Artificial Intelligence-Supported Development of Health Guideline Questions.

BACKGROUND: Guideline questions are typically proposed by experts. OBJECTIVE: To assess how large language models (LLMs) can support the development of guideline questions, providing insights on approaches and lessons learned. DESIGN: Two approaches for guideline question generation were assessed: 1) identification of questions conveyed by online search queries and 2) direct generation of guideline questions by LLMs. For the former, the researchers retrieved popular queries on allergic rhinitis using Google Trends (GT) and identified those conveying questions using both manual and LLM-based methods. They then manually structured as guideline questions the queries that conveyed relevant questions. For the second approach, they tasked an LLM with proposing guideline questions, assuming the role of either a patient or a clinician. SETTING: Allergic Rhinitis and its Impact on Asthma (ARIA) 2024 guidelines. PARTICIPANTS: None. MEASUREMENTS: Frequency of relevant questions generated. RESULTS: The authors retrieved 3975 unique queries using GT. From these, they identified 37 questions, of which 22 had not been previously posed by guideline panel members and 2 were eventually prioritized by the panel. Direct interactions with LLMs resulted in the generation of 22 unique relevant questions (11 not previously suggested by panel members), and 4 were eventually prioritized by the panel. In total, 6 of 39 final questions prioritized for the 2024 ARIA guidelines were not initially thought of by the panel. The researchers provide a set of practical insights on the implementation of their approaches based on the lessons learned. LIMITATION: Single case study (ARIA guidelines). CONCLUSION: Approaches using LLMs can support the development of guideline questions, complementing traditional methods and potentially augmenting questions prioritized by guideline panels. PRIMARY FUNDING SOURCE: Fraunhofer Cluster of Excellence for Immune-Mediated Diseases.

English tweets on allergy: Content analysis and association with surveillance data.

BACKGROUND: Analysis of X (formerly Twitter) posts can inform on the interest/perceptions that social media users have on health subjects. In this study, we aimed to analyse tweets on allergic conditions, comparing them with surveillance data. METHODS: We retrieved tweets from England on "allergy," "asthma," and "allergic rhinitis," published between 2016 and 2021. We estimated the correlation between the frequency of tweets on "asthma" and "allergic rhinitis" and English surveillance data on the incidence of asthma and allergic rhinitis medical visits. We performed sentiment analysis, computing a score informing on the emotional tone of assessed tweets. We applied a topic modelling approach to identify topics (clusters of words frequently occurring together) for tweets on each assessed condition. RESULTS: We analysed a total of 13,605 tweets on "allergy," 7767 tweets on "asthma," and 11,974 tweets on "allergic rhinitis." Food-related words were preponderant on tweets on "allergy," while "eyes" was the most frequent meaningful word on "allergy rhinitis" tweets. We observed seasonal patterns for tweets on "allergic rhinitis," both in their frequency and sentiment - the incidence of allergic rhinitis medical visits was moderately to strongly correlated with the frequency (ρ = 0.866) and sentiment (ρ = -0.474) of tweets on "allergic rhinitis." For tweets on "asthma," no such patterns/correlations were observed. The average sentiment score was negative for all assessed conditions, ranging from -0.004 ("asthma") to -0.083 ("allergic rhinitis"). CONCLUSIONS: Tweets on "allergic rhinitis" displayed a seasonal pattern regarding their frequency and sentiment, which correlated with surveillance data. No such patterns were observed for "asthma."

Adenoma detection rate by colonoscopy in real-world population-based studies: a systematic review and meta-analysis.

