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Recent studies have reported the involvement of peripheral nervous system (PNS) in association with MOG‐IgG, including isolated neuropathies. In this retrospective study we characterized the PNS involvement in MOG antibody associated disease (MOGAD). Six out of 215 MOGAD patients had PNS involvement (all polyradiculopathy) that occurred concurrently with a CNS demyelinating episode. We also demonstrated MOG expression in healthy human controls' proximal nerve root. Nine patients with true‐positive MOG‐IgG1 had PNS involvement temporally unrelated to a CNS demyelinating event. All these patients had an alternate etiology of PNS involvement. Isolated peripheral neuropathy is not a feature of MOGAD, but inflammatory nerve root involvement can occur concurrently with CNS demyelinating events. [ABSTRACT FROM AUTHOR]

In this work, synthesis of WO 3 nanoparticles is reported using a novel, yet simplified microwave-metal discharge approach. The discharge was triggered from the pointed tip of a tungsten electrode, which eventually got vaporized and deposited on the collector substrates surrounding the metallic electrode. The buildup of high electric field at the tip of the tungsten electrode ionized the surrounding air molecules that lead to the discharge formation. X-Ray diffraction revealed monoclinic phase of the synthesized WO 3 nanoparticles. The morphological analysis executed using transmission electron microscopy showed the presence of single crystalline nanoparticles in spherical, rhombic, and rectangular shapes. X-ray photoelectron spectroscopy confirmed the elemental composition and showed formation of stoichiometric WO 3. Thermal stability analysis showed high stability of the nanoparticles below 1200 °C. The nitrogen absorption-desorption studies suggested that the nanoparticles exhibited a mesoporous structure. The antimicrobial susceptibility tests indicated an increased resistance towards Gram-negative bacteria (E. coli) compared to Gram-positive bacteria (S. aureus). [Display omitted] [ABSTRACT FROM AUTHOR]

Objective : The objective was to describe the clinical presentations, radiologic features, and outcomes of patients with autoimmune encephalitis associated with myelin oligodendrocyte glycoprotein antibody (MOG). Background: During the past decade, the spectrum of the myelin oligodendrocyte glycoprotein antibody-associated diseases (MOGAD) has expanded. Recently, patients with MOG antibody encephalitis (MOG-E) who do not fulfill the criteria for ADEM have been reported. In this study, we aimed to describe the spectrum of MOG-E. Methods: Sixty-four patients with MOGAD were screened for encephalitis-like presentation. We collected the clinical, radiological, laboratory, and outcome data of the patients who presented with encephalitis and compared it with the non-encephalitis group. Results: We identified sixteen patients (nine males and seven females) with MOG-E. The median age of the encephalitis population was significantly lower than the non-encephalitis group (14.5 years (11.75–18) vs. 28 years (19.75–42), p = 0.0004). Twelve out of sixteen patients (75%) had fever at the time of encephalitis. Headache and seizure were present in 9/16 (56.2%) and 7/16 (43.75%) patients, respectively. FLAIR cortical hyperintensity was present in 10/16 (62.5%) patients. Supratentorial deep gray nuclei were involved in 10/16 (62.5%) patients. Three patients had tumefactive demyelination, and one patient had a leukodystrophy-like lesion. Twelve of 16 (75%) patients had a good clinical outcome. Patient with leukodystrophy pattern and other with generalized CNS atrophy showed a chronic progressive course. Conclusion: MOG-E can have heterogeneous radiological presentations. FLAIR cortical hyperintensity, tumefactive demyelination, and leukodystrophy-like presentations are novel radiological presentations associated with MOGAD. Though majority of MOG-E have a good clinical outcome, few patients can have chronic progressive disease even on immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research is to extend theoretical knowledge of key variables and their interactions that impact the persuasiveness of online influencers. The study explores the interactions between influencer gender, follower gender, influencer physical attractiveness, influencer product-match and influencer-follower homophily on persuasiveness of influencer product promotions. Although the extant literature shows the persuasive impact of attractiveness, product-match, gender and homophily, less is known about the interactions of these variables with each other and the gender of the influencer and his or her followers. These gaps in the literature are explored. Design/methodology/approach: The study is a scenario-based experiment where respondents were randomly assigned to cells where influencer attractiveness and product-match were manipulated. The variables of homophily and respondent gender were measured and recorded, respectively. The data were collected through an online survey done through Qualtrics. Findings: The findings show that for female influencers, homophily felt by their followers is a dominant persuasive factor, which tends to supersede the variables of attractiveness and product-match. For male influencers, homophily is an incremental persuasive variable. That is, homophily, attractiveness and product-match interact such that persuasiveness is highest when all three variables are strong. Research limitations/implications: Limitations are that the authors used a student sample and a hypothetical scenario-based experiment. Theoretical implications are interesting in that the authors have results which add to theory on the factors that make an online influencer more persuasive. Specifically, the authors contribute by extending theoretical knowledge about the interactions of key variables that influence the impact of online influencers. Practical implications: For a manager marketing products using influencers, it is very important to stress homophily cues for female influencers more than other variables. However, for male influencers, product knowledge or match, homophily and attractiveness all need to work simultaneously to maximize influencer persuasiveness. Social implications: One needs to understand that physical attractiveness and perceived homophily with the influencer have significant influence and persuasiveness, regardless of product or service. Hence, there needs to be social responsibility in what is advertised and promoted, given that followers may be persuaded by influencers no matter what the product or service is. Originality/value: To the best of the authors' knowledge, this is the first study that explores the persuasiveness of online influencers from the perspective of the variable interactions described above. [ABSTRACT FROM AUTHOR]

