Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic

Background: This study assessed the international variation in surgical neuro-oncology practice and 30-day outcomes of patients who had surgery for an intracranial tumor during the COVID-19 pandemic. Methods: We prospectively included adults aged ≥18 years who underwent surgery for a malignant or benign intracranial tumor across 55 international hospitals from 26 countries. Each participating hospital recorded cases for 3 consecutive months from the start of the pandemic. We categorized patients’ location by World Bank income groups (high [HIC], upper-middle [UMIC], and low- and lower-middle [LLMIC]). Main outcomes were a change from routine management, SARS-CoV-2 infection, and 30-day mortality. We used a Bayesian multilevel logistic regression stratified by hospitals and adjusted for key confounders to estimate the association between income groups and mortality. Results: Among 1016 patients, the number of patients in each income group was 765 (75.3%) in HIC, 142 (14.0%) in UMIC, and 109 (10.7%) in LLMIC. The management of 200 (19.8%) patients changed from usual care, most commonly delayed surgery. Within 30 days after surgery, 14 (1.4%) patients had a COVID-19 diagnosis and 39 (3.8%) patients died. In the multivariable model, LLMIC was associated with increased mortality (odds ratio 2.83, 95% credible interval 1.37–5.74) compared to HIC. Conclusions: The first wave of the pandemic had a significant impact on surgical decision-making. While the incidence of SARS-CoV-2 infection within 30 days after surgery was low, there was a disparity in mortality between countries and this warrants further examination to identify any modifiable factors

THE DESIGN, FABRICATION AND PRELIMINARY TESTING OF AN INDIGENOUS SINGLE SCREW EXTRUDER

Developing countries including Nigeria have become dumping grounds of unserviceable and broken down imported machineries because of poor adaptation. Detailed study and design of machines to suit local conditions will prevent poor adaptation of imported machines and high initial costs. In this study, a single screw starch extruder was designed, fabricated and tested using locally available materials. The extruder is the dry type and it has 27.12 kg/s capacity, a compression ratio of 4.5: 1 and is powered by a 5.5 kW electric motor. It consists of a hopper, feeding screw, extruder screw rotating in a barrel and variable die, all made of stainless steel. A unit of the machine costs N 470, 390.00.00 as at April 2015. When used to process cassava flour, a maximum temperature of 114°C was attained through viscous dissipation, up to an actual screw speed of 98.96 rpm (1.65 Hz) and extruder efficiency of 64%. Barrel temperature varied directly with extrusion time in a polynomial trend while actual extruder screw speed and efficiency varied inversely with extrusion time and it is best fitted with a polynomial trend

Extended Gumbel Type-2 Distribution: Properties and Applications

In this paper, we proposed a new four-parameter Extended Gumbel type-2 distribution which can further be split into the Lehman type I and type II Gumbel type-2 distribution by using a generalized exponentiated G distribution. The distributional properties of the proposed distribution have been studied. We derive the pth moment; thus, we generalize some results in the literature. Expressions for the density, moment-generating function, and rth moment of the order statistics are also obtained. We discuss estimation of the parameters by maximum likelihood and provide the information matrix of the developed distribution. Two life data, which consist of data on cancer remission times and survival times of pigs, were used to show the applicability of the Extended Gumbel type-2 distribution in modelling real life data, and we found out that the new model is more flexible than its submodels