Exploring Australian News Media Portrayals of Sustainable and Plant-Based Diets.

(1) Background: Dietary behaviour transformation is imperative for the attainment of more sustainable food systems, including an increased intake of plant-based foods and lower consumption of red meat and highly processed foods. The influence of news media coverage on public opinion regarding dietary behaviours is significant. Therefore, this study aimed to explore how sustainable/plant-based diets have been portrayed in Australian news media. (2) Methods: The Factiva global news database was used to search news articles published in Australia between 2018 and 2020. Relevant news articles were selected if they included keywords relating to sustainable diets, plant-based diets, and meat alternatives. We used a coding protocol to extract key information, such as date of publication, article topic, and any health, environmental and economic impacts. Then, we performed a framing and thematic analysis of the data. (3) Results: From 357 included articles, more than half of the articles encouraged increasing the intake of plant-based foods (53.5%) and reducing animal-derived food intake (55.2%). Several reasons for such shift from animal protein centric Australian diets were identified throughout the articles such as health benefits (15.4%), environmental impacts (11.2%), animal welfare (4.8%), seasonality and local food intake (5.3%), avoiding overconsumption (4.5%) and food wastage (4.5%). (4) Conclusions: The predominant frame in Australian news coverage about sustainable diets has been about consumption, more plant- and less animal-based products, with little nuance about the complex interplay of diet quality and environment in influencing food choices. Australian news media should broaden its coverage of sustainable diets to include health, environmental, and economic factors to improve public understanding and facilitate informed and sustainable food choices. Further research is needed to enhance comprehension of how the audience perceives media coverage on this topic, which will provide a more thorough understanding.

Revisiting frequencies of phonological sound classes in speech input: Change over time in child-directed speech.

The purpose of the current study was to revisit a controversial topic: whether frequencies of phonological consonant and vowel classes differ in speech directed to children and to adults. In addition, the current study investigated whether the frequency of phonological consonant and vowel classes changes with children's increasing chronological and/or developmental age. This study analyzed speech input from 44 adults to four different age groups of listeners (i.e., three groups of children at 6, 18, and 36 months of age and one group of adult listeners) in terms of frequency of occurrence of consonant and vowel classes. Results revealed that consonant stop, nasal, fricative and glide manner classes as well as all four consonant place classes were significantly different in speech directed to the four different age groups. A perspective is discussed to better understand the nature of frequency input of phonological sound classes.

Bye-Bye Bunny: Place and Manner Sequences in Children's C1VC2V-Shaped Words.

PURPOSE: Place and manner of articulation in American English-learning children's salient consonant-vowel-consonant-vowel (C1VC2V) target words (e.g., baby, bunny, and cookie) were compared with their actual productions of these words. We hypothesized that target words with repeated place and/or manner characteristics in C1VC2V consonant sequences would be matched in children's actual productions more frequently than target words with variegated place and manner sequences. This hypothesis was based on a proposal that children use available production system capacities to produce salient word forms derived from perceptual input on those word forms. METHOD: Place and manner sequences were analyzed in 2,092 tokens of C1VC2V target words produced by 18 typically developing children in the single-word period. All data were from these children's spontaneous functional speech in a familiar speaking context. Both target word forms and actual child productions of those targets were analyzed. RESULTS: Results indicated that C1VC2V word target sequences predominantly consisted of repetitions in both place and manner of articulation (e.g., labial-labial, stop-stop). Targets with repetitions of consonant sequences were matched more frequently than targets with variegated sequences for both place and manner (e.g., labial-coronal, stop-nasal) in these children's actual productions. Results also indicated that C1VC2V target words beginning with a labial consonant (e.g., baby, bunny, and piggy) were matched in children's actual productions more frequently than words with coronal or dorsal consonant onsets (e.g., daddy and cookie). DISCUSSION: In C1VC2V word forms, occurring in early output, children's actual productions matched their target word sequences when the words consisted of repeated sequences in both place and manner. These results suggest that salient target words with repeated sequences may help children support increases in their repertoire of meaningful vocalizations during the transition from babbling to meaningful speech.

