A novel low-cost high-fidelity porcine model of liver metastases for simulation training in robotic parenchyma-preserving liver resection.

In the era of minimally invasive surgery (MIS), parenchyma-preserving liver resections are gaining prominence with the potential to offer improved perioperative outcomes without compromising oncological safety. The surgeon learning curve remains challenging, and simulation plays a key role in surgical training. Existing simulation models can be limited by suboptimal fidelity and high cost.

The Role of Therapists' Attachment and Introject in Their Treatment Process and Outcome: A Systematic Review.

Previous reviews have examined empirical evidence of the relationship between therapists' internalized relational models, including therapists' attachment styles and Sullivan's notion of introject, and the therapeutic relationship. This review expands upon previous reviews by examining the effect of therapists' internalized relational models on the treatment process (e.g.

The netball injury evidence base: a scoping review of methodologies and recommendations for future approaches.

Background: Netball is a sport with a large participation base and a high risk of injuries. Effective injury prevention strategies are dependent upon a clear understanding of injury issues, aetiology and mechanisms, requiring robust research methodologies to ensure a reliable evidence base. This scoping review aims to identify the characteristics and range of netball injury research methodologies, to inform recommendations for future research.

Conceptualizing impulsivity as a construct in relation to posttraumatic stress disorder symptom severity among women.

Despite the established association between posttraumatic stress disorder (PTSD) and impulsivity, the literature is limited regarding impulsivity as a multifaceted construct. That is, the field's understanding of how PTSD symptoms may increase particular impulsive tendencies and behaviors is constrained by examining impulsivity solely as an umbrella term. The aim of the present study was to determine if there are differential associations between PTSD symptom severity and various components of impulsivity across multiple self-report measures.

Evaluating the Impact of a Global Cleft Speech Mentorship Program on Expanding Practitioner Competency in Low- and Middle-Income Countries.

A primary challenge in global cleft care lies in the limited opportunities for cleft-specific training and mentorship available to speech practitioners worldwide, particularly in low-income and middle-income countries (LMICs). In addition, the limited number of speech therapists with cleft experience in LMICs creates a significant barrier to access to care for individuals with cleft lip and palate globally. The inaccessibility of cleft-specific clinical instruction and cleft-trained speech therapists impacts the effectiveness of intervention and, subsequently, the speech-language development of cleft-affected individuals worldwide.

Operational patient care pathway: building pragmatic medical interoperability through health engagements.

The future operational demand for medical support in Western militaries will likely outstrip available resources, necessitating burden-sharing through medical interoperability with allies and partners. However, the current North Atlantic Treaty Organization (NATO) model of interoperability through standardisation, while achieving high levels of commonality and integration along the operational patient care pathway (OPCP), is high-cost and resource-intensive. We have termed this model assured interoperability.

Determining recommended acceptable intake limits for N-nitrosamine impurities in pharmaceuticals: Development and application of the Carcinogenic Potency Categorization Approach (CPCA).

N-Nitrosamine impurities, including nitrosamine drug substance-related impurities (NDSRIs), have challenged pharmaceutical industry and regulators alike and affected the global drug supply over the past 5 years. Nitrosamines are a class of known carcinogens, but NDSRIs have posed additional challenges as many lack empirical data to establish acceptable intake (AI) limits. Read-across analysis from surrogates has been used to identify AI limits in some cases; however, this approach is limited by the availability of robustly-tested surrogates matching the structural features of NDSRIs, which usually contain a diverse array of functional groups.

A scoping review and critique of the Input-Output subtyping dimension of spatial neglect.

Spatial neglect is a common and debilitating disorder after stroke whereby individuals have difficulty reporting, orienting, and/or responding to the contralesional side of space. Given the heterogeneity of neglect symptom presentation, various neglect subtypes have been proposed to better characterize the disorder. This review focuses on the distinction between Input neglect (i.

The association between quality of therapeutic alliance and treatment outcomes in teletherapy: A systematic review and meta-analysis.

Objective: The strength of the therapeutic alliance is widely understood to impact treatment outcomes, however, the alliance-outcome relationship in teletherapy has remained relatively unexamined. The aim of this meta-analysis is to systematically summarize the relationship between therapeutic alliance and treatment outcomes in teletherapy with adult patients conducted via videoconferencing or telephone.

Methods: We conducted a systematic search of the databases PsycINFO, PsycARTICLES, ProQuest Dissertation Databases, EMBASE, The Cochrane Library, MEDLINE, Google Scholar, and PubMed for studies published before June 26, 2023.

Contemporary Treatment of Microtia-Atresia.

Microtia-atresia is a congenital deformity affecting the external ear and ear canal that can present with varying degrees of severity and morbidity. Treatment occurs along a spectrum and primarily centers on improving aesthetic appearance. Many cases of microtia will not be effectively treated with conservative measures and will require some form of reconstruction.

