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Introduction: Effective, time-critical intervention in acute stroke is crucial to mitigate mortality rate and morbidity, but delivery of reperfusion treatments is often hampered by pre-, in-, or inter-hospital system level delays. Disjointed, repetitive, and inefficient communication is a consistent contributor to avoidable treatment delay. In the era of rapid reperfusion therapy for ischemic stroke, there is a need for a communication system to synchronize the flow of clinical information across the entire stroke journey. Material/Methods: A multi-disciplinary development team designed an electronic communications platform, integrated between web browsers and a mobile application, to link all relevant members of the stroke treatment pathway. The platform uses tiered notifications, geotagging, incorporates multiple clinical score calculators, and is compliant with security regulations. The system safely saves relevant information for audit and research. Results: Code Stroke Alert is a platform that can be accessed by emergency medical services (EMS) and hospital staff, coordinating the flow of information during acute stroke care, reducing duplication, and error in clinical information handover. Electronic data logs provide an auditable trail of relevant quality improvement metrics, facilitating quality improvement, and research. Discussion: Code Stroke Alert will be freely available to health networks globally. The open-source nature of the software offers valuable potential for future development of plug-ins and add-ons, based on individual institutional needs. Prospective, multi-site implementation, and measurement of clinical impact are underway.

Introduction:The global demand for endovascular clot retrieval (ECR) has grown rapidly in recent years creating challenges to healthcare system planning and resource allocation. This study aims to apply our established computational model to predict and optimise the performance and resource allocation of ECR services within regional Australia, and applying data from the state of South Australia as a modelling exercise. Method: Local geographic information obtained using the Google Maps application program interface and real-world data was input into the discrete event simulation model we previously developed. The results were obtained after the simulation was run over 5 years. We modelled and compared a single-centre and two-centre ECR service delivery system. Results: Based on the input data, this model was able to simulate the ECR delivery system in the state of South Australia from the moment when emergency services were notified of a potential stroke patient to potential delivery of ECR treatment. In the model, ECR delivery improved using a two-centre system compared to a one-centre system, as the percentage of stroke patients requiring ECR was increased. When 15% of patients required ECR, the proportion of 'failure to receive ECR' cases for a single-centre system was 17.35%, compared to 3.71% for a two-centre system. Conclusions: Geolocation and resource utilisation within the ECR delivery system are crucial in optimising service delivery and patient outcome. Under the model assumptions, as the number of stroke cases requiring ECR increased, a two-centre ECR system resulted in increased timely ECR delivery, compared to a single-centre system. This study demonstrated the flexibility and the potential application of our DES model in simulating the stroke service within any location worldwide.

variable with possible covariates in multiple regression modeling.Results The prevalence of moderate to severe depression in the PT population was 41.2%. Multiple regression to predict PHQ-9 diagnosed depression based on TFI total score, clinical variables, and demographics showed a significant odds ratio for TFI (OR: 1.084, CI: 1.065-1.096, p<0.001). The increase of sub-scores for quality of life interference and emotionality showed significant increases in odds for depression (OR: 1.031, CI: 1.016-1.046, p<0.001; OR: 1.042, CI: 1.027-1.058, p<0.001). Unemployed vs. employed and laterality were also associated with an increased odds of depression, and age with decreased odds while controlling for tinnitus score.Moderate to severe anxiety was present in 43.1%. Multiple regression analysis showed TFI was associated with increased of odds for anxiety (OR: 1.056, CI: 1.043-1.070, p<0.001). TFI sub-scores for emotionality (OR: 1.043, p<0.001), quality of life (OR: 1.019, p<0.005), and cognitive interferences (OR: 0.983, p = 0.015) were found to be significantly associated with anxiety scores. Conclusion The estimated prevalence of moderate to severe depression and anxiety in the US PT population is 41.2% and 43.1%, respectively, which is higher than a recent systematic review of depression in tinnitus suggesting a depression prevalence of 33%. TFI score was significantly associated with both depression and anxiety. Similarly, more granular sub-scores of the TFI elucidate how PT affects the psychological health of these patients. Disclosures E.

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