The usefulness of procalcitonin in aiding physician assessment and treatment of potential serious bacterial infections

Background: Procalcitonin (PCT) is used as a biomarker for the diagnosis of serious bacterial infections (SBI). To date, studies have not compared PCT to clinical judgment and it remains unclear whether PCT adds to the physician’s clinical judgment when diagnosing SBI. Purpose: To evaluate the diagnostic usefulness of PCT in comparison to blood culture results and the physician’s clinical judgment in patients presenting to the emergency department with signs of SBI. Methods: A prospective cohort study was conducted with 400 patients suspected of having an SBI who presented to the emergency department at 2 community hospitals in Wisconsin from 2016 to 2018. PCT was performed on all patients in addition to the standard of care (SOC) for suspected SBI. PCT results were not available to the physicians throughout the duration of the study. Physicians completed a brief survey that asked if they thought the patient was septic upon ordering SOC labs and again after they reviewed the SOC lab results. Data were collected to determine if patients were diagnosed with an SBI during their stay. Multivariate logistic regression was used to examine factors associated with an SBI diagnosis. Results:Among the patients, 186 (46.5%) were diagnosed with an SBI during their hospital stay. High serum levels of PCT (≥0.25 ng/ mL) were an independently significant predictor for an SBI diagnosis in patients with signs of infection (odds ratio [OR]: 1.96, 95% CI: 1.13–3.39; P=0.016). In addition, patients suspected of having an SBI are 2.62 times more likely to be diagnosed with an SBI when the blood culture result is positive (OR: 2.62, 95% CI: 1.19–5.77; P=0.017) and 7.13 times more likely to be diagnosed with an SBI when the physician believes the patient is septic after reviewing the SOC lab results (OR: 7.13, 95% CI: 3.64–13.97; P Conclusion: Procalcitonin, blood culture results, and clinician judgment after reviewing standard-of-care labs provide important diagnostic value when diagnosing serious bacterial infections. Clinician judgment before reviewing SOC lab results was not associated with an SBI diagnosis; thus, SOC labs do have added value in aiding physician assessment of potential SBI. This study offers a unique perspective as, to date, no other studies have compared PCT results to clinical judgment

Response of Sunflower (Helianthus annuus L.) Leaf Surface Defenses to Exogenous Methyl Jasmonate

Helianthus annuus, the common sunflower, produces a complex array of secondary compounds that are secreted into glandular trichomes, specialized structures found on leaf surfaces and anther appendages of flowers. The primary components of these trichome secretions are sesquiterpene lactones (STL), a diverse class of compounds produced abundantly by the plant family Compositae and believed to contribute to plant defense against herbivory. We treated wild and cultivated H. annuus accessions with exogenous methyl jasmonate, a plant hormone that mediates plant defense against insect herbivores and certain classes of fungal pathogens. The wild sunflower produced a higher density of glandular trichomes on its leaves than the cultivar. Comparison of the profiles of glandular trichome extracts obtained by liquid chromatography–mass spectroscopy (LC-MS) showed that wild and cultivated H. annuus were qualitatively similar in surface chemistry, although differing in the relative size and proportion of various compounds detected. Despite observing consistent transcriptional responses to methyl jasmonate treatment, we detected no significant effect on glandular trichome density or LC-MS profile in cultivated or wild sunflower, with wild sunflower exhibiting a declining trend in overall STL production and foliar glandular trichome density of jasmonate-treated plants. These results suggest that glandular trichomes and associated compounds may act as constitutive defenses or require greater levels of stimulus for induction than the observed transcriptional responses to exogenous jasmonate. Reduced defense investment in domesticated lines is consistent with predicted tradeoffs caused by selection for increased yield; future research will focus on the development of genetic resources to explicitly test the ecological roles of glandular trichomes and associated effects on plant growth and fitness

The usefulness of procalcitonin in aiding physician assessment and treatment of potential serious bacterial infections

Background: Procalcitonin (PCT) is used as a biomarker for the diagnosis of serious bacterial infections (SBI). To date, studies have not compared PCT to clinical judgment and it remains unclear whether PCT adds to the physician’s clinical judgment when diagnosing SBI. Purpose: To evaluate the diagnostic usefulness of PCT in comparison to blood culture results and the physician’s clinical judgment in patients presenting to the emergency department with signs of SBI. Methods: A prospective cohort study was conducted with 400 patients suspected of having an SBI who presented to the emergency department at 2 community hospitals in Wisconsin from 2016 to 2018. PCT was performed on all patients in addition to the standard of care (SOC) for suspected SBI. PCT results were not available to the physicians throughout the duration of the study. Physicians completed a brief survey that asked if they thought the patient was septic upon ordering SOC labs and again after they reviewed the SOC lab results. Data were collected to determine if patients were diagnosed with an SBI during their stay. Multivariate logistic regression was used to examine factors associated with an SBI diagnosis. Results:Among the patients, 186 (46.5%) were diagnosed with an SBI during their hospital stay. High serum levels of PCT (≥0.25 ng/ mL) were an independently significant predictor for an SBI diagnosis in patients with signs of infection (odds ratio [OR]: 1.96, 95% CI: 1.13–3.39; P=0.016). In addition, patients suspected of having an SBI are 2.62 times more likely to be diagnosed with an SBI when the blood culture result is positive (OR: 2.62, 95% CI: 1.19–5.77; P=0.017) and 7.13 times more likely to be diagnosed with an SBI when the physician believes the patient is septic after reviewing the SOC lab results (OR: 7.13, 95% CI: 3.64–13.97; P Conclusion: Procalcitonin, blood culture results, and clinician judgment after reviewing standard-of-care labs provide important diagnostic value when diagnosing serious bacterial infections. Clinician judgment before reviewing SOC lab results was not associated with an SBI diagnosis; thus, SOC labs do have added value in aiding physician assessment of potential SBI. This study offers a unique perspective as, to date, no other studies have compared PCT results to clinical judgment

Do Women Withhold Honest Sexual Communication When They Believe Their Partner’s Manhood is Threatened?

We explored whether women who perceive that their partners’ manhood is precarious (i.e., easily threatened) censor their sexual communication to avoid further threatening their partners’ masculinity. We operationalized women’s perceptions of precarious manhood in a variety of ways: In Study 1, women who made more money than their partners were twice as likely as those who did not to fake orgasms. In Study 2, women’s higher perceptions of partners’ precarious manhood indirectly predicted faking orgasms more, lower sexual satisfaction, and lower orgasms rate through greater anxiety and less honest communication. In Study 3, women who imagined a partner whose masculinity was insecure (vs. secure) were less willing to provide honest sexual communication, via anxiety. Together, the studies demonstrate a relationship between women’s perceptions of partner insecurity, anxiety, sexual communication, and sexual satisfaction. </jats:p

sj-docx-1-spp-10.1177_19485506211067884 – Supplemental material for Do Women Withhold Honest Sexual Communication When They Believe Their Partner’s Manhood is Threatened?

Supplemental material, sj-docx-1-spp-10.1177_19485506211067884 for Do Women Withhold Honest Sexual Communication When They Believe Their Partner’s Manhood is Threatened? by Jessica A. Jordan, Joseph A. Vandello, Martin Heesacker and Dylan M. Larson-Konar in Social Psychological and Personality Science</p