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Background: Haglund deformity is characterized by an enlarged posterosuperior calcaneus, often with inflammation of the retrocalcaneal bursa and Achilles tendon. This study aims to determine if obesity is associated with an increased rate of complications after Haglund resection.Methods: A retrospective review was conducted on patients who underwent surgical resection for Haglund deformity from January 2015 to December 2023 at a single academic center. The patient cohort was initially stratified by body mass index (BMI) into normal (BMI < 25), overweight (25 ≤ BMI < 30), and obese (BMI ≥ 30). For those classified as obese, further subclassification was performed using the standard system: obesity class I (mild obesity) = BMI 30.0-34.9; obesity class II (moderate obesity) = BMI 35.0-39.9; and obesity class III (severe obesity) = BMI ≥40.0. Data on demographics, surgical techniques, and weightbearing were collected and analyzed. Postoperative complications were compared between groups.Results: Of the 370 patients included in this study, 20 (5.4%) were classified as normal, 77 (20.8%) were overweight, and 273 (73.8%) were obese. Within the cohort of patients with obesity, 96 (35.2%) were classified as obesity class I, 96 (35.2%) as obesity class II, and 81 (29.7%) as obesity class III. The obese group had a higher proportion of females (70.0%) and Black/African American race (24.5%), and a higher prevalence of diabetes mellitus (22.0%) and American Society of Anesthesiologists scores compared with other groups. Additionally, analysis within the obesity subclassifications revealed significant differences in smoking status, with a higher proportion of nonsmokers as obesity class increased (58.3% in class I, 76.0% in class II, and 79.0% in class III; P= .01). Follow-up duration averaged 10.5 months, with wound breakdown rates significantly higher in the obese group vs the overweight or normal groups (11.0% vs 2.6% vs 0.0%, P= .02). No significant differences in wound complications or outcomes were observed between patients based on different obesity subclassifications.Conclusion: Our findings demonstrate that after Haglund resection, obese patients have a higher risk of complications, particularly wound breakdown. This underscores the necessity of careful patient selection and perioperative optimization.

Stochastic epigenetic mutations (SEMs) have been proposed as novel aging biomarkers to capture heterogeneity in age-related DNA methylation changes. SEMs are defined as outlier methylation patterns at cytosine-guanine dinucleotide sites, categorized as hypermethylated (hyperSEM) or hypomethylated (hypoSEM) relative to a reference. Because SEMs are defined by their outlier status, it is critical to differentiate extreme values due to technical noise or data artifacts from those due to real biology. Using technical replicate data, we found SEM detection is not reliable: across 3 datasets, 24 to 39% of hypoSEM and 46 to 67% of hyperSEM are not shared between replicates. We identified factors influencing SEM reliability—including blood cell type composition, probe beta-value statistics, genomic location, and presence of SNPs. We used these factors in a training dataset to build a machine learning-based filter that removes unreliable SEMs, and found this filter enhances reliability in two independent validation datasets. We assessed associations between SEM loads and aging phenotypes in the Framingham Heart Study and discovered that associations with aging outcomes were in large part driven by hypoSEMs at baseline methylated probes and hyperSEMs at baseline unmethylated probes, which are the same subsets that demonstrate highest technical reliability. These aging associations were preserved after filtering out unreliable SEMs and were enhanced after adjusting for blood cell composition. Finally, we utilized these insights to formulate best practices for SEM detection and introduce a novel R package, SEMdetectR, which uses parallel programming for efficient SEM detection with comprehensive options for detection, filtering, and analysis.

Lesser metatarsophalangeal joint (MTPJ) instability is a common cause of metatarsalgia and is associated with plantar plate pathology. The instability is often due to chronic attenuation and attritional changes of the plantar plate and collateral ligaments, leading to eventual rupture. The plantar plate and collateral ligaments serve as the primary stabilizers of the MTPJ, and rupture or attenuation of these ligaments leads to instability. Surgical intervention is often necessary for plantar plate tears, with various approaches and techniques available.

