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A cross-cultural study of intimate relationships explored correlates of love around the world. Structural Equation Modeling found similar factors associated with love across nine cultural regions, as well as across eight relationship types defined by men and women, married or unmarried, in opposite-sex or same-sex relationships. The correlates are similar in spite of any variations in mean levels of the factors. The correlates occur in the following categories: motivation, partner suitability, intimacy dimensions, exchange processes, conflict resolution, and wellbeing. The findings have implications for future research, self-reflection, and couples counseling.

High-mountain plant communities are strongly determined by abiotic conditions, especially low temperature, and are therefore susceptible to effects of climate warming. Rising temperatures, however, also lead to increased evapotranspiration, which, together with projected shifts in seasonal precipitation patterns, could lead to prolonged, detrimental water deficiencies. The current study aims at comparing alpine plant communities along elevation and water availability gradients from humid conditions (north-eastern Alps) to a moderate (Central Apennines) and a pronounced dry period during summer (Lefka Ori, Crete) in the Mediterranean area. We do this in order to (1) detect relationships between community-based indices (plant functional leaf and growth traits, thermic vegetation indicator, plant life forms, vegetation cover and diversity) and soil temperature and snow duration and (2) assess if climatic changes have already affected the vegetation, by determining directional changes over time (14-year period; 2001–2015) in these indices in the three regions. Plant community indices responded to decreasing temperatures along the elevation gradient in the NE-Alps and the Apennines, but this elevation effect almost disappeared in the summer-dry mountains of Crete. This suggests a shift from low-temperature to drought-dominated ecological filters. Leaf trait (Leaf Dry Matter Content and Specific Leaf Area) responses changed in direction from the Alps to the Apennines, indicating that drought effects already become discernible at the northern margin of the Mediterranean. Over time, a slight increase in vegetation cover was found in all regions, but thermophilisation occurred only in the NE-Alps and Apennines, accompanied by a decline of cold-adapted cushion plants in the Alps. On Crete, xeromorphic shrubs were increasing in abundance. Although critical biodiversity losses have not yet been observed, an intensified monitoring of combined warming-drought impacts will be requ

Background and Aim: Accurate assessment of hepatic reserve is key to staging and treatment allocation in patients with hepatocellular carcinoma (HCC). The Child-Pugh score (CPS) and Model for End-Stage Liver Disease (MELD) are most widely used to measure liver function, despite limitations. Novel emerging scores based on serum albumin- bilirubin (ALBI) grade and platelet-albumin-bilirubin (PALBI) grade have shown superior discriminatory and prognostic ability in assessing liver function. We analyzed their applicability in patients with HCC undergoing commonly prescribed surgical and locoregional therapies and compared them with currently used models, in a real-world cohort. Method(s): Patients who underwent surgical resection or locoregional therapy for HCC after a multidisciplinary meeting were retrospectively identified from a single tertiary hospital between 2009 and 2015. Those who underwent liver transplantation or treatment for conditions other than HCC were excluded. Overall survival (OS) was stratified by MELD score, CPS, Barcelona Clinic Liver Cancer (BCLC) stage, and ALBI and PALBI grades. The utility of each scoring system as a prognostic indicator was assessed using univariate Cox regression analysis, and the Harrell's Cindex was used to determine discriminatory ability. Multivariate Cox regression analysis was performed to identify independent predictors of OS. Result(s): A total of 124 patients were included, with a mean age of 65.4 years and mainly hepatitis C-related liver disease (45%). Most had compensated CPS A cirrhosis (81%) at diagnosis. A total of 25 patients underwent surgical resection, 31 had thermal ablation, and 68 had transarterial chemoembolization (TACE). The median OS was 27 months. OS was significantly associated with ALBI, PALBI, MELD, CPS (P < 0.001), and BCLC grade (P = 0.01) on a univariate analysis. On a multivariate analysis, baseline sodium level (hazard ratio [HR], 0.88; 95% CI, 0.81-0.96; P = 0.004), bilirubin level (HR, 1.0

Background and Aim: Esophageal food bolus obstruction (EFBO) is a common presenting problem in emergency departments worldwide. There is a paucity of data relating to efficacy of pre-endoscopic and endoscopic management, resulting in a wide variety of clinical practice. Consensus guidelines do not advocate strongly for pre-endoscopic medications, but they remain commonly used. We aimed to evaluate the natural history, management, and outcomes of patients presenting with EFBO and to establish the efficacy of pre-endoscopic and endoscopic treatment options. Method(s): ICD-10 codes identified adult patients aged >= 18 years admitted with EFBO to two Australian tertiary centers from 2010 to 2018. Medical records were reviewed to determine baseline characteristics, medical and endoscopic treatments, and outcomes. A subgroup analysis compared patients who passed the EFBO without endoscopic intervention with patients who required endoscopy. A multivariate logistical regression analysis was performed. Result(s): A total of 396 patients were included (median age, 55 years; IQR, 38-71; 67% male). Of these, 134 patients (34%) had a prior history of EFBO, 78 (20%) had gastroesophageal reflux disease, and 58 (15%) had asthma. No differences in baseline characteristics were noted between patients who spontaneously cleared the obstruction and those who required endoscopy. Median length of stay was 2 days (IQR, 1- 2). A total of 265 patients (67%) received a mean of 1.4 (SD +/- 1.22) pre-endoscopic medications. Glucagon (41%), glyceryl trinitrate (35%), and cola drink (34%) were most often administered, successfully relieving the EFBO in 13%, 11%, and 12% of patients, respectively. No medication significantly reduced the need for endoscopic intervention. Multivariable analysis showed that tolerating saliva (odds ratio [OR], 1.95; P = 0.025) and liquids (OR, 2.28; P = 0.001) significantly predicted spontaneous resolution of the EFBO without endoscopy. A total of 302 patients (76%) r

Background: We aimed to compare glycemic control, insulin requirements, and outcomes in women with type 1 diabetes in pregnancy treated with continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI). Method(s): A retrospective cohort study was conducted of singleton pregnancies (>20 weeks gestation) in women with type 1 diabetes (2010-2015) at a specialist multidisciplinary maternity network in Australia. Antenatal characteristics, diabetes history and treatment details, and maternal and neonatal outcomes were compared for women with type 1 diabetes using CSII and MDI. Bolus calculator settings were reviewed for CSII. Data were obtained from individual medical records, linkage to pathology, and the Birthing Outcomes System database. Result(s): There were no differences in maternal characteristics or diabetes history between women managed with CSII (n = 40) and MDI (n = 127). Women treated with CSII required less insulin and less increase in total daily insulin dose/kg than MDI (40% vs. 52%). Both groups achieved similar glycemic control and no differences in pregnancy outcome. In the CSII group, carbohydrate:insulin ratios were intensified across gestation (30% breakfast, 27% lunch, 22% dinner), and insulin sensitivity factors (ISFs) changed little (7% breakfast, 0% lunch, -10% dinner). Conclusion(s): There was no difference in glycemic control or pregnancy outcomes in women using CSII or MDI managed in a multidisciplinary setting. Greater adjustments are needed to ISFs with CSII therapy. Overall, these data do not support recommending CSII in pregnancy with potentially higher patient and staff demands and costs and lack of improvement in HbA1c and pregnancy outcomes.© Copyright 2017, Mary Ann Liebert, Inc.