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Evaluation of Split Hand Syndrome in Early Diagnosis of Amyotrophic Lateral Sclerosis by Nerve Conduction Study as a Diagnostic Tool

Abstract
Background: Amyotrophic lateral sclerosis (ALS), a
degenerative disease of the motor neurons that can present
diversly. Needle electromyography (EMG) is the gold
standard investigation for the diagnosis of ALS. Split hand
syndrome (SHS) demonstrated by nerve conduction study
(NCS); a noninvasive tool could be useful in diagnosing
ALS. This study aimed to assess SHS by NCS in ALS.
Materials & Method: This diagnostic accuracy case-control
study included 37 cases of ALS and 37 age and gendermatched
controls. Compound muscle action potential
(CMAP) and distal motor latency (DML) of median and
ulnar nerves and the ratio of median and ulnar CMAP and
DML were compared between study groups. The diagnostic
validity testing of electrophysiological SHS was also done.
Results: The mean age of the ALS and control groups were
similar, 39.8±2.7 and 39.3±2.6 years, respectively. Sixteen
(43.2%) ALS patients were in 30-59 years age group. Malefemale
ratio was 5.2. In the ALS group, median-ulnar CMAP
ratio was lower and median-ulnar DML ratio was prolonged
than the control. The diagnostic efficacy of median-ulnar
CMAP ratio and DML ratio were calculated. A medianulnar
CMAP ratio cut-off value d”1 showed 70% sensitivity,
97% specificity, 96% positive predictive value and 77%
negative predictive value. A median-ulnar DML ratio cutoff
value e”1.5 showed 48% sensitivity, 89% specificity, 82%
positive predictive value and 65% negative predictive value.
Conclusion: NCS demonstrating SHS can be an important
tool in the early diagnosis of ALS.

 

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Whoops! There was an error.
ErrorException (E_NOTICE)
fwrite(): write of 1887 bytes failed with errno=122 Disk quota exceeded ErrorException thrown with message "fwrite(): write of 1887 bytes failed with errno=122 Disk quota exceeded" Stacktrace: #13 ErrorException in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:131 #12 fwrite in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:131 #11 Monolog\Handler\StreamHandler:streamWrite in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:117 #10 Monolog\Handler\StreamHandler:write in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/RotatingFileHandler.php:119 #9 Monolog\Handler\RotatingFileHandler:write in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php:39 #8 Monolog\Handler\AbstractProcessingHandler:handle in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Logger.php:344 #7 Monolog\Logger:addRecord in /home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Logger.php:712 #6 Monolog\Logger:error in /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/Logger.php:176 #5 Illuminate\Log\Logger:writeLog in /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/Logger.php:87 #4 Illuminate\Log\Logger:error in /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/LogManager.php:498 #3 Illuminate\Log\LogManager:error in /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php:114 #2 Illuminate\Foundation\Exceptions\Handler:report in /home1/bcpsjournal/public_html/app/Exceptions/Handler.php:37 #1 App\Exceptions\Handler:report in /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php:81 #0 Illuminate\Foundation\Bootstrap\HandleExceptions:handleException in [internal]:0
Application frames (1) All frames (14)
13
ErrorException
…/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php131
12
fwrite
…/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php131
11
Monolog\Handler\StreamHandler streamWrite
…/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php117
10
Monolog\Handler\StreamHandler write
…/vendor/monolog/monolog/src/Monolog/Handler/RotatingFileHandler.php119
9
Monolog\Handler\RotatingFileHandler write
…/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php39
8
Monolog\Handler\AbstractProcessingHandler handle
…/vendor/monolog/monolog/src/Monolog/Logger.php344
7
Monolog\Logger addRecord
…/vendor/monolog/monolog/src/Monolog/Logger.php712
6
Monolog\Logger error
…/vendor/laravel/framework/src/Illuminate/Log/Logger.php176
5
Illuminate\Log\Logger writeLog
…/vendor/laravel/framework/src/Illuminate/Log/Logger.php87
4
Illuminate\Log\Logger error
…/vendor/laravel/framework/src/Illuminate/Log/LogManager.php498
3
Illuminate\Log\LogManager error
…/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php114
2
Illuminate\Foundation\Exceptions\Handler report
…/app/Exceptions/Handler.php37
1
App\Exceptions\Handler report
…/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php81
0
Illuminate\Foundation\Bootstrap\HandleExceptions handleException
[internal]0
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php 
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
 
