Hand robotics

No clue if this is an actual product or a graduate students work.But your stroke department should know and compare it to these 51 posts on gloves, these 7 on grasping, these 154 on hand, these 46 on fingers.  Your stroke department should already have evaluated all these so it should be easy to determine if this new one is better. But that has no chance in hell of having occurred. You're screwed until everything in stroke is destroyed and survivors run things.
https://www.facebook.com/ScienceNaturePage/videos/894920293973563/

International Journal of Stroke

The International Journal of Stroke is the official publication of the World Stroke Organisation[sic]. It provides a significant contribution to the international stroke research community by concentrating on both the clinical aspects of stroke from around the world as well as basic science contributions in areas of clinical interest. (Note, nothing to do with helping survivors.)
You can look at the last six months of articles and see not one single discussion on  strategy or attacking any of the rehabilitation problems in stroke. It seems to be all about the initial stroke intervention. Absolutely nothing on stopping the neuronal cascade of death. This is the reason this organization needs to be destroyed and refocused on supporting survivors.
http://wso.sagepub.com/

Using Intel’s Xeon Phi for Brain Research Visualization

Your doctor should be using this to show you exactly where your damage occurred and then map the stroke protocols needed to fix that damage. But that is light years beyond your doctors current understanding and expertise. We are still in the Dark Ages in stroke and will be until we completely destroy the existing stroke medical establishment and start over with survivors in charge.
https://www.top500.org/news/using-intels-xeon-phi-for-brain-research-visualization/

BDNF Genotype Interacts with Motor Function to Influence Rehabilitation Responsiveness Poststroke

And just when the hell is somebody going to write up a fucking stroke protocol on the use of BDNF for stroke recovery? Or is everyone in stroke a chickenshit? Not willing to publicly write up anything for survivors? This is why the complete stroke medical establishment needs to be destroyed.
http://journal.frontiersin.org/article/10.3389/fneur.2016.00069/full?utm_source=newsletter&

Christine T. Shiner^1,2, Kerrie D. Pierce¹, Angelica G. Thompson-Butel^1,2, Terry Trinh^1,2, Peter R. Schofield^1,2 and Penelope A. McNulty^1,2*

• ¹Neuroscience Research Australia, Sydney, NSW, Australia
• ²School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia

Background: Persistent motor impairment is common but highly heterogeneous poststroke. Genetic polymorphisms, including those identified on the brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) genes, may contribute to this variability by limiting the capacity for use-dependent neuroplasticity, and hence rehabilitation responsiveness.

Objective: To determine whether BDNF and APOE genotypes influence motor improvement facilitated by poststroke upper-limb rehabilitation.

Methods: BDNF-Val66Met and APOE isoform genotypes were determined using leukocyte DNA for 55 community-dwelling patients 2–123 months poststroke. All patients completed a dose-matched upper-limb rehabilitation program of either Wii-based Movement Therapy or Constraint-induced Movement Therapy. Upper-limb motor function was assessed pre- and post-therapy using a suite of functional measures.

Results: Motor function improved for all patients post-therapy, with no difference between therapy groups. In the pooled data, there was no significant effect of BDNF or APOE genotype on motor function at baseline, or following the intervention. However, a significant interaction between the level of residual motor function and BDNF genotype was identified (p = 0.029), whereby post-therapy improvement was significantly less for Met allele carriers with moderate and high, but not low motor function. There was no significant association between APOE genotype and therapy outcomes.

Conclusion: This study identified a novel interaction between the BDNF-Val66Met polymorphism, motor-function status, and the magnitude of improvement with rehabilitation in chronic stroke. This polymorphism does not preclude, but may reduce, the magnitude of motor improvement with therapy, particularly for patients with higher, but not lower residual motor function. BDNF genotype should be considered in the design and interpretation of clinical trials.

