Development of a Smart Modular Heat Recovery Unit Adaptable into a Ventilated Façade

This paper presents the designing aspects and first experimental characterization of an adaptable Smart Modular Heat Recovery Unit (SMHRU) developed under the scope of the E2VENT Project. This SMHRU is being designed as a part of an adaptable renovation module for the retrofitting of multi-storey residential building from the 60's, 70's across Europe that embeds the SMHRU and an energy storage system based on a phase change material. This heat recovery unit will be adjustable to be integrated into the ventilated façade cavity, and able to recover heat from ventilation air, preheating the ventilation air in winter and precooling it in summer. This will allow an efficient combination of consumption reduction and acceptable air indoor quality. The first part of the paper presents designing considerations and thermal stationary analysis of the heat recovery unit, which is based on experimental correlations obtained for air-to-air compact offset-strip-fin plate heat exchangers. Secondly CFD analysis of the distributor of the SMHRU is presented. Finally prototype first performance estimation based on experimental results is presented.This work has been developed under the project “E2VENT: Energy Efficient Ventilated Façades” funded by the Horizon 2020 framework of the European Union, Project No. 637261

Complex brain circuits studied via simultaneous and permanent detection of three transported neuroanatomical tracers in the same histological section.

Experimental neuroanatomical tracing methods lie at the basis of the study of the nervous system. When the scientific question is relatively straightforward, it may be sufficient to derive satisfactory answers from experiments in which a single neuroanatomical tracing method is applied. In various scientific paradigms however, for instance when the degree of convergence of two different projections on a particular cortical area or subcortical nucleus is the subject of study, the application of single tracing methods can be either insufficient or uneconomical to solve the questions asked. In cases where chains of projections are the subjects of study, the simultaneous application of two tracing methods or even more may be compulsory. The present contribution focuses on combinations of several neuroanatomical tract-tracing strategies, enabling in the end the simultaneous, unambiguous and permanent detection of three transported markers according to a three-color paradigm. A number of combinations of three tracers or of two tracers plus the immunocytochemical detection of a neuroactive substance can be conceived; we describe several of these combinations implemented by us using the present multitracer protocol

Odpowiedź na dożylne podawanie rt-PA u pacjentów w podeszłym wieku z udarem mózgu

Użycie rekombinowanego tkankowego aktywatora plazminogenu (rt-PA, recombined tissue plasminogen activator) u pacjentów powyżej 80. roku życia z udarem mózgu pozostaje kontrowersyjne i wciąż trwa debata nad istnieniem różnic w odpowiedzi na rt-PA, zależnych od płci. Autorzy ocenili kliniczną wartość terapii trombolitycznej u osób powyżej 80. roku życia (grupa osób starszych) w porównaniu z grupą osób młodszych oraz oszacowali obecność różnic w odpowiedzi na rt-PA wynikających z różnicy płci. Wszystkich kolejno przyjmowanych pacjentów (n = 157), leczonych rt-PA, oceniano prospektywnie od lipca 2001 roku, włączając 49 chorych w podeszłym wieku, którzy spełnili kryteria Narodowego Instytutu Zaburzeń Neurologicznych i Udaru (NINDS, National Institute of Neurological Disorders and Stroke). Grupy starszych i młodszych osób porównano pod kątem: zmian w punktacji Skali Udaru Narodowego Instytutu Zdrowia (NIHSS, National Institute of Health Stroke Scale) w 1. godzinie, w 24. godzinie oraz 7. dnia po podaniu rt-PA; korzystnego rezultatu 90. dnia ([wg zmodyfikowanej Skali Rankina {mRS, modified Rankin Scale}] mRS 0–1 lub 2, jeżeli mRS = 2 przed udarem); objawowych krwawień oraz odsetka zgonów. Za pomocą regresji logistycznej wykazano, że wyjściowa punktacja w NIHSS (iloraz szans [OR, odds ratio] 0,59; 95-procentowy przedział ufności [CI, confidence interval] 0,41-0,84) była niezależnym czynnikiem prognostycznym korzystnego rezultatu, ale nie płeć (OR 0,72; 95% CI 0,33-1,56) lub wiek powyżej 80 lat (OR 0,74; 95% CI 0,32-1,70). Wskaźniki poprawy klinicznej, śmiertelności czy objawowego krwawienia do ośrodkowego układu nerwowego również nie wiązały się z wiekiem ani z płcią. Podsumowując, odpowiedź na dożylne podanie rt-PA nie jest upośledzona u starszych pacjentów z udarem mózgu, a wrażliwość na leczenie jest taka sama u mężczyzn i u kobiet. Polski Przegląd Neurologiczny 2008; 4 (1): 36-3

Bottlenecks in the Acute Stroke Care System during the COVID-19 Pandemic in Catalonia