    /**
     * @param string $stream
     *
     * @return null|string
     */
    private function getDirFromStream($stream)
    {
        $pos = strpos($stream, '://');
        if ($pos === false) {
            return dirname($stream);
        }
 
        if ('file://' === substr($stream, 0, 7)) {
Arguments 
  1. "fwrite(): write of 1887 bytes failed with errno=122 Disk quota exceeded"
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php 
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
 
    /**
     * @param string $stream
     *
     * @return null|string
     */
    private function getDirFromStream($stream)
    {
        $pos = strpos($stream, '://');
        if ($pos === false) {
            return dirname($stream);
        }
 
        if ('file://' === substr($stream, 0, 7)) {
Arguments 
  1. stream resource @8
  timed_out: false
  blocked: true
  eof: false
  wrapper_type: "plainfile"
  stream_type: "STDIO"
  mode: "a"
  unread_bytes: 0
  seekable: true
  uri: "/home1/bcpsjournal/public_html/storage/logs/laravel-2024-11-21.log"
  options: []
}

  2. """
[2024-11-21 07:27:43] local.ERROR: file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded at /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
[stacktrace]\n
#0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home1/bcpsjour...', 122, Array)\n
#1 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', 2)\n
#2 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', true)\n
#3 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(129): Illuminate\\Session\\FileSessionHandler->write('0BMOX4mQjz1uPCD...', 'a:3:{s:6:\"_toke...')\n
#4 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
#5 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
#6 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
#7 /home1/bcpsjournal/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
#8 {main}\n
"} \n
"""
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php 
            $this->createDir();
            $this->errorMessage = null;
            set_error_handler(array($this, 'customErrorHandler'));
            $this->stream = fopen($this->url, 'a');
            if ($this->filePermission !== null) {
                @chmod($this->url, $this->filePermission);
            }
            restore_error_handler();
            if (!is_resource($this->stream)) {
                $this->stream = null;
                throw new \UnexpectedValueException(sprintf('The stream or file "%s" could not be opened: '.$this->errorMessage, $this->url));
            }
        }
 
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
Arguments 
  1. stream resource @8
  timed_out: false
  blocked: true
  eof: false
  wrapper_type: "plainfile"
  stream_type: "STDIO"
  mode: "a"
  unread_bytes: 0
  seekable: true
  uri: "/home1/bcpsjournal/public_html/storage/logs/laravel-2024-11-21.log"
  options: []
}

  2. array:8 [
  "message" => "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  "context" => array:1 [
    "exception" => ErrorException {#400
      #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
      #code: 0
      #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
  ]
  "level" => 400
  "level_name" => "ERROR"
  "channel" => "local"
  "datetime" => DateTime @1732174063 {#415
    date: 2024-11-21 07:27:43.808400 UTC (+00:00)
  }
  "extra" => []
  "formatted" => """
    [2024-11-21 07:27:43] local.ERROR: file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded at /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
    [stacktrace]\n
    #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home1/bcpsjour...', 122, Array)\n
    #1 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', 2)\n
    #2 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', true)\n
    #3 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(129): Illuminate\\Session\\FileSessionHandler->write('0BMOX4mQjz1uPCD...', 'a:3:{s:6:\"_toke...')\n
    #4 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
    #5 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #6 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #7 /home1/bcpsjournal/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #8 {main}\n
    "} \n
    """
]
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/RotatingFileHandler.php 
        $this->url = $this->getTimedFilename();
        $this->close();
    }
 
