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During different stages of the organizational life cycle we sometimes need more manager-oriented people and at other times more leader-oriented people. However most of the time we need them both in order to achieve a balance within the organization. Slovenia is a post-transition economy, facing new challenges and opportunities therefore the need for leader-oriented people is expected to be huge. Nevertheless our research showed that in Slovenian profit and non-profit organizations, upper management positions have been occupied by manager-oriented people but at the same time a balance exists between the two roles. We also found out that managers and leaders perceive the success of their organisations in quite a similar way. An adapted Hickman's questionnaire together with a content analysis of subordinates' comments about how they perceive their organization was used to ascertain the differences between them and their superiors. By knowing how employees perceive their managers and how the latter perceive themselves and their organizations we can develop better approaches to management development in post-transition economies.<\/jats:p>","DOI":"10.2478\/v10051-009-0006-1","type":"journal-article","created":{"date-parts":[[2009,8,21]],"date-time":"2009-08-21T21:18:23Z","timestamp":1250889503000},"page":"87-94","source":"Crossref","is-referenced-by-count":0,"title":["Managers and Leaders in Organizations of a Post-transition Economy"],"prefix":"10.2478","volume":"42","author":[{"given":"Mojca","family":"Prevodnik","sequence":"first","affiliation":[{"name":"Koper Faculty of Management, University of Primorska, Cankarjeva 5, 6000 Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Koper Faculty of Management, University of Primorska, Cankarjeva 5, 6000 Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2009,6,10]]},"container-title":["Organizacija"],"language":"en","link":[{"URL":"https:\/\/content.sciendo.com\/view\/journals\/orga\/42\/3\/article-p87.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/v10051-009-0006-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:02:54Z","timestamp":1777446174000},"score":17.9959,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/v10051-009-0006-1"}},"issued":{"date-parts":[[2009,5,1]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2009,6,10]]},"published-print":{"date-parts":[[2009,5,1]]}},"alternative-id":["10.2478\/v10051-009-0006-1"],"URL":"https:\/\/doi.org\/10.2478\/v10051-009-0006-1","ISSN":["1581-1832","1318-5454"],"issn-type":[{"value":"1581-1832","type":"electronic"},{"value":"1318-5454","type":"print"}],"published":{"date-parts":[[2009,5,1]]}},{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:35:49Z","timestamp":1793115349074,"version":"4.5.0"},"reference-count":0,"publisher":"School of Economics and Business University of Ljubljana","issue":"1","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Economic and Business Review"],"abstract":"<jats:p>Background and objective: In this paper, we explore first-generation leadership succession in family businesses which, despite extensive literature on the subject, remains insufficiently understood. Our goal is to acquire new knowledge and understanding regarding this phenomenon with a view to making it more effective.\nMethod: The basis of our research is a qualitative multiple case study that includes six medium-sized manufacturing family businesses. We conducted semi-structured interviews with incumbents, successors and family representatives, and analysed the data obtained using the content analysis method.\nResults: The data analysis and interpretation led to a definition of the category \u201cThe way ahead: the process of succession\u201d along with descriptions of its nine elements that help answer three research questions.\nConclusions: The research results show significant differences between the processes considered together with their uniqueness. While the need for succession planning and plan preparation is clearly expressed, no steps are taken due to the underestimation of its importance, the lack of both experience and relevant knowledge, often accompanied by emotional burdens that discourage planning.\nContribution: The study contributes original insights and new knowledge concerning the leadership succession process, succession planning, and its implementation.<\/jats:p>","DOI":"10.15458\/2335-4216.1316","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T05:23:03Z","timestamp":1677734583000},"page":"24-40","source":"Crossref","is-referenced-by-count":3,"title":["The Process of the Intergenerational Succession of Leadership in a Family Business"],"prefix":"10.15458","volume":"25","author":[{"given":"Bojan","family":"Dolar","sequence":"first","affiliation":[{"name":"University of Primorska, Faculty of Management, Koper, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"University of Primorska, Faculty of Management, Koper, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30783","published-online":{"date-parts":[[2023,3,1]]},"container-title":["Economic and Business Review"],"language":"en","link":[{"URL":"https:\/\/www.ebrjournal.net\/cgi\/viewcontent.cgi?article=1316&amp;context=home","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:23:16Z","timestamp":1793114596000},"score":17.829462,"resource":{"primary":{"URL":"https:\/\/www.ebrjournal.net\/home\/vol25\/iss1\/3"}},"issued":{"date-parts":[[2023,3,1]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,1]]}},"URL":"https:\/\/doi.org\/10.15458\/2335-4216.1316","ISSN":["2335-4216"],"issn-type":[{"value":"2335-4216","type":"electronic"}],"published":{"date-parts":[[2023,3,1]]}},{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T17:54:40Z","timestamp":1754157280956,"version":"3.41.2"},"reference-count":30,"publisher":"Emerald","issue":"5","license":[{"start":{"date-parts":[[2009,5,22]],"date-time":"2009-05-22T00:00:00Z","timestamp":1242950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2009,5,22]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>The basic purpose of this research is to study the influence selection factors have on the effectiveness of evolutionary change methods in civil engineering companies in Slovenia.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>A combination of qualitative and quantitative approaches to research work was applied. In the process of quantitative data analysis, the statistical methods of bivariant and multivariant analysis were used.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>Based on the results of the research, the authors can conclude that the size of a company has no effect on any of the dimensions in selection factors. On the other hand, in seven of the 16 evolutionary change methods applied by the companies, the research results have confirmed the importance of selection factors.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Research limitations\/implications<\/jats:title><jats:p>In the interpretation of research findings, it should be taken into account that, at the time the research was conducted, the civil engineering industry was undergoing a period of crisis and was ranked among the least profitable industries within the Slovene economy. For this reason, a generalisation of the research findings is not appropriate.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p>The research findings will allow executive managements to make a more efficient selection from the many available change methods, and also to apply them with greater efficiency. As a result, efficiency and effectiveness in companies can be expected to increase, which is of crucial importance when it comes to corporate entities operating in late\u2010transition or post\u2010transition environments.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>The article represents an original contribution to understanding the change method selection factors related to the size of companies, as well as their influence on the selected method of evolutionary change process.<\/jats:p><\/jats:sec>","DOI":"10.1108\/00251740910960079","type":"journal-article","created":{"date-parts":[[2009,5,30]],"date-time":"2009-05-30T07:06:20Z","timestamp":1243667180000},"page":"681-701","source":"Crossref","is-referenced-by-count":1,"title":["The influence of selection factors on evolutionary change methods"],"prefix":"10.1108","volume":"47","author":[{"given":"Peter","family":"Friedl","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","reference":[{"key":"key2022012120273396800_b1","unstructured":"Ansoff, I.H. 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(1998), \u201cWhy do employees resist change?\u201d, Harvard Business Review on Change, Harvard Business School Press, Boston, MA, pp. 139\u201058."}],"container-title":["Management Decision"],"language":"en","link":[{"URL":"http:\/\/www.emeraldinsight.com\/doi\/full-xml\/10.1108\/00251740910960079","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/00251740910960079\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/00251740910960079\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T23:44:17Z","timestamp":1753400657000},"score":17.767414,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/md\/article\/47\/5\/681-701\/282752"}},"subtitle":["A case in the civil engineering industry"],"issued":{"date-parts":[[2009,5,22]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2009,5,22]]}},"alternative-id":["10.1108\/00251740910960079"],"URL":"https:\/\/doi.org\/10.1108\/00251740910960079","ISSN":["0025-1747"],"issn-type":[{"type":"print","value":"0025-1747"}],"published":{"date-parts":[[2009,5,22]]}},{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:15:45Z","timestamp":1762521345496,"version":"3.41.2"},"reference-count":12,"publisher":"Emerald","issue":"2","license":[{"start":{"date-parts":[[2010,4,13]],"date-time":"2010-04-13T00:00:00Z","timestamp":1271116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2010,4,13]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p><jats:italic>The purpose of the paper is to present the common use of the Delphi method, the analytical hierarchy process (AHP) and dynamic fuzzy cognitive maps for the development of a future scenario in correlation with climate warming.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p><jats:italic>A combination of the Delphi method, the analytical hierarchy process (AHP) and dynamic fuzzy cognitive maps was employed to construct a future scenario as a learning device.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p><jats:italic>Based on the data, the future is not going to be so bad but also not very attractive even if it is assumed that human consciousness about global warming issues will remain high. After a few years or so it will be possible to stop negative climate processes but not possible to fix the problem in the sense that the situation we have now can be substantially improved.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p><jats:italic>This paper is of interest for foresight practitioners and policy makers who want to employ a hybrid approach to scenario development.<\/jats:italic><\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p><jats:italic>The paper is the first to try to use a combination of different methods for scenario development related to climate change.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1108\/14636681011035771","type":"journal-article","created":{"date-parts":[[2010,4,17]],"date-time":"2010-04-17T07:24:24Z","timestamp":1271489064000},"page":"38-48","source":"Crossref","is-referenced-by-count":24,"title":["Scenario planning for climate strategies development by integrating group Delphi, AHP and dynamic fuzzy cognitive maps"],"prefix":"10.1108","volume":"12","author":[{"given":"Roberto","family":"Biloslavo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Slavko","family":"Dolin\u0161ek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","reference":[{"key":"key2022031820092090100_b1","doi-asserted-by":"crossref","unstructured":"Armstrong, J.S. (Ed.) (2001), Principles of Forecasting: A Handbook for Researchers and Practitioners, Kluwer Academic, Boston, MA.","DOI":"10.1007\/978-0-306-47630-3"},{"key":"key2022031820092090100_b2","doi-asserted-by":"crossref","unstructured":"Eden, C. and Ackermann, F. (1998), Making Strategy \u2013 The Journey of Strategic Management, Sage Publications, London.","DOI":"10.4135\/9781446217153"},{"key":"key2022031820092090100_b3","unstructured":"Ghoshal, S., Bartlett, C.A. and Moran, P. (1999), \u201cA new manifesto for management\u201d, Sloan Management Review, Vol. 40 No. 3, pp. 9\u201020."},{"key":"key2022031820092090100_b4","unstructured":"Huff, A.S. (1990), Mapping Strategic Thought, Wiley, Chichester."},{"key":"key2022031820092090100_b5","unstructured":"Kosko, B. (1997), Fuzzy Engineering, Prentice\u2010Hall, Englewood Cliffs, NJ."},{"key":"key2022031820092090100_b6","unstructured":"Laukkanen, M. (1998), \u201cConducting casual mapping research: opportunites and challenges\u201d, in Eden, C. and Spender, J.C. (Eds), Managerial and Organisational Cognition, Sage Publications, Thousand Oaks, CA, pp. 168\u2010209."},{"key":"key2022031820092090100_b7","doi-asserted-by":"crossref","unstructured":"Li, S., Davies, B., Edwards, J., Kinman, R. and Duan, Y. (2002), \u201cIntegrating group Delphi, fuzzy logic and expert systems for marketing strategy development: the hybridisation and its effectiveness\u201d, Marketing Intelligence & Planning, Vol. 20 No. 5, pp. 273\u201094.","DOI":"10.1108\/02634500210441521"},{"key":"key2022031820092090100_b8","unstructured":"Linstone, H.A. and Turoff, M. (Eds) (1975), The Delphi Method: Technology and Application, Addison\u2010Wesley, Reading, MA."},{"key":"key2022031820092090100_b9","doi-asserted-by":"crossref","unstructured":"Lootsma, F.A. (1997), Fuzzy Logic for Planning and Decision Making, Kluwer Academic, Dordrecht.","DOI":"10.1007\/978-1-4757-2618-3"},{"key":"key2022031820092090100_b10","unstructured":"Porter, M.E. (1985), Competitive Advantage, The Free Press, New York, NY."},{"key":"key2022031820092090100_b11","doi-asserted-by":"crossref","unstructured":"Saaty, T.L. (1980), The Analytic Hierarchy Process, McGraw\u2010Hill, New York, NY.","DOI":"10.21236\/ADA214804"},{"key":"key2022031820092090100_b12","unstructured":"Saaty, T.L. (1994), Fundamentals of Decision Making and Priority Theory, University of Pittsburgh, Pittsburgh, PA."}],"container-title":["Foresight"],"language":"en","link":[{"URL":"http:\/\/www.emeraldinsight.com\/doi\/full-xml\/10.1108\/14636681011035771","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/14636681011035771\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/14636681011035771\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:32:01Z","timestamp":1753403521000},"score":17.767414,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/fs\/article\/12\/2\/38-48\/83820"}},"issued":{"date-parts":[[2010,4,13]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,4,13]]}},"alternative-id":["10.1108\/14636681011035771"],"URL":"https:\/\/doi.org\/10.1108\/14636681011035771","ISSN":["1463-6689"],"issn-type":[{"type":"print","value":"1463-6689"}],"published":{"date-parts":[[2010,4,13]]}},{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:05:47Z","timestamp":1787011547742,"version":"build-2736575974"},"reference-count":165,"publisher":"Emerald","issue":"6","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BPMJ"],"published-print":{"date-parts":[[2021,10,12]]},"abstract":"<jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title>\n                    <jats:p>This paper aims to define knowledge transfer and small and medium enterprise\u2019s (SME's) effectiveness. This research framework examines how employees understand, create and apply knowledge in a day-to-day working context, and how knowledge and other organisational factors influence knowledge transfer within the organisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title>\n                    <jats:p>\n                      A qualitative research approach was applied. The authors conducted semi-structured group interviews with the members of three departments of a small hi-tech company. All collected data were manually coded, using\n                      <jats:italic>in vivo<\/jats:italic>\n                      coding and discussed among the authors. As the continuation of the semi-structured group interview, the technique of cognitive maps was applied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Findings<\/jats:title>\n                    <jats:p>According to the results, the critical elements of knowledge transfer within small hi-tech companies seem (1) available slack time, (2) reciprocity and level of trust among employees, (3) social capital of employees and (4) practically oriented technical knowledge. It is also noted that the knowledge transfer is carried out to solve the problems identified by the employees, and these seek knowledge directly from the knowledge bearers who represent a kind of organisational memory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Practical implications<\/jats:title>\n                    <jats:p>Knowledge transfer in SMEs occurs almost exclusively face-by-face, and individuals involved pay attention to the time required by this process. The co-creation of an organisational space that allows and supports an open discussion within and between departments is therefore of fundamental importance in order not to preclude organisational learning. In addition, non-financial incentives must be established to help transfer tacit knowledge. This allows to overcome the difficulty of employees in recognising the organisational knowledge base that they see above all in themselves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title>\n                    <jats:p>This paper throws additional light on understanding how knowledge transfer happens within small hi-tech companies. The applied qualitative research methods allow a better understanding of the \u201chow\u201d and \u201cwhy\u201d questions associated with the social processes surrounding knowledge transfer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1108\/bpmj-10-2020-0441","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T09:58:11Z","timestamp":1629453491000},"page":"1747-1774","source":"Crossref","is-referenced-by-count":13,"title":["Knowledge transferring and small and medium enterprise\u2019s (SME's) effectiveness: emerging insights and future 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Sustainable practices in the hospitality sector optimize food production and use, introduce innovative solutions and increase employee satisfaction in running environmentally friendly restaurants. This study examines the changes required for a restaurant to make a sustainable transition and the role of key stakeholders (i.e., chefs, head sommeliers, owners and main suppliers) in this process. It focuses on a prestigious Slovenian restaurant that has been awarded a Michelin Green Star and is 80% self-sufficient. The single case study uses semi-structured interviews, the critical incident method and participant observation to collect data. The results showed that in the case of the analyzed restaurant, the lifestyle of the owner\/chef decisively shapes the culture of the restaurant, laying the foundation for its sustainable transformation. 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Corporate reputation, customer\u2010market scope and quality are also mentioned significantly less often in Slovene statements. Although some gaps between the theoretical ideal and corporate practice may exist in both settings, many differences may be explained by macroeconomic volatility, industry structure, and institutional environments.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Research limitations\/implications<\/jats:title><jats:p>Although the Slovene sample size is smaller than comparable US studies, it is an equivalent sample of the two nations' largest firms. The time difference between the Slovene and US samples is not a critical issue in this study since it mimics the time delay between the behaviour of the US firms and the subsequent behaviour of Slovene firms in writing mission statements.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p>The conclusions can help managers in US multinational firms to better understand some implicit differences in understanding organisations and their relationships with the business and social environment when they do business with firms from CEE.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>The paper presents what are differences between Slovene and American companies regarding mission statements content and stakeholders involved and it gives some possible explanations for them based on cultural and historical differences.<\/jats:p><\/jats:sec>","DOI":"10.1108\/00251740710746024","type":"journal-article","created":{"date-parts":[[2007,6,19]],"date-time":"2007-06-19T11:04:57Z","timestamp":1182251097000},"page":"773-788","source":"Crossref","is-referenced-by-count":22,"title":["Mission statements in Slovene enterprises"],"prefix":"10.1108","volume":"45","author":[{"given":"Roberto","family":"Biloslavo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monty","family":"Lynn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"140","reference":[{"key":"key2022031720471819500_b1","unstructured":"Agency of the Republic of Slovenia for Payments (2005), Seznam 100 najuspe\u0161nej\u0161ih podjetij po \u010distem dobi\u010dku v letu 2003, Agency of the Republic of Slovenia for Payments, Ljubljana."},{"key":"key2022031720471819500_b3","doi-asserted-by":"crossref","unstructured":"Andol\u0161ek, D.M. and \u0160tebe, J. 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Based on the literature review, we develop a KM audit instrument and apply it to a specific HE institution in order to assess the status of its KM processes. From our study, we can conclude that even if an institution is \u2018academic\u2019 in nature and apparently successful, this fact does not necessarily mean that KM processes are institutionalised within the organisation. From this point of view, a HE institution is likely to be subject to the same limitations as any other organisation in the knowledge business. Our paper further gives recommendations to managers of HE institutions on how to assess the effectiveness of KM in their organisations as well as providing information for other researchers who want to conduct a KM audit in similar organisations. 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However, \u201cgreen\u201d identity is not fully exploited in terms of being used as a distinctive feature of a company and as such it does not sufficiently contribute to gaining competitive advantage for a company.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-heading\">Research limitations\/implications<\/jats:title>\n                    <jats:p>Although constituted by all relevant Slovene companies, the sample is limited in size. Further research could be done with a larger sample to test the findings. Different tools and media of marketing communication and a stakeholder survey could confirm the importance of the findings and significance for green reputation development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title>\n                    <jats:p>Senior company management can use the findings from the research presented here as a starting\u2010point for the development of corporate reputation as a \u201cgreen\u201d company through appropriate use of corporate communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title>\n                    <jats:p>The research paper contributes to the scarce literature on green reputation development, which is almost non\u2010existent with regard to non\u2010multinational companies from post\u2010transition and transition economies. The paper also reveals new findings about the problem of standardisation within \u201cgreen\u201d marketing communication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1108\/00251740910978359","type":"journal-article","created":{"date-parts":[[2009,7,18]],"date-time":"2009-07-18T07:06:05Z","timestamp":1247900765000},"page":"1158-1173","source":"Crossref","is-referenced-by-count":70,"title":["Web sites as tools of communication of a \u201cgreen\u201d company"],"prefix":"10.1108","volume":"47","author":[{"given":"Roberto","family":"Biloslavo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Trnav\u010devi\u010d","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"140","reference":[{"key":"key2022012219424675700_b1","doi-asserted-by":"crossref","unstructured":"Alessandri, S.W. 