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Improvements in stroke treatment could save more lives

stroke
Credit: CC0 Public Domain

Yale researchers have found ways to treat stroke patients that may otherwise be untreatable.

In a study published in the Journal of Neurosurgery, principal investigators Yale’s Charles Matouk, MD, associate professor of neurosurgery, and Nils Petersen, MD, Ph.D. associate professor of neurology, show that a method called direct carotid puncture (DCT) offers a life-saving and surprisingly safe alternative to the standard mechanical thrombectomy for patients with difficult-to-access arteries.

Americans have more than 795,000 strokes every year, leading to 140,000 deaths annually. Treatment options depend on when the stroke patient is brought to the hospital.

During the first four-and-a-half hours after a stroke starts, patients can receive tissue plasminogen activator (tPA), a protein that breaks down blood clots. But after that, it’s too late for tPA, as the risk of bleeding becomes too high. For the most severe subtype of stroke, caused by a blood clot blocking a major artery in the brain, doctors strive to combine tPA with thrombectomy, a procedure where a stent is used to remove the clot causing the stroke. Surgeons get the stent to the brain by threading a catheter through a patient’s artery, usually from the groin. While this works well in many cases, it can be a long and tricky journey.

“As we age, the blood vessels become more twisted, like the knots of a tree, and it becomes more difficult to navigate up to the head,” says Dr. Matouk. For about five to 10 percent of stroke patients, this artery anatomy problem makes mechanical thrombectomies nearly impossible.

“We know that time is brain for the patient,” says Dr. Petersen. Every minute a stroke goes untreated, 1.9 million neurons die, so immediate treatment is key to saving lives and avoiding disability.

For their study, Dr. Matouk and Dr. Petersen

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EU plans big building renovation project to save energy

BRUSSELS (AP) — The European Union is announcing a major building renovation project this week seeking to cut down energy costs and polluting emissions while providing a big boost to the construction industry.

EU Commission President Ursula von der Leyen said Monday that the 27-nation bloc “must speed up” the pace of renovations if it is to meet climate change targets and said most efforts will go to schools, hospitals and social housing.

The bloc is littered with buildings that fail to contain heat in winter and cannot keep people cool in summer, creating massive energy bills that sap local budgets but also pollute cities and the atmosphere.

“Our buildings are responsible for 40% of our energy consumption,” said von der Leyen. And even though many buildings have or are being renovated, “at the current pace, it would take more than a century to bring emissions from our buildings to zero.”

The public funding of such projects would also help offset the massive damage that the coronavirus pandemic has done to the bloc’s economy. Some of the financial aid involved is set to come from the 750 billion-euro recovery fund backed by EU leaders over the summer.

The European Union has set a target to renovate 3% of government buildings each year, but because of poor monitoring some studies suggest this target is far from being met.

Last month, Energy Commissioner Kadri Simson stressed the need for renovations to meet the bloc’s target of climate neutrality and said the rate of renovations must now double. He stressed that more than a third of the bloc’s emissions come from buildings, through heating and air-conditioning.

The official announcement of the plans is set for Wednesday.

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Follow all AP stories on climate change issues at https:/apnews.com/hub/Climate.

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To Save On Labor, Contractors And Owners Turn To A Surprising Ally: Chemistry

Contractors and the owners who hire them have always looked for ways to shorten construction timelines and shave costs off their budgets. But with the health and safety of their workforce top of mind, construction professionals have another priority: reducing the number of laborers who actually need to be on-site at one time.

While masks and temperature checks can help, reducing the human density of a construction site is perhaps the most effective tool for preventing viral transmission. To lower the amount of labor they need, contractors and owners are now enlisting the aid of scientifically advanced construction materials.

“We’ve definitely seen an increase in inquiries as a result of the shutdowns and site requirements,” said Tim Yeiser, president of Dricrete, a construction materials company. “Contractors are trying to get as much work done as quickly and efficiently as possible, and we’ve known for decades that one of the best ways to do that is to rely on chemistry.”

Yeiser’s flagship product is Dricrete, a concrete additive that forms an impermeable chemical lattice to keep water out. The product is mainly used in underground parking structures in multifamily and mixed-use buildings to keep out groundwater that could otherwise seep in and damage the structure.

To build underground parking facilities, contractors would typically need to painstakingly deploy a waterproof plastic membrane across the entire job site before they could begin pouring concrete. Depending on the size of the site, that process can require 10 to 15 people, Yeiser said. On sites that use more advanced materials, the need for labor is far lower.

“When contractors use Dricrete, the waterproofing material gets mixed in at the plant, so there’s no need to do any more work on-site, it’s a totally hands-off process,” Yeiser said. “We’ve poured entire parking garages with just one

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‘Employee’ or ‘independent contractor’? DOL proposed definitions could save companies millions

A new U.S. Department of Labor proposal aimed at clarifying whether workers should be classified as “employees” or “independent contractors” could have a major impact on how companies do business and pay their workers – although there are a number of “ifs” associated with the proposition.

“The Department’s proposal aims to bring clarity and consistency to the determination of who’s an independent contractor under the Fair Labor Standards Act (FLSA),” said Secretary of Labor Eugene Scalia. “Once finalized, it will make it easier to identify employees covered by the Act, while respecting the decision other workers make to pursue the freedom and entrepreneurialism associated with being an independent contractor.”

“The rule we proposed today continues our work to simplify the compliance landscape for businesses and to improve conditions for workers,” said Wage and Hour Division Administrator Cheryl Stanton. “The Department believes that streamlining and clarifying the test to identify independent contractors will reduce worker misclassification, reduce litigation, increase efficiency, and increase job satisfaction and flexibility.”

Announced on Sept. 22, the DOL’s proposed rule would:

  • Adopt an “economic reality” test to determine a worker’s status as an FLSA employee or an independent contractor. The test considers whether a worker is in business for himself or herself (independent contractor) or is economically dependent on a putative employer for work (employee)
  • Identify and explain two “core factors” — specifically the nature and degree of the worker’s control over the work, and the worker’s opportunity for profit or loss based on initiative and/or investment. Those factors help determine if a worker is economically dependent on someone else’s business or is in business for himself or herself;
  • Identify three other factors that may serve as additional guideposts in the analysis: the amount of skill required for the work; the degree of permanence of the working
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