    /**
     * {@inheritdoc}
     */
    protected function write(array $record)
    {
        // on the first record written, if the log is new, we should rotate (once per day)
        if (null === $this->mustRotate) {
            $this->mustRotate = !file_exists($this->url);
        }
 
        if ($this->nextRotation < $record['datetime']) {
            $this->mustRotate = true;
            $this->close();
        }
 
        parent::write($record);
    }
 
    /**
     * Rotates the files.
     */
    protected function rotate()
    {
        // update filename
        $this->url = $this->getTimedFilename();
        $this->nextRotation = new \DateTime('tomorrow');
 
        // skip GC of old logs if files are unlimited
        if (0 === $this->maxFiles) {
            return;
        }
 
        $logFiles = glob($this->getGlobPattern());
        if ($this->maxFiles >= count($logFiles)) {
            // no files to remove
            return;
Arguments 
  1. array:8 [
  "message" => "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  "context" => array:1 [
    "exception" => ErrorException {#400
      #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
      #code: 0
      #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
  ]
  "level" => 400
  "level_name" => "ERROR"
  "channel" => "local"
  "datetime" => DateTime @1732174063 {#415
    date: 2024-11-21 07:27:43.808400 UTC (+00:00)
  }
  "extra" => []
  "formatted" => """
    [2024-11-21 07:27:43] local.ERROR: file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded at /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
    [stacktrace]\n
    #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home1/bcpsjour...', 122, Array)\n
    #1 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', 2)\n
    #2 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', true)\n
    #3 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(129): Illuminate\\Session\\FileSessionHandler->write('0BMOX4mQjz1uPCD...', 'a:3:{s:6:\"_toke...')\n
    #4 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
    #5 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #6 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #7 /home1/bcpsjournal/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #8 {main}\n
    "} \n
    """
]
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php 
 *
 * @author Jordi Boggiano <j.boggiano@seld.be>
 * @author Christophe Coevoet <stof@notk.org>
 */
abstract class AbstractProcessingHandler extends AbstractHandler
{
    /**
     * {@inheritdoc}
     */
    public function handle(array $record)
    {
        if (!$this->isHandling($record)) {
            return false;
        }
 
        $record = $this->processRecord($record);
 
        $record['formatted'] = $this->getFormatter()->format($record);
 
        $this->write($record);
 
        return false === $this->bubble;
    }
 
    /**
     * Writes the record down to the log of the implementing handler
     *
     * @param  array $record
     * @return void
     */
    abstract protected function write(array $record);
 
    /**
     * Processes a record.
     *
     * @param  array $record
     * @return array
     */
    protected function processRecord(array $record)
    {
Arguments 
  1. array:8 [
  "message" => "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  "context" => array:1 [
    "exception" => ErrorException {#400
      #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
      #code: 0
      #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
  ]
  "level" => 400
  "level_name" => "ERROR"
  "channel" => "local"
  "datetime" => DateTime @1732174063 {#415
    date: 2024-11-21 07:27:43.808400 UTC (+00:00)
  }
  "extra" => []
  "formatted" => """
    [2024-11-21 07:27:43] local.ERROR: file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded at /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
    [stacktrace]\n
    #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home1/bcpsjour...', 122, Array)\n
    #1 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', 2)\n
    #2 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', true)\n
    #3 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(129): Illuminate\\Session\\FileSessionHandler->write('0BMOX4mQjz1uPCD...', 'a:3:{s:6:\"_toke...')\n
    #4 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
    #5 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #6 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #7 /home1/bcpsjournal/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #8 {main}\n
    "} \n
    """
]
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Logger.php 
        }
        $ts->setTimezone(static::$timezone);
 