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This study explores how Joint Sustainability Reports (JSR), built on the EU Voluntary Sustainability Reporting Standard for non-listed SMEs (VSME), can serve as a cooperative and digitally supported framework to enhance transparency, comparability, and efficiency while strengthening universities\u2019 third mission of societal engagement and knowledge transfer. Qualitative interviews with six sustainability experts from German and Austrian universities of applied sciences (UAS) highlight persistent challenges such as data gaps, staffing shortages, and weak strategic anchoring. The findings show that VSME-based JSRs, through shared data collection, centralised coordination, and modular reporting, enable resource and data pooling, standardised indicators, and cross-university synergies. 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The expert group was composed of seven experts from the field of management. The process ran for four rounds to reach the final consensus examining 25 dualities and eventually focusing them down to the final 23. In addition to their practical relevance of understanding the dualities, the findings also have implications for both the literature on strategic management and the paradox lens on organisational theory through an understanding of duality in terms of the TTOP model. 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Research data have been collected through a survey. The research sample was composed of 317 Bosnian companies that employ from 10 to 600 employees. Collected data were analysed by use of factor analysis and structural equation modelling. This is the first research carried out to prove influence of some organisational factors on knowledge management effectiveness in developing country such as Bosnia and Herzegovina by use of structural equation modelling. The research results suggest that organisational culture mediates the impact of human capital, information technology, organisational structure, and leadership on knowledge management effectiveness and confirm the hypothesis that the latter influences financial and nonfinancial indicators of business performance. The findings carry theoretical implications for knowledge management literature as they extend the scope of research on knowledge management from examining a set of independent organizational factors to examining a system\u2010wide mechanism that connects organisational elements and knowledge management effectiveness. 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content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>The paper presents the concept of duality, which presupposes the synthesis of two apparently opposing organisation's properties. The purpose of the paper is to empirically verify whether management of dualities correlates with effectiveness and efficiency of organisations.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>The research examines 21 dualities at the normative and strategic level of organisational policy. The research was undertaken in two phases. In the first phase, effectiveness and efficiency indicators were defined by applying the analytic hierarchy process method within an expert group. In the second phase, a questionnaire was sent to 49 CEOs of mid\u2010size and large companies operating in the food, beverage and foodstuff production industry in Slovenia. The questionnaire applied the semantic differential scale.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>The fundamental research hypothesis argues that organisations that are able to transcend the so\u2010called duality paradox thus enhance their effectiveness or\/and efficiency. The results partly confirm this fundamental hypothesis within the limitations of the research sample. In terms of future research, the findings offer a valuable starting point for studies involving a larger sample of industries and organisations.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p>The research findings present enough evidence that although management of dualities does not assure effectiveness and efficiency of organisation, it is a core driver that should enhance a firm's performance relative to its competitors. This means that managers need to develop an ability to constructively face the tensions of opposing dualities, and instead of choosing one at the expense of the other, generating a creative solution of the tensions in the form of a new dynamic model that recognizes dualities as complements and not as forces facing each other.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>From a theoretical point of view, it has been observed that management and organisational research have been mainly focused on the definition of organisational dualities or paradoxes and how organisations can sustain competing demands simultaneously. 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The main objective of the study was to research if companies\u2019 environmental performance relates to the quality of information contained in the environmental reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In order to assess the environmental performance of companies involved we develop the Environmental Performance Index based on the Slovenian Environment Agency\u2019s data on emissions in air, water and waste. We measured the correlation between the Environmental Performance Index and quality of environmental reporting using Spearman\u2019s correlation coefficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Conclusion<\/jats:title>\n                    <jats:p>The results of our analyses revealed that there is no significant correlation between companies\u2019 environmental performance and the quality of their environmental reporting. However, the reasons for the obtained result can be at least partially attributed to the low quality level of analysed environmental reports. This is a reason why the calculated correlation is not as tangible as it would be if company reports would provide more information and therefore more data for analysis. Our findings suggest that voluntary environmental reporting should be complemented by legally defined mandatory elements for such reporting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/orga-2023-0021","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T04:56:25Z","timestamp":1700196985000},"page":"309-323","source":"Crossref","is-referenced-by-count":4,"title":["Relationship Between Environmental Reports and Environmental Performance: A case of the Processing Industry in the Republic of Slovenia"],"prefix":"10.2478","volume":"56","author":[{"given":"Sonja","family":"Fink Babi\u010d","sequence":"first","affiliation":[{"name":"Lampret Consulting , Nova Gorica , Slovenija"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"University of Primorska , Faculty of Management , Koper , Slovenija"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borut","family":"Kodri\u010d","sequence":"additional","affiliation":[{"name":"University of Primorska , Faculty of Management , Koper , Slovenija"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"2026042900261514449_j_orga-2023-0021_ref_001","doi-asserted-by":"crossref","unstructured":"Acar, M. & Temiz, H. 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Semistructured interviews, with top and middle management, were conducted together with the analysis of several internal and external documents, to corroborate the case analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Findings<\/jats:title>\n                    <jats:p>Results show how the potentiality of digital technologies allows the development of new sustainable business models, which, though, still need to gain legitimation to be accepted. The study findings allow drawing both on the business model innovation theory and on the legitimation theory, as they show how legitimation is a dynamic concept that involves internal as well as external stakeholders to support business model innovation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title>\n                    <jats:p>The paper is novel, since it addresses the topic of sustainable business models development, showing how companies can get legitimation. The paper builds on existing theories and provides a practical example.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1108\/md-09-2019-1296","type":"journal-article","created":{"date-parts":[[2020,6,15]],"date-time":"2020-06-15T09:47:37Z","timestamp":1592214457000},"page":"1643-1662","source":"Crossref","is-referenced-by-count":63,"title":["Business model transformation toward sustainability: the impact of 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Having adopted various domains of the Cynefin framework, the research explores AI's transformative potential and provide insights regarding how organisations can harness AI-driven solutions for strategic planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/methodology\/approach<\/jats:title>\n                    <jats:p>This conceptual paper theorises the role of AI in strategic planning process in a VUCA world by integrating extant knowledge across multiple literature streams. The \u201cmodel paper\u201d approach was adopted to provide a theoretical framework predicting relationships among considered concepts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The paper highlights potential application of the Cynefin framework to manage complexities in strategic decision-making process, the transformative impact of AI at different stages of strategic planning, the required strategic planning characteristics within VUCA to be supported by AI and the attendant challenges posed by AI integration in the uncertain business landscape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Originality\/value<\/jats:title>\n                    <jats:p>This study pioneers a theoretical exploration of AI's role in strategic planning within the VUCA business landscape, guided by the Cynefin framework. 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All rights reserved. Published by Elsevier Ltd. All rights reserved.","name":"copyright","label":"Copyright"}]},{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T08:11:35Z","timestamp":1792743095798,"version":"4.5.0"},"reference-count":130,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A coach\u2019s managerial and pedagogical tasks in the sports training process constitute the substantive core of their work, while decision-making serves as the fundamental method underpinning these tasks. Some decisions made by coaches result from deliberate, analytical thinking, which involves extensive information gathering, analysis, and discussion. Others, however, are made quickly and spontaneously, triggered by unforeseen situations during training or competition that demand immediate action. Consequently, the purpose of this study is to develop a conceptual framework for understanding coaches\u2019 decision-making behavior in conventional sports. This framework aims to establish appropriate relationships between the various decisions coaches make during the training process and theoretical concepts related to decision-making, both in general and within the coaching context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To design the research, we used the methodology of a conceptual paper and a \u201cmodel paper\u201d approach, which seeks to build a theoretical framework that predicts relationships between distinct research concepts and scientific disciplines, aiming to integrate them into a cohesive model of coaches\u2019 decision-making behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The proposed conceptual framework encompasses a comprehensive range of situations that may arise during the sports training process and potential ways to address them. This framework identifies different types of decisions and characteristics associated with coaches\u2019 decision-making behavior. It incorporates various sport-specific and general theories of decision-making and cognitive functioning to offer a deeper understanding of how coaches process and execute decisions in diverse contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The developed conceptual framework outlines three primary types of decisions\u2014strategic, tactical, and operational\u2014each playing a distinct role in the broader sports training process. These decisions are based on different cognitive processes, which manifest in varied decision-making behaviors and are reinforced by specific leadership styles. The practical value of this framework lies in its potential application for selecting appropriate experts to address the diverse decision-making scenarios encountered in sports training. This ensures the alignment of decision-making styles with the requirements of specific training situations, thereby enhancing the effectiveness and outcomes of the coaching process.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyg.2024.1498186","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T01:14:00Z","timestamp":1736385240000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Conceptual framework of coaches\u2019 decision-making in conventional sports"],"prefix":"10.3389","volume":"15","author":[{"given":"Edvard","family":"Kolar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rado","family":"Pi\u0161ot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa\u0161a","family":"Veli\u010dkovi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matej","family":"Tu\u0161ak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1080\/00336297.2011.10483687","article-title":"Taking the next step: ways forward for coaching science","volume":"63","author":"Abraham","year":"2011","journal-title":"Quest"},{"key":"ref2","article-title":"Professional judgement and decision making in sport coaching: to jump or not to jump","volume-title":"International conference on naturalistic decision making 2015","author":"Abraham","year":"2015"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1080\/02640410500189173","article-title":"The coaching schematic: validation through expert coach consensus","volume":"24","author":"Abraham","year":"2006","journal-title":"J. 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The study compares the implementation of a waste recycling protocol (WRP) in the operating rooms of two hospitals: Cattinara University Hospital (CU) and Sahlgrenska University Hospital (SU). The aim was to quantify biocontaminated waste management before and after WRP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>At CU, after waste monitoring (November 2023-March 2024), a structured WRP was introduced, including containers for plastic, glass, paper, metal, general and biocontaminated waste, staff training, and informative posters, and the results were recorded (June 2023-April 2024). At SU, waste was monitored from February to April 2024, along with number\/type of surgical procedures. CO\u2082-equivalent (CO\u2082e) emissions were calculated using standardized emission factors for each waste category.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Result<\/jats:title>\n                  <jats:p>Before WRP at CU, 2,203 kg waste were produced (all \u201cbiocontaminated\u201d), resulting in 8,371kg CO\u2082e and \u20ac3,082 costs. After WRP, 11,689kg of waste were generated, of which 2,549kg (21.8%) was recycled. CO\u2082e was reduced by 5,133kg (11.6%) with cost savings of \u20ac2,203 (13.5%).<\/jats:p>\n                  <jats:p>At SU (26 surgical procedures: 46 % open, 54% laparoscopic), 376kg waste was produced: 2.5% cardboard, 3.9% plastic, 53.7% general, and 36.7% biocontaminated waste. CO\u2082e was 1,597kg: 63.2% from general and 32.8% from biocontaminated waste. WRP implementation started in January 2025.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Recycling in operating rooms is feasible and effective when paired with staff training and targeted infrastructure changes. The results highlight the potential for waste reduction and carbon savings through systematic waste segregation and support broader adoption of sustainability strategies for environmentally responsible and resource-efficient surgery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf149.051","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T23:02:04Z","timestamp":1755039724000},"source":"Crossref","is-referenced-by-count":0,"title":["Sustainability in surgery: comparison of waste management optimization between two European centers"],"prefix":"10.1093","volume":"112","author":[{"given":"Manuela","family":"Mastronardi","sequence":"first","affiliation":[{"name":"Cattinara University Hospital , Trieste ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Cattinara University Hospital , Trieste ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"de Manzini","sequence":"additional","affiliation":[{"name":"Cattinara University Hospital , Trieste ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Cattinara University Hospital , Trieste ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luana","family":"Genova","sequence":"additional","affiliation":[{"name":"San Raffaele Hospital , Milan ,","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Rangelova","sequence":"additional","affiliation":[{"name":"Sahlgrenska University Hospital , Gothenburg ,","place":["Sweden"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,11]]},"container-title":["British Journal of Surgery"],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/Supplement_11\/znaf149.051\/63986065\/znaf149.051.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/Supplement_11\/znaf149.051\/63986065\/znaf149.051.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T23:02:04Z","timestamp":1755039724000},"score":11.531364,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znaf149.051\/8227521"}},"issued":{"date-parts":[[2025,8]]},"references-count":0,"journal-issue":{"issue":"Supplement_11","published-online":{"date-parts":[[2025,8,11]]},"published-print":{"date-parts":[[2025,8,11]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znaf149.051","ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,8]]},"article-number":"znaf149.051"},{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T07:09:05Z","timestamp":1782544145706,"version":"3.54.5"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,8,23]],"date-time":"2020-08-23T00:00:00Z","timestamp":1598140800000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A 64-year-old man underwent catheter ablation (CA) of atrial fibrillation with intracardiac echocardiography (ICE) assistance. As the probe was advanced toward the right atrium, sudden abdominal pain was felt by the patient with hypotension and tachycardia requiring fluids and vasopressors for hemodynamic stabilization. The inferior vena cava (IVC) was injured by the passing probe and open repair was then performed. To our knowledge, this is the first reported case of symptomatic IVC laceration by the probe used for ICE during CA.<\/jats:p>","DOI":"10.1093\/jscr\/rjaa201","type":"journal-article","created":{"date-parts":[[2020,5,30]],"date-time":"2020-05-30T19:08:49Z","timestamp":1590865729000},"source":"Crossref","is-referenced-by-count":5,"title":["An uncommon case of inferior vena cava injury during atrial fibrillation ablation"],"prefix":"10.1093","volume":"2020","author":[{"given":"Manuela","family":"Pastoricchio","sequence":"first","affiliation":[{"name":"Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, Cattinara University Hospital, Trieste 34149, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Dell\u2019Antonio","sequence":"additional","affiliation":[{"name":"Division of Clinical Surgery, Department of Medical, Surgical and Health Sciences, Cattinara University Hospital, Trieste 34149, 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This approach provides a bridge or link between different concepts and scientific disciplines. The methodological approach was the \u201cmodel paper\u201d which aims to provide a theoretical framework that predicts relationships between concepts. A model paper identifies connections between constructs and introduces new constructs.\nFindings: The development of the substantive model for the preparation of the NSS revealed that the comprehensive sport system at the national level can be understood within the framework of five substructures (financial, organizational, developmental, material, and program) that contribute significantly to the development and implementation of activities related to sport and physical activity. They are interconnected and interdependent and are surrounded by a so-called integrity framework that protects the sport system from the deviations of modern society. The methodological process model reveals that for the implementation of the process of NSS preparation, the most appropriate is the strategic management methodology, which enables accurate and efficient management of planning, organization, implementation, and control of the NSS. 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Cochrane Database Syst Rev. 2015;2015(7):CD009919. https:\/\/doi.org\/10.1002\/14651858.CD009919.pub2.","journal-title":"Cochrane Database Syst Rev"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02689-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-024-02689-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02689-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T21:02:02Z","timestamp":1770757322000},"score":11.134005,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-024-02689-3"}},"issued":{"date-parts":[[2025,1,9]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["2689"],"URL":"https:\/\/doi.org\/10.1007\/s00068-024-02689-3","ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"published":{"date-parts":[[2025,1,9]]},"assertion":[{"value":"25 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Authors have no conflict of interest to declare","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"3"},{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:47:03Z","timestamp":1787010423076,"version":"build-2736575974"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Trauma Acute Care Surg"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Although contrast-enhanced abdominal computed tomography (CEACT) is still considered the criterion standard for the assessment of suspected acute diverticulitis, in recent years, the use of point-of-care ultrasound (POCUS) has been spreading more and more in this setting. The aim of this study was to compare CEACT to POCUS for the diagnosis and staging of suspected acute diverticulitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      This is a prospective study conducted on 55 patients admitted to the emergency department of two Italian Hospitals with a clinical suspicion of acute diverticulitis between January 2014 and December 2017. All the patients included underwent POCUS first and CEACT immediately afterward, with the diagnosis and the staging reported according to the Hinchey (H) classification modified by Wasvary et al. [Wasvary H, Turfah F, Kadro O, Beauregard W. Same hospitalization resection for acute diverticulitis.\n                      <jats:italic toggle=\"yes\">Am Surg<\/jats:italic>\n                      . 