Public Health Commons^™

A Multitrait Genetic Study Of Hemostatic Factors And Hemorrhagic Transformation After Stroke Treatment, Cristina Gallego-Fabrega, Gerard Temprano-Sagrera, Jara Cárcel-Márquez, Elena Muiño, Natalia Cullell, Miquel Lledós, Laia Llucià-Carol, Jesús M Martin-Campos, Tomás Sobrino, José Castillo, Mònica Millán, Lucía Muñoz-Narbona, Elena López-Cancio, Marc Ribó, Jose Alvarez-Sabin, Jordi Jiménez-Conde, Jaume Roquer, Silvia Tur, Victor Obach, Juan F Arenillas, Tomas Segura, Gemma Serrano-Heras, Joan Marti-Fabregas, Marimar Freijo-Guerrero, Francisco Moniche, Maria Del Mar Castellanos, Alanna C Morrison, Nicholas L Smith, Paul S De Vries, Israel Fernández-Cadenas, Maria Sabater-Lleal

Journal Articles

BACKGROUND: Thrombolytic recombinant tissue plasminogen activator (r-tPA) treatment is the only pharmacologic intervention available in the ischemic stroke acute phase. This treatment is associated with an increased risk of intracerebral hemorrhages, known as hemorrhagic transformations (HTs), which worsen the patient's prognosis.

OBJECTIVES: to investigate the association between genetically determined natural hemostatic factors' levels and increased risk of HT after r-tPA treatment.

METHODS: Using data from genome-wide association studies on the risk of HT after r-tPA treatment and data on 7 hemostatic factors (factor [F]VII, FVIII, von Willebrand factor [VWF], FXI, fibrinogen, plasminogen activator inhibitor-1, and tissue plasminogen activator), we performed …

Mortality And Morbidity Among Individuals With Hypertension Receiving A Diuretic, Ace Inhibitor, Or Calcium Channel Blocker: A Secondary Analysis Of A Randomized Clinical Trial, Jose-Miguel Yamal, Journey Martinez, Mikala C Osani, Xianglin L Du, Lara M Simpson, Barry R Davis

Journal Articles

IMPORTANCE: The long-term relative risk of antihypertensive treatments with regard to mortality and morbidity is not well understood.

OBJECTIVE: to determine the long-term posttrial risk of primary and secondary outcomes among trial participants who were randomized to either a thiazide-type diuretic, calcium channel blocker (CCB), or angiotensin-converting enzyme (ACE) inhibitor with up to 23 years of follow-up.

DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a multicenter randomized, double-blind, active-controlled clinical trial, followed up with participants aged 55 years or older with a diagnosis of hypertension and at …

Automated Large Vessel Occlusion Detection Software And Thrombectomy Treatment Times: A Cluster Randomized Clinical Trial, Juan Carlos Martinez-Gutierrez, Youngran Kim, Sergio Salazar-Marioni, Muhammad Bilal Tariq, Rania Abdelkhaleq, Arash Niktabe, Anjan N Ballekere, Ananya S Iyyangar, Mai Le, Hussain Azeem, Charles C Miller, Jon E Tyson, Sandi Shaw, Peri Smith, Mallory Cowan, Isabel Gonzales, Louise D Mccullough, Andrew D Barreto, Luca Giancardo, Sunil A Sheth

Journal Articles

IMPORTANCE: The benefit of endovascular stroke therapy (EVT) in large vessel occlusion (LVO) ischemic stroke is highly time dependent. Process improvements to accelerate in-hospital workflows are critical.

OBJECTIVE: to determine whether automated computed tomography (CT) angiogram interpretation coupled with secure group messaging can improve in-hospital EVT workflows.

