Treatment of Small Cell Lung Cancer in the Elderly

Abstract Small cell lung cancer (SCLC) accounts for approximately 20% of lung carcinomas. Chemotherapy is the cornerstone of treatment for SCLC. In limited disease, the median survival time is about 12–16 months, with a 4%–5% long-term survival rate; in extensive disease the median survival time is 7–11 months. More than 50% of lung cancer patients are diagnosed when they are over the age of 65, and about 30% are over 70. Elderly patients tolerate chemotherapy poorly compared with their younger counterparts, because of age-related progressive reductions in organ function and comorbidities. The standard therapy for limited disease is combined chemoradiotherapy, followed by prophylactic brain irradiation for patients achieving complete responses. In the elderly, the addition of radiotherapy to chemotherapy must be carefully evaluated, considering the slight survival benefit and potential for substantial toxicity incurred with this treatment. The best approach is to design clinical trials that specifically include geriatric assessment to develop active and well-tolerated chemotherapy regimens for elderly SCLC patients. Survival improvement for SCLC patients requires a better understanding of tumor biology and the subsequent development of novel therapeutic strategies. Several targeted agents have been introduced into clinical trials in SCLC, but a minority of these new agents offers a promise of improved outcomes, and negative results are reported more commonly than positive ones. This review focuses on the main issues in the treatment of elderly SCLC patients

Recycling of Lithium-Ion Batteries: Overview of Existing Processes, Analysis and Performance

Lithium-ion batteries (LIBs) have become a widespread technology for electrochemical energy storage in the current era of digitalization and transport electrification, being used as electric stationary storage as well as for powering electric vehicles, e-bikes and portable electronic devices such as smartphones and laptops. However, LIBs contain valuable materials, such as cobalt, nickel, lithium and graphite, whose supply has become critical to meet the increasing demand of batteries. Therefore, proper recycling processes are required in order to recover these materials from spent batteries and re-use them to produce new batteries in a sustainable cycle. This contribution provides an extensive survey of the main recycling routes available today, focusing specifically on pyrometallurgical and hydrometallurgical processes based in Europe, North America and Asia. Attention is also devoted to the recycling behaviour of individuals and companies and to the possible ways to increase their recycling rate. The comparison of different processes allows for the ranking of best practices as well as the drawbacks of different process units, with identification of which materials can be recovered, their recovery rate, and an assessment of the overall recycling efficiency of the process for different battery sizes (small and large, for portable electronics and electric vehicles, respectively). The analysis reveals that pyrometallurgical processes can flexibly treat different LIB chemistries but, since the electrolyte and graphite are burnt in the process, the global recycling efficiency cannot compete with hydrometallurgical processes, especially for small format batteries. Nevertheless, hydrometallurgical processes typically require preliminary mechanical separation treatments to separate the black mass, which contains valuable electrodic materials, as well as complex precipitation steps, which eventually reduce the material recovery rate and the applicability to diverse LIB chemistries. Finally, the study reports an analysis of the electrochemical performance of a battery made with recycled materials, showing that even if recycled cathodic materials had a lower gravimetric capacity and solid-state diffusivity, the performance of a recycled battery could be compensated by simple minor changes to the cell design which would ultimately decrease the specific energy density by a few percent compared to a LIB made with virgin materials

Three Cases of Long-Lasting Tumor Control with Erlotinib after Progression with Gefitinib in Advanced Non-Small Cell Lung Cancer

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Design guidelines for secondary lithium-ion battery electrodes to overcome performance limitations of recycled cathode materials

Today the ever-growing demand of lithium-ion batteries for electric vehicles is posing a terrible burden on materials availability. In particular, high performance cathode materials, such as LiNixMnyCozO2 (NMC), are becoming increasingly critical, thus requiring recycling processes to maximise their reutilisation. Recyclers are moving towards closed loop solutions, such as co-precipitation and direct recycling methods, which however can provide recycled materials with decreased electrochemical and transport properties compared to virgin ones. This work uses numerical modelling to provide design guidelines to overcome performance losses of recycled cathode materials. The model and its parametrisation are validated against experimental data of a virgin NMC cell. An impact assessment on battery performance is carried out showing that a plausible decrease in theoretical volumetric capacity and Li diffusivity in cathode active material leads to both lower accessible capacity during discharge and inferior performance during charge. Nevertheless, a design analysis indicates that recycling degradation can be effectively overcome by simple compensatory measures, such as a limited increase in electrode thicknesses and/or minor decrease in active material diameter, providing similar roundtrip efficiency, energy density, safe thermal operation and performance of the original cell made with virgin materials

Recycling streams for lithium-ion batteries and modelling to compensate performance loss of recycled cathode active materials

Introduction The increasing demand of lithium-ion batteries (LIBs) for electric vehicles, combined with the lack of critical raw materials (e.g., cobalt, nickel, lithium) and the necessity to dispose spent batteries, is pushing proper recycling strategies to recover these materials for their re-use in new batteries. Pyrometallurgical and hydrometallurgical processes are rather established, while direct recycling processes are promising. In any case, the regenerated cathode materials might have a lower quality than those prepared from virgin precursors. In order to meet the stringent requirements of the automotive sector, changes in the electrode design may be required when recycled cathode active materials are used. Material and Methods An extensive survey of the main recycling processes is provided, focusing specifically on the ones which are currently at industrial level. A Doyle-Fuller-Newman electrochemical model is used to provide guidelines to the electrode design to compensate the performance loss of recycled cathode materials, focusing mainly on LiNixMnyCo1-x-yO2 (NMC) chemistry for which an extensive parametrization and validation is performed. Results Pyrometallurgical processes can handle a broader variety of LIB chemistries compared to hydrometallurgical processes, although with a lower recycling efficiency. Hydrometallurgical processes, instead, are limited by initial mechanical separation treatments to obtain the black mass, which affect the material recovery rate and flexibility to treat different LIB chemistries. The electrochemical model is validated against experimental data of a commercial cell (Samsung SDI 94 Ah), showing accurate predictions of voltage and capacity. When recycled active materials with reduced solid-state diffusivity and nominal capacity are simulated, the model shows a decrease in accessible capacity of a few percentages at 0.3-1 C, which can be compensated by increasing marginally the electrode thickness, ultimately resulting in a minor decrease in specific energy density of the battery pack. Discussion The analysis shows that the current recycling processes have some limitations, namely the loss of lithium in the slag in pyrometallurgical processes and the sensitivity to mechanical separations for the recovery of the black mass in hydrometallurgy. Nevertheless, electrochemical modelling indicates that recycled active materials can be effectively used to re-build new batteries with minor modifications to the cell design, suggesting that a sustainable chain for LIBs is feasible

Notulae to the Italian alien vascular flora: 10

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates published elsewhere are provided as Suppl. material 1

Notulae to the Italian alien vascular flora: 10

In this contribution, new data concerning the distribution of vascular flora alien to Italy are presented. It includes new records, confirmations, exclusions, and status changes for Italy or for Italian administrative regions. Nomenclatural and distribution updates published elsewhere are provided as Suppl. material 1