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Abstract Introduction Osteoporotic vertebral compression fractures (VCFs) are common. An increase in mortality associated with osteoporotic VCFs has been well documented. The purpose of this study was to assess the impact of time to surgery on 1-year survival in patients with osteoporotic vertebral compression fractures. Methods In a retrospective cohort study with prospective mortality follow-up, consecutive patients aged ≥ 60 years who had operative treatment of a low-energy fracture of a thoracolumbar vertebra and had undergone surgical stabilization between January 2015 and December 2018 were identified from our institutional database. By chart review, additional information on hospitalization time, comorbidities (expressed as ASA - American Society of Anesthesiologists Scale), complications and revision surgery was obtained. Time-to-surgery was defined as the time between admission and surgery. Mortality data was assessed by contacting the patients by phone, mail or the national social insurance database. Results Two hundred sixty patients (mean age 78 years, SD 7 years, range, 60 to 93; 172 female) were available for final analysis. Mean follow-up was 40 months (range, 12 to 68 months). Fifty-nine patients (22.7%) had died at final follow-up and 27/260 patients (10.4%) had died within 1 year after the surgery. Time-to-surgery was not different for patients who died within 1 year after the surgery and those who survived (p = .501). In-hospital complications were seen in 40/260 (15.4%) patients. Time-to-surgery showed a strong correlation with hospitalization time (Pearson’s r = .614, p

Abstract Statistical models built using different data sources and methods can exhibit conflicting patterns. We used the northern stock of black sea bass (Centropristis striata) as a case study to assess the impacts of using different fisheries data sources and laboratory‐derived physiological metrics in the development of thermal habitat models for marine fishes. We constructed thermal habitat models using generalized additive models (GAMs) based on various fisheries datasets as input, including the NOAA Northeast Fisheries Science Center (NEFSC) bottom trawl surveys, various inshore fisheries‐independent trawl surveys (state waters), NEFSC fisheries‐dependent observer data, and laboratory‐based physiological metrics. We compared each model's GAM response curve and coupled them to historical ocean conditions in the U.S. Northeast Shelf using bias‐corrected ocean temperature output from a regional ocean model. Thermal habitat models based on shelf‐wide data (NEFSC fisheries‐dependent observer data and fisheries‐independent spring and fall surveys) explained the most variation in black sea bass presence/absence data at ~15% deviance explained. Models based on a narrower range of sampled thermal habitat from inshore survey data in the Northeast Area Monitoring and Assessment Program (NEAMAP) and the geographically isolated Long Island Sound data performed poorly. All models had similar lower thermal limits around 8.5℃, but thermal optima, when present, ranged from 16.7 to 24.8℃. The GAMs could reliably predict habitat from years excluded from model training, but due to strong seasonal temperature fluctuations in the region, could not be used to predict habitat in seasons excluded from training. We conclude that survey data source can greatly impact development and interpretation of thermal habitat models for marine fishes. We suggest that model development be based on data sources that sample the widest range of ocean temperature and physical habitat throughout multiple seasons when possible, and encourage thorough consideration of how data gaps may influence model uncertainty.

The paper presents the state of the art of the European Erasmus Project KA2 – WIN: Writing For Inclusion – dedicated to school inclusion and the use of alternative teaching methodologies such as Digital Storytelling. Starting from a survey on the theme of educational care from a theoretical and pedagogical point of view, the article focuses - in the central parts - on the activities carried out with the students and teachers at the European primary schools involved. The article highlighted the social, as well as educational and cultural implications of the research work carried out by the educational and university institutions involved, with a broad theoretical-methodological reflection which will close, in the coming months, with the assessment of the project itself.

BackgroundPeople with genetic predispositions to cancer are faced with complex health decisions about managing their risk. Decision aids can support informed, values-based decisions, alongside shared decision-making with a clinician. Whilst diagnoses of genetic predispositions to cancer are increasing, there is no scalable decision aid to support these people. This paper presents an accessible, relevant decision aid template which can be adapted for different predispositions to cancer.MethodsThe decision aid template was co-developed with 12 patients affected by cancer and informed by empirical and theoretical literature. In addition, consultations were conducted with a further 19 people with Lynch syndrome; a specific genetic predisposition to cancer. Clinical stakeholders were consulted regularly. Coulter's framework for decision aid development guided the process, and these activities were complemented by the International Patient Decision Aid Standards, and the latest evidence on communicating risk in decision aids. Programme theory was developed to hypothesise how the decision aid would support decision-making and contextual factors which could influence the process. Guiding principles co-developed with the patient panel described how the decision aid could effectively engage people.ResultsThe in-depth co-design process led to the identification of five core components of an accessible decision aid template for people with a genetic predisposition to cancer: defining the decision; a table showing implications of each option; optional further details such as icon arrays to show tailored risk and personal narratives; values clarification activity; and a summary to facilitate discussion with a clinician. Specific guidance was produced describing how to develop each component. The guiding principles identified that the decision aid template needed to promote trust, reduce distress, and be comprehensive, personally relevant and accessible in order to engage people.ConclusionAdopting a co-design process helped ensure that the decision aid components were relevant and accessible to the target population. The template could have widespread application through being adapted for different genetic predispositions. The exact content should be co-designed with people from diverse backgrounds with lived experience of the specific predisposition to ensure it is as useful, engaging and relevant as possible.