DESIGN, SETTING, AND PARTICIPANTS: This cluster randomized stepped-wedge clinical trial took place from January 1, 2021, through February 27, 2022, at 4 comprehensive stroke centers (CSCs) in the greater Houston, Texas, area. All 443 participants with LVO stroke who presented through the emergency department were treated with EVT at the 4 CSCs. Exclusion …

Women With Large Vessel Occlusion Acute Ischemic Stroke Are Less Likely To Be Routed To Comprehensive Stroke Centers, Muhammad Bilal Tariq, Iman Ali, Sergio Salazar-Marioni, Ananya S Iyyangar, Hussain M Azeem, Swapnil Khose, Victor Lopez, Rania Abdelkhaleq, Louise D Mccullough, Sunil A Sheth, Youngran Kim

Journal Articles

Background Prehospital routing of patients with large vessel occlusion (LVO) acute ischemic stroke (AIS) to centers capable of performing endovascular therapy may improve clinical outcomes. Here, we explore whether distance to comprehensive stroke centers (CSCs), stroke severity, and sex are associated with direct-to-CSC prehospital routing in patients with LVO AIS. Methods and Results In this cross-sectional study, we identified consecutive patients with LVO AIS from a prospectively collected multihospital registry throughout the greater Houston area from January 2019 to June 2020. Primary outcome was prehospital routing to CSC and was compared between men and women using modified Poisson regression including …

Determining The Proportionality Of Ischemic Stroke Risk Factors To Age, Elizabeth Hunter, John D. Kelleher

Articles

While age is an important risk factor, there are some disadvantages to including it in a stroke risk model: age can dominate the risk score and lead to over-or under-predictions in some age groups. There is evidence to suggest that some of these disadvantages are due to the non-proportionality of other risk factors with age, eg, risk factors contribute differently to stroke risk based on an individual’s age. In this paper, we present a framework to test if risk factors are proportional with age. We then apply the framework to a set of risk factors using Framingham heart study data …

Current Topics In Technology-Enabled Stroke Rehabilitation And Reintegration: A Scoping Review And Content Analysis, Katryna Cisek

Articles

Background. There is a worldwide health crisis stemming from the rising incidence of various debilitating chronic diseases, with stroke as a leading contributor. Chronic stroke management encompasses rehabilitation and reintegration, and can require decades of personalized medicine and care. Information technology (IT) tools have the potential to support individuals managing chronic stroke symptoms. Objectives. This scoping review identifies prevalent topics and concepts in research literature on IT technology for stroke rehabilitation and reintegration, utilizing content analysis, based on topic modelling techniques from natural language processing to identify gaps in this literature. Eligibility Criteria. Our methodological search initially identified over 14,000 …

Health Disparities In Rural Kentucky Counties: Mortality Outcomes And The “Rural Penalty”, Aaron R. Tims

Scholarship in Medicine - All Papers

Objective: The object of this paper is to investigate the relationship between rurality and the national top five causes of death in Kentucky counties.

Methods: We used Spearman correlations to quantify the relationship between percent rurality and the crude death rate for heart disease, malignant neoplasia, unintentional injury, chronic lower respiratory disease, and cerebrovascular disease for each Kentucky county. We also used a Spearman correlation to compare and correlate percent rurality and mortality due to heart disease as these two factors changed between data from 2000 and 2010.

Results: Our research demonstrated statistically significant correlations between percent rurality and the …

Blood Pressure Responses Are Dependent On Call Type And Related To Hypertension Status In Firefighters, Paige J Rynne, Cassandra C Derella, Carly Mcmorrow, Rachel L Dickinson, Stephanie Donahue, Andrew A Almeida, Megan Carty, Deborah L Feairheller

College of Population Health Faculty Papers

Background: Impaired cardiovascular health is a concern for firefighters, with over 50% of line-of-duty deaths having cardiac causes. Many firefighters have hypertension and <25% have their blood pressure (BP) controlled. The alarm response could be an unidentified cardiac risk, but interestingly, the BP response to different calls and on-the-job activity is unknown.

Purpose: We aimed to measure the physiological stress resulting from different call types (fire, medical) and job activity (riding apparatus, pre-alert alarms) through ambulatory BP (ABP) monitoring in a population of firefighters.

