Background: Intravenous thrombolysis (IVT) plays a prominent role in the treatment of acute ischemic stroke (AIS). The sooner IVT is administered, the higher the odds of a good outcome. Therefore, registering the in-hospital time to treatment with IVT, i.e. the door-to-needle time (DNT), is a powerful way to measure quality improvement. The aim of this study was to identify determinants that are associated with extended DNT. Methods: Patients receiving IVT in 2015 and 2016 registered in the Dutch Acute Stroke Audit were included. DNT and onset-to-door time (ODT) were dichotomized using the median (i.e. extended DNT) and the 90th percentile (i.e. severely extended DNT). Logistic regression was performed to identify determinants associated with (severely) extended DNT/ODT and its effect on in-hospital mortality. A linear model with natural spline was used to investigate the association between ODT and DNT. Results: Included were 9518 IVT treated patients from 75 hospitals. Median DNT was 26 min (IQR 20-37). Determinants associated with a higher likelihood of extended DNT were female sex (OR 1.17, 95% CI 1.05-1.31) and admission during off-hours (OR 1.12, 95% CI 1.01-1.25). Short ODT correlated with longer DNT, whereas longer ODT correlated with shorter DNT. Young age (OR 1.38, 95% CI 1.07-1.76) and admission to a comprehensive stroke center (OR 1.26, 1.10-1.45) were associated with severely extended DNT, which was associated with in-hospital mortality (OR 1.54, 95%CI 1.19-1.98). Conclusions: Even though DNT in the Netherlands is short compared to other countries, lowering the DNT may be achievable by focusing on specific subgroups.@en

In the literature two different views on the time course of activation of "recognition units" - hypothetical units that represent identity information - are proposed. The first view assumes that the recognition units accumulate activation gradually over time. The second assumes that the activation levels increase fast initially and then start to decrease. Hagenzieker and Van der Heijden (1990) have proposed a more general information-processing model, which is compatible with both views. In this model a treshold determines what type of time course will be obtained. For below-threshold-activation values a gradual accumulation of activation will be found; for above-threshold values activation levels will first increase and then, because of inhibition, decrease. This model served as a starting-point for the present paper. Elaboration of this model led to two testable hypotheses with regard to identification performance. The first prediction is that evidence for inhibition should be observed only under relatively bright luminance conditions. The second is that, given inhibition, the amount of the effect of this inhibition should increase over time. A partial-report bar-probe task was used to test the predictions. The experiment involved two luminance conditions and the information was sampled at two different moments in time. To control for possible localization artefacts a digit-naming task was also used. Evidence for inhibition was found in both luminance conditions. In accordance with the model the amount of the effect of inhibition increased over time.@en

In the literature two different views with regard to the time course of activation of "recognition units" -hypothetical entities that represent identity information -are proposed. Both views are derived from a restricted set of phenomena in visual perception. The first view gets its intuitions from phenomena such as those summarized by Bloch's law; these phenomena show integration or summation of activation over time. This "grow-and-grow" view assumes that recognition units accumulate activation gradually over times The second view finds its inspiration in phenomena such as Mach-bands and simultaneous contrast; these phenomena show inhibition or steady-state suppression over time. This "grow-and-shrink" view assumes that the activation levels increase fast initially and then start to decrease. The perception literature strongly suggests that it may be light intensity that determines whether mainly integration (and phenomena such as Bloch's law) or inhibition (and phenomena such as Mach-bands) is obtained. So it is also likely that both information-processing views apply only to a limited range of intensity conditions; the "grow-and-grow" view to conditions of low-flight intensities, and the "grow-and-shrink" view to conditions of intermediate-and high-light intensities. It is argued that, to arrive at a complete view, a visual phenomenon that applies to the complete range of light intensities should be taken as a background for generating hypotheses about time courses in visual-information processing. The Broca-Sulzer effect is such a phenomenon. Starting from this phenomenon a simple, synthesizing, information-processing model is derived that is compatible with both the "grow-and-grow" view and the "grow-andshrink" view. It is shown that, besides the relevant temporal properties, this model also produces the appropriate spatial properties.@en