1999;65:632\u2013635.] Three surgeons performed all the POCUS, and the same two radiologists retrospectively analyzed all the CEACT images. The radiologists were informed of the clinical suspicion but unaware of the POCUS findings. The CEACT was used as the criterion standard for the comparison.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The final cohort included 30 females (55%) and 25 males (45%). The median age was 62 years (range, 24\u201388 years), and the median body mass index was 26 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (range, 19\u201342 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ). Forty-six of 55 patients had a confirmed diagnosis of acute diverticulitis on both POCUS and CEACT, whereas, in 7 patients, the diagnosis was not confirmed by both methods. Point-of-care ultrasound sensitivity and specificity were 98% and 88%, respectively. Point-of-care ultrasound positive and negative predictive values were 98% and 88%, respectively. Point-of-care ultrasound accuracy was 96%. Point-of-care ultrasound classified 33 H1a, 11 H1b, 1 H2, and 1 H3 acute diverticulitis. This staging was confirmed in all patients but three (93%) by CEACT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Point-of-care ultrasound appeared a reliable technique for the diagnosis and the staging of clinically suspected H1 and H2 acute diverticulitis. It could contribute in saving time and resources and in avoiding unnecessary radiation exposure to most patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LEVEL OF EVIDENCE<\/jats:title>\n                    <jats:p>Diagnostic test, level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/ta.0000000000003229","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:02:26Z","timestamp":1623283346000},"page":"393-398","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Surgeon-performed ultrasound for the staging of acute diverticulitis: Preliminary results of a prospective study"],"prefix":"10.1097","volume":"91","author":[{"given":"Mauro","family":"Zago","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mariani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Alessandra","family":"Pestalozza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Poillucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Bellio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"bib1-20250806","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1177\/1756283X15621228","article-title":"Diverticulosis today: Unfashionable and still under-researched","volume":"9","year":"2016","journal-title":"Therap Adv Gastroenterol"},{"key":"bib2-20250806","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5009\/gnl16552","article-title":"Diverticular disease: an update on pathogenesis and management","volume":"12","year":"2018","journal-title":"Gut 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A systematic review and meta-analysis","volume":"23","year":"2019","journal-title":"Tech Coloproctol"},{"key":"bib40-20250806","first-page":"179","article-title":"Antibiotics versus no antibiotics in the treatment of acute uncomplicated diverticulitis \u2014 a systemic review and meta-analysis","volume":"20","year":"2018","journal-title":"Int J Lab Hematol"},{"key":"bib41-20250806","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/j.ejim.2013.03.016","article-title":"Treatment of elderly patients with uncomplicated diverticulitis, even with comorbidity, at home","volume":"24","year":"2013","journal-title":"Eur J Intern Med"}],"container-title":["Journal of Trauma and Acute Care Surgery"],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/TA.0000000000003229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T16:06:05Z","timestamp":1754496365000},"score":11.007652,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/TA.0000000000003229"}},"issued":{"date-parts":[[2021,6,10]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/ta.0000000000003229","ISSN":["2163-0763","2163-0755"],"issn-type":[{"value":"2163-0763","type":"electronic"},{"value":"2163-0755","type":"print"}],"published":{"date-parts":[[2021,6,10]]}},{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T01:03:04Z","timestamp":1777683784699,"version":"3.51.4"},"reference-count":63,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HSM"],"published-print":{"date-parts":[[2023,1,24]]},"abstract":"<jats:p>BACKGROUND: In the last 15 years, theoretical discussions, and empirical research on the domain of business models have grown significantly. Different authors understand and focus on either constituencies of business models or narratives. The question remains what the predictive value of business model is. OBJECTIVES: The purpose of this interdisciplinary conceptual paper is to investigate and discuss business models as scientific models. METHODS: This article is conceptual, although previous studies on business models enrich this discussion. RESULTS: A narrative perspective on business models shows that they also have a predictive value that is expressed through language not in numbers, maps, and diagrams. The process of reflexivity that is contextualised and bounded in the form of a narrative lies at the centre of designing and changing the business model. The article provides substantial discussion on business models as scientific models, and their predictive power. These concepts have not been deeply discussed yet. CONCLUSIONS: An argument is provided to support the proposition that business models can be considered as scientific models that is, however, embedded in specific organizational, cultural, and technological contexts. Future research needs to be directed towards the empirical analysis of narratives in companies.<\/jats:p>","DOI":"10.3233\/hsm-220036","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T11:08:44Z","timestamp":1657278524000},"page":"15-25","source":"Crossref","is-referenced-by-count":2,"title":["Business models as scientific models: The question of perspective?"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3120-6821","authenticated-orcid":false,"given":"Anita","family":"Trnav\u010devi\u0107","sequence":"first","affiliation":[{"name":"University of Primorska, Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6135-0536","authenticated-orcid":false,"given":"Roberto","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"University of Primorska, Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1031-0611","authenticated-orcid":false,"given":"Tine","family":"Bertoncel","sequence":"additional","affiliation":[{"name":"Faculty of Organisation Studies, Novo Mesto, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1625-0499","authenticated-orcid":false,"given":"Carlo","family":"Bagnoli","sequence":"additional","affiliation":[{"name":"University Ca' Foscari, Venice, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5678-0737","authenticated-orcid":false,"given":"Aleksander","family":"Jane\u0161","sequence":"additional","affiliation":[{"name":"University of Primorska, Koper, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7092-4944","authenticated-orcid":false,"given":"Bernard","family":"McKenna","sequence":"additional","affiliation":[{"name":"University of Queensland Business School, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3291-673X","authenticated-orcid":false,"given":"\u00c7a\u011fri","family":"Bulut","sequence":"additional","affiliation":[{"name":"Yasar University, Izmir, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/HSM-220036_ref1","unstructured":"Bauman Z Globalization: the human consequences. 59025th ed. 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They can be isolated or multiple and can involve the duodenum, jejunum and ileum. Acute complications are extremely rare, with an aspecific pattern of symptoms. The aim of the study is to report the different patterns of presentation of patients with complicated jejunoileal diverticula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective descriptive study on a consecutive series of patients admitted for complicated jejunoileal diverticula in four Italian surgical departments between 2012 and 2019. Complications included acute diverticulitis, bleeding, perforation and intestinal obstruction. Patients presenting with complicated duodenal or Meckel's diverticula were not included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six patients were enrolled. The median age was 77 (46\u201394) years. Abdominal pain, fever and nausea\/vomiting were the most frequent symptoms at presentation. Abdominal computed tomography (CT) was diagnostic in 35% of patients. Ten (38%) patients had bowel perforation, nine (35%) acute diverticulitis, five (19%) bowel obstruction and two (8%) had intestinal bleeding. Twenty\u2010one (81%) patients underwent surgery, two (8%) were managed by CT\u2010guided drainage of collections and three (11%) were treated with antibiotics. One patient died post\u2010operatively. The median hospital stay was 9 (5\u201362) days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acutely complicated jejunoileal diverticula are infrequent, but a strong suspect should be raised whenever elderly patients are admitted for unspecific abdominal pain with a non\u2010diagnostic CT scan. Conservative management may be offered in very selected cases if a diagnosis is obtained, but in most instances, surgery is both diagnostic and therapeutic.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.16128","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T02:47:39Z","timestamp":1594003659000},"page":"1454-1458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Jejunoileal diverticula: a\n                    <scp>broad spectrum<\/scp>\n                    of complications"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0864-4420","authenticated-orcid":false,"given":"Gabriele","family":"Bellio","sequence":"first","affiliation":[{"name":"Department of General Surgery Cattinara Hospital  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Emergency Surgery and Trauma Unit, Department of Surgery Humanitas Clinical and Research Center  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Zago","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Minimally Invasive Surgery Unit San Pietro General Hospital  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-3370","authenticated-orcid":false,"given":"Dario","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery Cisanello Hospital  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Chiarugi","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery Cisanello Hospital  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Coppola","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Minimally Invasive Surgery Unit San Pietro General Hospital  Bergamo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cattinara Hospital  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"de Manzini","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cattinara Hospital  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000343598"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.12659\/PJR.895354"},{"key":"e_1_2_7_4_1","first-page":"7","article-title":"Jejunal diverticulitis ascending to the duodenum as a rare cause of acute abdomen","volume":"8","author":"Fresow R","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330842"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4733.18.07745-3"},{"key":"e_1_2_7_7_1","first-page":"11","article-title":"Ileal diverticulitis: an uncommon diagnosis for right lower quadrant pain","volume":"11","author":"Kleyman S","year":"2012","journal-title":"J. Surg. Case Rep."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-4-172"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.14.5916"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.15422\/amsrj.2015.03.016"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)33700-8"},{"key":"e_1_2_7_13_1","first-page":"20","article-title":"Laparoscopic vs. open approach for pT3\/pT4 colorectal cancer in the elderly: ten\u2010year experience in a single center","volume":"73","author":"Troian M","year":"2018","journal-title":"Minerva Chir."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1986.tb01820.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1971.01350030010002"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v3.i4.49"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e328303bfdb"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2008.04.023"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v2.i1.26"},{"key":"e_1_2_7_20_1","first-page":"1929","article-title":"Non surgical management of acute jejunal diverticulitis: a review","volume":"92","author":"Novak J","year":"1997","journal-title":"Am. J. Gastroenterol."},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i34.4714"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1963.01310110042007"},{"key":"e_1_2_7_23_1","first-page":"8162797","article-title":"Flare\u2010up diverticulitis in the terminal ileum in short interval after conservative therapy: report of a case","volume":"2016","author":"Nakatani K","year":"2016","journal-title":"Case Rep. Surg."},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i36.10480"}],"container-title":["ANZ Journal of Surgery"],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fans.16128","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16128","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.16128","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16128","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T19:00:52Z","timestamp":1693940452000},"score":9.857874,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.16128"}},"issued":{"date-parts":[[2020,7]]},"references-count":23,"journal-issue":{"issue":"7-8","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1111\/ans.16128"],"URL":"https:\/\/doi.org\/10.1111\/ans.16128","archive":["Portico"],"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2020-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]},{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:38:37Z","timestamp":1791999517318,"version":"4.4.0"},"reference-count":39,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T00:00:00Z","timestamp":1732838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Acute cholecystitis (AC) presents a significant burden in emergency surgical settings. Early laparoscopic cholecystectomy (ELC) is the standard of care for AC, yet its implementation varies. This study aims to assess the impact of preoperative waiting time (WT) on postoperative length of stay (LOS) in patients undergoing urgent cholecystectomy. Methods: From June 2021 to September 2022, data on patients undergoing urgent cholecystectomy for AC or pancreatitis were collected from two university hospitals. Patients were categorized into early (ELC) or delayed (DLC) cholecystectomy groups based on WT. The primary outcome was the assessment of the variables influencing LOS via univariate and multivariate analyses. Results: This study included 170 patients, predominantly female, with a median age of 64.50 years. ELC was performed in 58.2% of cases, with a median WT of 0 days, while DLC was performed in 41.8%, with a median WT of 3 days. Postoperative complications occurred in 21.8% of cases, with LOS being significantly shorter in the ELC group (median 5 days vs. 9 days; p = 0.001). Multivariate analysis confirmed that WT (OR 8.08 (1.65\u201377.18; p = 0.033)) was the most important predictor of LOS. Conclusions: ELC is associated with a shorter LOS and with DLC, aligning with the WSES recommendations. Earlier surgery reduces the risk of complications and overall hospital costs. An extended WT contributes to a prolonged LOS, underscoring the importance of timely access to operating theaters for acute biliary pathologies.<\/jats:p>","DOI":"10.3390\/jcm13237263","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T08:24:14Z","timestamp":1732868654000},"page":"7263","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Preoperative Waiting Time Affects the Length of Stay of Patients Treated via Laparoscopic Cholecystectomy in an Acute Care Surgical Setting"],"prefix":"10.3390","volume":"13","author":[{"given":"Livia","family":"Bressan","sequence":"first","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy"},{"name":"Department of General Surgery, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste University, Strada di Fiume 447, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0838-964X","authenticated-orcid":false,"given":"Matteo Maria","family":"Cimino","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Vaccari","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenia","family":"Capozzela","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste University, Strada di Fiume 447, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste University, Strada di Fiume 447, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Porta","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Bortul","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI), Trieste University, Strada di Fiume 447, 34149 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayato","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/TA.0000000000000699","article-title":"Operative delay to laparoscopic cholecystectomy: Racking up the cost of health care","volume":"79","author":"Schwartz","year":"2015","journal-title":"J. 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For this type of study formal consent by the institutional research committee\u00a0is\u00a0not\u00a0required in Italy.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}},{"value":"Informed consent was obtained from all individual participants included in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]},{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:55:06Z","timestamp":1788353706576,"version":"build-2803163510"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Infected necrotizing pancreatitis and walled-off necrosis are associated with substantial morbidity and mortality. The evolution from open necrosectomy to minimally invasive and endoscopic strategies has improved outcomes, yet complex cases may require multimodal approaches. Materials and Methods: A systematic literature search was performed across PubMed, Web of Science, and Google Scholar from inception to 15 July 2024, following PRISMA 2020 guidelines. Only RCTs directly comparing endoscopic and surgical necrosectomy were included. We analyzed RCTs enrolling adults with infected necrotizing pancreatitis or symptomatic\/infected walled-off necrosis, irrespective of etiology, comparing endoscopic step-up strategies with surgical or minimally invasive step-up approaches. Outcomes assessed included mortality, complications, hospital stay, long-term pancreatic function, and quality of life. Results: Six RCTs comprising 1045 patients were identified. Endoscopic necrosectomy demonstrated comparable mortality to surgical or minimally invasive step-up approaches (8\u201318% vs. 6\u201315%) but significantly reduced rates of pancreatic fistula (8% vs. 34%, p &lt; 0.01), new-onset organ failure, and, in several studies, shortened hospital stay. Median timing of intervention ranged from 4 to 6 weeks after pancreatitis onset, although some trials reported earlier or delayed drainage, highlighting variability in clinical practice. Long-term endocrine and exocrine pancreatic function, as well as quality of life, were largely similar between techniques, although early recovery and physical functioning scores favored endoscopy in selected studies. Conclusions: Endoscopic necrosectomy offers a safer peri-procedural profile compared with surgical approaches, but complex or anatomically unfavorable necrosis may still require surgical intervention. Individualized multimodal management, informed by evolving evidence, represents the cornerstone of modern care for patients with infected necrotizing pancreatitis and walled-off necrosis.<\/jats:p>","DOI":"10.3390\/medicina61122149","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T12:39:43Z","timestamp":1764679183000},"page":"2149","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Endoscopic Versus Surgical Management for Infected Necrotizing Pancreatitis and Walled-Off Necrosis: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3525-3692","authenticated-orcid":false,"given":"Manuela","family":"Mastronardi","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"},{"name":"General Surgery Unit, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0658-622X","authenticated-orcid":false,"given":"Giada","family":"Moghnie","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9227-8613","authenticated-orcid":false,"given":"Sara","family":"Crociato","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2856-8311","authenticated-orcid":false,"given":"Chiara","family":"Menghini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-791X","authenticated-orcid":false,"given":"Alessio Biagio Filippo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0565-0489","authenticated-orcid":false,"given":"Paola","family":"Germani","sequence":"additional","affiliation":[{"name":"General Surgery Unit, Cattinara University Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9698-9110","authenticated-orcid":false,"given":"Margherita","family":"Sandano","sequence":"additional","affiliation":[{"name":"Department of Surgery, San Carlo Borromeo Hospital, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8362-9044","authenticated-orcid":false,"given":"Nicol\u00f2","family":"de Manzini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Health Sciences, University of Trieste, 34129 Trieste, Italy"},{"name":"Department of Surgery, San Carlo Borromeo Hospital, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-2744","authenticated-orcid":false,"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of Surgery, San Carlo Borromeo Hospital, Azienda Socio-Sanitaria Territoriale Santi Paolo e Carlo, 20142 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ben-Ami Shor, D., Ritter, E., Borkovsky, T., and Santo, E. 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Sweden, Tallaght University Hospital, Tallaght, Ireland, Trieste University Hospital, Trieste, Italy, Helsinki University Hospital, Helsinki, Finland, Karolinska University Hospital, Stockholm, Sweden, Humanitas Clinical and Research Center, Milano, Italy, Orebro University Hospital, Orebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, PA, Orebro University Hospital, Orebro, Sweden, Tallaght University Hospital, Tallaght, Ireland, Trieste University Hospital, Trieste, Italy, Helsinki University Hospital, Helsinki, Finland, Karolinska University Hospital, Stockholm, Sweden, Humanitas Clinical and Research Center, Milano, Italy, Orebro University Hospital, Orebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,10,17]]},"container-title":["Journal of the American College of 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Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Trauma Acute Care Surg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>Preoperative identification of the cause of adhesive small bowel obstruction (ASBO) is crucial for decision making. Some computed tomography (CT) findings can be indicative of single adhesive bands or matted adhesions. Our aim was to build a predictive model based on CT data to discriminate ASBO due to single adhesive band or matted adhesions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A retrospective single center study was conducted, covering all consecutive patients with a preoperative CT scan, undergoing urgent surgery for ASBO between January 1, 2005, and December 31, 2017. Preoperative CT scans were blindly reviewed, and all the CT findings indicative of single adhesive band or matted adhesions described in literature were recorded. According to intraoperative findings, ASBOs were retrospectively classified into single band and matted ASBO. All observed CT findings were compared between the two groups. A predictive model based on logistic regression was developed, and its ability was quantified by discrimination and calibration. Internal cross-validation was conducted by bootstrap resampling.