https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:51394 Wed 24 Apr 2024 12:04:11 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33544 -9). The lead single-nucleotide polymorphism (rs12445022) was also associated with cerebral white matter hyperintensities (OR [95% CI] = 1.10 [1.05-1.16] ; p = 5.3 × 10^-5 ; N = 3,670), but not intracerebral hemorrhage (OR [95% CI] = 0.97 [0.84-1.12] ; p = 0.71; 1,545 cases, 1,481 controls). rs12445022 is associated with mRNA expression of ZCCHC14 in arterial tissues (p = 9.4 × 10^-7) and DNA methylation at probe cg16596957 in whole blood (p = 5.3 × 10^-6). Interpretation: 16q24.2 is associated with SVS. Associations of the locus with expression of ZCCHC14 and DNA methylation suggest the locus acts through changes to regulatory elements.]]> Wed 15 Dec 2021 16:10:00 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:24807 Wed 15 Dec 2021 16:07:00 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47147 post hoc cost-effectiveness analysis was undertaken. Part A: patient-level cost and health effect data (Multidimensional Fatigue Inventory (MFI) scores) were derived from the MIDAS trial and analysis undertaken from a health-system perspective. Part B: a secondary analysis simulated the societal impact of modafinil therapy in terms of national productivity costs. Results: Part A: Mean cost of modafinil treatment was AUD$3.60/day/patient for a minimally clinically important change (10 points) in total MFI fatigue score, i.e., AUD$0.36/day/unit change in fatigue score per patient. For the base case scenario, the ICER of using modafinil (versus placebo) was AUD$131.73 ($90.17 - 248.15, for minimum and maximum costs, respectively). Part B: The potential productivity cost-savings to society were calculated as nearly AUD$467 million over 1 year, and up to $383,471,991,248 over 10 years, from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors, representing a significant societal benefit. Conclusions: Modafinil is a highly cost-effective treatment for post-stroke fatigue, offering significant productivity gains and potential cost-savings to society from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors.]]> Wed 14 Dec 2022 15:27:36 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:14744 Wed 11 Apr 2018 14:16:29 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:9232 Wed 11 Apr 2018 13:10:28 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25880 Wed 10 Nov 2021 15:05:31 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42923 Wed 07 Sep 2022 13:07:20 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38703 Wed 06 Jul 2022 10:42:43 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:48570 Tue 21 Mar 2023 18:40:40 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:27769 SNP]) and tested the hypothesis that WMH heritability differs between hypertensive and nonhypertensive individuals. Methods: WMHV was measured on MRI in the stroke-free cerebral hemisphere of 2336 ischemic stroke cases with GWAS data. After adjustment for age and intracranial volume, we determined which cardiovascular risk factors were independent predictors of WMHV. Using the genome-wide complex trait analysis tool to estimate H_SNP for WMHV overall and within subgroups stratified by risk factors found to be significant in multivariate analyses. Results: A significant proportion of the variance of WMHV was attributable to common SNPs after adjustment for significant risk factors (H_SNP=0.23; P=0.0026). H_SNP estimates were higher among hypertensive individuals (H_SNP=0.45; P=7.99x10^-5); this increase was greater than expected by chance (P=0.012). In contrast, estimates were lower, and nonsignificant, in nonhypertensive individuals (H_SNP=0.13; P=0.13). Conclusions: A quarter of variance is attributable to common SNPs, but this estimate was greater in hypertensive individuals. These findings suggest that the genetic architecture of WMH in ischemic stroke differs between hypertensives and nonhypertensives. Future WMHV GWAS studies may gain power by accounting for this interaction.]]> Tue 21 Jul 2020 09:44:12 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:54333 1.8. The primary outcome was good functional outcome at 90 days, defined as a modified Rankin Scale (mRS) score 0-2. follow-up infarct volume, core expansion and penumbral salvage volumes were secondary outcomes. Of 572 anterior circulation EVT patients, CTP source image data required to generate objective maps were available in 170, and a Target Mismatch was present in 151 (89%). The rate of 90-day good functional outcome was similar between Target Mismatch (53%) and Large Core Non-Mismatch groups (46%, p = 0.629). Median follow-up infarct volume in the Large Core Non-Mismatch group (104ml [IQR 25ml-189ml]) was larger than that in the Target Mismatch patients (16ml [8ml-47ml], p<0.001). Despite a lack of formal CTP selection criteria, the majority of patients treated at our centres had a Target Mismatch. Patients without Target Mismatch had larger follow-up infarct volumes, but the functional recovery rate was similar to that in Target Mismatch patients. Infarct volumes should be included as objective assessment criteria in the evaluation of the efficacy of EVT in non-Target Mismatch patients.]]