Introduction: The COVID-19 pandemic resulted in significant healthcare reorganizations, potentially striking standard medical care. We investigated the impact of the COVID-19 pandemic on acute stroke care quality and clinical outcomes to detect healthcare system's bottlenecks from a territorial point of view. Methods: Crossed-data analysis between a prospective nation-based mandatory registry of acute stroke, Emergency Medical System (EMS) records, and daily incidence of COVID-19 in Catalonia (Spain). We included all stroke code activations during the pandemic (March 15-May 2, 2020) and an immediate prepandemic period (January 26-March 14, 2020). Primary outcomes were stroke code activations and reperfusion therapies in both periods. Secondary outcomes included clinical characteristics, workflow metrics, differences across types of stroke centers, correlation analysis between weekly EMS alerts, COVID-19 cases, and workflow metrics, and impact on mortality and clinical outcome at 90 days. Results: Stroke code activations decreased by 22% and reperfusion therapies dropped by 29% during the pandemic period, with no differences in age, stroke severity, or large vessel occlusion. Calls to EMS were handled 42 min later, and time from onset to hospital arrival increased by 53 min, with significant correlations between weekly COVID-19 cases and more EMS calls (rho = 0.81), less stroke code activations (rho = -0.37), and longer prehospital delays (rho = 0.25). Telestroke centers were afflicted with higher reductions in stroke code activations, reperfusion treatments, referrals to endovascular centers, and increased delays to thrombolytics. The independent odds of death increased (OR 1.6 [1.05-2.4], p 0.03) and good functional outcome decreased (mRS ≤2 at 90 days: OR 0.6 [0.4-0.9], p 0.015) during the pandemic period. Conclusion: During the COVID-19 pandemic, Catalonia's stroke system's weakest points were the delay to EMS alert and a decline of stroke code activations, reperfusion treatments, and interhospital transfers, mostly at local centers. Patients suffering an acute stroke during the pandemic period had higher odds of poor functional outcome and death. The complete stroke care system's analysis is crucial to allocate resources appropriately

Workflow times and outcomes in patients triaged for a suspected severe stroke

Introduction: Current recommendations for regional stroke destination suggest that patients with severe acute stroke in non-urban areas should be triaged based on the estimated transport time to a referral thrombectomy-capable center. Methods: We performed a post hoc analysis to evaluate the association of pre-hospital workflow times with neurological outcomes in patients included in the RACECAT trial. Workflow times evaluated were known or could be estimated before transport allocation. Primary outcome was the shift analysis on the modified Rankin score at 90 days. Results: Among the 1,369 patients included, the median time from onset to emergency medical service (EMS) evaluation, the estimated transport time to a thrombectomy-capable center and local stroke center, and the estimated transfer time between centers were 65 minutes (interquartile ratio [IQR] = 43–138), 61 minutes (IQR = 36–80), 17 minutes (IQR = 9–27), and 62 minutes (IQR = 36–73), respectively. Longer time intervals from stroke onset to EMS evaluation were associated with higher odds of disability at 90 days in the local stroke center group (adjusted common odds ratio (acOR) for each 30-minute increment = 1.03, 95% confidence interval [CI] = 1.01–1.06), with no association in the thrombectomy-capable center group (acOR for each 30-minute increment = 1.01, 95% CI = 0.98–1.01, pinteraction = 0.021). No significant interaction was found for other pre-hospital workflow times. In patients evaluated by EMS later than 120 minutes after stroke onset, direct transport to a thrombectomy-capable center was associated with better disability outcomes (acOR = 1.49, 95% CI = 1.03–2.17). Conclusion: We found a significant heterogeneity in the association between initial transport destination and neurological outcomes according to the elapse of time between the stroke onset and the EMS evaluation (ClinicalTrials.gov: NCT02795962). ANN NEUROL 2022;92:931–942

Effectiveness of thrombectomy in stroke according to baseline prognostic factors: inverse probability of treatment weighting analysis of a population-based registry

Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Methods Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score 3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups’ criteria). Results Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3). Conclusions Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors

Caveolin-1-Enhanced Motility and Focal Adhesion Turnover Require Tyrosine-14 but Not Accumulation to the Rear in Metastatic Cancer Cells

Caveolin-1 is known to promote cell migration, and increased caveolin-1 expression is associated with tumor progression and metastasis. In fibroblasts, caveolin-1 polarization and phosphorylation of tyrosine-14 are essential to promote migration. However, the role of caveolin-1 in migration of metastatic cells remains poorly defined. Here, caveolin-1 participation in metastatic cell migration was evaluated by shRNA targeting of endogenous caveolin-1 in MDA-MB-231 human breast cancer cells and ectopic expression in B16-F10 mouse melanoma cells. Depletion of caveolin-1 in MDA-MB-231 cells reduced, while expression in B16-F10 cells promoted migration, polarization and focal adhesion turnover in a sequence of events that involved phosphorylation of tyrosine-14 and Rac-1 activation. In B16-F10 cells, expression of a non-phosphorylatable tyrosine-14 to phenylalanine mutant failed to recapitulate the effects observed with wild-type caveolin-1. Alternatively, treatment of MDA-MB-231 cells with the Src family kinase inhibitor PP2 reduced caveolin-1 phosphorylation on tyrosine-14 and cell migration. Surprisingly, unlike for fibroblasts, caveolin-1 polarization and re-localization to the trailing edge were not observed in migrating metastatic cells. Thus, expression and phosphorylation, but not polarization of caveolin-1 favor the highly mobile phenotype of metastatic cells