Plant seedlings of peas, tomatoes, and cucumbers exude compounds that are needed for growth and chemoattraction of bv. 3841 and Sp7.

This study characterizes seedling exudates of peas, tomatoes, and cucumbers at the level of chemical composition and functionality. A plant experiment confirmed that bv. 3841 enhanced growth of pea shoots, while Sp7 supported growth of pea, tomato, and cucumber roots.

Prehospital emergency care in a humanitarian environment: an overview of the ethical considerations.

Recent history has demonstrated that UK Defence personnel can be used, potentially with little notice, in humanitarian disaster zones. The provision of prehospital emergency care (PHEC) in a humanitarian environment requires an innovative approach to overcome the technical challenges of a resource-limited setting. In addition to technical challenges, prehospital practitioners working in a humanitarian environment can expect to be faced with ethically testing situations that they are not familiar with in their usual practice.

War and disaster are forcing a major rethink around mass casualty management.

Mass casualty events (MASCAL) do not follow the same rules as typical major incidents. In the West at least, the latter often occur in stable, networked trauma systems, whereas MASCAL are characterised by overwhelming numbers of patients, compounded by protracted scene and transport times, decompensated response systems and significant disruption to infrastructure, command and control.This paper describes the 8Ds approach being taken by the UK Defence Medical Services and the North Atlantic Treaty Organization Emergency Medicine Panel framework to approach MASCAL.

Medics as influencers: a historical analysis of British Army military medical exercises in Kenya over two decades.

Introduction: Annual British Army medical training exercises have run in Kenya since the early 1990s, initially with a dual purpose-to deliver the Kenyan Extended Programme of Immunisation (in remote locations) and to undertake austere training. This provided a specific response to a capability gap request from the partner nation, but as this gap closed, the exercise changed in various ways. This study aimed to qualitatively explore the impact of these exercises on the Kenyan healthcare system and the influence and relationships between the nations.

Measures of trauma exposure and trauma response: A scoping review.

Background: In contrast to the vast clinical, theoretical, and empirical literature on the impact of trauma, relatively few studies have reviewed the trauma measures that researchers and clinicians can choose to use in their work. This scoping review aimed to catalog all trauma measures (trauma exposure and its subjective responses) that have been published in the peer-reviewed literature, developed for use with adult populations.

Method: Through a systematic search of the literature and the screening of 19,631 abstracts, a total of 363 unique trauma measures were identified.

Recreating diasporic identity and community: Examination of transgender and nonbinary latinx healing from family rejection.

The purpose of this study was to explore the experience of healing from family rejection among transgender and nonbinary Latinx individuals. Participants were asked how they navigated family dynamics related to gender identity and specific behaviors or resources that promoted their healing from experiences of family rejection. Data from 12 interviews with Latinx nonbinary and transgender adults were analyzed through a critical-constructivist grounded theory method resulting in a hierarchy composed of three clusters related to the core category (healing from family rejection leads to the recreation of diasporic identity and community as one learns to live authentically in their ethnic/racial gendered expression).

Exploring the Efficacy of an Online Intervention in Processing Experiences of Heterosexism Among Autistic-LGBQ + Individuals.

This experimental study explored the use of online expressive writing interventions to cope with distress from heterosexist events among a sample of autistic-LBGQ + individuals. This study included an open writing condition and an emotion focused therapy guided writing condition. Over 89% of the participants indicated that the writing exercises were helpful in processing the event, with significant decreases for measures of depressive and trauma/stressor symptoms.

Defence context for the UK's Defence Engagement (Health).

Defence Engagement (DE) has been a core UK Defence task since 2015. DE (Health) is the use of military medical capabilities to achieve DE effects within the health sector to achieve security and defence objectives. DE (Health) practitioners must understand the underlying defence context that shapes these objectives.

Nonoptimal bacteria species induce neutrophil-driven inflammation and barrier disruption in the female genital tract.

Neutrophil recruitment and activation within the female genital tract are often associated with tissue inflammation, loss of vaginal epithelial barrier integrity, and increased risk for sexually transmitted infections, such as HIV-1. However, the direct role of neutrophils on vaginal epithelial barrier function during genital inflammation in vivo remains unclear. Using complementary proteome and immunological analyses, we show high neutrophil influx into the lower female genital tract in response to physiological surges in progesterone, stimulating distinct stromal, immunological, and metabolic signaling pathways.

Migration Rates on Swim Plates Vary between Escherichia coli Soil Isolates: Differences Are Associated with Variants in Metabolic Genes.

This study investigates migration phenotypes of 265 Escherichia coli soil isolates from the Buffalo River basin in Minnesota, USA. Migration rates on semisolid tryptone swim plates ranged from nonmotile to 190% of the migration rate of a highly motile E. coli K-12 strain.