Medical Research Articles

Non-invasive neurostimulation: an emerging therapeutic modality in veterinary neurology

Non-invasive neurostimulation involves techniques that stimulate the nervous system without penetrating the skin. These techniques, which range from electrical and magnetic to other types of stimulation, are designed to alter the activity of nerve cells and the broader networks they form. Although these methods have proven effective and safe for treating certain neurological conditions in humans, their success varies significantly from one individual to another. This variability can be because of the lack of standardised stimulation protocols, biological differences among individuals and the particular state of the neural areas being targeted. Various non-invasive neurostimulation techniques have been investigated, particularly in human medicine, including transcutaneous vagal nerve stimulation, transcutaneous electrical nerve stimulation on various nerves, repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Of these, repetitive transcranial magnetic stimulation has emerged as the leading technique in research for human and veterinary medicine because of its potential in treating a wide range of neurological disorders. In the field of veterinary medicine, the use of non-invasive neurostimulation as a treatment approach is still in its early phases, with only a few reports documenting its application in managing seizures and behavioural issues in animals.

A Critical Look at Racism in the Clinical Learning Environment.

Academic medicine has long acknowledged the importance of diversity, equity, and inclusion (DEI) in the pursuit of health equity. Despite this recognition, the clinical learning environment (CLE) has struggled to foster an equitable and inclusive ecosystem that supports diverse learners and faculty.Efforts to dismantle racism in medicine represent an important approach to supporting diverse learners and faculty in the CLE, but they have fallen short of their intended impact. The reasons for this failure are complex and may include a limited understanding of the impact of racism and a misguided conviction that knowledge of harm suffered by minoritized groups is a sufficient driver of change.To advance understanding and increase motivation to dismantle racist systems within academic medicine, this paper posits 2 frameworks, Interest Convergence (IC) and Critical Whiteness Study (CWS). IC asserts that racial equity progresses only when it aligns with the interests of the majority, while CWS examines how Whiteness as a social construct upholds power and privilege, often to the detriment of White individuals themselves.Utilizing these frameworks, the authors detail how Whiteness negatively impacts the health of White people and impedes entry to medical school for low- and middle-income, first-generation White students. The authors illustrate how practices-such as patient- and family-centered care and competency-based medical education-which are intended to improve care and medical education for all, are fully aligned with and integral to DEI principles. The authors conclude that racism and upholding Whiteness cause harm to majority as well as minoritized peoples, while DEI principles provide the foundation for best practices in the CLE and improve outcomes for all.

Mechanism of Polygala-Acorus in Treating Autism Spectrum Disorder Based on Network Pharmacology and Molecular Docking.

Recent epidemic survey data have revealed a globally increasing prevalence of autism spectrum disorders (ASDs). Currently, while Western medicine mostly uses a combination of comprehensive intervention and rehabilitative treatment, patient outcomes remain unsatisfactory. Polygala-Acorus, used as a pair drug, positively affects the brain and kidneys, and can improve intelligence, wisdom, and awareness; however, the underlying mechanism of action is unclear. We performed network pharmacology analysis of the mechanism of Polygala-Acorus in treating ASD and its potential therapeutic effects to provide a scientific basis for the pharmaceutical's clinical application. The chemical compositions and targets corresponding to Polygala-Acorus were obtained using the Traditional Chinese Medicine Systematic Pharmacology Database and Analysis Platform, Chemical Source Website, and PharmMapper database. Disease targets in ASD were screened using the DisGeNET, DrugBank, and GeneCards databases. Gene Ontology functional analysis and metabolic pathway analysis (Kyoto Encyclopedia of Genes and Genomes) were performed using the Metascape database and validated via molecular docking using AutoDock Vina and PyMOL software. Molecular docking analysis showed that the key active components of Polygala- Acorus interacted with the following key targets: EGFR, SRC, MAPK1, and ALB. Thus, the key active components of Polygala-Acorus (sibiricaxanthone A, sibiricaxanthone B tenuifolin, polygalic acid, cycloartenol, and 8-isopentenyl-kaempferol) have been found to bind to EGFR, SRC, MAPK1, and ALB. This study has preliminarily revealed the active ingredients and underlying mechanism of Polygala-Acorus in the treatment of ASD, and our predictions need to be proven by further experimentation.