Microwave-metal discharge-based drilling of metallic materials involves use of thermal energy from the plasma column for material removal. However, poor control over plasma generated in atmospheric air causes wide heat-affected zone (HAZ) and poor surface integrity around the drilled hole. The present work is an attempt to minimize drilling-related defects by incorporating circulating liquid dielectric as the drilling media. Performance of microwave drilling was assessed after machining in liquid dielectric and atmospheric air media. Stainless steel (AISI 304) and pure tungsten were chosen as the work and tool materials, respectively. Process performance parameters, such as diametrical overcut, circularity, HAZ and material removal rate (MRR), were evaluated for the drilling intervals of 40, 50 and 60 s. It was observed that the dissipation of microwave power within the liquid dielectric medium reduces the intensity of the plasma column. In addition, pressure applied by the liquid dielectric medium over the plasma column aids in its confinement. As a result, a relatively less intense and more uniform plasma column is generated in the liquid dielectric medium, which reduces erosive action on the work material. This controlled removal of work material results in a significant reduction (up to 90%) in HAZ. The uniform nature of plasma column yielded better hole circularity in liquid dielectric medium. [ABSTRACT FROM AUTHOR]

The article presents case studies related to Myelin Oligodendrocyte glycoprotein antibody syndrome and seizures. Topics include a 12‑year‑old girl presented with acute onset unsteadiness and imbalance while walking and diminution of vision from both eyes; and a 13‑year‑old boy presented with recurrent episodes of focal neurological deficits associated with pure motor paraparesis with stiffness of limbs, and horizontal binocular diplopia which were responsive to corticosteroids.

