scholarly journals A dynamic simulation framework for CT perfusion in stroke assessment built from first principles

2021 ◽  
Author(s):  
Sarah E. Divel ◽  
Soren Christensen ◽  
William P. Segars ◽  
Maarten G. Lansberg ◽  
Norbert J. Pelc
Keyword(s):  
Dynamic Simulation ◽  
First Principles ◽  
Ct Perfusion ◽  
Simulation Framework ◽  
Stroke Assessment

scholarly journals Turnaround Time of Acute Multi-Modal Stroke Imaging Should Not Be More Than 11 Minutes

2020 ◽  
Author(s):  
Channa Senanayake ◽  
James Beharry ◽  
Stanley Tsui ◽  
Paul Mouthaan ◽  
Teddy Y. Wu ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Multimodal Imaging ◽  
Ct Perfusion ◽  
High Volume ◽  
Turnaround Time ◽  
Real World Data ◽  
Stroke Imaging ◽  
Ct Angiogram ◽  
Contrast Ct ◽  
Stroke Assessment

Abstract Background: Multimodal stroke imaging (Non-contrast CT, CT perfusion and CT angiogram) is essential to acute stroke assessment, there is currently no benchmark for this key process from real world data. Methods: Retrospective review of the turnaround time of consecutive multimodal imaging performed for acute stroke assessment at two high volume stroke centers in Australasia from July to September 2019.Results: 252 imaging studies were included from both sites. The overall median time from acquisition to imaging availability was 13 minutes (IQR 11- 16). The median for Christchurch and Box Hill were 11 minutes (IQR 10 – 12) and 15 minutes (IQR 13 – 19) respectively. Conclusions: Multimodal stroke imaging turnaround time of 11 minutes is a reasonable benchmark.

scholarly journals 110 The benefits of a clinical triage tool in acute stroke

2019 ◽  
Vol 90 (e7) ◽  
pp. A35.3-A36
Author(s):  
Khaled Alanati ◽  
Sean Byrnes ◽  
James Evans ◽  
David Campbell ◽  
Ellen Wall
Keyword(s):  
Acute Stroke ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Ct Perfusion ◽  
Standard Of Care ◽  
Current Standard ◽  
Web Based ◽  
Clinical Assessments ◽  
Treatment Window ◽  
Stroke Assessment

IntroductionThe advances in management of ischemic stroke and the extended treatment window have greatly increased the demand for acute stroke assessment. There is a need for fast and accurate triage both to identify candidates for acute stroke assessment and to minimize cost and time expended on unnecessary assessments and investigations.We examined the potential benefit of a web-based triage tool designed to be used in the emergency department to identify patients suitable for hyperacute treatment based on the current standard of care.MethodsWe performed a retrospective analysis of Electronic medical records of 235 patients, reviewed by the neurology team at Gosford Hospital for the consideration of hyperacute treatment over six months in 2017. Each patient’s time of onset of symptoms, premorbid function and presenting deficit, as well as the type of treatment received, were collected. By entering those data to our new triage system, we estimated the number of clinical reviews and advanced imaging that could have been avoided.ResultsOut of the 235 patients that were reviewed, 71 patients either received thrombolysis and/or were sent for endovascular treatment, and 164 patients were not suitable for hyperacute treatment. Using the triage tool, we identified that 26% (n=61) of the rapid clinical assessment and 32% (n=42) of CT perfusion scans performed could have been avoided.ConclusionUse of a web-based triage tool is not only effective to identify patients suitable for hyperacute management but also to avoid over-investigation and prioritize rapid neurological clinical assessments.

The modeling of a Tokamak plasma discharge, from first principles to a flight simulator

2021 ◽  
Author(s):  
Emiliano Fable ◽  
Filip Janky ◽  
W Treutterer ◽  
Michael Englberger ◽  
Raphael Schramm ◽  
...  
Keyword(s):  
Control System ◽  
First Principles ◽  
Plasma Discharge ◽  
Tokamak Plasma ◽  
Flight Simulator ◽  
Plasma Model ◽  
Simulation Framework ◽  
Control Room ◽  
Modeling Tool ◽  
Control Schemes

Abstract A newly developed tool to simulate a tokamak full--discharge is presented. The tokamak "flight--simulator" Fenix couples the tokamak control system with a fast and reduced plasma model, yet realistic enough to take into account several of the plasma non--linearities. Distinguishing feature of this modeling tool is that it only requires the Pulse Schedule (PS) as input to the simulator. The output is a virtual realization of the full discharge, which time traces can then be used to judge if the PS satisfies control/physics goals or needs to be revised. This tool is thought for routine use in the control--room before each pulse is performed, but can also be used off--line to correct PS in advance, or to develop and validate reduced models, control schemes, and in general the simulation framework.

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