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  • 11
    Online Resource
    Online Resource
    Caracterización tectono-estructural y sectores favorables para hidrocarburos de las cuencas occidentales del sur de Cuba a partir de métodos no sísmicos de exploración
    Universidad Industrial de Santander ; 2023
    In:  Boletín de Geología Vol. 45, No. 2 ( 2023-06-15)
    Details
    In: Boletín de Geología, Universidad Industrial de Santander, Vol. 45, No. 2 ( 2023-06-15)
    Abstract: Las cuencas sedimentarias constituyen un objetivo tradicional de la exploración de petróleo y gas en todos los territorios. La cartografía de sus espesores sedimentarios es un elemento esencial por considerar, pero no siempre se dispone de esta información por la limitación en el volumen y calidad de los trabajos sísmicos y de perforación realizados. Las cuencas sedimentarias al sur del archipiélago cubano tienen un basamento magnético integrado por secuencias de rocas volcánicas con ofiolitas. La cartografía de los espesores sedimentarios y la composición del basamento pueden establecerse a partir del procesamiento e interpretación de los datos de campos potenciales. Se utilizó un enfoque integrado que consideró la determinación de la profundidad al basamento magnético y el modelado físico-geológico 2D de campos potenciales. Se utilizaron complementariamente, métodos morfométricos a partir del Modelo de Elevación Digital 90 × 90 m. El objetivo principal de la investigación fue caracterizar desde el punto de vista tectono-estructural las cuencas occidentales del sur de Cuba y el objetivo específico fue establecer los sectores favorables para hidrocarburos, básicamente, a partir de la espectrometría aérea con rayos gammas en sectores terrestres. El campo de las profundidades al basamento magnético (datos magnéticos y de pozos) se aproximó a los límites conocidos de las cuencas. El modelado físico-geológico 2D de campos potenciales por el perfil de estudio confirmó el modelo geológico de partida. Las localidades más promisorias para hidrocarburos correspondieron al pozo Taco Taco n.o1 (Cuenca Los Palacios) y los pozos someros La Paila y El Sulfuroso y los pozos Madruga (Cuenca Vegas).
    Type of Medium: Online Resource
    ISSN: 0120-0283 , 2145-8553
    Uniform Title: Tectono-structural characterization and favorable sectors for hydrocarbons in the western basins of southern Cuba from non-seismic exploration methods
    URL: Journal
    URL: Article
    DOI: 10.18273/revbol
    DOI: 10.18273/revbol.v45n2-2023007
    Language: Unknown
    Publisher: Universidad Industrial de Santander
    Publication Date: 2023
    detail.hit.zdb_id: 2682008-0
    SSG: 7,36
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  • 12
    Online Resource
    Online Resource
    Propuesta de sectores perspectivos para depósitos de hidrocarburos en la zona de Majaguillar-Martí, Cuba
    Universidad Nacional de Colombia ; 2019
    In:  Boletín de Ciencias de la Tierra , No. 46 ( 2019-07-01), p. 33-41
    Details
    In: Boletín de Ciencias de la Tierra, Universidad Nacional de Colombia, , No. 46 ( 2019-07-01), p. 33-41
    Abstract: El sector Majaguillar-Martí es de interés para incrementar las reservas probadas y probables Cuba, siendo el objetivo principal de este trabajo: proponer sectores perspectivos para depósitos de hidrocarburos en el mismo. Para esto se procesaron los campos potenciales, la aerogammaespectrometría y los datos del relieve, considerando los pozos y las manifestaciones de hidrocarburos presentes, todo sobre la base del modelo geológico correspondiente. Se estudiaron las zonas donde el relieve posee sutiles máximos residuales, los cuales podrían ser la causa de una mineralización carbonática y de sílice secundarias, vinculadas a microfiltraciones de hidrocarburos. Se obtuvo un mapa de anomalías complejas en el que se muestran las coincidencias espaciales correspondientes, fueron señaladas nueve áreas de interés, después de su comparación con la sísmica. Esta interpretación se validó, parcialmente, a partir de perfiles de reconocimiento del Complejo Redox realizado en dos de las áreas propuestas, cuyos resultados son mostrados en este trabajo.
