Catalytic Effect of Reactive Extraneous Mineral Composites on Char and Tar Distribution during Pyrolysis of Highveld Partially Oxidized Fine-Coal Reject and Its Beneficiated Residues.

In this study, the South African partially oxidized fine-coal reject (FCR), which is associated with human health and environmental problems and sustains high disposal expenses, was subjected to density-separation, chemical fractionation, and demineralization experiments to isolate and evaluate the mode of occurrence of mineral-matter (MM) effects on the FCR pyrolysis. A unique composite of two reactive oxides (i.e., MgO and Fe2O3) and a hydrated oxide [i.e., Ca(OH)2] representing major extraneous coal-minerals were blended with either FCR, demineralized FCR, and its beneficiated samples to evaluate the yields of pyrolytic products and activation energy following a novel procedure. The properties of FCR samples and their pyrolytic products were determined by different analyses. Results indicate that the reactive oxides and a hydrated oxide composite addition increased the average activation energy (332.0-476.5 kJ/mol) for FCR due to the initial Ca(OH)2 decomposition and Fe2O3 reduction that took place under pyrolysis conditions. The FCR mineral-rich sink fractions achieved the highest carbon conversion (char yield = 78.8% and tar yield = 5.1%) compared to those of other samples (e.g., <1.9 g/cm3 float char yield = 87.3% and tar yield = 2.3%) evaluated due to higher proportions of calcite/dolomite/pyrite cleats and nonmineral inorganics (Ca, Mg, Na, and Fe) which catalyzed the pyrolysis reactions. On the other hand, CaCO3, CaMg(CO3)2, and metakaolinite formations in the char derived from a blend of reactive oxides and a hydrated oxide composite and FCR interfere with the pyrolysis reactions. Also, deoxygenation reactions were impeded by oxygen present in the reactive oxides and a hydrated oxide composite. The potent catalytic effects of cleat minerals and the extraneous minerals associated with cracking of heavy tars to lighter fractions open opportunities to further understand the mode of occurrence of MM present in FCR during utilization in global pyrolysis. This may reduce waste disposal costs, health-hazards, air-pollution, and FCR volumes and augments feed-coals.

Clinicopathological Analysis of HIF-1alpha and TERT on Survival Outcome in Glioblastoma Patients: A Prospective, Single Institution Study.

Glioblastoma multiforme is a highly malignant and aggressive primary brain tumor with a dismal prognosis. We studied the association of immunohistochemical expression of hypoxia inducible factor-1 alpha (HIF-1α), telomerase reverse transcriptase (TERT), isocitrate dehydrogenase 1 (IDH1) and tumor protein p53 with overall survival (OS) in glioblastoma patients uniformly treated by standard of care, with adequate follow-up. In 87 patient samples studied, 59 were male and 28 were female. The median age was 55 years. The median follow-up was 27.7 months and the median overall survival was 14.9 months. Nuclear staining of HIF-1α was expressed in all samples and scored as strong in 42 (48%) and weak in 45 (52%). Multivariable Cox regression revealed strong HIF-1α expression as an independent poor prognostic factor (Hazard Ratio 2.12, 95% CI 1.20 - 3.74, P = 0.01). There was a statistically significant difference in OS (9.8 months vs. 16.3 months) between the "HIF-1α - strong and TERT - strong" and the "HIF-1α - weak and TERT - weak" patient subgroups, as evaluated by Kaplan-Meier analysis (P = 0.005). In our study, HIF-1α expression was an independent predictor of OS. The subgroup of patients with strong expression of both HIF-1α and TERT had the poorest prognosis.

Body Mass Index as a Prognostic Marker in Glioblastoma Multiforme: A Clinical Outcome.

PURPOSE: Correlation of body mass index (BMI) with clinical outcome in patients with glioblastoma is not well documented. Hence, we studied the association between survival and pretreatment BMI in glioblastoma patients. METHODS AND MATERIALS: In this retrospective study, only patients with histopathology-confirmed glioblastoma were included. Their BMIs were calculated from height and weight measurements and recorded in medical records at their first examination. Treatment plans for all patients consisted of concurrent radiation therapy and temozolomide, followed by maintenance therapy with temozolomide. The primary endpoint was overall survival (OS). Univariate and multivariate Cox proportional hazards models were used to estimate the mortality risk associated with BMI as a continuous and categorical variable. A BMI of 18.5 to 24.9 kg/m2 was classified as normal, 25.0 to 29.9 kg/m2 as overweight, and ≥30.0 kg/m2 as obese. RESULTS: Data from 392 patients treated from January 2008 through June 2016 were analyzed. At a median follow-up of 48.6 months, the median OS was 13.5 months in normal subjects, 15.4 months in overweight subjects, and 15.1 months in obese subjects. A total of 81% of the patients died. The hazard ratios for overweight and obese patients were 0.70 (95% confidence interval, 0.54-0.92; P = .009) and 0.66 (95% confidence interval, 0.45-0.98; P = .04), respectively, when adjusted for age, Karnofsky performance score, and extent of resection. Sex, diabetes, and hypertension had no significant interactions. CONCLUSIONS: Patients with elevated BMIs had significantly better OS in our series of patients. The mechanism of this interaction needs to be explored further to understand this association.

Stereotactic radiosurgery results in three cases of intramedullary spinal cord arteriovenous malformations.

BACKGROUND CONTEXT: Intramedullary spinal cord arteriovenous malformations (AVMs) are rare and have an unfavorable prognosis. We report our experience of treating three symptomatic patients with stereotactic radiosurgery (SRS). The standard treatment for these lesions are embolization or microsurgical resection. There are only a few reports of efficacy of radiosurgery in these cases. PURPOSE: To study the efficacy of radiosurgery in intramedullary spinal cord AVM patients, who failed or refused conventional treatment. STUDY SETTING: This study reports the results of SRS in 3 cases of intramedullary spinal cord AVMs. PATIENT SAMPLE: Three symptomatic patients diagnosed with intramedullary spinal cord AVMs. Two patients underwent embolization previously and one was newly diagnosed. OUTCOME MEASURES: The AVM obliteration was assessed by yearly high-resolution magnetic resonance imaging (MRI). Clinical examination was carried out every 6 months. METHODS: Three symptomatic patients with intramedullary spinal cord AVMs were treated with SRS using the cyberknife system from January 2010 to May 2011. All the three patients presented with acute neurologic symptoms. Two patients were treated previously with embolization. As per protocol, patients underwent a plain computed tomography (CT), CT angiography, high-resolution MRI, and conventional spinal angiography for radiotherapy planning. The mean target volume was 4.05 cc. The prescribed dose was 21 Gy in three fractions on consecutive days. No special immobilization was done during treatment. Continuous image guidance of the treated area was done using the specialized spine tracking software. Follow-up was done by yearly clinical examination and high-resolution spine MRI after SRS. RESULTS: Mean follow-up was 36 months. Follow-up MRI revealed absence of flow voids, suggesting complete obliteration of the AVM in two patients, with significant improvement in neurologic and functional symptoms. The third patient did not show any clinical improvement or deterioration. There was no incidence of hemorrhage after SRS in any patient and the treatment was well tolerated without any significant complications. CONCLUSIONS: Stereotactic radiosurgery for intramedullary spinal AVMs appears to be well tolerated and effective in selected cases.