Lung transplantation for cystic fibrosis: differential characteristics and outcomes between children and adults.

The survival benefit of lung transplantation (LTx) for cystic fibrosis (CF) patients is well demonstrated. We aim to compare children and adult CF recipients to assess whether there are differences in survival and clinical outcomes, and to identify risk factors for mortality. A retrospective analysis of 442 consecutive LTx performed at our institution in a 20-year period was conducted. CF patients were distributed into two groups: children (age The study group included 120 consecutive CF patients: 50 children (13 ± 3 years) and 70 adults (25 ± 6 years) undergoing 111 bilateral, 4 lobar, 4 combined and 1 unilateral LTx. Comparative analysis (children versus adults): survival (overall; 5, 10 and 15 years) 57, 45, 35% vs 67, 55, 43% (P = 0.32); survival (1-year survivors; 5, 10 and 15 years): 75, 64, 46% vs 90, 75, 59% (P = 0.09); 30-day mortality: 14 vs 16% (P = 0.27); urgent LTx: 32 vs 17% (P = 0.04); use of cardiopulmonary bypass (CPB): 56 vs 28% (P = 0.002); intensive care unit stay: 20 ± 19 vs 10 ± 9 days (P = 0.006); AR episodes (n): 1.4 ± 0.7 vs 1.2 ± 0.8 (P = 0.004). Incidence of PGD and freedom from CLAD did not differ between groups. Predictors of mortality were: use of CPB (HR 3.12; 95% CI 1.33-7.35; P Paediatric CF patients usually present with poorer pre-transplant status, require CPB more frequently and have a higher incidence of post-LTx diabetes and infections. This might explain the trend towards a better long-term survival observed in adult CF patients

Near-normal aerobic capacity in long-term survivors after lung transplantation

The aim of this study was to elucidate whether long-term LT survivors with normal spirometry achieve normal exercise capacity, and to identify predictive factors of exercise capacity. This was a cross-sectional multicentre study, where bilateral LT recipients who survived at least 10 years after LT, with normal spirometry, no diagnosis of CLAD and modified Medical Research Council dyspnoea degree ≤2 underwent cardiopulmonary exercise testing (CPET). 28 LT recipients were included with a mean± age of 48.7±13.6 years. Oxygen uptake (V' ) had a mean± value of 21.49±6.68 mL·kg −1 ·min −1 (75.24±15.6%) and the anaerobic threshold was reached at 48.6±10.1% of the V' predicted. The mean± heart rate reserve at peak exercise was 17.56±13.6%. The oxygen pulse increased during exercise and was within normal values at 90.5±19.4%. The respiratory exchange ratio exceeded 1.19 at maximum exercise. The median (25-75 th percentile) EuroQol-5D score was 1 (0.95-1), indicating a good quality of life. The median (25-75 th percentile) International Physical Activity Questionnaire score was 5497 (4007-9832) MET-min·week −1 with 89% of patients reporting more than 1500 MET-min·week −1. In the multivariate regression models, age, sex and diffusing capacity of the lung for carbon monoxide remained significantly associated with V' (mL·kg −1 ·min −1); haemoglobin and forced expiratory volume in 1 s were significantly associated with maximum work rate (watts), after adjusting for confounders. We report for the first time near-normal peak V' values during CPET and normal exercise capacity in long-term LT recipients without CLAD. This is a multicentre study reporting, for the first time, near-normal peak V ' values during cardiopulmonary exercise testing and normal exercise capacity in long-term lung transplant recipients without CLA

Design Considerations for Unconventional Electrochemical Energy Storage Architectures

Batteries have become fundamental building blocks for the mobility of modern society. Continuous development of novel battery chemistries and electrode materials has nourished progress in building better batteries. Simultaneously, novel device form factors and designs with multi-functional components have been proposed, requiring batteries to not only integrate seamlessly to these devices, but to also be a multi-functional component for a multitude of applications. Thus, in the past decade, along with developments in the component materials, the focus has been shifting more and more towards novel fabrication processes, unconventional configurations, and additional functionalities. This work attempts to critically review the developments with respect to emerging electrochemical energy storage configurations, including, amongst others, paintable, transparent, flexible, wire or cable shaped, ultra-thin and ultra-thick configurations, as well as hybrid energy storage-conversion, or graphene-incorporated batteries and supercapacitors. The performance requirements are elaborated together with the advantages, but also the limitations, with respect to established electrochemical energy storage technologies. Finally, challenges in developing novel materials with tailored properties that would allow such configurations, and in designing easier manufacturing techniques that can be widely adopted are considered