BACKGROUND: Adenoma detection rate (ADR) is a quality indicator set at a minimum of 25% in unselected populations by the European Society of Gastrointestinal Endoscopy (ESGE). Nevertheless, a lack of pooled observational data resembling real-world practice limits support for this threshold. We aimed to perform a systematic review with meta-analysis to evaluate the pooled rates for conventional adenoma detection, polyp detection (PDR), cecal intubation, bowel preparation, and complications in population-based studies. METHODS: The PubMed, Scopus, and Web of Science databases were searched until May 2023 for populational-based studies reporting overall ADR in unselected individuals. A random-effects model was used for meta-analysis. RESULTS: 31 studies were included, comprising 3 644 561 subjects. A high quality of procedures was noticeable, with a high cecal intubation rate and low complication rate. The overall pooled ADR, PDR, and rate of cancer detection were 26.5% (95%CI 23.3% to 29.7%), 38.3% (95%CI 32.5% to 44.1%), and 2.7% (95%CI 1.5% to 3.9%), respectively. ADR varied according to indication: screening 33.3% (95%CI 24.5% to 42.2%), surveillance 42.9% (95%CI 36.9% to 49.0%), and diagnostic 24.7% (95%CI 19.5% to 29.9%), with subgroup analysis revealing rates of 34.4% (95%CI 22.0% to 40.5%) for post-fecal occult blood test and 26.6% (95%CI 22.6% to 30.5%) for primary colonoscopy screening. Diminutive conventional adenomas yielded a pooled rate of 59.9% (95%CI 43.4% to 76.3%). The pooled rate for overall serrated lesion detection was 12.4% (95%CI 8.8% to 16.0%). Male sex and higher age were significantly associated with an ADR above the benchmark. CONCLUSION: This first meta-analysis relying on real-world observational studies supports the ESGE benchmark for ADR, while suggesting that different benchmarks might be used according to indication, sex, and age.

Individuals' attitudes toward digital mental health apps and implications for adoption in Portugal: web-based survey.

BACKGROUND: The literature is consensual regarding the academic community exhibiting higher levels of mental disorder prevalence than the general population. The potential of digital mental health apps for improving access to resources to cope with these issues is ample. However, studies have yet to be performed in Portugal on individuals' attitudes and perceptions toward digital mental health applications or their preferences and decision drivers on obtaining mental health care, self-assessment, or treatment. OBJECTIVE: This study aims to understand the determinants of digital mental health applications use in the Portuguese academic community of Porto, along with potential adoption barriers and enablers. METHODS: A cross-sectional, web-based survey was delivered via dynamic email to the University of Porto's academic community. Data collection occurred between September 20 and October 20, 2022. We used structural equation modeling to build three models, replicating a peer-reviewed and published study and producing a newly full mediation model shaped by the collected data. We tested the relationships between use of digital mental health apps and perceived stress, perceived need to seek help for mental health, perceived stigma, past use of mental health services, privacy concerns, and social influence. RESULTS: Of the 539 participants, 169 (31.4%) reported having used digital mental health apps. Perceived stress and a latent variable, comprising perceptions of mental health problems and coping strategies, were positively associated with mental health app use, while privacy concerns regarding one's information being accessible to others were negatively associated. Perceived stigma, need to seek help, and close relationships did not have a statistically significant direct effect. CONCLUSIONS: These findings can inform product and policy development of new, better-targeted digital mental health app interventions, with implications for researchers and academia, industry, and policymakers. Our study concludes that, to maximize adherence to these apps, they should have low to no financial charges, demonstrate evidence of their helpfulness and focus on the timely delivery of care. We also conclude that to foster digital mental health app use, there is a need to improve mental health literacy, namely regarding self-awareness of one's conditions, acceptable stress levels, and overall behavior towards mental health. TRIAL REGISTRATION: RR2-10.2196/41040.

Optical design optimization for improved lamp-reflector units in high-flux solar simulators.

High flux solar simulators are artificial solar facilities developed to imitate the on-sun operations of concentrating solar power technologies but under a well-controlled lab-scale environment. We report the optical enhancement of different high flux solar simulators for solar thermal and thermochemical applications. The solar simulator enhancement is numerically conducted by optimizing the geometry of ellipsoidal reflectors at focal lengths of 1600, 1800, and 2000 mm. The Monte Carlo ray-tracing technique is employed to evaluate the optical performance of different reflector designs. The typical seven-lamp solar simulator arrangement in hexagonal configuration is modeled to analyze the optical performance at different focal lengths. In addition, different xenon arc lamps are modeled with rated powers of 3000, 4000, 4500, and 5000 W for assessing the radiative flux characteristics of the proposed solar simulators. After the optimization, theoretical results show that peak fluxes and radiative powers of 7.2-14.3MW/m2 and 5.06-10.4 kW, respectively, can be achieved with the proposed designs of solar simulators for the different rated powers. Compared with a commercial reflector, theoretical peak flux and power can be improved up to 36% and 17.9%, respectively, with the proper combination of lamp-reflector units. We provide design alternatives to select a more suitable light source at low-rated powers (≤5000W) and different focal lengths of the reflector, which simplifies the complexity of the design and improves the performance of solar simulators.

