Background In randomized clinical trials, compared to Internal Medicine, admission to Geriatrics improved clinical outcomes of frail older patients accessing the Emergency Department (ED). Whether this advantage is maintained also in the “real world” is uncertain. We compared long-term survival of patients admitted to Geriatrics or Internal Medicine wards after stratification for background risk and across a variety of discharge diagnoses. selleck chemicals Methods Data were derived from the “Silver Code National Project”, an observational study of 180,079 unselected 75+ years old persons, admitted via the ED to Internal Medicine (n=169,717, 94.2%) or Geriatrics (n=10,362) wards in Italy. The Dynamic Silver Code (DSC), based on administrative data, was applied to balance for background risk between participants admitted to Geriatrics or Internal Medicine. Results One-year mortality was 33.7%, lower in participants discharged from Geriatrics (32.1%) than from Internal Medicine (33.8%; p less then 0.001), and increased progressively across four DSC risk classes (p less then 0.001). Admission to Geriatrics was associated with survival advantage in DSC class II to IV participants, with HR (95% CI) of 0.88 (0.83-0.94), 0.86 (0.80-0.92) and 0.92 (0.86-0.97), respectively. Cerebrovascular diseases, cognitive disorders, and heart failure were the discharge diagnoses with the widest survival benefit from admission to Geriatrics, which was mostly observed in DSC class III. Conclusions Admission to Geriatrics may provide long-term survival benefit in subjects who, based on the DSC, may be considered at an intermediate risk. Specific clinical conditions should be considered in the ED to improve selection of patients to be targeted for Geriatrics admission.Beyond demonstrated effectiveness, research needs to identify how peer support can be implemented in real-world settings. Telephone peer support offers one approach to this. The purpose of this study is to evaluate telephone peer support provided by trained peer staff for high-risk groups, implemented according to key tasks or functions of the Reciprocal Peer Support model (RPS) providing both standardization and adaptability. The methods used in the study include the review of contact data for years 2015-2016 from telephone peer support services of Rutgers Health University Behavioral Health Care, serving veterans, police, mothers of children with special needs, and child protection workers; structured interviews with peer supporters and clients; and audit of case notes. Across 2015-2016, peer supporters made 64,786 contacts with a total of 5,616 callers. Adaptability was apparent in 22% of callers’ relationships lasting ≤1 month and 43% ≥1 year, voicemails valued as communicating presence, 92% of callers receiving support with psychosocial issues, 65% with concrete problems, such as medical or other services, 88% receiving social support, and 88% either resolving an issue (e.g., finding employment) or making documented progress (e.g., getting professional treatment, insurance, or children’s services). With the balance of standardization and adaptability provided by the RPS, telephone peer support can address diverse needs and provide diverse contact patterns, assistance, support, and benefits.Methylation of miRNAs at the 2′-hydroxyl group on the ribose at 3′-end (2′-O-methylation, 2’Ome) is critical for miRNA function in plants and Drosophila. Whether this methylation phenomenon exists for mammalian miRNA remains unknown. Through LC-MS/MS analysis, we discover that majority of miR-21-5p isolated from human non-small cell lung cancer (NSCLC) tissue possesses 3′-terminal 2’Ome. Predominant 3′-terminal 2’Ome of miR-21-5p in cancer tissue is confirmed by qRT-PCR and northern blot after oxidation/β-elimination procedure. Cancerous and the paired non-cancerous lung tissue miRNAs display different pattern of 3′-terminal 2’Ome. We further identify HENMT1 as the methyltransferase responsible for 3′-terminal 2’Ome of mammalian miRNAs. Compared to non-methylated miR-21-5p, methylated miR-21-5p is more resistant to digestion by 3’→5′ exoribonuclease polyribonucleotide nucleotidyltransferase 1 (PNPT1) and has higher affinity to Argonaute-2, which may contribute to its higher stability and stronger inhibition on programmed cell death protein 4 (PDCD4) translation, respectively. Our findings reveal HENMT1-mediated 3′-terminal 2’Ome of mammalian miRNAs and highlight its role in enhancing miRNA’s stability and function.Background The LACE+ (Length of stay, Acuity of admission, Charlson Comorbidity Index [CCI] score, and Emergency department [ED] visits in the past 6 mo) index risk-prediction tool has never been successfully tested in a neurosurgery population. Objective To assess the ability of LACE+ to predict adverse outcomes after supratentorial brain tumor surgery. Methods LACE+ scores were retrospectively calculated for all patients (n = 624) who underwent surgery for supratentorial tumors at the University of Pennsylvania Health System (2017-2019). Confounding variables were controlled with coarsened exact matching. The frequency of unplanned hospital readmission, ED visits, and death was compared for patients with different LACE+ score quartiles (Q1, Q2, Q3, and Q4). Results A total of 134 patients were matched between Q1 and Q4; 152 patients were matched between Q2 and Q4; and 192 patients were matched between Q3 and Q4. Patients with higher LACE+ scores were significantly more likely to be readmitted within 90 d (90D) of discharge for Q1 vs Q4 (21.88% vs 46.88%, P = .005) and Q2 vs Q4 (27.03% vs 55.41%, P = .001). Patients with larger LACE+ scores also had significantly increased risk of 90D ED visits for Q1 vs Q4 (13.33% vs 30.00%, P = .027) and Q2 vs Q4 (22.54% vs 39.44%, P = .039). LACE+ score also correlated with death within 90D of surgery for Q2 vs Q4 (2.63% vs 15.79%, P = .003) and with death at any point after surgery/during follow-up for Q1 vs Q4 (7.46% vs 28.36%, P = .002), Q2 vs Q4 (15.79% vs 31.58%, P = .011), and Q3 vs Q4 (18.75% vs 31.25%, P = .047). Conclusion LACE+ may be suitable for characterizing risk of certain perioperative events in a patient population undergoing supratentorial brain tumor resection.