Introduction

Motor impairment is a common, disabling, and inherently heterogeneous outcome of stroke (1, 2). Patients typically present across a broad clinical continuum and undergo variable and often incomplete recovery of motor function over time and in response to targeted rehabilitation (3). Predicting poststroke prognosis and recovery potential has gained a prominent research focus, with the most common predictive factors being measures of lesion size (4, 5), location (6, 7), corticospinal tract integrity (8, 9), and initial impairment severity (10, 11). While more extensive corticospinal tract damage and more severe baseline impairment are generally associated with poorer prognosis poststroke (10–12), these factors alone cannot fully explain the degree of variability in poststroke motor outcomes and patients’ response to motor therapies (3, 13). In order to optimize rehabilitation and thus maximize poststroke recovery, a deeper understanding of the factors that mediate this residual variability is necessary.

Genetic variation may account for some of the unexplained variance in stroke recovery. In particular, single-nucleotide polymorphisms (SNPs) in genes related to cortical plasticity and neural repair could influence an individual’s capacity for use-dependent plasticity, and hence their responsiveness to poststroke rehabilitation [for review, see Ref. (14)]. Numerous genes of interest continue to emerge in the growing field of stroke genetics (14, 15). Here, we have adopted a candidate gene approach based on two genetic factors with the strongest evidence in subacute stroke and extended this investigation into the chronic setting. The candidate genes are the brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) genes (16).

The BDNF gene encodes for the neurotrophin most abundantly expressed in the brain and involved in neuronal differentiation, survival, and synaptic plasticity (17–19). Approximately 30% of the Caucasian population and a higher percentage of the Asian population possess an SNP (rs6265) in the BDNF gene, resulting in a valine to methionine substitution at codon 66, the Val66Met polymorphism (20). This polymorphism alters the intracellular trafficking and activity-dependent release of BDNF (21, 22), and in healthy cohorts has been associated with a reduced capacity for use-dependent plasticity in the motor cortex (23–26) and impaired motor learning (26).

The BDNF-66Met allele may be detrimental to recovery following stroke (14), but the evidence to date remains contentious (27). Studies have primarily focused on subacute outcomes following spontaneous recovery, where both a significant negative association between Val66Met and stroke outcome (28–31) and a modest or negligible effect have been reported (16, 32–34). There is scant evidence of whether the Val66Met polymorphism influences long-term stroke recovery or responsiveness to targeted therapies. There is some suggestion that it may alter patient responsiveness to non-invasive brain stimulation (35, 36), but to date, no significant effect of this genotype on motor therapy has been identified (13).

Single-nucleotide polymorphisms within the APOE gene are less prevalent but potentially stronger genetic mediators of poststroke recovery (16). This gene encodes for a glycoprotein primarily involved in lipid transport and metabolism, but it also plays an important role in neuronal repair and synaptic remodeling (37, 38). Two SNPs (rs429358 and rs7412) in the APOE gene give rise to three distinct APOE isoforms, ε2 (Cys¹¹²/Arg¹⁵⁸Cys), ε3 (Cys¹¹²/Arg¹⁵⁸), and ε4 (Cys¹¹²Arg/Arg¹⁵⁸) (39). The ε4 isoform is present in only 10–20% of the population (40) but has been strongly implicated in the risk for Alzheimer’s disease (41, 42) and cardiovascular pathology (40, 43). Studies of APOE ε4 in stroke have mainly focused on stroke incidence rather than outcome (43), although emerging evidence suggests that the ε4 allele may have a detrimental effect on poststroke recovery (16, 44–46). Like BDNF, it remains uncertain whether APOE genotype can influence motor function and rehabilitation outcomes more chronically poststroke (13).

Here, we investigated whether BDNF and APOE genotype influence how stroke patients with stable motor function respond to a targeted protocol of upper-limb motor therapy poststroke. Data were collected from a pooled cohort of patients who received a dose-matched protocol of either Constraint-induced Movement Therapy, the current gold standard in upper-limb stroke rehabilitation, or Wii-based Movement Therapy, recently shown to be an engaging and equally efficacious therapy alternative (47). Given that no differences were demonstrated in any measure of upper-limb motor function between these two therapies (47), we did not expect to see differences according to therapy type, but rather according to genotype. We hypothesized that all patients would make some degree of motor improvement post-therapy, although those who possessed the BDNF-66Met or APOE-ε4 alleles would have less improvement with a standardized dose of therapy.

