GastroZentrum Hirslanden Zürich

Social media has fundamentally altered how information is created, disseminated, and consumed, with growing impact on spine surgeons and professional societies. Traditional academic publishing remains the standard for research validation, but digital platforms now shape much of the real-time dialogue in spine care. To explore strategies for integrating spine surgeons' social media presence with traditional publishing channels to enhance knowledge dissemination, support clinical innovation, and improve member engagement within spine societies. This perspective reviews current patterns of social media use among spine surgeons, focusing on platforms such as X (formerly Twitter), Instagram, and LinkedIn. It analyzes benefits (reach, speed, interactivity) and challenges (variable quality, lack of peer review, potential bias), and proposes a conceptual hybrid model in which social media and peer-reviewed journals function in a complementary rather than competitive manner. Social media enables rapid sharing of clinical insights, techniques, and innovations, and facilitates engagement with both peers and patients. However, it often privileges observational data, lower-level evidence, and real-world experiences that do not easily fit into traditional high-level evidence frameworks. A hybrid approach is proposed in which professional societies (1) formally recognize curated social media content as a feeder for peer-reviewed work; (2) create more inclusive forums for lower-level evidence and case-based discussions; and (3) intentionally link digital dialogues to structured academic outputs. By aligning the dynamic, interactive nature of social media with the rigor and credibility of traditional publishing, spine societies can foster greater member engagement, accelerate innovation, and reinforce their role as thought leaders. A deliberate, hybrid communication strategy can bridge the gap between digital and print, creating a more collaborative and inclusive platform for advancing spine surgery. Integrating social media with traditional publishing can accelerate the dissemination of practical, real-world clinical insights, ultimately enhancing surgeon education and improving patient care in spine surgery.

Up to 30% of patients with metastatic castration-resistant prostate cancer (mCRPC) have DNA damage repair (DDR) gene alterations, mainly in BRCA2. PARP inhibitors (PARPi) are standard treatments for BRCA1/2-altered patients with mCRPC, and evidence for platinum agents is limited. This study assesses single-agent platinum therapy in patients with mCRPC with and without DDR alterations. This multicenter, retrospective study included patients with mCRPC with known DDR status treated with platinum monotherapy. DDR-positive (DDR+) patients had deleterious germline or somatic alterations in DDR genes (BRCA1, BRCA2, CDK12, ATM, CHEK2, PALB2, or FANCA), whereas DDR-negative (DDR-) patients had no such alterations. Prostate-specific antigen (PSA) response, progression-free survival (PFS, PSA/clinical/radiographic), and overall survival (OS) were assessed in DDR+ and DDR- groups. Among 129 patients, 81 had DDR+ and 48 had DDR- cancers. A PSA decline of ≥50% was demonstrated in 48% in BRCA, 9% in DDR+ non-BRCA, and 13% in DDR- patients (P < .0001). Objective responses occurred in 37.5% in BRCA, 11% in DDR+ non-BRCA, and 13% in DDR- patients (P = .017). No response was reported in DDR+ patients who had received previous PARPi (n = 16). The median PSA response was 5 months for BRCA, 2 months for DDR+ non-BRCA, and 1.7 months for DDR- patients, respectively (P = .015), whereas the median clinical/radiographic PFS was 4.7 months, 2.8 months, and 2 months, respectively (P = .2). In PARPi-naïve patients, the median OS was 13.7 months for BRCA, 8.7 months for DDR+ non-BRCA, and 6.1 months for DDR- patients (P = .013). Single-agent platinum agents show significant anticancer activity in BRCA-mutated patients with mCRPC without previous PARPi exposure. With their low cost and broad availability, platinum agents offer a practical alternative, particularly in regions where PARPi are inaccessible.

The use of epigenetic clocks for measuring age acceleration in the field of cancer research has been a common practice for many years. In forensic genetics, DNA methylation can be used to estimate the age of a stain donor. As lifestyle and disease can alter a person’s methylation profile, the accuracy of forensic age estimation tools might decrease compared to the chronological age when estimating a person affected by cancer. In our study, we applied the VISAGE enhanced age estimation tool on blood samples from cancer patients suffering from a variety of cancer entities, including solid and hematologic tumours. A comparison of the age estimation errors between the cancer patients (n = 100) and a healthy control cohort (n = 102) revealed small statistically significant differences and a tendency towards age acceleration in the blood of these patients. Although this study showed that in patients with aggressive cancers (like CLL or AML) estimation accuracy is clearly decreased, for most entities the observed differences were subtle and an analysis of individual CpG sites did not reveal strikingly different methylation patterns. Conclusively, age estimation on blood stains from cancer patients might not result in significantly higher estimation errors, except for very aggressive forms of cancer.

Das Erasmus+-Projekt CultureNature Literacy (CNL) wurde im Nationalpark Hohe Tauern konzeptionell/inhaltlich mitentwickelt, dort auf seine Praxistauglichkeit erprobt und gleichzeitig auf die Fragestellung hin „Was bringt das CNL-Projekt dem Nationalpark?“ reflektiert. Dabei kann – aus der Perspektive des Nationalparks – festgehalten werden, dass durch die intensive Auseinandersetzung mit dem CNL-Bildungsansatz, welcher auf das Verständnis der Natur-Kultur-Beziehung zu einer nachhaltigen Zukunftsgestaltung abzielt, die internen, strategischen und inhaltlichen Kompetenzen des Nationalparks gestärkt werden konnten. Ebenso wurde das Bildungsangebot des Nationalparks erweitert, wobei die Adaptierbarkeit und internationale Verwendbarkeit der entwickelten Materialien den Wert des Projekts über den Nationalpark hinaus verdeutlichen. Die Integration von CNL stärkt auch die Rolle des Nationalparks als Bildungsstätte. Der Nationalpark wird zu einem Modellprojekt für nachhaltige Bildung, das Besucher*innen und Institutionen als Vorbild dienen kann​.