Materials and methods: During 111 12-h work shifts firefighters wore an ABP monitor. BP was measured at 30-min intervals and manual measurements were prompted when the pager went off or whenever they felt stress.

Results: Firefighters were hypertensive (124.3 ± 9.9/78.1 ± 6.7 mmHg), overweight …

A Review Of Risk Concepts And Models For Predicting The Risk Of Primary Stroke, Elizabeth Hunter, John D. Kelleher

Articles

Predicting an individual's risk of primary stroke is an important tool that can help to lower the burden of stroke for both the individual and society. There are a number of risk models and risk scores in existence but no review or classification designed to help the reader better understand how models differ and the reasoning behind these differences. In this paper we review the existing literature on primary stroke risk prediction models. From our literature review we identify key similarities and differences in the existing models. We find that models can differ in a number of ways, including the …

Barriers To Care For Poststroke Visual Deficits In Alberta, Canada, Kiran Pohar Manhas, Karim F. Damji, Katelyn Brehon, Jennis Jiang, Peter Faris, Fiona Costello

Department of Ophthalmology & Visual Sciences

Poststroke visual impairment (VI) negatively affects rehabilitation potential and quality of life for stroke survivors. In this cross-sectional observational study, stroke survivors and providers were surveyed to quantify perspectives regarding care for poststroke VI in Alberta, Canada (n = 46 survivors; n = 87 providers). Few patients (35%) felt prepared to cope with VI at the time of discharge from acute stroke and inpatient rehabilitation settings. Less than 25% of stroke survivors, and <16% of providers, felt referral processes were adequate. 95.2% of providers and 82% of stroke survivors advocated for a provincial clinical pathway to improve care quality for poststroke VI.

Machine Learning Automated Detection Of Large Vessel Occlusion From Mobile Stroke Unit Computed Tomography Angiography, Alexandra L Czap, Mersedeh Bahr-Hosseini, Noopur Singh, Jose-Miguel Yamal, May Nour, Stephanie Parker, Youngran Kim, Lucas Restrepo, Rania Abdelkhaleq, Sergio Salazar-Marioni, Kenny Phan, Ritvij Bowry, Suja S Rajan, James C Grotta, Jeffrey L Saver, Luca Giancardo, Sunil A Sheth

Journal Articles

BACKGROUND: Prehospital automated large vessel occlusion (LVO) detection in Mobile Stroke Units (MSUs) could accelerate identification and treatment of patients with LVO acute ischemic stroke. Here, we evaluate the performance of a machine learning (ML) model on CT angiograms (CTAs) obtained from 2 MSUs to detect LVO.

METHODS: Patients evaluated on MSUs in Houston and Los Angeles with out-of-hospital CTAs were identified. Anterior circulation LVO was defined as an occlusion of the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or anterior cerebral artery vessels and determined by an expert human reader. A ML model to detect LVO …

Evaluation Of A Community-Based Performance Arts Programme For People Who Have Experienced Stroke In The Uk: Protocol For The Shaper-Stroke Odysseys Study, Carolina Estevao, Maria Baldellou Lopez, Rachel E. Davis, Lucinda Jarret, Tayana Soukup, Ioannis Bakolis, Andy Healey, Jean Harrington, Anthony Woods, Nikki Crane, Fiona Jones, Carmine Pariante, Daisy Fancourt, Nick Sevdalis

Faculty Publications

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. …

Younger Age Of Stroke In Low-Middle Income Countries Is Related To Healthcare Access And Quality, Mohammad H Rahbar, Martin Medrano, Franck Diaz-Garelli, Cosme Gonzalez Villaman, Sepideh Saroukhani, Sori Kim, Amirali Tahanan, Yahaira Franco, Gelanys Castro-Tejada, Sarah A Diaz, Manouchehr Hessabi, Sean I Savitz

