Effects of strain and genotype on maternal care behavior.

<p>Behavioral strain differences between C57BL/6N and Balb/c mothers with a glucocorticoid receptor wildtype (GR +/+) or a heterozygous deletion (GR +/−) are exemplarily presented for four different behavioral measures: (A) ‘licking/grooming’, (B) ‘passive nursing’, (C) ‘self-grooming out of nest’ and (D) ‘climbing/digging’. While strains were found to differ significantly in all four measures, GR genotype did not affect the behavior. Moreover, a significant strain-by-genotype-interaction was found with respect to ‘licking/grooming’. While C57BL/6N +/+ dams spent more time ‘licking/grooming’ than Balb/c mothers of both GR genotypes, no difference was found between C57BL/6N +/− mothers and Balb/c dams. Data are presented as untransformed means ± standard error of the mean, * p<0.05, ** p<0.01.</p

Ethogram used for the assessment of maternal care behavior in C57BL/6N and Balb/c dams.

<p>Behavioral measures are categorized according to their presumed function in ‘self-maintenance’, ‘caring’ and ‘neglecting behavior’.</p

Summary of all data generated by behavioral observations and the pup retrieval test.

<p>Data analysis was done using GLMs on the basis of 26 dams belonging to four different treatment groups: Balb/c wildtypes (+/+; n = 7), Balb/c with a heterozygous mutation of the GR (+/−; n = 6 for behavioral observations, n = 5 for the pup retrieval test) C57BL/6N wildtypes (+/+; n = 6), C57BL/6N with a heterozygous mutation of the GR (+/−; n = 7). Data are given as untransformed means ± standard error of the mean (s.e.m.). The statistical analysis is summarized with respect to the transformation used (NT = not transformed, sqrt = square root transformation, angular = angular transformation) and the effects of “strain”, “GR genotype” and “strain-by-GR-genotype-interaction” (T = tendency; *p<0.05, **p<0.01).</p

Data_Sheet_1_Establishing an MSU service in a medium-sized German urban area—clinical and economic considerations.docx

Background and purposeMobile stroke units (MSU) have been demonstrated to improve prehospital stroke care in metropolitan and rural regions. Due to geographical, social and structural idiosyncrasies of the German city of Mannheim, concepts of established MSU services are not directly applicable to the Mannheim initiative. The aim of the present analysis was to identify major determinants that need to be considered when initially setting up a local MSU service.MethodsLocal stroke statistics from 2015 to 2021 were analyzed and circadian distribution of strokes and local incidence rates were calculated. MSU patient numbers and total program costs were estimated for varying operating modes, daytime coverage models, staffing configurations which included several resource sharing models with the hospital. Additional case-number simulations for expanded catchment areas were performed.ResultsMedian time of symptom onset of ischemic stroke patients was 1:00 p.m. 54.3% of all stroke patients were admitted during a 10-h time window on weekdays. Assuming that MSU is able to reach 53% of stroke patients, the average expected number of ischemic stroke patients admitted to MSU would be 0.64 in a 10-h shift each day, which could potentially be increased by expanding the MSU catchment area. Total estimated MSU costs amounted to € 815,087 per annum. Teleneurological assessment reduced overall costs by 11.7%.ConclusionThis analysis provides a framework of determinants and considerations to be addressed during the design process of a novel MSU program in order to balance stroke care improvements with the sustainable use of scarce resources.</p