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The building industry accounts for about 40% of all climate impacts, stemming from construction and renovation processes, use of buildings and demolition, disposal and recycling of buildings and building materials. The Danish Parliament passed a Danish Climate Act in 2020 to reduce greenhouse gas emissions by 70% by 2030, and an action plan in 2021 to create a Circular Economy (CE) in DK that can support the achievement of climate neutrality by 2050. About 20% of the Danish housing stock is affordable housing with approx. 560.000 affordable housing homes, inhabited by nearly 1 million out of 5.8 million people. In 2020 the Danish Government decided on the most significant overall housing agreement to set aside EUR 5,5 billion for ‘Green renovations’ and the building of new affordable housing. Building and renovating affordable housing in Denmark can thus become significant drivers for the Danish building industry’s transition to CE. Therefore, developing integrated tools and methodologies for life cycle thinking and CE assessment for the built environment is necessary. We have identified four significant gaps in this endeavour in a previously released literature review: For CE to succeed, it is necessary to take a circular view of the life cycle of buildings, which includes the service life phase, the reuse phase and the recycle phase; To achieve CE, it is necessary to continue research regarding the possibilities of integrating Life Cycle Assessment (LCA), Life Cycle Cost (LCC) and Social Life Cycle Assessment (S-LCA) into Life Cycle Sustainability Assessment (LCSA); S-LCA needs further maturation and development; It is imperative to focus upon operationalising LCSA for practitioners in all phases of a building’s life cycle. This paper aims to outline a strategy for analysing and discussing these four gaps and their interrelation in-depth and suggest an action research proposal to understand better how to bridge the gaps from a research perspective.

A randomized trial involving patients with acute coronary syndromes showed that prasugrel was superior to ticagrelor with regard to the incidence of death, myocardial infarction, or stroke within 1 year, with no increased risk of bleeding.

We present new near-infrared (IR) spectra (0.80–1.35 μm) of the pre-Main Sequence source PV Cep taken during a monitoring program of eruptive variables we are conducting since some years. Simultaneous photometric and spectroscopic observations are systematically carried out during outburst and quiescence periods. By correlating extinction-free parameters, such as HI recombination lines and underlying continuum, it is possible to infer on the mechanism(s) responsible for their origin. Accretion and mass loss processes have a dominant role in determining the PV Cep irregular variability of both continuum and line emission. The potentialities of the observational modality are also discussed.

We present the collection of all the mid- and far-IR observations ( λ =3–170 μm) of the young eruptive variable PV Cep available so far in the literature. These data allow us to confirm that flux variability is a prominent feature at mid-IR wavelength ( λ =3–25 μm). Color-magnitude plots clearly indicate that the observed variability is not extinction-driven, but mainly influenced by fluctuations of the mass accretion rate. We interpret such variability as due to a hot spot created onto the stellar surface by the column of accreting matter, which heats the inner parts of the disk and determines the observed increase of the near- mid-IR luminosity. A quantitative characterization is given for both the spot itself and the additional thermal component created by it. Far-IR data ( λ =60–170 μm) are consistent with the presence of a temperature stratification in a massive and quite un-evolved circumstellar disk.

ObjectiveTo evaluate changes in residual platelet reactivity (RPR) over time, and bleeding and ischaemic events rate using 5 vs 10 mg maintenance dose (MD) regimens of prasugrel 1 month after acute coronary syndrome (ACS).BackgroundThe optimal level of RPR with prasugrel may change over time after an ACS.MethodsAfter 60 mg loading dose of prasugrel (T0) followed by 10 mg/day for 1 month, patients were randomised to receive prasugrel 10 mg/day (n=95, group A) or 5 mg/day MD (n=98, group B) up to 1 year. RPR was assessed at T0, 37 (T1) and 180 days (T2). The primary end point was Bleeding Academic Research Consortium (BARC) bleeding events ≥2 between 1 and 12 months, and the secondary composite end point was cardiac death, myocardial infarction, stroke and definite/probable stent thrombosis.ResultsFrom T0 to T1, RPR significantly increased in both groups A and B and the increase was higher for group B (δ ADP 10 µmol: 13.8%±14.7% vs 23.5%±19.2%, p=0.001). At T2 a lower rate of high RPR patients were found in group A (2.6% vs13.3%; p=0.014). The BARC type ≥2 bleeding occurred in 12.6% of group A versus 4.1% of group B (OR 0.29, 95% CI 0.09 to 0.94) and secondary end point in 2.1% vs 1.0% (p=0.542), respectively, without stent thrombosis.ConclusionsRPR increases shifting from 60 mg loading dose to 10 mg/day prasugrel MD with a further increase of RPR reducing prasugrel MD to 5 mg 1 month after ACS. Clinical value of these pharmacodynamic findings should be proved in larger clinical trials.Trial registration numberNCT01790854.

