Observation of auditory perceptual and visuo-spatial characteristic of a patient with hemangiopericytoma in occipital lobe: a magnetoencephalography (MEG) study

The present study discussed functional reorganization and alteration in respond to the slow-growing tumour, hemangiopericytoma in the occipital cortex. Visual evoked field (VEF) and auditory evoked field (AEF) using magnetoencephalography (MEG) was used to evaluate the source localization and brain activity. Results of VEF source localization show a typical brain waves. Brain activity of the occipital lobe demonstrate low activation in the ipsilateral to the tumour. However, result shows the activation on the contralateral hemisphere was high and bigger in activation volume. AEF result shows an identical source localization and both side of the temporal lobe are activated. This result suggests that there is a positive plasticity in auditory cortex and slow-growing tumour can induce functional reorganization and alteration to the brain

Challenges in managing a patient with central post stroke pain

Objective: This is a case illustration of the challenges in managing a patient with central post stroke pain secondary to right thalamic bleed. We describe in detail the events of this case management and the challenges that we had encountered. Method: We report a case of a 68-yearold lady who had right thalamic bleed secondary to hypertensive crisis in 2015 and was further complicated with central post stroke pain over the hemiparetic side. In our report, we describe in detail the challenges in managing the patient to improve her function to achieve a better quality of life. Conclusion: This article illustrates the importance of a multidisciplinary approach and knowledge of various methods in managing a patient with central post stroke pain

Reliability of standardized uptake value normalized to lean body mass using the liver as a reference organ, in contrast-enhanced 18F-FDG PET/CT imaging

Purpose: To evaluate the reliability of standardized uptake value (SUV) normalized to lean body mass for maximum (SULmax) and mean values (SULmean) as well as maximum SUV values (SUVmax) in contrast-enhanced 18F-FDG PET/CT by assessment of inter-reader agreement, using the liver as a reference organ. Materials and methods: 272 images of baseline PET/CT scans were analyzed. A volume of interest (VOI) of 30-mm in diameter was placed by two independent readers in the right liver lobe to measure the parameters. An analysis was performed for the variance, intra-class correlation coefficient (ICC), and Bland-Altman plots. Results and discussion: For Reader 1, the SUVmax ranging from 1.33 to 5.94 (3.20 ± 0.69), SULmean ranging from 0.84 to 3.46 (1.90 ± 0.40) and SULmax ranging from 1.18 to 4.07 (2.38 ± 0.50), were obtained; for Reader 2 the SUVmax ranging from 1.47 to 5.43 (3.20 ± 0.70), SULmean ranging from 0.84 to 3.45 (1.90 ± 0.40), and SULmax ranging from 1.18 to 4.48 (2.38 ± 0.50), were obtained. The coefficient of variance for SUVmax, SULmean, and SULmax, were 21.9%, 21.1%, and 20.8%, respectively, having no significant differences between Reader 1 and Reader 2. The ICC of the two readers for SUVmax, SULmean and SULmax were 0.975, 0.982 and 0.977 (95% CI of 0.97, 0.98 and 0.97; p < .001) respectively. Bland-Altman plots revealed that SUVmax gave the best agreement with 97.1% of measurements falling within 2SD. Conclusion: There is an excellent inter-reader agreement for liver SUVmax, SULmean and SULmax, and the best reliability of measurements achieved with SULmax in contrast-enhanced PET/CT scans

The combined use of interleukin-6 with serum albumin for mortality prediction in critically ill elderly patients: the interleukin-6-to-albumin ratio

Background: The association between interleukin-6 (IL-6) and serum albumin (ALB) with mortality in critically ill elderly patients, either as stand-alone biomarkers or in combination, has been scarcely reported. We, therefore, aimed to investigate the prognostic value of the IL-6-to-albumin ratio in this special population. Patients and methods: This was a cross-sectional study conducted in the mixed intensive care unit (ICU) of two university-affiliated hospitals in Malaysia. Consecutive elderly patients (aged above or equal to 60 years) admitted to the ICU, who underwent simultaneous measurement of plasma IL-6 and serum ALB, were recruited. The prognostic value of the IL-6-to-albumin ratio was assessed by analysis of the receiver-operating characteristic (ROC) curve. Results: A total of 112 critically ill elderly patients were recruited. The outcome of all-cause ICU mortality was 22.3%. The calculated IL-6-to-albumin ratio was significantly higher in the non-survivors compared to the survivors {14.1 [interquartile range (IQR), 6.5–26.7] vs 2.5 [(IQR, 0.6–9.2) pg/mL, p <0.001]}. The area under the curve (AUC) of IL-6-to-albumin ratio for discrimination of ICU mortality was 0.766 [95% confidence interval (CI), 0.667–0.865, p <0.001] which was slightly higher than that of IL-6 and albumin alone. The ideal cut-off value of the IL-6-to-albumin ratio was above 5.7 with a sensitivity of 80.0% and specificity of 64.4%. After adjusting for severity of illness, the IL-6-to-albumin ratio remained as an independent predictor of ICU mortality with an adjusted odd ratio of 0.975 (95% CI, 0.952–0.999, p = 0.039). Conclusion: The IL-6-to-albumin ratio offers a slight improvement in mortality prediction than either of its constituent individual biomarkers and as such, it may be a potential tool to aid in the prognostication of critically ill elderly patients although this requires further validation in a larger prospective study