This article describes the etiology, clinical presentation, surgical management, and outcomes for treatment of the failed first metatarsophalangeal (MTP) joint arthroplasty. Failure following implant arthroplasty typically creates large osseous deficits and surgical management can be difficult. Salvage arthrodesis provides reliable joint stability while maintaining hallux length. Outcomes following conversion of a failed MTP joint arthroplasty to MTP joint arthrodesis have demonstrated consistent pain relief and high satisfaction: however, high rates of complication and nonunion have been reported. Bone graft may be necessary to fill large voids in the joint. Other revision options for failed arthroplasty have been described, but outcomes remain inconsistent and varied. Ultimately, conversion to MTP joint arthrodesis is the recommended intervention for treatment of the failed MTP arthroplasty implant, providing sufficient stability and pain relief.

Shotcrete and compressed air are often utilised for providing temporary support in tunnel excavation. On occasions of concurrent application of shotcrete and compressed air, there would be concerns of the quality of concrete sprayed within pressurised space, as well as the strength development of shotcrete in pressurised environment. To address these concerns, field experimentation of the shotcrete strength development under compressed air pressure was conducted, and the results are reported in this paper.

De novo sequencing of any novel peptide/protein is a difficult task. Full sequence coverage, isomeric amino acid residues, inter- and intramolecular S–S bonds, and numerous other post-translational modifications make the investigators employ various chemical modifications, providing a variety of specific fragmentation MSnpatterns. The chemical processes are time-consuming, and their yields never reach 100%, while the subsequent purification often leads to the loss of minor components of the initial peptide mixture. Here, we present the advantages of the EThcD method that enables establishing the full sequence of natural intact peptides of ranid frogs in de novo top-down mode without any chemical modifications. The method provides complete sequence coverage, including the cyclic disulfide section, and reliable identification of isomeric leucine/isoleucine residues. The proposed approach demonstrated its efficiency in the analysis of peptidomes of ranid frogs from several populations of Rana arvalis, Rana temporaria, and Pelophylax esculentuscomplexes.

This article reviews the etiology, clinical presentation, classification schemes, and treatment options for osteochondral lesions of the talus. These lesions typically occur after a traumatic injury and are best diagnosed on MRI. Asymptomatic lesions and incidentally found lesions are best treated conservatively; however, acute displaced osteochondral fragments may require surgical treatment. Lesion characteristics may dictate surgical technique. Outcomes following surgical treatment may be impacted by patient age, BMI, and lesion characteristics.

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Field experiments were conducted in 2021 and 2022 to evaluate the effect of irrigation timing on S‐ethyl‐N,N‐dipropylthiocarbamate (EPTC), flumioxazin, pyroxasulfone, and flumioxazin + pyroxasulfone weed control efficacy and safety in dry bean (Phaseolus vulgarisL.). Treatments consisted of EPTC (3430 g ai ha−1), flumioxazin (53.6 g ai ha−1), pyroxasulfone (119 g ai ha−1), and flumioxazin + pyroxasulfone (70.4 + 89.3 g ai ha−1) incorporated with overhead irrigation at 1, 4, and 8 days after herbicide treatment (DAT). A nontreated and hand‐weeded check were included for comparison. Delaying irrigation until 8 DAT resulted in 11% and 19% injury in the pyroxasulfone and flumioxazin + pyroxasulfone treatments, respectively, but the crop recovered within 5 weeks after treatment. Delaying irrigation until 8 DAT increased total weed dry weight by 52%. Generally, flumioxazin + pyroxasulfone provided better weed control compared to flumioxazin or pyroxasulfone applied alone. Irrigation timing did not influence dry bean yield. Seed yield was 160 kg ha−1in the nontreated check and 2521 kg ha−1in the hand‐weeded check. Seed yield in the flumioxazin + pyroxasulfone treatment (2425 kg ha−1) was similar to the hand‐weeded check. Flumioxazin + pyroxasulfone provided very good weed control with acceptable crop safety. While irrigation timing may play a role in flumioxazin or pyroxasulfone injury, other soil and environmental factors may influence dry bean response to these herbicides. Delaying irrigation until 8 days after herbicide application resulted in 11%–19% crop injury.Delaying irrigation until to 8 days after herbicide application reduced stand density by up to 14%.Delaying irrigation until 8 days after herbicide application increased total weed dry weight by 52%.Flumioxazin + pyroxasulfone provided good weed control with acceptable crop safety.Irrigation timing did not influence dry bean seed yield.