Background: Governments have imposed lockdowns in the wake of the COVID-19 pandemic. Hospitals have restricted outpatient clinics and elective services meant for non-COVID illnesses. This has led to patients facing unprecedented challenges and uncertainties. This study was carried out to assess patients' concerns and apprehensions about the effect of the lockdown on their treatments. Materials and Methods: An ambispective, observational cross-sectional single centre study was conducted. Patients were contacted telephonically and requested to answer a structured questionnaire. Their responses were documented and summarized as frequency and proportions. Results: A total of 727 patients were interviewed. Epilepsy (32%) was the most common neurological illness in our cohort followed by stroke (18%). About half the patients and/or their caregivers reported health-related concerns during the lockdown. The primary concern was how to connect with their treating neurologist if need arose. Forty-seven patients (6.4%) had drug default. Among patients on immunomodulatory treatments, only eight patients had drug default. High compliance rates were also observed in the stroke and epilepsy cohorts. Of the 71 patients who required emergency care during the lockdown, 24 could reach our hospital emergency. Fourteen patients either had a delay or could not seek emergency care. Two-thirds of our patients found the telemedicine experience satisfactory. Conclusion: The ongoing pandemic will continue to pose challenges to both physicians and patients. Patients in follow-up may need to be contacted regularly and counselled regarding the importance of maintaining drug compliance. Telemedicine can be used to strengthen the healthcare delivery to patients with non-COVID illnesses. [ABSTRACT FROM AUTHOR]

Keywords: Isaac's syndrome; hemi body; Myokymia; Neuromyotonia; autoimmunity EN Isaac's syndrome hemi body Myokymia Neuromyotonia autoimmunity 1126 1128 3 10/05/21 20211001 NES 211001 Peripheral nerve hyperexcitability syndromes are a heterogenous group of disorders with involuntary, continuous muscle activity. Initially, the twitches involved the muscles of the left calf followed by arm, thigh and trunk muscles of the left side within a span of 2 years. To the best of our knowledge, this is the first case of hemi-Isaac's syndrome or acquired neuromyotonia with hemi-body phenotype. [Extracted from the article]

What We Already Know About This Topic: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: Although randomized trials show that patients do well when given less blood, there remains a persistent impression that orthopedic surgery patients require a higher hemoglobin transfusion threshold than other patient populations (8 g/dl vs. 7 g/dl). The authors tested the hypothesis in orthopedic patients that implementation of a patient blood management program encouraging a hemoglobin threshold less than 7 g/dl results in decreased blood use with no change in clinical outcomes.Methods: After launching a multifaceted patient blood management program, the authors retrospectively evaluated all adult orthopedic patients, comparing transfusion practices and clinical outcomes in the pre- and post-blood management cohorts. Risk adjustment accounted for age, sex, surgical procedure, and case mix index.Results: After patient blood management implementation, the mean hemoglobin threshold decreased from 7.8 ± 1.0 g/dl to 6.8 ± 1.0 g/dl (P < 0.0001). Erythrocyte use decreased by 32.5% (from 338 to 228 erythrocyte units per 1,000 patients; P = 0.0007). Clinical outcomes improved, with decreased morbidity (from 1.3% to 0.54%; P = 0.01), composite morbidity or mortality (from 1.5% to 0.75%; P = 0.035), and 30-day readmissions (from 9.0% to 5.8%; P = 0.0002). Improved outcomes were primarily recognized in patients 65 yr of age and older. After risk adjustment, patient blood management was independently associated with decreased composite morbidity or mortality (odds ratio, 0.44; 95% CI, 0.22 to 0.86; P = 0.016).Conclusions: In a retrospective study, patient blood management was associated with reduced blood use with similar or improved clinical outcomes in orthopedic surgery. A hemoglobin threshold of 7 g/dl appears to be safe for many orthopedic patients. [ABSTRACT FROM AUTHOR]