The Influence of Pilates Exercises on Body Composition, Muscle Strength, and Gait Speed in Community-Dwelling Older Women: A Randomized Controlled Trial.

ABSTRACT: Aibar-Almazán, A, Martínez-Amat, A, Cruz-Díaz, D, Jesús de la Torre-Cruz, M, Jiménez-García, JD, Zagalaz-Anula, N, Redecillas-Peiró, MT, Mendoza-Ladrón de Guevara, N, and Hita-Contreras, F. The influence of Pilates exercises on body composition, muscle strength, and gait speed in community-dwelling older women: a randomized controlled trial. J Strength Cond Res 36(8): 2298-2305, 2022-Population aging is a global phenomenon that has wide-ranging consequences for the health of individuals, including age-related obesity, muscle loss, and a decline in muscle strength and gait speed. These alterations are associated with disability, functional decline, and mortality in older adults. The objective of this study was to analyze the effects of Pilates exercises on body composition, handgrip strength, and physical performance among community-dwelling Spanish women aged 60 and older. A randomized controlled trial of a 12-week Pilates training program was conducted. A total of 109 women were randomly allocated to either a control ( n = 54) or a Pilates ( n = 55) group. Body composition was evaluated by bioelectrical impedance. Body mass index (BMI), percentage of body fat, and height-adjusted skeletal muscle mass index (SMI) were assessed before and immediately after the intervention, as were physical performance, estimated by gait speed (timed up-and-go test), and handgrip strength. Statistically significant improvements ( p < 0.05) were observed both within and between groups for handgrip strength (Cohen's d = 0.40 and 0.52 respectively) and gait speed (Cohen's d = 0.86 and 0.87 respectively). After 12 weeks, BMI significantly decreased (Cohen's d = 0.07) only in the Pilates group. No significant differences were observed regarding SMI. In conclusion, a 12-week Pilates exercise intervention on community dwelling women over 60 years old shows beneficial effects on muscle strength, physical performance, and BMI, but failed to induce any changes on body composition.

Effects of a Light Crude Oil Spill on a Tropical Coastal Phytoplankton Community.

Oiling scenarios following spills vary in concentration and usually can affect large coastal areas. Consequently, this research evaluated different crude oil concentrations (10, 40, and 80 mg L-1) on the nearshore phytoplanktonic community in the southern Gulf of Mexico. This experiment was carried out for ten days using eight units of 2500 L each; factors monitored included shifts in phytoplankton composition, physicochemical parameters and the culturable bacterial abundance of heterotrophic and hydrocarbonoclastic groups. The temperature, salinity, and nutrient concentrations measured were within the ranges previously reported for Yucatan Peninsula waters. The total hydrocarbon concentration (TPH) in the control at T0 indicated the presence of hydrocarbons (PAHs 0.80 µg L-1, aliphatics 7.83 µg L-1 and UCM 184.09 µg L-1). At T0, the phytoplankton community showed a similar assemblage structure and composition in all treatments. At T10, the community composition remained heterogeneous in the control, in agreement with previous reports for the area. However, for oiled treatments, Bacillariophyceae dominated at T10. Hydrocarbonoclastic bacteria were associated with oiled treatments throughout the experiment, while heterotrophic bacteria were associated with control conditions. Our results agreed with previous works at the taxonomic level showing the presence of Bacillariophyceae and Dinophyceae in oil-related treatments, where these groups showed the major interactions in co-occurrence networks. In contrast, Chlorophyceae showed the key node in the co-occurrence network for the control. This study aims to contribute to knowledge on phytoplankton community shifts during a crude oil spill in subtropical oligotrophic regions.

Efficient System for Delimitation of Benign and Malignant Breast Masses.

