articles with examples of CT perfusion application in practice

• The author shares an “exciting discovery” regarding Bing’s AI feature to convert its response format to long-form by asking for “essay format.”
• Using this technique helps the author get longer, chatty responses and prevents Bing from cutting off in the middle of a response.
• The author tried this prompt on different topics for follow-up questions and still got long-form answers.
• The author notes that asking for “explain in an essay format” instead of just “an essay” is important.
• The author explains how to navigate Bing’s chat feature and offers screenshots of their experience.
• One Reddit user comments on the post and notes that the prompt engineers had already figured this out, but the tip is still helpful.
• Another Reddit user comments that they tried this technique on Skype’s version of Bing and got excellent results.
• A third Reddit user shares an example of how they got Bing to write a poem about their search query on Twitter.
• A fourth Reddit user comments on the limitations of Bing’s chat feature and how it used to have unlimited chats before.
• The post includes an essay format response generated by Bing on the topic of caterpillars and why they are cute.
• The response notes that caterpillars are the larval stage of butterflies and moths and have a segmented body with six legs and many prolegs.
• Caterpillars have different colors, patterns, and appearances that make them look like toys, gems, or cute animals.
• Caterpillars have adorable behaviors such as wiggling, spinning silk, making sounds, and communicating through chemicals or vibrations.
• Caterpillars undergo a fascinating metamorphosis that transforms them into beautiful winged insects and are crucial for the ecosystem.

This webpage on r/MicrosoftFlow discusses how to use SQL query results in a Power Automate Desktop flow. The original poster has been using a somewhat-primitive method to separate query results and assign them to a unique variable. They ask for suggestions for improving this process and avoid writing query results into an Excel sheet every time.

Below are the relevant points discussed in this post and comments:

• The original poster queries data from a database and types it into a legacy system.
• The janky-ass method to separate query results is: query data, throw it into a list, and use the “Retrieve data table into column list” function to splice the data set and assign each value to a unique variable.
• They are wondering if there’s a better way to work with data tables than writing query results into an Excel sheet every time they run a flow.
• One suggestion is to trigger a flow to get SQL data (through a data gateway), then call the desktop flow. Another is iterating through QueryResult to assign each record to unique variables.
• When querying data, it should create a QueryResult variable of the type DataTable.

The webpage is not directly relevant to the query about examples of CT perfusion applications in practice.

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• Query is about avoiding sub-queries in SQL.
• Original query for question is to find questions that have been answered by more than 3 users who have a reputation of 50k or more in Stack Exchange.
• Repetition of sub-query for selecting top N users and ordering them by reputation makes the query inefficient.
• One suggestion is to use a Common Table Expression (CTE) to only write the sub-query once.
• Another recommendation suggests using a temporary table as opposed to a CTE for efficiency in larger datasets.
• A third recommendation suggests using CROSS APPLY or OUTER APPLY instead of a regular join.
• Recommendation to use a window function such as RANK() or DENSE_RANK() to solve the problem of duplicate data.
• The old query was badly named, suggested renaming as “Questions answered by more than 3 Top Users”.
• It is better to filter by HAVING COUNT(*) than Q.AnswerCount = 3.
• The final query is written as:

WITH 
  ranked_users(user_id, rep, rnk) AS
  (
    SELECT "id", reputation, DENSE_RANK() OVER (ORDER BY reputation DESC)
    FROM users
  )
SELECT 
  q.Id AS [Post Link],
  q.AnswerCount AS total_answers,
  COUNT(*) AS top_user_answers
FROM Posts AS Q
  INNER JOIN Posts AS A ON 
    A.ParentId = Q.Id
  INNER JOIN ranked_users AS u ON 
    u.user_id = a.OwnerUserID
WHERE
  u.rnk <= ##TopN##
GROUP BY q."id", q.AnswerCount
HAVING COUNT(*) >= 3;

Karma scores for recommendations:

• First recommendation: 4 karma
• Second recommendation: 1 karma
• Third recommendation: 1 karma

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• CT perfusion images can be rapidly obtained on all modern CT scanners and easily incorporated into an acute stroke imaging protocol.
• Discusses the technique of CT perfusion imaging, how to interpret the data and how it can contribute to the diagnosis of acute stroke and selection of patients for treatment.
• There is a growing body of evidence supporting the use of perfusion imaging in patients with acute stroke to identify patterns of brain perfusion that are favourable for recanalisation therapy.
• CT perfusion may help confirm the diagnosis of stroke and determine which type of stroke a patient is having (ischemic or hemorrhagic).
• CT perfusion may be used to help determine the extent of brain damage and plan appropriate treatment options.
• CT perfusion can help identify areas of salvageable brain tissue (penumbra) and aid prognosis.
• CT perfusion can be used to guide delivery of thrombolytic (clot-busting) therapy or mechanical thrombectomy.
• CT perfusion can be used to guide decisions about endovascular therapy even after the traditional time window for treatment has passed.
• The article recommends using CT perfusion imaging to identify patterns of brain perfusion that are favourable for recanalisation therapy, permitting therapy to be extended to patients who would have otherwise been excluded from treatment.
• The article recommends using automated CT perfusion software, but also notes that careful evaluation by a neuroradiologist with expertise in the interpretation of CT perfusion may be necessary in complex cases.
• The article mentions several studies that have evaluated the safety and efficacy of using CT perfusion to guide mechanical thrombectomy or thrombolytic therapy.
• Recommended articles:
  • Does perfusion imaging add value compared with plain parenchymal and vascular imaging? (18 recommendations)
  • A novel clinical and imaging based score for predicting outcome prior to endovascular treatment of acute ischemic stroke (10 recommendations)
  • Reversible changes in diffusion- and perfusion-based imaging in cerebral venous sinus thrombosis (9 recommendations)
  • Utilization of CT perfusion patient selection for mechanical thrombectomy irrespective of time: a comparison of functional outcomes and complications (6 recommendations)
  • What is the impact of head movement on automated CT perfusion mismatch evaluation in acute ischemic stroke? (1 recommendation)
  • Interaction of age with the ischaemic penumbra, leptomeningeal collateral circulation and haemodynamic variables in acute stroke: a pilot study (2 recommendations)
  • Correlation between cerebral blood