The temporal relationship between auditory and visual cues is a fundamental feature in the determination of whether these signals will be integrated. The window of perceived simultaneity (TBW) is a construct that describes the epoch of time during which asynchronous auditory and visual stimuli are likely to be perceptually bound. Recently, a number of studies have demonstrated the capacity for perceptual training to enhance temporal acuity for audiovisual stimuli (i.e., narrow the TBW). These studies, however, have only examined multisensory perceptual learning that develops in response to feedback that is provided when making judgments on simple, low-level audiovisual stimuli (i.e., flashes and beeps). Here we sought to determine if perceptual training was capable of altering temporal acuity for audiovisual speech. Furthermore, we also explored whether perceptual training with simple or complex audiovisual stimuli generalized across levels of stimulus complexity. Using a simultaneity judgment (SJ) task, we measured individuals’ temporal acuity (as estimated by the TBW) prior to, immediately following, and one week after four consecutive days of perceptual training. We report that temporal acuity for audiovisual speech stimuli is enhanced following perceptual training using speech stimuli. Additionally, we find that changes in temporal acuity following perceptual training do not generalize across the levels of stimulus complexity in this study. Overall, the results suggest that perceptual training is capable of enhancing temporal acuity for audiovisual speech in adults, and that the dynamics of the changes in temporal acuity following perceptual training differ between simple audiovisual stimuli and more complex audiovisual speech stimuli. [ABSTRACT FROM AUTHOR]

In this study, we sought to investigate the use and impact of POCUS by ICU triage teams in hospitals outside of the ICU. B Introduction: b Point of care ultrasound (POCUS) has become an integral asset in intensive care units (ICU). [Extracted from the article]

We investigated the association between the ECCP intervention and critical care utilization in ED patients with Diabetic Ketoacidosis (DKA). Duration of critical care and ICU bed utilization by patients admitted during ECCP hours were compared to patients admitted during non-ECCP hours. B Conclusions: b DKA patients admitted to the ICU during ECCP hours were found to have decreased critical care duration and increased likelihood of downgrade to non-ICU level of care while still in the ED. [Extracted from the article]

During this global pandemic, it is more important than ever for institutions of higher education who have distinguished themselves by their small classes and interactive approaches to focus on ways to distinguish themselves from their peers with online means of instruction. The authors detail a means of enhancing a master of business administration (MBA) coaching program using the National Society of Experiential Education's eight principles of experiential education. The authors offer five themes from detailed reflections of MBA students and participants in a leadership certificate course to highlight the value of structuring MBA programs. Our findings may benefit program directors and coaches who wish to enhance their value propositions. [ABSTRACT FROM AUTHOR]

Objective: Neurological emergencies saw a paradigm shift in approach during the coronavirus disease-2019 (COVID-19) pandemic with the challenge to manage patients with and without COVID-19. We aimed to compare the various neurological disorders and 3 months outcome in patients with and without SARS-CoV-2 infection. Methods: In an ambispective cohort study design, we enrolled patients with and without SARS CoV-2 infection coming to a medical emergency with neurological disorders between April 2020 and September 2020. Demographic, clinical, biochemical, and treatment details of these patients were collected and compared. Their outcomes, both in-hospital and at 3 months were assessed by the modified Rankin Scale (mRS). Results: Two thirty-five patients (235) were enrolled from emergency services with neurological disorders. Of them, 81 (34.5%) were COVID-19 positive. The mean (SD) age was 49.5 (17.3) years, and the majority of the patients were male (63.0%). The commonest neurological diagnosis was acute ischemic stroke (AIS) (43.0%). The in-hospital mortality was higher in the patients who were COVID-19 positive (COVID-19 positive: 29 (35.8%) versus COVID-19 negative: 12 (7.8%), P value: <0.001). The 3 months telephonic follow-up could be completed in 73.2% of the patients (142/194). Four (12.1%) deaths occurred on follow-up in the COVID-19 positive versus fifteen (13.8%) in the COVID-19 negative patients (P value: 1.00). The 3-month mRS was worse in the COVID-19 positive group (P value <0.001). However, this was driven by higher in-hospital morbidity and mortality in COVID-19 positive patients. Conclusion: Patients with neurological disorders presenting with COVID-19 infection had worse outcomes, including in-hospital and 3 months disability. [ABSTRACT FROM AUTHOR]