Regional cerebral blood perfusion changes in chronic stroke survivors as potential brain correlates of the functional outcome following gamiied home-based rehabilitation (IntelliRehab)—a pilot study

Background: Hospital-based stroke rehabilitation for stroke survivors in developing countries may be limited by staffing ratios and length of stay that could hamper recovery potential. Thus, a home-based, gamified rehabilitation system (i.e., IntelliRehab) was tested for its ability to increase cerebral blood flow (CBF), and the secondary impact of changes on the upper limb motor function and functional outcomes. Objective: To explore the effect of IntelliRehab on CBF in chronic stroke patients and its correlation with the upper limb motor function. Methods: Two-dimensional pulsed Arterial Spin Labelling (2D-pASL) was used to obtain CBF images of stable, chronic stroke subjects (n = 8) over 3-months intervention period. CBF alterations were mapped, and the detected differences were marked as regions of interest. Motor functions represented by Fugl-Meyer Upper Extremity Assessment (FMA) and Stroke Impact Scale (SIS) were used to assess the primary and secondary outcomes, respectively. Results: Regional CBF were significantly increased in right inferior temporal gyrus and left superior temporal white matter after 1-month (p = 0.044) and 3-months (p = 0.01) of rehabilitation, respectively. However, regional CBF in left middle fronto-orbital gyrus significantly declined after 1-month of rehabilitation (p = 0.012). Moreover, SIS-Q7 and FMA scores significantly increased after 1-month and 3-months of rehabilitation. There were no significant correlations, however, between CBF changes and upper limb motor function. Conclusions: Participants demonstrated improved motor functions, supporting the benefit of using IntelliRehab as a tool for home-based rehabilitation. However, within-participant improvements may have limited potential that suggests the need for a timely administration of IntelliRehab to get the maximum capacity of improvement

Optimal power dispatch of hybrid PV/diesel systems using heuristic bio-inspired algorithms

Generally due to the strategic equatorial region, Malaysia is advancing into solar energy as a replacement of alternative source for an electrical energy production to meet the escalation load demand. Thus, the integrated hybrid system like PVGenset set system are developed to generate power to meet load demand where it can be fitted into its local geography and others according to specification. However, this does not guarantee the hybrid system to generate power optimally as weather conditions (solar insolation, temperature and others) changes periodically and influence the power generation and the power dispatch to the load. Therefore, the hybrid system does not operate at the optimal state and without a proper dispatching controller it may lead to over stress one or the other hybrid system component causes frequent wear and tear with higher maintenance cost to the system. In order to curb this situation, the hybrid system requires a specific approach along with a controller to search and to dispatch the hybrid PV-Genset system generated power at the best potential optimal state. A Bio-Heuristic approach can be applied to determine the optimal power generation while a dispatch controller dispatches the electric hybrid power system to the load demand. The aim of this research is to implement the selected bio-heuristic approach such as Particle Swarm Optimisation (PSO) while Fuzzy Logic is used as a dispatch controller for a small scale hybrid PV-Genset system. The simulation of the hybrid PV-Gertset system modelling is simulated using two types of tropical weather conditions (sunny and rainy). From this research, simulation results are obtained and series of analysis is conducted using MATLAB/SlMULINK. Through the analysis, results have shown the contribution of each hybrid system component operates at the optimum level while power is dispatch to the load based on the hybrid system capability

Alteration in the functional organization of the default mode network following closed non-severe traumatic brain injury

