Pregled posta

Marketing

Acute Ischemic Stroke and Thrmobolysis Location: Comparing Telemedicine and Stroke Center Treatment Outcomes (Hospital Practice)

Telemedicine has been increasingly used as an option for acute ischemic stroke treatment at hospitals where neurological expertise is not available. The aim of this study was to compare the outcome of stroke patients treated with systemic thrombolysis at our academic hub regional stroke centers (hub) versus our spoke hospital telemedicine locations (spoke) Methods Data were retrospectively reviewed for consecutive patients admitted for stroke treatment with intravenous tissue plasminogen activator at our hub (128 patients) and at the spoke centers (27 patients) over a 2-year period. Mortality was selected as a primary outcome measure, and post-thrombolysis intracranial hemorrhage (PT-ICH) rate, hospital length of stay (LOS), and discharge modified Rankin Scale (mRS) score were selected as secondary outcome measures. Logistic regression models were used to determine the effect of thrombolysis treatment site on stroke outcomes. Results Demographic and clinical variables of patients treated at the hub versus spoke sites were similar, except for a lower initial platelet count and a shorter time from ictus onset to needle in the spoke group. With covariates, the treatment site (hub vs spoke) did not have a significant impact on mortality (10.9% vs 11.1%; P = 0.34), nor on PT-ICH (20.3% vs 33.3%; P < 0.35). Site did not reach significance in affecting discharge outcome: 52.3% versus 51.9% of patients had good outcomes (mRS 0–3) and 47.7% versus 48.1% patients had poor outcomes (mRS, 4–6; P = 0.16). Length of stay was also not significantly affected by site: 8.8 days versus 10.7 days (P < 0.23). Conclusion The hub-and-spoke telemedicine model for acute ischemic stroke treatment seems to carry similar efficacy and safety outcomes at the regional academic hub and spoke centers.

Telemedicine has been increasingly used as an option for acute ischemic stroke treatment at hospitals where neurological expertise is not available. The aim of this study was to compare the outcome of stroke patients treated with systemic thrombolysis at our academic hub regional stroke centers (hub) versus our spoke hospital telemedicine locations (spoke) Methods Data were retrospectively reviewed for consecutive patients admitted for stroke treatment with intravenous tissue plasminogen activator at our hub (128 patients) and at the spoke centers (27 patients) over a 2-year period. Mortality was selected as a primary outcome measure, and post-thrombolysis intracranial hemorrhage (PT-ICH) rate, hospital length of stay (LOS), and discharge modified Rankin Scale (mRS) score were selected as secondary outcome measures. Logistic regression models were used to determine the effect of thrombolysis treatment site on stroke outcomes. Results Demographic and clinical variables of patients treated at the hub versus spoke sites were similar, except for a lower initial platelet count and a shorter time from ictus onset to needle in the spoke group. With covariates, the treatment site (hub vs spoke) did not have a significant impact on mortality (10.9% vs 11.1%; P = 0.34), nor on PT-ICH (20.3% vs 33.3%; P < 0.35). Site did not reach significance in affecting discharge outcome: 52.3% versus 51.9% of patients had good outcomes (mRS 0–3) and 47.7% versus 48.1% patients had poor outcomes (mRS, 4–6; P = 0.16). Length of stay was also not significantly affected by site: 8.8 days versus 10.7 days (P < 0.23). Conclusion The hub-and-spoke telemedicine model for acute ischemic stroke treatment seems to carry similar efficacy and safety outcomes at the regional academic hub and spoke centers.

Chevrolet (pronounced /???vr??le?/), also known as Chevy (pronounced /???vi/), is a brand of vehicle produced by General Motors Company (GM). Founded by Louis Chevrolet and ousted GM founder William C. Durant on November 8, 1911,[1] Chevrolet was acquired by General Motors in 1917. Chevrolet was positioned by Alfred Sloan to sell a lineup of mainstream vehicles to directly compete against Henry Ford's Model T in the 1920s, with "Chevrolet" or "Chevy" being at times synonymous with GM. In North America, Chevrolet offers a full range of automobiles, from subcompact cars to medium-duty commercial trucks.United States and Canada
Main article: General Motors Canada

On November 8, 1911 racecar driver and automotive engineer Louis Chevrolet cofounded the Chevrolet Motor Car Company with William C. Durant (ousted founder of General Motors) and investment partners William Little (maker of the Little automobile) and Dr. Edwin R. Campbell (son-in-law of Durant).

