Progress on the implementation of Energy Performance Certificates in EU

Energy performance certificates (EPCs) are a key policy tool to inform about and to foster improvements to the energy performance of the building stock. Since their introduction in 2002 by the Energy Performance of Buildings Directive (EPBD), EPCs have been implemented across Member States (MSs) in different ways, depending on the political and legal context, the available technical capacities, as well as the characteristics of the buildings stock and buildings market in general. In 2021, in the context of ?Fit for 55? legislative package, the European Commission proposed the third revision of the EPBD. The proposal improves the provisions on EPCs, their issuing and display, and their databases. In particular, it pursues harmonisation across MSs through a mandatory template for EPCs and a harmonised scale of energy performance classes. This report presents the results of a survey conducted by JRC among MSs to collect information on how each MS has implemented the EPC scheme. It highlights differences among MSs regarding the energy uses included in the calculation, the floor area considered, the definition of energy classes, the main indicator(s), the number of EPCs issued, the availability of a national register, the mechanisms in place to ensure the quality of EPCs

Beyond the First Year: Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation

Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1 year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1 year. Among 1066 KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0–45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3 years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections

Acute kidney injury promotes development of papillary renal cell adenoma and carcinoma from renal progenitor cells.

Acute tissue injury causes DNA damage and repair processes involving increased cell mitosis and polyploidization, leading to cell function alterations that may potentially drive cancer development. Here, we show that acute kidney injury (AKI) increased the risk for papillary renal cell carcinoma (pRCC) development and tumor relapse in humans as confirmed by data collected from several single-center and multicentric studies. Lineage tracing of tubular epithelial cells (TECs) after AKI induction and long-term follow-up in mice showed time-dependent onset of clonal papillary tumors in an adenoma-carcinoma sequence. Among AKI-related pathways, NOTCH1 overexpression in human pRCC associated with worse outcome and was specific for type 2 pRCC. Mice overexpressing NOTCH1 in TECs developed papillary adenomas and type 2 pRCCs, and AKI accelerated this process. Lineage tracing in mice identified single renal progenitors as the cell of origin of papillary tumors. Single-cell RNA sequencing showed that human renal progenitor transcriptome showed similarities to PT1, the putative cell of origin of human pRCC. Furthermore, NOTCH1 overexpression in cultured human renal progenitor cells induced tumor-like 3D growth. Thus, AKI can drive tumorigenesis from local tissue progenitor cells. In particular, we find that AKI promotes the development of pRCC from single progenitors through a classical adenoma-carcinoma sequence

The Owl's Flight. Hegel's Legacy in a different voice

The main aim of the present book is to unlock an innovative horizon of research and comparison engaging with a line of thinking that, like Hegel’s, has not yet exhausted its theoretical implications for individual and collective life into society

162 HIV-1 infected pregnant women and vertical transmission: Results of a prospective study,162 Donne gravide HIV-1 positive e la trasmissione verticale del virus: Risultati di uno studio prospettico

Background: Aim of this paper is to describe the changes over a 16-year period of the characteristics and management of HIV infected pregnant women. Methods. Prospective study: analysis of data obtained from 162 women and 176 infants. Factors evaluated included: maternal sociodemographic level, immunological and virological parameters, antiretroviral therapy, mode of delivery, pregnancy outcome and babies follow-up. Results. The proportion of women with heterosexual acquisition of infection has increased significantly from 13.5% in 1985-1989 to 47.1% in 1996-2001 (p<0.0005, Fisher's exact test), while the proportion acquiring HIV through injecting drugs has declined. Mean CD4 cell count at delivery was 535x106/1 (±522.3x106/1). In 1990, 50% of mothers received antiretroviral therapy, rising significantly to 87.5% in 2000. The elective cesarean section was introduced in 1998 and its rate has increased to 75% in 2000. The vertical transmission rate changed from 9.5% in 1985-1989 to 14.3% in 1996-2000 (this difference was not statistically significant, Fisher's exact test). Conclusions. Social characteristics of the HIV-infected women have changed since the mid-1980s: in recent times women are having children at increasingly older ages and are more likely to know that they are HIV infected when they become pregnant. Antiretroviral therapy, elective caesarean delivery and avoidance of breastfeeding can reduce transmission of HIV, but the vertical transmission rate was unaffected by their use in our study and it remains high in comparison with rates reported from other studies