{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:00:02Z","timestamp":1785301202928,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006920","name":"University of Pennsylvania","doi-asserted-by":"publisher","award":["0000000115"],"award-info":[{"award-number":["0000000115"]}],"id":[{"id":"10.13039\/100006920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Improving stroke recognition and promoting immediate action are critical to enhancing prehospital stroke care. For two decades, the FAST (Face, Arm, Speech, Time) mnemonic has been widely taught, yet it fails to capture many posterior circulation strokes. To address these limitations, BE FAST (adding Balance and Eye symptoms) was introduced but showed reduced recall for more common symptoms represented by FAST, likely due to common symptoms being placed after less common ones, thus weakening retention of the original FAST elements. To improve both detection and action, we propose\n FAST BEE<\/jats:bold>\n \u2014keeping FAST first and adding BE after FAST with an additional \u201cE\u201d for Emergency Medical Services (EMS) call. This structure reinforces the urgency of activating EMS by repeating the call\u2010to\u2010action within the mnemonic. We further introduce a novel\n FAST BEE cartoon<\/jats:bold>\n as a visual tool to enhance learning, recall across diverse populations, and immediate action (EMS call) in public. Using the bee metaphor provides a memorable, engaging, and globally adaptable educational strategy in English\u2010speaking populations. FAST BEE offers a fresh, action\u2010oriented framework that builds on the familiarity of FAST, emphasizes immediate EMS activation, and holds promise to strengthen stroke action awareness worldwide. Further evaluation of effectiveness in various English\u2010speaking populations is needed.\n <\/jats:p>","DOI":"10.1002\/cns.71003","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T07:45:31Z","timestamp":1782719131000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["FAST BEE (Keeping FAST First): A Public Stroke Education Design to Drive EMS Activation"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9335-8981","authenticated-orcid":false,"given":"Renyu","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, and Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Department of Anesthesiology and Perioperative Medicine Robert Wood Johnson University Hospital, Rutgers University New Brunswick New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5197-9181","authenticated-orcid":false,"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology Minhang Hospital Affiliated to Fudan University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7347-802X","authenticated-orcid":false,"given":"Siju V.","family":"Abraham","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Jubilee Mission, Medical College & Research Institute Thrissur Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8719-4968","authenticated-orcid":false,"given":"Gary A.","family":"Ford","sequence":"additional","affiliation":[{"name":"Radcliffe Department of Medicine University of Oxford Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930231177204"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00527-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.015169"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.035696"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1624800"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13931"},{"key":"e_1_2_6_8_1","unstructured":"R.Liu \u201cFAST BEE Intro \u201d (2025)."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.12674"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.01.001"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.513143"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/09658211.2024.2336161"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00203"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.490078"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/17474930251378229"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.14005"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/JNN.0000000000000755"},{"key":"e_1_2_6_18_1","unstructured":"R.Kozak \u201cR\u00c1PIDO\u2014A New Spanish Acronym to Raise Stroke Awareness \u201d(2021) https:\/\/www.heart.org\/en\/news\/2021\/03\/12\/rapido\u2010a\u2010new\u2010spanish\u2010acronym\u2010to\u2010raise\u2010stroke\u2010awareness."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13175033"}],"container-title":["CNS Neuroscience & Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cns.71003","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cns.71003","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cns.71003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:14:10Z","timestamp":1785298450000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cns.71003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":18,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/cns.71003"],"URL":"https:\/\/doi.org\/10.1002\/cns.71003","archive":["Portico"],"relation":{},"ISSN":["1755-5930","1755-5949"],"issn-type":[{"value":"1755-5930","type":"print"},{"value":"1755-5949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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