Journal Articles

Stroke is the second leading cause of mortality globally with higher burden and younger age in low-middle income countries (LMICs) than high-income countries (HICs). However, it is unclear to what extent differences in healthcare access and quality (HAQ) and prevalence of risk factors between LMICs and HICs contribute to younger age of stroke in LMICs. In this systematic review, we conducted meta-analysis of 67 articles and compared the mean age of stroke between LMICs and HICs, before and after adjusting for HAQ index. We also compared the prevalence of main stroke risk factors between HICs and LMICs. The unadjusted mean …

Antiplatelet Use In Ischemic Stroke, Marharyta Kamarova, Sheharyar Baig, Hamish Patel, Kimberley Monks, Mohammad Wasay, Ali Ali, Jessica Redgrave, Arshad Majid, Simon M. Bell

Section of Neurology

Objective: A literature review of antiplatelet agents for primary and secondary stroke prevention, including mechanism of action, cost, and reasons for lack of benefit.
Data sources: Articles were gathered from MEDLINE, Cochrane Reviews, and PubMed databases (1980-2021). Abstracts from scientific meetings were considered. Search terms included ischemic stroke, aspirin, clopidogrel, dipyridamole, ticagrelor, cilostazol, prasugrel, glycoprotein IIb/IIIa inhibitors.
Study selection and data extraction: English-language original and review articles were evaluated. Guidelines from multiple countries were reviewed. Articles were evaluated independently by 2 authors.
Data synthesis: An abundance of evidence supports aspirin and clopidogrel use for secondary stroke prevention. In the acute …

Utilising A Systematic Review-Based Approach To Create A Database Of Individual Participant Data For Meta- And Network Meta-Analyses: The Release Database Of Aphasia After Stroke, Louise R. Williams, Myzoon Ali, Kathryn Vandenberg, Linda J. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copland, Tamara B. Cranfill, Marie Di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil Hawkins, Katerina Hilari, Jacqueline Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M T Jesus, Maria Kambanaros, Eun K. Kang, Eman M. Khedr, Anthony P H Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann C. Laska, Béatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian Macwhinney, Rebecca S. Marshall, Flavia Mattioli, İlknur Maviş, Marcus Meinzer, Reza Nilipour, Enrique Noé, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel P. Martins, Cathy Price, Tatjana P. Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke Van De Sandt-Koenderman, Ineke Van Der Meulen, Evy Visch-Brink, Linda Worrall, Heather H. Wright, Marian C. Brady, The Release Collaborators

Research outputs 2014 to 2021

Background: Collation of aphasia research data across settings, countries and study designs using big data principles will support analyses across different language modalities, levels of impairment, and therapy interventions in this heterogeneous population. Big data approaches in aphasia research may support vital analyses, which are unachievable within individual trial datasets. However, we lack insight into the requirements for a systematically created database, the feasibility and challenges and potential utility of the type of data collated. Aim: To report the development, preparation and establishment of an internationally agreed aphasia after stroke research database of individual participant data (IPD) to facilitate planned …

Associations Between Vascular Diseases And Alzheimer's Disease Or Related Dementias In A Large Cohort Of Men And Women With Colorectal Cancer, Xianglin L Du, Lulu Song, Paul E Schulz, Hua Xu, Wenyaw Chan

Journal Articles

BACKGROUND: Long term risk of Alzheimer's disease (AD) and related dementias (ADRD) associated with vascular diseases in people with colorectal cancer is unknown.

OBJECTIVE: to determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in a cohort of patients with colorectal cancer.

METHODS: This retrospective cohort study consisted of 210,809 patients diagnosed with colorectal cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database with follow-up from 1991-2016, who were free of any ADRD at the baseline (< 30 days after the date of cancer diagnosis).

RESULTS: The crude 26-year cumulative incidence of total ADRD in …

Risk Of Developing Alzheimer's Disease And Related Dementias In Association With Cardiovascular Disease, Stroke, Hypertension, And Diabetes In A Large Cohort Of Women With Breast Cancer And With Up To 26 Years Of Follow-Up, Xianglin L Du, Lulu Song, Paul E Schulz, Hua Xu, Wenyaw Chan

Journal Articles

BACKGROUND: No study on the long-term incidence of Alzheimer's disease (AD) and related dementias (ADRD) has been reported in women with breast cancer by vascular diseases.