More at link

Higher Consumption of Potatoes May Increase Risk of Hypertension

And  some day far far in the future we will have a stroke diet protocol. But first we will need to destroy the existing stroke associations for not creating and following a strategy to solve all the problems in stroke. 

Higher Consumption of Potatoes May Increase Risk of Hypertension

In a new study, researchers at Brigham and Women’s Hospital (BWH) and the Harvard T.H. Chan School of Public Health have found that a higher intake of potatoes and French fries may be associated with an increased risk of high blood pressure (hypertension) in adults.
The findings are published online in the British Medical Journal on May 17, 2016.
“In our observational study participants who did not have high blood pressure at baseline, and consumed four or more servings a week of potatoes (boiled, baked or mashed) later had a higher risk of developing hypertension compared to those who consumed one or less than one serving a month,” said lead author Lea Borgi, MD, a physician in the Renal Division at BWH.  “Additionally, we found that if a participant replaced one serving of  boiled, baked or mashed potato per day with a non-starchy vegetable, it was associated with a lower risk of hypertension.”
Through three prospective, longitudinal, US, cohort studies, researchers followed 62,175 women in the Nurses’ Health Study, 88,475 women in Nurses’ Health Study II and 36,803 men in the Health Professionals Follow-Up Study who did not have high blood pressure at the beginning of the study.
Compared with consumption of less than one serving a month, participants who consumed 4 or more than 4 servings a week had an increased risk of hypertension of 11% for boiled, baked or mashed potatoes and of 17% for French fries. The researchers did not find an association between the consumption of potato chips and a higher risk of developing hypertension.
The researchers acknowledge the possible limitations of their study, including the fact that participants self reported a diagnosis from a health care provider of high blood pressure. “We take into account all of the data that are available to us and make the relevant statistical adjustments. However, because this is an observational study, there is always a possibility that our findings can be explained by something that we were not able to consider in our analysis,” Borgi and colleagues note. Although the study did not specifically ask participants what kind of potatoes they consumed, white potatoes are considered the most commonly eaten.
Future research will continue to focus on the association between potato consumption and increased risk for disease, including hypertension.
This study was funded by research grants by the National Institute of Health (UM1 CA186107, R01 HL034594, UM1 CA176726, UM1 CA167552, and R01 HL35464) and an American Heart Association fellowship award.

I bet this will not be followed up because we have NO stroke leadership and NO stroke strategy. All stroke survivors are fucking screwed until the existing stroke organizations are destroyed and replaced with survivor focused ones.

The readable article here;

Researchers build molecule that could significantly reduce brain damage in stroke victims

 

The research backing this up.

“Zipped Synthesis” by Cross-Metathesis Provides a Cystathionine β-Synthase Inhibitor that Attenuates Cellular H₂S Levels and Reduces Neuronal Infarction in a Rat Ischemic Stroke Model

The next revolution in stroke care

Bullshit!!!  I completely disagree with the conclusion, that is giving up and I never give up. Care is the word you should never hear in stroke, Results is what you want your doctor to use.
You solve the neuronal cascade of death and the death and disability from stroke will be reduced considerably. This is why the complete stroke medical leadership needs to be destroyed.
http://www.ncbi.nlm.nih.gov/pubmed/25331417

Teasell R¹, Rice D, Richardson M, Campbell N, Madady M, Hussein N, Murie-Fernandez M, Page S.