Role of the histone tails in histone octamer transfer.

The exceptionally high positive charge of the histones, concentrated in the N- and C-terminal tails, is believed to contribute to the stability of the nucleosome by neutralizing the negative charge of the nucleosomal DNA. We find, on the contrary, that the high positive charge contributes to instability, performing an essential function in chromatin remodeling. We show that the tails are required for removal of the histone octamer by the RSC chromatin remodeling complex, and this function is not due to direct RSC-tail interaction. We also show that the tails are required for histone octamer transfer from nucleosomes to DNA, and this activity of the tails is a consequence of their positive charge. Thus, the histone tails, intrinsically disordered protein regions, perform a critical role in chromatin structure and transcription, unrelated to their well-known role in regulation through posttranscriptional modification.

Disruption of nucleosomes by DNA groove binders of clinical significance and implications for chromatin remodeling.

Small molecules that bind in the minor groove of DNA are in clinical use as antibiotics and antitumor drugs. Two members of this class of molecules, netropsin and chromomycin, are shown here to displace DNA from the nucleosome and promote transfer of the histone octamer to an acceptor protein. The effects of these groove-binding molecules are exploited to address an outstanding problem in the mechanism of the RSC chromatin remodeling complex. RSC and other remodeling complexes are DNA translocases, acting near the center of the nucleosomal DNA, but translocation is apparently impossible because DNA cannot slide across the histone surface in the nucleosome. Netropsin and chromomycin promote the release of DNA from the histone surface, enhance the formation of a RSC-nucleosome complex, and synergize with RSC in chromatin remodeling. These findings are in keeping with an involvement of bulge translocation in chromatin remodeling.

Climate variability and change are drivers of salmonellosis in Australia: 1991 to 2019.

Salmonellosis is a climate-sensitive gastroenteritis with over 92 million cases and over 50,000 deaths a year globally. Australia has high rates of salmonellosis compared with other industrialised nations. This study used a negative binomial time-series regression model to investigate the association between Australian salmonellosis notifications and monthly climate variables including El Niño Southern Oscillation (ENSO) and mean temperature anomaly from 1991 to 2019. Between 1991 and 2019 in Australia there were 275,753 salmonellosis notifications and the median annual rate for salmonellosis was 40.1 per 100,000 population. Salmonellosis notifications exhibited strong seasonality, reaching a peak in summer and a minimum in winter. There was an estimated increase of 3.4 % in salmonellosis cases nationally per 1 °C increase in monthly mean temperature anomaly (incidence rate ratio [IRR] of 1.034, 95 % confidence interval [CI]: 1.009, 1.059). Similar associations between salmonellosis and mean temperature anomaly were found for some states. Mean temperature anomaly exhibited an upward trend of 0.9 °C over the period 1991 to 2019. Additionally, a positive association was found between salmonellosis in Australia and ENSO whereby El Niño periods were associated with 7.9 % more salmonellosis cases compared to neutral periods (IRR 1.079, 95 % CI: 1.019, 1.143). A similar ENSO association was detected in the two eastern states of New South Wales and Queensland. This study suggests public health preventative measures to reduce salmonellosis could be enhanced in some regions during El Niño as well as during times of increased temperatures.

Salmonellosis in Australia in 2020: possible impacts of COVID-19 related public health measures.