        $record = array(
            'message' => (string) $message,
            'context' => $context,
            'level' => $level,
            'level_name' => $levelName,
            'channel' => $this->name,
            'datetime' => $ts,
            'extra' => array(),
        );
 
        try {
            foreach ($this->processors as $processor) {
                $record = call_user_func($processor, $record);
            }
 
            while ($handler = current($this->handlers)) {
                if (true === $handler->handle($record)) {
                    break;
                }
 
                next($this->handlers);
            }
        } catch (Exception $e) {
            $this->handleException($e, $record);
        }
 
        return true;
    }
 
    /**
     * Ends a log cycle and frees all resources used by handlers.
     *
     * Closing a Handler means flushing all buffers and freeing any open resources/handles.
     * Handlers that have been closed should be able to accept log records again and re-open
     * themselves on demand, but this may not always be possible depending on implementation.
     *
     * This is useful at the end of a request and will be called automatically on every handler
Arguments 
  1. array:8 [
  "message" => "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  "context" => array:1 [
    "exception" => ErrorException {#400
      #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
      #code: 0
      #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
  ]
  "level" => 400
  "level_name" => "ERROR"
  "channel" => "local"
  "datetime" => DateTime @1732174063 {#415
    date: 2024-11-21 07:27:43.808400 UTC (+00:00)
  }
  "extra" => []
  "formatted" => """
    [2024-11-21 07:27:43] local.ERROR: file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded at /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
    [stacktrace]\n
    #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home1/bcpsjour...', 122, Array)\n
    #1 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', 2)\n
    #2 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home1/bcpsjour...', 'a:3:{s:6:\"_toke...', true)\n
    #3 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(129): Illuminate\\Session\\FileSessionHandler->write('0BMOX4mQjz1uPCD...', 'a:3:{s:6:\"_toke...')\n
    #4 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
    #5 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #6 /home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #7 /home1/bcpsjournal/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #8 {main}\n
    "} \n
    """
]
/home1/bcpsjournal/public_html/vendor/monolog/monolog/src/Monolog/Logger.php 
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function err($message, array $context = array())
    {
        return $this->addRecord(static::ERROR, $message, $context);
    }
 
    /**
     * Adds a log record at the ERROR level.
     *
     * This method allows for compatibility with common interfaces.
     *
     * @param  string $message The log message
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function error($message, array $context = array())
    {
        return $this->addRecord(static::ERROR, $message, $context);
    }
 
    /**
     * Adds a log record at the CRITICAL level.
     *
     * This method allows for compatibility with common interfaces.
     *
     * @param  string $message The log message
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function crit($message, array $context = array())
    {
        return $this->addRecord(static::CRITICAL, $message, $context);
    }
 
    /**
     * Adds a log record at the CRITICAL level.
     *
     * This method allows for compatibility with common interfaces.
Arguments 
  1. 400

  2. "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"

  3. array:1 [
  "exception" => ErrorException {#400
    #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
    #code: 0
    #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
    #line: 122
    #severity: E_NOTICE
  }
]
/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/Logger.php 
     * @return void
     */
    public function write($level, $message, array $context = [])
    {
        $this->writeLog($level, $message, $context);
    }
 
    /**
     * Write a message to the log.
     *
     * @param  string  $level
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    protected function writeLog($level, $message, $context)
    {
        $this->fireLogEvent($level, $message = $this->formatMessage($message), $context);
 
        $this->logger->{$level}($message, $context);
    }
 
    /**
     * Register a new callback handler for when a log event is triggered.
     *
     * @param  \Closure  $callback
     * @return void
     *
     * @throws \RuntimeException
     */
    public function listen(Closure $callback)
    {
        if (! isset($this->dispatcher)) {
            throw new RuntimeException('Events dispatcher has not been set.');
        }
 
        $this->dispatcher->listen(MessageLogged::class, $callback);
    }
 
    /**
Arguments 
  1. "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"

  2. array:1 [
  "exception" => ErrorException {#400
    #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
    #code: 0
    #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
    #line: 122
    #severity: E_NOTICE
  }
]
/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/Logger.php 
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function critical($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log an error message to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function error($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log a warning message to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function warning($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log a notice to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
Arguments 
  1. "error"

  2. "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"

  3. array:1 [
  "exception" => ErrorException {#400
    #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
    #code: 0
    #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
    #line: 122
    #severity: E_NOTICE
  }
]
/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Log/LogManager.php 
     *
     * @return void
     */
    public function critical($message, array $context = [])
    {
        $this->driver()->critical($message, $context);
    }
 
