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implicates the central projections of the sensory ganglion cells ie, a lesion in the posterior columns of the spinal cord Regional loss of a re ex is usually a sign of a radiculopathy Sensory Loss (See also pages 138 to 142) Most polyneuropathies cause impairment of both motor and sensory functions, but one may be affected more than the other In most of the toxic and metabolic neuropathies, sensory loss exceeds weakness; and in sensory neuronopathy, there is no motor de cit By contrast, in GBS paralysis is more prominent than sensory loss These differences are emphasized in the descriptions of individual peripheral nerve diseases in the later parts of the chapter In the polyneuropathies, sensation is affected symmetrically in the distal segments of the limbs, and more in the legs than in the arms In most types, all sensory modalities (touch-pressure, pain and temperature, vibratory and joint position senses) are impaired or eventually lost, although one modality may be affected out of proportion to the others, or super cial sensation may be impaired more than deep sensation Vibratory sense is often affected more than position and tactile senses In extreme cases, as the neuropathy worsens, there is spread of sensory loss from the distal to more proximal parts of the limbs and, eventually, to the anterior abdomen, thorax, and the face An escutcheon pattern of sensory loss over the abdomen and thorax in severe axonal neuropathy may be mistaken for the sensory level of a spinal cord lesion Another characteristic form of sensory loss affects the trunk, scalp, and face; this is the pattern of a sensory ganglionopathy that is the result of simultaneous affection of distal and proximal parts of the sensory nerve A pattern that is the converse of the large ber sensory may be manifest in some diseases namely, a loss of pain and temperature sensation with either sparing or lesser impairment of touchpressure, vibratory, and position senses This pattern resembles the dissociated sensory disturbance of syringomyelia (pages 140 and 1084) In some types of polyneuropathy it may be found predominantly in the lumbosacral region (it was originally referred to as lumbosacral syringomyelia ) This pseudosyringomyelic dissociation of sensation may extend over the arms, trunk, and even cranial surfaces Thevenard was the rst to question its spinal basis, and it is now generally agreed that most such examples are due to hereditary or certain acquired small- ber sensory neuropathies (amyloidosis, toxins such as chemotherapy, in congenital absence of pain, Riley-Day syndrome, and Tangier disease) Exceptionally, as in one of the families studied by Adams and associates, all forms of sensation may be lost over the entire body, while motor power and autonomic functions are preserved Most often, universal sensory loss is attributable to an acquired disease affecting the sensory ganglia (sensory neuronopathy); usually this is a paraneoplastic process, but certain toxic or immune diseases do the same (eg, Sjogren disease, scleroderma) Paresthesias, Pain, and Dysesthesias These sensory symptoms have been described in Chap 9 They tend to be especially marked in the hands and feet Pins and needles, stabbing, tingling, prickling, electrical, and Novocain-like feeling, are the adjectives chosen by patients to describe these abnormalities In some sensory neuropathies paresthesias and numbness are the only demonstrable features; objective sensory loss is lacking Certain neuropathies cause pain, which may be described as burning, aching, sharp and cutting, or crushing, and at times may resemble the lightning pains of tabes dorsalis Perversion of sensation (allodynia) is common-.

options may not have the vega to make up for the losses on the long option positions If you are trading a double diagonal spread using options on futures, you need to account for any basis difference between the underlying contract for the near-term options versus the deferred contract There can be substantial price difference between futures contract that may cause the near-term strangle to be misaligned with the deferred The example we used with the S&P is a futuresbased spread, but it works beautifully because the May S&P options are serial options based on the June futures This avoids basis differences between underlying contracts A common mistake for novice traders is to look at the long double diagonal spread as free trade by buying the near-term options at a lower premium and selling out-of-the-money deferred options at an equal or higher premium The dif culty with this spread is that the Greeks are not in your favor The volatility effect on the deferred short option is likely to be greater than the near term and thus create signi cant volatility risk The theta will be much greater on the short-term purchased options causing the purchased options to lose value much faster regardless of the movement of the underlying asset

We talk about these things called KPIs quite a bit Seems that everyone has some KPIs that they have to manage and need to understand the process of managing them during the business process Again, on this topic there are is a ton of additional information and material that is available so I ll keep my discussion just to the comments that make sense to our topic here rather than going into too much conceptual information There are a number of situations where the whole idea of KPIs needs to be revisited and reworded Maybe we can call it something else so that we get a clear picture of what these indicators really are I ve reviewed some of my projects and identified some of the critical areas where we will have to focus during the process of developing the correct KPIs One of my cardinal rules is that we try desperately to avoid having too many KPIs I can t tell you the number of times where I ve seen a dashboard overloaded with KPIs and you re constantly trying to manage one or the other of these different indicators We all know that there are critical indicators that will make or break our businesses and we just have to find the right ones and make sense of them