BACKGROUND: More than seventy per cent of salmonellosis in Australia is thought to be due to contaminated food. Rates of salmonellosis vary across the Australian states and territories, with the highest rates in the Northern Territory. In 2020, to control coronavirus disease 2019 (COVID-19), Australia implemented public health measures including border closures, physical distancing and hygiene advice. This study analyses salmonellosis notification rates in 2020 and considers possible impacts of COVID-19 measures. METHODS: Monthly and annual salmonellosis notifications per 100,000 population, for each of Australia's eight states and territories for the years 2015 to 2020, were extracted from Australia's publicly accessible National Notifiable Diseases Surveillance System. For each jurisdiction, the salmonellosis rate each month in 2020 was compared with the previous 5-year median rate for that calendar month. The possible impacts of COVID-19 public health measures on salmonellosis notifications in the respective states and territories were examined. RESULTS: The annual Australian salmonellosis notification rate was 27% lower in 2020 than the previous 5-year median. The reduction in salmonellosis rate varied throughout Australia. States and territories with more stringent, more frequent or longer COVID-19 public health measures had generally greater salmonellosis rate reductions. However, Tasmania had a 50% deeper reduction in salmonellosis rate than did the Northern Territory, despite similar restriction levels. CONCLUSIONS: Salmonellosis notifications decreased in Australia during the global COVID-19 pandemic. The reduction in notifications corresponded with the implementation of public health measures. Persistence of high rates in the Northern Territory could indicate the overarching importance of demographic and environmental factors.

Relationship between the target word form and children's productions: place of articulation in Consonant-Vowel-Consonant (C1VC2) words in American English.

The aim of the present study was to investigate relationships between characteristics of children's target words and their actual productions during the single-word period in American English. Word productions in spontaneous and functional speech from 18 children acquiring American English were analyzed. Consonant sequences in 3,328 consonant-vowel-consonant (C1VC2) target words were analyzed in terms of global place of articulation (labials, coronals, and dorsals). Children's actual productions of place sequences were compared between target words containing repeated place sequences (e.g., mom, map, dad, not) and target words containing variegated place sequences (e.g., mat, dog, cat, nap). Overall, when the target word contained two consonants at the same global place of articulation (e.g., labial-labial, map; coronal-coronal, not), approximately 50% of children's actual productions matched consonant place characteristics. Conversely, when the target word consisted of variegated place sequences (e.g., mat, dog, cat, nap), only about 20% of the productions matched the target consonant sequences. These results suggest that children's actual productions are influenced by their own production abilities as well as by the phonetic forms of target words.

The development of tonal duration in Mandarin-speaking children.

Developmental changes in suprasegmental tonal duration were investigated in monolingual Mandarin-speaking children. Tone durations were acoustically measured in five- and eight-year-old children and adults. Children's tone duration and variability decreased with age. Five-year-olds produced significantly longer tone durations than adults. Adult-like duration patterns existed in all children: Tone 4 was the shortest and tone 3 the longest. Duration differences between tones 2 and 3 became larger between five- and eight-year-olds. Results suggest a prolonged process of tone development beyond establishing phonological contrasts, which can be viewed as a hybrid of physiological production capacities and perceptual learning for maximal contrastivity.

Vowel Context Effects on Consonant Repetition in Early Words.

Purpose Consonant repetitions within words are a well-attested speech error pattern in children's early speech acquisition. We investigated the role of intervening vowel context in understanding speech forms containing consonant repetitions in early words. Intrasyllabic consonant-vowel (CV) sequences within consonant-vowel-consonant (CVC) and consonant-vowel-consonant-vowel (CVCV) forms containing consonant repetitions were analyzed to evaluate whether children's lack of independent movement control for the tongue in word-level sequences might contribute to these observed speech patterns. Method Spontaneous speech data produced by 10 typically developing children learning American English were analyzed longitudinally from the onset of word use to 36 months. Overall patterns and word shape effects for nine CV combinations occurring in their CVC and CVCV word shapes that contained repeated nonadjacent consonants and the intervening vowel were analyzed. Results Three CV combinations-coronal-front vowel, labial-central vowel, and dorsal-back vowel-occurred at above-chance levels. Preference for these CV patterns was strong in CVCV but not in CVC word shapes. These CV combinations occurred frequently at all time periods analyzed for CVCV's while decreasing across time for CVC's. Conclusions Analysis of intrasyllabic patterns within word forms containing consonant repetitions revealed that consonant repetitions in many early words occurred at above-chance levels in the context of articulatorily compatible vowels. Results suggest that children's production system capacities are an important contributing principle accounting for vowel context effects within word forms containing consonant repetitions during earliest speech acquisition.

