BOVA is Superior to sPESI in Identification of High Risk Pulmonary Embolism Patients

Introduction: Prognostic models exist for the purpose of stratifying patients with acute pulmonary embolism. Of these, the Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are the most well-known, although more recent composite models, like the BOVA score, are now being studied and implemented. Comparative efficacy of these scores to predict long term mortality is not well established. Methods: We performed a retrospective analysis of all consecutive patients diagnosed with PE using computed tomography scan from 2014-2016 at an urban tertiary-referral medical center. Cox proportional hazard analyses were performed to compare the performance of two prognostic models – sPESI and BOVA – to predict all-cause in-hospital and cumulative one-year mortality. Results: The all-cause in-hospital mortality rate was 6.0%, and cumulative one-year mortality rate was 21.3%. In adjusted analyses, a BOVA score \u3e4 was significantly associated with an increased in-hospital mortality (HR 3.5, 95% CI: 1.4-9.0, p = 0.009) and one-year mortality (HR 2.0, 95% CI: 1.0-3.9, p = 0.04), as compared to a BOVA score \u3c4. However, the sPESI (p = 0.14) did not show a significant association with one-year mortality. In identifying in-hospital mortality, the sPESI had high sensitivity (100%) and low specificity (10.1%), whereas the BOVA score had low sensitivity (20.0%) and high specificity (92.7%). Similar trends were seen for one-year mortality. Conclusion: In this study, a high BOVA score was found to be the best predictor of both short and long-term mortality in PE patients. A low sPESI score identified with high sensitivity patients with low-risk PEs

Do Misperceptions of Peer Drinking Influence Personal Drinking Behavior? Results From a Complete Social Network of First-Year College Students

This study considered the influence of misperceptions of typical versus self-identified important peers\u27 heavy drinking on personal heavy drinking intentions and frequency utilizing data from a complete social network of college students. The study sample included data from 1,313 students (44% male, 57% White, 15% Hispanic/Latinx) collected during the fall and spring semesters of their freshman year. Students provided perceived heavy drinking frequency for a typical student peer and up to 10 identified important peers. Personal past-month heavy drinking frequency was assessed for all participants at both time points. By comparing actual with perceived heavy drinking frequencies, measures of misperceptions of heavy drinking (accurately estimate, overestimate, underestimate) were constructed for both general and important peers. These misperceptions were then used as predictors of concurrent and prospective personal heavy drinking frequency and intentions using network autocorrelation analyses. The majority of students (84.8%) overestimated, 11.3% accurately estimated, and 3.9% underestimated heavy drinking among their general peers, whereas 42.0% accurately estimated, 36.9% overestimated, and 21.1% underestimated important peers\u27 heavy drinking. For both referents, overestimation of peer heavy drinking was associated with more frequent heavy drinking and higher drinking intentions at both time points. Importantly, the effects of underestimating and overestimating close peers\u27 drinking on personal alcohol use were significant after controlling for the influence of misperceptions of general peers\u27 heavy drinking. Close peers are a critical referent group in assessments related to social norms for young adult alcohol use. Implications for prevention and intervention are discussed

An Event- and Network-Level Analysis of College Students’ Maximum Drinking Day

Background—Heavy episodic drinking is common among college students and remains a serious public health issue. Previous event-level research among college students has examined behaviors and individual-level characteristics that drive consumption and related consequences but often ignores the social network of people with whom these heavy drinking episodes occur. The main aim of the current study was to investigate the network of social connections between drinkers on their heaviest drinking occasions. Methods—Sociocentric network methods were used to collect information from individuals in the first-year class (N=1342) at one university. Past-month drinkers (N=972) reported on the characteristics of their heaviest drinking occasion in the past month and indicated who else among their network ties was present during this occasion. Results—Average max drinking day indegree, or the total number of times a participant was nominated as being present on another students’ heaviest drinking occasion, was 2.50 (SD = 2.05). Network autocorrelation models indicated that max drinking day indegree (e.g., popularity on heaviest drinking occassions) and peers’ number of drinks on their own maximum drinking occasions were significantly associated with participant maximum number of drinks, after controlling for demographic variables, pregaming, and global network indegree (e.g., popularity in the entire first-year class). Conclusion—Being present at other peers’ heaviest drinking occasions is associated with greater drinking quantities on one’s own heaviest drinking occasion. These findings suggest the potential for interventions that target peer influences within close social networks of drinkers

Barium effect on germination, plant growth, and antioxidant enzymes in Cucumis sativus L. plants

Barium (Ba) is a nonessential element that can cause several deleterious effects in most organisms. Elevated Ba concentrations can be toxic for plants and may affect growth and disturbances in homeostasis. This study aimed to evaluate the Ba stress, the plant-tolerance limits, and the detoxification strategy adopted by Cucumis sativus L. The effect of Ba on seed's germination and vegetative development of this species was evaluated. For germination test, different Ba concentrations were used (0, 200, 500, 1,000, and 2,000 μM). Results showed that germination was stimulated with 500 and 2,000 µM of Ba. The toxicity effect on plant development was studied by treating the plants with increasing doses of Ba (100, 200, 300, and 500 μM) during 45 days. Shoot and root dry biomass production decreased significantly with elevated Ba concentrations, although water content enhanced in the roots. The concentration of Ba, 500 µM, induced high Ba accumulation in shoots and roots (9 times higher than in the control plants). Moreover, results showed that catalase, guaiacol peroxidase, and ascorbate peroxidase activities were stimulated in the different tissues of cucumber plants which highlight the occurring of an oxidative damage through Ba treatments and the involvement of the plant enzymatic antioxidant defense system

