Interhospital Transfer Before Thrombectomy Is Associated With Delayed Treatment and Worse Outcome in the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke).

BACKGROUND: Endovascular treatment with mechanical thrombectomy (MT) is beneficial for patients with acute stroke suffering a large-vessel occlusion, although treatment efficacy is highly time-dependent. We hypothesized that interhospital transfer to endovascular-capable centers would result in treatment delays and worse clinical outcomes compared with direct presentation. METHODS: STRATIS (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) was a prospective, multicenter, observational, single-arm study of real-world MT for acute stroke because of anterior-circulation large-vessel occlusion performed at 55 sites over 2 years, including 1000 patients with severe stroke and treated within 8 hours. Patients underwent MT with or without intravenous tissue plasminogen activator and were admitted to endovascular-capable centers via either interhospital transfer or direct presentation. The primary clinical outcome was functional independence (modified Rankin Score 0-2) at 90 days. We assessed (1) real-world time metrics of stroke care delivery, (2) outcome differences between direct and transfer patients undergoing MT, and (3) the potential impact of local hospital bypass. RESULTS: A total of 984 patients were analyzed. Median onset-to-revascularization time was 202.0 minutes for direct versus 311.5 minutes for transfer patients ( CONCLUSIONS: In this large, real-world study, interhospital transfer was associated with significant treatment delays and lower chance of good outcome. Strategies to facilitate more rapid identification of large-vessel occlusion and direct routing to endovascular-capable centers for patients with severe stroke may improve outcomes. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02239640

Synthetic strategies to nanostructured photocatalysts for CO2 reduction to solar fuels and chemicals

Artificial photosynthesis represents one of the great scientific challenges of the 21st century, offering the possibility of clean energy through water photolysis and renewable chemicals through CO2 utilisation as a sustainable feedstock. Catalysis will undoubtedly play a key role in delivering technologies able to meet these goals, mediating solar energy via excited generate charge carriers to selectively activate molecular bonds under ambient conditions. This review describes recent synthetic approaches adopted to engineer nanostructured photocatalytic materials for efficient light harnessing, charge separation and the photoreduction of CO2 to higher hydrocarbons such as methane, methanol and even olefins

Photoelectrocatalytic Degradation of Organic Pollutants in Aqueous Solution Using a Pt-TiO2 Film

A series of Pt-TiO2 films with nanocrystaline structure was prepared by a procedure of photodeposition and subsequent dip-coating. The Pt-TiO2 films were characterized by X-ray diffraction, scanning electronic microscope, electrochemical characterization to examine the surface structure, chemical composition, and the photoelectrochemical properties. The photocatalytic activity of the Pt-TiO2 films was evaluated in the photocatalytic (PC) and photoelectrocatalytic (PEC) degradation of formic acid in aqueous solution. Compared with a TiO2 film, the efficiency of formic acid degradation using the Pt-TiO2 films was significantly higher in both the PC and PEC processes. The enhancement is attributed to the action of Pt deposits on the TiO2 surface, which play a key role by attracting conduction band photoelectrons. In the PEC process, the anodic bias externally applied on the illuminated Pt-TiO2 films can further drive away the accumulated photoelectrons from the metal deposits and promote a process of interfacial charge transfer

Photocatalytic conversion of CO2 to hydrocarbons by light-harvesting complex assisted Rh-doped TiO2 photocatalyst

Photocatalytic reduction of CO2 into valuable hydrocarbons using TiO2 is a promising route for mitigating the effects of global warming and meeting future energy demands. However, TiO2 utilises UV light for photocatalysis and its hydrocarbon yields are still low. In order to enhance the light absorption and increase yields, light-harvesting complexes (LHCII) extracted from spinach were attached to the surface of Rh-doped TiO2 (TiO2:Rh) resulting in a hybrid catalyst, TiO2:Rh-LHCII. The LHCII can absorb visible light in green plants, which convert CO2 to sugars via photosynthesis. CO, acetaldehyde and methyl formate were produced from aqueous CO2 solution in a stirred batch reactor under visible-light irradiation. The yields of acetaldehyde and methyl formate were enhanced by almost ten and four times respectively, when using TiO2:Rh-LHCII compared to those of TiO2:Rh