Training clinicians to lead clinical IT projects.

Across New Zealand, a huge programme of work is being initiated to improve the health information systems of our sector. The goals of this plan are to address major risks and issues such as cybersecurity and our inability to securely share health data across organisations for clinical care. To fulfil the promise of planned health IT initiatives, we must involve clinicians of all disciplines to help lead, design and implement projects. However, there is currently little pragmatic training available for clinicians to learn how to do so. In 2019, Waitemata District Health Board and the National Institute for Health Innovation developed and delivered a 'hands-on' Clinical Digital Academy training programme for multidisciplinary clinicians. This paper describes the programme, the initial cohort's evaluation feedback and recommendations for the future.

Inter-Institutional Partnerships to Develop Veterinarian-Investigators through the NIH Comparative Biomedical Scientist Training Program Benefit One Health Goals.

Limitations in workforce size and access to resources remain perennial challenges to greater progress in academic veterinary medicine and engagement between human and veterinary medicine (One Health). Ongoing resource constraints occur in part due to limited public understanding of the role veterinarians play in improving human health. One Health interactions, particularly through interdisciplinary collaborations in biomedical research, present constructive opportunities to inform resource policies and advance health care. To this end, inter-institutional partnerships between individual veterinary medical education programs (VMEPs) and several National Institutes of Health (NIH) intramural research programs have created synergies beyond those provided by individual programs. In the NIH Comparative Biomedical Scientist Training Program (CBSTP), interdisciplinary cross-training of veterinarians consisting of specialty veterinary medicine coupled with training in human disease research leading to a PhD, occurs collaboratively on both VMEP and NIH campuses. Pre-doctoral veterinary student research opportunities have also been made available. Through the CBSTP, NIH investigators and national biomedical science policy makers gain access to veterinary perspective and expertise, while veterinarians obtain additional opportunities for NIH-funded research training. CBSTP Fellows serve as de facto ambassadors enhancing visibility for the profession while in residence at NIH, and subsequently through a variety of university, industry, and government research appointments, as graduates. Thus, the CBSTP represents an inter-institutional opportunity that not only addresses critical needs for veterinarian-scientists in the biomedical workforce, but also simultaneously exposes national policy makers to veterinarian-scientists' specialized training, leading to more effective realization of One Health goals to benefit human and animal health.

Combined extracts of Moringa oleifera, Murraya koeingii leaves, and Curcuma longa rhizome increases energy expenditure and controls obesity in high-fat diet-fed rats.

BACKGROUND: LI85008F is a proprietary combination of leaf extracts of Moringa oleifera, Murraya koeingii, and extract of Curcuma longa rhizome. This herbal extract combination is an effective weight loss supplement for overweight and obese subjects. The present study aimed to investigate the thermogenic potential of the LI85008F in high-fat diet (HFD)-induced obese Sprague Dawley rats. METHODS: Seven rats received a regular diet (RD), and twenty-one rats received a high-fat diet (HFD) for 56 days. On day 28, the HFD-fed rats were randomized into three groups (n = 7). Starting from day 29 through day 56, one HFD-fed group received daily oral gavage of 0.5% Carboxymethylcellulose Sodium (CMC) alone (HFD), and the remaining two groups received 100 and 250 mg/kg LI85008F (LI85008F-100 and LI85008F-250, respectively). Body weight, fat mass, fat cell size, liver weight, liver triglyceride were measured. The energy metabolism parameters were measured using indirect calorimetry. In serum, the metabolic and endocrine markers were analyzed. The adipogenic and thermoregulatory proteins expression in the white adipose tissue (WAT) were analyzed using an immunoblot assay. RESULTS: Supplementation with both doses of LI85008F significantly increased resting energy expenditure (REE) in the obese rats. The LI85008F-250 rats showed significant up-regulation of uncoupling protein-1 (UCP-1) expression, as compared with the HFD rats. LI85008F significantly reduced body weight gain, fat mass, fat cell size, liver weight, and hepatic triglycerides. Serum triglyceride, total cholesterol, glucose, leptin, and fat cell markers were significantly reduced in LI85008F-supplemented rats compared to the HFD rats. CONCLUSION: The present data suggest that LI85008F reduces body fat mass and controls body weight gain via increasing energy metabolism in combination with reduced lipogenesis in diet-fed obese rats.