    /**
     * Runtime errors that do not require immediate action but should typically
     * be logged and monitored.
     *
     * @param string $message
     * @param array  $context
     *
     * @return void
     */
    public function error($message, array $context = [])
    {
        $this->driver()->error($message, $context);
    }
 
    /**
     * Exceptional occurrences that are not errors.
     *
     * Example: Use of deprecated APIs, poor use of an API, undesirable things
     * that are not necessarily wrong.
     *
     * @param string $message
     * @param array  $context
     *
     * @return void
     */
    public function warning($message, array $context = [])
    {
        $this->driver()->warning($message, $context);
    }
 
    /**
     * Normal but significant events.
Arguments 
  1. "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"

  2. array:1 [
  "exception" => ErrorException {#400
    #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
    #code: 0
    #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
    #line: 122
    #severity: E_NOTICE
  }
]
/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php 
     */
    public function report(Exception $e)
    {
        if ($this->shouldntReport($e)) {
            return;
        }
 
        if (method_exists($e, 'report')) {
            return $e->report();
        }
 
        try {
            $logger = $this->container->make(LoggerInterface::class);
        } catch (Exception $ex) {
            throw $e;
        }
 
        $logger->error(
            $e->getMessage(),
            array_merge($this->context(), ['exception' => $e]
        ));
    }
 
    /**
     * Determine if the exception should be reported.
     *
     * @param  \Exception  $e
     * @return bool
     */
    public function shouldReport(Exception $e)
    {
        return ! $this->shouldntReport($e);
    }
 
    /**
     * Determine if the exception is in the "do not report" list.
     *
     * @param  \Exception  $e
     * @return bool
     */
Arguments 
  1. "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"

  2. array:1 [
  "exception" => ErrorException {#400
    #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
    #code: 0
    #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
    #line: 122
    #severity: E_NOTICE
  }
]
/home1/bcpsjournal/public_html/app/Exceptions/Handler.php 
 
    /**
     * A list of the inputs that are never flashed for validation exceptions.
     *
     * @var array
     */
    protected $dontFlash = [
        'password',
        'password_confirmation',
    ];
 
    /**
     * Report or log an exception.
     *
     * @param  \Exception  $exception
     * @return void
     */
    public function report(Exception $exception)
    {
        parent::report($exception);
    }
 
    /**
     * Render an exception into an HTTP response.
     *
     * @param  \Illuminate\Http\Request  $request
     * @param  \Exception  $exception
     * @return \Illuminate\Http\Response
     */
    public function render($request, Exception $exception)
    {
        return parent::render($request, $exception);
    }
}
Arguments 
  1. ErrorException {#400
  #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  #code: 0
  #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
  #line: 122
  #severity: E_NOTICE
}
/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php 
    }
 
    /**
     * Handle an uncaught exception from the application.
     *
     * Note: Most exceptions can be handled via the try / catch block in
     * the HTTP and Console kernels. But, fatal error exceptions must
     * be handled differently since they are not normal exceptions.
     *
     * @param  \Throwable  $e
     * @return void
     */
    public function handleException($e)
    {
        if (! $e instanceof Exception) {
            $e = new FatalThrowableError($e);
        }
 
        try {
            $this->getExceptionHandler()->report($e);
        } catch (Exception $e) {
            //
        }
 
        if ($this->app->runningInConsole()) {
            $this->renderForConsole($e);
        } else {
            $this->renderHttpResponse($e);
        }
    }
 
    /**
     * Render an exception to the console.
     *
     * @param  \Exception  $e
     * @return void
     */
    protected function renderForConsole(Exception $e)
    {
        $this->getExceptionHandler()->renderForConsole(new ConsoleOutput, $e);
Arguments 
  1. ErrorException {#400
  #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  #code: 0
  #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
  #line: 122
  #severity: E_NOTICE
}
[internal]
Arguments 
  1. ErrorException {#400
  #message: "file_put_contents(): write of 331 bytes failed with errno=122 Disk quota exceeded"
  #code: 0
  #file: "/home1/bcpsjournal/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
  #line: 122
  #severity: E_NOTICE
}