In this study, a high-performing scheme is introduced to delimit benign and malignant masses in breast ultrasound images. The proposal is built upon by the Nonlocal Means filter for image quality improvement, an Intuitionistic Fuzzy C-Means local clustering algorithm for superpixel generation with high adherence to the edges, and the DBSCAN algorithm for the global clustering of those superpixels in order to delimit masses' regions. The empirical study was performed using two datasets, both with benign and malignant breast tumors. The quantitative results with respect to the BUSI dataset were JSC≥0.907, DM≥0.913, HD≥7.025, and MCR≤6.431 for benign masses and JSC≥0.897, DM≥0.900, HD≥8.666, and MCR≤8.016 for malignant ones, while the MID dataset resulted in JSC≥0.890, DM≥0.905, HD≥8.370, and MCR≤7.241 along with JSC≥0.881, DM≥0.898, HD≥8.865, and MCR≤7.808 for benign and malignant masses, respectively. These numerical results revealed that our proposal outperformed all the evaluated comparative state-of-the-art methods in mass delimitation. This is confirmed by the visual results since the segmented regions had a better edge delimitation.

Detection of Trypanosoma cruzi DNA in false negative samples of collected triatomines, xenodiagnosis material, and biopsies of experimentally infected animals.

Direct test over the gut material from triatomine vectors and xenodiagnosis over mammalian hosts are classical techniques for Trypanosoma cruzi parasitological diagnosis. Nevertheless, negative results can be a source of uncertainty. Experimental models have allowed evaluating the tissue invasion of different strains of T. cruzi, but conventional techniques for tissue biopsies involve time-consuming and elaborated procedures and have low sensitivity. Gut material of collected triatomines (microscopically negative) (n = 114), material of mammal xenodiagnoses (microscopically negative) (n = 138), and biopsy material (microscopically negative) from experimentally infected animals (n = 34) with isolates from endemic areas of Chagas' disease from Venezuela were used for DNA extraction and PCR for the amplification of kinetoplast DNA (kDNA) and satellite DNA (sDNA) of T. cruzi. Positive PCR was observed in 53.6% of collected triatomine material, 15.8% of parasitological negative xenodiagnosis material, and 70.6% in biopsies, revealing underestimation by the parasitological tests and the valour of this analysis with preserved material. Anzoátegui was the state with the highest percentage of infection, and the triatomine species Rhodnius prolixus and Panstrongylus geniculatus had the highest percentages of infection. Didelphis marsupialis and Canis familiaris were the most infected by T. cruzi revealed by PCR of xenodiagnosis material. In addition, the PCR technique allowed demonstrating the invasion of T. cruzi in all tissues analyzed, constituting a molecular marker of tissue invasion.

Saliva Sampling and Its Direct Lysis, an Excellent Option To Increase the Number of SARS-CoV-2 Diagnostic Tests in Settings with Supply Shortages.

As part of any plan to lift or ease the confinement restrictions that are in place in many different countries, there is an urgent need to increase the capacity of laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Detection of the viral genome through reverse transcription-quantitative PCR (RT-qPCR) is the gold standard for this virus; however, the high demand of the materials and reagents needed to sample individuals, purify the viral RNA, and perform the RT-qPCR has resulted in a worldwide shortage of several of these supplies. Here, we show that directly lysed saliva samples can serve as a suitable source for viral RNA detection that is less expensive and can be as efficient as the classical protocol, which involves column purification of the viral RNA. In addition, it bypasses the need for swab sampling, decreases the risk of the health care personnel involved in the testing process, and accelerates the diagnostic procedure.

Criteria for Psychosis in Major and Mild Neurocognitive Disorders: International Psychogeriatric Association (IPA) Consensus Clinical and Research Definition.

Psychosis is common among individuals with neurocognitive disorders, is difficult to manage, and causes considerable burden and stress to patients and caregivers. Developing effective treatments is a substantial unmet medical need but research has been slowed by the need for updated consensus diagnostic criteria. To address this need, the International Psychogeriatrics Association initiated a process to develop criteria for clinical use, research, and treatment development efforts. The process included clinical, regulatory, and industry stakeholders as well as input from a global network of experts in geriatric psychiatry responding to two surveys (N = 336). Results from the consensus process confirmed that clinicians wanted elaboration of aspects of the definition proposed by Jeste and Finkel in 2000 to ensure that the criteria are applied appropriately. Based on discussions, the survey, and emerging research, criteria were revised to apply to psychosis occurring with all major and mild neurocognitive disorders. Other important changes include providing examples of hallucinations and delusions and clarifying time course, impact, and exclusionary criteria. This definition of psychosis in major and mild neurocognitive disorders can be used to advance many types of research including development of much needed pharmacologic and nonpharmacologic interventions for psychosis in patients with neurocognitive disorders.