Age is a strong predictor of cardiogenic shock (CS) and death in patients with acute myocardial infarction (AMI). Few data on the impact of a routine early percutaneous revascularization strategy in elderly patients with CS complicating AMI exist. We performed an analysis of age-related differences in outcome in 280 consecutive patients with AMI complicated by CS who underwent primary percutaneous coronary intervention (PCI) between January 1995 and September 2004 and who were included in a single-center prospective registry of primary PCI for AMI. Of the 280 patients with CS, 104 (37%) were ≥75 years. The mean age of the elderly group was 81 ± 5 years, and half of the patients were ≥80 years. Most patients in both groups underwent PCI within 6 hours of their symptom onset. The PCI success rates were 92% in the elderly group and 97% in the younger patient group ( P = .062). The 6-month mortality rates were 56% in the elderly group and 26% in the younger patient group ( P < .001). At multivariate analysis, the variables independently related to the risk of 1-year mortality in the elderly group were age (hazard ratio 1.07, 95% CI 1.02-1.12, P = .005) and PCI failure (hazard ratio 4.01, 95% CI 1.53-10.51, P = .005). A strategy of routine emergency PCI in elderly patients with CS complicating AMI is highly feasible. Among elderly patients, age remains to be a strong predictor of mortality. However, outcome after successful PCI is better than previously reported.

We examined 55 consecutive patients successfully treated with primary percutaneous coronary intervention (PCI) for a first acute myocardial infarction with left ventricular (LV) systolic dysfunction. In all patients we performed echocardiographic examination, dosage of plasma brain natriuretic peptide, serum carboxy-terminal propeptide and telopeptide of procollagen type I and amino-terminal propeptide of procollagen type III at days 1 and 3, and at 1 and 6 months after index infarction. The hypertensive patients (group 1; n =30) differed for higher baseline blood pressure (133±4 mm Hg vs 118±4 mm Hg; P =0.03), greater LV mass index (108±5 vs 94±4 g m −2 , P =0.03) and lower mitral E/A wave peak (0.8±0.06 vs 1.1±0.12, P =0.02) with respect to non-hypertensive patients (group 2; n =25). From day 1 to month 6 carboxy-terminal propeptide of procollagen type I and amino-terminal propeptide of procollagen type III increased ( P <0.005 and P <0.05, respectively) in both groups, whereas carboxy-terminal telopeptide of procollagen type I increased from day 1 to day 3 ( P <0.01 in both groups, respectively) and then decreased from day 3 to month 6 ( P <0.01 and P <0.05 in both groups, respectively). From day 1, brain natriuretic peptide decreased in both groups ( P <0.005). There was no significant difference between the two groups in values of procollagens and natriuretic peptide. Finally, LV diastolic volume and function at 6 months were similar in the two groups. Thus, in patients with reperfused acute myocardial infarction and LV dysfunction, antecedent hypertension was not associated with a different pattern of serum procollagen release and ventricular remodelling at 6 months of follow-up.