Palmer amaranth is one of the most troublesome pigweeds in crop production systems in the United States. It only recently started to appear in the Pacific Northwest (PNW). A coordinated extension and outreach effort among land grant universities (University of Idaho, Oregon State University, and Washington State University), Amalgamated Sugar, other commodity commissions, and industry was launched to track Palmer amaranth in the PNW. In 2023, tissue samples were collected from pigweeds suspected to be Palmer amaranth with tests providing confirmation. Palmer amaranth was detected in several crops as well as right‐of‐way and private property. Most of the Palmer amaranth populations were confirmed to be resistant to glyphosate. Additional surveys and resistance screening efforts are underway to map the distribution of Palmer amaranth and assess the level of herbicide resistance across the region. Earn 0.5 CEUs in Integrated Pest Management by reading this article and taking the quiz at https://web.sciencesocieties.org/Learning‐Center/Courses.

BACKGROUND:Medial subtalar dislocations are rare in adolescent patients, presenting treatment challenges. While several reports of non-operative management of adolescent medial subtalar dislocation exist in the literature, no report to date has addressed rehabilitation specifics for successful return-to-sport.CASE PRESENTATION:The patient is a 17-year-old male who sustained an acute traumatic left medial subtalar dislocation with concomitant ligamentous and osseous injuries during a soccer game. After examination and appropriate imaging, it was determined the patient would be best treated with non-operative management and underwent a progressive exercise rehabilitation program for successful return-to-sport.OUTCOME AND FOLLOW-UP:After rehabilitation, the patient was able to return-to-sport after 25 weeks with full return to prior soccer performance. At 13 month follow-up, patient reported nearly 100% return to prior sport performance via two patient-reported outcome measures.DISCUSSION:This case report and rehabilitation protocol illustrates a successful return-to-sport for a rare and devastating orthopedic injury in an adolescent.

We investigated the trajectory of depressive symptoms (“depression”) from the start of the COVID-19 pandemic in South Africa (March 2020) until 2021, between individuals with and without pre-pandemic depression, specifically regarding the role of food security. Our investigation used publicly available panel data (N = 6,930) from the South African National Income Dynamics Study Coronavirus Rapid Mobile Survey (SA-NIDS-CRAM from 2020–2021) on those who had also participated in the pre-pandemic South African National Income Dynamics Study (SA-NIDS, 2017) depression interview. We investigated trends in depressive symptomatology (based on a 2-item Patient Health Questionnaire) at SA-NIDS-CRAM Wave 2 (July 2020), Wave 3 (February 2021) and Wave 5 (May 2021). Generalized estimating equations (GEE) with post-estimation linear combinations of estimators were fitted to investigate the roles of pre-pandemic depression (based on 2017 SA-NIDS data) and food insecurity during the pandemic on depressive symptomatology. During the pandemic, the highest levels of depression were observed consistently among those with pre-pandemic depression and food insecurity; and were lowest among those without pre-pandemic depression and food security. Depressive symptomatology rose in nearly equal magnitude during the early phases of the pandemic in two groups: those without pre-pandemic depression but food insecure during the pandemic; as well as those with pre-pandemic depression but food secure during the pandemic. However, this dynamic changed later in the pandemic, when higher depressive symptomatology was observed in the group with both pre-pandemic depression and food insecurity, widening the gap between them from Wave 3 (adj β = 0.63, p < 0.01) to Wave 5 (adj β = 0.79, p < 0.01). Our results highlight the importance of addressing both population mental health and food insecurity, particularly at the early stages of a crisis/disaster. As we showed that mental health impact is linked to food insecurity during a pandemic, strengthening social protection measures, especially around food and nutrition, would help build resilience to crises in the long term.

