OBJECTIVE We compared 1-year outcomes in insulin-treated diabetes mellitus (ITDM) and non-ITDM patients compared to nondiabetic (DM) patients following contemporary percutaneous coronary intervention (PCI). ITD-1 ic50 BACKGROUND ITDM is associated with extensive atherosclerotic disease and worse cardiovascular prognosis compared to non-ITDM patients. METHODS We evaluated PCI patients at a large tertiary center from 2010 to 2016, grouped according to diabetes and treatment status at baseline. One-year major adverse cardiac events (MACE) were defined as a composite of death, myocardial infarction (MI), or target vessel revascularization. Outcomes were adjusted using multivariable Cox regression methods. RESULTS During the study period, 16,889 patients underwent PCI including 13.7% ITDM, 34.0% non-ITDM, and 52.3% non-DM patients. Patients with DM were younger, including more females and non-white patients, with higher body mass index and greater prevalence of prior revascularization and chronic kidney disease. Compared to others, ITDM patients more often presented with acute coronary syndrome, in-stent restenosis, or severe lesion calcification. There were no differences in discharge rates of dual antiplatelet therapy and statins, whereas beta-blockers were more commonly prescribed in DM patients. At 1-year, both ITDM and non-ITDM patients had greater risk of MACE compared with non-DM patients, and ITDM conferred greater adjusted risk than non-ITDM (ITDM = HR 2.11, 95% CI [1.79,2.50]; non-ITDM = HR 1.27, 95%CI [1.09,1.47]). CONCLUSIONS The negative prognostic effect of DM following contemporary PCI is heightened in the presence of insulin treatment, compared to non-DM patients. Focus on secondary prevention, prescription of and adherence to optimal medical therapy is necessary for post-PCI risk reduction. © 2020 Wiley Periodicals, Inc.BACKGROUND Optimal management of regional lymph nodes for thin cutaneous melanoma is uncertain. We evaluated regional lymph node involvement and 5-year melanoma-specific survival (MSS) in patients with thin (≤1 mm) primary melanoma. METHODS Patients with a melanoma, American Joint Committee on Cancer Staging 8th Edition pT1a (60 years. The 5-year MSS was similar for observed and SLNB cohorts (99.66% versus 98.92%) but worse for T1b lesions (98.90%) and clinical nodal recurrence (66.89%). CONCLUSION Overall prognosis for T1 melanoma is excellent with nodal involvement being rare. However, the American Joint Committee on Cancer 8th Edition T1b melanoma correlates with significantly worse 5-year MSS and increased regional nodal recurrence (notably for 0.8-1.0 mm lesions with ulceration). Further characterization of high-risk groups for nodal positivity that impacts patient outcome is needed for the pT1 melanoma cohort. © 2020 Royal Australasian College of Surgeons.During herbicide spray application, non-target terrestrial plants (NTTPs) growing in the off-field area need to be protected from unacceptable effects of herbicide drift. The risk of such unintended effects is assessed in order to establish whether a particular use can be approved - possibly in combination with mitigation measures. In Europe, the risk of herbicide treatment to NTTPs is assessed based on tier 2 studies done under controlled conditions in greenhouses. Following the concept of a tiered testing approach, higher tier field studies under more realistic conditions could be used to refine the risk assessment. No current guideline for conducting higher tier NTTP field studies is available. We have developed an NTTP higher tier field study method done on an experimental plant community established by sowing of a seed mixture. The setup was optimized in three pilot field studies and subsequently used for a definitive study testing effects of the herbicide iofensulfuron-sodium. Results show that the method can be regarded as a suitable higher tier option for assessing effects of herbicides on NTTPs. Growth of species from the soil seed bank cannot be avoided and has to be carefully considered when evaluating results. Adaptations of the study design may be necessary when testing different herbicides. Community level endpoints were at the same level as single species endpoints. Results of the field study were compared to standard greenhouse study results for the same herbicide. NOERs in the field were about a factor of 10 higher and show that the current tier 2 risk assessment for NTTPs can be regarded as protective in this case. Whether the present field study design and the assessed endpoints can be used in higher tier risk assessment of NTTPs depends on selection of the specific protection goal and requires further discussion. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Pseudomonas aeruginosa isolates from cystic fibrosis patients are often mucoid (due to the overexpression of exopolysaccharide alginate) yet lost motility. It remains unclear about how P. aeruginosa coordinately regulates alginate production and the type IV pili-driven twitching motility. Here we showed that sigma 22 factor (AlgT/U), an activator of alginate biosynthesis, repressed twitching motility by inhibiting the expression of pilin (PilA) through the intermediate transcriptional regulator AmrZ, which directly bound to the promoter region of pilA in both mucoid strain FRD1 and non-mucoid strain PAO1. Four conserved AmrZ-binding sites were found in pilA promoters among 10 P. aeruginosa strains although their entire pilA promoters had low identity. AmrZ has been reported to be essential for twitching in PAO1. We found that AmrZ was also required for twitching in mucoid FRD1, yet a high level of AmrZ inhibited twitching motility. This result was consistent with the phenomenon that twitching is frequently repressed in mucoid strains, in which the expression of AmrZ was highly activated by AlgT. Additionally, AlgT also inhibited the transcription of pilMNOP operon, which is involved in efficient pilus assembly. Our data elucidated a mechanism for how AlgT and AmrZ coordinately controlled twitching motility in P. aeruginosa. © 2020 Society for Applied Microbiology and John Wiley & Sons Ltd.