Dietary intervention and prevention of cognitive-related outcomes in healthy older adults without cognitive dysfunction

In the last decade, the association between diet and cognitive function/dementia has been largely investigated in observational studies, while there was a lack of evidence from randomized clinical trials (RCTs) on the prevention of late-life cognitive disorders though dietary intervention in cognitively healthy older adults. In the present article, we reviewed RCTs published in the last three years (2014-2016) exploring nutritional intervention efficacy in preventing the onset of late-life cognitive disorders and dementia in cognitively healthy subjects aged over 60 years using different levels of investigation (i.e., dietary pattern changes/ medical food/nutraceutical supplementation/multidomain approach and dietary macro-and micronutrient approaches). From the included RCTs, there was moderate evidence that intervention through dietary pattern changes, medical food/nutraceutical supplementation, and multidomain approach improved specific cognitive domains or cognitive-related blood biomarkers. Moreover, there was high evidence that protein supplementation improved specific cognitive domains. For fatty acid supplementation, mainly long-chain polyunsaturated fatty acids, there was emerging evidence suggesting an impact of this approach in improving specific cognitive domains, MRI findings, and/or cognitive-related biomarkers also in selected subgroups of older subjects although some results were conflicting. Moreover, there was convincing evidence of an impact of non-flavonoid polyphenol and flavonoid supplementations in improving specific cognitive domains and/or MRI findings. Finally, there was only low evidence suggesting efficacy of intervention with homocysteine-related vitamins in improving cognitive functions, dementia incidence, or cognitive-related biomarkers in cognitively healthy older subjects

Nutritional interventions in patients with Alzheimer’s disease and other late-life cognitive disorders

Given the impact of nutrition on neuroprotection largely investigated in observational studies, in the present article, we reviewed evidence from randomized clinical trials (RCTs) published in the last three years (2014-2016) exploring nutritional intervention efficacy in slowing cognitive impairment progression and achieving cognitive-related outcomes in patients aged 60 years and older with mild cognitive impairment (MCI), preclinical Alzheimer\u2019s disease (AD), prodromal AD, AD, unspecified dementia, and vascular dementia using different levels of investigation (i.e., medical food/nutraceutical supplementation/multidomain approach and dietary food/macro-and micronutrient approaches). From the reviewed RCTs, there was emerging evidence that nutritional intervention through medical food/nutraceutical supplementation (Fortasyn Connect\uae and another similar nutraceutical formulation) and multidomain approach improved magnetic resonance imaging findings and other cognitive-related biomarkers, but without clear effect on cognition in mild AD and MCI. Moreover, there was some evidence of a positive effect of antioxidant-rich foods (nuts) in improving specific cognitive domains and cognitive-related outcomes in MCI and mild-to-moderate dementia, but only in small samples. There was also convincing evidence for fatty acid supplementation, mainly n-3 polyunsaturated fatty acids (PUFAs), in improving specific cognitive domains and/or cognitive-related biomarkers in MCI and AD. Furthermore, antioxidant vitamin and trace element supplementations improved only cognitive-related outcomes and biomarkers, without effect on cognitive function in AD and MCI patients. Finally, high-dose B vitamin supplementation in AD and MCI patients improved cognitive outcomes but only in the subjects with a high baseline plasma n-3 PUFA, while folic acid supplementation had positive impact on specific cognitive domains

Coordinated Regulation of Niche and Stem Cell Precursors by Hormonal Signaling

In the developing Drosophila ovary, the ecdysone signaling pathway controls the differentiation of both niche and germ line stem cell precursors

A Novel Ecdysone Receptor Mediates Steroid-Regulated Developmental Events during the Mid-Third Instar of Drosophila

The larval salivary gland of Drosophila melanogaster synthesizes and secretes glue glycoproteins that cement developing animals to a solid surface during metamorphosis. The steroid hormone 20-hydroxyecdysone (20E) is an essential signaling molecule that modulates most of the physiological functions of the larval gland. At the end of larval development, it is known that 20E—signaling through a nuclear receptor heterodimer consisting of EcR and USP—induces the early and late puffing cascade of the polytene chromosomes and causes the exocytosis of stored glue granules into the lumen of the gland. It has also been reported that an earlier pulse of hormone induces the temporally and spatially specific transcriptional activation of the glue genes; however, the receptor responsible for triggering this response has not been characterized. Here we show that the coordinated expression of the glue genes midway through the third instar is mediated by 20E acting to induce genes of the Broad Complex (BRC) through a receptor that is not an EcR/USP heterodimer. This result is novel because it demonstrates for the first time that at least some 20E-mediated, mid-larval, developmental responses are controlled by an uncharacterized receptor that does not contain an RXR-like component

2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.Peer reviewe