The search for biomarkers that quantify biological aging (particularly ‘omic’-based biomarkers) has intensified in recent years. Such biomarkers could predict aging-related outcomes and could serve as surrogate endpoints for the evaluation of interventions promoting healthy aging and longevity. However, no consensus exists on how biomarkers of aging should be validated before their translation to the clinic. Here, we review current efforts to evaluate the predictive validity of omic biomarkers of aging in population studies, discuss challenges in comparability and generalizability and provide recommendations to facilitate future validation of biomarkers of aging. Finally, we discuss how systematic validation can accelerate clinical translation of biomarkers of aging and their use in gerotherapeutic clinical trials.

Passive light-emitting-diode (LED) drivers have recently been adopted by the lighting industry in street lighting applications due to their high robustness against extreme weather conditions, long lifetime, and high percentage of recyclable components. With the increasing trend of smart lamp posts, there are new requests for dimmable passive street lighting systems. This article presents a novel dimmable technology for passive LED drivers. By adding a switchable parallel capacitor across the input current-limiting inductor, a small freewheeling period between the inductor and capacitor can provide an artificial dead angle, which reduces the power for a passive half-bridge voltage doubler LED driver. The operating principle of this new dimming mechanism is explained, and a full analysis is included. The new dimmable mechanism has been practically confirmed in a 120-W passive LED system. The theoretical and practical results are in good agreement.

Background: Despite substantial increase in total ankle arthroplasty (TAA) nationwide, there are few studies comparing flat-cut vs chamfer-cut talar systems in TAA with regard to radiographic aseptic loosening rates of the implant.Methods: This retrospective study included 189 Salto-Talaris TAA and 132 INBONE II primary TAA with a minimum 1-year follow-up. Patient characteristics were obtained including gender, age at surgery, body mass index (BMI), smoking status, primary diagnosis, surgical time, and the presence of diabetes. Radiographic evidence for aseptic loosening was assessed. Statistical analysis was performed for comparison in outcomes between Salto-Talaris and INBONE II.Results: The mean age of the study population was 63.5 ± 9.8 years at surgery. Mean follow-up was 4.9 ± 3.0 years. Radiographic aseptic loosening of the tibial implant showed no significant difference between the 2 groups: Salto-Talaris, 18%, and INBONE II, 18.9% (P= .829). Aseptic loosening of the talar implant also showed no significant difference between the 2 groups: Salto-Talaris, 1.6%, and INBONE II, 1.5% (P= .959). No variables, including the implant type, were found to contribute to the aseptic loosening rate of either the tibia or talus.Conclusion: In our cohort, we observed no difference in radiographic implant aseptic loosening between Salto-Talaris and INBONE II systems.Level of Evidence: Level IV, retrospective case series study.