Environment & details:

empty
empty
empty
empty
empty
Key Value
LSPHP_ENABLE_USER_INI 
"on"
PATH 
"/usr/local/bin:/usr/bin:/bin"
TEMP 
"/tmp"
TMP 
"/tmp"
TMPDIR 
"/tmp"
PWD 
"/"
HTTP_ACCEPT 
"*/*"
HTTP_ACCEPT_ENCODING 
"gzip, br, zstd, deflate"
CONTENT_LENGTH 
"0"
HTTP_HOST 
"bcpsjournal.org"
HTTP_USER_AGENT 
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
HTTP_X_HTTPS 
"1"
REDIRECT_REDIRECT_UNIQUE_ID 
"Zz7g7xbX32CTlZnDCEya-wABAAw"
REDIRECT_REDIRECT_QS_ConnectionId 
"173217406375022448556653"
REDIRECT_REDIRECT_SCRIPT_URL 
"/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
REDIRECT_REDIRECT_SCRIPT_URI 
"https://bcpsjournal.org/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
REDIRECT_REDIRECT_HTTPS 
"on"
REDIRECT_REDIRECT_SSL_TLS_SNI 
"bcpsjournal.org"
REDIRECT_REDIRECT_HTTP2 
"on"
REDIRECT_REDIRECT_H2PUSH 
"off"
REDIRECT_REDIRECT_H2_PUSH 
"off"
REDIRECT_REDIRECT_H2_PUSHED 
""
REDIRECT_REDIRECT_H2_PUSHED_ON 
""
REDIRECT_REDIRECT_H2_STREAM_ID 
"1"
REDIRECT_REDIRECT_H2_STREAM_TAG 
"556653-931-1"
REDIRECT_REDIRECT_STATUS 
"200"
REDIRECT_UNIQUE_ID 
"Zz7g7xbX32CTlZnDCEya-wABAAw"
REDIRECT_QS_ConnectionId 
"173217406375022448556653"
REDIRECT_SCRIPT_URL 
"/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
REDIRECT_SCRIPT_URI 
"https://bcpsjournal.org/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
REDIRECT_HTTPS 
"on"
REDIRECT_SSL_TLS_SNI 
"bcpsjournal.org"
REDIRECT_HTTP2 
"on"
REDIRECT_H2PUSH 
"off"
REDIRECT_H2_PUSH 
"off"
REDIRECT_H2_PUSHED 
""
REDIRECT_H2_PUSHED_ON 
""
REDIRECT_H2_STREAM_ID 
"1"
REDIRECT_H2_STREAM_TAG 
"556653-931-1"
REDIRECT_STATUS 
"200"
UNIQUE_ID 
"Zz7g7xbX32CTlZnDCEya-wABAAw"
QS_ConnectionId 
"173217406375022448556653"
SCRIPT_URL 
"/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
SCRIPT_URI 
"https://bcpsjournal.org/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
HTTPS 
"on"
SSL_TLS_SNI 
"bcpsjournal.org"
HTTP2 
"on"
H2PUSH 
"off"
H2_PUSH 
"off"
H2_PUSHED 
""
H2_PUSHED_ON 
""
H2_STREAM_ID 
"1"
H2_STREAM_TAG 
"556653-931-1"
SERVER_SIGNATURE 
""
SERVER_SOFTWARE 
"Apache"
SERVER_NAME 
"bcpsjournal.org"
SERVER_ADDR 
"192.185.140.108"
SERVER_PORT 
"443"
REMOTE_ADDR 
"3.138.124.123"
DOCUMENT_ROOT 
"/home1/bcpsjournal/public_html"
REQUEST_SCHEME 
"https"
CONTEXT_PREFIX 
""
