Testing and Evaluation of a Novel Hemostatic Matrix in a Swine Junctional Hemorrhage Model.

Introduction: In an ongoing effort to improve survival and reduce blood loss from hemorrhagic injuries on the battlefield, new hemostatic dressings continue to be developed. This study aimed to determine the efficacy of a novel silicon dioxide-based hemostatic matrix (HM) and compare it with the current military standard Quikclot Combat Gauze (QCG) utilizing a lethal femoral artery injury model.

Materials And Methods: The femoral arteries of 20 anesthetized swine were isolated, and an arteriotomy was performed.

Evaluating outcomes for robotic-assisted inguinal hernia repair in males with prior urologic surgery: a propensity-matched analysis from a national database.

Background: Controversy exists regarding the safety and effectiveness of minimally invasive inguinal hernia repairs in patients with a history of prior urologic pelvic operations (PUPO), such as a prostatectomy, which causes scarring and disruption of the retropubic tissue planes. Our study sought to examine whether a history of PUPO impacts surgical outcomes in males undergoing robotic-assisted inguinal hernia repair.

Methods: The Americas Hernia Society Quality Collaborative (AHSQC) database was queried to identify male patients who underwent a robotic inguinal hernia repair with 30-day follow-up.

T1-T2 Disk Herniation Presenting With Horner Syndrome: A Case Report With Literary Review.

Horner syndrome or oculosympathetic paresis is caused by interruption of the sympathetic nerve supply to the face and eye that manifests as facial anhidrosis, blepharoptosis, and miosis. This sympathetic pathway begins in the hypothalamus and synapses in the intermediolateral gray substance of the spinal cord at C8-T2 levels making it susceptible to disruption via a high thoracic intervertebral disk herniation. We present a rare case of a patient with T1-T2 intervertebral disk herniation and Horner syndrome who was treated surgically.

Alexis St. Martin Gastropexy: A Novel Technique for Gastropexy During Percutaneous Endoscopic Gastrostomy Tube Placement.

Background: Percutaneous endoscopic gastrostomy (PEG) is a preferred method of long-term enteral nutritional support. Despite its ease of placement, it has a 4% major complication rate, requiring surgical intervention or hospitalization. Early PEG tube dislodgment can cause peritonitis, requiring emergent laparotomy at significant morbidity and cost.

Environmental regulation in transition: Policy officials' views of regulatory instruments and their mapping to environmental risks.

This study re-analysed 14 semi-structured interviews with policy officials from the UK Department for Environment, Food and Rural Affairs (Defra) to explore the use of a variety of regulatory instruments and different levels of risk across 14 policy domains and 18 separately named risks. Interviews took place within a policy environment of a better regulation agenda and of broader regulatory reform. Of 619 (n) coded references to 5 categories of regulatory instrument, 'command and control' regulation (n = 257) and support mechanisms (n = 118) dominated the discussions, with a preference for 'command and control' cited in 8 of the policy domains.

Monetising the impacts of waste incinerators sited on brownfield land using the hedonic pricing method.

In England and Wales planning regulations require local governments to treat waste near its source. This policy principle alongside regional self-sufficiency and the logistical advantages of minimising distances for waste treatment mean that energy from waste incinerators have been built close to, or even within urban conurbations. There is a clear policy and research need to balance the benefits of energy production from waste incinerators against the negative externalities experienced by local residents.

Better by design: business preferences for environmental regulatory reform.

We present the preferences for environmental regulatory reform expressed by 30 UK businesses and industry bodies from 5 sectors. While five strongly preferred voluntary regulation, seven expressed doubts about its effectiveness, and 18 expressed no general preference between instrument types. Voluntary approaches were valued for flexibility and lower burdens, but direct regulation offered stability and a level playing field.

Learning curve and early clinical outcomes for a robotic surgery novice performing robotic single site cholecystectomy.

Background: A rapid training protocol has been developed for robotic surgery novices to learn robotic single-incision techniques. This study assesses the learning curve and early clinical results for a robotic surgery novice starting single-site cholecystectomy.

Methods: A chart review was performed on the surgeon's first 55 patients to undergo this procedure.