Disparities and Trends in Door-to-Needle Time The FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities)

Background and Purpose: In the United States, about half of acute ischemic stroke patients treated with tPA (tissue-type plasminogen activator) receive treatment within 60 minutes of hospital arrival. We aimed to determine the proportion of patients receiving tPA within 60 minutes (door-to-needle time [DTNT] ≤60) and 45 minutes (DTNT ≤45) of hospital arrival by race/ethnicity and sex and to identify temporal trends in DTNT ≤60 and DTNT ≤45. Methods: Among 65 654 acute ischemic stroke admissions in the National Institute of Neurological Disorders and Stroke-funded FL-PR CReSD study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities) from 2010 to 2015, we included 6181 intravenous tPA-treated cases (9.4%). Generalized estimating equations were used to determine predictors of DTNT ≤60 and DTNT ≤45. Results: DTNT ≤60 was achieved in 42% and DTNT ≤45 in 18% of cases. After adjustment, women less likely received DTNT ≤60 (odds ratio, 0.81; 95% confidence interval, 0.72–0.92) and DTNT ≤45 (odds ratio, 0.73; 95% confidence interval, 0.57–0.93). Compared with Whites, Blacks less likely had DTNT ≤45 during off hours (odds ratio, 0.68; 95% confidence interval, 0.47–0.98). Achievement of DTNT ≤60 and DTNT ≤45 was highest in South Florida (50%, 23%) and lowest in West Central Florida (28%, 11%). Conclusions: In the FL-PR CReSD, achievement of DTNT ≤60 and DTNT ≤45 remains low. Compared with Whites, Blacks less likely receive tPA treatment within 45 minutes during off hours. Treatment within 60 and 45 minutes is lower in women compared with men and lowest in West Central Florida compared with other Florida regions and Puerto Rico. Further research is needed to identify reasons for delayed thrombolytic treatment in women and Blacks and factors contributing to regional disparities in DTNT

Disparities and Trends in Door-to-Needle Time The FL-PR CReSD Study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities)

Background and Purpose: In the United States, about half of acute ischemic stroke patients treated with tPA (tissue-type plasminogen activator) receive treatment within 60 minutes of hospital arrival. We aimed to determine the proportion of patients receiving tPA within 60 minutes (door-to-needle time [DTNT] ≤60) and 45 minutes (DTNT ≤45) of hospital arrival by race/ethnicity and sex and to identify temporal trends in DTNT ≤60 and DTNT ≤45. Methods: Among 65 654 acute ischemic stroke admissions in the National Institute of Neurological Disorders and Stroke-funded FL-PR CReSD study (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities) from 2010 to 2015, we included 6181 intravenous tPA-treated cases (9.4%). Generalized estimating equations were used to determine predictors of DTNT ≤60 and DTNT ≤45. Results: DTNT ≤60 was achieved in 42% and DTNT ≤45 in 18% of cases. After adjustment, women less likely received DTNT ≤60 (odds ratio, 0.81; 95% confidence interval, 0.72–0.92) and DTNT ≤45 (odds ratio, 0.73; 95% confidence interval, 0.57–0.93). Compared with Whites, Blacks less likely had DTNT ≤45 during off hours (odds ratio, 0.68; 95% confidence interval, 0.47–0.98). Achievement of DTNT ≤60 and DTNT ≤45 was highest in South Florida (50%, 23%) and lowest in West Central Florida (28%, 11%). Conclusions: In the FL-PR CReSD, achievement of DTNT ≤60 and DTNT ≤45 remains low. Compared with Whites, Blacks less likely receive tPA treatment within 45 minutes during off hours. Treatment within 60 and 45 minutes is lower in women compared with men and lowest in West Central Florida compared with other Florida regions and Puerto Rico. Further research is needed to identify reasons for delayed thrombolytic treatment in women and Blacks and factors contributing to regional disparities in DTNT

