Intravenous thrombolysis for multi-ethnic Asians with acute ischaemia stroke in Malaysian public primary stroke centres versus acute stroke ready hospitals: Comparison of real-world clinical outcomes.

INTRODUCTION: Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator is beneficial in acute ischaemic stroke (AIS). We aim to compare the realworld clinical outcomes and service efficiency of IVT in Malaysian primary stroke centres (PSCs) versus acute stroke ready hospitals (ASRHs). MATERIALS AND METHODS: We conducted a multi-centre cohort study involving 5 PSCs and 7 ASRHs in Malaysia. Through review of medical records of AIS patients who received IVT from 01 January 2014 to 30 June 2021, real-world data was extracted for analysis. Univariate and multivariate regression models were employed to evaluate the role of PSCs versus ASRHs in post-IVT outcomes and complications. Statistical significance was set at p<0.05. RESULTS: A total of 313 multi-ethnic Asians, namely 231 from PSCs and 82 from ASRHs, were included. Both groups were comparable in baseline demographic, clinical, and stroke characteristics. The efficiency of IVT delivery (door-toneedle time), functional outcomes (mRS at 3 months post- IVT), and rates of adverse events (intracranial haemorrhages and mortality) following IVT were comparable between the 2 groups. Notably, 46.8% and 48.8% of patients in PSCs and ASRHs group respectively (p=0.752) achieved favourable functional outcome (mRS≤1 at 3 months post-IVT). Regression analyses demonstrated that post-IVT functional outcomes and adverse events were independent of the role of PSCs or ASRHs. CONCLUSION: Our study provides real-world evidence which suggests that IVT can be equally safe, effective, and efficiently delivered in ASRHs. This may encourage the establishment of more ASRHs to extend the benefits of IVT to a greater proportion of stroke populations and enhance the regional stroke care.

Velocimetry and response surface regression analysis of a swirling bed tested with mesh-coupled axial blade distributor.

Fluidized bed technology is being used in several industrial processes. The well-controlled fluidization of a bed material is a prerequisite for successful implementation of this technology. Several variants of distributors are being tested for fluidized beds; however, scant information is available on their working regimes. In this study, an annular distributor was constructed by fixing blades between two concentric rings and covering the assembly with a wire mesh. This new distributor design was tested for fluidization of batches of a spherical bed material at different blade angles and superficial air velocities (SAVs). High-speed imaging and MATLAB supported velocimetry techniques were used to generate velocity vector fields of fluidized beds. These fields were analyzed further for bed velocity measurements at different bed zones. A response surface regression model was applied on the data to predict the response of the bed parameters. Statistically, the bed velocity was predicted to be about 0.497 m/s with the confidence interval in the range of 0.4948-0.4999. The experimental bed velocity remained between 0.531 m/s and 0.538 m/s under an optimized blade angle of 60°, SAV of 2.3 m/s, and bed weight of 500 g.

Nitrogen Pollution Impact and Remediation through Low Cost Starch Based Biodegradable polymers.

The world does not have too much time to ensure that the fast-growing population has enough land, food, water and energy. The rising food demand has brought a positive surge in fertilizers' demand and agriculture-based economy. The world is using 170 million tons of fertilizer every year for food, fuel, fiber, and feed. The nitrogenous fertilizers are being used to meet 48% of the total food demand of the world. High fertilizer inputs augment the reactive nitrogen levels in soil, air, and water. The unassimilated reactive nitrogen changes into a pollutant and harms the natural resources. The use of controlled-release fertilizers for slowing down the nutrients' leaching has recently been practiced by farmers. However, to date, monitoring of the complete discharge time and discharge rate of controlled released fertilizers is not completely understood by the researchers. In this work, corn starch was thermally processed into a week gel-like coating material by reacting with urea and borate. The granular urea was coated with native and processed starch in a fluidized bed reactor having bottom-up fluid delivery system. The processed starch exhibited better thermal and mechanical stability as compared to the native starch. Unlike the pure starch, the storage modulus of the processed starch dominated the loss modulus. The release time of urea, coated with processed starch, remained remarkably larger than the uncoated urea.

A study of the junction between the straight sinus and the great cerebral vein.

