Clinical validation of 3D virtual modelling for laparoscopic complete mesocolic excision with central vascular ligation for proximal colon cancer.

Introduction: Laparoscopic Complete Mesocolic Excision (CME) with Central Vascular Ligation (CVL) in colon cancer surgery has not been broadly adopted in part because of safety concerns. Pre-operative 3-D virtual modelling (3DVM) may help but needs validation.

Methods: 3DVM were routinely constructed from CT mesenteric angiograms (CTMA) using a commercial service (Visible Patient, Strasbourg, France) for consecutive patients during our CMECVL learning curve over three years.

Improving Compliance With Evidence-Based Laboratory Testing Recommendations and Monitoring Associated Patient Outcomes.

A team comprising nursing, medical staff, and administrative leaders at an urban academic orthopedic hospital in the northeastern United States sought to revise a preoperative laboratory testing protocol based on evidence and practice guidelines. The goal was to decrease unnecessary tests by 20% without negatively affecting patient outcomes. After adding the revised protocol to the electronic health record, audits revealed that the target goal was not met and additional strategies were implemented, including educational webinars for surgeon office personnel who ordered tests, additional webinars for advanced practice professionals, and the creation of scorecards to track surgeons' progress.

Sun-related knowledge and practices in Irish construction and agricultural workers.

Background: Agricultural and construction workers spend much of their work time outdoors and have higher risks of developing skin cancer when compared to indoor workers. However, there is limited research on ultraviolet radiation (UVR) exposure knowledge, sun safety practices and constraints within these occupational groups in Ireland.

Aims: This study aimed to examine self-reported time spent outdoors in a sample of Irish agricultural and construction workers; to describe and compare UVR exposure knowledge, safety practices and perceived constraints in both occupational groups, and to assess the association of demographic, personal and occupational factors with sun-related knowledge, practices and perceived constraints.

Impact of Simulation Training on Core Skill Competency of Undergraduate Medical Students.

Introduction: Simulation based medical training (SBMT) is gaining traction for undergraduate learning and development. We designed, implemented, and independently assessed the impact of an SBMT programme on competency in surgical history taking and clinical examination for senior clinical students.

Methods: With institutional ethical approval and initial pilot study of student volunteers that ensured format appropriateness, we implemented an SBMT programme weekly for ten weeks during the core surgery module of our Medicine degree programme.

Intraoperative near infrared functional imaging of rectal cancer using artificial intelligence methods - now and near future state of the art.

Colorectal cancer remains a major cause of cancer death and morbidity worldwide. Surgery is a major treatment modality for primary and, increasingly, secondary curative therapy. However, with more patients being diagnosed with early stage and premalignant disease manifesting as large polyps, greater accuracy in diagnostic and therapeutic precision is needed right from the time of first endoscopic encounter.

Surgeon assessment of significant rectal polyps using white light endoscopy alone and in comparison to fluorescence-augmented AI lesion classification.

Purpose: Perioperative decision making for large (> 2 cm) rectal polyps with ambiguous features is complex. The most common intraprocedural assessment is clinician judgement alone while radiological and endoscopic biopsy can provide periprocedural detail. Fluorescence-augmented machine learning (FA-ML) methods may optimise local treatment strategy.

Twenty First Century Technological Toolbox Innovation for Transanal Minimally Invasive Surgery (TAMIS).

Transanal minimally invasive surgery (TAMIS) is an effective procedure that plays an important role in the care of patients with significant rectal neoplasia and polyps including early-stage cancers. However, it is perhaps underutilised and under threat from both advanced flexible endoscopic procedures and proceduralists (who often act as gatekeepers for referral to colorectal surgeons), as well as from robotic surgery proponents. TAMIS advocates can learn and adopt practice insights from both these fields and incorporate available technological innovations building on the huge accomplishments already delivered in this area.

Technical and functional design considerations for a real-world interpretable AI solution for NIR perfusion analysis (including cancer).

Near infrared (NIR) analysis of tissue perfusion via indocyanine green fluorescence assessment is performed clinically during surgery for a range of indications. Its usefulness can potentially be further enhanced through the application of interpretable artificial intelligence (AI) methods to improve dynamic interpretation accuracy in these and also open new applications. While its main use currently is for perfusion assessment as a tissue health check prior to performing an anastomosis, there is increasing interest in using fluorophores for cancer detection during surgical interventions with most research being based on the paradigm of static imaging for fluorophore uptake hours after preoperative dosing.

CLASSICA: Validating artificial intelligence in classifying cancer in real time during surgery.

Aim: Treatment pathways for significant rectal polyps differ depending on the underlying pathology, but pre-excision profiling is imperfect. It has been demonstrated that differences in fluorescence perfusion signals following injection of indocyanine green (ICG) can be analysed mathematically and, with the assistance of artificial intelligence (AI), used to classify tumours endoscopically as benign or malignant. This study aims to validate this method of characterization across multiple clinical sites regarding its generalizability, usability and accuracy while developing clinical-grade software to enable it to become a useful method.

Ethical perspectives on surgical video recording for patients, surgeons and society: systematic review.

Background: Operating-room audiovisual recording is increasingly proposed, although its ethical implications need elucidation. The aim of this systematic review was to examine the published literature on ethical aspects regarding operating-room recording.