Author information

Abstract

Stroke is the second leading cause of death and disability worldwide. Initiatives to decrease the burden of stroke have largely focused on prevention and acute care strategies. Despite considerable resources and attention, the focus on prevention and acute care has not been successful in changing the clinical trajectory for the majority of stroke patients. While efforts to prevent strokes will continue to have an impact, the total burden of stroke will increase due to the aging population and decreased mortality rates. There is strong evidence for the effectiveness of rehabilitation in better managing stroke and its related disabilities. The time has come to shift the attention in stroke care and research from prevention and cure to a greater focus and investment in the rehabilitation and quality of life of stroke survivors. The rebalancing of stroke care and research initiatives requires a reinvestment in rehabilitation and community reintegration of stroke survivors.

KEYWORDS:

acute care; prevention; rehabilitation; stroke

PMID:

25331417

[PubMed - indexed for MEDLINE]

At what point does one stop being diplomatic and adopt a rebellious stance?

I never even attempted a diplomatic stance since none of the major stroke orgs., ASA, NSA, WSO had ANY outreach to survivors. With absolutely no survivor welcome at all they need to be destroyed and rebuilt with survivor needs in mind. As a friend once told me this goes against the Dale Carnegie book, 'How to Win Friends and Influence People'. I don't give a shit about stroke medical leadership  fee fees. They have had decades to do something right for survivors and have completely failed. I look forward to the aggrieved wailings of stroke leaders, I will respond in kind.

ComeBackStrong Mobile App - Smartphone app from NSA

This app would only be good for those who are technologically advanced enough to already own and use a smartphone. My parents for example have never even used a cell phone, this would be way beyond their abilities. User testing must not have been very extensive, or they didn't even bother to think about who the average stroke user would be. Total lack of thinking about usability.  And you wonder why I think all the stroke leadership must be destroyed.
stroke.org/stroke-resources/resource-library/comebackstrong-mobile-app?

With support from the Patient Centered Outcomes Research Institute (PCORI), this customizable mobile app has been developed for stroke survivors specifically based on their feedback and needs.
The app provides the stroke survivor or their caregiver with the ability to:

• create a detailed listing of all medications and set reminders for when to take them
• add important contact information including who to contact in an emergency and your physicians
• understand common medical terms relevant to stroke
• learn more about modifiable and non-modifiable stroke risk factors
• find helpful information about the physical, emotional, and cognitive conditions of stroke
• improve their rehabilitation through video instruction
• find a support group
• special sections for “Am I having a stroke?” and “Send help message with my location”

The app was developed through a collaboration with National Stroke Association, The State University of New York (SUNY) Downstate Medical Center, City University of New York (CUNY), and The Arthur Ashe Institute for Urban Health.
Currently available in the Apple Store and Google Play Store

An open email/question to Matt Lopez, president of the NSA

If all my readers would send an email to him asking tough questions maybe he would condescend to talk to us. My email to him and his reply: What a waste of time, he totally blew me off. I would do the same for the ASA and WSO but have no email addresses, better yet would be emails to all the boards of directors. This is why the complete stroke medical leadership needs to be destroyed.
A few hundred thousand emails might concentrate his mind,

MLopez@stroke.org

Mr. Lopez,

Congratulations on taking the reins of the National Stroke Association. Now the real question comes down to: How do you want to be remembered? As a visionary, who tackled the extremely difficult problems in stroke even though there was no clue as to how to solve them? Or as a caretaker that just pushes the simplicity of F.A.S.T. and prevention? Your choice. If you do want to go down the visionary route I would suggest not listening to your staff at the NSA.

My ideas here - What would a great stroke association look like?
Contact

Myself, plain survivor - Deans' Stroke Musings

Amy, PT survivor - mycerebellarstrokerecovery

Rebecca Dutton OT, writer of My Last Degree: A Therapist Goes Home After a Stroke, Clinical Reasoning in Physical Disabilities
and blog - http://homeafterstroke.blogspot.com/

Barb, author, Stroke After Stroke: A Rower's Pilgrimage - barb's recovery

Peter Levine, stroke researcher, best-selling author of Stronger After Stroke - The Stroke Recovery Blog
Dr Ellen Taliaferro - Emergency Room doctor - writer of Strokedaze - http://strokedaze.typepad.com/strokedaze/
Lady Bren - writer of The World According to Lady Bren - http://ladybrensworld.blogspot.com/
Nina - writer of Mindpop - http://mindpop.net/
Blue Shoe Farm - writer of A Year of Living In My Head - http://mymorbidhead.blogspot.com/

I'm sure if you ask your staff about me I'm sure there are a few who would say he's an arrogant son-of-a-bitch who has no  authority to question the stroke world because he has no medical training. It's true, I have no training about medicine but I am a programmer and I know specifically about cause and effect and can tell when things are not working.