Tummy time without the tears: The impact of parent positioning and play.

The American Academy of Pediatrics (AAP) recommends that infants spend supervised time in the prone (tummy) position to foster motor development and prevent cranial deformities. However, infants may not tolerate the position, and consequently, caregivers may avoid placing their infants in the prone position. The AAP recommends that caregivers provide toys or interaction during tummy time. We evaluated the individual and combined effects of a play mat and experimenter interaction on negative vocalizations and head elevation during tummy time-positive effects were limited. Next, we evaluated a parent-led intervention wherein mothers interacted with their infants, using a toy, while lying chest-to-chest. This intervention was associated with a reduction in negative vocalizations and an increase in head elevation for the majority of infants. Additionally, mothers rated the effectiveness of the parent-led intervention more favorably than the experimenter-led intervention, suggesting the effects of the parent-led intervention were also socially valid.

Who Can Help Us on This Journey? African American Woman with Breast Cancer: Living in a City with Extreme Health Disparities.

This qualitative descriptive research study looks at the services that community-based breast cancer support agencies provide to underserved and African American women who are at risk for or diagnosed with breast cancer in Memphis, Tennessee. We seek their understanding of breast cancer mortality disparities in Memphis. Data were collected using semi-structured in-depth focus groups with five breast cancer support agencies. Categories and patterns were established using thematic analysis and a deductive a priori template of codes. Thematic analysis is a method for identifying, analyzing, and reporting themes within the data. The main themes identified within support agencies for African American women with breast cancer who live in Memphis were barriers to the use of services, education, health system support, and emotional support. Numerous sub themes included cost of medications, support group supplemental programming, eligibility for mobile services, patient/provider communication, optimism about the future, and family advice. Procrastinating, seeking second options, fearfulness, insurance, childcare, and transportation were barriers to care. Community-based breast cancer support agencies play a critical role as connectors for women with breast cancer who live in medically underserved areas and must find their way within a fragmented medical care system.

Wheat Extract Oil (WEO) Attenuates UVB-Induced Photoaging via Collagen Synthesis in Human Keratinocytes and Hairless Mice.

The efficacy of wheat extract oil (WEO), standardized to glucosylceramides, for protecting against ultraviolet B (UVB)-induced damage of skin barrier function was assessed using the SHK-1 hairless mouse model and two human skin cell lines, namely, CCD-986sk and HeCaT. The ability of repeated oral administration of 30, 60, and 120 mg of WEO/kg/day for 12 weeks to prevent skin damage of SKH-1 hairless mice induced by UVB irradiation was evaluated. The results demonstrated that UVB-induced water evaporation (transepidermal water loss, TEWL) was significantly decreased by WEO. Similarly, UVB-induced losses in moisture and skin elasticity were improved by WEO supplementation. WEO attenuated the tissue procollagen type I, hyaluronic acid (HA), and ceramide reductions induced by UVB treatment as well. Collagen concentrations in skin tissue were increased in the WEO-treated mice, while UVB-induced epidermal thickening was reduced. In vitro studies using HeCaT human keratinocytes confirmed increased HA and collagen synthesis in response to WEO treatment. This may occur via WEO suppression of matrix metallopeptidase-1 (MMP-1), since its induction by UVB treatment was diminished in treated CCD-986sk cells. Oral administration of WEO improves skin barrier function in UVB-irradiated mice by attenuating damage typically observed in photoaging. This research further clarifies the clinical benefits previously observed by dietary WEO consumption.

