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Paraneoplastic neurologic syndromes are cancer-associated, immune-mediated neurologic manifestations that may involve any part of the nervous system. They usually present with characteristic neurologic features and should be considered in high-risk phenotypes such as limbic encephalitis, encephalomyelitis, rapidly progressive cerebellar syndrome, opsoclonus-myoclonus, sensory neuronopathy, enteric neuropathy, and Lambert-Eaton myasthenic syndrome. The diagnosis is made by antibody positivity in the serum or cerebrospinal fluid, in the presence of an appropriate clinical phenotype. Findings on antibody testing by immunoblot should always be verified by immunofluorescence. We report a rare case of sensory neuronopathy with triple paraneoplastic antibody positivity (anti-Hu, anti-collapsing response-mediator protein 5, and anti-amphiphysin) on immunoblot but only anti-Hu positivity on immunofluorescence. The presence of lower facial dyskinesias should raise the possibility of an immune-mediated neurologic syndrome in the appropriate clinical context. Keywords: Ataxia, paraneoplastic, PNS, sensory neuronopathy, SNN, Author(s): S Sidharth [1]; Ayush Agarwal (corresponding author) [1]; Divyani Garg [1]; Anita Mahadevan [2]; Shamim A Shamim [3]; Pranjal Gupta [4]; Divya M Radhakrishnan [1]; Awadh K Pandit [1]; [...]

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.

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]

What are the typical printing behaviors of students? What is the extent of wastage? What are student attitudes towards different pay-per-print schemes? What might be strategies for educational institutions to achieve less printing while not impeding pedagogical quality?

Byline: Ayush. Agarwal, Pritam. Mazumdar, Pranjal. Gupta, Ajay. Garg, Divya. Radhakrishnan, Animesh. Das, Awadh. Pandit, Achal. Srivastava Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an inherited, [...]

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]

Byline: Kanchana. Pillai, Deepti. Vibha, Pranjal. Gupta, Pachipala. Sudheer, Biswamohan. Mishra, Rahul. Oinam, Ayush. Mohan, Kamalesh. Tayade, Padma. Srivastava, Manjari. Tripathi, Achal. Srivastava, Rohit. Bhatia, Roopa. Rajan, Awadh. Pandit, Rajesh. [...]

Byline: Pranjal. Gupta, Biswamohan. Misra, Pachipala. Sudheer, Rohit. Bhatia, Mamta. Singh, M. P. Srivastava, Manjari. Tripathi, Achal. Srivastava, Kameshwar. Prasad, Deepti. Vibha, V. Vishnu, Awadh. Pandit, Rajesh. Singh, Anu. Gupta, [...]

Byline: Ayush. Agarwal, Pranjal. Gupta, Archana. Sharma, Anu. Gupta, Ajay. Garg, Roopa. Rajan, Venugopalan. Vishnu, Rohit. Bhatia, Mamta. Singh, Vinay. Goyal, M. Padma Srivastava Sir, Myelin oligodendrocyte glycoprotein (MOG) antibodies [...]

Introduction: The development of new autoantigen discovery techniques, like programmable phage immunoprecipitation sequencing (PhIP-Seq), has accelerated the discovery of neural-specific autoantibodies. Herein, we report the identification of a novel biomarker for paraneoplastic neurologic syndrome (PNS), Sloan-Kettering-Virus-Family-Transcriptional-Corepressor-2 (SKOR2)- IgG, utilizing PhIP-Seq. We have also performed a thorough clinical validation using normal, healthy, and disease/cancer control samples. Methods: Stored samples with unclassified staining at the junction of the Purkinje cell and the granule cell layers were analyzed by PhIP-Seq for putative autoantigen identification. The autoantigen was confirmed by recombinant antigen-expressing cell-based assay (CBA), Western blotting, and tissue immunofluorescence assay colocalization. Results: PhIP-Seq data revealed SKOR2 as the candidate autoantigen. The target antigen was confirmed by a recombinant SKOR-2-expressing, and cell lysate Western blot. Furthermore, IgG from both patient samples colocalized with a commercial SKOR2-specific IgG on cryosections of the mouse brain. Both SKOR2 IgG-positive patients had central nervous system involvement, one presenting with encephalitis and seizures (Patient 1) and the other with cognitive dysfunction, spastic ataxia, dysarthria, dysphagia, and pseudobulbar affect (Patient 2). They had a refractory progressive course and were diagnosed with adenocarcinoma (Patient 1: lung, Patient 2: gallbladder). Sera from adenocarcinoma patients without PNS (n=30) tested for SKOR2-IgG were negative. Discussion: SKOR2 IgG represents a novel biomarker for PNS associated with adenocarcinoma. Identification of additional SKOR2 IgG-positive cases will help categorize the associated neurological phenotype and the risk of underlying malignancy. [ABSTRACT FROM AUTHOR]

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]

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]

India always had cultural and commercial linkage with Central Asian countries in past. However, in spite of these linkages, actual trade volume remained below potential after Independence of India. Since the beginning of the new millennium, the growing energy security needs compelled India to look for newer sources of energy products and the export basket of the five Central Asian countries, namely, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan fitted perfectly with this goal. This paper looks into the trade pattern between Central Asian Countries and India and it first discusses a brief account of the share of Central Asian countries (CAC) in India's trade basket and then it analyzes the nature of products traded between India and five countries of CAC viz. Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan. Major products exported and imported have been along with sectors with growing export inclination are identified. [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]

The association of hematological parameters especially platelet parameters with disease severity in malaria is poorly understood. We aimed to characterize the platelet parameters across Plasmodium falciparum and Plasmodium vivax malaria stratified by severity and to elucidate the potential role of platelet parameters to predict disease severity. Individuals > 18 years, of either gender with microscopically proven symptomatic malaria were prospectively enrolled between October 2014 and August 2016 in a tertiary center in Manipal, India. Severity of malaria was defined as per the WHO definition. Among 159 patients, 32 (20.1%) had severe malaria. 116 (73%) had infection with P. vivax, 37 (23%) P. falciparum and 6 mixed infection. Thrombocytopenia was seen in 32 (86.4%) of P. falciparum and 105 (90.5%) of P. vivax malaria cases. Patients with renal failure (p=0.02), shock (p=0.04) and liver dysfunction (p<0.001) had significantly lower platelet count compared to those who did not. Admission platelet count of 50,000 cell/mm3 had a sensitivity and specificity of 65.6% and 70.6% respectively, to discriminate severe malaria. A plateletcrit of 0.05% had a sensitivity and specificity of 65.6 % and of 70.6% respectively. Thrombocytopenia was seen in 89.3% of malaria cases due to both P. vivax and P. falciparum. Platelet count and plateletcrit could be used as markers of disease severity. P. vivax malaria which has been traditionally regarded as 'benign' can be as sinister and menacing as P. falciparum malaria and hence warrants equal attention. Unnecessary transfusion of platelets should be avoided. [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]