    Type of Medium: Online Resource
    ISSN: 2357-3740 , 0120-3630
    URL: Article
    DOI: 10.15446/rbct.n46.78701
    Language: Unknown
    Publisher: Universidad Nacional de Colombia
    Publication Date: 2019
    detail.hit.zdb_id: 2600079-9
    SSG: 7,36
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  • 13
    Online Resource
    Online Resource
    Neuropathologic Findings in Elderly HIV-Positive Individuals
    Oxford University Press (OUP) ; 2022
    In:  Journal of Neuropathology & Experimental Neurology Vol. 81, No. 7 ( 2022-06-03), p. 565-576
    Details
    In: Journal of Neuropathology & Experimental Neurology, Oxford University Press (OUP), Vol. 81, No. 7 ( 2022-06-03), p. 565-576
    Type of Medium: Online Resource
    ISSN: 0022-3069 , 1554-6578
    URL: Article
    DOI: 10.1093/jnen/nlac040
    RVK:
    XA 55250
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2033048-0
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  • 14
    Online Resource
    Online Resource
    Predictors of clinically significant quality of life impairment in Parkinson’s disease
    Springer Science and Business Media LLC ; 2021
    In:  npj Parkinson's Disease Vol. 7, No. 1 ( 2021-12-16)
    Details
    In: npj Parkinson's Disease, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2021-12-16)
    Abstract: Quality of life (QOL) plays an important role in independent living in Parkinson’s disease (PD) patients, being crucial to know what factors impact QoL throughout the course of the disease. Here we identified predictors of QoL impairment in PD patients from a Spanish cohort. PD patients recruited from 35 centers of Spain from the COPPADIS cohort from January 2016, to November 2017, were followed up during 2 years. Health-related QoL (HRQoL) and global QoL (GQoL) were assessed with the 39-item Parkinson’s disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8), respectively, at baseline (V0) and at 24 months ± 1 month (V2). Clinically significant QoL impairment was defined as presenting an increase (PDQ-39SI) or decrement (EUROHIS-QOL8) at V2 ≥ 10% of the score at baseline (V0). A comparison with a control group was conducted for GQoL. GQoL did not change significantly in PD patients ( N  = 507; p  = 0.686) or in the control group ( N  = 119; p  = 0.192). The mean PDQ-39SI was significantly increased in PD patients (62.7 ± 8.5 years old; 58.8% males; N  = 500) by 21.6% (from 16.7 ± 13 to 20.3 ± 16.4; p   〈  0.0001) at V2. Ninety-three patients (18.6%) presented a clinically significant HRQoL impairment at V2. To be younger (OR = 0.896; 95% CI 0.829–0.968; p  = 0.006), to be a female (OR = 4.181; 95% CI 1.422–12.290; p  = 0.009), and to have a greater increase in BDI-II (Beck Depression Inventory-II) (OR = 1.139; 95% CI 1.053–1.231; p  = 0.001) and NMSS (Non-Motor Symptoms Scale) (OR = 1.052; 95% CI 1.027–1.113; p   〈  0.0001) total scores from V0 to V2 were associated with clinically significant HRQoL impairment at the 2-year follow-up (Hosmer–Lemeshow test, p  = 0.665; R 2  = 0.655). An increase in ≥5 and ≥10 points of BDI-II and NMSS total score at V2 multiplied the probability of presenting clinically significant HRQoL impairment by 5 (OR = 5.453; 95% CI 1.663–17.876; p  = 0.005) and 8 (OR = 8.217; 95% CI, 2.975–22.696; p  = 0.002), respectively. In conclusion, age, gender, mood, and non-motor impairment were associated with clinically significant HRQoL impairment after the 2-year follow-up in PD patients.