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>A total of 116 patients were analyzed (males, 53.5%; median age, 68 years; single band ASBO in 65.5% of cases). The odds of single band ASBO were increased four times in presence of complete obstruction (odds ratios, 4.19; 95% confidence interval, 1.49\u201312.56) and seven times in presence of fat notch sign (odds ratios, 7.37; 95% confidence interval, 1.83\u201340.03). The predictive model combining all CT findings had an accuracy of 86% in single band ASBO prediction. Accuracy decreased to 79% in the internal validation. Sensitivity, specificity, and positive and negative predictive values were calculated at different cut-points of the predicted risk: using a 0.70 cut-point, the specificity is 80%, the sensitivity is 68%, and the positive and negative predictive values are 87% and 57%, respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>The proposed predictive model based on combination of specific CT findings may elucidate whether ASBO is caused by single bands or matted adhesions and, consequently, influence the clinical pathway.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE<\/jats:title>\n            <jats:p>Prognostic study, level IV<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ta.0000000000003182","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T08:15:51Z","timestamp":1617351351000},"page":"917-923","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":14,"title":["Adhesive small bowel obstruction: Single band or matted adhesions? 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Radiol"},{"issue":"3","key":"bib15-20250806","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1148\/radiology.185.3.1438761","article-title":"Closed-loop and strangulating intestinal obstruction: CT signs","volume":"185","year":"1992","journal-title":"Radiology"},{"key":"bib16-20250806","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.jclinepi.2015.04.005","article-title":"Prediction models need appropriate internal, internal-external, and external validation","volume":"69","year":"2016","journal-title":"J Clin Epidemiol"},{"issue":"7","key":"bib17-20250806","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1007\/s11605-017-3418-x","article-title":"Defining the need for surgery in small-bowel obstruction","volume":"21","year":"2017","journal-title":"J Gastrointest Surg"},{"issue":"4","key":"bib18-20250806","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1177\/000313481207800428","article-title":"Factors predicting need for and delay in surgery in small bowel obstruction","volume":"78","year":"2012","journal-title":"Am Surg"},{"issue":"4","key":"bib19-20250806","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1002\/bjs.5775","article-title":"Meta-analysis of oral water-soluble contrast agent in the management of adhesive small bowel obstruction","volume":"94","year":"2007","journal-title":"Br J Surg"},{"issue":"5","key":"bib20-20250806","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/s004640000104","article-title":"Laparoscopic management of mechanical small bowel obstruction: are there predictors of success or failure?","volume":"14","year":"2000","journal-title":"Surg Endosc"},{"key":"bib21-20250806","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/1471-2482-14-77","article-title":"Laparoscopic versus open adhesiolysis for small bowel obstruction \u2014 a multicenter, prospective, randomized, controlled trial","volume":"14","year":"2014","journal-title":"BMC Surg"}],"container-title":["Journal of Trauma and Acute Care Surgery"],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/TA.0000000000003182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T16:19:37Z","timestamp":1754497177000},"score":8.553825,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/TA.0000000000003182"}},"issued":{"date-parts":[[2021,3,23]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/ta.0000000000003182","ISSN":["2163-0763","2163-0755"],"issn-type":[{"value":"2163-0763","type":"electronic"},{"value":"2163-0755","type":"print"}],"published":{"date-parts":[[2021,3,23]]}},{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:12:18Z","timestamp":1777515138603,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The ACS\u2010NSQIP surgical risk calculator (SRC) is an open\u2010access online tool that estimates the chance for adverse postoperative outcomes. The risk is estimated based on 21 patient\u2010related variables and customized for specific surgical procedures. The purpose of this monocentric retrospective study is to validate its predictive value in an Italian emergency setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January to December 2018, 317 patients underwent surgical procedures for acute cholecystitis (<jats:italic>n<\/jats:italic>\u2009=\u2009103), appendicitis (<jats:italic>n<\/jats:italic>\u2009=\u200983), gastrointestinal perforation (<jats:italic>n<\/jats:italic>\u2009=\u200945), and intestinal obstruction (<jats:italic>n<\/jats:italic>\u2009=\u200986). Patients\u2019 personal risk was obtained and divided by the average risk to calculate a personal risk ratio (RR). Areas under the ROC curves (AUC) and Brier score were measured to assess both the discrimination and calibration of the predictive model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The AUC was 0.772 (95%CI 0.722\u20130.817, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; Brier 0.161) for serious complications, 0.887 (95%CI 0.847\u20130.919, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; Brier 0.072) for death, and 0.887 (95%CI 0.847\u20130.919, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; Brier 0.106) for discharge to nursing or rehab facility. Pneumonia, cardiac complications, and surgical site infection presented an AUC of 0.794 (95%CI 0.746\u20130.838, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; Brier 0.103), 0.836 (95%CI 0.790\u20130.875, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; Brier 0.081), and 0.729 (95%CI 0.676\u20130.777, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; Brier 0.131), respectively. A RR\u2009&gt;\u20091.24, RR\u2009&gt;\u20091.52, and RR\u2009&gt;\u20092.63 predicted the onset of serious complications (sensitivity\u2009=\u200960.47%, specificity\u2009=\u200964.07%; NPV\u2009=\u200981%), death (sensitivity\u2009=\u200982.76%, specificity\u2009=\u200962.85%; NPV\u2009=\u200997%), and discharge to nursing or rehab facility (sensitivity\u2009=\u200980.00%, specificity\u2009=\u200969.12%; NPV\u2009=\u200995%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The calculator appears to be accurate in predicting adverse postoperative outcomes in our emergency setting. A RR cutoff provides a much more practical method to forecast the onset of a specific type of complication in a single patient.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05705-w","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T20:03:39Z","timestamp":1595621019000},"page":"3710-3719","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Is the ACS\u2010NSQIP Risk Calculator Accurate in Predicting Adverse Postoperative Outcomes in the Emergency Setting? An Italian Single\u2010center Preliminary Study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2222-3822","authenticated-orcid":false,"given":"Giovanni","family":"Scotton","sequence":"first","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Del Zotto","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalisa","family":"Zucca","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Terranova","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Fracon","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Paiano","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Cosola","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"de Manzini","sequence":"additional","affiliation":[{"name":"Department of General Surgery ASUGI, Cattinara Hospital Strada di Fiume 447 34149 Trieste TS Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0733\u20108627(02)00080\u20109"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2010.01.045"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.09.10"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640615606012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2017.09.015"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2013.07.385"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.12.05"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco\u20102017\u2010000160"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908500421"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.12126"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181c30fb2"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.03.040"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010018\u20104041\u20101"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.JNS161377"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.24357"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010016\u20104717\u20103"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmig.2016.10.005"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2019.0093"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2018.07.015"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001015"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001558"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481708300730"}],"container-title":["World Journal of Surgery"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05705-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-020-05705-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-020-05705-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-020-05705-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T16:14:37Z","timestamp":1703348077000},"score":8.484037,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-020-05705-w"}},"issued":{"date-parts":[[2020,7,24]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1007\/s00268-020-05705-w"],"URL":"https:\/\/doi.org\/10.1007\/s00268-020-05705-w","archive":["Portico"],"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"published":{"date-parts":[[2020,7,24]]},"assertion":[{"value":"8 July 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2020","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"All authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]},{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T09:43:14Z","timestamp":1780393394645,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to assess the indication for surgical treatment of incidentally discovered Meckel's diverticulum (MD) on the basis of clinical and histological features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The charts of patients undergoing surgery for MD were analysed. Two groups were identified: (1) patients who had incidentally discovered MD resected (incidental MD, IMD) and (2) patients who received first\u2010line surgery for a complicated MD (CMD). Demographics and intraoperative and post\u2010operative outcomes were compared. Histological findings were also analysed and compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010five patients were included in the study. IMD was observed in 39 patients (60%), while CMD was observed in 26 (40%). Male gender was significantly more frequent in CMD (<jats:italic>P<\/jats:italic> = 0.020), and mean age was significantly higher in IMD (<jats:italic>P<\/jats:italic> = 0.025). Body mass index and the American Society of Anesthesiologists score &gt;2 were similar in both groups. Laparoscopy was carried out in 36% of IMD and in 50% of CMD patients (<jats:italic>P<\/jats:italic> = 0.309). A tangential resection was performed in 92% of IMD and 73% of CMD patients (<jats:italic>P<\/jats:italic> = 0.07). No complications related to diverticular resection were found in IMD, while they occurred in 8% of CMD patients (<jats:italic>P<\/jats:italic> =\u20090.931). Meanly, diverticula were longer when complicated (<jats:italic>P<\/jats:italic> = 0.001). CMD showed significant histological differences and more frequent gastric ectopic mucosa (<jats:italic>P<\/jats:italic> =\u20090.039). A malignant tumour was incidentally found in IMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As surgery is mandatory in CMD, the optimal management of IMD remains uncertain. Mucosal abnormalities may favour complications, but these cannot be identified before excision. Stapled diverticulectomy is safe and effective. A surgical approach to IMD may prevent complications at a very low cost.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16189","type":"journal-article","created":{"date-parts":[[2020,8,12]],"date-time":"2020-08-12T04:31:11Z","timestamp":1597206671000},"page":"1694-1699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Incidentally discovered Meckel's diverticulum: should I stay or should I go?"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-3370","authenticated-orcid":false,"given":"Dario","family":"Tartaglia","sequence":"first","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Cremonini","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Strambi","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Ginesini","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cattinara University Hospital  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Paiano","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cattinara University Hospital  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Quilici","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Castagna","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salomone","family":"Di Saverio","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Insubria  Varese Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Coccolini","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Chiarugi","sequence":"additional","affiliation":[{"name":"Emergency Surgery Unit and Trauma Center The University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000154270.14308.5f"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(76)90043-X"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-199306000-00017"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2017.0180"},{"key":"e_1_2_7_6_1","first-page":"39","article-title":"Is incidental Meckel's diverticulum resected safely?","volume":"121","author":"Zulfikaroglu B","year":"2008","journal-title":"N. 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Gastroenterol."},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1080\/110241501316914894"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107680609901011"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31815aaaf8"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-004-7512-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908501010"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2006.11679933"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4293\/JSLS.2014.00349"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004649901167"},{"key":"e_1_2_7_22_1","first-page":"129","article-title":"Acute symptomatic Meckel diverticulum management. Our experience on seven consecutive cases","volume":"85","author":"Robustelli U","year":"2014","journal-title":"Ann. Ital. Chir."},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-008-9832-0"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.4170"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-1433.2004.03191.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00187950"}],"container-title":["ANZ Journal of Surgery"],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.16189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T05:57:02Z","timestamp":1693893422000},"score":8.484005,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.16189"}},"issued":{"date-parts":[[2020,8,11]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/ans.16189"],"URL":"https:\/\/doi.org\/10.1111\/ans.16189","archive":["Portico"],"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"published":{"date-parts":[[2020,8,11]]},"assertion":[{"value":"2020-06-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]},{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:52:29Z","timestamp":1786510349622,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T00:00:00Z","timestamp":1679788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>There is increasing recognition that point-of-care ultrasound (POCUS), performed by the clinician at the bedside, can be a natural extension of the clinical examination\u2014the modern abdominal \u201cstethoscope\u201d and provides an opportunity to expedite the care pathway for patients with acute gallbladder disease. The primary aims of this study were to benchmark the accuracy of surgeon-performed POCUS in suspected acute gallbladder disease against standard radiology or pathology reports and to compare time to POCUS diagnosis with time to definitive imaging. This prospective single-arm observational cohort study was conducted in four hospitals in Ireland, Italy, and Portugal to assess the accuracy of POCUS against standard radiology in patients with suspected acute biliary disease (ClinicalTrials.govIdentifier: NCT02682368). The findings of surgeon-performed POCUS were compared with those on definitive imaging or surgery. Of 100 patients recruited, 89 were suitable for comparative analysis, comparing POCUS with radiological findings in 84 patients and with surgical\/histological findings in five. The overall global accuracy of POCUS was 88.7% (95% CI, 80.3\u201394.4%), with a sensitivity of 94.7% (95% CI, 85.3\u201398.9%), a specificity of 78.1% (95% CI, 60.03\u201390.7%), a positive likelihood ratio (LR+) of 4.33 and negative likelihood ratio (LR) of 0.07. The mean time from POCUS to the final radiological report was 11.9 h (range 0.06\u201354.9). In five patients admitted directly to surgery, the mean time between POCUS and incision was 2.30 h (range 1.5\u20135), which was significantly shorter than the mean time to formal radiology report. Sixteen patients were discharged from the emergency department, of whom nine did not need follow-up. Our study is one of the very few to demonstrate a high concordance between surgeon-performed POCUS of patients without a priori radiologic diagnosis of gallstone disease and shows that the expedited diagnosis afforded by POCUS can be reliably leveraged to deliver earlier definitive care for patients with acute gallbladder pathology, as the general surgeon skilled in POCUS is uniquely positioned to integrate it into their bedside assessment.<\/jats:p>","DOI":"10.3390\/diagnostics13071248","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T01:38:36Z","timestamp":1679881116000},"page":"1248","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The Accuracy of Point-of-Care Ultrasound (POCUS) in Acute Gallbladder Disease"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4587-8792","authenticated-orcid":false,"given":"Bogdan-Daniel","family":"Dumbrava","sequence":"first","affiliation":[{"name":"Department of Surgery, Royal College of Surgeons in Ireland, Connolly Hospital, Blanchardstown, D02 YN77 Dublin, Ireland"},{"name":"Department of Surgery, Ponderas Academic Hospital, 014142 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary Alan","family":"Bass","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal College of Surgeons in Ireland, Connolly Hospital, Blanchardstown, D02 YN77 Dublin, Ireland"},{"name":"Division of Traumatology, Emergency Surgery & Surgical Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6469-2382","authenticated-orcid":false,"given":"Amro","family":"Jumean","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-0946","authenticated-orcid":false,"given":"Nuha","family":"Birido","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Corbally","sequence":"additional","affiliation":[{"name":"Department of Surgery, Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen 15503, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Surgery, Tondela-Viseu Hospital Center, Av. 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Surg."},{"key":"ref_5","first-page":"e11209","article-title":"Point-of-Care ultrasound training: An Assessment of Interns\u2019 needs and barriers to training","volume":"12","author":"Jarwan","year":"2020","journal-title":"Cureus"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00534-012-0568-9","article-title":"TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)","volume":"20","author":"Yokoe","year":"2013","journal-title":"J. Hepato-Biliary-Pancreat. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00068-016-0651-z","article-title":"Tailored Ultrasound Learning for Acute Care Surgeons. A Review of The Musec (Modular Ultrasound Estes Course) Project","volume":"42","author":"Zago","year":"2016","journal-title":"Eur. J. Trauma Emerg. 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(NOM) of traumatic splenic injuries in adults: a national 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For\u00a0this\u00a0type\u00a0of\u00a0study\u00a0a formal\u00a0ethical approval was not needed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]},{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:03:07Z","timestamp":1793250187005,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The American College of Surgeons NSQIP surgical risk calculator provides an estimation of 30-day postoperative adverse outcomes. It is useful in the identification of high-risk patients needing clinical optimization and supports the informed consent process. The purpose of this study is to validate its predictive value in the Italian emergency setting.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>STUDY DESIGN:<\/jats:title>\n            <jats:p>Six Italian institutions were included. Inclusion diagnoses were acute cholecystitis, appendicitis, gastrointestinal perforation or obstruction. Areas under the receiving operating characteristic curves, Brier score, Hosmer-Lemeshow index, and observed-to-expected event ratio were measured to assess both discrimination and calibration. Effect of the Surgeon Adjustment Score on calibration was then tested. A patient\u2019s personal risk ratio was obtained, and a cutoff was chosen to predict mortality with a high negative predicted value.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>A total of 2,749 emergency procedures were considered for the analysis. The areas under the receiving operating characteristic curve were 0.932 for death (0.921 to 0.941, p &lt; 0.0001; Brier 0.041) and 0.918 for discharge to nursing or rehabilitation facility (0.907 to 0.929, p &lt; 0.0001; 0.070). Discrimination was also strong (area under the receiving operating characteristic curve &gt;0.8) for renal failure, cardiac complication, pneumonia, venous thromboembolism, serious complication, and any complication. Brier score was informative (&lt;0.25) for all the presented variables. The observed-to-expected event ratios were 1.0 for death and 0.8 for discharge to facility. For almost all other variables, there was a general risk underestimation, but the use of the Surgeon Adjustment Score permitted a better calibration of the model. A risk ratio &gt;3.00 predicted the onset of death with sensitivity = 86%, specificity = 77%, and negative predicted value = 99%.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>The American College of Surgeons NSQIP surgical risk calculator has proved to be a reliable predictor of adverse postoperative outcomes also in Italian emergency settings, with particular regard to mortality. We therefore recommend the use of the surgical risk calculator in the multidisciplinary care of patients undergoing emergency abdominal surgery.