Durant from the management of GM in 1910. Durant took over the Flint Wagon Works, incorporating both the Mason and Little companies. As head of Buick Motor Company, prior to founding GM, Durant had hired Louis Chevrolet to drive Buicks in promotional races. [2] Durant wanted to use Chevrolet's name as a racer to rebuild his own reputation.

Actual design work for the first Chevy, the costly Series C Classic Six was drawn up by Etienne Planche, following the instructions of his old friend Louis. The first C prototype was ready months before Chevrolet was actually incorporated.

Chevrolet first used its "Bowtie emblem"[3] logo in 1913. It is said to have been designed from wallpaper Durant once saw in a French hotel. More recent research by historian Ken Kaufmann presents a compelling case that the logo is based upon a logo for "Coalettes".[4] Others claim that the design was a stylized Swiss cross, in honor of the homeland of Chevrolet's parents.[5]ouis Chevrolet had differences with Durant over design and in 1915 sold Durant his share in the company. By 1916, Chevrolet was profitable enough to allow Durant to repurchase a majority of shares in GM. After the deal was completed in 1917, Durant was president of General Motors, and Chevrolet was merged into GM, becoming a separate division. In 1917 Chevrolet factories were located at New York City; Tarrytown, N.Y.; Flint, Michigan; Toledo, Ohio; St. Louis, Missouri; Oakland, California; Fort Worth, Texas, and Oshawa, Ontario. [6] In the 1918 model year, Chevrolet introduced the Model D, a V8-powered model in four-passenger roadster and five-passenger tourer models. It also started production of an overhead valve in-line six. Most cars of the era had only low compression flat head engines. These cars had 288in3 55 hp (41 kW) engines with Zenith carburetors and three-speed transmissions.

Chevrolet continued into the 1920s, 1930s, and 1940s competing with the Ford brand, and after the fairly new Chrysler Corporation formed Plymouth in 1928, Plymouth, Ford, and Chevrolet were known as the "Low-priced three"

Chevrolet had a great influence on the American automobile market during the 1950s and 1960s. In 1953 they produced the Corvette, a two-seater sports car with a fibreglass body. In 1957, Chevy introduced their first fuel-injected engine [7], the Rochester Ramjet option on Corvette and passenger cars at $484. [8] In 1960 they introduced the Corvair with a rear-mounted air-cooled engine. In 1963, one out of every ten cars sold in the United States was a Chevrolet.[9]
Chevrolet Camaro 2010

The basic Chevrolet small-block V-8 design has remained in continuous production since its debut in 1955, longer than any other mass-produced engine in the world, although current versions share few if any parts interchangeable with the original. Descendants of the basic small-block OHV V-8 design platform in production today have been much modified with advances such as aluminium block and heads, electronic engine management and sequential port fuel injection, to name but a few. Descendants of the small-block V-8 in the form of the LT V-8s, and had influence in the design of the LS V-8s, both of which are still installed in Chevrolet vehicles. The original small-block design is simplistic compared to the overhead-cam V-8 that Ford Motor Company used and continues to use in its line of larger cars and light trucks. Depending on the vehicle type, Chevrolet V-8s are built in displacements from 4.3 to 9.4 litres with outputs ranging from 110 horsepower (82 kW) to 720 horsepower (540 kW) as installed at the factory. The engine design has also been used over the years in GM products built and sold under the Pontiac, Oldsmobile, Buick, Hummer, Opel (Germany), and Holden (Australia) nameplates.

In 2010, General Motors replaced the advertising agency Campbell-Ewald, which served Chevrolet for 91 years, with Publicis Worldwide. Campbell-Ewald of Interpublic Group of Companies had served

The Coney Island Cyclone (better known as simply the Cyclone) is a historic Wooden roller coaster in the Coney Island section of Brooklyn, New York City. The Cyclone was operated by Astroland until it closed on September 7, 2008. It is currently operated by the newly created Dreamland Amusement Park.

The Cyclone was declared a New York City landmark on July 12, 1988, and was placed on the National Register of Historic Places on June 26, 1991.

