Campbell, B. C.V. et al. (2019) Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data.ABSTRACT Background: CT-perfusion (CTP) and MRI may assist patient selection for endovascular thrombectomy. We aimed to establish whether imaging assessments of ischaemic core and penumbra volumes were associated with functional outcomes and treatment effect.

Campbell, B. C. V. et al. (2018) Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. Lancet Neurology, 17(1), pp. 47-53. (doi:10.1016/S1474-4422(17)30407-6) This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/149670/ variables. An alternative approach using propensity-score stratification was also used. To account for between-trial variance we used mixed-effects modeling with a random effect for trial incorporated in all models. Bias was assessed using the Cochrane tool.Findings: Of 1764 patients in 7 trials, 871 were allocated to endovascular thrombectomy. After exclusion of 74 patients (72 who did not undergo the procedure and 2 with missing data on anaesthetic strategy), 236/797 (30%) of endovascular patients were treated under GA. At baseline, GA patients were younger and had shorter time to randomisation but similar pre-treatment clinical severity compared to non-GA. Endovascular thrombectomy improved functional outcome at 3 months versus standard care in both GA (adjusted common odds ratio (cOR) 1·52, 95%CI 1·09-2·11, p=0·014) and non-GA (adjusted cOR 2·33, 95%CI 1·75-3·10, p<0·001) patients. However, outcomes were significantly better for those treated under non-GA versus GA (covariate-adjusted cOR 1·53, 95%CI 1·14-2·04, p=0·004; propensitystratified cOR 1·44 95%CI 1·08-1·92, p=0·012). The risk of bias and variability among studies was assessed to be low.Interpretation: Worse outcomes after endovascular thrombectomy were associated with GA, after adjustment for baseline prognostic variables. These data support avoidance of GA whenever possible. The procedure did, however, remain effective versus standard care in patients treated under GA, indicating that treatment should not be withheld in those who require anaesthesia for medical reasons. Funding:The HERMES collaboration was funded by an unrestricted grant from Medtronic to the University of Calgary. Research in contextEvidence before this study between abolition of the thrombectomy treatment effect in MR CLEAN and no effect in THRACE. Three single-centre randomised trials of general anaesthesia versus conscious sedation found either no difference in functional outcome between groups or a slight benefit of general anaesthesia. Added value of this studyThese data from contemporary, high quality randomised trials form the largest study to date of the association between general anesthesia and the benefit of endovascular thrombectomy versus standard care. We used two different approaches to adjust for baseline imbalances (multivariable logistic regression and propensity-score stratification). We found that GA for endovascular thrombectomy, as practiced in contemporary clinical care across a wide range of expert centres during the rand...

Fused pyrimidine derivativesFused pyrimidine derivatives R 0515 Thiadiazolyl Quinazolones as Potential Antiviral and Antihypertensive Agents. -Compounds (IXa) and (IXb) show antiviral activity, while compound (IXc) shows antihypertensive activity. -(PANDEY*, V. K.; TUSI, S.; TUSI, Z.; RAGHUBIR, R.; DIXIT, M.; JOSHI, M. N.; BAJPAI, S. K.; Indian J.

A wavelet-based denoising technique is investigated for suppressing EMG noise and motion artifact in ambulatory ECG. EMG noise is reduced by thresholding the wavelet coefficients using an improved thresholding function combining the features of hard and soft thresholding. Motion artifact is reduced by limiting the wavelet coefficients. Thresholds for both the denoising steps are estimated using the statistics of the noisy signal. Denoising of simulated noisy ECG signals resulted in an average SNR improvement of 11.4 dB, and its application on ambulatory ECG recordings resulted in L(2) norm and max-min based improvement indices close to one. It significantly improved R-peak detection in both the cases.

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Impedance cardiography is a noninvasive technique for monitoring stroke volume, based on sensing variation in the thoracic impedance, z(t), due to blood flow. In this technique, first derivative of impedance, dz/dt, is used to calculate two parameters: ventricular ejection time and (-dz/dt) max . Respiration and motion artifacts cause base line drift in the sensed impedance waveform, particularly during exercise, and this drift results in errors in the estimation of the two parameters. Ensemble averaging of dz/dt signal suppresses respiratory and motion artifacts but it introduces distortion in the signal. In this study, a wavelet based denoising method is used to cancel corrupting respiratory artifacts from the dz/dt and z(t) signals in order to make a reliable estimate of cardiac output.

The objective of this investigation is to study the influence of superheat temperature and applied uniform electric field across the liquid-vapor interface during film boiling using a coupled level set and volume of fluid algorithm. The hydrodynamics of bubble growth, detachment, and its morphological variation with electrohydrodynamic forces are studied considering the medium to be incompressible, viscous, and perfectly dielectric at near critical pressure. The transition in interfacial instability behavior occurs with increase in superheat, the bubble release being periodic both in space and time. Discrete bubble growth occurs at a smaller superheat whereas vapor columns form at the higher superheat values. Destabilization of interfacial motion due to applied electric field results in decrease in bubble separation distance and increase in bubble release rate culminating in enhanced heat transfer rate. A comparison of maximum bubble height owing to application of different intensities of electric field is performed at a smaller superheat. The change in dynamics of bubble growth due to increasing superheat at a high intensity of electric field is studied. The effect of increasing intensity of electric field on the heat transfer rate at different superheats is determined. The boiling characteristic is found to be influenced significantly only above a minimum critical intensity of the electric field.

The present work is focused on the analyses of the bubble growth and heat transfer characteristics in saturated film boiling at various levels of gravity. In addition to this, the occurrence of self-similarity in interface structures during the bubble growth is examined. The phenomenon of bubble growth is strongly influenced by the buoyant forces due to gravity and its dominant effect is found to be replaced by the electrohydrodynamic forces in reduced gravity conditions. The decrease in gravitational acceleration results in increasing the characteristic wavelength and time scale. The bubble volume and maximum height before pinch-off thus increase enormously as the gravity value is reduced. The bubble pinch-off velocity is found to be decreased significantly in the case of reduced gravity condition. Heat transfer rate deteriorates in reduced gravity conditions which can be recovered by the externally imposed electric field. The dominance of electric field on the heat transfer rate is found to be more in reduced gravity condition. However, as the value of imposed electric field is enhanced, the difference in the effect of increasing heat flux tends to reduce.