Background: First metatarsophalangeal (MTP) arthrodesis is a common surgical intervention for addressing MTP pain and deformity. Despite great interest on the topic of return to sport (RTS) after first MTP arthrodesis in the literature, no systematic review exists on this topic. The purpose of this systematic review is to investigate RTS after first MTP arthrodesis.Methods: This study is a systematic review using PubMed, Web of Science, CINAHL, and MEDLINE from database inception until May 10, 2023. Search algorithm used was (MTPJ OR MTP OR “hallux rigidus” OR cheilectomy OR metatarsal OR metatarsophalangeal) AND (arthrodesis OR fusion) AND sport. Inclusion criteria were surgical intervention of first MTP arthrodesis and outcomes related to sport.Results: Ten articles were included out of 249 articles initially retrieved. Patients (n = 450) had a frequency weighted mean (FWM) age of 58.6 ± 5.1 years with a FWM follow-up time of 32.1 ± 18.9 months. A total of 153 patients (reported in 34.0% of patients) had a FWM postoperative Foot and Ankle Ability Measure Sport score of 70.4 ± 21.8 at final follow-up. For sporting activities reported by multiple studies (running, yoga, golf, hiking, tennis, elliptical, and biking), about 9.8% to 28.1% of patients (n = 69 reports) stated that sporting activity difficulty decreased, 67.2% to 87.5% of patients (n = 340 reports) stated that sporting activity remained the same, and 1.8% to 8.5% of patients (n = 23 reports) stated that sporting activity difficulty increased after first MTP arthrodesis depending on the sporting activity. One article reported RTS time of 11.7 ± 5.1 weeks after first MTP arthrodesis (n = 39).Conclusion: RTS after first MTP arthrodesis is highly variable depending on patient and sport. Numerous different sporting activities have high rates of RTS after first MTP arthrodesis, with a majority of patients reporting similar or increased ability to perform sporting activities after surgery.

Weeds can influence the economics of alfalfa (Medicago sativaL.) production by reducing forage yield and nutritive value or by contaminating hay. Field studies were conducted in Idaho in 2021 and 2022 to evaluate the effect of weed control treatments on alfalfa forage accumulation, weed biomass, and nutritive value. In addition, the relationship between the proportion of individual weed species biomass and alfalfa nutritive value was assessed. These studies included eight different herbicide and herbicide combination treatments, including the untreated check. Treatments were comprised of preemergence, early postemergence (after 80% alfalfa emergence), and postemergence (third trifoliate alfalfa) herbicide applications. Data collection included weed control efficacy, weed and alfalfa biomass, and alfalfa nutritive value. Additional samples were collected and combined in these alfalfa to weed biomass proportions (percentage by weight): 0/100, 20/80, 40/60, 60/40, 80/20, and 100/0, for wet chemistry analysis of forage nutritive value to evaluate the relationship between the proportion of individual weed species biomass and alfalfa nutritive value. The acetochlor‐only treatment provided less than 50% weed control, while the EPTC (S‐ethyl‐N,N‐dipropylthiocarbamate)‐only treatment provided 54%–81% weed control. The control provided by acetochlor and EPTC was less than that provided by treatments containing imazamox and imazamox plus bromoxynil. Weed biomass in forage (23%–55% of total biomass) due to poor or no weed control reduced crude protein, increased fiber concentrations, and reduced the relative feed value. The relationship between the proportion of individual weed species biomass and alfalfa nutritive value was linear for all weed species evaluated. Poor weed control increased weed biomass and reduced forage nutritive value.Effective weed control reduced forage accumulation due to reduced weed control and herbicide injury to alfalfa.A linear relationship between weed biomass proportion and mixed stand nutritive value is described.The risk of nitrate poisoning may increase when alfalfa hay has 60% or more biomass from certain weeds. Poor weed control increased weed biomass and reduced forage nutritive value. Effective weed control reduced forage accumulation due to reduced weed control and herbicide injury to alfalfa. A linear relationship between weed biomass proportion and mixed stand nutritive value is described. The risk of nitrate poisoning may increase when alfalfa hay has 60% or more biomass from certain weeds.