The success of 1925's Thunderbolt and 1926's Tornado led Jack and Irving Rosenthal to buy land at the intersection of Surf Avenue and West 10th Street for a coaster of their own. With a $100,000 investment, they hired Vernan Keenan to design a new coaster. A man named Harry C. Baker supervised the construction, which was done by area companies including National Bridge Company (which supplied the steel) and Cross, Austin, & Ireland (which supplied the lumber). The final cost of the Cyclone has been reported to be around $146,000 to $175,000. When the Cyclone opened on June 26, 1927, a ride cost only twenty-five cents compared to the $8 in the 2009 Season.

In 1935, the Rosenthals took over management of Palisades Park. The Cyclone was put under the supervision of Christopher Feucht, a Coney Island veteran who had built a ride called Drop the Dips in 1907, and then doing minor retracking work on the Cyclone. The ride continued to be extremely popular; one of its many stories is from 1948, when a coal miner with aphonia visited Coney Island. According to legend, he had not spoken in years but screamed while going down the Cyclone's first drop, saying "I feel sick" as his train returned to the station. He prompty fainted after realizing he had just spoken

On July 31, 2007, a 53-year old man broke several vertebrae, while riding the cyclone. He died four days later. This is the only time in the Cyclone's history that a person died after sustaining injuries from the ride.

By the 1960s, attendance at Coney Island had lowered. By 1968, the Cyclone was deteriorating and it was shut down in 1969.[verification needed]

In 1971, the Cyclone was bought by the city of New York for one million dollars. Lack of riders hurt profits, and the ride was condemned. In 1972, it was nearly destroyed because the New York Aquarium (which is located adjacent to the ride) wanted to expand.[7] A "Save the Cyclone" campaign ensued, and the coaster was leased to the Astroland amusement park for $57,000 per year. Astroland's owners had the ride refurbished, and it reopened on July 3, 1975.

In 1978, it was featured in the film version of The Wiz as the home of its version of the Tinman, and its size compared to the rest of Oz raised to enormous proportions. In the 1980s, events like the Mermaid Parade and Sideshows by the Seashore brought visitors back to Coney Island and the Cyclone. Despite the closing of Astroland Park on September 7, 2008, the Cyclone will remain in operation due to its status as a New York City landmark. The ride is now owned completely by (75 feet along 834 Surf Avenue and 500 feet along West 10th Street, 40°34?30?N 73°58?39?W? / ?40.575°N 73.9775°W? / 40.575; -73.9775) the Parks Department. The former concession stands, built into the structure of the roller coaster, are now home to the Coney Island History Project[10], and a stand selling Cyclone based shirts, hats, and on-ride photos.

The Cyclone was declared a city landmark in 1988 and a National Historic Landmark in 1991.

In 1977, Richard Rodriguez, (USA) set a marathon record of 104 hours. Richard was only age 19 when he broke the record. Today, he currently holds the record for the longest marathon on a roller coaster with 401 hours on the Pepsi Max Big One at Blackpool Pleasure Beach in England.

The roller coaster's 70th birthday was celebrated in 1997 with a tightrope walk by Tino Wallenda between the ride's two highest points; that year, a single ride cost four dollars. The track today is 2,650 feet long (including six fan turns and nine drops) and a 26 meter drop at its highest point; the first drop is at a 60 degree angle. Each of the three trains is made up of three eight-person cars, but only two trains can run simultaneously. The ride's top speed is 97 km/h and it takes about one minute and fifty seconds. As of June 28, 2008, the current cost was eight dollars with a five dollar "reride" option. The "re-ride" option also gives riders the ability to choose their seats. In addition, a souvenir booth located near the exit sells photos of passengers taken at the first drop. The Coney Island Cyclone is an ACE Coaster Classic and Coaster Landmark; it has also been honored by baseball's Brooklyn Cyclones as the source for their team name.

The popularity of the Cyclone has inspired several coasters to share the exact same layout (or a mirror version of it). Until 2005, there were four duplicates of the Cyclone at Six Flags parks. Two of these have been demolished: the

Proposing a framework for comparative analysis of the relationship between the media and the political system, this book surveys media institutions in eighteen West European and North American democracies. It identifies the principal dimensions of variation in media systems and the political variables which have shaped their evolution. It then pinpoints three major models of media systems development (the Polarized Pluralist, Democratic Corporatist and Liberal models) and explains why the media play a different role in politics in each of these systems.