Trends on Novel Targets and Nanotechnology-Based Drug Delivery System in the Treatment of Parkinson's disease: Recent Advancement in Drug Development.

Parkinson's disease (PD) is a progressive neurodegenerative disorder that impacts a significant portion of the population. Despite extensive research, an effective cure for PD remains elusive, and conventional pharmacological treatments often face limitations in efficacy and management of symptoms. There has been a lot of discussion about using nanotechnology to increase the bioavailability of small- molecule drugs to target cells in recent years. It is possible that PD treatment might become far more effective and have fewer side effects if medication delivery mechanisms were to be improved. Potential alternatives to pharmacological therapy for molecular imaging and treatment of PD may lie in abnormal proteins such as parkin, α-synuclein, leucine-rich repeat serine and threonine protein kinase 2. Published research has demonstrated encouraging outcomes when nanomedicine-based approaches are used to address the challenges of PD therapy. So, to address the present difficulties of antiparkinsonian treatment, this review outlines the key issues and limitations of antiparkinsonian medications, new therapeutic strategies, and the breadth of delivery based on nanomedicine. This review covers a wide range of subjects, including drug distribution in the brain, the efficacy of drug-loaded nano-carriers in crossing the blood-brain barrier, and their release profiles. In PD, the nano-carriers are also used. Novel techniques of pharmaceutical delivery are currently made possible by vesicular carriers, which eliminate the requirement to cross the blood-brain barrier (BBB).

Transformative Learning Among Organ Procurement Organization Donor Family Volunteers.

Introduction: Some family members who previously made the decision to donate a family member's organs support the organ procurement organization (OPO) through volunteer work. Volunteers were asked to describe their family's organ donation story to educate the general and medical communities about organ donation. This study explored the transformative learning experienced by volunteers during and following the organ donation consent process and throughout their volunteer work. Methods/Approach: A narrative inquiry research methodology and transformative learning theoretical framework was used and 6 volunteers were recruited to participate. Two semistructured virtual interviews were conducted. Interviews were transcribed, radically reduced, and subjected to holistic-content and holistic-form narrative analysis. Findings: Participants experienced strong emotional responses during and after the loss of their family member, characterized as a period of disorientation, which lasted for an extended period preventing transformative learning. After the OPO contacted participants regarding the opportunity to volunteer, participants experienced a period of self-examination when they reengaged with the topic of organ donation. Critical reflection occurred through the act of storytelling about their family's organ donation story during their volunteer work. Storytelling to the community facilitated making meaning of their loss and transformations. Conclusion: Volunteering for an OPO played an important role by initiating self-examination and critical reflection of their prior assumptions. Through storytelling, participants reflected on their roles and made meaning of their organ donation experiences. The act of inviting donor families to reengage with the topic of organ donation through volunteer work fostered positive permanent meaningful transformations.

Exploring Parent Treatment Decision-Making in Relapsed and Refractory Neuroblastoma: A Qualitative Study

Parents often become involved in making treatment decisions for their child with cancer when there is no standard treatment protocol, typically seen in poor-prognosis cancers. Advances in scientific medicine has led to more treatment options being available for children resulting in parents making repeated treatment decisions depending on their child’s response to treatment. The emotional turmoil of their child's cancer diagnosis can be exacerbated when combined with making decisions that have uncertain outcomes. This study aimed to identify, describe, explore, and explain how parents made repeated treatment decisions and the role of emotion in decision-making when their child had relapsed or refractory neuroblastoma, a poor-prognosis cancer.Data were collected using qualitative interviews between 2020-2022 with parents of children with relapsed or refractory neuroblastoma in the United Kingdom. Data were analysed using Reflexive Thematic Analysis.Eighteen parents who made between one to six treatment decisions participated. Decision-making incorporated four themes which enabled, influenced, and informed how parents made treatment decisions: 1) time as a structure within decision-making; 2) uncertainty and its relationships with treatment risk, side effects and outcomes; 3) parent oscillation of their cognitive and emotional adjustment; 4) parent responsibility and involvement in decision-making. Time was the central organising concept which structured and organised parent decision-making. We adopted Orlikowski and Yates’s (2002) temporal structures to characterise the experience of time and Stroebe and Schut’s (1999) dual-processing theory to explore the oscillation of parent adjustment of their situation cognitively and emotionally. A conceptual framework showed the interrelationships of these themes.