    Type of Medium: Online Resource
    ISSN: 2373-8057
    URL: Article
    DOI: 10.1038/s41531-021-00256-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2819218-7
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  • 15
    Online Resource
    Online Resource
    Falls Predict Acute Hospitalization in Parkinson’s Disease
    IOS Press ; 2023
    In:  Journal of Parkinson's Disease Vol. 13, No. 1 ( 2023-01-31), p. 105-124
    Details
    In: Journal of Parkinson's Disease, IOS Press, Vol. 13, No. 1 ( 2023-01-31), p. 105-124
    Abstract: Background: There is a need for identifying risk factors for hospitalization in Parkinson’s disease (PD) and also interventions to reduce acute hospital admission. Objective: To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort. Methods: PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit. Results: Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065–5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319–6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757–8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124–4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080–8.322; p = 0.035) was an independent predictor of AH. Conclusion: Falls is an independent predictor of AH in PD patients.
    Type of Medium: Online Resource
    ISSN: 1877-7171 , 1877-718X
    URL: Article
    DOI: 10.3233/JPD-212539
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2023
    detail.hit.zdb_id: 2599550-9
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  • 16
    Online Resource
    Online Resource
    Effect of Direct Transportation to Thrombectomy-Capable Center vs Local Stroke Center on Neurological Outcomes in Patients With Suspected Large-Vessel Occlusion Stroke in Nonurban Areas : The RACECAT Randomized Clinical Trial
    American Medical Association (AMA) ; 2022
    In:  JAMA Vol. 327, No. 18 ( 2022-05-10), p. 1782-
    Details
    In: JAMA, American Medical Association (AMA), Vol. 327, No. 18 ( 2022-05-10), p. 1782-
    Abstract: In nonurban areas with limited access to thrombectomy-capable centers, optimal prehospital transport strategies in patients with suspected large-vessel occlusion stroke are unknown. Objective To determine whether, in nonurban areas, direct transport to a thrombectomy-capable center is beneficial compared with transport to the closest local stroke center. Design, Setting, and Participants Multicenter, population-based, cluster-randomized trial including 1401 patients with suspected acute large-vessel occlusion stroke attended by emergency medical services in areas where the closest local stroke center was not capable of performing thrombectomy in Catalonia, Spain, between March 2017 and June 2020. The date of final follow-up was September 2020. Interventions Transportation to a thrombectomy-capable center (n = 688) or the closest local stroke center (n = 713). Main Outcomes and Measures The primary outcome was disability at 90 days based on the modified Rankin Scale (mRS; scores range from 0 [no symptoms] to 6 [death] ) in the target population of patients with ischemic stroke. There were 11 secondary outcomes, including rate of intravenous tissue plasminogen activator administration and thrombectomy in the target population and 90-day mortality in the safety population of all randomized patients. Results Enrollment was halted for futility following a second interim analysis. The 1401 enrolled patients were included in the safety analysis, of whom 1369 (98%) consented to participate and were included in the as-randomized analysis (56% men; median age, 75 [IQR, 65-83] years; median National Institutes of Health Stroke Scale score, 17 [IQR, 11-21] ); 949 (69%) comprised the target ischemic stroke population included in the primary analysis. For the primary outcome in the target population, median mRS score was 3 (IQR, 2-5) vs 3 (IQR, 2-5) (adjusted common odds ratio [OR], 1.03; 95% CI, 0.82-1.29). Of 11 reported secondary outcomes, 8 showed no significant difference. Compared with patients first transported to local stroke centers, patients directly transported to thrombectomy-capable centers had significantly lower odds of receiving intravenous tissue plasminogen activator (in the target population, 229/482 [47.5%] vs 282/467 [60.4%]; OR, 0.59; 95% CI, 0.45-0.76) and significantly higher odds of receiving thrombectomy (in the target population, 235/482 [48.8%] vs 184/467 [39.4%]; OR, 1.46; 95% CI, 1.13-1.89). Mortality at 90 days in the safety population was not significantly different between groups (188/688 [27.3%] vs 194/713 [27.2%]; adjusted hazard ratio, 0.97; 95% CI, 0.79-1.18). Conclusions and Relevance In nonurban areas in Catalonia, Spain, there was no significant difference in 90-day neurological outcomes between transportation to a local stroke center vs a thrombectomy-capable referral center in patients with suspected large-vessel occlusion stroke. These findings require replication in other settings. Trial Registration ClinicalTrials.gov Identifier: NCT02795962