Background: Infection is a serious complication of primary total ankle arthroplasty (TAA) and can lead to implant failure and revision surgery. Various demographic, comorbidity, and surgical factors have been associated with an increased risk of infection. However, the evidence base remains limited, and further research is needed regarding infection in TAA. This study aims to analyze risk factors of infection and explore outcomes following infected TAA.Methods: A retrospective cohort study was conducted using data from a single institution from 2002 to 2022. Patients who underwent primary TAA and had subsequent infection were identified through annual registry surveillance and matched using propensity score matching (PSM) based on various demographic, comorbidity, and surgical factors. Demographics were compared between the matched groups using Mann-Whitney Utest and Fisher exact test. The outcomes following infection were identified and summarized using descriptive statistics.Results: A total of 1863 patients who underwent primary TAA were identified, and 19 were diagnosed with an infection. The identifiable overall infection rate was 1.0%. After PSM, there were no significant differences in the difference in age, gender, BMI, and smoking status between the infected and control cohort. There was a statistically significant increase in the rate of diabetes in the infected cohort. The subsequent surgical intervention resulted in limb salvage in 18 (94.7%) cases. Out of the total number of cases, 2-stage revision to total ankle replacement was performed in 7 cases, whereas revision to arthrodesis and isolated polyethylene exchange were each carried out in 4 cases. One patient had to undergo amputation; however, at the time of the most recent follow-up, all patients were found to be free of infection.Conclusion This study demonstrated high rates of a history of smoking and diabetes in the infected TAA cohort. The diabetes rate in the infected group was significantly higher than the noninfected controls. Two-stage revision to total ankle replacement was performed in 7 cases, and revision to arthrodesis and isolated polyethylene exchange were each carried out in 4 cases. Overall, a high rate of limb salvage was reported.Level of Evidence: Level III, case-control study.

For thin-film thermoelectric modules with electrodes deposited on the sides of the thermoelectric material, the diffusion of atoms from the electrode affects the module’s performance. Long-term aging is crucial when the module is for practical applications. In this study, Bi2Te3thin films with a highly preferred orientation were fabricated by a co-sputtering deposition method. Cu was used as the electrode because of its high electrical conductivity; it migrates through the Bi2Te3film via surface and grain boundary diffusion. The diffusing Cu segregates at grain boundaries and forms a Cu2–xTe intermetallic compound on the sample surface. Contact resistivity at the interface between the Cu electrode and Bi2Te3thin films substantially increases with aging time. Long-term aging unavoidably degrades the power factor (PF) of the pristine Bi2Te3since n-type Bi2Te3converts into p-type by the formation of antisite defects. The study shows that the diffusing Cu from the electrodes of the Cu/Bi2Te3/Cu module significantly mitigates the degradation of the PF after long-term aging.

Background: There is limited data evaluating the effect of obesity on outcomes following total ankle arthroplasty (TAA), especially in adequate sample sizes to detect impacts on patient-reported outcomes (PROs). The purpose of this study was to assess the effect of obesity on complication rates and PROs.Methods: This was a single-institution, retrospective study of 1093 primary TAA performed between 2001 and 2020. Minimum follow-up was 2 years. Patients were stratified by body mass index (BMI) into control (BMI = 18.5-29.9; n = 615), obesity class I (BMI = 30.0-34.9; n = 285), and obesity class II (BMI > 35.0; n = 193) groups. Patient information, intraoperative variables, postoperative complications, and PRO measures were compared between groups using univariable statistics. Multivariable Cox regression was performed to assess risk for implant failure. Mean follow-up was 5.6 years (SD: 3.1).Results: Compared to control and class I, class II patients had the lowest mean age (P= .001), highest mean ASA score (P< .001), and greatest proportion of female sex (P< .001) and Black/African American race (P= .005). There were no statistically significant differences in postoperative complications (infection, implant failure, or impingement) across the BMI classes (P> .05). Preoperatively, class II had lower (worse) mean scores for Foot and Ankle Outcome Score pain and ADL subscales than controls (post hoc pairwise P< .001 for both). At final follow-up, both class II and class I had lower (worse) mean Short Musculoskeletal Function Assessment (post hoc pairwise P< .001 and P= .030, respectively) and 36-Item Short Form Health Survey scores (post hoc pairwise P< .001 and P= .005, respectively) than controls.Conclusion: At midterm follow-up, obesity was not associated with increased rates of complications after TAA. Patients with obesity reported worse musculoskeletal function and overall quality of life after TAA but there was no differential improvement in PROs across BMI classes. To our knowledge, this is the largest single-institution study to date examining the effect of obesity on outcomes after primary TAA.Level of Evidence: Level III, retrospective comparative study.

