Mechanical thrombectomy in acute stroke – Five years of experience in Poland

Objectives Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250±99min. 90.3% of the studied patients had MT within 6h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% – emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization – in 30.7%, mRS of 0–2 – in 31.4% and mRS of 6 in 22% of cases. Conclusion Our results can help harmonize standards for MT in Poland according to international guidelines

Electricity Usage Settlement System Based on a Cryptocurrency Instrument

This article reviews the issue of the use of cryptocurrencies (crypto-assets, in general) for an electricity settlement system. The development of digital techniques, including blockchain-based mechanisms, has meant that an increased interest in blockchain-based solutions is to be expected. Blockchain and similar approaches are characterised by decentralisation, so they are concurrent with the trends of the transforming power sector. Decentralised energy generation based on a high proportion of prosumer installations requires the implementation of a new settlement system for grid activities related to electricity use. The first projects of such systems based on a dedicated cryptocurrency have emerged. Based on these, the general concept of such a system with its own cryptocurrency called CCE is presented, including variants implementing net-metering and net-billing. Furthermore, issues requiring interdisciplinary research work and discussion before implementing such systems were identified. A settlement system in which a cryptocurrency is linked to a unit of energy used could be a first step towards introducing a new universal means of value exchange, linked to energy as the primary measure of the value of goods

Impact of the Lockdown during the COVID-19 Pandemic on Electricity Use by Residential Users

The COVID-19 pandemic and the associated lockdown can be regarded as a forced social experiment, the results of which show how to use energy under specific conditions. During this period, there was a reduction in electricity consumption at the level of the power system, but a different specificity distinguishes the group of household users. The article aims at presenting and analysing the identified issues concerning residential electricity users based on the experience from the COVID-19 pandemic lockdown. Data from energy meters from almost 7000 flats in Warsaw’s housing estates during the lockdown in 2020 and the analogous period before the pandemic were used. The analysis showed that, on average, residential users staying practically the whole day in their flats increased their energy consumption, but without increasing their average daily peak power, smoothing the profile in the morning hours to the level reaching the peak power that had occurred in the analogous period before the lockdown. The peak power of the sections feeding the different numbers of dwellings also remained practically unchanged during the lockdown compared to the pre-pandemic period. The pressure to work and educate remotely should contribute to an increase in the digital competence of society, which may result in an increased interest in new forms of activity and cooperation based on demand-side response and prosumption mechanisms, with digital settlements for energy exchange and services

Mechanical thrombectomy in acute stroke : five years of experience in Poland

Objectives: Mechanical thrombectomy (MT) is not reimbursed by the Polish public health system. We present a description of 5 years of experience with MT in acute stroke in Comprehensive Stroke Centers (CSCs) in Poland. Methods and results: We retrospectively analyzed the results of a structured questionnaire from 23 out of 25 identified CSCs and 22 data sets that include 61 clinical, radiological and outcome measures. Results: Most of the CSCs (74%) were founded at University Hospitals and most (65.2%) work round the clock. In 78.3% of them, the working teams are composed of neurologists and neuro-radiologists. All CSCs perform CT and angio-CT before MT. In total 586 patients were subjected to MT and data from 531 of them were analyzed. Mean time laps from stroke onset to groin puncture was 250 99 min. 90.3% of the studied patients had MT within 6 h from stroke onset; 59.3% of them were treated with IV rt-PA prior to MT; 15.1% had IA rt-PA during MT and 4.7% - emergent stenting of a large vessel. M1 of MCA was occluded in 47.8% of cases. The Solitaire device was used in 53% of cases. Successful recanalization (TICI2b–TICI3) was achieved in 64.6% of cases and 53.4% of patients did not experience hemorrhagic transformation. Clinical improvement on discharge was noticed in 53.7% of cases, futile recanalization - in 30.7%, mRS of 0–2 - in 31.4% and mRS of 6 in 22% of cases. Conclusion: Our results can help harmonize standards for MT in Poland according to international guideline