Perceived physical fitness mediates the relationship between parental support and physical activity enjoyment in overweight and obese adolescents.

The relationship between parental support and physical activity enjoyment appears to be mediated by individual-level factors. The aim of this study was to examine whether the relationship between perceived parental support and physical activity enjoyment is mediated by overweight and obese adolescents' physical fitness, both subjectively and objectively assessed. A total of 163 participants (mean age =14.30 years, 55.8% boys) with an average body mass index of 28.97 kg/m2 took part in this study. Participants completed a questionnaire of parental influence regarding physical activity, a questionnaire of physical self-perception and several fitness tests (cardiorespiratory fitness, lower limbs muscular strength and flexibility) using the ALPHA-fitness battery. The results showed that relationship between perceived parental support and physical activity enjoyment is mediated by the overweight and obese adolescents' perceived cardiorespiratory fitness and flexibility. We suggest to create educational guidelines for parents to increase the support and improve overweight and obese students' positive perceived physical competence, in order to achieve a greater adherence to physical activity and greater physical activity enjoyment.

Optical improvement for modulating a high flux solar simulator designed for solar thermal and thermochemical research.

This study presents the optical improvement of a high flux solar simulator (HFSS) with controllable flux-spot capabilities developed for researching solar thermal and thermochemical processes. The HFSS is comprised of seven 2.5 kWel Xenon arc lamps coupled with ellipsoidal reflectors, a servo-controlled attenuator curtain, and three-axes linear test bench. Different attenuators were designed and tested in order to identify the best curtain geometry to improve the HFSS modulation with the lowest possible radiative losses. The optical design improvement was performed with the aid of TracePro, a Monte Carlo ray-tracing software. From simulation results, radiative peak flux from 1700 to 480 kWm-2 from the focal plane to 300 mm further back was estimated without curtains. By using the attenuators, flux levels from 1570 to 92 kWm-2 at the focal plane were also estimated. An experimental validation was achieved with a single lamp-reflector unit obtaining peak flux distributions from 200±20 kWm-2 to 97±9.7 kWm-2 from the focal plane to 300 mm behind. Flux modulation from 170 to 1.5 kWm-2 was also measured at the focal plane using a servo-controlled curtain from fully-open slats (0°) to partially closed (60°). With this attenuator, introduced as the shutter of the system, the use of several lamps or electronic rectifiers is avoided and the radiative flux is modulated with high resolution in an optomechatronical form.

Risk of Falls in Healthy Older Adults: Benefits of High-Intensity Interval Training Using Lower Body Suspension Exercises.

The objective of this study was to compare the effects of high-intensity interval training (HIIT) and moderate-intensity interval training (MIIT) programs, both with a suspension training system, on several fall risk factors in healthy older adults. A total of 82 participants (68.23 ± 2.97 years) were randomized to HIIT (n = 28), MIIT (n = 27), or control (n = 27) groups. Balance confidence (Activities-specific Balance Confidence Scale), fear of falling (Falls Efficacy Scale-International), dynamic balance (Timed Up and Go test), and gait analysis (OptoGait optical detection system) were assessed. Statistical analysis showed improvements after the intervention in the HIIT group compared with the MIIT and control groups regarding the fear of falling (p < .05 and p < .01, respectively), gait (both ps < .05), and dynamic balance (p < .05 and p < .01, respectively), whereas both HIIT and MIIT groups improved balance confidence compared with the control group (p < .01 and p < .05, respectively). We can conclude that HIIT has significant beneficial effects of fall risk in older adults.

TAC y PET/TC con 18-FDG para evaluar la respuesta al tratamiento en linfoma de Hodgkin y no Hodgkin.