OBJECTIVE: to determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in women with breast cancer.

METHODS: Study identified 246,686 women diagnosed with breast cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Women were free of ADRD at the time of cancer diagnosis and followed from 1991 to 2016.

RESULTS: Cumulative incidence of AD over 26 years of follow-up varied …

Psychosocial Risk Factors And Cardiovascular Disease And Death In A Population-Based Cohort From 21 Low-, Middle-, And High-Income Countries, Ailiana Santosa, Annika Rosengren, Chinthanie Ramasundarahettige, Sumathy Rangarajan, Jephat Chifamba, Scott A. Lear, Paul Poirier, Karen E. Yeates, Rita Yusuf, Romaina Iqbal

Community Health Sciences

Importance: Stress may increase the risk of cardiovascular disease (CVD). Most studies on stress and CVD have been conducted in high-income Western countries, but whether stress is associated with CVD in other settings has been less well studied.
Objective: To investigate the association of a composite measure of psychosocial stress and the development of CVD events and mortality in a large prospective study involving populations from 21 high-, middle-, and low-income countries across 5 continents.
Design, setting, and participants: This population-based cohort study used data from the Prospective Urban Rural Epidemiology study, collected between January 2003 and March 2021. Participants …

Individualized Response To Semantic Versus Phonological Aphasia Therapies In Stroke, Sigfus Kristinsson, Alexandra Basilakos, Jordan Elm, Leigh Ann Spell, Leonardo Bonilha, Chris Rorden, Dirk Den Ouden Ph.D., Christy Cassarly, Souvik Sen, Argye Hillis, Gregory Hickok, Julius Fridriksson Ph.D.

Faculty Publications

Attempts to personalize aphasia treatment to the extent where it is possible to reliably predict individual response to a particular treatment have yielded inconclusive results. The current study aimed to (i) compare the effects of phonologically versus semantically focussed naming treatment and (ii) examine biographical and neuropsychological baseline factors predictive of response to each treatment. One hundred and four individuals with chronic post-stroke aphasia underwent 3 weeks of phonologically focussed treatment and 3 weeks of semantically focussed treatment in an unblinded cross-over design. A linear mixed-effects model was used to compare the effects of treatment type on proportional change in …

Trend Of Research Visualization Of Covid-19 Complications In Pubmed Database Using Scientometric Analysis From 2020 To March 20, 2021, Dr. Abeel Naseer, Dr. Muhammad Shoaib, Mr. Nusrat Ali, Dr. Muhammad Bilal

Library Philosophy and Practice (e-journal)

This study focused to evaluate the published articles on PubMed whose focus was to study the different relations between COVID 19, and different complications caused due to it. The main complications that were used to formulate this study are Deep Venous Thrombosis (DVT), Stroke, Pulmonary Embolism, Disseminated Intravascular Coagulation (DIC), Myocardial Infarction (MI), anosmia, and pneumonia. The data was extracted from the PubMed database on March 20, 2021at 03:20 PM, PST with the period of 2020 to March 20, 2021. We used Biblioshiny, VOSviewer, and MS Excel software to analyze data and found 2375 published documents. The results revealed that …

Mortalidad Por Accidente Cerebrovascular En Guatemala 2018: Patrones E Inequidades, Alejandro Cerón, Gila Goldstein

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por accidente cerebrovascular (ACV) en Guatemala con el propósito de identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir de ACV en Guatemala muestra marcadas desigualdades por departamento, las que son aún más marcadas al comparar por municipio. El riesgo de morir es también más alto en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Deberían implementarse medidas de salud pública orientadas a los municipios y grupos en mayor riesgo de morir de ACV. Este estudio …

Stroke: Identifying Symptoms And Acting Fast To Save Lives And Prevent Permanent Disabilities, Mary E. Helander, Bernard Appiah, Miriam Mutambudzi

Population Health Research Brief Series

Stroke is the 5^th leading cause of death in the United States. Strokes and their long-term effects are preventable. Recognizing the symptoms of stroke and acting quickly can prevent death and minimize long-term disabilities. Family members and bystanders have an important role to play. This issue brief describes stroke symptoms and prevention guidelines, summarizes the information 9-1-1 callers should be prepared to provide when someone is having a stroke, and discusses the importance of acting quickly to save lives and long-term damage.