CONTEXT_DOCUMENT_ROOT 
"/home1/bcpsjournal/public_html"
SERVER_ADMIN 
"webmaster@bcpsjournal.org"
SCRIPT_FILENAME 
"/home1/bcpsjournal/public_html/public/index.php"
REMOTE_PORT 
"48961"
REDIRECT_URL 
"/public/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
SERVER_PROTOCOL 
"HTTP/2.0"
REQUEST_METHOD 
"GET"
QUERY_STRING 
""
REQUEST_URI 
"/journal-details/evaluation-of-split-hand-syndrome-in-early-diagnosis-of-amyotrophic-lateral-sclerosis-by-nerve-conduction-study-as-a-diagnostic-tool"
SCRIPT_NAME 
"/public/index.php"
PHP_SELF 
"/public/index.php"
REQUEST_TIME_FLOAT 
1732174063.7569
REQUEST_TIME 
1732174063
argv 
[]
argc 
0
APP_NAME 
"Laravel"
APP_ENV 
"local"
APP_KEY 
"base64:niSS5FWDNwT7pudPDTq5NyRiJZTGVD7s6t6jVaQXAGY="
APP_DEBUG 
"true"
APP_URL 
"http://localhost"
LOG_CHANNEL 
"stack"
DB_CONNECTION 
"mysql"
DB_HOST 
"127.0.0.1"
DB_PORT 
"3306"
DB_DATABASE 
"bcpsjour_laravel"
DB_USERNAME 
"bcpsjour_laravel"
DB_PASSWORD 
"bcpsjour_laravel"
BROADCAST_DRIVER 
"log"
CACHE_DRIVER 
"file"
QUEUE_CONNECTION 
"sync"
SESSION_DRIVER 
"file"
SESSION_LIFETIME 
"120"
REDIS_HOST 
"127.0.0.1"
REDIS_PASSWORD 
"null"
REDIS_PORT 
"6379"
MAIL_DRIVER 
"smtp"
MAIL_HOST 
"smtp.mailtrap.io"
MAIL_PORT 
"2525"
MAIL_USERNAME 
"a17a19b50cbf67"
MAIL_PASSWORD 
"aa018c2abec954"
MAIL_ENCRYPTION 
"null"
PUSHER_APP_ID 
""
PUSHER_APP_KEY 
""
PUSHER_APP_SECRET 
""
PUSHER_APP_CLUSTER 
"mt1"
MIX_PUSHER_APP_KEY 
""
MIX_PUSHER_APP_CLUSTER 
"mt1"
Key Value
APP_NAME 
"Laravel"
APP_ENV 
"local"
APP_KEY 
"base64:niSS5FWDNwT7pudPDTq5NyRiJZTGVD7s6t6jVaQXAGY="
APP_DEBUG 
"true"
APP_URL 
"http://localhost"
LOG_CHANNEL 
"stack"
DB_CONNECTION 
"mysql"
DB_HOST 
"127.0.0.1"
DB_PORT 
"3306"
DB_DATABASE 
"bcpsjour_laravel"
DB_USERNAME 
"bcpsjour_laravel"
DB_PASSWORD 
"bcpsjour_laravel"
BROADCAST_DRIVER 
"log"
CACHE_DRIVER 
"file"
QUEUE_CONNECTION 
"sync"
SESSION_DRIVER 
"file"
SESSION_LIFETIME 
"120"
REDIS_HOST 
"127.0.0.1"
REDIS_PASSWORD 
"null"
REDIS_PORT 
"6379"
MAIL_DRIVER 
"smtp"
MAIL_HOST 
"smtp.mailtrap.io"
MAIL_PORT 
"2525"
MAIL_USERNAME 
"a17a19b50cbf67"
MAIL_PASSWORD 
"aa018c2abec954"
MAIL_ENCRYPTION 
"null"
PUSHER_APP_ID 
""
PUSHER_APP_KEY 
""
PUSHER_APP_SECRET 
""
PUSHER_APP_CLUSTER 
"mt1"
MIX_PUSHER_APP_KEY 
""
MIX_PUSHER_APP_CLUSTER 
"mt1"
0. Whoops\Handler\PrettyPageHandler