    Type of Medium: Online Resource
    ISSN: 0098-7484
    URL: Article
    DOI: 10.1001/jama.2022.4404
    RVK:
    XA 10000
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2022
    detail.hit.zdb_id: 2958-0
    detail.hit.zdb_id: 2018410-4
    SSG: 5,21
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  • 17
    Online Resource
    Online Resource
    Percepción y conocimiento popular sobre el cocodrilo 〈em〉Crocodylus acutus〈/em〉 (Reptilia:Crocodylidae) en zonas aledañas al río Tempisque, Guanacaste, Costa Rica
    Universidad Estatal a Distancia ; 2012
    In:  UNED Research Journal Vol. 4, No. 2 ( 2012-12-01), p. 191-202
    Details
    In: UNED Research Journal, Universidad Estatal a Distancia, Vol. 4, No. 2 ( 2012-12-01), p. 191-202
    Abstract:  El cocodrilo americano (Crocodylus acutus) es una especie amenazada por la pérdida de hábitat y la caza ilegal. En el río Tempisque, Costa Rica, sus poblaciones se han recuperado considerablemente pero siguen siendo vulnerables porque su nicho y hábitat se traslapan con las actividades humanas, lo que genera un conflicto humano-cocodrilo (CHC) que se agrava por conocimientos populares erróneos. Este trabajo evalúa la percepción y el conocimiento popular sobre los cocodrilos mediante 336 encuestas en 11 pueblos de los cantones Carrillo, Santa Cruz y Cañas de Guanacaste. Además se analizó la relación entre la percepción de peligrosidad de los cocodrilos según el pueblo de residencia, la edad, el sexo, el grado académico y la ocupación de los encuestados. La población considera que en sus pueblos existen demasiados cocodrilos, que son peligrosos y agresivos. En general conocen poco sobre la biología de C. acutus, pero bastante sobre su comportamiento, estado de conservación y protección estatal. Las personas encuestadas creen necesario regular las poblaciones de cocodrilos, sugieren la eliminacióno el traslado selectivo (las cuales tienen diversas implicaciones) y parecen dispuestos a cooperar en planes de manejo. Se insta a seleccionar pueblos clave para reforzar los programas de educación ambiental con contenidos sobre la biología de la especie, seguridad y prevención de CHC. A futuro, parece necesario establecer un plan de manejo pararegular las poblaciones de cocodrilos en algunos sitios específicos de la cuenca del río Tempisque.ABSTRACTPerception and popular culture about the crocodile (Crocodylus acutus) near Tempisque River, Guanacaste, Costa Rica. The American crocodile (Crocodylus acutus) is an endangered species due to habitat loss and illegal hunting. Its population has recovered significantly in the Tempisque River, Costa Rica; nevertheless, they are still vulnerable because their niche and habitat overlap human activities, which causes a human-crocodile conflict worsened by mistaken popular beliefs. We evaluated popular perception and knowledge with 336 surveys in 11 towns of Carrillo, Santa Cruz and Cañas, in Guanacaste. We also tested the relationships among residence, occupation, sex, age and educational grade and perception of danger. The inhabitants believe there is an excess of crocodiles near their towns, and the reptiles are considered dangerous and aggressive. Overall, they know little about the biology of C. acutus,but much about its behavior, conservation status and state protection. To regulate the crocodile population, they consider elimination or relocation necessary (both have different implications). They seem, however, willing to cooperate in management plans. It is important to choose key towns to strengthen existent environmental education programs with contents about the biology of the species, security, and conflict avoidance. In the near future, we recommend the establishment of a management plan to regulate crocodile population in some specific spots within the Tempisque River’s Basin.
