ORCID Profile
0000-0002-6527-1296
Current Organisations
Hospital Universitari Vall d'Hebron. Stroke Unit, Department of Neurology
,
Bond University
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Publisher: Wiley
Date: 18-06-2014
DOI: 10.1111/JON.12130
Abstract: The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93% 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8 95% CI, 1.9-7.6). CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality.
Publisher: SAGE Publications
Date: 15-12-2022
DOI: 10.1177/17474930211035032
Abstract: Randomized evidence for endovascular thrombectomy safety and efficacy in patients with large core strokes is lacking. To demonstrate endovascular thrombectomy efficacy and safety in patients with large core on non-contrast CT or perfusion imaging (CT/MR) and determine if there is heterogeneity of treatment effect in large cores based on the imaging modality. SELECT2 is a prospective, randomized, multi-center, assessor-blinded controlled trial with adaptive enrichment design, enrolling up to 560 patients. Patients who meet the clinical criteria and have anterior circulation large vessel occlusions with large core on either NCCT (ASPECTS 3-5) or perfusion imaging (CTP [rCBF < 30%] and/or MRI [ADC < 620] ≥ 50 cc) will be randomized in a 1:1 ratio to undergo endovascular thrombectomy or medical management (MM) only up to 24 h of last known well. The distribution of 90-day mRS scores is the primary outcome. Functional independence (mRS = 0-2) rate is a secondary outcome. Other secondary outcomes include safety (symptomatic ICH, neurological worsening, mortality) and imaging outcomes. A normal approximation of the Wilcoxon-Mann-Whitney test (the generalized likelihood ratio test) to assess the primary outcome. Functional independence rates, safety and imaging outcomes will also be compared. The SELECT2 trial will evaluate endovascular thrombectomy safety and efficacy in large cores on either CT or perfusion imaging and may provide randomized evidence to extend endovascular thrombectomy eligibility to larger population.
Publisher: Elsevier BV
Date: 2019
Publisher: Emerald
Date: 06-2012
DOI: 10.1108/17582951211229735
Abstract: The purpose of this paper is to investigate whether providing additional prompts in a visitor expenditure survey results in higher reported expenditure. Respondents to a self‐completion survey of event visitors were randomly allocated either an aggregated or disaggregated expenditure format in a quasi‐experimental design. ANOVA is used to identify significant differences in mean reported expenditure to the alternative formats. The research finds that provision of additional prompts in the expenditure module of a visitor survey results in higher reported expenditures in half the expenditure categories and, most importantly, in total expenditure. Collection of accurate visitor expenditure data is critical to estimation of the economic benefits of tourism and special events. Over or under estimation of direct expenditures associated with an event may have implications for future investment in the event by public and/or private agencies. Very few field tests of this fundamental issue in measurement error have been reported in the tourism literature. The few reported ex les have tended to report results inconsistent with a priori expectations, although they have been based on very small s le size and therefore are limited by low power. This study is based on a large s le size and produces results consistent with a priori expectations.
Publisher: WORLD SCIENTIFIC
Date: 27-03-2013
Publisher: Elsevier BV
Date: 08-2006
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2022
DOI: 10.1161/STROKEAHA.121.037073
Abstract: Cerebral edema after large hemispheric infarction is associated with poor functional outcome and mortality. Net water uptake (NWU) quantifies the degree of hypoattenuation on unenhanced-computed tomography (CT) and is increasingly used to measure cerebral edema in stroke research. Hemorrhagic transformation and parenchymal contrast staining after thrombectomy may confound NWU measurements. We investigated the correlation of NWU measured postthrombectomy with volumetric markers of cerebral edema and association with functional outcomes. In a pooled in idual patient level analysis of patients presenting with anterior circulation large hemispheric infarction (core 80–300 mL or Alberta Stroke Program Early CT Score ≤5) in the HERMES (Highly Effective Reperfusion Evaluated in Multiple Endovascular Stroke trials) data set, cerebral edema was defined as the volumetric expansion of the ischemic hemisphere expressed as a ratio to the contralateral hemisphere(rHV). NWU and midline-shift were compared with rHV as the reference standard on 24-hour follow-up CT, adjusted for hemorrhagic transformation and the use of thrombectomy. Association between edema