• Vest Hicks posted an update 1 week, 3 days ago

    AIM Interstitial lung disease (ILD) is an extra-muscular manifestation of antisynthetase syndrome (ASS). The aim of this study is to analyze the clinical characteristics of anti-EJ associated ILD in a large cohort of patients. METHODS Retrospective cohort study of patients with anti-EJ associated ILD. All available data of clinical and laboratory characteristics, pulmonary function tests, laboratory parameters, high resolution computed tomography (HRCT) and treatment were collected and analyzed from medical records. RESULTS We identified 51 subjects. Average age at diagnosis was 55.6 years. Thirty-two of 51 patients were female. Concurrent autoantibodies against Ro52 were seen in 92.2% patients studied. HRCT patterns were mainly non-specific interstitial pneumonia (NSIP). The predominant myositis subset was amyopathic dermatomyositis (ADM) (41.2%) followed by dermatomyositis and polymyositis. Thirty-four patients improved on corticosteroids alone or in combination with immunosuppressive drugs as treatment and ten patients were stabilized. However, eleven patients (21.6%) initially improved during 12.0 ± 4.4 months, then progressively recurred despite steroid treatment (mean prednisone dose 11.6 ± 3.5 mg). The recurrence group included a significantly higher proportion of patients with NSIP pattern (p  less then  0.05). In the literature review the most common manifestations of anti-EJ ASS were ILD (89.3%) and myositis (58.9%). CONCLUSION ILD are common features of the anti-EJ ASS. Patients with anti-EJ ILD often had an onset of ILD with lower lung-predominant opacities and NSIP. Although the disease responded well to the initial combination therapy of corticosteroid and immunosuppressant, recurrence was frequent. NSIP pattern was significantly more frequent in the recurrence group. BACKGROUND Data on the risk of death following an asthma exacerbation are scarce. With this multinational cohort study, we assessed all-cause mortality rates, mortality rates following an exacerbation, and patient characteristics associated with all-cause mortality in asthma. METHODS Asthma patients aged ≥18 years and with ≥1 year of follow-up were identified in 5 European electronic databases from the Netherlands, Italy, UK, Denmark and Spain during the study period January 1, 2008-December 31, 2013. Patients with asthma-COPD overlap were excluded. Severe asthma was defined as use of high dose ICS + use of a second controller. Severe asthma exacerbations were defined as emergency department visits, hospitalizations or systemic corticosteroid use, all for reason of asthma. RESULTS The cohort consisted of 586,436 asthma patients of which 42,611 patients (7.3%) had severe asthma. The age and sex standardized all-cause mortality rates ranged between databases from 5.2 to 9.5/1000 person-years (PY) in asthma, and between 11.3 and 14.8/1000 PY in severe asthma. The all-cause mortality rate in the first week following a severe asthma exacerbation ranged between 14.1 and 59.9/1000 PY. Mortality rates remained high in the first month following a severe asthma exacerbation and decreased thereafter. Higher age, male gender, comorbidity, smoking, and previous severe asthma exacerbations were associated with mortality. CONCLUSION All-cause mortality following a severe exacerbation is high, especially in the first month following the event. click here Smoking cessation, comorbidity-management and asthma-treatment focusing on the prevention of exacerbations might reduce associated mortality. The mechanisms and underlying causes of bilateral asymmetry among healthy runners of different levels remain unclear. This cross-sectional laboratory study aimed to investigate the effects of running speed and running experience or competitive level on bilateral symmetry during running. Eleven competitive runners, 9 recreational runners and 11 novice runners were recruited in this study. They ran on an instrumented treadmill for 3 min at each of 5 fixed speeds (8, 9, 10, 11 and 12 km/h) in a randomized order. Bilateral asymmetry was evaluated and quantified using symmetry index (SI) of temporal and kinetic parameters. Overall, SI ranged between 0.8% for stride time and 21.4% for vertical average loading rate. Significant speed effects were observed on SI of flight time (p = .012), which was significantly higher at 8 km/h than that of the other 4 speeds (p = .023, 0.005, 0.023 and 0.028, respectively). Group-by-speed interactions were detected on SI in time to peak vertical ground reaction force (p = .032) and vertical average loading rate (p = .002). The competitive runners presented linear reduction in the SI with increasing speed from 8 to 12 km/h (R2 > 0.94); for the recreational runners, SI changed nonlinearly and presented a roughly U-shaped trend across speeds (R2 > 0.88); and for the novice runners, changes of SI across speed were inconsistent and dependent on parameters of interest (R2 > 0.64). Bilateral asymmetry was affected by both running speed and runners’ running experience or competitive level. The competitive runners were found to run with a more symmetrical manner with a greater running speed, the recreational runners demonstrated the most symmetrical pattern at the critical speed, whereas the novice runners showed inconsistent trends. Phishing is a social engineering tactic where a malicious actor impersonates a trustworthy third party with the intention of tricking the user into divulging sensitive information. Previous social engineering research in a real-world setting has shown an interaction between the personality of the target and the persuasion principle used. This study investigated whether this interaction is present in the realm of email phishing. Additionally, a signal detection theory framework was used to evaluate how the various persuasion principles influence accuracy, sensitivity (d’), and response criterion placement. A personality inventory and an email identification task (phishing or legitimate) were used. These data support previous findings that high extroversion is predictive of increased susceptibility to phishing attacks. The various persuasions principles elicited diverse response criterions and sensitivities, though all investigated persuasion principles resulted in a liberal decision criterion, except one. These findings are interpreted and discussed.