Methods: MEDLINE (via PubMed), Embase, and Cochrane databases were systematically searched for articles describing ethical aspects regarding surgical (both intracorporeal and operating room) recording from database inception to the present (the last search was undertaken in July 2022).

Health literacy among self-help leprosy group members reduces stereotype endorsement and stigma-related harm in rural Nepal.

There is increasing appreciation that group memberships can have both beneficial and damaging impacts on health. In collaboration with Nepal Leprosy Trust (NLT), this longitudinal study explores a group-based approach to stigma reduction among people affected by leprosy in rural Nepal (N = 71)-a hard to reach and underrepresented non-WEIRD population. Informed by the 'social cure' literature, and the progressive model of self-stigma, we use a longitudinal design.

Perioperative factors associated with postoperative morbidity after emergency laparotomy: a retrospective analysis in a university teaching hospital.

Emergency Laparotomy (EL) is associated with significant morbidity and mortality. Variation in practice and patient outcomes for patients undergoing emergency laparotomy has been identified through the UK National Emergency Laparotomy Audit (NELA), with 30-day mortality ranging from 11 to 15%. A correlation between preoperative haemodynamic parameters and increased postoperative mortality has been demonstrated by both NELA and other observational studies.

Benign breast papilloma: Is surgical excision necessary?

In many centers internationally, current standard of care is to excise all papillomas of the breast, despite recently reported low rates of upgrade to malignancy on final excision. The objective of this study was to determine the upgrade rate to malignancy in patients with papilloma without atypia. A retrospective review of a prospectively maintained database of all cases of benign intraductal papilloma in a tertiary referral symptomatic breast unit between July 2008 and July 2018 was performed.

The Cost Effectiveness of Birth-Cohort Hepatitis C Screening During Pre-Admission Testing for Elective Procedures at a Single Specialty Orthopedic Hospital.

In 2012, the Centers for Disease Control and Prevention issued a recommendation for hepatitis C screening of adults born between 1945-1965. Our institution incorporated birthcohort screening into its pre-admission testing program for elective orthopedic procedures on February 3, 2015. The goal of this study was to report the results and costs of pre-admission birth-cohort hepatitis C screening at our institution from February 3, 2015, to January 27, 2017.

Minimally invasive approaches to the management of anastomotic leakage following restorative rectal cancer resection.

Aim: Management of anastomotic leakage (AL) following rectal resection has evolved with increasing use of less invasive techniques. The aim of this study was to review the management of AL following restorative rectal cancer resection in a tertiary referral centre.

Method: A retrospective review of a prospectively maintained database was performed.

Bored like Hell: Religiosity reduces boredom and tempers the quest for meaning.

Boredom involves a lack meaning. Conversely, religiosity offers people a sense of meaning. Accordingly, we proposed that by imbuing a sense of meaningfulness, religiosity leads people to experience less boredom.

Effect of standardizing the lactose content of cheesemilk on the properties of low-moisture, part-skim Mozzarella cheese.

The texture, functionality, and quality of Mozzarella cheese are affected by critical parameters such as pH and the rate of acidification. Acidification is typically controlled by the selection of starter culture and temperature used during cheesemaking, as well as techniques such as curd washing or whey dilution, to reduce the residual curd lactose content and decrease the potential for developed acidity. In this study, we explored an alternative approach: adjusting the initial lactose concentration in the milk before cheesemaking.

Eaten up by boredom: consuming food to escape awareness of the bored self.

Research indicates that being bored affectively marks an appraised lack of meaning in the present situation and in life. We propose that state boredom increases eating in an attempt to distract from this experience, especially among people high in objective self-awareness. Three studies were conducted to investigate boredom's effects on eating, both naturally occurring in a diary study and manipulated in two experiments.

Effect of camel chymosin on the texture, functionality, and sensory properties of low-moisture, part-skim Mozzarella cheese.

The objective of this study was to compare the effect of coagulant (bovine calf chymosin, BCC, or camel chymosin, CC), on the functional and sensory properties and performance shelf-life of low-moisture, part-skim (LMPS) Mozzarella. Both chymosins were used at 2 levels [0.05 and 0.

Quality indicators for inflammatory bowel disease: development of process and outcome measures.

Introduction: Variation in adherence to management guidelines for inflammatory bowel disease (IBD) suggests variable quality of care. Quality indicators (QIs) can be developed to measure the structure, processes, and outcomes of health care delivery. The RAND/UCLA appropriateness method was used to develop a set of process and outcome QIs to define quality of care for IBD.

Colorectal Neoplasia Differentially Expressed (CRNDE), a Novel Gene with Elevated Expression in Colorectal Adenomas and Adenocarcinomas.

An uncharacterized gene locus (Chr16:hCG_1815491), now named colorectal neoplasia differentially expressed (gene symbol CRNDE), is activated early in colorectal neoplasia. The locus is unrelated to any known protein-coding gene. Microarray analysis of 454 tissue specimens (discovery) and 68 previously untested specimens (validation) showed elevated expression of CRNDE in >90% of colorectal adenomas and adenocarcinomas.

Sexual selection on male development time in the parasitoid wasp Nasonia vitripennis.

Mating systems are shaped by a species' ecology, which sets the stage for sexual selection. Males of the gregarious parasitoid wasp Nasonia vitripennis compete to mate virgin females at the natal site, before females disperse. Males could increase their fitness by being larger and monopolizing female emergence sites or by emerging earlier pre-empting access to females.