The debilitating effect of traumatic brain injury (TBI) extends years after the initial injury and hampers the recovery process and quality of life. In this study, we explore the functional reorganization of the default mode network (DMN) of those affected with non-severe TBI. Traumatic brain injury (TBI) is a wide-spectrum disease that has heterogeneous effects on its victims and impacts everyday functioning. The functional disruption of the default mode network (DMN) after TBI has been established, but its link to causal effective connectivity remains to be explored. This study investigated the differences in the DMN between healthy participants and mild and moderate TBI, in terms of functional and effective connectivity using resting-state functional magnetic resonance imaging (fMRI). Nineteen non-severe TBI (mean age 30.84 ± 14.56) and twenty-two healthy (HC; mean age 27.23 ± 6.32) participants were recruited for this study. Resting-state fMRI data were obtained at the subacute phase (mean days 40.63 ± 10.14) and analyzed for functional activation and connectivity, independent component analysis, and effective connectivity within and between the DMN. Neuropsychological tests were also performed to assess the cognitive and memory domains. Compared to the HC, the TBI group exhibited lower activation in the thalamus, as well as significant functional hypoconnectivity between DMN and LN. Within the DMN nodes, decreased activations were detected in the left inferior parietal lobule, precuneus, and right superior frontal gyrus. Altered effective connectivities were also observed in the TBI group and were linked to the diminished activation in the left parietal region and precuneus. With regard to intra-DMN connectivity within the TBI group, positive correlations were found in verbal and visual memory with the language network, while a negative correlation was found in the cognitive domain with the visual network. Our results suggested that aberrant activities and functional connectivities within the DMN and with other RSNs were accompanied by the altered effective connectivities in the TBI group. These alterations were associated with impaired cognitive and memory domains in the TBI group, in particular within the language domain. These findings may provide insight for future TBI observational and interventional research

Quantification of standardised uptake value for ¹⁸F-FDG positron emission tomography in Malaysia

The role of Positron Emission Tomography/Computed Tomography (PET/CT) modalities is becoming more important concomitantly with the increase of oncology cases in Malaysia. Thus, it is the perfect time to perform a study to standardise the PET/CT image quality in Malaysia. This study aimed to compare the quantification of image quality of PET/CT with a standardised uptake value (SUV) parameter. In general, this study was carried out with the purpose of identifying the standardisation of quantification of standardised uptake value, SUVcontrolled for 18F-FDG PET between two independent PET modalities at two different institutions. The analysis was done on the SUVcontrolled of technical techniques (PET phantom) as a control standard for the validation of the PET-CT images of selected subjects with Fasting Blood Glucose index as the adjusted index to synchronise the two independent data sets. It was found that the SUVcontrolled was a potential conversion marker to validate the in vivo standardisation techniques for the two independent PET/CT modality systems based on the reference standard of the matched FBS and the in vitro 18F-FDG phantom. This study confirmed that the two independent PET modalities at paired-centre could potentially be standardised on the independent image quality based on the SUVmax quantification as the two independent measured were insignificantly different

Inconsistency of lesion quantitative assessment in 2D SUV and 3D SUV quantification techniques for [18F]-FDG PET/CT: a phantom study

This study was performed to assess the inconsistency of lesion quantification in standardised uptake value (SUV) [ 18F]-FDG between Ellipse (2-Dimensional) and Ellipsoid (3-Dimensional) quantification techniques by using PET/ CT image quality phantom. Reconstructed images of PET/CT ACR phantom was used to assess the quantification of SUV (SUVmax, SUVavg and SUVmin) on selected regions of interest. Statistical analysis of paired t-test was performed to compare the lesion quantification in SUV [18F]-FDG between 2D and 3D techniques. The quantification techniques were consistently similar of assessment between 2D SUVmax and 3D SUVmax at 12mm of ROI lesion with [(0.00 ± 0.02), t(29)=-0.48, p>0.05]. However, the rest of quantification techniques of 2D SUVmax, 3D SUVmax, 2D SUVavg, 3D SUVavg, 2D SUVmin and 3D SUVmin, results shown significant inconsistency since the p >0.05]. However, the rest of quantification techniques of 2D SUVmax, 3D SUVmax, 2D SUVavg, 3D SUVavg, 2D SUVmin and 3D SUVmin, results shown significant inconsistency since the p<0.05. This phantom study has proven that there were inconsistency of lesion quantitative assessment in 2D SUV and 3D SUV quantification techniques for [18F]-FDG PET/CT

The abolishment of death penalty as capital punishment: A comparative study of death penalty between Malaysia and Australia / Siti Adzlin Mohd Anwer … [et al.]

Throughout the world, the subject of the relevancy of death penalty has become a polemic issue that will never be ceased from being debated unless all the countries in the world has finally come to a resolution that the imposition of death penalty should be completely abolished be it in law or in practice. Malaysia is among the nations that still preserve the imposition of death penalty in its criminal justice system. The method of execution is by hanging the criminals to death and a mandatory death sentence will be imposed towards the criminals who are guilty of the offence of discharging firearms at public, intentional murder and trafficking in dangerous drugs. While Malaysia is still practicing this gruesome law, most of the world's nations especially in the big part of Europe had already taken away this type of punishment from their laws. According to these 'civilised' nations, death penalty is a cruel punishment that denies the right to life of human beings. Besides, the punishment is being condemned for it is prone to establish unfairness and miscarriage of justice especially in a situation where an innocent man is being put to death and he will only be exonerated after several years of his execution. In order to know whether these arguments are valid and justified, a comparative study will be conducted between Malaysia and Australia. We choose to compare the law of Malaysia with Australia since both are applying common law principle