Background: Patients with injection drug use (IDU)-associated infections traditionally experience prolonged hospitalizations, which often result in negative experiences and bad outcomes. Harm reduction approaches that value patient autonomy and shared decision-making regarding outpatient treatment options may improve outcomes. We sought to identify health care professionals (HCPs) perspectives on the barriers to offering four different options to hospitalized people who use drugs (PWUD): long-term hospitalization, oral antibiotics, long-acting antibiotics at an infusion center, and outpatient parenteral antibiotics. Methods: We recruited HCPs ( n = 19) from a single tertiary care center in Portland, Maine. We interviewed HCPs involved with discharge decision-making and other HCPs involved in the specialized care of PWUD. Semi-structured interviews elicited lead HCP values, preferences, and concerns about presenting outpatient antimicrobial treatment options to PWUD, while support HCPs provided contextual information. We used the iterative categorization approach to code and thematically analyze transcripts. Results: HCPs were willing to present outpatient treatment options for patients with IDU-associated infections, yet several factors contributed to reluctance. First, insufficient resources, such as transportation, may make these options impractical. However, HCPs may be unaware of existing community resources or viable treatment options. They also may believe the hospital protects patients, and that discharging patients into the community exposes them to structural harms. Some HCPs are concerned that patients with substance use disorder will not make ‘good’ decisions regarding outpatient antimicrobial options. Finally, there is uncertainty about how responsibility for offering outpatient treatment is shared across changing care teams. Conclusion: HCPs perceive many barriers to offering outpatient care for people with IDU-associated infections, but with appropriate interventions to address their concerns, may be open to considering more options. This study provides important insights and contextual information that can help inform specific harm reduction interventions aimed at improving care of people with IDU-associated infections.

Recently, poly(ADP-ribosyl)ation polymerase inhibitors (PARPis), which induce synthetic lethality of tumor cells with DNA damage repair defects, have emerged as a promising therapy for ovarian, breast, and pancreatic cancer. Although the PARPi Olaparib is limited to treating cancer patients with DNA repair deficiencies, the PARPi Niraparib is FDA approved to treat ovarian cancer patients regardless of their status in DNA repair pathways. Despite differences in the affinity to PARP enzymes, the rationale behind the clinical use of Niraparib in patients without DNA repair deficiencies is still lacking. Moreover, only Olaparib has been approved for pancreatic ductal adenocarcinoma (PDAC) patients with BRCA mutations, accounting for only 5-7% of total PDACs. It remains unclear whether Niraparib could be beneficial to PDACs without BRCA mutations. We found that Niraparib inhibits ovarian and PDAC tumor cell growth, regardless of BRCA mutational status, more effectively than Olaparib. Unlike Olaparib, which is known to activate STAT3, Niraparib inhibits STAT3 activity in ovarian and PDAC cancer cell lines and patient tumors. Moreover, Niraparib regulates the expression of several STAT3 downstream genes involved in apoptosis. Overexpression of a constitutively activated STAT3 mutant rescues Niraparib-induced cancer cell apoptosis. Our results suggest that Niraparib inhibits pSTAT3 by interfering with SRC tyrosine kinase. Collectively, our studies provide a mechanism underlying Niraparib’s ability to induce tumor cell apoptosis without BRCA mutations, suggesting the potential use of Niraparib for treating PDAC patients regardless of BRCA status.

Physical education and sports for people with disabilities are the areas of physical and social rehabilitation. The im- plementation of this can be possible through the use of an inclusive approach in the training process of athletes with disabilities. Anthropometric measurements and testing of athletes with disabilities were conducted to determine the impact of an inclusive approach in the construction of the training process. The main purpose of this research was to demonstrate the positive impact of inclusive training sessions within the developed program on the development of the physical abilities of athletes with disabilities. The research used theoretical (analysis of scientific and methodologi- cal literature; analysis of sports programs for athletes with disabilities), empirical (pedagogical observation; pedagog- ical experiment) methods, as well as methods of mathematical statistics. The results of the research showed a positive impact from the training on the developed karate program for people with disabilities. It also presented the increase of the testing results in the exercises “Sit and reach test”, “Standing long jump” and “Abdominal crunches”.

Urolithiasis ranks second among urological diseases, after inflammatory processes, and first among surgical interventions in urological hospitals. The problem of this disease treatment is a long-term rehabilitation and disablement, which entails a significant increase in costs and requires changes in the tactics of treatment of patients. Since its introduction until today, percutaneous nephrolithotomy (PCNL) is the standard treatment for nephrolithiasis with a stone size of more than 1.5–2.0 cm. In its standard version, PCNL ends with the placement of nephrostomy catheter through the formed parenchymal channel, but there are techniques of the surgery completion either without nephrostomy catheter with a JJ stent – tubeless PCNL, or without nephrostomy and JJ stent at all – totally tubeless PCNL. However, nowadays, the use of tubeless and totally tubeless techniques is one of the most controversial topics in percutaneous nephrolithotomy in terms of safety and efficacy in their application. Aim. To analyze the results and safety of percutaneous nephrolithotomy by means of tubeless and totally tubeless techniques based on scientific evidence. Analysis of the scientific literature shows that tubeless and totally tubeless PCNL techniques are a safe method of percutaneous surgery and their application reduces pain and analgesic requirements in the postoperative period, shortens the length of postoperative hospital stay, and enhances recovery after surgery in patients, therefore resulting in cost-saving treatment. Conclusions. Tubeless and totally tubeless PCNLs are recommended for widespread use in urological practice, but it is worth to mention that these techniques should be performed in selected patients and by an operating surgeon with significant experience in percutaneous surgery.