> Tue 20 Feb 2024 16:05:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41945 Tue 16 Aug 2022 14:24:17 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:19823 Tue 09 Jun 2020 09:48:40 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29940 Thu 04 Nov 2021 10:39:20 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:34659 20%), but this was only statistically significant in adjusted analyses (unadjusted hazard ratio [HR], 0.79; 95% confidence interval [CI] , 0.58-1.07; P=0.13; adjusted HR, 0.77; 95% CI, 0.59-0.99; P=0.045). Older age (75-84 years; HR, 4.9; 95% CI, 2.8-8.7; P < 0.001) and increasing stroke severity (HR, 1.5; 95% CI, 1.3-1.9; P < 0.001) were associated with increased mortality, while being married (HR, 0.70; 95% CI, 0.49-0.99; P=0.042) was associated with increased likelihood of survival. Cardiovascular disease (including stroke) was listed either as the primary or secondary cause of death in 80% (211/264) of all deaths. Conclusions: Our results demonstrate the potential long-term and sustained benefit of nurse-initiated multidisciplinary protocols for management of fever, hyperglycemia, and swallowing dysfunction. These protocols should be a routine part of acute stroke care.]]> Thu 03 Feb 2022 12:20:16 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:1980 Sat 24 Mar 2018 08:33:15 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:2292 Sat 24 Mar 2018 08:26:57 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18958 Sat 24 Mar 2018 07:58:56 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20967 Sat 24 Mar 2018 07:54:23 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21244 P = 0·77 at discharge; co-located acute/rehabilitation stroke care: 109·5 ± 21·7 vs. traditionally separated acute/rehabilitation stroke care: 104·4 ± 27·9; P = 0·8875 at 90 days post-discharge). Total length of hospital stay was 5·28 days less in co-located acute/rehabilitation stroke care compared with traditionally separated acute/rehabilitation stroke care (24·15 ± 3·18 vs. 29·42 ± 4·5, P = 0·35). There was significant improvement in functional independence measure efficiency score among participants assigned to co-located acute/rehabilitation stroke care compared with traditionally separated acute/rehabilitation stroke care (co-located acute/rehabilitation stroke care: median 1·60, interquartile range: 0·87–2·81; traditionally separated acute/rehabilitation stroke care: median 0·82, interquartile range: 0·27–1·57, P = 0·0393). Linear regression analysis revealed a high inverse correlation (R² = 0·89) between functional independence measure efficiency and time spent in the acute stroke unit. Conclusion: This proof-of-concept study has shown that co-located acute/rehabilitation stroke care was just as effective as traditionally separated acute/rehabilitation stroke care as reflected in functional independence measure scores, but significantly more efficient as shown in greater functional independence measure efficiency. Co-located acute/rehabilitation stroke care has potential for significantly improved hospital bed utilization with no patient disadvantage.]]> Sat 24 Mar 2018 07:53:02 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25277 −11; odds ratio (OR) = 1.42, 95% confidence interval (CI) = 1.28–1.57). All four loci exhibited evidence for heterogeneity of effect across the stroke subtypes, with some and possibly all affecting risk for only one subtype. This suggests distinct genetic architectures for different stroke subtypes.]]> Sat 24 Mar 2018 07:38:17 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:22678 Sat 24 Mar 2018 07:12:09 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32413 Mon 23 Sep 2019 12:03:48 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:46403 Mon 21 Nov 2022 10:00:52 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47867 Fri 03 Feb 2023 14:14:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47863 n = 45 hospitals) were analyzed. Differences in processes of care by the timing of discharge are described. Multilevel regression and survival analyses (up to 180 days postevent) were undertaken. Results: Among 30,649 registrants, 2621 (8.6%) were discharged on weekends (55% male; median age 74 years). Compared to those discharged on weekdays, patients discharged on weekends were more often patients with a transient ischemic attack (weekend 35% vs. 19%; p < 0.001) but were less often treated in a stroke unit (69% vs. 81%; p < 0.001), prescribed antihypertensive medication at discharge (65% vs. 71%; p < 0.001) or received a care plan if discharged to the community (47% vs. 53%; p < 0.001). After accounting for patient characteristics and clustering by hospital, patients discharged on weekends had a 1 day shorter length of stay (coefficient = -1.31, 95% confidence interval [CI] = -1.52, -1.10), were less often discharged to inpatient rehabilitation (aOR = 0.39, 95% CI = 0.34, 0.44) and had a greater hazard of death within 180 days (hazard ratio = 1.22, 95% CI = 1.04, 1.42) than those discharged on weekdays. Conclusions: Patients with stroke/transient ischemic attack discharged on weekends were more likely to receive suboptimal care and have higher long-term mortality. High quality of stroke care should be consistent irrespective of the timing of hospital discharge.]]> Fri 03 Feb 2023 14:00:52 AEDT ]]>