Orally administered Cannabigerol (CBG) in rats: Cannabimimetic actions, anxiety-like behavior, and inflammation-induced pain

Cannabigerol (CBG) is a phytocannabinoid found in cannabis that is promoted for medical use and other health benefits, but current empirical data on the behavioral effects of CBG are lacking. The purpose of this study was to evaluate the effects of a wide dose range of orally administered CBG on outcomes related to its potential cannabimimetic effects (cannabinoid tetrad), as well as effects on anxiety-like behavior, inflammation and related pain hypersensitivity. In a series of experiments, male and female Sprague Dawley rats received oral CBG (per os [p.o.]) or vehicle prior to testing of effects on 1) the cannabinoid tetrad (30–600 mg/kg, p.o.): assessments of locomotor activity, body temperature, antinociception (tail flick test), and catalepsy (bar test); 2) acoustic startle response (ASR) test of anxiety-like behavior (30–300 mg/kg, p.o.); 3) carrageenan-induced inflammation (paw edema), hyperalgesia (Hargreaves test), and allodynia (von Frey test) tests (10–60 mg/kg, p.o.). Positive control groups were administered THC (0–30 mg/kg, p.o.) for the cannabinoid tetrad assay, the benzodiazepine lorazepam (0–3 mg/kg, intraperitoneal [i.p.]) for the ASR test, or the opioid analgesic morphine (0–10 mg/kg, i.p.) for the carrageenan-induced inflammation and pain hypersensitivity tests. CBG did not produce cannabimimetic actions in the tetrad, but increased locomotor activity at the highest doses (300–600 mg/kg). THC produced typical dose-related cannabimimetic effects. CBG did not produce anxiolytic effects in the ASR test, while groups pretreated with lorazepam did show reductions in ASR. Finally, pretreatment with CBG prior to an intraplantar injection of carrageenan did not prevent the induction of an acute inflammatory state (i.e., increased paw edema and associated hyperalgesia and allodynia). In contrast, morphine alleviated hyperalgesia and allodynia induced by intraplantar carrageenan but did not affect the development of paw edema. In sum, these data do not support the use of oral CBG for anxiety or inflammatory pain.

Pre-clinical experiences among nursing students of reputable Islamic university in the capital city of Indonesia

Clinical trainings were employed in the nursing sciences in order to provide student’s experiences in applying nursing care according to the theory. They required to accomplish some competencies depending on their study levels. Students would also experience the possible barriers and challenge during clinical trainings. However, there were limited number of research which explored these experiences, especially in nursing students. This study aimed to explore the experiences of nursing students in performing fundamental nursing pre-clinical activities. This research conducted qualitative study with phenomenological approach. This study involved 5 nursing students according to inclusive criteria. Data collection method used in-depth interview techniques. The obtained data were analysed further using Colaizzi test. The collected data identified six themes of student’s experiences, such as student’s understanding about pre-clinic, their experiences during preclinic, theoretical gaps with hospital procedures, some barriers in clinical practice, student’s expectation, and obtained support during pre-clinic trainings. Pre-clinical trainings allowed nursing students to gain various medical experience and knowledge regarding nursing care. They could implement and compare the nursing theory with actual conditions in the hospital and society living. This topic needed to assess further about the benefits of pre-clinic trainings.

A Descriptive Analysis of the Nutraceutical Constituents, Extraction Techniques, and Possible Health Benefits of Tamarind