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/xcs.0000000000000445","type":"journal-article","created":{"date-parts":[[2022,10,3]],"date-time":"2022-10-03T08:00:23Z","timestamp":1664784023000},"page":"387-398","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Can the American College of Surgeons NSQIP Surgical Risk Calculator Accurately Predict Adverse Postoperative Outcomes in Emergency Abdominal Surgery? An Italian Multicenter Analysis"],"prefix":"10.1097","volume":"236","author":[{"given":"Giovanni","family":"Scotton","sequence":"first","affiliation":[{"name":"From the Department of General Surgery, ASUITS, Cattinara Hospital, Trieste, Italy (Scotton, de Manzini, Biloslavo)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"La Greca","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma \u2013 Universit\u00e0 Cattolica del Sacro Cuore, Italy (La Greca)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Lirusso","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Santa Maria della Misericordia (ASUFC) University Hospital, Udine, Italy (Lirusso)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mariani","sequence":"additional","affiliation":[{"name":"Department of Emergency General Surgery, Legnano Hospital, ASST Ovest Milanese, Legnano, MI, Italy (Mariani)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Zago","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery Department, A. 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Currently, the most popular classifications, based on radiological findings, are the modified Hinchey, American Association for the Surgery of Trauma (AAST), and World Society of Emergency Surgery (WSES) classifications. We hypothesize that all classifications are equivalent in predicting outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>This is a retrospective study of 597 patients from four medical centers between 2014 and 2021. Based on clinical, radiological, and intraoperative findings, patients were graded according to the three classifications. Regression analysis and receiver operating characteristic curve analysis were used to compare six outcomes: need for intervention, complications, major complications (Clavien-Dindo &gt;2), reintervention, hospital length of stay, and mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>A total of 597 patients were included. Need for intervention, morbidity, and reintervention rates significantly increased with increasing AAST, modified Hinchey, and WSES grades. The area under the curve (AUC) for the need for intervention was 0.84 for AAST and 0.81 for modified Hinchey (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.039). The AUC for major complications was 0.75 for modified Hinchey and 0.70 for WSES (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.009). No differences were found between the three classifications when comparing AUCs for mortality, complications, and reintervention rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>The AAST, WSES, and modified Hinchey classifications are similar in predicting complications, reintervention, and mortality rates. American Association for the Surgery of Trauma and modified Hinchey scores result the most adequate for predicting the need for surgery and the occurrence of major complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE<\/jats:title>\n            <jats:p>Prognostic and Epidemiological; Level III.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ta.0000000000004133","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T00:01:30Z","timestamp":1693785690000},"page":"326-331","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["What are the differences between the three most used classifications for acute colonic diverticulitis? 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Endovascular aspiration thrombectomy (EAT) has entered the field leading to the possibility of treating acute arterial occlusions with a minimally invasive approach. The aim of the study was to provide contemporary data on results after use of EAT in AMI patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>The study was a retrospective, observational, multicentre study conducted in 10 Italian centres. Patients with AMI, undergoing EAT of the superior mesenteric artery (SMA) with the Penumbra Indigo system (Penumbra Inc., Alameda, CA, USA) from January 1, 2020 to December 31, 2024 were enrolled. Technical success and mortality were the primary outcomes. Secondary outcomes included perioperative complications and length of stay in the hospital and intensive care unit (ICU).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>\n                      Forty-eight consecutive AMI patients undergoing EAT were enrolled in the study. The median age of the study population was 80 years (interquartile range [IQR]\u2009=\u200968-86), and 52% were male. The median time from emergency acceptance up to referral for definitive treatment was 1 hour (IQR\u2009=\u20091-5), with 77% of patients presenting to the hospital less than 6 hours from onset of symptoms. Overall, 29 patients (60%) received only EAT at presentation, whereas 19 patients (39%) received a combined general surgical procedure at the same time of endovascular intervention. Technical success of EAT was achieved in 44 cases (92%). Thirty-one patients (64%) required ICU stay, with a median duration of 1.5 days. Severe postoperative complications (i.e. Clavien-Dindo scale &gt;3) occurred in 28 patients (58%), and the average duration of hospital stay was 10 days. The overall rate of 90-day mortality was 46% (n\u2009=\u200922); of these, 19 deaths occurred in the first 30 days and 3 additional events occurred between 30 and 60 days after index presentation. On multivariable analysis, a procedure longer than 90 minutes (odds ratio [OR] 6.3; 95% confidence interval [CI], 1.0-37.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.041) and Clavien-Dindo score greater than 3 (OR 19.5; 95% CI, 3.2-115.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009&lt;.001) resulted as independent factors for mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>The application of the Penumbra Indigo system for EAT of the SMA in AMI cases may provide an effective total endovascular procedure for its solution, providing high technical success rates. However, mortality rates are still high, owing to the severity of illness and comorbid status of patients, with most death events occurring in the first 30 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>The results of this study demonstrate that endovascular aspiration thrombectomy of the superior mesenteric artery for treatment of acute mesenteric ischemia may provide a safe and effective procedure for this condition. However, mortality rates are still high, owing to the severity of illness and comorbid status of patients, with most death events occurring in the first 30 days. Longer procedures and severe postoperative adverse events were also identified to be associated with higher odds of death, thereby highlighting potential bundles for improving care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261479535","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:36:35Z","timestamp":1787938595000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Endovascular Aspiration Thrombectomy of the Superior Mesenteric Artery for Treatment of Acute Mesenteric Ischemia: Results From the ENDO-SMA2MI Registry"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7156-7827","authenticated-orcid":false,"given":"Mario","family":"D\u2019Oria","sequence":"first","affiliation":[{"name":"Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 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Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment.\nThe study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia.\n<bold>Methods<\/bold>\nThis is a prospective multicentre study. Adult patients with clinical suspicion of AMI (n=250) will be included. Blood will be sampled on admission, at and after interventions, or during the first 48h of suspicion of AMI if no intervention undertaken. Samples will be collected and the following serum or plasma biomarkers measured at Tartu University Hospital laboratory: intestinal fatty acid-binding protein (I-FABP), alpha-glutathione S-transferase (Alpha- GST), interleukin 6 (IL-6), procalcitonin (PCT), ischaemia-modified albumin (IMA), D-lactate, D-dimer, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and lipopolysaccharide-binding protein (LBP). Additionally, more common laboratory markers will be measured in routine clinical practice at study sites.\nDiagnosis of AMI will be confirmed by computed tomography angiography, surgery, endoscopy or autopsy.\nStudent\u2019s t or Wilcoxon rank tests will be used for comparisons between transmural vs. suspected (but not confirmed) AMI (comparison A), confirmed AMI of any stage vs suspected AMI (comparison B) and non-transmural AMI vs transmural AMI (comparison C). Optimal cut-off values for each biomarker for each comparison will be identified based on the AUROC analysis and likelihood ratios calculated with positive likelihood ratio &gt;10 (&gt;5) and negative likelihood ratio &lt;0.1 (&lt;0.2) considered of high (moderate, respectively) diagnostic accuracy. All biomarkers with at least moderate accuracy will be entered as binary covariates (using the best cutoffs) into the multivariable stepwise regression analysis to identify the best combination of biomarkers for all comparisons separately. The best models for each comparison will be used to construct a practical score to distinguish between no AMI, non-transmural AMI and transmural AMI.\nAs a result of this study, we aim to propose a score including set of biomarkers that can be used for diagnosis and decision-making in patients with suspected AMI.\n<bold>Trial registration number: <\/bold>NCT06212921<\/p>","DOI":"10.21203\/rs.3.rs-4087503\/v1","type":"posted-content","created":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T19:50:20Z","timestamp":1710532220000},"source":"Crossref","is-referenced-by-count":1,"title":["Biomarkers In Prediction of Acute Mesenteric Ischaemia: a prospective multicentre study (BIPAMI study): a study protocol"],"prefix":"10.21203","author":[{"given":"Kadri","family":"Tamme","sequence":"first","affiliation":[{"name":"University of Tartu"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Acosta","sequence":"additional","affiliation":[{"name":"Lund 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LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]},{"name":"Eesti Teadusagentuur","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute mesenteric ischaemia (AMI) is a life-threatening disease where early diagnosis is critical to avoid morbidity and mortality from extensive irreversible bowel necrosis. Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment.<\/jats:p>\n                    <jats:p>The study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This is a prospective multicentre study. Adult patients with clinical suspicion of AMI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009250) will be included. Blood will be sampled on admission, at and after interventions, or during the first 48\u00a0h of suspicion of AMI if no intervention undertaken. Samples will be collected and the following serum or plasma biomarkers measured at Tartu University Hospital laboratory: intestinal fatty acid-binding protein (I-FABP), alpha-glutathione S-transferase (Alpha- GST), interleukin 6 (IL-6), procalcitonin (PCT), ischaemia-modified albumin (IMA), D-lactate, D-dimer, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and lipopolysaccharide-binding protein (LBP). Additionally, more common laboratory markers will be measured in routine clinical practice at study sites.\n                    <\/jats:p>\n                    <jats:p>Diagnosis of AMI will be confirmed by computed tomography angiography, surgery, endoscopy or autopsy.<\/jats:p>\n                    <jats:p>Student\u2019s t or Wilcoxon rank tests will be used for comparisons between transmural vs. suspected (but not confirmed) AMI (comparison A), confirmed AMI of any stage vs suspected AMI (comparison B) and non-transmural AMI vs transmural AMI (comparison C). Optimal cut-off values for each comparison will be identified based on the AUROC analysis and likelihood ratios calculated. Positive likelihood ratio\u2009&gt;\u200910 (&gt;\u20095) and negative likelihood ratio\u2009&lt;\u20090.1 (&lt;\u20090.2) indicate high (moderate) diagnostic accuracy, respectively. All biomarkers with at least moderate accuracy will be entered as binary covariates (using the best cutoffs) into the multivariable stepwise regression analysis to identify the best combination of biomarkers for all comparisons separately. The best models for each comparison will be used to construct a practical score to distinguish between no AMI, non-transmural AMI and transmural AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>As a result of this study, we aim to propose a score including set of biomarkers that can be used for diagnosis and decision-making in patients with suspected AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>NCT06212921 (Registration Date 19\u201301-2024).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-024-02491-3","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T03:02:14Z","timestamp":1719975734000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Biomarkers In Prediction of Acute Mesenteric Ischaemia: a prospective multicentre study (BIPAMI study): a study protocol"],"prefix":"10.1186","volume":"24","author":[{"given":"Kadri","family":"Tamme","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Acosta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bj\u00f6rck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dumitru","family":"Casian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Damaskos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karri","family":"Kase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalle","family":"Kisand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Lakbar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladislav","family":"Mihnovit\u0161","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Murruste","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merli","family":"M\u00e4ndul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Nuzzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Padar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Starkopf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Visconti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Reintam Blaser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"2491_CR1","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.ejvs.2017.01.010","volume":"53","author":"M Bj\u00f6rck","year":"2017","unstructured":"Bj\u00f6rck M, Koelemay M, Acosta S, Bastos Goncalves F, K\u00f6lbel T, Kolkman JJ, et al. 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Participating sites will obtain approval from local ethics committees, local approaches regarding delayed consent, consent by next-of-kin and waiver of consent may vary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"ARB has received speaker or consultancy fees from Nestl\u00e9, VIPUN Medical, Nutricia and Fresenius Kabi, and is holding a grant from Estonian Research Council (PRG1255). AF has received speaker fees from B Braun and Fresenius Kabi. AN has received speaker or consultancy fees from Abbvie and Janssen, research funding from MSD-Avenir, and PhD grants from Fondation de l\u2019Avenir and SNFGE. KT, SA, AB, MB, DC, DD, KKa, KKi, IL, VM, MMu, MM\u00e4, MP, JS and DV declare no conflicts of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"201"},{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:04:29Z","timestamp":1785179069334,"version":"3.55.0"},"reference-count":67,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T00:00:00Z","timestamp":1657152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is a need for implementation and maturation of an inclusive trauma system in every country in Europe, with patient centered care by dedicated surgeons. This process should be initiated by physicians and medical societies, based on the best available evidence, and supported and subsequently funded by the government and healthcare authorities. A systematic approach to organizing all aspects of trauma will result in health gain in terms of quality of care provided, higher survival rates, better functional outcomes and quality of life. In addition, it will provide reliable data for both research, quality improvement and prevention programs. Severely injured patients need surgeons with broad technical and non-technical competencies to provide holistic, inclusive and compassionate care. Here we describe the philosophy of the surgical approach and define the necessary skills for trauma, both surgical and other, to improve outcome of severely injured patients. As surgery is an essential part of trauma care, surgeons play an important role for the optimal treatment of trauma patients throughout and after their hospital stay, including the intensive care unit (ICU). However, in most European countries, it might not be obvious to either the general public, patients or even the physicians that the surgeon must assume this responsibility in the ICU to optimize outcomes. The aim of this paper is to define key elements in terms of trauma systems, trauma-specific surgical skills and active critical care involvement, to organize and optimize trauma care in Europe.<\/jats:p>","DOI":"10.1007\/s00068-022-02014-w","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T17:11:47Z","timestamp":1657213907000},"page":"627-634","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["What trauma patients need: the European dilemma"],"prefix":"10.1007","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1462-6840","authenticated-orcid":false,"given":"Falco","family":"Hietbrink","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mariani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4l Aksel","family":"Naess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Rey-Valc\u00e1rcel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Bass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan I.","family":"Brundage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrique","family":"Alexandrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Peralta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke P. 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The study aimed to evaluate the compliance to the proposed postoperative pathway and the determinants of late recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a multicenter observational prospective study involving 13 Italian centers. Inclusion criteria targeted adults undergoing emergency surgery for intestinal occlusion or perforation. The primary end point was the early recovery rate (discontinuation of intravenous fluids and the initiation of oral intake on postoperative day three) and its determinants. The secondary end point were reasons for uncompliance to postoperative ERP items.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between March 2023 and March 2024, 760 patients were recruited and analyzed, 60.2 with intestinal obstruction and 39.8 with intra\u2010abdominal infections. Recovery was achieved by 53.7% of patients on postoperative Day 3. Among determinants, clinical frailty and ASA status negatively correlated with recovery whereas the absence of surgical drains, anesthetic depth monitoring and intraoperative goal\u2010directed fluid therapy positively correlated with recovery. An analysis of the reasons for noncompliance with postoperative items revealed that aside from postoperative complications, the most frequently cited reason was protocol deviation for clinical decision, accounting for approximately 10%\u201315% of noncompliance for each item.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study showed that half of the patients reached the recovery goal on postoperative Day 3 and that early recovery after surgery is influenced both by intrinsic patient factors and by adherence to ERP strategies. Future research should prioritize strategies to improve ERP adherence and postoperative compliance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70312","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T04:30:30Z","timestamp":1774499430000},"page":"1213-1220","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of Compliance to Enhanced Recovery Protocol After Emergency Laparotomy"],"prefix":"10.1002","volume":"50","author":[{"given":"Marco","family":"Ceresoli","sequence":"first","affiliation":[{"name":"University of Milano\u2010Bicocca School of Medicine and Surgery  Monza Italy"},{"name":"General and Emergency Surgery Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Fumagalli","sequence":"additional","affiliation":[{"name":"University of Milano\u2010Bicocca School of Medicine and Surgery  Monza Italy"},{"name":"General and Emergency Surgery Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-2744","authenticated-orcid":false,"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"Department of General Surgery Cattinara University Hospital ASUGI  Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"La Greca","sequence":"additional","affiliation":[{"name":"Dip.to Scienze Mediche e Chirurgiche UOC Chirurgia d'Urgenza e Trauma Fondazione Policlinico Universitario A. Gemelli IRCCS Roma \u2010 Universit\u00e0 Cattolica del Sacro Cuore  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Carlucci","sequence":"additional","affiliation":[{"name":"Department of Emergency and General Surgery IRCCS San Raffaele Hospital  Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Pesenti","sequence":"additional","affiliation":[{"name":"UOC Chirurgia Generale e d'Urgenza Dip. chirurgico H. A. Manzoni  Lecco Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Occhionorelli","sequence":"additional","affiliation":[{"name":"s.s.d. Emergency surgery Surgical Department University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Bisagni","sequence":"additional","affiliation":[{"name":"Department of Surgery ASST Lodi  Lodi Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Feo","sequence":"additional","affiliation":[{"name":"UOC Chirurgia Generale Provinciale Azienda USL di Ferrara \u2010 Universit\u00e0 di Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1615-3370","authenticated-orcid":false,"given":"Dario","family":"Tartaglia","sequence":"additional","affiliation":[{"name":"General Emergency Surgery Unit and Trauma Center Pisa University Hospital  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Parini","sequence":"additional","affiliation":[{"name":"General Surgery Department Santa Maria della Misericordia Hospital Rovigo \u2010 ULSS 5  Rovigo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Runfola","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery Unit Department of Emergency ARNAS \u201cG. Brotzu\u201d  Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Somigli","sequence":"additional","affiliation":[{"name":"Dipartimento Chirurgia usl toscana centro\u2010 ospedale Santa Maria Nuova  Firenze Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Visconti","sequence":"additional","affiliation":[{"name":"Chirurgia Generale d\u2019Urgenza e PS AOU Citt\u00e0 della Salute e della Scienza  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mariani","sequence":"additional","affiliation":[{"name":"General Surgery Ospedale di Legnano ASST ovest Milanese  Legnano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diletta","family":"Cassini","sequence":"additional","affiliation":[{"name":"General Surgery ASST Milano\u2010Nord  Sesto San Giovanni Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Mingoli","sequence":"additional","affiliation":[{"name":"President of the Italian Society of Emergency Surgery and Trauma (SICUT)  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Braga","sequence":"additional","affiliation":[{"name":"University of Milano\u2010Bicocca School of Medicine and Surgery  Monza Italy"},{"name":"General and Emergency Surgery Fondazione IRCCS San Gerardo dei Tintori  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Study Collaborative 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Journal of Surgery"],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70312","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70312","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70312","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T04:08:10Z","timestamp":1779422890000},"score":5.4311104,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70312"}},"issued":{"date-parts":[[2026,3,25]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/wjs.70312"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70312","archive":["Portico"],"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"published":{"date-parts":[[2026,3,25]]}},{"institution":[{"name":"Research Square"}],"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T16:20:47Z","timestamp":1788193247348,"version":"build-2803163510"},"posted":{"date-parts":[[2026,6,24]]},"group-title":"In Review","reference-count":31,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"accepted":{"date-parts":[[2026,6,10]]},"abstract":"<title>Abstract<\/title>\n                <p>\n                  <bold>Purpose.