Contact me at any time

Dean Reinke

Dear Dean,

Thank you for your note and congratulations.  As a stroke survivor myself, I am passionate and committed to leading National Stroke Association and working with members of the community so that we can make an even greater impact within the stroke community.  As you know our mission is to reduce the incidence and impact of stroke including providing the resources and support to stroke survivors, their caregivers and circle of support. Although I am new to the organization, I always welcome constructive dialogue and look forward to becoming fully engaged with the stroke community, (Bullshit)which you and I are both a member of as stroke survivors.

Thank you again for your note.

Best regards,

Matt

Phosphodiesterase inhibition as a therapeutic target for brain ischemia.

Another interesting piece of research needing followup. But that won't occur until we destroy the existing failures of stroke associations. What a great stroke association would look like.
 httpha://europepmc.org/abstract/med/26350339

(PMID:26350339)

• Abstract
• Citations
• BioEntities
• Related Articles
• External Links

Soares LM, Prickaerts J, Milani H, Del Bel E, Steinbusch HW, de Oliveira RM

CNS & Neurological Disorders Drug Targets [2015]

Type: Journal Article

Abstract

Highlight Terms Diseases(2)

Preclinical studies have shown that phosphodiesterase inhibitors (PDE-Is) represent a potential pharmacological strategy for the treatment of brain ischemia sequelea. PDE-Is 3, 4 and 5 have been tested in several brain ischemia models. All the three PDE-Is after acute or chronic treatment decreased the degree of neurodegeneration and most of them improved functional recovery after brain injury by specific cellular and molecular mechanisms mainly involving an anti-inflammatory and/or neuroprotection action. In contrast to the large number of investigations using PDE-Is in experimental brain ischemia research, the number of clinical studies is still limited. The purpose of this review is to summarize the data currently available on the effects of PDE-Is in experimental models of cerebral ischemia.

Progress we are making toward a cure for Parkinsons

At least the Michael J. Fox Foundation puts out an annual report. The ASA, NSA and WSO do nothing of the sort because they aren't even trying to SOLVE any of the problems in stroke. And this is precisely why these organizations need to be destroyed, they are useless for survivors.
Parkinsons annual report
The ASA annual report is here: not much to see
http://www.heart.org/idc/groups/heart-public/@wcm/@cmc/documents/downloadable/ucm_469976.pdf
I could find nothing from the WSO.
The NSA annual report is worthless, they seem to spend NO money on research.
http://www.stroke.org/sites/default/files/resources/2014%20Annual%20Report.pdf

Guargantuan F*cking Whoopee.

There is absolutely nothing factual in this report that says RESULTS WERE BETTER.' Care' is NOT WHAT YOU MEASURE! Once again putting out fucking useless press releases. I don't give a shit about access or impact, that is only for people that don't have anything concrete to puff up about. Another reason the complete stroke medical system must be destroyed, they can't even tell us the truth about anything.