    Type of Medium: Online Resource
    ISSN: 1659-441X , 1659-4266
    URL: Article
    DOI: 10.22458/urj.v4i2.8
    Language: Unknown
    Publisher: Universidad Estatal a Distancia
    Publication Date: 2012
    detail.hit.zdb_id: 2756324-8
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  • 18
    Online Resource
    Online Resource
    VARIANTES ANATÓMICAS DE LA ARTERIA HEPÁTICA COMÚN
    Universidad Nacional de Cordoba ; 2020
    In:  Revista Argentina de Anatomía Clínica Vol. 12, No. 3 ( 2020-11-18), p. 137-143
    Details
    In: Revista Argentina de Anatomía Clínica, Universidad Nacional de Cordoba, Vol. 12, No. 3 ( 2020-11-18), p. 137-143
    Abstract: Introducción: Las variantes de la arteria hepática común han sido estudiadas y descritas desde la antigüedad, con la subsecuente aparición de clasificaciones anatómicas para su correcta identificación. Se ha descrito que hasta un 40% de la población presentan dichas variantes. Metodología: Se realizó una revisión sistemática de la literatura utilizando los descriptores “arteria hepática”, “variación anatómica” y “anatomía” donde se obtuvo un registro de 22203 que habían sido reportados por diferentes investigadores anteriormente y se analizaron en conjunto. Resultados: La variantes anatómicas de la AHC fueron estudiadas y clasificadas por Michels, Lippert y Pabst, y Hiatt. Según la clasificación de Hiatt, 80,46% de los individuos se agrupan dentro del grupo I, 6,46% dentro del grupo II, 6,10% en el grupo III, 1,50% en el grupo IV, 1,32% en el grupo V y 0,02% en el grupo VI. El grupo X de Michels, no contemplado en la clasificación de Hiatt, representó el 0,04% de la muestra. Conclusiones: Se recomienda realizar estudios de imagen preoperatorios cuando se considere apropiado puesto que podría incidir en la disminución de complicaciones quirúrgicas y postquirúrgicas y se debería considerar realizar estudios descriptivos para determinar la incidencia de variantes anatómicas en la población local.   Introduction: Variants of the common hepatic artery have been studied and described since ancient times, with the subsequent appearance of anatomical classifications for their correct identification. It has been reported that up to 40% of the population present these variants. Methodology: A systematic review of the literature was carried out by using the key words “hepatic artery”, “anatomic variation” and “anatomy”, resulting in a registry of 2203 individuals previously reported by various researchers which was analyzed as a whole. Results: Anatomical variants were studied and described by Michels, Lippert & Pabst, and Hiatt. According to the Hiatt classification, 80,46% of individuals were sorted in group I, 6,46% in group II, 6,10% in group III, 1,50% in group IV, 1,32% in group V and 0,02% in group VI. Michels’ group X, not included in Hiatt’s classification, represented 0,04% of the sample. Conclusions: Preoperative imaging studies are recommended when appropriate since it could result in a decrease in surgical and post-surgical complication. Descriptive studies that determine the incidence of anatomical variants in the local population should be considered.
    Type of Medium: Online Resource
    ISSN: 1852-8023
    URL: Issue
    URL: Article
    DOI: 10.31051/1852.8023.v12.n3
    DOI: 10.31051/1852.8023.v12.n3.29604
    Language: Unknown
    Publisher: Universidad Nacional de Cordoba
    Publication Date: 2020
    detail.hit.zdb_id: 2929412-5
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  • 19
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    Online Resource
    Workflows and Outcomes in Patients With Suspected Large Vessel Occlusion Stroke Triaged in Urban and Nonurban Areas
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Stroke Vol. 53, No. 12 ( 2022-12), p. 3728-3740
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. 12 ( 2022-12), p. 3728-3740
    Abstract: We aim to compare the outcome of patients from urban areas, where the referral center is able to perform thrombectomy, with patients from nonurban areas enrolled in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion). Methods: Patients with suspected large vessel occlusion stroke, as evaluated by a Rapid Arterial Occlusion Evaluation score of ≥5, from urban catchment areas of thrombectomy-capable centers during RACECAT trial enrollment period were included in the Stroke Code Registry of Catalonia. Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with an ischemic stroke. Secondary outcomes included mortality at 90 days, rate of thrombolysis and thrombectomy, time from onset to thrombolysis, and thrombectomy initiation. Propensity score matching was used to assemble a cohort of patients with similar characteristics. Results: The analysis included 1369 patients from nonurban areas and 2502 patients from urban areas. We matched 920 patients with an ischemic stroke from urban areas and nonurban areas based on their propensity scores. Patients with ischemic stroke from nonurban areas had higher degrees of disability at 90 days (median [interquartle range] modified Rankin Scale score, 3 [2–5] versus 3 [1–5], common odds ratio, 1.25 [95% CI, 1.06–1.48] ); the observed average effect was only significant in patients with large vessel stroke (common odds ratio, 1.36 [95% CI, 1.08–1.65]). Mortality rate was similar between groups(odds ratio, 1.02 [95% CI, 0.81–1.28] ). Patients from nonurban areas had higher odds of receiving thrombolysis (odds ratio, 1.36 [95% CI, 1.16–1.67]), lower odds of receiving thrombectomy(odds ratio, 0.61 [95% CI, 0.51–0.75] ), and longer time from stroke onset to thrombolysis (mean difference 38 minutes [95% CI, 25–52]) and thrombectomy(mean difference 66 minutes [95% CI, 37–95] ). Conclusions: In Catalonia, Spain, patients with large vessel occlusion stroke triaged in nonurban areas had worse neurological outcomes than patients from urban areas, where the referral center was able to perform thrombectomy. Interventions aimed at improving organizational practices and the development of thrombectomy capabilities in centers located in remote areas should be pursued. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.122.040768
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1467823-8
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  • 20
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    Online Resource
    Association of Time of Day With Outcomes Among Patients Triaged for a Suspected Severe Stroke in Nonurban Catalonia
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Stroke Vol. 54, No. 3 ( 2023-03), p. 770-780
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 54, No. 3 ( 2023-03), p. 770-780
    Abstract: We aim to assess whether time of day modified the treatment effect in the RACECAT trial (Direct Transfer to an Endovascular Center Compared to Transfer to the Closest Stroke Center in Acute Stroke Patients With Suspected Large Vessel Occlusion Trial), a cluster-randomized trial that did not demonstrate the benefit of direct transportation to a thrombectomy-capable center versus nearest local stroke center for patients with a suspected large vessel stroke triaged in nonurban Catalonia between March 2017 and June 2020. Methods: We performed a post hoc analysis of RACECAT to evaluate if the association between initial transport routing and functional outcome differed according to trial enrollment time: daytime (8:00 am –8:59 pm ) and nighttime (9:00 pm –7:59 am ). Primary outcome was disability at 90 days, as assessed by the shift analysis on the modified Rankin Scale score, in patients with ischemic stroke. Subgroup analyses according to stroke subtype were evaluated. Results: We included 949 patients with an ischemic stroke, of whom 258 patients(27%) were enrolled during nighttime. Among patients enrolled during nighttime, direct transport to a thrombectomy-capable center was associated with lower degrees of disability at 90 days (adjusted common odds ratio [acOR] , 1.620 [95% CI, 1.020–2.551]); no significant difference between trial groups was present during daytime (acOR, 0.890 [95% CI, 0.680–1.163] ; P interaction =0.014). Influence of nighttime on the treatment effect was only evident in patients with large vessel occlusion(daytime, acOR 0.766 [95% CI, 0.548–1.072]; nighttime, acOR, 1.785 [95% CI, 1.024–3.112] ; P interaction 〈 0.01); no heterogeneity was observed for other stroke subtypes ( P interaction 〉 0.1 for all comparisons). We observed longer delays in alteplase administration, interhospital transfers, and mechanical thrombectomy initiation during nighttime in patients allocated to local stroke centers. Conclusions: Among patients evaluated during nighttime for a suspected acute severe stroke in non-urban areas of Catalonia, direct transport to a thrombectomy-capable center was associated with lower degrees of disability at 90 days. This association was only evident in patients with confirmed large vessel occlusion on vascular imaging. Time delays in alteplase administration and interhospital transfers might mediate the observed differences in clinical outcome. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02795962.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.122.041013
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1467823-8
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