<\/bold>\n                  To evaluate whether common bowel-related CT signs alone can reliably identify irreversible bowel injury in acute mesenteric ischemia (AMI) and to develop a radiological score to enhance reporting and assist clinical decision-making.\n                  <bold>Methods.<\/bold>\n                  This ancillary analysis of the multicentre AMESI study included 157 patients with suspected or confirmed AMI from 11 international sites. Predefined bowel-related CT signs were retrospectively assessed by two independent radiologists, blinded to clinical data. Predictive scores for irreversible bowel injury (transmural necrosis) and AMI of any severity, as confirmed by clinical outcomes, were constructed and tested using regression models.\n                  <bold>Results.<\/bold>\n                  The final score, optimized for arterial occlusive AMI, classified patients as high-risk for irreversible injury if either decreased\/absent bowel wall enhancement or pneumatosis intestinalis (each giving 2 points) was present, or if two of the following were observed (each giving 1 point): bowel dilatation, portal\/mesenteric venous gas, or paper-thin bowel wall. Using a cut-off of \u2265\u20092 points, the score correctly identified irreversible damage in 62 of 80 patients, the overall accuracy was 70%. Sensitivity analysis using histologically confirmed transmural necrosis showed comparable performance. In most of the false negative cases (n\u2009=\u200918, five of them with no signs), time from CT to confirmed necrosis was &gt;\u20096 hours. No single score could distinguish reliably between three categories: no AMI, reversible, and irreversible injury.\n                  <bold>Conclusions<\/bold>\n                  . \nThe AMESI CT-score, developed in this study demonstrated moderate accuracy in predicting irreversible bowel injury and may aid in triaging AMI patients for surgical versus endovascular treatment. However, absence of radiological signs does not exclude bowel necrosis.\n                  <italic>\n                    <bold>Clinical Trials registration:<\/bold>\n                  <\/italic>\n                  <italic>NCT06445660<\/italic>\n                  <italic>\n                    <bold>Date of registration:<\/bold>\n                  <\/italic>\n                  <italic>2024-06-06<\/italic>\n                <\/p>","DOI":"10.21203\/rs.3.rs-9992565\/v1","type":"posted-content","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T02:42:36Z","timestamp":1782268956000},"source":"Crossref","is-referenced-by-count":0,"title":["CT-Based Radiological Score (AMESI CT-Score) for Severity of Bowel Injury in Acute Mesenteric Ischemia"],"prefix":"10.21203","author":[{"given":"MARTIN","family":"REIM","sequence":"first","affiliation":[{"name":"Tartu University 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This multicentric study aims to define the surgical approach for emergency resective surgery in left colonic perforation peritonitis, determine the factors influencing the choice between MIS and open surgery, and identify factors associated with laparotomic conversion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective data from 516 patients treated for left colonic perforation between January 2019 and December 2023 across six Italian centers was collected. Variables analyzed included patient demographics, disease and surgical characteristics, post-operative complications, and long-term outcomes. Univariate and multivariate regression models were performed to identify factors associated with surgical\u00a0choice and likelihood of conversion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Only 24.5% of patients underwent laparoscopic approach, with a conversion rate of 52.8%. MIS was associated to lower CCI and MPI and less severe septic status at arrival. MIS was mostly performed by colorectal surgeons, compared to acute care surgeons. The post-operative outcome, considering LOS, ICU admission, post-operative complications and mortality rate, was better in the MIS group. The multivariate regression model revealed that CCI, MPI, and night-time surgery were negatively associated with MIS while colorectal surgeons had a positive association. Laparotomic conversion more commonly occurred in older patients with a higher MPI and CCI and more severe septic status; these patients had a worse post-operative outcome. MPI was the only factor with statistical significance in the univariate analysis, associated with conversion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Although MIS is associated with better post-operative outcomes, it is underutilized in the emergency setting. Patients requiring laparotomic conversion had higher morbidity and mortality compared to those who underwent successful laparoscopy. Limiting factors for MIS include logistic factors, patient severity, and surgical skills, therefore careful patient selection and surgical training is crucial.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11611-w","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T22:05:58Z","timestamp":1739916358000},"page":"2370-2379","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Minimally invasive approach to peritonitis from left colonic perforation: a retrospective multicenter observational study"],"prefix":"10.1007","volume":"39","author":[{"given":"Marco","family":"Ceresoli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6352-9556","authenticated-orcid":false,"given":"Carola Anna 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World J Emerg Surg 2021(16):1\u201348. https:\/\/doi.org\/10.1186\/S13017-021-00387-8","journal-title":"World J Emerg Surg"},{"key":"11611_CR16","first-page":"1","volume":"64","author":"LBJ Nielsen","year":"2017","unstructured":"Nielsen LBJ, Tengberg LT, Bay-Nielsen M (2017) Laparoscopy in major abdominal emergency surgery seems to be a safe procedure. Dan Med J 64:1","journal-title":"Dan Med J"},{"key":"11611_CR17","doi-asserted-by":"publisher","first-page":"1690","DOI":"10.1007\/s00464-007-9413-7","volume":"21","author":"I Hassan","year":"2007","unstructured":"Hassan I, Cima RR, Larson DW, Dozois EJ, Byrne MMO, Larson DR, Pemberton JH (2007) The impact of uncomplicated and complicated diverticulitis on laparoscopic surgery conversion rates and patient outcomes. Surg Endosc 21:1690\u20131694. https:\/\/doi.org\/10.1007\/s00464-007-9413-7","journal-title":"Surg Endosc"},{"key":"11611_CR18","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1177\/0003134820950295","volume":"87","author":"Z Moghadamyeghaneh","year":"2021","unstructured":"Moghadamyeghaneh Z, Talus H, Fitzgerald S, Muthusamy M, Stamos MJ, Roudnitsky V (2021) Outcomes of minimally invasive colectomy for perforated diverticulitis. Am Surg 87:561\u2013567. https:\/\/doi.org\/10.1177\/0003134820950295","journal-title":"Am Surg"},{"key":"11611_CR19","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1111\/j.1463-1318.2008.01667.x","volume":"11","author":"J Vermeulen","year":"2009","unstructured":"Vermeulen J, Coene PPLO, Van Hout NM, Van Der Harst E, Gosselink MP, Mannaerts GHH, Weidema WF, Lange JF (2009) Restoration of bowel continuity after surgery for acute perforated diverticulitis: should Hartmann\u2019s procedure be considered a one-stage procedure? Colorectal Dis 11:619\u2013624. https:\/\/doi.org\/10.1111\/j.1463-1318.2008.01667.x","journal-title":"Colorectal Dis"},{"key":"11611_CR20","doi-asserted-by":"publisher","first-page":"5656","DOI":"10.1007\/s00464-016-4869-y","volume":"30","author":"S Di Saverio","year":"2016","unstructured":"Di Saverio S, Vennix S, Birindelli A, Weber D, Lombardi R, Mandrioli M, Tarasconi A, Bemelman WA (2016) Pushing the envelope: laparoscopy and primary anastomosis are technically feasible in stable patients with Hinchey IV perforated acute diverticulitis and gross faeculent peritonitis. Surg Endosc 30:5656\u20135664. https:\/\/doi.org\/10.1007\/s00464-016-4869-y","journal-title":"Surg Endosc"}],"container-title":["Surgical Endoscopy"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11611-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-11611-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11611-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T03:53:39Z","timestamp":1743047619000},"score":3.898384,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-11611-w"}},"issued":{"date-parts":[[2025,2,18]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["11611"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-11611-w","ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"published":{"date-parts":[[2025,2,18]]},"assertion":[{"value":"18 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Marco Ceresoli, Carola Anna Paolina Ferro, Antonio La Greca, Stefano Piero Bernardo Cioffi, Alan Biloslavo, Mauro Podda, Federico Coccolini, and all the members of the collaborative groups have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure\u00a0"}}]},{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T23:25:53Z","timestamp":1773789953932,"version":"3.50.1"},"posted":{"date-parts":[[2026]]},"group-title":"SSRN","reference-count":0,"publisher":"Elsevier BV","content-domain":{"domain":[],"crossmark-restriction":false},"abstract":"<jats:p>BackgroundNon-occlusive mesenteric ischemia (NOMI) remains poorly described and defined in the literature. This study aims to describe the clinical profile, risk factors, diagnostics, management, and outcomes of NOMI patients within the prospective multicenter AMESI cohort.MethodsPatients with NOMI were compared to patients with other subtypes of AMI, and patients with suspected but not confirmed AMI.ResultsNOMI patients (n=55) had a median age of 70, and 61.8% were male. At diagnosis, NOMI patients were more critically ill than other AMI (231 arterial, 73 venous, 48 with an unclear mechanism) or no AMI (n=159) patients, with median SOFA and APACHE II scores of 11 and 25, respectively. Shock at the time of suspicion (54.5%) was the most common initial sign. Although median lactate levels were elevated (4.3 mmol\/L), 25.4% had normal lactate at diagnosis. Despite being used as a first-line diagnostic tool in 83.6% of NOMI cases, CT confirmed the diagnosis in only 52.7%. In-hospital mortality was 72.7%, the highest among subtypes of AMI. History of myocardial infarction, vasopressor use, and raised creatinine at the time of suspicion predicted NOMI. Bowel necrosis predicted mortality and ongoing antiplatelet therapy was associated with survival. AMI Patients with an unclear mechanism resembled NOMI in comorbidity burden and mortality, despite having a less severe illness.ConclusionsCompared with other AMI subtypes, NOMI patients were more critically ill. CT confirmed the diagnosis in only half of the cases. Difficulties in diagnosis likely contributed to missed cases and persistently poor outcomes observed in NOMI patients.<\/jats:p>","DOI":"10.2139\/ssrn.6302835","type":"posted-content","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:59:26Z","timestamp":1773777566000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics and Outcomes of Non-occlusive Mesenteric Ischemia: A Substudy of a Prospective Multicenter Observational Cohort"],"prefix":"10.2139","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3897-7311","authenticated-orcid":true,"given":"Vladislav","family":"Mihnovit\u0161","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4444-5979","authenticated-orcid":true,"given":"Merli","family":"Koitm\u00e4e","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6110-0417","authenticated-orcid":true,"given":"Kadri","family":"Tamme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6561-9734","authenticated-orcid":true,"given":"Martin","family":"Bj\u00f6rck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3225-0798","authenticated-orcid":true,"given":"Stefan","family":"Acosta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1504-6162","authenticated-orcid":true,"given":"Miklosh","family":"Bala","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0883-2744","authenticated-orcid":true,"given":"Alain","family":"Biloslavo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6860-8405","authenticated-orcid":true,"given":"Zsolt","family":"Bodnar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4823-0804","authenticated-orcid":true,"given":"Dumitru","family":"Casian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darja","family":"Clinch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-9684","authenticated-orcid":true,"given":"Zaza","family":"Demetrashvili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4499-0483","authenticated-orcid":true,"given":"Virginia  Dur\u00e1n","family":"Mu\u00f1oz-Cruzado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7416-9843","authenticated-orcid":true,"given":"Alastair","family":"Forbes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7411-9046","authenticated-orcid":true,"given":"Hanne","family":"Fuglseth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8489-0324","authenticated-orcid":true,"given":"Mohan","family":"Gurjar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3152-9196","authenticated-orcid":true,"given":"Benjamin","family":"Hess","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghuang","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3046-7149","authenticated-orcid":true,"given":"Moran  Hellerman","family":"Itzhaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4070-1616","authenticated-orcid":true,"given":"Karri","family":"Kase","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0113-8174","authenticated-orcid":true,"given":"Kristoffer","family":"Lein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2647-7790","authenticated-orcid":true,"given":"Matthias","family":"Linder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1647-5110","authenticated-orcid":true,"given":"Cecilia  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 Dzulkarnaen","family":"Zakaria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4321-3287","authenticated-orcid":true,"given":"Joel","family":"Starkopf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annika","family":"Reintam Blaser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:59:26Z","timestamp":1773777566000},"score":3.8082943,"resource":{"primary":{"URL":"https:\/\/www.ssrn.com\/abstract=6302835"}},"issued":{"date-parts":[[2026]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2139\/ssrn.6302835","published":{"date-parts":[[2026]]},"subtype":"preprint"},{"institution":[{"name":"Research Square"}],"indexed":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T23:36:32Z","timestamp":1744500992725,"version":"3.38.0"},"posted":{"date-parts":[[2024,8,16]]},"group-title":"In Review","reference-count":30,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"accepted":{"date-parts":[[2024,7,15]]},"abstract":"<title>Abstract<\/title>\n        <p>Background\n Mild acute biliary pancreatitis (MABP) presents significant clinical and economic challenges due to its potential for relapse.  Current guidelines advocate for early cholecystectomy (EC) during the same hospital admission to prevent recurrent acute pancreatitis (RAP). Despite these recommendations, implementation in clinical practice varies, highlighting the need for reliable and accessible predictive tools. The MINERVA study aims to develop and validate a machine learning (ML) model to predict the risk of RAP in MABP patients, enhancing decision-making processes.\nMethods\n The MINERVA study will be conducted across multiple academic and community hospitals in Italy. Adult patients with a clinical diagnosis of MABP who have not undergone EC during index admission will be included. Exclusion criteria encompass non-biliary aetiology, severe pancreatitis, and the inability to provide informed consent. The study involves both retrospective data from the MANCTRA-1 study and prospective data collection. Data will be captured using REDCap. The ML model will utilise convolutional neural networks (CNN) for feature extraction and risk prediction. The model includes the following steps: the spatial transformation of variables using kernel Principal Component Analysis (kPCA), the creation of 2D images from transformed data, the application of convolutional filters, max-pooling, flattening, and final risk prediction via a fully connected layer. Performance metrics such as accuracy, precision, recall, and area under the ROC curve (AUC) will be used to evaluate the model.\nDiscussion\n The MINERVA study addresses the gap in predicting RAP risk in MABP patients by leveraging advanced ML techniques. By incorporating a wide range of clinical and demographic variables, the MINERVA score aims to provide a reliable, cost-effective, and accessible tool for healthcare professionals. The project emphasises the practical application of AI in clinical settings, potentially reducing the incidence of RAP and associated healthcare costs. 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While Hartmann\u2019s procedure has traditionally been the standard treatment, growing evidence supports primary anastomosis as a safe and effective alternative. The benefit of adding a diverting ileostomy in this scenario remains uncertain. This study aimed to evaluate the clinical impact of a diverting stoma after emergency left-sided colectomy with primary anastomosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective multicentre cohort study. All consecutive adult patients undergoing emergency left-sided colectomy with primary anastomosis between 2019 and 2023 were included. Patients were divided into two groups according to the use of a diverting stoma (DS) or no stoma (NS). The primary outcome was 30-day mortality. Secondary outcomes included postoperative morbidity, anastomotic leak, reoperation, readmission, and 1-year stoma-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 211 patients were included, of whom 75 (35.2%) received a diverting stoma. While baseline demographic characteristics and comorbidities were similar between the two cohorts, patients in the DS group presented with significantly higher rates of generalized peritonitis. Thirty-day mortality did not differ (DS 2.2% vs NS 1.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.656). Anastomotic leak occurred in 4.0% of DS and 8.8% of NS patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.192). Reoperations were fewer in the DS group (4.0% vs 12.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.044). Readmission rates were higher among patients with diversion (16.2% vs 2.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). One-year stoma-free survival favored the NS group (96.7% vs 83.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diverting stoma after emergency left-sided colectomy with primary anastomosis does not influence mortality or overall morbidity but was associated with reduced reoperations related to anastomotic leaks. Diversion is associated with higher readmission rates and delayed stoma reversal, highlighting the importance of individualized, evidence-based decision-making in emergency colorectal surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-026-05177-9","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T05:16:58Z","timestamp":1782364618000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Emergency left side colectomy and primary anastomosis with or without diverting stoma: a comparative study"],"prefix":"10.1007","volume":"41","author":[{"given":"Marco","family":"Ceresoli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Podda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carola Anna 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Because the study involved only the analysis of existing, de-identified data and did not include any direct patient contact or intervention, formal approval from the institutional Ethics Review Board (ERB) was not required, in accordance with local regulations. 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Guidelines on ERAS in emergency surgery have been recently published; however, few evidences are still available in the literature. The aim of this study was to evaluate the feasibility of an enhanced recovery protocol in a large cohort of patients undergoing emergency surgery and to identify possible factors impacting postoperative protocol compliance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective multicenter observational study including patients who underwent major emergency general surgery for either intra\u2010abdominal infection or intestinal obstruction. The primary endpoint of the study is the adherence to ERAS postoperative protocol. Secondary endpoints are 30\u2010day mortality and morbidity rates, and length of hospital stay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 589 patients were enrolled in the study, 256 (43.5%) of them underwent intestinal resection with anastomosis. Major complications occurred in 92 (15.6%) patients and 30\u2010day mortality was 6.3%. Median adherence occurred on postoperative day (POD) 1 for naso\u2010gastric tube removal, on POD 2 for mobilization and urinary catheter removal, and on POD 3 for oral intake and i.v. fluid suspension. Laparoscopy was significantly associated with adherence to postoperative protocol, whereas operative fluid infusion\u2009&gt;\u200912\u00a0mL\/Kg\/h, preoperative hyperglycemia, presence of a drain, duration of surgery and major complications showed a negative association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The present study supports that an enhanced recovery protocol in emergency surgery is feasible and safe. Laparoscopy was associated with an earlier recovery, whereas preoperative hyperglycemia, fluid overload, and abdominal drain were associated with a delayed recovery.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-06984-9","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T16:02:37Z","timestamp":1680796957000},"page":"1339-1347","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Implementing Enhanced Perioperative Care in Emergency General Surgery: A Prospective Multicenter Observational Study"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7935-3842","authenticated-orcid":false,"given":"Marco","family":"Ceresoli","sequence":"first","affiliation":[{"name":"General and Emergency Surgery Department, School of Medicine and Surgery Milano\u2010Bicocca University Via Pergolesi 33 20900 Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Biloslavo","sequence":"additional","affiliation":[{"name":"General Surgery Department Cattinara Hospital, ASUGI Strada Di Fiume, 447 34149 Trieste Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Bisagni","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery ASST Lodi Lodi Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Ciuffa","sequence":"additional","affiliation":[{"name":"General and Emergency Surgery IRCCS Ospedale San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fortuna","sequence":"additional","affiliation":[{"name":"General Surgery Ospedale S. 