Effect Of Occupational Therapy Home Visit Discharge Planning On Participation After Stroke: Protocol For The Home Rehab Trial, Natasha A. Lannin, Lindy Clemson, Avril Drummond, Mandy Stanley, Leonid Churilov, Kate Laver, Sophie O'Keefe, Ian Cameron, Maria Crotty, Tim Usherwood, Nadine E. Andrew, Laura Jolliffe, Dominique A. Cadilhac

Research outputs 2014 to 2021

Introduction: After first stroke, the transition from rehabilitation to home can be confronting and fraught with challenges. Although stroke clinical practice guidelines recommend predischarge occupational therapy home visits to ensure safe discharge and provision of appropriate equipment, there is currently limited evidence to support this recommendation. Methods and analysis: The HOME Rehab trial is a national, multicentre, phase III randomised controlled trial with concealed allocation, blinded assessment and intention-to-treat analysis being conducted in Australia. The trial aim is to determine the effect and potential cost-effectiveness of an enhanced occupational therapy discharge planning intervention that involves pre and postdischarge home visits, …

The Development Of Aboriginal Brain Injury Coordinator Positions: A Culturally Secure Rehabilitation Service Initiative As Part Of A Clinical Trial, Elizabeth Armstrong, Kathy Mccoy, Rebecca Clinch, Maureen Merritt, Renee Speedy, Meaghan Mcallister, Kym Heine, Natalie Ciccone, Melanie Robinson, Julie Coffin

Research outputs 2014 to 2021

Brain injury, resulting from stroke and traumatic brain injury, is a common occurrence in Australia, with Aboriginal people affected at a significant rate and impact felt by individuals, families and communities. Access to brain injury rehabilitation services for Aboriginal people is reported to be often limited, with very little support outside the hospital environment. Our research involving Aboriginal brain injury survivors and their families to date has revealed that people often manage ‘on their own’ following such events. Following recommendations from survivors and their families, the Healing Right Way clinical trial, currently underway in Western Australia, has created the role …

Call To Action: Sars-Cov-2 And Cerebrovascular Disorders (Cascade), Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Brown, Bruce Cv Campbell, Salvador Cruz-Flores, Deidre Anne De Silva, Mario Di Napoli, Afshin A. Divani, Randall C. Edgell, Johanna T. Fifi, Abdoreza Ghoreishi, Teruyuki Hirano, Keun Sik Hong, Chung Y. Hsu, Josephine F. Huang, Manabu Inoue, Amanda L. Jagolino, Moira Kapral, Hoo Fan Kee, Zafer Keser, Rakesh Khatri

Epidemiology and Biostatistics Publications

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based …

Test–Retest Reliability And Minimal Detectable Change Of Corticospinal Tract Integrity In Chronic Stroke, Allison F. Lewis, Makenzie Myers, Jenny Heiser, Jessica F. Baird, Jill C. Stewart

Faculty Publications

Diffusion tensor imaging (DTI) can be used to index white matter integrity of the corticospinal tract (CST) after stroke; however, the psychometric properties of DTI‐based measures of white matter integrity are unknown. The purpose of this study was to examine test–retest reliability as determined by intraclass correlation coefficients (ICC) and calculate minimal detectable change (MDC) of DTI‐based measures of CST integrity using three different approaches: a Cerebral Peduncle approach, a Probabilistic Tract approach, and a Tract Template approach. Eighteen participants with chronic stroke underwent DTI on the same magnetic resonance imaging scanner 4 days apart. For the Cerebral Peduncle approach, …