Impact of State Stroke Systems of Care Laws on Stroke Outcomes   

Erika B Fulmer  ¹ , Dana Keener Mast  ² , Lucas Godoy Garraza  ² , Siobhan Gilchrist  ³ , Aysha Rasool  ^{1   4} , Ye Xu  ² , Amanda Brown  ³ , Nina Omeaku  ³ , Zhiqiu Ye  ¹ , Bruce Donald  ³ , Sharada Shantharam  ¹ , Sallyann Coleman King  ¹ , Adebola Popoola  ¹ , Kristen Cincotta  ²

Affiliations

• PMID: 37957987
• PMCID: PMC10648022
• DOI: 10.3390/healthcare11212842

Abstract

Since 2003, 38 US states and Washington, DC have adopted legislation and/or regulations to strengthen stroke systems of care (SSOCs). This study estimated the impact of SSOC laws on stroke outcomes. We used a coded legal dataset of 50 states and DC SSOC laws (years 2003-2018), national stroke accreditation information (years 1997-2018), data from the Healthcare Cost and Utilization Project (years 2012-2018), and National Vital Statistics System (years 1979-2019). We applied a natural experimental design paired with longitudinal modeling to estimate the impact of having one or more SSOC policies in effect on outcomes. On average, states with one or more SSOC policies in effect achieved better access to primary stroke centers (PSCs) than expected without SSOC policies (ranging from 2.7 to 8.0 percentage points (PP) higher), lower inpatient hospital costs (USD 610-1724 less per hospital stay), lower age-adjusted stroke mortality (1.0-1.6 fewer annual deaths per 100,000), a higher proportion of stroke patients with brain imaging results within 45 min of emergency department arrival (3.6-5.0 PP higher), and, in some states, lower in-hospital stroke mortality (5 fewer deaths per 1000). Findings were mixed for some outcomes and there was limited evidence of model fit for others. No effect was observed in racial and/or rural disparities in stroke mortality.

        

United States organization takes first place for World Stroke campaign

Big f*cking whoopee.
It was just a damned lazy press campaign. They didn't solve any of the problems in stroke.
Until the complete stroke medical world gets destroyed and recreated with survivors in charge will anything useful get done. They've had decades to prove their incompetence.
http://www.imperialvalleynews.com/index.php/news/health-news/2174-united-states-organization-takes-first-place-for-world-stroke-campaign.html
The American Heart Association/American Stroke Association topped entries from 44 other countries to earn the World Stroke Organization’s First Place “Gold Award” for World Stroke Day 2014.
A consortium of Brazilian stroke societies places second and the Pakistan Stroke Society and NARC, third.
Through its Together to End Stroke initiative, sponsored by Covidien, the American Stroke Association leveraged a thoughtful mix of social and traditional media tactics around World Stroke Day to help the public remember the most common stroke warning signs and how to respond.

Michael J. Fox Foundation Announces New Funding for Alzheimer’s, Parkinson’s Research

Where the FUCK is the similar story from our stroke associations? Does the board of directors not demand that this type of initiative occur from the management? No wonder nothing gets accomplished in stroke. I hate this fucking waiting around for somebody else to solve the problem.
This is precisely why everything in stroke must be destroyed and start over again.

http://www.biosciencetechnology.com/articles/2015/03/michael-j-fox-foundation-announces-new-funding-alzheimers-parkinsons-research?

Stroke Rounds: 'Golden Hour' Care Unlikely for One-Third of Americans

And because the stroke medical world has put all their eggs in the tPA basket strokies are f*cking screwed. tPA gets to maybe 10% of the people that are eligible for it at stroke centers and of those that get it it fully works to reverse the stroke only 12% of the time.  That scenario is one of the many reasons why the complete stroke medical world needs to be destroyed. This is why we need fast, objective diagnosis of strokes that don't require neurologists or scans or a stroke center for most patients.
Like this:

1. New EEG electrode set for fast and easy measurement of brain function abnormalities

2. Eye-Tracking Tool Might Quickly Spot Stroke

3.  How the wave of a wand can detect bleeding in the brain 

4. Neurokeeper EEG Headset Spots Signs of Stroke in Brainwave Signatures 

5.  Pupil response via infrared light 

6. Brain oximeter and frontal near-infrared spectroscopy

7. Ischiban headband 

Maybe you want to look at these;
The Qualcomm Xprize for the tricorder has selected 10 finalists?
I've already pointed out  these 17 ways for objective diagnosis. 

http://www.medpagetoday.com/Cardiology/Strokes/50328
Even under an optimistic scenario, as many as 114 million people in the U.S. would be unable to reach a comprehensive stroke center (CSC) using ground transportation within the critical treatment "golden hour," researchers estimated.
Using mathematical optimization modeling assuming the conversion of up to 20 optimally located primary stroke centers (PSCs) to CSCs per state, researcher Michael T. Mullen, MD, of the University of Pennsylvania, Philadelphia, and colleagues estimated that 63% of the population would live within a 1-hour drive and an additional 23% within a 1-hour flight of a stroke center.