Background: Tamarind is a multifunctional tree, with nearly every portion having significant nutritional or therapeutic use. The fruit, which produces acidic pulp, is the most valuable and often utilized portion. Objective: The aim of this paper is to discuss the distribution, habitat, chemical constituents and extraction techniques of tamarind. Methods: This study reviews the chemical constituents, health benefits and extraction techniques of tamarind. Databases such as PubMed, Scopus, Science Direct, and Google Scholar were used to search articles from 1990 to 2022. The key search terms included tamarind, phytoconstituents extraction and anti-nutritional factor. Research studies also included similar plant parts extracted from similar solvents which were considered in this review. Results: According to our observations, Tamarindus indica is a crucial plant with significant pharmacological properties. It is extensively used as a conventional medicine to treat a variety of disorders; however, its active ingredients require further investigation for future drug development and pharmacological activity. Tamarind contains a diverse range of bioactive compounds, including polyphenols, flavonoids, alkaloids, vitamins, and minerals, which have been associated with various health-promoting properties. The study examines different extraction methods used to isolate tamarind's bioactive constituents, such as solvent extraction, supercritical fluid extraction (SFE), and microwave-assisted extraction (MAE). Furthermore, the research highlights the potential health benefits of tamarind, including antioxidant activity, anti-inflammatory effects, gastrointestinal support, cardiovascular benefits, and antimicrobial properties. Discussion: Tamarind includes citric acid, linoleic acid, volatile oils, vitamin C, potassium, Camp sterol, -amyrin, Tannins, saponins, and glycosides as a result of this. It has several pharmacological properties such as reducing swelling, preventing oxidation, hypolipidemic, weight loss, antibacterial, hepatoprotective, anthelmintic, and painkiller properties. These properties will assist to generate interest in Tamarind and develop novel preparations with more medicinal and commercial potential. The findings indicate that tamarind holds significant promise as a natural resource for developing functional foods, nutraceuticals, and pharmaceuticals with potential positive impacts on human health.

Exploring potentials of Electuaries for Controlling Chronic Respiratory Diseases in Unani Medicine: A Systematic Review

Background: Chronic respiratory diseases rate has been increasing alarmingly, causing huge burden on the mortality and morbidity. Environmental pollution and occupational exposure, the major identified risk factors and endless adverse effects of conventional medicine put forward the need for better alternative options. Electuaries are the pharmaceutical formulation of poly herbal drugs that are employed as effective remedy for respiratory disorders in Unani system of medicine. Objective: The aim is to assess the effectiveness of Unani pharmaco-therapeutics in the management of various respiratory diseases and the computation of drug/water and drug/sugar ratio for the elaborated electuaries. Methods: A web-based review on certain selected Unani drugs and its molecular mechanism was carried out using the data bases such as Pub Med, Google Scholar, Science Direct and Scopus published until the end of June 2022. Results: It was observed that several single drugs such as Khayarshambar (Cassia fistula L.), Sapistan (Cordia dichotama Forst), Asl-us- Soos (Glycyrrhiza glabra L.), Khatmi (Althea officianialis L.), Za’fran (Crocus sativus L.), Behīdāna (Cydonia oblonga Mill.) etc. used in Unani formulations claimed to be effective in management of respiratory diseases like COVID 19. The herbs and its chemical constituents showed the preventive effect on respiratory diseases with inflammatory cell mediators, lung pathologies, airway response and immunomodulatory effects. The results of research studies (preclinical, clinical or in silico) and their molecular mechanisms on Electuaries have proved to be optimal for the respiratory system. Conclusion: Unani poly-pharmaceutics showed anti-inflammatory, anti-viral, anti-bacterial, anti-allergic, anti- tussive, mucolytic actions arresting respiratory diseases.

Nature’s Signature in Ayurveda with an Ethnopharmacological Approach: A Narrative Review

: The nature's signature in Āyurveda i.e. Doctrine of Signatures (DOS), which calls for utilizing natural substances that resemble a particular body part or organ, is consistent with the ethnopharmacological practice of choosing therapeutic plants based on their visible physical qualities. In order to promote health and treat ailments, the ancient Indian medical system known as Āyurveda employs natural ingredients including plants, minerals, and animal products. The study of conventional medicine and the application of natural products for therapeutic reasons are known as ethno-pharmacology. This review explores various research on ayurvedic herbs, their doctrinal signature, and the status of our understanding of ethno-pharmacology. However, by integrating Āyurveda plants' doctrinal signatures with ethnopharmacological methods, it might be better to comprehend the therapeutic potential of plants and create novel treatments for a range of ailments. Combining these two perspectives might assist in understanding how nature may heal and how natural medicines could improve health and wellness. It was believed that a plant containing parts that resembled portions of human bodies, animals, or other items had practical use for those parts, animals, or objects. This philosophy was shown in some of the Indian medicinal plants that are discussed in this article.

KSDKG: construction and application of knowledge graph for kidney stone disease based on biomedical literature and public databases.

