Case Report: Unusual High-Grade Diffuse Leptomeningeal Glioneuronal Tumor Mimicking Tuberculous Meningitis in a Child from an Endemic Region

Background: Diffuse leptomeningeal glioneuronal tumor (DL-GNT) is a new entity described in the 2016 World Health Organization (WHO) classification of brain tumors. While DL-GNT is predominantly an indolent tumor that affects young boys, high-grade DL-GNT is unusual and seldom reported in children.Case Presentation: In this report, we describe the challenges and pitfalls associated with diagnosing this high-grade variant in a tuberculosis-endemic region. We highlight the importance of identifying non-typical imaging findings, i.e., non-enhancing cystic lesions with high T2 signal along the leptomeningeal surface, that may expedite the diagnosis of this condition. Histopathologic correlations with MR spectroscopy findings are also discussed. Conclusion: We provide the first clinical imaging report of utilizing MR spectroscopy to distinguish DL-GNT from tuberculosis with histopathologic correlation

Effect of ethanol treatment on shrinkage of oil palm trunk for the drying process

Oil palm trunk is one of the promising biomass materials due to the high volume of unused waste components and increasing worldwide demand to replace conventional wood. This study aimed to investigate the feasibility of using ethanol as a drying agent for oil palm trunks with different dimensional surfaces (radial, tangential and longitudinal sections). Radial shrinkage percentage for the outer layer is 1.50% (untreated) and 1.22 % (treated) respectively. In comparison, the inner layer of the untreated sample was recorded at 2.54 % shrinkage and the treated sample was at 2.29%. The tangential sample for the inner untreated sample shows 2.60% and the treated sample shows 2.40%. The same pattern of shrinkage was shown for the tangential section on the outer layer as 1.81% and 1.10% of the untreated and treated sample respectively. For the longitudinal surface, the inner layer section of the untreated sample was recorded at 0.39% compared to the treated sample at 0.25%. In comparison, a longitudinal surface section for the outer layer of the untreated sample was recorded at 0.38% while the treated sample was recorded at 0.33% shrinkage percentage. The effect of ethanol treatment on the shrinkage is significantly different between different sections (P-value: 0.01) and between the outer and inner layers (P-value: 0.02). The result suggested that ethanol treatment could be an option for the oil palm trunk drying process. Dried oil palm trunk can be utilized as a potential substitution of biomass and wood to produce various products

Effects of Torrefaction Process on Chemical Properties of Small Diameter Acacia mangium Wood

Torrefaction refers to a thermal process that involves the processing of biomass in a torrefied to produce a "charred" product that can be utilised as a fuel or as a soil amendment. People need energy sources to meet their basic needs and live the kind of life they want. Acacia mangium was selected in order to produce biochar and determine the lignocellulosic affected by the holding temperature and residence time. The chemical properties of torrefied Acacia mangium biochar were investigated at different holding temperatures and residence times. Torrefaction were carried out at several process temperatures, ranging from 200 to 300°C, with residence time ranging from 30 to 90 minutes. According to the findings, the effects of holding temperature and residence time on the chemical properties of torrefied Acacia mangium biochar was carried out. The results show that the chemical properties decreased with an increase in both the holding temperature and residence time except for the lignin percentage content. It shows that as the holding temperature and residence time increased, the lignin content increased. The results shows that the chemical properties are decreased, except for the lignin content, which is not affected by the factors. The chemical bond in lignin content is hard for breaking down. Hence, torrefaction is accountable for the decrease of chemical properties and the breaking of chemical bonds in chemical properties

Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Background: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

On the Mechanism of Turbulent Heat Transfer of Liquid Metals Flowing in Circular Conduits

171 p.Thesis (Ph.D.)--University of Illinois at Urbana-Champaign, 1959.U of I OnlyRestricted to the U of I community idenfinitely during batch ingest of legacy ETD

Assessment for learning : supervisory feedback practice in higher education

Assessment for learning is a term used to denote a continuous assessment of student’s progress with accompanying feedback to improve learning. So, this paper aims to investigate the assessment feedback (AFB) practices among supervisors in one of Higher Education (HE) institutions in Malaysia on three specific dimensions; Timeliness, Meaningfulness and Specificity. It also examined the significant mean difference of perceived Supervisory AFB practices in relation to postgraduate (PG) students’ gender, mode of study (MOS) and field of study (FOS) using crosssectional survey design. A total of 306 PG students who were currently pursuing their research studies have been selected using multistage cluster sampling technique. A self-developed instrument known as Supervisory Assessment Feedback Questionnaire (reliability index .92) which consisted of 38 items was used to collect the data. Overall result shown that Supervisory AFB practices were at the highest level for Meaningfulness (M=4.35, SD = .69), followed by Timeliness (M=4.35, SD =.69) and finally Specificity (M=3.85, SD= .53). The AFB forms practiced among supervisors resulted in verbal form (M=2.87, SD= .69) higher compared to written (M=2.77, SD= .71) meanwhile the PG students’ preferences were in both. Besides, the supervisory AFB practiced seems to be significantly differed on gender factor. In summary, these results revealed some insight to be considered in order to establish an effective Supervisory AFB practice in Malaysian HE

From principle to practice : assessment for learning in Malaysian school-based assessment classroom

School-Based Assessment (SBA) has been implemented in Malaysian schools in 2011 with attempts to (i) achieve the aspiration of National Philosophy of Education towards developing learners’ physical, emotional, spiritual and intellectual abilities, (ii) reduce exam-oriented learning, (iii) evaluate learners’ learning progress and (iv) enhance teachers’ integrity in assessing, recording and reporting of learners’ learning. Malaysian SBA system laid emphasis on features like Standard-Referenced Assessment, Holistic, Integration, Balance, Robust and Assessment for Learning (AfL). The purpose of this study is (i) to investigate teachers’ AfL competencies across gender, teaching experience and measurement training and (ii) to examine the effect of gender, teaching experience and measurement training on the AfL practices. A set of questionnaire consisted of 30 items on 4 point frequency scale was used to collect data from 408 respondents which have been randomly selected using the cluster sampling procedure from 10 districts. Data were analyzed using descriptive and inferential statistics. Overall results showed that the competency levels of AfL practices were mainly at the basic level. Effect of gender were found statistically significant on the level of practices. The implications of the results that underpin AfL are discussed to enhance teachers’ overall assessment competency