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Neuropeptide Y (NPY1-36) is a vasoconstrictor peptide co-secreted with catecholamines by sympathetic nerves, the adrenal medulla, and neoplasms such as pheochromocytomas and paragangliomas (PPGLs). It is produced by the intracellular cleavage of proNPY and metabolized into multiple fragments with distinct biological activities. NPY immunoassays for PPGL have a diagnostic sensitivity ranging from 33 to 100%, depending on the antibody used. We have validated a multiplex micro-UHPLC-MS/MS assay for the specific and sensitive quantification of proNPY, NPY1-39, NPY1-37, NPY1-36, NPY2-36, NPY3-36, NPY1-35, NPY3-35, and the C-flanking peptide of NPY (CPON) (collectively termed NPYs), and determined the NPYs reference intervals and concentrations in 32 PPGL patients before, during, and after surgery. Depending on the peptide measured, NPYs were above the upper reference limit (URL) in 20% to 67% of patients, whereas plasma free metanephrine and normetanephrine, the gold standard for PPGL, were above the URL in 40% and 87% of patients, respectively. Age, sex, tachycardia, and tumor localization were not correlated with NPYs. Plasma free metanephrines performed better than NPYs in the detection of PPGL, but NPYs may be a substitute for an early diagnosis of PPGL for patients that suffer from severe kidney impairment or receiving treatments that interfere with catecholamine reuptake.

Background Stiff person syndrome (SPS) is an autoimmune condition involving antibodies against several components of the inhibitory synapse in the spinal cord, with glutamic acid decarboxylase antibodies being the predominant immune marker. SPS affects approximately 1 patient per million population per year. The effect of intravenous immunoglobulin (IVIG) has been established, but studies on the long‐term efficacy of regular IVIG are limited. Objectives To review clinical details and long‐term treatment response using a patient‐reported questionnaire in SPS and related syndromes. Methods Patients were identified from a tertiary neuroimmunology clinic based on classical clinical symptoms, autoimmune profiles, and neurophysiological changes (Dalakas criteria). They were followed up after treatment to assess the response to IVIG. Results A total of 23 patients fulfilled the selection criteria. Patients' demographic profiles and clinical presentations were akin to that reported in literature. There was significant improvement in the functional ability (assessed by the modified Rankin scale [mRS]) and quality of life (QoL) following treatment with IVIG within 4 to 10 weeks (pre‐mRS vs. post‐mRS, P

Summary Coronavirus 19 (COVID‐19) has been associated with both transient and persistent systemic symptoms that do not appear to be a direct consequence of viral infection. The generation of autoantibodies has been proposed as a mechanism to explain these symptoms. To understand the prevalence of autoantibodies associated with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection, we investigated the frequency and specificity of clinically relevant autoantibodies in 84 individuals previously infected with SARS‐CoV‐2, suffering from COVID‐19 of varying severity in both the acute and convalescent setting. These were compared with results from 32 individuals who were on the intensive therapy unit (ITU) for non‐COVID reasons. We demonstrate a higher frequency of autoantibodies in the COVID‐19 ITU group compared with non‐COVID‐19 ITU disease control patients and that autoantibodies were also found in the serum 3–5 months post‐COVID‐19 infection. Non‐COVID patients displayed a diverse pattern of autoantibodies; in contrast, the COVID‐19 groups had a more restricted panel of autoantibodies including skin, skeletal muscle and cardiac antibodies. Our results demonstrate that respiratory viral infection with SARS‐CoV‐2 is associated with the detection of a limited profile of tissue‐specific autoantibodies, detectable using routine clinical immunology assays. Further studies are required to determine whether these autoantibodies are specific to SARS‐CoV‐2 or a phenomenon arising from severe viral infections and to determine the clinical significance of these autoantibodies., Acute infection with COVID is associated with a pattern of autoantibodies including a high proportion with epidermal antibodies. This autoantibody pattern is more common in severe COVID and is persistent up to 6 months.