Natural fiber‐reinforced composites are gaining significant popularity for their biodegradability and eco‐friendliness. Fiber modifications and hybridization have been used to address issues like hydrophilicity and fiber inhomogeneity. However, efficient manufacturing is still a challenge for natural fiber‐reinforced polymer composites. The present study explores the potential of microwave processing of hybrid laminates composed of sisal and jute fibers. The laminates, consisting of linear low‐density polyethylene (LLDPE) as matrix and sisal and jute as reinforcement materials were subjected to microwave processing at specific power, time, frequency, and loads. Four types of laminates with different stacking sequences: sisal‐sisal‐sisal (SSS), sisal‐jute‐sisal (SJS), jute‐sisal‐jute (JSJ), and jute‐jute‐jute (JJJ) were developed. The developed composites showed ~3% void content, with the SJS and JSJ composite having the least and highest void content, respectively. The SJS composite showed the highest tensile and flexural strength of 15.27 and 20.40 MPa, respectively, out of all the configurations and an improvement of 42% and 85% over pure LLDPE. Hybrid composites having high‐strength fibers in the skin layer exhibited superior mechanical properties. Microscopic examination of the fractured specimens revealed that fiber pull‐out and fiber breakage were the primary failure mechanisms of failure. Lateral failure due to delamination between matrix and fiber was predominant with grip and gauge regions as frequent failure points. The incorporation of sisal and jute fiber reinforcement into the polymers doesn't change the thermal stability of the fabricated composites significantly. The above results show that microwave‐assisted processing is a promising method for producing natural fiber‐reinforced hybrid polymer composites. Highlights: Development of hybrid laminates using microwave energy at 2.45 GHz.The mechanism of microwave‐based processing of polymer composites has been discussed.Effect of layering sequence on mechanical and thermal properties of the developed composite.Assessment of tensile strength with morphology, flexural strength and thermo‐gravimetric analysis. [ABSTRACT FROM AUTHOR]

A case study of a 38‑year‑old gentleman presented with two episodes of sudden onset right hemiparesis in the past 3 years with good recovery along with progressively increasing cognitive impairment. Topics include Cognitive functions were impaired with the pronounced impairment of frontal and temporal lobes on detailed assessment; and computed tomographic (CT) angiography showed multiple fusiform aneurysms in the bilateral distal cervical internal carotid artery.

Objective: Seizures are a common manifestation of paraneoplastic neurologic syndromes. The objective of this study was to describe the seizure characteristics and outcomes in patients with high‐risk paraneoplastic autoantibodies (>70% cancer association) and to determine factors associated with ongoing seizures. Methods: Patients from 2000 to 2020 with seizures and high‐risk paraneoplastic autoantibodies were retrospectively identified. Factors associated with ongoing seizures at last follow‐up were evaluated. Results: Sixty patients were identified (34 males, median age at presentation = 52 years). ANNA1‐IgG (Hu; n = 24, 39%), Ma2‐IgG (n = 14, 23%), and CRMP5‐IgG (CV2; n = 11, 18%) were the most common underlying antibodies. Seizures were the initial presenting symptom in 26 (43%), and malignancy was present in 38 (63%). Seizures persisted for >1 month in 83%, and 60% had ongoing seizures, with almost all patients (55/60, 92%) still being on antiseizure medications at last follow‐up a median of 25 months after seizure onset. Ongoing seizures at last follow‐up were associated with Ma2‐IgG or ANNA1‐IgG compared to other antibodies (p =.04), highest seizure frequency being at least daily (p =.0002), seizures on electroencephalogram (EEG; p =.03), and imaging evidence of limbic encephalitis (LE; p =.03). Death occurred in 48% throughout the course of follow‐up, with a higher mortality in patients with LE than in those without LE (p =.04). Of 31 surviving patients at last follow‐up, 55% continued to have intermittent seizures. Significance: Seizures in the setting of high‐risk paraneoplastic antibodies are frequently resistant to treatment. Ongoing seizures are associated with ANNA1‐IgG and Ma2‐IgG, high seizure frequency, and EEG and imaging abnormalities. Although a subset of patients may respond to immunotherapy and achieve seizure freedom, poor outcomes are frequently encountered. Death was more common among patients with LE. [ABSTRACT FROM AUTHOR]