Comparison of cytotoxicity of IQOS aerosols to smoke from Marlboro Red and 3R4F reference cigarettes.

This study compared the cytotoxicity of IQOS aerosols to smoke from Marlboro Red (MR) and 3R4F reference cigarettes. Aerosol/smoke solutions were tested as the gas vapor phase (GVP), particulate phase (total particulate matter or TPM), or whole aerosol/smoke (WA), the latter being what smokers actually inhale. Cytotoxicities were evaluated using the LDH, MTT and neutral red uptake (NRU) assays in conjunction with eight different cell types, mainly from the respiratory system. Most test solutions did not compromise the plasma membranes of cells (LDH). However, mitochondrial activity (MTT) and dye uptake/lysosomal activity (NRU) were equally depressed by IOQS aerosols and cigarette smoke solutions at the high concentrations. Our NRU data with mouse NIH/3T3 transformed fibroblasts were similar to those previously reported by the IQOS manufacturer and showed little cytotoxicity in the NRU assay. In both studies with NIH/3T3 cells, the results were significantly different from 3RF4 cigarette smoke, suggesting reduced toxicity with IQOS. However, by expanding evaluations to a broader spectrum of cells that included respiratory system cells and by including higher concentrations of GVP, as well as WA, cytotoxicity equivalent to that of Marlboro Red and 3R4F cigarettes was frequently observed with IQOS aerosols in the MTT and NRU assays.

Toxicological studies on the botanical supplement LI12542F6 containing extracts of Sphaeranthus indicus flower heads and Mangifera indica (mango tree) bark.

LI12542F6, a botanical extract composed of Sphaeranthus indicus and Mangifera indica, was evaluated for mutagenicity in bacteria, clastogenicity in mouse bone marrow, acute oral and dermal toxicity in the rat, irritation (dermal, eye) in rabbit, and subacute and subchronic toxicity (28 and 90 days) in the rat. All studies followed standard OECD test protocols, in accordance with the principles of Good Laboratory Practice (GLP). LI12542F6 did not induce mutations in the bacterial assay using Salmonella and Escherichia coli strains, nor did it induce genotoxic effects in erythrocytes from mouse bone marrow. LI12542F6 was found to have oral and dermal LD 50 values greater than the limit dose of 2,000 mg/kg body weight in the rat. In an eye irritation/corrosion test, LI12542F6 caused conjunctival redness, corneal opacity, and chemosis and is classified as Category 2A ("irritating to eyes - reversible eye effect"). Doses in the 28-day and 90-day rat oral toxicity studies were 0, 500, 1,000, and 1,500 and 0, 1,000, 1,500, and 2,000 mg/kg body weight/day, respectively, administered by gavage. Both studies featured a recovery period. Minor effects were random and not treatment related except for local irritation of the forestomach in the 28-day study, evidenced by histopathologic examination, in mid- and high-dose animals. The frequency and severity of these effects were reduced in the recovery group; irritation was not found in the forestomach of rats in the 90-day study. The no observed adverse effect level (NOAEL) was greater than the highest dose tested, that is, >2,000 mg/kg in the 90-day study. This botanical composition will be marketed commercially for muscle health as Myotor™.

iQOS: evidence of pyrolysis and release of a toxicant from plastic.