The Pollution Haven Hypothesis (PHH) claims that following the international trade, developing countries tend to specialize and export pollution-intensive goods to advanced countries. The current study examines the PHH claim in the context of exports of the six major ASEAN countries to Japan in the Environmental Kuznets Curve (EKC) framework for the period 1989-2017. The Fully Modified Ordinary Least Square (FMOLOS) panel co-integration approach has been employed to estimate the coefficients of the EKC model. The results reveal that the EKC does exist while the exports of pollution-intensive goods from the ASEAN to Japan increase the CO2 emission. The study concludes that world pollution cannot be curtailed unless advanced countries reduce the consumption of pollution-intensive goods. Therefore, an integrated well-devised global program is imperative to tackle the alarming issue of global warming, and advanced countries should lead this program.

Objectives: To know the role of child abuse and neglect (CAN) in developing psychological problems during long after life Study Design: Observational study. Setting: Department of Psychiatry and Behavioral Sciences, Govt. Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan. Period: August 2015 and February 2016. Material and Methods: Three hundred and forty (340) consecutive eligible adults complaining one of the psychological/psycho-medical problems viz. depression, anxiety, phobia, abdominal pain, or recurring diarrhea were registered using purposive sampling technique. The recruiters were asked to give responses against CAN-related questions in a locally designed Survey Form after recording the demographic information. Collected data was processed using techniques in SPSS version 17.0. Results: Of 340 cases, 297 (87.4%) were identified as psychological or psycho-medical patients. The problems appeared in 192 (90.6% of total 222) females, 221 (89.5%) rural residents, or 13 (92.9%) cases with socioeconomically poor family background at childhood. Similarly, a subject from nuclear family system was 9 times (95% CI: 5.818-14.476, p = .0001) more vulnerable to the problems than those of joint family system (92.3 vs. 29.6%). History of CAN was reported by 95.9% (n = 281) of diagnosed patients. Moreover, 85.6 to 100% victim of CAN by parents, family acquaintances or school teachers faced the mental health issues. Whereas, mental depression prevailed in CAN reporters. Conclusion: The CAN is a potential predictor for the psychological problems in life long after; hence deserves prompt practical considerations.

COVID-19 has been associated with both transient and persistent systemic symptoms that do not appear to be a direct consequence of viral infection. The generation of autoantibodies has been proposed as a mechanism to explain these symptoms. To understand this phenomenon in more detail, we investigated the frequency and specificity of clinically relevant autoantibodies in 84 individuals previously infected with SARS-CoV-2, suffering from COVID-19 of varying severity in both the acute and convalescent setting. These were compared with results from 32 individuals who were on ITU for non COVID reasons. We demonstrate a higher frequency of autoantibodies in the COVID-19 ITU group compared with non-COVID-19 ITU disease control patients and that autoantibodies were also found in the serum 3-5 months post COVID-19 infection. Non-COVID patients displayed a diverse pattern of autoantibodies; in contrast, the COVID-19 groups had a more restricted panel of autoantibodies including skin, skeletal muscle and cardiac antibodies. Our results demonstrate that severe COVID-19 induces a pattern of autoantibodies that may correlate with and contribute to the immune pathology associated with the long-term sequelae of infection.

In the last decade, a large number of neuronal cell-surface antibodies have been described which are responsible for a range of neuroimmunological central nervous system disorders. Unlike the paraneoplastic antibodies which target intracellular antigens, these antibodies appear to be pathogenic and hence identification and prompt treatment can make a substantial impact on clinical outcomes of these patients. We review the common antibodies against the ionotropic glutamate receptors (NMDAR, AMPAR), metabotropic glutamate receptors (mGluR1 and mGluR5), voltage-gated potassium channel-complex proteins (LGI1, CASPR2), and other antibodies targeted against glycine receptor, glutamic acid decarboxylase, gamma-amino butyric acid B, dopamine-2-receptor and dipeptidyl-peptidase-like protein 6.

