glycol, and glycerol, respectively, in 2 M aqueous KOH. The Pd loading of the anode was increased to 6 mg cm(-2) by combining four single electrodes to produce a maximum peak power density with ethanol at 80 °C of 335 mW cm(-2) . Such high power densities result from a combination of the open 3 D structure of the anode electrode and the high electrochemically active surface area of the Pd catalyst, which promote very fast kinetics for alcohol electro-oxidation. The peak power and current densities obtained with ethanol at 80 °C approach the output of H2 -fed proton exchange membrane fuel cells.

Energy and chemicals from the selective electrooxidation of renewable diols by organometallic fuel cells.

Organometallic fuel cells catalyze the selective electrooxidation of renewable diols, simultaneously providing high power densities and chemicals of industrial importance. It is shown that the unique organometallic complex [Rh(OTf)(trop2NH)(PPh3)] employed as molecular active site in an anode of an OMFC selectively oxidizes a number of renewable diols, such as ethylene glycol , 1,2-propanediol (1,2-P), 1,3-propanediol (1,3-P), and 1,4-butanediol (1,4-B) to their corresponding mono-carboxylates. The electrochemical performance of this molecular catalyst is discussed, with the aim to achieve cogeneration of electricity and valuable chemicals in a highly selective electrooxidation from diol precursors.

Electrooxidation of ethylene glycol and glycerol on Pd-(Ni-Zn)/C anodes in direct alcohol fuel cells.

The electrooxidation of ethylene glycol (EG) and glycerol (G) has been studied: in alkaline media, in passive as well as active direct ethylene glycol fuel cells (DEGFCs), and in direct glycerol fuel cells (DGFCs) containing Pd-(Ni-Zn)/C as an anode electrocatalyst, that is, Pd nanoparticles supported on a Ni-Zn phase. For comparison, an anode electrocatalyst containing Pd nanoparticles (Pd/C) has been also investigated. The oxidation of EG and G has primarily been investigated in half cells. The results obtained have highlighted the excellent electrocatalytic activity of Pd-(Ni-Zn)/C in terms of peak current density, which is as high as 3300 A g(Pd)(-1) for EG and 2150 A g(Pd)(-1) for G. Membrane-electrode assemblies (MEA) have been fabricated using Pd-(Ni-Zn)/C anodes, proprietary Fe-Co/C cathodes, and Tokuyama A-201 anion-exchange membranes. The MEA performance has been evaluated in either passive or active cells fed with aqueous solutions of 5 wt % EG and 5 wt % G. In view of the peak-power densities obtained in the temperature range from 20 to 80 °C, at Pd loadings as low as 1 mg cm(-2) at the anode, these results show that Pd-(Ni-Zn)/C can be classified amongst the best performing electrocatalysts ever reported for EG and G oxidation.