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Objective: A high glycemic index and high glycemic load diet has been associated with slower progression of amyotrophic lateral sclerosis (ALS), suggesting a benefit from high blood glucose levels. We examined the association between average blood glucose level and ALS progression in two independent cohorts. Methods: Sporadic ALS patients enrolled in the ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS) who completed a 3-month follow-up visit and had available blood samples were included. Hemoglobin A1c (HbA1c) was measured from whole blood collected at the 3-month follow-up. From the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database, we included ALS patients with one or more HbA1c measurements at enrollment and available death information. Associations between HbA1c with revised ALS functional rating scale (ALSFRS-R)/ALSFRS total score change, and tracheostomy-free survival/survival were examined in these cohorts using linear regression, linear mixed-effects models, and Cox proportional hazard models, adjusted for covariates. Results: In the ALS COSMOS cohort (n = 193), HbA1c level was not significantly associated with the change in the ALSFRS-R total score from baseline to the 3-month follow-up (p = 0.8) nor baseline to the 6-month follow-up (p = 0.4). No significant association was found between HbA1c level and tracheostomy-free survival (p = 0.8). In the PRO-ACT cohort (n = 928), no significant association was found between HbA1c level and the rate of ALSFRS decline in the first 200 days (p = 0.81 for interaction) nor between HbA1c level and survival (p = 0.45). Interpretation: We did not find convincing evidence that mean blood glucose level is associated with disease progression among ALS patients. [ABSTRACT FROM AUTHOR]

A case study is conducted for a submerged floating tunnel module (SFTM) in wet tow conditions. Inspired by the successful wet tow operations of spar platforms, a wet tow scenario is examined where a tunnel module, floating horizontally with a half-diameter draft, is towed by tugboats using towlines. To evaluate the static stability of the SFTM during wet tow, numerical static offset tests are performed at varying tow speeds to determine the equivalent system stiffness. These static offset tests consider surge, sway, roll, and yaw motions. Statistical analyses are subsequently performed based on the encounter-frequency approximation with varying equivalent stiffnesses. The most probable extreme motion analysis for 3 h under sea state 4 ( H S = 2.44   m and T P = 8.1   s ) shows that the beam sea condition causes the largest heave (0.6 m), and the stern sea (30 deg.) leads to the largest yaw response (0.85 deg.), which is likely to cause an instantaneous decrease in towing stability. [ABSTRACT FROM AUTHOR]

This letter to the editor discusses a case report of a 52-year-old woman with amyotrophic lateral sclerosis (ALS) who experienced rapid disease progression after starting semaglutide, a GLP-1 agonist, for type 2 diabetes mellitus treatment. The patient's condition deteriorated significantly, leading to the emergence of new symptoms and substantial weight loss. The authors suggest that the use of GLP-1 agonists may impact the progression of ALS and call for further research to understand this potential association. [Extracted from the article]

Study Objectives: Inflammatory and immune mechanisms are considered in restless legs syndrome (RLS) pathophysiology with several autoimmune diseases associated with RLS. There is a paucity of studies examining RLS prevalence in myasthenia gravis (MG), an autoimmune neuromuscular disease. This study investigated RLS prevalence and association with patient-reported measures in a large registry of participants with MG using a validated RLS diagnostic questionnaire., Methods: The Myasthenia Gravis Foundation of America MG Patient Registry is used on a semiannual basis to survey participants with MG. Patients aged ≥ 18 years, living in the United States, and answering "yes" to physician diagnosed MG were invited by email to enroll in an RLS-customized web-based survey. Collection of data included demographics, disease variables, patient-reported measures with a simple depression scale, MG-quality of life-15 revised, MG-activities of daily living instruments, and 13-item short-form Cambridge-Hopkins diagnostic questionnaire for RLS. Multivariable logistic regression models explored the association between RLS and MG variables of interest., Results: A total of 630 eligible participants with MG (age: 62.8 ± 13.2; 54.9% female; 91.6% White) completed the survey. The overall prevalence of RLS was 14.8%. The prevalence of clinically significant RLS was 8.4%. The odds of having RLS were increased with higher (worse) MG-activities of daily living, MG-quality of life-15 revised, and depression scores. History of "thymic tumor with thymectomy" and "continuous positive airway pressure therapy" were also independent predictors of RLS., Conclusions: RLS is common in patients with MG and is associated with worse functional status, quality of life, and depression. The thymus could play a key role in an autoimmune process associating MG with RLS., Citation: AlGaeed M, McPherson T, Lee I, et al. Prevalence of restless legs and association with patient-reported outcome measures in myasthenia gravis. J Clin Sleep Med . 2025;21(2):269-276., (© 2025 American Academy of Sleep Medicine.)