In the recent years of industrial revolution, 3D printing has shown to grow as an expanding field of new applications. The low cost solutions and short time to market makes it a favorable candidate to be utilized in the dynamic fields of engineering. Additive printing has the vast range of applications in many fields. This study presents the wide range of applications of the 3D printers along with the comparison of the additive printing with the traditional manufacturing methods have been shown. A tutorial is presented explaining the steps involved in the prototype printing using Rhinoceros 3D and Simplify 3D software including the detailed specifications of the end products that were printed using the Delta 3D printer., Comment: Accepted for oral presentation at 2019 Second International Conference on Latest trends in Electrical Engineering and Computing Technologies (Intellect 2019)

Immune-mediated inflammation of the brain has been recognized for more than 50 years, although the initial descriptions were mainly thought to be secondary to an underlying neoplasm. Some of these paraneoplastic encephalitides express serum antibodies, but these were not thought to be pathogenic but instead have a T-cell-mediated pathophysiology. Over the last two decades, several pathogenic antibodies against neuronal surface antigens have been described in autoimmune encephalitis, which are amenable to immunotherapy. Several of these antibodies are directed against glutamate receptors (GluRs). NMDAR encephalitis (NMDARE) is the most common of these antibodies, and patients often present with psychosis, hallucinations, and reduced consciousness. Patients often progress on to develop confusion, seizures, movement disorders, autonomic instability, and respiratory depression. Although initially described as exclusively occurring secondary to ovarian teratoma (and later other tumors), non-paraneoplastic forms are increasingly common, and other triggers like viral infections are now well recognized. AMPAR encephalitis is relatively less common than NMDARE but is more likely to paraneoplastic. AMPAR antibodies typically cause limbic encephalitis, with patients presenting with confusion, disorientation, memory loss, and often seizures. The syndromes associated with the metabotropic receptor antibodies are much rarer and often can be paraneoplastic-mGluR1 (cerebellar degeneration) and mGluR5 (Ophelia syndrome) being the ones described in literature.With the advance in molecular biology techniques, it is now possible to detect these antibodies using cell-based assays with high sensitivity and specificity, especially when coupled with brain tissue immunohistochemistry and binding to live cell-based neurons. The rapid and reliable identification of these antibodies aids in the timely treatment (either in the form of identifying/removing the underlying tumor or instituting immunomodulatory therapy) and has significantly improved clinical outcome in this otherwise devastating group of conditions.

Objectives: To know the association between reporting of Qisas and Diyat Laws and elements in medicolegal certificates (MLCs)against injuries in children. Study Design: Retrospective cross sectional. Setting: Two DHQ and 2 THQ level hospitals in Sialkot, Pakistan. Period: January-March 2015. Method: The MLCs (issued from 1st January through 31st December 2014) were segregated on the basis of history of the cases. All the certificates of each history were reviewed for the criminal law reporting. The inclusion criteria (i.e. at least one MLC with law reporting) meeting histories were included in the study. The MLCs on history of fight were kept in group A while that of other histories in B. The data was subjected to SPSS for analysis of the variables. Results: Incidence rate of law reporting was found as 50.4% in the pooled data. Only 160 (71.1%) or 54 (43.2%) cases of group A or B were certified according to the Qisas and Diyat Laws, respectively. On the average, higher reporting rate was observed in group A and Bfrom July through November, 2014 (45.3 and 44.5%, respectively). The law certification had insignificant association with none of the elements in MLC except age in group A with more likelihood for a 10-18 years old child (RR = 1.69; 1.060-2.693; p = .04). Subsections 337-F1 (Ghayr Jaifah Damiyah) and 337-L2were frequently reported in almost all the histories of cases. Conclusion: Most of the MLCs on fight were certified according to the Qisas and Diyat Laws. Moreover, measures by authorities are needed to limit the incidences ofinjuries in children.