markers and day 90 functional outcomes (modified Rankin Scale) was assessed using ordinal logistic regression. Overall (n=144), there was no correlation between NWU and rHV (r s =0.055, P =0.51). In sub-group analyses, a weak correlation between NWU with rHV was observed after excluding patients with any degree of hemorrhagic transformation (r s =0.211, P =0.015), which further improved after excluding thrombectomy patients (r s =0.453, P =0.001). Midline-shift correlated strongly with rHV in all sub-group analyses (r s .753, P =0.001). Functional outcome at 90 days was negatively associated with rHV (adjusted common odds ratio, 0.46 [95% CI, 0.32–0.65] P .001) and midline-shift (adjusted common odds ratio, 0.85 [95% CI, 0.78–0.92] P .001) but not NWU (adjusted common odds ratio, 1.00 [95% CI, 0.97–1.03] P =0.84), adjusted for age, baseline National Institutes of Health Stroke Scale, and thrombectomy. Prognostic performance of NWU improved after excluding patients with hemorrhagic transformation and thrombectomy (adjusted odds ratio, 0.90 [95% CI, 0.80–1.02] P =0.10). NWU correlated poorly with conventional markers of cerebral edema and was not associated with clinical outcome in the presence of hemorrhagic transformation and thrombectomy. Measuring NWU postthrombectomy requires validation before implementation into clinical research. At present, the use of NWU should be limited to baseline CT, or follow-up CT only in patients without hemorrhagic transformation or treatment with thrombectomy.
Publisher: Wiley
Date: 25-07-2022
DOI: 10.1002/ANA.26418
Abstract: This study was undertaken to evaluate functional and safety outcomes for endovascular thrombectomy (EVT) versus medical management (MM) in patients with large vessel occlusion (LVO) and mild neurological deficits, stratified by perfusion imaging mismatch. The pooled cohort consisted of patients with National Institutes of Health Stroke Scale (NIHSS) < 6 and internal carotid artery (ICA), M1, or M2 occlusions from the Extending the Time for Thrombolysis in Emergecy Neurological Deficits - Intra-Arterial (EXTEND-IA) Trial, Tenecteplase vs Alteplase before Endovascular Thrombectomy in Ischemic Stroke (EXTEND-IA TNK) trials Part I/II and prospective data from 15 EVT centers from October 2010 to April 2020. RAPID software estimated ischemic core and mismatch. Patients receiving primary EVT (EVT Of 540 patients, 286 (53%) received EVT Overall, EVT was not associated with improved clinical outcomes in mild strokes due to LVO, and sICH was increased. However, in patients with target mismatch profile, EVT was associated with increased functional independence. Perfusion imaging may be helpful to select mild stroke patients for EVT. ANN NEUROL 2022 :364-378.
Publisher: WORLD SCIENTIFIC
Date: 27-03-2013
Publisher: American Medical Association (AMA)
Date: 04-2019
Publisher: Elsevier BV
Date: 08-2007
Publisher: Informa UK Limited
Date: 25-04-2018
Publisher: Elsevier BV
Date: 04-2016
Publisher: Massachusetts Medical Society
Date: 06-04-2023
Publisher: Emerald
Date: 05-2005
DOI: 10.1108/09596110510591891
Abstract: This paper sets out to report on research that investigated hospitality managers' expectations of graduate skills and compared those expectations with student perceptions of what hospitality managers value. The research adopted a generic skills framework and data were collected through a s le survey of 850 Australian hospitality managers and 211 undergraduate hospitality management students. Managers rated skills associated with interpersonal, problem solving, and self‐management skill domains as most important while students appeared to have realistic perceptions of the skills that managers value when recruiting hospitality graduates. The most substantial areas of disagreement came in those skills associated with the conceptual and analytical domain. Industry managers tended to discount the skills in this domain relative to students. The s le of managers used in this study were predominantly of Australian nationality and, in an increasingly global hospitality labor market, there may be some benefit in repeating this study with managers from different cultural backgrounds. A number of strategies are proposed in the paper for bridging the expectation gaps and ensuring better learning outcomes for students and industry stakeholders. In adopting the generic skills framework this research presents an alternative to previous studies that have used a management competencies framework. As such, it is of more immediate value to those responsible for designing undergraduate hospitality management curriculum who need to ensure that programs meet academic standards as well as industry and student expectations regarding the skill sets needed in the workplace.
Publisher: Elsevier BV
Date: 08-2009
Location: Spain
No related grants have been discovered for Michael Raybould.