A Lot of Progress, With More to Be Done: A Response to NIH Pathways to Prevention Report “Research Gaps for Long‐Term Drug Therapies for Osteoporotic Fracture Prevention”

AbstractComa and disorders of consciousness (DoC) are highly prevalent and constitute a burden for patients, families, and society worldwide. As part of the Curing Coma Campaign, the Neurocritical Care Society partnered with the National Institutes of Health to organize a symposium bringing together experts from all over the world to develop research targets for DoC. The conference was structured along six domains: (1) defining endotype/phenotypes, (2) biomarkers, (3) proof-of-concept clinical trials, (4) neuroprognostication, (5) long-term recovery, and (6) large datasets. This proceedings paper presents actionable research targets based on the presentations and discussions that occurred at the conference. We summarize the background, main research gaps, overall goals, the panel discussion of the approach, limitations and challenges, and deliverables that were identified.

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The Big Why of Implementing Computational Thinking In STEM Education: A Systematic Literature Review

Malaysian Journal of Social Sciences and Humanities (MJSSH) ◽

10.47405/mjssh.v6i3.706 ◽

2021 ◽

Vol 6 (3) ◽

pp. 272-289

Author(s):

Norhafizan Abdul Wahab ◽

Othman Talib ◽

Fazilah Razali ◽

Nurzatulshima Kamarudin

Keyword(s):

Literature Review ◽

Stem Education ◽

Systematic Literature Review ◽

Web Of Science ◽

Meta Analysis ◽

Computational Thinking ◽

Considerable Effect ◽

Research Gaps ◽

Prisma Statement

Computational Thinking (CT) has been increasingly embraced as a reformation in STEM education. This paper discusses why the implementation of CT would have a considerable effect on STEM education. The first objective of this systematic literature review is to identify the subjects that incorporate the most elements of CT in STEM education. Secondly, it aims to provide an overview of CT practices in the classrooms. Finally, the major findings of this study seek to discuss the benefits and challenges of the use of CT in STEM education. Fifteen articles were methodically selected from Scopus, Web of Science, Dimensions, and Google Scholar databases as the relevant studies to be discussed in this systematic study, based on the PRISMA Statement (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) review technique. This review identifies current research gaps and directions for the practice and implementation of CT in STEM education. Further analysis of the articles has contributed to a conclusion that CT has become more widespread and multi-disciplinary and seems to have propagated improvements in STEM education. Still, a new study is required, especially on long-term implications.

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The Cost-Effectiveness of an RCT to Establish Whether 5 or 10 Years of Bisphosphonate Treatment Is the Better Duration for Women With a Prior Fracture

Medical Decision Making ◽

10.1177/0272989x09336077 ◽

2009 ◽

Vol 29 (6) ◽

pp. 678-689 ◽

Cited By ~ 12

Author(s):

Matt D. Stevenson ◽

Jeremy E. Oakley ◽

Myfawny Lloyd Jones ◽

Alan Brennan ◽

Juliet E. Compston ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Effective ◽

Fracture Prevention ◽

Published Data ◽

Bisphosphonate Treatment ◽

Net Benefit ◽

England And Wales ◽

Term Efficacy ◽

The Cost

Purpose. Five years of bisphosphonate treatment have proven efficacy in reducing fractures. Concerns exist that long-term bisphosphonate treatment may actually result in an increased number of fractures. This study evaluates, in the context of England and Wales, whether it is cost-effective to conduct a randomized controlled trial (RCT) and what sample size may be optimal to estimate the efficacy of bisphosphonates in fracture prevention beyond 5 years. Method. An osteoporosis model was constructed to evaluate the cost-effectiveness of extending bisphosphonate treatment from 5 years to 10 years. Two scenarios were run. The 1st uses long-term efficacy data from published literature, and the 2nd uses distributions elicited from clinical experts. Results of a proposed RCT were simulated. The expected value of sample information technique was applied to calculate the expected net benefit of sampling from conducting such an RCT at varying levels of participants per arm and to compare this with proposed trial costs. Results. Without further information, the better duration of bisphosphonate treatment was estimated to be 5 years using the published data but 10 years using the elicited expert opinions, although in both cases uncertainty was substantial. The net benefit of sampling was consistently high when between 2000 and 5000 participants per arm were recruited. Conclusions. An RCT to evaluate the long-term efficacy of bisphosphonates in fracture prevention appears to be cost-effective for informing decision making in England and Wales.

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Update on compliant flooring and wearable hip protectors for fracture prevention in long-term care

Gerontechnology ◽

10.4017/gt.2010.09.02.104.00 ◽

2010 ◽

Vol 9 (2) ◽

Author(s):

F. Feldman ◽

A.C. Laing ◽

S. Robinovitch

Keyword(s):

Long Term Care ◽

Fracture Prevention ◽

Term Care ◽

Hip Protectors

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THE NIH PATHWAYS TO PREVENTION PROGRAM

Innovation in Aging ◽

10.1093/geroni/igz038.2747 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S749-S749

Author(s):

Keisha L Shropshire

Keyword(s):

Public Health ◽

Disease Prevention ◽

Fracture Prevention ◽

Critical Assessment ◽

National Institutes Of Health ◽

Public Health Issue ◽

Evidence Based ◽

Prevention Research ◽

Research Needs ◽

Research Gaps

Abstract The National Institutes of Health Office of Disease Prevention (ODP) Pathways to Prevention (P2P) Program identifies research gaps, methodological and scientific weaknesses in selected scientific areas; suggests research needs; and moves the field forward through an unbiased, evidence-based assessment of a complex public health issue. P2P workshops are designed for topics that have incomplete or underdeveloped research and that have a need for a synthesis and critical assessment of the published literature. This talk will explain the purpose of this P2P workshop on use of drug therapies for osteoporotic fracture prevention within the larger context of NIH efforts to promote prevention research.

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MANAGEMENT OF ENDOCRINE DISEASE: Atypical femoral fractures: risks and benefits of long-term treatment of osteoporosis with anti-resorptive therapy

Acta Endocrinologica ◽

10.1530/eje-17-1002 ◽

2018 ◽

Vol 178 (3) ◽

pp. R81-R87 ◽

Cited By ~ 20

Author(s):

Robert A Adler

Keyword(s):

Osteoporotic Fracture ◽

Femoral Fractures ◽

Osteoporosis Treatment ◽

Term Treatment ◽

Atypical Femoral Fractures ◽

Treatment Of Osteoporosis ◽

Endocrine Disease ◽

Long Term Treatment ◽

Term Management

Modern osteoporosis treatment began in the mid-1990s with the approval of amino-bisphosphonates, anti-resorptive agents that have been shown to decrease osteoporotic fracture risk by about half. In 2005, the first cases of atypical femoral fractures (AFF), occurring in the shaft of the femur, were reported. Since then, more cases have been found, leading to great concern among patients and a dramatic decrease in bisphosphonate prescribing. The pathogenesis and incidence of AFF are reviewed herein. Management and an approach to prevention or early detection of AFF are also provided. Denosumab, a more recently approved anti-resorptive medication has also been associated with AFF. Long-term management of osteoporosis and prevention of fracture are challenging in light of this serious but uncommon side effect, yet with an aging population osteoporotic fracture is destined to increase in frequency.

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