Immune-mediated inflammation of the brain has been recognized for more than 50 years, although the initial descriptions were mainly thought to be secondary to an underlying neoplasm. Some of these paraneoplastic encephalitides express serum antibodies, but these were not thought to be pathogenic but instead have a T-cell-mediated pathophysiology. Over the last two decades, several pathogenic antibodies against neuronal surface antigens have been described in autoimmune encephalitis, which are amenable to immunotherapy. Several of these antibodies are directed against glutamate receptors (GluRs). NMDAR encephalitis (NMDARE) is the most common of these antibodies, and patients often present with psychosis, hallucinations, and reduced consciousness. Patients often progress on to develop confusion, seizures, movement disorders, autonomic instability, and respiratory depression. Although initially described as exclusively occurring secondary to ovarian teratoma (and later other tumors), non-paraneoplastic forms are increasingly common, and other triggers like viral infections are now well recognized. AMPAR encephalitis is relatively less common than NMDARE but is more likely to paraneoplastic. AMPAR antibodies typically cause limbic encephalitis, with patients presenting with confusion, disorientation, memory loss, and often seizures. The syndromes associated with the metabotropic receptor antibodies are much rarer and often can be paraneoplastic-mGluR1 (cerebellar degeneration) and mGluR5 (Ophelia syndrome) being the ones described in literature.With the advance in molecular biology techniques, it is now possible to detect these antibodies using cell-based assays with high sensitivity and specificity, especially when coupled with brain tissue immunohistochemistry and binding to live cell-based neurons. The rapid and reliable identification of these antibodies aids in the timely treatment (either in the form of identifying/removing the underlying tumor or instituting immunomodulatory therapy) and has significantly improved clinical outcome in this otherwise devastating group of conditions.

Vehicles are getting transformed from a single source of energy to dual or multiple sources of energy due to ever-increasing fuel problems and environment-related issues. Although hybrid vehicles provide environmental friendly option, however, they require sophisticated mechanical, electrical, and electronic parts and systems. As a result, hybrid cars are more expensive than fossil fuel-based conventional cars. One of the cost effective options is to convert used fossil fuel-based conventional cars into hybrid or electric cars. This conversion requires installation of electric motor and complex electronic control system for smooth and safe operation. This paper presents necessary details about the conversion of a conventional fossil fuel-based car into a solar-electric hybrid (SOLECT) car. Conversion of a conventional car into a SOLECT car can help people to save on fuel costs and protect environment.

BackgroundThe longer-term trajectory of seizures associated with autoimmune encephalitis (AIE) is not clear. Recent data in NMDA AIE suggests seizures manifest early and are generally short lived, but in LGI1 AIE they occur later and continue longer. We characterised seizure semiology and associated prognosis in two cohorts of AIE patients.MethodsCase note review of 14 patients with a ‘definite’ diagnosis of anti-NMDAR AIE and 14 patients with LGI1 AIE showed the latter to occur in older adults. Patients were categorized as having seizures within one month of presentation or no seizures and the semiology was classified as focal or generalised onset.ResultsIn the NMDA group A, 3/7 patients (23%) had focal onset compared to 6/11 patients (55%) in the LGI1 group, with predominantly faciobrachial dystonic seizures. NMDA patients were more likely to be seizure-free at 6 months (9/12, 75%) compared to LGI1 patients (6/14, 43%). Similarly, much fewer NMDAR patients remained on ant-epileptic medications at 1 year compared to the LGI1 patients. Neither seizure semiology at presentation nor presence of inflammation on MRI correlated with longer term seizure trajectory in both groups.ConclusionSeizures are common presenting symptoms in these AIE groups. More NMDA patients were seizure-free at 6 months and did not require AEDs after 1 year compared to the LGI1 patients. LGI1 patients represented a more susceptible group of AIE patients to epilepsy.

IntroductionIn patients with stiff person syndrome (SPS) and related syndromes the objective of treatment is to provide symptomatic relief from stiffness and spasms. Intravenous immunoglobulin (IVIG) therapy is a commonly prescribed treatment for SPS patients, however there is no widely used method of assessing the effectiveness of IVIG treatment in SPS. This issue has been addressed by the introduction of the Birmingham Response to IVIG Treatment (BRIT) scale.MethodsData from 21 patients was retrospectively analysed to explore a number of outcomes including: time to diagnosis, antibody statuses, clinical phenotype, first symptom, distribution of stiffness and EMG changes and treatments received.9/21 patients had pre- and post-IVIG BRIT data, which was analysed using paired t-tests.ResultsAverage time from first presentation to diagnosis was 37 months (range: 1–180 months). Anti-GAD antibody was positive in 18/21 (85.7%) with two glycine positive and one seronegative patient. EMG changes were found in 5/15 (33.3%) of patients.Both functional ability score (p=0.0422) and quality of life score (p=0.0175) improved with statistical significance after receiving IVIG treatment.ConclusionIVIG treatment is effective in improving quality of life and functional ability in SPS patients. Treatment response can be comprehensively measured using the BRIT scale.

