05). The rate of POPF in the HR-PD group was 39%. Mortality was comparable between the two groups (3% vs 4%). Although general, cancer- and pancreas-specific QoL were comparable between the HR-PD and C-TP groups, endocrine and exocrine insufficiency occurred in all the C-TP patients, compared to only 13% and 63% of the HR-PD patients respectively, and C-TP patients had worse diabetes-specific QoL. C-TP may be considered rather than HR-PD only in few selected cases and after adequate counselling. C-TP may be considered rather than HR-PD only in few selected cases and after adequate counselling. To understand the effectiveness of Rescue Improvement Conference, a forum that addresses failure to rescue (FTR). Every year over 150,000 patients die after elective surgery in the United States. FTR is the phenomenon whereby delayed recognition and/or response to serious surgical complications leads to a progressive cascade of adverse events culminating in death. Rescue Improvement Conference is an adapted version of the Ottawa-style M&M conference, designed to address common contributors to FTR ineffective communication and inadequate problem solving. Mixed methods data were used to evaluate Rescue Improvement Conference, a bi- monthly forum that was first introduced in our academic medical center in 2018. Conference effectiveness data were collected via survey and open-text responses after five conferences between September 2018 and February 2020. We focused on five indicators of effectiveness educational value, conference takeaways, discussion time, changes to surgical practice, and actionable oplications by providing stakeholders a forum to identify and discuss factors that contribute to FTR. To review breast cancer incidence in women with atypical ductal hyperplasia (ADH) diagnosed by core needle biopsy (CNB) and managed non-operatively. ADH found on CNB is associated with an upgrade to carcinoma in 10-50% of women, thus surgical excision remains the standard of care. Safety of non-operative management is unknown. ADH patients diagnosed between1/2004-10/2018 were identified. Subsequent breast cancer events were compared between those who were excised and those who met predetermined criteria of low risk and were thus observed. Subsequent breast cancer events were classified as index site event if identified in the same quadrant as prior ADH. Multivariable logistic regression models were used to assess potential predictors of subsequent breast cancer events. 478 women with 483 ADH lesions were identified; 309 were observed and 174 underwent excision. Median follow-up was 5.2 years. Prior breast cancer history was the only factor associated with subsequent breast cancer risk (OR 2.25, 95%CI 1.04-4.87). After excluding patients with a breast cancer history, there was no association of age, race, chemoprevention or surgical excision of ADH with future cancer risk. 21/387 patients without a breast cancer history developed a subsequent cancer; 10 (7.3%) in the surgical group and 11 (4.4%) in the observed (p = 0.2). Two cancers were identified at the index site in the surgery group (2/137, 1.5%) and three in those observed (3/250, 1.2%). Observation, rather than surgical excision, is safe in select women with ADH. National guidelines should consider observation for this select group of patients. Observation, rather than surgical excision, is safe in select women with ADH. National guidelines should consider observation for this select group of patients. To develop and validate a pretreatment prognostic score in pancreatic cancer (PDAC). Pretreatment prognostication in PDAC is important for treatment decisions but remains challenging. Available prognostic tools are derived from selected cohorts of patients who underwent resection, excluding up to 20% of patients with exploration only, and do not adequately reflect the pretreatment scenario. Patients undergoing surgery for PDAC in Heidelberg from 07/2006 to 06/2014 were identified from a prospective database. Pretreatment parameters were extracted from the database and the laboratory information system. Parameters independently associated with overall survival by uni- and multivariable analyses were used to build a prognostic score. A contemporary cohort from Verona was used for external validation. In 1197 patients, multiple pretreatment parameters were associated with overall survival by univariable analyses. ASA-classification, CA19-9, CEA, CRP, albumin, and platelet count were independently associated with survival and were used to create the Heidelberg Prognostic Pancreatic Cancer (HELPP)-score. The HELPP-score was closely associated with overall survival (median survival between 31.3 and 4.8 months; 5-year survival rates between 35% and 0%) and was able to stratify survival in subgroups with or without resection as well as in CA19-9 non-secretors. In the resected subgroup the HELPP-score stratified survival independently of pathological prognostic factors. The HELPP-score was externally validated and was superior to CA19-9 in both the development and validation cohorts. The HELPP-score is a readily available prognostic tool based on pretreatment routine parameters to stratify survival in PDAC independently of resection status and pathological tumor stage. The HELPP-score is a readily available prognostic tool based on pretreatment routine parameters to stratify survival in PDAC independently of resection status and pathological tumor stage. The purpose of this review was to provide an evidence-based recommendation for community-based programs to mitigate gun violence, from the Eastern Association for the Surgery of Trauma (EAST). Firearm Injury leads to >40,000 annual deaths and >115,000 injuries annually in the United States. https://www.selleckchem.com/ Communities have adopted culturally relevant strategies to mitigate gun related injury and death. Two such strategies are gun buyback programs and community-based violence prevention programs. The Injury Control and Violence Prevention Committee of EAST developed Population, Intervention, Comparator, Outcomes (PICO) questions and performed a comprehensive literature and gray web literature search. Using GRADE methodology, they reviewed and graded the literature and provided consensus recommendations informed by the literature. A total of 19 studies were included for analysis of gun buyback programs. Twenty-six studies were reviewed for analysis for community-based violence prevention programs. Gray literature was added to the discussion of PICO questions from selected websites.