Diffusion and upscaling of municipal climate mitigation and adaptation strategies in Germany.

Unlabelled: Drawing on data for the 104 largest German cities, and deeper analysis of six mid-sized cities (including forerunners, followers and latecomers in climate mitigation and adaptation), we find that the spread of local mitigation and adaptation strategies across Germany can be explained by a combination of horizontal diffusion and vertical upscaling. Specifically, while the spread of climate mitigation initiatives in the 1990s was triggered primarily by transnational municipal networks (horizontal diffusion), the development and revision of climate mitigation strategies and the emergence of climate adaptation strategies during the last decade have been driven mainly by national and subnational funding programmes (vertical upscaling). Notably, forerunner cities are less dependent on external funding than followers and latecomers, because they have more internal capacity to act.

Assessment of Irreversible Tissue Injury in Extensive Ischemic Stroke-Potential of Quantitative Cerebral Perfusion.

Computed tomography perfusion (CTP) is used as a tool to select ischemic stroke patients for endovascular treatment (EVT) and is currently investigated in the setting of extensive stroke with low Alberta Stroke Program Early CT scores (ASPECTS). The purpose of this study was to perform a comprehensive quantitative analysis of cerebral blood flow within the ischemic lesion compared to threshold-derived core lesion volumes. We hypothesized that the degree of cerebral blood volume (CBV) reduction within the ischemic lesion is predictive of irreversible tissue injury and functional outcome in patients with low ASPECTS.

New imaging score for outcome prediction in basilar artery occlusion stroke.

Objective: In ischemic posterior circulation stroke, the utilization of standardized image scores is not established in daily clinical practice. We aimed to test a novel imaging score that combines the collateral status with the rating of the posterior circulation Acute Stroke Prognosis Early CT score (pcASPECTS). We hypothesized that this score (pcASCO) predicts functional outcome and malignant cerebellar edema (MCE).

Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization.

Intravenous thrombolytic therapy with alteplase (IVT) is a standard of care in ischemic stroke, while recent trials investigating direct endovascular thrombectomy (EVT) approaches showed conflicting results. Yet, the effect of IVT on secondary injury volumes in patients with complete recanalization has not been analyzed. We hypothesized that IVT is associated with worse functional outcome and aggravated secondary injury volumes when administered to patients who subsequently attained complete reperfusion after EVT.