In the present study 20 human brains were used to verify the presence of a small body projecting into the floor of the straight sinus at its junction with the great cerebral vein. The elevation could be identified at the anterior end of the floor of the straight sinus with an empty cavity underlying it. Histologically, the elevation was found to consist of interwoven bundles of collagen fibres covered by vascular endothelium continuous with that of the straight sinus. The importance of such an elevation in the regulation of blood flow from the great cerebral vein to the straight sinus is discussed from a hydrodynamic point of view.

Host-Parasite Relationships of Meloidogyne arenaria and M. incognita on Susceptible Soybean.

Pathogenicity and reproduction of single and combined populations of Meloidogyne arenaria and M. incognita on a susceptible soybean (Glycine max cv. Davis) were investigated. Significant galling and egg mass production were observed on roots of greenhouse-grown soybean inoculated with M. arenaria and M. incognita, in combination and individually. M. arenaria produced more galls and egg masses than M. incognita, whereas in combined inoculation with both nematode species, gall and egg production was intermediate. In growth chamber tests, inoculations with M. arenaria and M. incognita, singly or in combination, produced more galls and egg masses at 30 C than at 25 C. At 25 C, M. arenaria alone produced significantly more galls and egg masses than the combined M. arenaria plus M. incognita, while M. incognita produced the fewest. At 30 C, numbers of egg masses produced by M. arenaria did not differ significantly from combined M. arenaria and M. incognita. In temperature tank tests, M. incognita produced more galls and egg masses at 28 C than at 24 C soil temperature. In contrast, numbers of galls, egg masses, and eggs of M. arenaria were slightly higher at 24 C than at 28 C. Combined inoculum of both nematode species produced greater numbers of galls at 24 C than at 28 C.

Quantitative and histomorphological studies on the geniculate ganglion of the facial nerve in man.

The human geniculate ganglion was studied histologically and quantitatively. It appeared pyramidal in shape. The mean diameter of the side of the triangle constituting its base was 1,050 micrometer and its mean height 1,800 micrometer; the volume of the ganglion was 26 X 10(7) micrometer 3. The ganglionic cells were arranged in clusters with longitudinally extending bundles of nerve fibres in between. At the apex of the ganglion compact neurons were delineated from those in the rest of the ganglion by a bundle of nerve fibres. Moreover, scattered solitary nerve cells were met with between fibres of the greater petrosal and the chorda tympani nerves. The mean neuronal population was 1,070, the mean cell volume 11,913 micrometer 3, the cell territory 242,990 micrometer 3 and the volume of the intercellular space 231,077 micrometer 3. Extraganglionic vessels approximated the ganglion perpendicular to its long axis, while further intraganglionic vessels extended in a direction parallel to the long axis of the ganglion and vertical terminal ramifications formed dense vascular channels around the capsule of the nerve cells. The significance of that pattern of blood supply was discussed.

Rare tumors of the intestines and rectum.

Some rare tumors of the intestines and rectum (eight cases) have been presented and discussed. All were successfully managed without operative mortality. I have presented some observations deduced from these cases which might aid in the diagnosis of such rare tumors--the importance of palpating the terminal ileum in any abdominal operation and the necessity for a frozen section biopsy from suspicious schistosomal masses of the sigmoid colon or the rectum before deciding to resect them. I have discussed cases of carcinoma of the rectum where microscopic schistosomal deposits were spotted and stressed that in such cases it is a mere coincidental association.

The surgical gallbladder.

A series of 412 personally performed cholecystectomies is analyzed and discussed. Surgical cases were divided into groups based on whether or not the gallbladder was visualized by cholecystography. A third group required immediate surgery without attempting radiologic investigation. We do not accept the diagnosis of dyskinesia which is a radiological finding as an indication for surgery and no such cases are included in the series. Quite a number of cases operated on for "chronic cholecystitis" were found at surgery to have other less common pathological lesions, as proved by later histologic examination of the excised gallbladders. Bilharzial gallbladder disease is discussed and the new terms bilharzial cholecystitis and bilharzioma of the gallbladder are suggested for the lesions described. We stress the need to explore, inspect and aspirate the common bile duct in every case of calculous cholecystitis as the only alternative to operative cholangiography. By so doing biliary fistulas were completely eliminated from the series.