INTRODUCTION: The assessment of lymphoma response to treatment is based on imaging studies. OBJECTIVE: To correlate the assessment of lymphoma treatment response by computed tomography (CT) and by positron emission tomography/computed tomography (PET/CT). METHOD: Cross-sectional, observational study, where records of patients with lymphoma under surveillance by CT and PET/CT were reviewed. RESULTS: The study population consisted of 43 patients with a mean age of 32.7 ± 22.4 years; 26 (60.5 %) had a diagnosis of Hodgkin's lymphoma and 17 (9.5 %) had non-Hodgkin lymphoma. By CT, 34 (79.1 %) were diagnosed with disease and nine (20.9 %) without disease. The criteria used to assess the response was radiologist experience in 39 (90.7 %) and RECIST 1.1 criteria in four (9.3 %). The diagnosis by 18-FDG PET/CT was no response to treatment or partial response-recurrence in 32 (74.4 %) and response to treatment in 11 (25.6 %); with PERCIST criteria in 13 (30.2 %) and Deuaville criteria in 30 (69.8 %). When the diagnosis by CT versus 18-FDG PET/CT was compared, out of 11 patients with complete response on PET/CT, three had a similar CT diagnosis. Of the 34 patients with data consistent disease diagnosed by CT, 26 had similar results by 18-FDG PET/CT (p = 0.54). CONCLUSION: The value of lymphoma treatment response on CT does not agree with that obtained by 18-FDG PET/CT.

INTRODUCCIÓN: La evaluación de la respuesta al tratamiento de linfoma se basa en estudios de imagen. OBJETIVO: Correlacionar la evaluación de la respuesta al tratamiento de linfoma mediante tomografía axial computarizada (TAC) y tomografía por emisión de positrones/tomografía computarizada (PET/TC). MÉTODO: Estudio observacional transversal en el que se revisaron expedientes de pacientes con linfoma en vigilancia mediante TAC y PET/TC. RESULTADOS: La población de estudio estuvo constituida por 43 pacientes con edad media de 32.7 ± 22.4 años; 26 (60.5 %) tenían diagnóstico de linfoma de Hodgkin y 17 (9.5 %), de linfoma no Hodgkin. Por TAC se diagnosticaron 34 (79.1 %) con enfermedad y nueve (20.9 %) sin enfermedad. El criterio para evaluar la respuesta fue la experiencia del médico imagenólogo en 39 (90.7 %) y RECIST 1.1 en cuatro (9.3 %). Por PET/TC con 18-FDG se diagnosticó falta de respuesta al tratamiento o respuesta parcial-recurrencia en 32 pacientes (74.4 %) y con respuesta al tratamiento en 11 (25.6 %); con los criterios PERCIST en 13 (30.2 %) y con los de Deuaville en 30 (69.8 %). Al comparar el diagnóstico por TAC contra PET/TC, de 11 pacientes con respuesta total, tres tuvieron diagnóstico tomográfico similar. De los 34 pacientes con datos de enfermedad diagnosticados por tomografía, 26 tuvieron resultados similares por PET/TC con 18-FDG (p = 0.54). CONCLUSIÓN: El valor de la respuesta al tratamiento por TAC en linfoma no concuerda con el obtenido mediante PET/TC con 18-FDG.

Hypocholesterolemia is an independent risk factor for depression disorder and suicide attempt in Northern Mexican population.

BACKGROUND: Cholesterol has been associated as a risk factor for cardiovascular disease. Recently, however, there is growing evidence about crucial requirement of neuron membrane cholesterol in the organization and function of the 5-HT1A serotonin receptor. For this, low cholesterol level has been reported to be associated with depression and suicidality. However there have been inconsistent reports about this finding and the exact relationship between these factors remains controversial. Therefore, we investigated the link between serum cholesterol and its fractions with depression disorder and suicide attempt in 467 adult subjects in Mexican mestizo population. METHODS: Plasma levels of total cholesterol, triglycerides, and high-density lipoprotein cholesterol (HDL-c) and low density lipoprotein cholesterol (LDL-c) were determined in 261 MDD patients meeting the DSM-5 criteria for major depressive disorder (MDD), 59 of whom had undergone an episode of suicide attempt, and 206 healthy controls. RESULTS: A significant decrease in total cholesterol, LDL-cholesterol, VLDL-cholesterol and triglyceride serum levels was observed in the groups of MDD patients and suicide attempt compared to those without suicidal behavior (p < 0.05). After adjusting for covariates, lower cholesterol levels were significantly associated with MDD (OR 4.229 CI 95% 2.555 - 7.000, p<.001) and suicide attempt (OR 5.540 CI 95% 2.825 - 10.866, p<.001) CONCLUSIONS: These results support the hypothesis that lower levels of cholesterol are associated with mood disorders like MDD and suicidal behavior. More mechanistic studies are needed to further explain this association.