OBJECTIVE: To evaluate performance of the I quit original smoking (iQOS) heat-not-burn system as a function of cleaning and puffing topography, investigate the validity of manufacturer's claims that this device does not burn tobacco and determine if the polymer-film filter is potentially harmful. METHODS: iQOS performance was evaluated using five running conditions incorporating two different cleaning protocols. Heatsticks were visually and stereomicroscopically inspected preuse and postuse to determine the extent of tobacco plug charring (from pyrolysis) and polymer-film filter melting, and to elucidate the effects of cleaning on charring. Gas chromatography-mass spectrometry headspace analysis was conducted on unused polymer-film filters to determine if potentially toxic chemicals are emitted from the filter during heating. RESULTS: For all testing protocols, pressure drop decreased as puff number increased. Changes in testing protocols did not affect aerosol density. Charring due to pyrolysis (a form of organic matter thermochemical decomposition) was observed in the tobacco plug after use. When the manufacturer's cleaning instructions were followed, both charring of the tobacco plug and melting of the polymer-film filter increased. Headspace analysis of the polymer-film filter revealed the release of formaldehyde cyanohydrin at 90°C, which is well below the maximum temperature reached during normal usage. DISCUSSION: Device usage limitations may contribute to decreases in interpuff intervals, potentially increasing user's intake of nicotine and other harmful chemicals. This study found that the tobacco plug does char and that charring increases when the device is not cleaned between heatsticks. Release of formaldehyde cyanohydrin is a concern as it is highly toxic at very low concentrations.

Investigation of age-adjusted D-dimer using an uncommon assay.

BACKGROUND: Use of an age-adjusted D-dimer for the evaluation of acute pulmonary embolus (PE) has been prospectively validated in the literature and has become a practice recommendation from major medical societies. Most research on this subject involves the most common D-dimer assays reporting in Fibrinogen Equivalent Units (FEU) with a non-age-adjusted manufacturer-recommended cutoff of 500 ng/ml FEU. Limited research to date has evaluated age-adjustment in assays that report in D-Dimer Units (D-DU), which use a manufacturer-recommended cutoff of 230 ng/ml D-DU. Despite scant evidence, an age-adjusted formula using D-DU has been recently endorsed by the American College of Emergency Physicians (ACEP). This formula seems arbitrary in its derivation and unnecessarily deviates from existing thresholds, thus prompting the creation of our novel-age adjustment formula. The goal of this study was to retrospectively evaluate the test characteristics of our novel age-adjusted D-dimer formula using the D-DU assay in comparison to existing traditional and age-adjusted D-dimer thresholds for the evaluation of acute PE in the ED. METHODS: This was a retrospective chart review at an academic quaternary health system with three EDs and 195,000 combined annual ED visits. Only patients with D-dimer testing and CT PE protocol (CTPE) imaging were included. Admission and discharge diagnosis codes were used to identify acute PE. Outcome measures were sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of an unadjusted traditional threshold (230) compared with both novel and ACEP-endorsed age adjusted thresholds, (Age × 5) - 20 and Age × 5 if >50, respectively. Estimates with their exact 95% threshold were performed. RESULTS: 4846 adult patients were evaluated from January 2012 to July 2017. Group characteristics include a mean age of 52 and a frequency of acute PE diagnosis by CTPE of 8.25%. Traditional D-dimer cutoff demonstrated a sensitivity of 99.8% (95% CI 98.6-100), specificity of 16.7% (95% CI 15.6-17.8) and NPV of 99.9% (95% CI 99.3-100). Our novel age-adjusted D-dimer thresholds had a sensitivity of 97.0% (95% CI 94.8-98.4), specificity of 27.9% (95% CI 26.6-29.2) and NPV of 99.0% (95% CI 98.3-99.5) with the ACEP-endorsed formula demonstrating similar test characteristics. CONCLUSION: Use of an age-adjusted D-dimer on appropriately selected patients being evaluated for acute PE in the ED with a D-DU assay increases specificity while maintaining a high sensitivity and NPV. Both our novel formula and the ACEP-endorsed age-adjusted formula performed well, with our novel formula showing a trend towards improved testing characteristics.