Advertisement

Ground access would be lower in the southeastern U.S. "Stroke Belt" than in non-Stroke Belt states (32% versus 58.6%; P=0.02) and lower in states without emergency medical service routing policies (52.7% versus 68.3%; P=0.04), Mullen and colleagues wrote online in Neurology.
The modeling also suggested that in one-quarter of states, less than 60% of the population would have 60-minute air or ground access to a CSC.
"Because CSCs have not yet been proven to improve outcomes relative to other hospitals, the ideal level of population access is unknown," the researchers wrote. "Nonetheless, variability in access across states is important, because it suggests that there is a potential for significant geographic disparities in access to care."
Three-Tiered System for Stroke Treatment
In an effort to maximize early treatment of stroke patients, a three-tiered system based on the ability to care for increasingly complicated stroke patients has been proposed consisting of acute-stroke-ready hospitals, PSCs, and CSCs.

Certification of CSCs began in September of 2012, and as of May 2014 there were 70 certified CSCs operating in 25 states in the U.S., according to figures from the American Heart Association.
In their newly published study, Mullen and colleagues used mathematical modeling to estimate the optimal number and location of CSCs -- to which some PSCs could theoretically convert -- to maximize 1-hour access to care within the U.S.
"Up to 20 PSCs per state were selected for conversion to maximize the population with 60-minute access by ground and air," the researchers wrote. "Access was compared across states based on region and the presence of state-level emergency medical service policies preferentially routing patients to stroke centers."
There were 811 PSCs and no CSCs in the U.S. in 2010, according to figures from the Joint Commission, and two-thirds of Americans (65.8%) had 60-minute ground access to these centers, according to the researchers.
"After adding up to 20 optimally located CSCs per state, 63.1% of the U.S. population had 60-minute ground access and 86% had 60-minute ground/air access to a CSC," the researchers wrote.

Spatial cognitive rehabilitation and motor recovery after stroke - Current opinion in neurology, 2014

I really don't give a shit about your opinion, give me facts and published research.  You also go down the wrong route of focusing on rehabilitation rather than stopping the neuronal cascade of death resulting in much less disability and thus maybe then rehabilitation might work.
GAH!!!! This is why the complete stroke medical world needs to be destroyed, no one is even focusing on the correct problem.
http://journals.lww.com/co-neurology/Abstract/2014/12000/Spatial_cognitive_rehabilitation_and_motor.7.aspx

Barrett, A.M.^a; Muzaffar, Tufail^b

Abstract

Purpose of review: Stroke rehabilitation needs to take major steps forward to reduce functional disability for survivors. In this article, we suggest that spatial retraining might greatly increase the efficiency and efficacy of motor rehabilitation, directly addressing the burden and cost of paralysis after stroke.

Recent findings: Combining motor and cognitive treatment may be practical, as well as addressing the needs after moderate-to-severe stroke. Spatial neglect could suppress motor recovery and reduce motor learning, even when patients receive appropriate rehabilitation to build strength, dexterity, and endurance. Spatial neglect rehabilitation acts to promote motor as well as visual–perceptual recovery. These findings, and the previous underemphasized studies, make a strong case for combining spatial neglect treatment with traditional exercise training. Spatial neglect therapies might also provide motor stimulation if people cannot participate in intensive movement therapies because of limited strength and endurance after stroke.

Summary: Spatial retraining, currently used selectively after right-brain stroke, may be broadly useful after stroke to promote rapid motor recovery.