Kidney stone disease (KSD) is a common urological disorder with an increasing incidence worldwide. The extensive knowledge about KSD is dispersed across multiple databases, challenging the visualization and representation of its hierarchy and connections. This paper aims at constructing a disease-specific knowledge graph for KSD to enhance the effective utilization of knowledge by medical professionals and promote clinical research and discovery. Text parsing and semantic analysis were conducted on literature related to KSD from PubMed, with concept annotation based on biomedical ontology being utilized to generate semantic data in RDF format. Moreover, public databases were integrated to construct a large-scale knowledge graph for KSD. Additionally, case studies were carried out to demonstrate the practical utility of the developed knowledge graph. We proposed and implemented a Kidney Stone Disease Knowledge Graph (KSDKG), covering more than 90 million triples. This graph comprised semantic data extracted from 29,174 articles, integrating available data from UMLS, SNOMED CT, MeSH, DrugBank and Microbe-Disease Knowledge Graph. Through the application of three cases, we retrieved and discovered information on microbes, drugs and diseases associated with KSD. The results illustrated that the KSDKG can integrate diverse medical knowledge and provide new clinical insights for identifying the underlying mechanisms of KSD. The KSDKG efficiently utilizes knowledge graph to reveal hidden knowledge associations, facilitating semantic search and response. As a blueprint for developing disease-specific knowledge graphs, it offers valuable contributions to medical research.

Wohlfahrtiimonas chitiniclastica: current insights and complementary review from Chinese cases.

Wohlfahrtiimonas chitiniclastica is an emerging zoonotic pathogen associated with bacteremia, myiasis, and soft tissue infections. It is insufficiently identified and underestimated due to reasons, such as shortcomings of the traditional identification techniques and language barriers in local case reports from different regions. In this review, we summarize the currently available literature. In particular, we added previously overlooked cases from Chinese and other medical communities. The clinical characteristics, identification, and treatment of W. chitiniclastica are discussed. This work provides a complete review of the previous work including cases from human, animal, and other sources.

Exosomal Micro RNA Isolation in White-Tailed Deer (Odocoileus virginianus) for Diagnostic Biomarker Discovery.

Molecular approaches are becoming more prevalent for the diagnosis of neurodegenerative diseases in human medicine and can be extended to diagnosis of wildlife diseases such as chronic wasting disease and other prion diseases. These diseases have been associated with exosome-bound molecular biomarkers of disease progression, such as proteins and micro RNA molecules (miRNA). We tested and optimized a method for exosomal miRNA isolation from minimally invasive, small-volume serum samples obtained from white-tailed deer (Odocoileus virginianus). We confirmed the isolation of exosomes and optimized a commercially available benchtop kit to obtain sufficient and pure RNA for miRNA sequencing. The selected method for RNA extraction combines two 500-μL serum aliquots into one elution column and re-eluting the final product of the column. We identified 137 miRNA present in healthy white-tailed deer that can be used as a baseline to identify putative miRNA biomarkers of disease progression and mechanisms of infection in future comparative disease studies. This approach to biomarker discovery may help to inform biological processes in wildlife populations and provide alternatives to invasive or postmortem samples.

Burden of Digestive Diseases in the United States Population: Rates and Trends.

Digestive diseases are common in the United States (U.S.) and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to expand on earlier findings and investigate rates and trends in the digestive disease burden in the U.S. The Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the U.S.: Multiple Cause-of-Death Data, Optum Clinformatics® Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care, and mortality with a digestive disease diagnosis. Digestive disease prevalence (claims-based, 2019) was 24.2% among Medicaid beneficiaries, 33.2% among private insurance enrollees, and 51.5% among Medicare beneficiaries and rose over the previous decade. Digestive diseases contributed to 42 million emergency department visits, 17 million hospital stays, and 472,000 deaths in 2019. Women had higher medical care rates with a digestive disease diagnosis, but mortality rates were higher among men. Blacks had higher medical care use and mortality rates compared with Whites, and Hispanics had lower rates. During the study period, ambulatory care and emergency department visit rates with a digestive disease diagnosis rose, while hospitalization and mortality rates declined. Among private insurance enrollees, rates were higher compared with national data for hospitalizations, but lower for emergency department visits. The digestive disease burden in the U.S. is substantial, particularly among Blacks and older adults. Further research is needed to better understand reasons for disparities and trends in health care use and mortality reported in this paper.

Clinical Trial Access in Diverse Populations.