Transcatheter aortic valve implantation (TAVI) is a minimally invasive option for severe aortic stenosis (AS). The Crea Aortic Valve (CAV) is a new self-expanding transcatheter aortic valve implant that has been successfully tested in preclinical studies. We aimed to assess the technical success, device performance, and early safety of the CAV System in a first-in-human study for the device in patients with severe AS. We prospectively evaluated the CAV using the Valve Academic Research Consortium (VARC)-3 criteria in three high-risk patients with severe AS. A computed tomography angiography and transthoracic echocardiographic (TTE) assessment were carried out, which was followed by TAVI according to standard protocol. TTE was performed before and after the procedure, before discharge, and at the 1- and 6-month clinical follow-ups to monitor the aortic valve area, the maximum velocity (Vmax), the mean (MG) and peak pressure gradients, and paravalvular leak (PVL). The CAV was successfully implanted, using the cusp-overlap technique for patient 1 and the coplanar view for patients 2 and 3, with good usability of the delivery system for optimal positioning, reduction of the Vmax to <2 m/s and MG to <10 mmHg, and trivial PVL. An atrioventricular block necessitating a permanent pacemaker occurred in one patient. There was no incidence of stroke, heart failure, or renal failure at 6 months of follow-up. The CAV was implanted with success, and the system performed as intended as per VARC-3 criteria. The device should be evaluated in a larger clinical study for further efficacy and safety data.

Androgen-receptor pathway inhibitors such as abiraterone and enzalutamide have demonstrated clinical benefit in patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to conduct a meta-analysis of published real-world evidence studies comparing outcomes among patients treated with enzalutamide or abiraterone in the first-line setting. We conducted a systematic literature review to identify eligible studies. Evaluated outcomes were: overall survival (OS), progression-free survival, prostate-specific antigen (PSA) progression-free survival, PSA response, all-grade adverse events, grade ≥3 adverse events, treatment discontinuation, and dose reduction. Each outcome's suitability for meta-analysis was evaluated by assessing whether there were sufficient data to make comparisons between studies, consistency between outcome definitions, and whether the studies adjusted for baseline patient characteristics. Outcomes deemed suitable for meta-analysis were analyzed using fixed-effect and random-effect models to obtain pooled-effect sizes. Sensitivity analyses were conducted to evaluate the robustness of conclusions. Of 1849 records reviewed, 30 were eligible for inclusion. Most outcomes were deemed unsuitable for meta-analysis due to a lack of adjustment for baseline characteristics, issues with inconsistent outcome definitions, and the small number of studies reporting each outcome. The only outcome deemed suitable for meta-analysis was OS. A total of 17 studies reported hazard ratios (HRs) for OS, 11 of which were adjusted for baseline characteristics. Among the studies reporting adjusted HRs, the pooled-effect estimate favored enzalutamide over abiraterone (reference group) in the fixed-effect model (HR: 0.90 [95% CI: 0.87-0.93]) and the random-effect model (HR: 0.90 [95% CI: 0.86-0.94]). These results were consistent across all sensitivity analyses. Across all analyses, enzalutamide demonstrated a statistically significant improvement in OS compared with abiraterone. These findings highlight the value of real-world evidence studies to demonstrate the potential of different therapies under real-world conditions and over long periods of time.

Studies have shown improved survival among individuals with cancer with higher levels of social support. Few studies have investigated social support and overall survival (OS) in individuals with advanced prostate cancer in an international cohort. We investigated the associations of marital status and living arrangements with OS among individuals with advanced prostate cancer in the International Registry for Men with Advanced Prostate Cancer (IRONMAN). IRONMAN is enrolling participants diagnosed with advanced prostate cancer (metastatic hormone-sensitive prostate cancer, mHSPC; castration-resistant prostate cancer, CRPC) from 16 countries. Participants in this analysis were recruited between July 2017 and January 2023. Adjusting for demographics and tumor characteristics, the associations were estimated using Cox regression and stratified by disease state (mHSPC, CRPC), age (<70, ≥70 years), and continent of enrollment (North America, Europe, Other). We included 2,119 participants with advanced prostate cancer, of whom 427 died during up to 5 years of follow-up (median 6 months). Two-thirds had mHSPC. Most were married/in a civil partnership (79%) and 6% were widowed. Very few married participants were living alone (1%), while most unmarried participants were living alone (70%). Married participants had better OS than unmarried participants [adjusted HR: 1.44; 95% confidence interval (CI): 1.02-2.02]. Widowed participants had the worst survival compared with married individuals (adjusted HR: 1.89; 95% CI: 1.22-2.94). Among those with advanced prostate cancer, unmarried and widowed participants had worse OS compared with married participants. This research highlighted the importance of social support in OS within this vulnerable population.