Rapidly progressive interstitial lung disease due to anti-MDA5 antibodies without skin involvement: a case report and literature review.

Anti-MDA5 antibodies have been strongly associated with rapidly progressive interstitial lung disease (RP-ILD) in dermatomyositis (DM) patients, especially in the clinically amyopathic subset (CADM). We present a case of anti-MDA5 antibody-associated RP-ILD in a patient with arthritis but with no other clinical signs suggestive of DM or CADM successfully treated with a combination of cyclophosphamide, cyclosporine and corticoids. A review of the literature was also done. Despite its rarity, anti-MDA5 antibody-associated ILD should be suspected in cases of RP-ILD even without other signs of DM or CADM as prompt and aggressive treatment could improve prognosis.

Analysis of the Effect Size of Overweight in Muscular Strength Tests Among Adolescents: Reference Values According to Sex, Age, and Body Mass Index.

Martínez-López, EJ, De La Torre-Cruz, M, Suárez-Manzano, S, and Ruiz-Ariza, A. Analysis of the effect size of overweight in muscular strength tests among adolescents: reference values according to sex, age, and body mass index. J Strength Cond Res 32(5): 1404-1414, 2018-The aim of this paper is to quantify the effect size of overweight on the results of muscular strength tests in adolescents and to report percentile tables based on sex, age, and body mass index (BMI). The study hypothesized that the effect size obtained from the difference between normal-weight and overweight youth would be greater than the differences between sexes within the same age group. A total of 11,044 Spanish adolescents (48.5% girls) aged 14.39 ± 1.21 years (range: 12-16 years) from 42 secondary schools participated in the research. Muscular strength was evaluated using standing long jump, hand grip strength (manual dynamometer), and sit-ups (30 seconds). The effect size was analyzed using the adjusted Hedges' g. The results show that 76.3 and 72.8% of overweight boys and girls, respectively, performed a standing long jump equal to or less than the normal-weight average. The 67.4 and 67.1% of overweight boys and girls, respectively, showed manual dynamometer values equal to or greater than the normal-weight average. Finally, 68.7 and 65.9% of overweight boys and girls, respectively, obtained measures for 30 seconds of sit-ups equal to or lower than the normal-weight average. It can therefore be concluded that the differential effect size between boys and girls is higher than that between normal-weight and overweight adolescents in the 3 strength tests analyzed. Despite the above, these results suggest the value of taking into account the BMI when assessing the muscular strength of young people, in addition to sex and age.

Observations on non-random distribution of spores of Henneguya spp. (Cnidaria: Myxosporea: Myxobolidae) within plasmodia.

Species of the cnidarian genus Henneguya Thélohan, 1892 (Myxosporea: Myxobolidae) are histozoic parasites commonly found in freshwater and, more rarely, in marine fish. The development of these parasites in fish tissues includes the formation of plasmodia within which occurs the sporogony originating spores with two caudal processes, which are usually randomly distributed within the plasmodia. In this report the authors present some cases of non-random distribution of the spores of six species of Henneguya within their plasmodia. Two different patterns of non-random distribution were found based on a literature survey. These patterns and their origin are discussed. Apparently this non-random distribution of the spores is due to both internal and external factors.

Transthyretin familial amyloid polyneuropathy (TTR-FAP) in Mallorca: a comparison between late- and early-onset disease.

The age of onset (AO) of hereditary ATTR amyloidosis (hATTR) is known to vary between populations, with differing characteristics reported according to AO in endemic/non-endemic foci. This was a retrospective study of patients with early AO (<50 years) and late AO (≥50 years) hATTR at our center in Mallorca. Data were collected on patient demographics, clinical disease manifestation, and physical symptoms. A total of 95 patients were analyzed, with mean follow-up of 9 years from diagnosis. The early AO group included 53 patients (33 male) and the late AO group included 42 patients (21 male). Neurologic involvement was the most common initial symptom, although it was significantly more frequent in the late AO vs. early AO group (p = 0.015). Autonomic involvement was observed in 26% of patients in the early AO group, but was rarely observed in the late AO group (5%). During follow up, cardiologic symptoms, renal involvement, and ophthalmologic symptoms were significantly more common in the late AO group (p < 0.05). This retrospective study demonstrates the variation in disease presentation and progression according to AO of hATTR at our Mallorcan center.