Vertebrate fossils and their context : contributions in honor of Richard H. Tedford. Bulletin of the AMNH ; no. 279

vii, 659 p. : ill. (2 col.), maps ; 26 cm.Includes bibliographical references.Foreword / Michael J. Novacek -- 1. Richard H. Tedford : field man, systematist, professor, and mentor / Michael O. Woodburne, Robert M. Hunt, Jr., Gina C. Gould, Eugene S. Gaffney and Lawrence J. Flynn -- 2. Dispersals of Neogene carnivorans between Asia and North America / Qiu Zhanxiang -- 3. Pinnipedimorph evolutionary biogeography / Thomas A. Deméré, Annalisa Berta and Peter J. Adam -- 4. Intercontinental migration of large mammalian carnivores : earliest occurrence of the Old World beardog Amphicyon (Carnivora, Amphicyonidae) in North America / Robert M. Hunt, Jr. -- 5. Notes on early Oligocene ursids (Carnivora, Mammalia) from Saint Jacques, Nei Mongol, China / Wang Banyue and Qiu Zhanxiang -- 6. New procyonines from the Hemingfordian and Barstovian of the Gulf Coast and Nevada, including the first fossil record of the Potosini / Jon A. Baskin -- 7. Pack hunting in Miocene borophagine dogs : evidence from craniodental morphology and body size / Blaire Van Valkenburgh, Tyson Sacco, and Xiaoming Wang -- 8. New material of Osbornodon from the early Hemingfordian of Nebraska and Florida / Xiaoming Wang -- 9. Carnivora (Mammalia, Felidae, Canidae, and Mustelidae) from the earliest Hemphillian screw bean local fauna, Big Bend National Park, Brewster County, Texas / Margaret Skeels Stevens and James Bowie Stevens -- 10. Chronostratigraphy, biochronology, datum events, land mammal ages, stage of evolution, and appearance event ordination / Everett Lindsay -- 11. New late Uintan to early Hemingfordian land mammal assemblages from the undifferentiated Sespe and Vaqueros formations, Orange County, and from the Sespe and equivalent marine formations in Los Angeles, Santa Barbara, and Ventura counties, southern California / David P. Whistler and E. Bruce Lander -- 12. Mammalian biochronology of Blancan and Irvingtonian (Pliocene and early Pleistocene) faunas from New Mexico / Gary S. Morgan and Spencer G. Lucas -- 13. Mexico's Middle Miocene mammalian assemblages : an overview / Ismael Ferrusquía-Villafranca -- 14. New evidence of Miocene Protoceratidae including a new species from Chiapas, Mexico / S. David Webb, Brian Lee Beatty and George Poinar, Jr. -- 15. New oreodont (Mammalia, Artiodactyla) from the late Oligocene (early Arikareean) of Florida / Bruce J. MacFadden and Gary S. Morgan -- 16. Craniodental analysis of Merychippus insignis and Cormohipparion goorisi (Mammalia, Equidae), Barstovian, North America / Michael O. Woodburne -- 17. Mimomys in North America / Charles A. Repenning -- 18. Dasyurids, perameloids, phalangeroids, and vombatoids from the early Pliocene Hamilton fauna, Victoria, Australia / William D. Turnbull, Ernest L. Lundelius, Jr. and Michael Archer -- 19. A new species of Muramura Pledge (Wynyardiidae: Marsupialia) from the Middle Tertiary of the Callabonna Basin, northeastern South Australia / Neville S. Pledge -- 20. The strange case of the wandering fossil / Thomas H. Rich, Thomas A. Darragh and Patricia Vickers-Rich -- 21. Oligocene/Miocene beds and faunas from Tieersihabahe in the northern Junggar Basin of Xinjiang / Ye Jie, Meng Jin and Wu Wenyu -- 22. Rodents from the Chinese Neogene : biogeographic relationships with Europe and North America / Qiu Zhuding and Li Chuankuei -- 23. Tedford's gerbils from Afghanistan / Lawrence J. Flynn, Alisa J. Winkler, Louis L. Jacobs and Will Downs, III -- 24. Another molar of the Miocene hominid Griphopithecus suessi from the type locality at Sandberg, Slovakia / Peter Holec and Robert J. Emry -- 25. Mimotricentes tedfordi, a new arctocyonid from the late Paleocene of California / Malcolm C. McKenna and Donald L. Lofgren -- 26. Phosphatochelys, a new side-necked turtle (Pelomedusoides: Bothremydidae) from the Paleocene of Morocco / Eugene S. Gaffney and Haiyan Tong