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will always be J.J. and Derek Watt 's little brother.

That dynamic played out in Gatorade's new commercial promoting the importance of hydration and seat safety.

The trio was part of another Gatorade commercial that also included their father.

While he will always be the youngest Watt brother, T.J. quickly emerged as a productive member of Pittsburgh's defense as a rookie in 2017.After spending his rookie season watching and learning from the veterans, Watt wants to be a more vocal part of the team as he enters his second NFL season.

“I’m not learning now,” Watt recently told Steelers.com . “I’m not going to be sitting in the hotel room with Keion (Adams) trying to figure out plays and stuff. I know all the plays, and I have relationships with the players now. I can be a little more vocal. I know who I’m working with out there. I feel like I’m going to be able to take more risks being able to contribute more now that I have more leeway. I feel more comfortable in the system.”

Steelers.com

Watt, who finished third on the Steelers with 7.0 sacks during his rookie season, can't wait to get the 2018 season started.

“I’m more excited than ever to come back for a second year,” Watt said. “Everyone says the offseason is going to fly by. I didn’t have all the Combine training and all that stuff, so it’ll was a little bit of a relief to kind of get away from football for a little bit, but then I got back into training, and am getting ready to go for the season. I’m going to be grinding the whole way. I’m excited.”

Last season, the Steelers' defense finished first in the NFL in sacks, seventh in scoring, fifth in yards allowed, fifth in pass defense and 10th against the run. The unit was gassed in their playoff loss to Jacksonville, however, as the Steelers gave up 38 points on defense.

"I think we're making progress," Steelers' president Art Rooney II said of his defense, via Ed Bouchette of the Pittsburgh Post-Gazette."We have a lot of young players on defense. We can get better . . . We need to add people to it, obviously."

Additional treatment may be necessary in patients with severe forms , as defined in Web Practical Instructions section 2.3, in particular: when very frequent syncope alters quality of life; when recurrent syncope without, or with a very short, prodrome exposes the patient to a risk of trauma; and when syncope occurs during a high-risk activity (e.g. driving, machine operation, flying, or competitive athletics, etc.) . Only 14% of the highly selected population with reflex syncope who are referred to specialized syncope units may need such additional treatment. 186 In general, no therapy is appropriate for every form of reflex syncope. The most important discriminant for the choice of therapy is age. A decision pathway for the selection of a specific therapy according to age, severity of syncope, and clinical forms is summarized in Figure 9 .

Figure 9
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Schematic practical decision pathway for the first-line management of reflex syncope (based on patient’s history and tests) according to age, severity of syncope, and clinical forms. are those aged <40 years while are >60 years, with an overlap between 40 and 60 years. of reflex syncope is defined in the text. The of prodrome is largely subjective and imprecise. A value of ≤5 s distinguishes arrhythmic from reflex syncope ; in patients without structural heart disease, a duration >10 s can distinguish reflex syncope from cardiac syncope. In practice, the prodrome is ‘absent or very short’ if it does not allow patients enough time to act, such as to sit or lie down. The heading’ identifies patients with chronic low BP values (in general, systolic around 110 mmHg, who have a clear history of orthostatic intolerance and orthostatic VVS). The group ‘‘ identifies patients in whom clinical features and results of tests suggest that sudden cardioinhibition is mainly responsible for syncope. One such clue is lack of prodrome, so patients without prodromes may, after analysis, fall into this category.

Remark:

• Overlap between subgroups is expected.

• In selected cases, pacing may be used in patients aged <40 years. This Task Force cannot give recommendations due to the lack of sufficient evidence from studies.

• In selected cases, fludrocortisone may be used in patients aged >60 years. This Task Force cannot give recommendations due to the lack of sufficient evidence from studies.

• Midodrine can be used at any age even if existing studies were performed in young patients.

• Patients with short or no prodrome should continue investigations to identify the underlying mechanism and guide subsequent therapy.

• Sometimes an ILR strategy should also be considered in patients aged <40 years.

BP = blood pressure; ILR = implantable loop recorder; VVS = vasovagal syncope.

Spontaneous or provoked by, sequentially, carotid sinus massage, tilt testing, or ILR.

Figure 9
View large Download slide

Schematic practical decision pathway for the first-line management of reflex syncope (based on patient’s history and tests) according to age, severity of syncope, and clinical forms. are those aged <40 years while are >60 years, with an overlap between 40 and 60 years. of reflex syncope is defined in the text. The of prodrome is largely subjective and imprecise. A value of ≤5 s distinguishes arrhythmic from reflex syncope ; in patients without structural heart disease, a duration >10 s can distinguish reflex syncope from cardiac syncope. In practice, the prodrome is ‘absent or very short’ if it does not allow patients enough time to act, such as to sit or lie down. The heading’ identifies patients with chronic low BP values (in general, systolic around 110 mmHg, who have a clear history of orthostatic intolerance and orthostatic VVS). The group ‘‘ identifies patients in whom clinical features and results of tests suggest that sudden cardioinhibition is mainly responsible for syncope. One such clue is lack of prodrome, so patients without prodromes may, after analysis, fall into this category.

Remark:

• Overlap between subgroups is expected.

• In selected cases, pacing may be used in patients aged <40 years. This Task Force cannot give recommendations due to the lack of sufficient evidence from studies.

• In selected cases, fludrocortisone may be used in patients aged >60 years. This Task Force cannot give recommendations due to the lack of sufficient evidence from studies.

• Midodrine can be used at any age even if existing studies were performed in young patients.

• Patients with short or no prodrome should continue investigations to identify the underlying mechanism and guide subsequent therapy.

• Sometimes an ILR strategy should also be considered in patients aged <40 years.

BP = blood pressure; ILR = implantable loop recorder; VVS = vasovagal syncope.

Spontaneous or provoked by, sequentially, carotid sinus massage, tilt testing, or ILR.

Education and lifestyle modifications have not been evaluated in randomized studies, but there is a consensus for implementing them as first-line therapy in all cases. These comprise reassurance about the benign nature of the disease, education regarding awareness and the possible avoidance of triggers and situations (e.g. dehydration and/or hot crowded environments), and the early recognition of prodromal symptoms in order to sit or lie down and activate counter-pressure manoeuvres without delay. If possible, triggers should be addressed directly, such as cough suppression in cough syncope, micturition in the sitting position, etc. Increased intake of oral fluids is also advised. Salt supplementation at a dose of 120 mmol/day of sodium chloride has been proposed. 259 In general, >50% of patients with recurrent syncopal episodes in the 1 or 2 years before evaluation do not have syncopal recurrences in the following 1 or 2 years and, in those with recurrences, the burden of syncope decreases by >70% compared with the preceding period. The effect of education and reassurance is probably the most likely reason for the decrease in syncope (see Supplementary Data Table 10 ). An example of a patient instruction sheet can be found in the Web Practical Instructions section 9.1: European Society of Cardiology information sheet for patients affected by reflex syncope.

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