Despite the disproportionate impact of cancer on minority groups, their participation in oncologic clinical trials remains low. Contributing factors include mistrust of the medical establishment, structural barriers, and implicit bias. Strategies to improve access and representation include pragmatic trial designs, patient navigation programs, financial support, and increasing diversity among medical professionals. Addressing these issues is crucial for ensuring equitable healthcare delivery and improving outcomes for underrepresented populations in clinical research.

Physical medicine and rehabilitation clerkships in medical school: A valuable and integrated addition to the advanced clerkships.

The medical specialty of physical medicine and rehabilitation (PM&R) focuses on quality of life, function, ability, and interdisciplinary care. PM&R clerkships are uniquely qualified to teach medical students about rehabilitation and the spectrum of postacute care, medical knowledge, and medical decision making related to health care affecting people with disabilities, health care disparities affecting people with disabilities, and the communication and teamwork strategies to provide a patient-centered approach to optimize function and outcomes. PM&R clerkships can be used to fulfill stakeholder and governing body requirements, such as medical knowledge, rehabilitation, critical judgment, health disparities, ethics, communication, teamwork, and patient-centered medical care, in order to maintain accreditation and provide a high-quality education This review provides both a rationale for a medical student clerkship in PM&R and an effective example of such an experience that has been implemented during medical school training.

Hemp Extract (Extractum Cannabis) in the Treatment of Gastrointestinal Distress and Dyspepsia: Historical Insights from Barcelona, Spain

This study explores the trajectory of interest in and use of Extractum Cannabis (hemp extract, i.e., extract of Cannabis sativa L.) for the symptomatic treatment of minor gastrointestinal distress and dyspepsia in nineteenth- and early twentieth-century Barcelona (Catalonia, Spain) prior to 1939, through a review of primary sources. The objective of this paper is to present a historical pharmaceutical and applied review of the medical use of the hemp genus (Cannabis L.) prior to its prohibition, thereby contributing to its recognition as a medicinal product. The information provided demonstrates evidence of the medicinal use of cannabis within the historical context studied. The interactions between this legacy medical use and the contemporary body of pharmacological and toxicological knowledge (on hemp, its constituents, and the endocannabinoid system in gastrointestinal and stomach disorders) are discussed, providing new possible clinical perspectives. Within its limitations—including the scope, limited accessibility to, and varying quality of archives—this research contributes to a more granular understanding of the historical embeddedness of psychoactive hemp medicines in northeastern Spain, suggesting that medical and pharmaceutical traditions could play a role in informing contemporary approaches to “medical marijuana”.