A Comparison Of Models For Evaluation And Transfer Of Patients With Suspected Large Vessel Occlusions, Edward Jauch, Parita Bhuva, Alex Schneider, Jason Thurman, Josh Lewis, Kathryn Mccarthy, Debra Philpot, Robin Jones, Albert Yoo, Don Frei

Neurology

Introduction: Mechanisms for the hospital identification of patients with suspected large vessel occlusions (LVO) vary widely based on referring and receiving stroke center resources. We compared processes for identifying patients with suspected LVO who may be candidates for endovascular therapy (EVT) at non-EVT hospitals and the criteria for interfacility transport to Comprehensive Stroke Centers (CSC) for potential EVT. Methods: Data were obtained from 4 CSC which serve distinct geographic regions, ranging from rural to urban environments, over a continuous 12 month period of time beginning year 2018. Patients transferred from all referring hospitals to these facilities were considered regardless of …

Effect Of 5-Minute Movies Shown Via A Mobile Phone App On Risk Factors And Mortality After Stroke In A Low- To Middle-Income Country: Randomized Controlled Trial For The Stroke Caregiver Dyad Education Intervention (Movies4stroke), Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Shahvaiz Magsi, Aresha Malani, Zahra Peera, Saadia Sattar, Masood Ahmed Akram, Sumaira Shahnawaz, Maryam Zulfiqar, Abdul Muqeet, Fabiha Zaidi, Saleem Sayani, Azmina Artani, Syed Iqbal Azam, Sarah Saleem

Section of Neurology

Background: Pakistan is the sixth most populous nation in the world and has an estimated 4 million stroke survivors. Most survivors are taken care of by community-based caregivers, and there are no inpatient rehabilitation facilities.
Objective: The objective of this study was to evaluate the effectiveness and safety of locally designed 5-min movies rolled out in order of relevance that are thematically delivered in a 3-month program to deliver poststroke education to stroke survivor and caregiver dyads returning to the community.
Methods: This study was a randomized controlled, outcome assessor–blinded, parallel group, single-center superiority trial in which participants (stroke survivor-caregiver …

Evaluating The Effectiveness Of Aquatic Therapy On Mobility, Balance, And Level Of Functional Independence In Stroke Rehabilitation: A Systematic Review And Meta-Analysis., Alice Mary Iliescu, Amanda Mcintyre, Joshua C. Wiener, Jerome Iruthayarajah, Andrea Lee, Sarah Caughlin, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To meta-analyze and systematically review the effectiveness of aquatic therapy in improving mobility, balance, and functional independence after stroke.

DATA SOURCES: Articles published in Medline, Embase, CINAHL, PsycINFO, and Scopus up to 20 August 2019.

STUDY SELECTION: Studies met the following inclusion criteria: (1) English, (2) adult stroke population, (3) randomized or non-randomized prospectively controlled trial (RCT or PCT, respectively) study design, (4) the experimental group received >1 session of aquatic therapy, and (5) included a clinical outcome measure of mobility, balance, or functional independence.

DATA EXTRACTION: Participant characteristics, treatment protocols, between-group outcomes, point measures, and measures of variability …

Effectiveness Of High-Intensity Interval Training For Fitness And Mobility Post Stroke: A Systematic Review., Joshua C. Wiener, Amanda Mcintyre, Scott Janssen, Jeffrey Ty Chow, Cristina Batey, Robert Teasell

Epidemiology and Biostatistics Publications

OBJECTIVE: To evaluate the evidence on the effectiveness of high-intensity interval training (HIIT) in improving fitness and mobility post stroke. TYPE: Systematic review.

LITERATURE SURVEY: Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for articles published in English up to January 2018.

METHODOLOGY: Studies were included if the sample was adult human participants with stroke, the sample size was ≥3, and participants received >1 session of HIIT. Study and participant characteristics, treatment protocols, and results were extracted.

SYNTHESIS: Six studies with a total of 140 participants met inclusion criteria: three randomized controlled trials and three pre-post studies. HIIT protocols ranged …