Ambient Particulate Matter (PM) has been shown to be associated with cardiopulmonary diseases and lung cancer. Several groups of investigators have shown that the size of the airborne particles and their surface area determine the potential to elicit inflammatory injury and other mechanisms of adverse cellular effects. Because traffic is an important source of PM, it seems obvious that physicochemical characterization of vehicles exhaust emission has an important impact on both quantitative and qualitative aspects of ambient PM. In the present study the exhaust emissions of 8 vehicles of different categories were analyzed to attempt to differentiate them. For such purpose the particulate was collected on SPME fibers exposed to the exhaust emission for 150 s. The particulate was first characterized by micro-Raman spectroscopy and then subjected to Fast Gas Chromatography-Mass Spectrometry analyses for the chemical identification of the Polycyclic Aromatic Hydrocarbons (PAHs) compounds, the organic fraction of particulate matter in air pollution with a major role in the toxicity, notably via its effects on inflammation. Both the particle count and the PAHs compositional data were assembled to be interpreted by Principal Components Analysis. This multivariate analysis grouped the data according mainly to the naphthalene amount, as well as the volume concentration of the particles smaller than 0.5 μm, suggesting that the different exhaust emissions could be easily differentiated. With this new methodology, future research should aim at establishing a mechanism of formation during internal engine combustion processes in order to obtain a clearer picture of the inflammatory and carcinogenic mechanisms of PM in the lungs.

We present high-contrast imaging observations of seven protoplanetary disks at 4um using the ERIS on the VLT. This study focuses on detecting scattered light from micron-sized dust particles and assessing the potential of the vAPP coronagraph for disk and planet characterization. Observations were performed in pupil-stabilized mode with the vAPP coronagraph. Data were reduced using reference differential imaging and angular differential imaging techniques, incorporating principal component analysis for point-source detection. Contrast curves and detection limits were computed for planetary companions and disk features. The infrared disk signal was resolved in all systems, with first-time 4um detections around AS 209 and Elias 2-24, revealing mostly axisymmetric structures extending up to 60au. Two gaps were detected in the radial profiles of TW Hya (22au, 35au) and AS 209 (50au, 100au). For Elias 2-24, scattered light emission matched ALMA observations of inner disk structures, marking their first mid-infrared detection. In the case of HD 100546, the vAPP uncovered flared disk structures and faint spiral arms consistent with previous observations. HD 163296 shows a bright inner dust ring, confirming disk asymmetries and features, but we did not detect any planet candidate within the achieved contrast limits. The disk around PDS 70 exhibits clear features, with faint structures detected within the cavity. The observations achieved contrasts enabling the detection of planets down to 800 K, but no companions were detected, implying either low-mass planets, cooler formation scenarios, or a large dust extinction of Av>20 mag. The vAPP performed robustly for imaging structures in protoplanetary disks at 4um, providing critical insights into disk morphology and constraints on planet formation processes. No planetary-mass companions with temperatures >1000K are present in our sample.

The aim of this study was to evaluate whether assessment of ST-segment changes in the 12-lead electrocardiogram from admission to 30 minutes after successful direct coronary angioplasty can predict myocardial damage and functional outcome in patients with acute myocardial infarction (AMI). Of 158 consecutive patients, 117 (92 men, aged 61 ± 11 years) were prospectively classified into 2 groups: group 1, <50% reduction in ST-segment elevation in a single selected lead (42 patients); group 2, ≥50% reduction in ST-segment elevation (75 patients). Baseline characteristics were similar except for anterior wall AMI and Killip class >2, which were more prevalent in group 1. Peak creatine kinase was significantly higher in group 1 (3,690 ± 2,809 vs 2,592 ± 1,960 U/L; p = 0.018). One-month echocardiograms were obtained in 102 patients (87%). Infarct zone wall motion score index decreased in both groups, but this reduction was higher in group 2 (p <0.001). Functional recovery (>0.22 decrease in infarct zone wall motion score index) was observed in 34% of group 1 and in 78% of group 2 patients (p <0.001). One-month left ventricular ejection fraction was higher in group 2 (p <0.001). At multivariate analysis, reduction of ST-segment elevation was the only independent predictor of functional recovery (p <0.001). In conclusion, ST-segment analysis provides rapid and inexpensive information allowing identification of patients who are likely to benefit the most from myocardial reperfusion as early as 30 minutes after the last balloon inflation.