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Gianluca Costa, Pietro Fransvea, Luca Lepre, Gianluca Liotta, Gianluca Mazzoni, Alan Biloslavo, Valentina Bianchi, Savino Occhionorelli, Alessandro Costa, Gabriele Sganga and the IGo-GIPS study group have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]},{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:25:53Z","timestamp":1787570753580,"version":"build-2736575974"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":70,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010607","name":"Universit\u00e0 degli Studi di Perugia","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100010607","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Appendiceal abscesses are a heterogeneous manifestation of acute appendicitis, with diverse pathological substrates and imaging phenotypes. The lack of standardized definitions hampers cross-study comparability and consistent diagnostic pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Italian Society of Surgical Research (SIRC) and the Italian Society of Emergency Surgery and Trauma (SICUT) conducted a four-round modified Delphi, culminating in an in-person consensus conference (Rome, November 6, 2025). A multidisciplinary panel refined the statements on pathological definitions, classifications, and imaging correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Consensus was reached on 22 statements. Part 1 reports seven statements that delineate the spectrum from uncomplicated to complicated appendicitis (phlegmonous, gangrenous, and perforated) and distinguishes appendiceal abscesses from appendiceal masses. An imaging framework centered on CT descriptors was used to support consistent radiology\u2013pathology correlations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These statements provide a unified taxonomy and diagnostic framework for appendiceal abscesses and related entities, improving interdisciplinary communication, and enabling cross-study comparability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-026-05174-y","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T13:07:36Z","timestamp":1781528856000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Appendiceal abscess: pathologic definitions and a diagnostic framework\u2014SIRC\/SICUT 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Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"110383"},{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:24:06Z","timestamp":1792103046871,"version":"4.4.0"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100005189","name":"estonian research competency council","doi-asserted-by":"publisher","award":["PRG1255"],"award-info":[{"award-number":["PRG1255"]}],"id":[{"id":"10.13039\/501100005189","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biomark&amp;#65533;Insights"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95%\u2009confidence intervals\u2009(CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      D-dimer was not significantly higher in MVT (n\u2009=\u200973) compared to non-AMI (n\u2009=\u2009287) patients (median 7.0\u2009mg\/L\u2009vs\u20094.5\u2009mg\/L,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95%\u2009CI 0.011-0.84;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.034) and elevated D-dimer (OR 2.59\/one SD increment, 95%\u2009CI 1.07-6.28;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95%\u2009CI 0.49-0.78).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>TRIAL REGISTRATION:<\/jats:title>\n                    <jats:p>NCT05218863 (registered 19.01.2022).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11772719241296631","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T04:14:16Z","timestamp":1732594456000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["D-Dimer in Acute Mesenteric Venous Thrombosis: A Prospective Case-Control International Multicenter Study"],"prefix":"10.1177","volume":"19","author":[{"given":"Stefan","family":"Acosta","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Malm\u00f6, Lund University, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika Reintam","family":"Blaser","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Tartu, Estonia"},{"name":"Department of Intensive Care Medicine, Lucerne Cantonal Hospital, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Nuzzo","sequence":"additional","affiliation":[{"name":"Intestinal Stroke Center, Department of Gastroenterology, IBD and Intestinal Failure, AP-HP. 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All authors completed the ICMJE uniform conflict of interest disclosure form.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"46"},{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:39:25Z","timestamp":1793417965717,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002301","name":"Estonian Research 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<jats:title>Methods<\/jats:title>\n                    <jats:p>All adult patients with clinical suspicion of AMI admitted or transferred to 32 participating hospitals from 06.06.2022 to 05.04.2023 were included. Participants who were subsequently shown not to have AMI or had localized intestinal gangrene due to strangulating bowel obstruction had only baseline and outcome data collected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AMI occurred in 0.038% of adult admissions in participating acute care hospitals worldwide. From a total of 705 included patients, 418 patients had confirmed AMI. In 69% AMI was the primary reason for admission, while in 31% AMI occurred after having been admitted with another diagnosis. Median time from onset of symptoms to hospital admission in patients admitted due to AMI was 24\u00a0h (interquartile range 9-48h) and time from admission to diagnosis was 6h (1\u201312\u00a0h). Occlusive arterial AMI was diagnosed in 231 (55.3%), venous in 73 (17.5%), non-occlusive (NOMI) in 55 (13.2%), other type in 11 (2.6%) and the subtype could not be classified in 48 (11.5%) patients. Surgery was the initial management in 242 (58%) patients, of which 59 (24.4%) underwent revascularization. Endovascular revascularization alone was carried out in 54 (13%), conservative treatment in 76 (18%) and palliative care in 46 (11%) patients. From patients with occlusive arterial AMI, revascularization was undertaken in 104 (45%), with 40 (38%) of them in one site admitting selected patients. Overall in-hospital and 90-day mortality of AMI was 49% and 53.3%, respectively, and among subtypes was lowest for venous AMI (13.7% and 16.4%) and highest for NOMI (72.7% and 74.5%). There was a high variability between participating sites for most variables studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The overall incidence of AMI and AMI subtypes varies worldwide, and case ascertainment is challenging. Pre-hospital delay in presentation was greater than delays after arriving at hospital. Surgery without revascularization was the most common management approach. Nearly half of the patients with AMI died during their index hospitalization. Together, these findings suggest a need for greater awareness of AMI, and better guidance in diagnosis and management.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial registration<\/jats:italic>\n                      : NCT05218863 (registered 19.01.2022).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13054-024-04807-4","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T10:02:51Z","timestamp":1706004171000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":79,"title":["Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study)"],"prefix":"10.1186","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1211-7372","authenticated-orcid":false,"given":"Annika","family":"Reintam 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Eur J Intern Med 129:100\u2013110","journal-title":"Eur J Intern Med"}],"container-title":["Journal of Anesthesia, Analgesia and Critical Care"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s44158-026-00338-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44158-026-00338-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s44158-026-00338-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T11:58:53Z","timestamp":1770983933000},"score":1.2585812,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s44158-026-00338-2"}},"issued":{"date-parts":[[2026,1,20]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["338"],"URL":"https:\/\/doi.org\/10.1186\/s44158-026-00338-2","ISSN":["2731-3786"],"issn-type":[{"value":"2731-3786","type":"electronic"}],"published":{"date-parts":[[2026,1,20]]},"assertion":[{"value":"7 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"IRB Information: this study was approved by the Local Research Ethics Committee of Pisa (Prot n 56478; 26\/09\/2019). The procedure was carried out in accordance with the Declaration of Helsinki (2000). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was not obtained in accordance with our Ethics Committee, considering the nature of the study and of the registry (prospective, observational) and that all the data collected were noted in a completely anonymous form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"30"},{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:23:31Z","timestamp":1792290211134,"version":"4.4.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Intra-abdominal infections (IAIs) are common and severe surgical emergencies associated with high morbidity and mortality. In recent years, there has been a worldwide increase in antimicrobial resistance associated with intra-abdominal infections, responsible for a significant increase in mortality rates. To improve the quality of treatment, it is crucial to understand the underlying local epidemiology, clinical implications, and proper management of antimicrobial resistance, for both community- and hospital-acquired infections. The IRIS study (Italian Register of Complicated Intra-abdominal InfectionS) aims to investigate the epidemiology and initial management of complicated IAIs (cIAIs) in Italy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Material and method<\/jats:title>\n            <jats:p>This is a prospective, observational, nationwide (Italy), multicentre study. approved by the coordinating centre ethic committee (Local Research Ethics Committee of Pisa (Prot n 56478\/\/2019). All consecutively hospitalized patients (older than 16\u00a0years of age) with diagnosis of cIAIs undergoing surgery, interventional drainage or conservative treatment have been included.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>4530 patients included from 23 different Italian hospitals. Community Acquired infection represented the 70.9% of all the cases. Among appendicitis, we found that 98.2% of the cases were community acquired (CA) and 1.8% Healthcare-associated (HA) infections. We observed that CA represented the 94.2% and HA 5.8% of Gastro Duodenal perforation cases. The majority of HA infections were represented by colonic perforation and diverticulitis (28.3%) followed by small bowel occlusion (19%) and intestinal ischemia (18%). 27.8% of patients presented in septic shock. Microbiological Samples were collected from 3208 (70.8%) patients. Among 3041 intrabdominal sample 48.8% resulted positive. The major pathogens involved in intra-abdominal infections were found to be <jats:italic>E.coli<\/jats:italic> (45.6%). During hospital stay, empiric antimicrobial therapy was administered in 78.4% of patients. Amoxicillin\/clavulanate was the most common antibiotic used (in 30.1% appendicitis, 30% bowel occlusion, 30.5% of cholecystitis, 51% complicated abdominal wall hernia, 55% small bowel perforation) followed by piperacillin\/tazobactam (13.3% colonic perforation and diverticulitis, 22.6% cholecystitis, 24.2% intestinal ischemia, 28.6% pancreatitis). Empiric antifungal therapy was administered in 2.6% of patients with no sign of sepsis, 3.1% of patients with clinical sign of sepsis and 4.1% of patients with septic shock. Azoles was administered in 49.2% of patients that received empiric antifungal therapy. The overall mortality rate was 5.13% (235\/4350). 16.5% of patients required ICU (748\/4350). In accordance with mortality, it is important to highlight that 35.7% of small bowel perforation, 27.6% of colonic perforation and diverticulitis, 25.6% of intestinal ischemia and 24.6% of gastroduodenal complications required ICU.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Antibiotic stewardship programs and correct antimicrobial and antimycotic prescription campaigns are necessary to ulteriorly improve the adequacy of drug usage and reduce the resistances burden. This will help in improving the care and the cure of the next generations.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13017-025-00590-x","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T07:23:46Z","timestamp":1742196226000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Epidemiological analysis of intra-abdominal infections in Italy from the Italian register of complicated intra-abdominal infections\u2014the IRIS study: a prospective observational nationwide 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Procedure was carried out in accordance with the Declaration of Helsinki (2000). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u201d","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human participants and\/or animals"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Merck Sharp & Dohme LLC provided financial support. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme LLC. Merck Sharp & Dohme LLC.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}],"article-number":"22"},{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:02:34Z","timestamp":1780095754869,"version":"3.54.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003509","name":"\u00d6rebro Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Accrued comorbidities are perceived to increase operative risk. Surgeons may offer operative treatments less often to their older patients with acute complicated calculous biliary disease (ACCBD). We set out to capture ACCBD incidence in older patients across Europe and the currently used treatment algorithms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The European Society of Trauma and Emergency Surgery (ESTES) undertook a snapshot audit of patients undergoing emergency hospital admission for ACCBD between October 1 and 31 2018, comparing patients under and\u2009\u2265\u200965 years. Mortality, postoperative complications, time to operative intervention, post\u2010acute disposition, and length of hospital stay (LOS) were compared between groups. Within the\u2009\u2265\u200965 cohort, comorbidity burden, mortality, LOS, and disposition outcomes were further compared between patients undergoing operative and non\u2010operative management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median age of the 338 admitted patients was 67 years; 185 patients (54.7%) of these were the age of 65 or over. Significantly fewer patients\u2009\u2265 65 underwent surgical treatment (37.8% vs. 64.7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Surgical complications were more frequent in the\u2009\u2265 65 cohort than younger patients, and the mean postoperative LOS was significantly longer. Postoperative mortality was seen in 2.2% of patients\u2009\u2265\u200965 (vs. 0.7%, <jats:italic>p<\/jats:italic>\u2009=\u20090.253). However, operated elderly patients did not differ from non\u2010operated in terms of comorbidity burden, mortality, LOS, or post\u2010discharge rehabilitation need.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Few elderly patients receive surgical treatment for ACCBD. Expectedly, postoperative morbidity, LOS, and the requirement for post\u2010discharge rehabilitation are higher in the elderly than younger patients but do not differ from elderly patients managed non\u2010operatively. With multidisciplinary perioperative optimization, elderly patients may be safely offered optimal treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov (Trial # NCT03610308).<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-06052-0","type":"journal-article","created":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T21:02:37Z","timestamp":1617483757000},"page":"2046-2055","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Patients over 65 years with Acute Complicated Calculous Biliary Disease are Treated Differently\u2014Results and Insights from the ESTES Snapshot Audit"],"prefix":"10.1002","volume":"45","author":[{"given":"Gary A.","family":"Bass","sequence":"first","affiliation":[{"name":"Division of Traumatology, Emergency Surgery &amp; Surgical Critical Care, Penn Presbyterian Medical Center University of Pennsylvania 19104 Philadelphia PA 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Variability exists in the techniques utilized to treat these conditions at an individual surgeon and unit level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To identify, through an international prospective nonrandomized cohort study, the epidemiology and areas of practice variability in management of acute complicated calculous biliary disease (ACCBD) and to correlate them against reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A preplanned analysis of the European Society of Trauma and Emergency Surgery (ESTES) 2018 Complicated Biliary Calculous Disease audit was performed. Patients undergoing emergency hospital admission with ACCBD between 1 October 2018 and 31 October 2018 were included. All eligible patients with acute complicated biliary calculous disease were recorded contemporaneously using a standardized predetermined protocol and a secure online database and followed-up through to 60\u00a0days from their admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Endpoints<\/jats:title>\n                    <jats:p>A two-stage data collection strategy collecting patient demographics, details of operative, endoscopic and radiologic intervention, and outcome metrics. Outcome measures included mortality, surgical morbidity, ICU stay, timing of operative intervention, and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three hundred thirty-eight patients were included, with a mean age of 65\u00a0years and 54% were female. Diagnosis at admission were: cholecystitis (45.6%), biliary pancreatitis (21%), choledocholithiasis with and without cholangitis (13.9% and 18%). Index admission cholecystectomy was performed in just 50% of cases, and 28% had an ERCP performed. Morbidity and mortality were low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first ESTES snapshot audit, a purely descriptive collaborative study, gives rich \u2018real world\u2019 insights into local variability in surgical practice as compared to international guidelines, and how this may impact upon outcomes. These granular data will serve to improve overall patient care as well as being hypothesis generating and inform areas needing future prospective study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00068-020-01433-x","type":"journal-article","created":{"date-parts":[[2020,7,6]],"date-time":"2020-07-06T19:06:37Z","timestamp":1594062397000},"page":"23-35","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns of prevalence and contemporary clinical management strategies in complicated acute biliary calculous disease: an ESTES \u2018snapshot audit\u2019 of practice"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-9443","authenticated-orcid":false,"given":"Gary Alan","family":"Bass","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-4595","authenticated-orcid":false,"given":"Amy","family":"Gillis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3552-9153","authenticated-orcid":false,"given":"Yang","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-487X","authenticated-orcid":false,"given":"Shahin","family":"Mohseni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the European Society for Trauma, Emergency Surgery (ESTES) Cohort Studies Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Shamiyeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Rosetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Klimbacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Klugsberger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Healy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Moriarty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Power","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Knightly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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The European Society of Trauma and Emergency Surgery (ESTES) snapshot audit of complicated biliary calculous disease aims to make novel comparisons between self-reported institutional adherence to the Tokyo guidelines (TG18) and \u2018real-world\u2019 contemporary practice across Europe.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A preplanned analysis of a prospective observational multicentre audit that captured patients undergoing emergency admission for complicated biliary calculous disease (complicated cholecystitis, biliary pancreatitis, or choledocholithiasis with or without cholangitis) between 1 and 31 October 2018 was performed. An anonymized survey was administered to participating sites.