AJTES Vol 8; No 2; Supplement 8 - November 2024; Abstracts Book - ACTES 2024

The 8th Albanian Congress of Trauma and Emergency Surgery (ACTES 2024) was a dynamic platform for exchanging cutting-edge knowledge, clinical expertise, and innovative trauma and emergency surgery research. This prestigious event will convene leading professionals from Albania and the international medical community, including surgeons, researchers, and healthcare providers. The congress aims to address contemporary challenges and advancements in trauma care, emergency surgical techniques, and interdisciplinary approaches to patient management. Key themes include the role of minimally invasive surgery in trauma, advancements in hemostatic techniques, damage control marks a pivotal event in the medical community, providing a dynamic platform for knowledge exchange, professional collaboration, and advancements in surgical science in Albania. This congress brings together experts, scholars, practitioners, and enthusiasts from trauma and emergency surgery, creating an opportunity for meaningful dialogue and innovation. Hosted in the vibrant city of Tirana, ACTES 2024 features a comprehensive program that addresses a broad spectrum of topics, including abdominal and chest injuries, vascular trauma, emergency surgical procedures, and the evolving challenges in nursing services for the modern era. The congress theme, "Trauma and emergency surgery and not only…” underscores a commitment to innovation, evidence-based practices, and groundbreaking discoveries. The event includes plenary sessions with renowned experts, scientific presentations, panel discussions, poster awards, networking opportunities, industry exhibitions, cultural activities, and Continuing Medical Education (CME) credits. Primary Content: Participants can expect an enriching professional experience complemented by opportunities for personal growth. The congress promotes collaboration, fosters international partnerships, and highlights the vital role of each attendee in advancing surgical knowledge and improving patient care. The ACTES 2024 is a dynamic platform for exchanging cutting-edge knowledge, clinical expertise, and innovative trauma and emergency surgery research. This prestigious event will convene leading professionals from Albania and the international medical community, including surgeons, researchers, and healthcare providers. The congress aims to address contemporary challenges and advancements in trauma care, emergency surgical techniques, and interdisciplinary approaches to patient management. Key themes include the role of minimally invasive surgery in trauma, advancements in hemostatic techniques, damage control resuscitation, the integration of trauma registries, and strategies for improving outcomes in mass casualty incidents. ACTES 2024 also emphasizes the importance of education and collaboration, featuring interactive workshops, live demonstrations, and case-based discussions. These sessions aim to enhance participants' practical skills and foster partnerships among institutions across the region and beyond. Through its comprehensive scientific program, ACTES 2024 underscores its commitment to elevating trauma and emergency surgical care standards, supporting evidence-based practice, and advocating for policy improvements in healthcare systems. This congress represents a unique opportunity to share insights, build networks, and shape the future of trauma and emergency surgery in Albania and the global healthcare community. Conclusion:ACTES 2024 is not just a gathering; it is a movement toward transforming the future of trauma and emergency surgery. Through active participation, the event aims to inspire innovation, encourage global collaboration, and make a lasting impact on surgical care worldwide. The 8th Albanian Congress of Trauma and Emergency Surgery is committed to continuously improving trauma and emergency care standards in Albania and beyond. By creating a space for learning, collaboration, and knowledge exchange, this congress strengthens the foundation for innovation and evidence-based practice. As healthcare professionals unite to share their expertise and insights, ACTES 2024 will undoubtedly impact trauma and emergency surgery trajectories, ultimately improving patient outcomes. Keywords: Trauma care; Emergency surgery; Damage control surgery; Minimally invasive techniquesMinimally invasive techniques; Multidisciplinary care; Acute care medicine; Hemostasis techniques; Mass casualty management; Surgical innovation; Trauma registries; Evidence-based practice; Healthcare systems improvement; Patient outcomes; Surgical education; Regional collaboration; ATLS, Trauma management; trauma education; BAT, PAT, abdominal injury, pelvic injury, acute care surgery, abdomen acute, oncologic surgery, cardiac surgery, AI, bariatric surgery, sleeve resection, chest trauma, lung cancer, vascular surgery, hernia surgery, colorectal cancer, pain, lung diseases, MVC, car accident, emergency medicine; Trauma care, emergency surgery, abdominal injuries, chest trauma, vascular injuries, nursing challenges, surgical innovation, CME credits, international collaboration, evidence-based practices.

Standardized surgical procedure for natural orifice specimen extraction surgery of precision functional sphincter-preserving surgery for ultra-low rectal cancer (NOSES-PPS) (2024 edition)

Natural orifice specimen extraction surgery of precision functional sphincter- preserving surgery for ultra-low rectal cancer (NOSES-PPS) is an innovative surgical technique that builds upon traditional laparoscopic surgery for low rectal cancer. This method utilizes a specially designed transparent screw-thread anal dilator and associated equipment to achieve precise tumor localization and resection through direct visualization via the anus. Digestive tract reconstruction is then accomplished using a combination of a precision circular stapler and manual suturing, thereby preserving sphincter function in patients with ultra-low rectal cancer. NOSES-PPS has been widely adopted across multiple provinces and cities in China, with over 500 cases successfully performed to date. The technique and its outcomes have been published in both national and international peer-reviewed journals, receiving significant recognition from the medical community. However, as a novel approach to rectal cancer surgery, there is currently a lack of authoritative clinical practice guidelines detailing the specific procedural steps of NOSES-PPS. To address this gap, the Colorectal Tumor Committee of the Chinese Medical Association, the Colorectal Cancer Committee of the Chinese Anti-cancer Association, and the China NOSES Collaborative Group have jointly led an effort to establish standardized guidelines for NOSES-PPS. This initiative involved the collaboration of experts in colorectal oncology from numerous large medical centers across China. Through multiple rounds of consultation and discussion, these experts have developed a comprehensive set of guidelines that detail the definition of NOSES-PPS, requirements for instrumentation, indications, key operative techniques, and the management of perioperative and postoperative complications. This guideline aims to promote the standardized implementation of NOSES-PPS in clinical practice.