Major trends in photodetectors design are the achievement of higher efficiencies and larger bandwidths. In this paper, the performance of zero-bias and biased pin waveguide photodetector is compared with respect to internal and external quantum efficiencies. Internal quantum efficiencies as high as 98 % are achieved.

When a laser diode (LD) is operated at high current densities, the junction temperature can rise significantly above the heat sink temperature. Generally, rise in junction temperature is a direct consequence of inability of different layers in a laser diode to dissipate heat efficiently due to finite thermal resistance. Usually, thermal resistance increases with a reduction in stripe width. Hence, the issue of thermal management becomes very important in modern days narrow stripe-geometry lasers. In this paper, the effect of stripe width on the junction temperature of a stripe-geometry semiconductor LD is analyzed by originating different heat sources. This has been accomplished using a simple technique for the measurement of junction temperature of a LD.

Major objective of monolithic integration of active optical components are small size, low power consumption, low cost, improved performance and reliability. Most of these goals can be achieved in multi-segment devices where each segment can be used as optical source, detector, amplifier, switch, modulator etc. In this paper, detecting properties of a four segment twin tandem-stripe monolithically integrated device are investigated experimentally. Results are justified with the help of hybrid active waveguide devices in order to make investigations more reliable.

This chapter reviews the history and the method for antinuclear autoantibodies (ANAs) testing on HEp-2 cells and its utility in a laboratory setting. Antinuclear antibody tests have their origin in the “L.E.” cell phenomenon, which was the observation that neutrophils from patients with systemic lupus erythematosus (SLE) ingested other leukocytes. Widespread commercial production of HEp-2 cells and the development of national quality control schemes ensured that the test entered worldwide routine laboratory usage. The nuclear envelope is the membrane that maintains the integrity of the nucleoplasm during interphase. Important autoantibodies are found against most of the cell cycle-related structures that have been mentioned, such as the centromeres, proliferating cell nuclear antigen, mitotic spindle proteins, and centriole proteins. The pattern on HEp-2 cells is usually sufficient to identify most of these autoantibodies. The majority of laboratories use a non-affinity-purified, fluorescein-conjugated second antibody directed against IgG, -A, and -M heavy chains (or anti-IgG heavy and light chains). The HEp-2 cells should be observed by using an epifluorescence microscope fitted with filters appropriate for fluorescein detection. The largest variation in results reported to quality control schemes relates to differences in fluorescence intensity of the samples. The ANA immunofluorescent HEp-2 test is intended to be used for screening and titration of circulating antinuclear antibodies. Autoantibodies occur in both physiological and pathological conditions.

Antineuronal antibodies are associated with rare paraneoplastic neurological syndromes, and their identification alerts clinicians to examine for the presence of a tumor. Presented here is laboratory experience (prevalence, difficulties, and procedures) and several interesting but inconclusive results. A total of 1045 samples were screened over a 2-year period; 91 showed a degree of binding of antibodies to the cerebellum, and 22 of these 91 were confirmed, by Western blot, to have specific antineuronal antibodies. Thirteen of 22 were Hu-positive, and 6 of these also had antinuclear antibodies. Six were Yo-positive, 2 had anti-Ma antibodies, and 1 was Tr-positive. An additional 27 of 91 patients had cerebellar antibodies giving recognized staining patterns (Hu, Yo, and Ma). However, Western blot did not confirm these specificities, and hence they were reported as atypical. Six of 27 of these patients had neoplasms; 3 of the 6 gave nucleolar patterns (not Ma). Two appeared similar to Yo, and 1 similar to Hu. Antineuronal antibodies are rare, and in the absence of a specific etiology patients should be examined further for the possible presence of an underlying tumor. Methodical classification of the antibodies must be conducted to avoid incorrect reporting. Further criteria on the typing/reporting of atypical results may aid diagnosis of paraneoplastic neurological syndromes.