The use of fetal tissues in regenerative medicine has long been a source of both promise and controversy. Since the turn of the century, their utilization has expanded because of antiinflammatory and analgesic properties, which have been theorized to act as an avenue for treating various orthopaedic conditions. With increased recognition and use, it is essential to understand the potential risks, efficacy, and long-term effects of these materials. Given the substantial body of literature published since 2015 (the date of the most recent review of fetal tissues in foot and ankle surgery), this manuscript provides an updated reference on the topic. Specifically, we evaluate the recent literature regarding the role of fetal tissues in wound healing, hallux rigidus, total ankle arthroplasty, osteochondral defects of the talus, Achilles tendinopathy, and plantar fasciitis.

The use of high-strength concrete (HSC) in constructing high-rise reinforced concrete buildings and their deep foundations is becoming more popular because of the significant reduction in member size and, thus, self-weight in structural members. However, the higher cement content in HSC may result in increased heat of hydration and autogenous shrinkage, growing concerns about forming early-age cracks in HSC structural members. This case study assessed the early-age cracking of HSC in bored pile construction of high-rise buildings. A nonlinear transient coupled thermal-mechanical response analysis was performed to evaluate the potential of early-age cracking caused by the heat of hydration generated in the HSC using ABAQUS and two subprograms, USDFLD and UEXPAN. A 3-D finite element model was developed considering thermal effects, time-dependent evolution of early-age strength and stiffness of HSC, crack strain development, autogenous shrinkage, and stress-relaxation in the analysis. Field measurements were carried out on a 3-m diameter bored pile constructed using Grade C50/60 HSC (fck,cube= 60 MPa) for a high-rise building project in Hong Kong to evaluate the validity of the numerical model. Optical fiber sensors were used to monitor the temperature changes of the pile for approximately 380 hours after casting. The temporal and spatial temperature distributions measured in the field measurements agree well with the simulations. Large thermal gradients and high tensile stress zones were observed across the horizontal cross-sections of the pile, resulting in the formation of vertical annular cracks. Based on the results of the analysis, the maximum crack widths were predicted and compared with the durability crack width limits.

BackgroundThe Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are validated scores for mortality prediction in patients with pulmonary embolism (PE). National Early Warning Score (NEWS) is a general prognostic risk score for multiple clinical settings. We investigated whether the NEWS had a comparable performance with the PESI and sPESI, for predicting intensive care unit (ICU) admission and death in patients with acute PE.MethodsIn haemodynamically stable patients with confirmed PE from the YEARS Study (2013–2015), we evaluated the performance of the NEWS, PESI and sPESI for predicting 7-day ICU admission and 30-day mortality. Receiver operating characteristic curves were plotted and the area under the curve (AUC) was calculated.ResultsOf 352 patients, 12 (3.4%) were admitted to the ICU and 5 (1.4%) died. The AUC of the NEWS for ICU admission was 0.80 (95% CI 0.66 to 0.94) and 0.92 (95% CI 0.82 to 1.00) for 30-day mortality. At a threshold of 3 points, NEWS yielded a sensitivity and specificity of 92% and 53% for ICU admission and 100% and 52% for 30-day mortality. The AUC of the PESI was 0.64 (95% CI 0.48 to 0.79) for ICU admission and 0.94 (95% CI 0.87 to 1.00) for mortality. At a threshold of 66 points, PESI yielded a sensitivity of 75% and a specificity of 38% for ICU admission. For mortality, these were 100% and 37%, respectively. The performance of the sPESI was similar to that of PESI.ConclusionIn comparison with PESI and sPESI, NEWS adequately predicted 7-day ICU admission as well as 30-day mortality, supporting its potential relevance for clinical practice.