The direct non-oxidative methane aromatization over commercially available gallium nitride powder has been investigated for the first time in a fixed bed reactor under continuous operation. Gallium nitride catalyst is highly active. High reaction temperatures (650–710 °C) are needed to initiate benzene formation due to the small surface area (8 m 2 g − 1 ) of the gallium nitride material, thermodynamic constraints and the low residence time (1–4 s). Besides benzene and toluene, C 2 species and coke were formed. [ABSTRACT FROM AUTHOR]

Background: Relative to first-time (primary) cardiac surgery, revision cardiac surgery is associated with increased transfusion requirements, but studies comparing these cohorts were performed before patient blood management (PBM) and blood conservation measures were commonplace. The current study was performed as an update to determine if this finding is still evident in the PBM era.Study Design and Methods: Primary and revision cardiac surgery cases were compared in a retrospective database analysis at a single tertiary care referral center. Two groups of patients were assessed: 1) those having isolated coronary artery bypass (CAB) or valve surgery and 2) all other cardiac surgeries. Intraoperative and whole hospital transfusion requirements were assessed for the four major blood components.Results: Compared to the primary cardiac surgery patients, the revision surgery patients required approximately twofold more transfused units intraoperatively (p < 0.0001) and approximately two- to threefold more transfused units for the whole hospital stay (p < 0.0001). Intraoperative massive transfusion (>10 red blood cell [RBC] units) was substantially more frequent with revision versus primary cardiac surgery (2.6% vs. 0.1% [p < 0.0001] for isolated CAB or valve and 6.1% vs. 1.9% [p < 0.0001] for all other cardiac surgeries). Revision surgery was an independent risk factor for both moderate (6-10 RBC units) and massive intraoperative transfusion.Conclusions: In the era of PBM, with restrictive transfusion strategies and a variety of methods for blood conservation, revision cardiac surgery patients continue to have substantially greater transfusion requirements relative to primary cardiac surgery patients. This difference in transfusion requirement was greater than what has been previously reported in the pre-PBM era. [ABSTRACT FROM AUTHOR]

MOG antibody associated disease is a relatively new disorder for which the full clinical spectrum is being described and the literature is evolving. The current study outlines the observations on a cohort of patients diagnosed with this clinical entity. This is a retrospective review of prospectively followed up patients with MOG antibody positive neurological illness. Case records of patients following up in neuroimmunology clinic of All India Institute of Medical Sciences(AIIMS), New Delhi from January 2007 to July 2019 were reviewed for MOG antibody positivity and those patients with positive antibody result were included in this study. A total of 20 patients were tested positive for MOG-IgG antibody. 75% were females. Median (Range) age was 30.5 years (8-58). Median disease duration was 22 months (1–139). Most common symptom at presentation was decrease in vision (unilateral or bilateral) (80%). Most common syndrome at onset was unilateral optic neuritis (ON) (40%) followed by bilateral ON (35%), transverse myelitis (TM)(15%), ON plus TM (5%) and cerebral syndrome (5%). Median number of demyelinating episodes per person was 2.5. Out of 29 affected eyes, 26 had good outcome. Out of 7 patients with motor disability, 5 patients had good outcome. MOG antibody associated disease presents predominantly as recurrent ON, but may also present as an opticospinal, cerebral or brainstem syndrome and recurrent myelitis. Many of the patients had relapses, but had good outcomes with treatment. Disease spectrum of anti-mog antibody associated disease. Figure showing the disease spectrum at onset (top) and at last follow up (bottom). Unlabelled Image • Anti-MOG antibody associated disease is an evolving entity which has not been studied extensively from an Indian perspective • We report a retrospective chart review of twenty patients with this disease • Though recurrent optic neuritis is the most common manifestation, this disease affects whole of neuroaxis sparing the peripheral nervous system • Good outcomes were noted in the patients studied despite frequent relapses. [ABSTRACT FROM AUTHOR]