25 research outputs found
Reductive opening of acyclic conjugated cyclopropyl ketones with lithium in liquid ammonia
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A Joint Review of "A History of Pi, by Petr Beckmann", St. Martins's Press, 1976, Barnes and Noble Books, 1989; "The Joy of Pi, by David Blatner", Walker & Co., 1997; "The Nothing That Is, by Robert Kaplan", Oxford University Press, 1999; "e: The Story of a Number, by Eli Maor", Princeton University Press, 1998; "An Imaginary Tale, by Paul Nahin", Princeton University Press, 1998; "Zero: The Biography of a Dangerous Idea, by Charles Seife", Viking Press, 2000.
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Organization of a U.S. County System for Comprehensive Acute Stroke Care
No full textBACKGROUND AND PURPOSE
Organized systems of care have the potential to improve acute stroke care delivery. The current report describes the experience of implementing a countywide system of spoke-and-hub Stroke Neurology Receiving Centers (SNRC) that incorporated several comprehensive stroke center recommendations.
METHODS
Observational study of patients with suspected stroke <5 hours duration transported by Emergency Medical System personnel to an SNRC during the first year of this system.
RESULTS
A total of 1,360 patients with suspected stroke were evaluated at 9 hub SNRCs, of which 553 (40.7%) had a discharge diagnosis of ischemic stroke. Of these 553, intravenous (IV) tPA was given to 110 patients (19.9% of ischemic strokes). Care at the 6 neurointerventional-ready SNRC was a major focus, where 25.1% (99/395) of the patients with ischemic stroke received acute IV or intraarterial reperfusion therapy, and where provision of such therapies was less common with milder stroke, higher age, and Hispanic origin. The door-to-needle time for IV tPA met the <60 minute target in only 25% of patients and was 37% longer (p=0.0001) when SNRCs were neurointerventional-ready.
CONCLUSIONS
A stroke system that incorporates features of comprehensive stroke centers can be effectively implemented, and with substantial rates of acute reperfusion therapy administration. Experiences potentially useful to broader implementation of comprehensive stroke centers are considered
Organization of a U.S. County System for Comprehensive Acute Stroke Care
No full textBACKGROUND AND PURPOSE
Organized systems of care have the potential to improve acute stroke care delivery. The current report describes the experience of implementing a countywide system of spoke-and-hub Stroke Neurology Receiving Centers (SNRC) that incorporated several comprehensive stroke center recommendations.
METHODS
Observational study of patients with suspected stroke <5 hours duration transported by Emergency Medical System personnel to an SNRC during the first year of this system.
RESULTS
A total of 1,360 patients with suspected stroke were evaluated at 9 hub SNRCs, of which 553 (40.7%) had a discharge diagnosis of ischemic stroke. Of these 553, intravenous (IV) tPA was given to 110 patients (19.9% of ischemic strokes). Care at the 6 neurointerventional-ready SNRC was a major focus, where 25.1% (99/395) of the patients with ischemic stroke received acute IV or intraarterial reperfusion therapy, and where provision of such therapies was less common with milder stroke, higher age, and Hispanic origin. The door-to-needle time for IV tPA met the <60 minute target in only 25% of patients and was 37% longer (p=0.0001) when SNRCs were neurointerventional-ready.
CONCLUSIONS
A stroke system that incorporates features of comprehensive stroke centers can be effectively implemented, and with substantial rates of acute reperfusion therapy administration. Experiences potentially useful to broader implementation of comprehensive stroke centers are considered
Kinetics of deprotonation of triphenyl(2-substituted-9-fluorenyl)phosphonium ions in 50% dimethyl sulfoxide-50% water. Intrinsic rate constants, imbalances and evidence for changes in transition state structure
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