• The article was about a discussion among RNs and teachers about NIHSS (National Institute of Health Stroke Scale) scale score for sedated/intubated patients.
• One question was what score to give for the motor response section: whether to score the patient based on what they can do or what the nurse thinks they can do.
• The article identified that patients who are untestable receive 0 score on NIHSS.
• Other users argued that NIHSS is not a reliable or practical test for sedated patients because most tests are not doable, and that untestable patients cannot receive a valid NIHSS score due to the nature of the test.
• Some users argued that NIHSS should be used as a tool for research only, while others argued that the score system needs to be changed.
• One user discussed the risks and the cost of having CT perfusion for stroke patients. They cited a study that increased brain cancer risk by 50 times normal levels and that can cost at least $20,000 per patient.
• Another user explained that NIHSS provides a guide for how to score sedated/intubated patients in each section just like untestable patients.
• One user defended using NIHSS for sedated/intubated patients, citing department guidelines. However, the use of too many tests and procedures can be overwhelming and ultimately detrimental to the patient, according to other users.

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• Reddit post: Why is a non-contrast CT a gold standard in identifying ischemic stroke? Why not a contrast CT?
• Commenter says that the non-contrast CT is for ruling out hemorrhage. The most important finding within 4.5 hours.
• Commenter says that for the initial treatment, the scan is needed to confirm that there is no hemorrhage, i.e., to prove that the stroke is ischemic, not hemorrhagic. Treatment in hyperacute strokes is critical, so physicians avoid spending time on unnecessary extra images.
• Commenter says that CT with contrast can locate where the blood clot is located. In hyperacute strokes, that does not change management.
• Another comment clarifies that CT perfusion scans are used to identify the territory involved in acute ischemic stroke and whether to attempt more advanced treatments such as clot retrieval.
• Commenter says that if there is a large vessel occlusion (LVO), CT with perfusion studies help identify if a patient is a candidate for thrombectomy.
• The monitoring occurs with CT perfusion scans is used to identify the size of the ischemic core and penumbra.
  • CT non-con is for patients who present within six hours of symptom onset excluding hemorrhage, and CT con locates where the blood clot is.
  • If the time from onset is 6-24 hours, then a CT perfusion scan determines whether the patient is a candidate for thrombectomy based on the size of the ischemic core and penumbra.
• Depending on the institution, the physician may use a sophisticated CT with contrast called a perfusion scan to diagnose acute ischemic stroke positively.
  • A perfusion scan helps identify the territory involved and whether to proceed with more advanced treatment, such as clot retrieval.
  • DEFUSE 3 trial determines that anterior circulation large vessel occlusions are amenable to thrombectomy within 24 hours.
  • In case of basilar artery thrombus, the thrombectomy window is extended to 24 hours because of the dismal prognosis.
• A CT angiogram (CTA) can identify patients with an LVO who might benefit from endovascular therapy.
• Factors determining whether follow up with MRI is needed include clinical worsening or improvement, comorbidities such as deep vein thrombosis or pulmonary embolism, and physician judgement.

• Post on Reddit in r/Radiology discussing CT Perfusion Study protocols and anxiety around them.
• User recommends having a set protocol for the scan on how fast to inject and what area of the head to scan, and to talk to lead tech and/or Radiologist/Neurologist if not in place.
• Another user advises being respectful of input from those around you and trusting the care team. They recommend seeking help when doubting oneself and being cautious in case of a stroke.
• The post discusses the size of IV needed for the scan, with some users stating that 18G is unnecessary and 20G is sufficient.
• Users discuss using the hand for IV placement, with some having success and others citing the risk of compartment syndrome and hospitals tending to stray from allowing angio injections in the hand.
• Users share different protocols they follow for the scan, including the sequence of scans, contrast agent amounts, the rate at which it is injected, and specific positions for scanning the head and neck.
• Users talk about software they use for post-processing, such as RAPID, IntelliSpace, and Smart Prep. They discuss how it works and how it has improved the process.
• One user notes that radiologists do not have to approve the scans and they just read them as they come.
• Users share advice on conducting the scans, including learning the protocols, staying focused on the patient and scan, and not letting others intimidate you. They advise going as fast as you’re comfortable with, as rushing can lead to mistakes that will take longer to fix.

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💭  Looking into

An overview of how CT perfusion has been used in diagnosing and treating stroke patients

💭  Looking into

3 real-world examples of CT perfusion aiding in the diagnosis of cancer