DE leads to a prolongation of the dTT in linear correlation with DE plasma concentrations (Hemoclot™ assay).

<p>A) dTT was measured with the Hemoclot™ assay in anticoagulation-naïve mice (n = 4), mice receiving 3×37.5 mg/kg over a 24 h feeding period (n = 3) and mice receiving 3×75 mg/kg (n = 3). Statistical significance was assessed with one-way ANOVA and Bonferroni correction. B) Calibration of the coagulometer with lyophilized standard DE plasma gives the DE concentration from the dTT values. Statistical significance was assessed with one-way ANOVA and Bonferroni correction. ** p<0.01; *** p<0.001.</p

Timeline diagram of the experimental procedures.

<p>Timeline diagram of the experimental procedures.</p

No difference in HT and neurological outcome under continuous anticoagulation 72 h after 1 h tMCAO.

<p>A) After 72 h of continuous anticoagulation after 1 h tMCAO, HT blood volume in DE 75 mg/kg pretreated mice (n = 6) and in control mice (n = 7) showed no significant difference. Haemoglobin assay was used for HT blood volume measurement. Results are given in µl presented in a box and whiskers plot depicting mean values, extreme values and the 25 to 75 percent interquartile range. B) Neurological function was evaluated on a 14 point scale (mNSS) after 72 h. Mice which died during the observation period were given 14 points as the worst outcome on the mNSS scale. The values of single mice and the medians are depicted in a dot plot. C) The number of surviving mice per group is given besides their mean body weight in gram.</p

Inclusion – exclusion criteria for MCAO experiments.

<p>Inclusion – exclusion criteria for MCAO experiments.</p

DE pretreatment does not lead to symptomatic hemorrhagic transformation after tMCAO.

<p>A) Neurological function after 1 h and 3 h tMCAO was assessed on a 14 point scale (mNSS) directly prior to reperfusion and at B) 24 h. The values of single mice and the medians are depicted in a dot plot. Statistical significance was assessed with a Mann-Whitney Test for two groups and a Kruskal-Wallis-Test with Dunn’s correction for three or more. * p<0.05.</p

Mice pretreated with DE did not show a greater risk of HT after tMCAO than control mice.

<p>The left two bars show HT volume after 1 h MCAO in control mice (n = 5) and DE-pre-treated mice 37,5 mg/kg (n = 6). Shown on the right is the HT volume after 3 h MCAO in control mice (n = 6), DE-pre-treated mice 37,5 mg/kg (n = 5) and DE-pre-treated mice 75 mg/kg (n = 5). Haemoglobin assay was used for HT blood volume measurement and results are given in µl. Results are showed in a box and whiskers plot depicting mean values, extreme values and the 25 to 75 percent interquartile range. Statistical significance was assessed with a one-way ANOVA with Bonferroni correction. No significant differences were detected.</p

Exemplary team-based acute stroke care algorithm.

<p>The algorithm needs to be adapted to the infrastructure and staff availiability of each individual hospital. The algorithm relies on a seamless cooperation with preclinical emergency medical services and encourages working in parallel with defined tasks for each stroke team member. The stroke alert is a speed dial collective call that summons all team members simultaneously to their respective workplaces.</p

Effects of the stroke team intervention on network-wide door-to-needle times.

<p>(A) Door-to-needle times of seven stroke units of the neurovascular network before and after the composite stroke team intervention. Data are given as median, 25 to 75% interquartile range (box) and extremes (whiskers). Statistical significance was assessed with a Mann-Whitney-U test, *** p < 0.001. (B) Individual median door-to-needle times in minutes of the seven stroke units before and after the stroke team intervention. Empty circles: University Hospital Frankfurt.</p

Exemplary team-based acute stroke care algorithm.

<p>The algorithm needs to be adapted to the infrastructure and staff availiability of each individual hospital. The algorithm relies on a seamless cooperation with preclinical emergency medical services and encourages working in parallel with defined tasks for each stroke team member. The stroke alert is a speed dial collective call that summons all team members simultaneously to their respective workplaces.</p

Study design and timeline of the INVN stroke team Rhein-Main quality campaign.

<p>Study design and timeline of the INVN stroke team Rhein-Main quality campaign.</p