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Following an open call for participation, 25 centres from nine countries enrolled 338 patients. All centres completed the anonymized survey. Fifteen centres (60 per cent) self-reported that a minority of patients were treated surgically on index admission, favouring interval cholecystectomy. This was replicated in the snapshot audit, in which 152 of 338 patients (45\u00b70 per cent) underwent index admission cholecystectomy, 17 (5\u00b70 per cent) had interval cholecystectomy, and the remaining 169 (50\u00b70 per cent) had not undergone surgery by the end of the 60-day follow-up. Centres that employed a dedicated acute care surgery model of care were more likely to perform index admission cholecystectomy compared with a traditional general surgery \u2018on call\u2019 service (57 versus 38 per cent respectively; odds ratio 2\u00b714 (95 per cent c.i. 1\u00b737 to 3\u00b735), P &amp;lt; 0\u00b7001). Six centres (24 per cent) self-reported routinely performing blood cultures in acute cholecystitis; patient-level audit data revealed that blood cultures were done in 47 of 154 patients (30\u00b75 per cent). No centre self-reported omitting antibiotics in the management of acute cholecystitis, and 144 of 154 (93\u00b75 per cent) of patients in the snapshot audit received antibiotics during their index admission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Awareness of TG18 recommendations was high, but self-reported adherence and objective snapshot audit data showed low compliance with TG18 in patients with complicated acute biliary calculous disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50294","type":"journal-article","created":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T17:38:31Z","timestamp":1589737111000},"page":"622-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Self-reported and actual adherence to the Tokyo guidelines in the European snapshot audit of complicated 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Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.","name":"copyright","label":"Copyright"}]},{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:05:53Z","timestamp":1789052753786,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012306","name":"Universit\u00e0 degli Studi di Trieste","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012306","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Damage control surgery (DCS) with staged reconstruction may offer an alternative to Hartmann\u2019s procedure in selected unstable patients with generalized peritonitis from acute diverticulitis, but its adoption in routine practice is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nationwide web-based survey explored management of Hinchey III-IV acute diverticulitis, institutional use of open abdomen, and knowledge and application of DCS. Categorical data were summarized as n (%). The survey was endorsed by Italian Society of Emergency and Trauma Surgery (SICUT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 175 respondents, 71.4% reported using Hartmann\u2019s procedure in at least half of severe cases, whereas 37.7% used primary anastomosis in at least one-quarter. Open abdomen was available in 82.3% of institutions. Awareness of DCS was reported by 148\/174 (85.1%), and 116\/168 (69.0%) had used it for severe diverticulitis; however, only 33\/147 (22.4%) used a clinical score. Hemodynamic instability (83.1%), severe peritoneal contamination (73.2%), and the opportunity for delayed anastomosis (64.1%) were the main indications. Respondents with greater emergency surgery commitment more often reported primary anastomosis (48.1% vs. 20.9%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), open abdomen availability (93.5% vs. 64.2%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and previous DCS use (75.5% vs. 58.1%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DCS is familiar to and has been used by most respondents, but selection and implementation remain heterogeneous and rarely score-based. Standardized criteria, shared terminology, and prospective outcome evaluation are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s13304-026-02834-0","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:06:18Z","timestamp":1789049178000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Damage control surgery and open abdomen in Hinchey III\u2013IV acute diverticulitis: current practice from a nationwide Italian 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Emergency surgery (ES) is associated with substantial morbidity and high stoma rates, whereas self-expanding metal stents (SEMS) as a bridge to surgery (BtS) may convert an emergency into an elective setting. This study aimed to compare the safety, efficacy, and quality-of-life outcomes of ES versus SEMS\/BtS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CROSCO-1 is a national, multicenter, prospective observational cohort study conducted in Italy (ClinicalTrials.gov NCT05801211). Consecutive adults with obstructive, non-metastatic left-sided colon cancer (June 2023\u2013October 2024) were included. Patients underwent ES or SEMS followed by elective resection. The primary endpoint was 1-year stoma rate. Secondary outcomes included morbidity, mortality, length of stay, time to chemotherapy, readmissions, oncologic outcomes, and 1-year quality of life (EQ-5D-5L).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 216 patients were analyzed (ES 144; SEMS\/BtS 72). One-year follow-up for the primary outcome was available for 134 ESG and 70 SEMS\/BtS patients. SEMS failure occurred in 8.3%. Major morbidity and mortality at 30 and 90\u00a0days were similar. The 1-year stoma rate was significantly lower after SEMS\/BtS (44.4 vs 73.4%). SEMS\/BtS reduced the risk of stoma persistence (adjusted OR 3.74 for ES;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). SEMS\/BtS was associated with fewer 30-day readmissions (4.2 vs 15.9%) and earlier chemotherapy initiation (76.1 vs 55.8%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). One-year oncologic outcomes were comparable, although limited by short follow-up. Quality of life was significantly better in the SEMS\/BtS group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In selected patients, SEMS as a bridge to surgery is associated with lower 1-year stoma rates and improved quality of life without increasing short-term morbidity. These findings support a tailored, multidisciplinary approach in experienced centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12929-9","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:14:28Z","timestamp":1780514068000},"page":"6567-6576","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Colonic resection or self-expanding metal stents for obstructive left colon cancer: results of a national multicenter prospective cohort study 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We still lack a reliable tool to select high-risk patients who could benefit from these alternatives. Our study aimed to prospectively validate the Chole-risk score in predicting postoperative complications in patients undergoing EC for ACC compared with other preoperative risk prediction models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The S.P.Ri.M.A.C.C. study is a World Society of Emergency Surgery prospective multicenter observational study. From 1st September 2021 to 1st September 2022, 1253 consecutive patients admitted in 79 centers were included. The inclusion criteria were a diagnosis of ACC and to be a candidate for EC. A Cochran-Armitage test of the trend was run to determine whether a linear correlation existed between the Chole-risk score and a complicated postoperative course. To assess the accuracy of the analyzed prediction models\u2014POSSUM Physiological Score (PS), modified Frailty Index, Charlson Comorbidity Index, American Society of Anesthesiologist score (ASA), APACHE II score, and ACC severity grade\u2014receiver operating characteristic (ROC) curves were generated. The area under the ROC curve (AUC) was used to compare the diagnostic abilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A 30-day major morbidity of 6.6% and 30-day mortality of 1.1% were found. Chole-risk was validated, but POSSUM PS was the best risk prediction model for a complicated course after EC for ACC (in-hospital mortality: AUC 0.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; 30-day mortality: AUC 0.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; in-hospital major morbidity: AUC 0.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; 30-day major morbidity: AUC 0.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). POSSUM PS with a cutoff of 25 (defined in our study as a \u2018Chole-POSSUM\u2019 score) was then validated in a separate cohort of patients. It showed a 100% sensitivity and a 100% negative predictive value for mortality and a 96\u201397% negative predictive value for major complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Chole-risk score was externally validated, but the CHOLE-POSSUM stands as a more accurate prediction model. CHOLE-POSSUM is a reliable tool to stratify patients with ACC into a low-risk group that may represent a safe EC candidate, and a high-risk group, where new minimally invasive endoscopic techniques may find the most useful field of action.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial Registration<\/jats:italic>\n                      : ClinicalTrial.gov NCT04995380.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13017-023-00488-6","type":"journal-article","created":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T16:54:25Z","timestamp":1679849665000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Prediction of morbidity and mortality after early cholecystectomy for acute calculous cholecystitis: results of the S.P.Ri.M.A.C.C. study"],"prefix":"10.1186","volume":"18","author":[{"given":"Paola","family":"Fugazzola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Cobianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Di Martino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Tomasoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Dal Mas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikri M.","family":"Abu-Zidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanni","family":"Agnoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ceresoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Coccolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salomone","family":"Di Saverio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Dominioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla Nikita","family":"Far\u00e8","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Frassini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Gambini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ari","family":"Lepp\u00e4niemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Maestri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Mart\u00edn-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest E.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Musella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew B.","family":"Peitzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"de la Hoz Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Sargenti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Sartelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Vigan\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Anderloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Biffl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Catena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ansaloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the S.P.Ri.M.A.C.C. 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Secondary approvals were obtained from all local ethics committees in the participating centers. Patients gave orally and written informed consent prior to inclusion.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20"},{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:23:08Z","timestamp":1791811388301,"version":"4.3.4"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A textbook outcome patient is one in which the operative course passes uneventful, without complications, readmission or mortality. There is a lack of publications in terms of TO on acute cholecystitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objetive<\/jats:title>\n                    <jats:p>The objective of this study is to analyze the achievement of TO in patients with urgent early cholecystectomy (UEC) for Acute Cholecystitis. and to identify which factors are related to achieving TO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This is a post hoc study of the SPRiMACC study. It\u00b4s a prospective multicenter observational study run by WSES. The criteria to define TO in urgent early cholecystectomy (TOUEC) were no 30-day mortality, no 30-day postoperative complications, no readmission within 30\u00a0days, and hospital stay\u2009\u2264\u20097\u00a0days (75th percentile), and full laparoscopic surgery. Patients who met all these conditions were taken as presenting a TOUEC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>1246 urgent early cholecystectomies for ACC were included. In all, 789 patients (63.3%) achieved all TOUEC parameters, while 457 (36.6%) failed to achieve one or more parameters and were considered non-TOUEC. The patients who achieved TOUEC were younger had significantly lower scores on all the risk scales analyzed. In the serological tests, TOUEC patients had lower values for in a lot of variables than non-TOUEC patients. The TOUEC group had lower rates of complicated cholecystitis. Considering operative time, a shorter duration was also associated with a higher probability of reaching TOUEC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Knowledge of the factors that influence the TOUEC can allow us to improve our results in terms of textbook outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13017-024-00539-6","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T02:01:47Z","timestamp":1710986507000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Textbook outcome in urgent early cholecystectomy for acute calculous cholecystitis: results post hoc of the S.P.Ri.M.A.C.C study"],"prefix":"10.1186","volume":"19","author":[{"given":"Paola","family":"Fugazzola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Carbonell-Morote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Cobianchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Coccolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jes\u00fas","family":"Rubio-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Sartelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Biffl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Catena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ansaloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Manuel","family":"Ramia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the S.P.Ri.M.A.C.C. 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Secondary approvals were obtained from all local ethics committees in the participating centers. Patients gave orally and written informed consent prior to inclusion.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12"},{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T04:06:24Z","timestamp":1778299584763,"version":"3.51.4"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T00:00:00Z","timestamp":1651190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The concept of \u201cweekend effect\u201d, that is, substandard healthcare during weekends, has never been fully demonstrated, and the different outcomes of emergency surgical patients admitted during weekends may be due to different conditions at admission and\/or different therapeutic approaches. Aim of this international audit was to identify any change of pattern of emergency surgical admissions and treatments during weekends. Furthermore, we aimed at investigating the impact of the COVID-19 pandemic on the alleged \u201cweekend effect\u201d.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The database of the CovidICE-International Study was interrogated, and 6263 patients were selected for analysis. Non-trauma, 18+ yo patients admitted to 45 emergency surgery units in Europe in the months of March\u2013April 2019 and March\u2013April 2020 were included. Demographic and clinical data were anonymised by the referring centre and centrally collected and analysed with a statistical package. This study was endorsed by the Association of Italian Hospital Surgeons (ACOI) and the World Society of Emergency Surgery (WSES).\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three-quarters of patients have been admitted during workdays and only 25.7% during weekends. There was no difference in the distribution of gender, age, ASA class and diagnosis during weekends with respect to workdays. The first wave of the COVID pandemic caused a one-third reduction of emergency surgical admission both during workdays and weekends but did not change the relation between workdays and weekends. The treatment was more often surgical for patients admitted during weekends, with no difference between 2019 and 2020, and procedures were more often performed by open surgery. However, patients admitted during weekends had a threefold increased risk of laparoscopy-to-laparotomy conversion (1% vs. 3.4%). Hospital stay was longer in patients admitted during weekends, but those patients had a lower risk of readmission. There was no difference of the rate of rescue surgery between weekends and workdays. Subgroup analysis revealed that interventional procedures for hot gallbladder were less frequently performed on patients admitted during weekends.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our analysis revealed that demographic and clinical profiles of patients admitted during weekends do not differ significantly from workdays, but the therapeutic strategy may be different probably due to lack of availability of services and skillsets during weekends. The first wave of the COVID-19 pandemic did not impact on this difference.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13017-022-00425-z","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T10:04:22Z","timestamp":1651226662000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The weekend effect on the provision of Emergency Surgery before and during the COVID-19 pandemic: case\u2013control analysis of a retrospective multicentre database"],"prefix":"10.1186","volume":"17","author":[{"given":"Giovanni D.","family":"Tebala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marika S.","family":"Milani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Cirocchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Bignell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giles","family":"Bond-Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanni","family":"Agnoletti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Catarci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salomone","family":"Di Saverio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluigi","family":"Luridiana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fausto","family":"Catena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Scatizzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Marini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the CovidICE-International Collaborative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Lo Dico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Stracqualursi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Russo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"D\u2019Errico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Cianci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Restini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Scialandrone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Guercioni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Pezzolla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. 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Massey, Georgios Seitidis, Dimitris Mavridis, & Stavros A. Antoniou have no financial or intellectual conflicts of interest to report Disclosures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent"}}]},{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T06:30:35Z","timestamp":1772692235545,"version":"3.50.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA&gt;1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13017-022-00407-1","type":"journal-article","created":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T06:03:13Z","timestamp":1643349793000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? 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Dig Liver Dis. 2020;52:1090\u20131.","journal-title":"Dig Liver Dis"}],"container-title":["World Journal of Emergency Surgery"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13017-022-00407-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13017-022-00407-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13017-022-00407-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T06:07:43Z","timestamp":1643350063000},"score":0.6529083,"resource":{"primary":{"URL":"https:\/\/wjes.biomedcentral.com\/articles\/10.1186\/s13017-022-00407-1"}},"issued":{"date-parts":[[2022,1,28]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["407"],"URL":"https:\/\/doi.org\/10.1186\/s13017-022-00407-1","ISSN":["1749-7922"],"issn-type":[{"value":"1749-7922","type":"electronic"}],"published":{"date-parts":[[2022,1,28]]},"assertion":[{"value":"23 November 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 January 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Formal ethical committee approval was not deemed to be necessary due to the retrospective nature and anonymised nature of the audit. However, the study was approved by the Comitato Etico ATS Sardegna on 22.12.2020 and was sponsored by the World Society of Emergency Surgery and by the Associazione dei Chirurghi Ospedalieri Italiani.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests. All authors certify that they have no affiliations with or involvement in any organisation or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"8"},{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:01:25Z","timestamp":1788490885743,"version":"build-2803163510"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T00:00:00Z","timestamp":1723248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Appendicitis is the most frequent global abdominal surgical emergency. An ageing population, who often exhibit atypical symptoms and delayed presentations, challenge conventional diagnostic and treatment paradigms.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>This study aims to delineate disparities in presentation, management, and outcomes between elderly patients and younger adults suffering from acute appendicitis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This subgroup analysis forms part of ESTES SnapAppy, a time-bound multi-center prospective, observational cohort study. It includes patients aged 15\u00a0years and above who underwent laparoscopic appendectomy during a defined 90-day observational period across multiple centers. Statistical comparisons were performed using appropriate tests with significance set at <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study cohort comprised 521 elderly patients (\u226565\u00a0years) and 4,092 younger adults (18\u201364\u00a0years). Elderly patients presented later (mean duration of symptoms: 7.88 vs. 3.56\u00a0days; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and frequently required computed tomography (CT) scans for diagnosis (86.1% vs. 54.0%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The incidence of complicated appendicitis was higher in the elderly (46.7% vs. 20.7%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Delays in surgical intervention were notable in the elderly (85.0% operated within 24\u00a0h vs. 88.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.018), with longer operative times (71.1 vs. 60.3\u00a0min; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Postoperative complications were significantly higher in the elderly (27.9% vs. 12.9%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), including severe complications (6.9% vs. 2.4%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and prolonged hospital stays (7.9 vs. 3.6\u00a0days; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our findings highlight significant differences in the clinical course and outcomes of acute appendicitis in the elderly compared to younger patients, suggesting a need for age-adapted diagnostic pathways and treatment strategies to improve outcomes in this vulnerable population.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-024-02620-w","type":"journal-article","created":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T11:02:12Z","timestamp":1723287732000},"page":"2155-2164","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Practice patterns and clinical outcomes in acute appendicitis differ in the elderly patient"],"prefix":"10.1007","volume":"50","author":[{"given":"Matteo 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Injury. 2023;54:56\u201362.","journal-title":"Injury"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02620-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-024-02620-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-024-02620-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T12:09:08Z","timestamp":1732622948000},"score":0.6452179,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-024-02620-w"}},"issued":{"date-parts":[[2024,8,10]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["2620"],"URL":"https:\/\/doi.org\/10.1007\/s00068-024-02620-w","ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"published":{"date-parts":[[2024,8,10]]},"assertion":[{"value":"17 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]},{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T01:05:41Z","timestamp":1793495141766,"version":"4.5.0"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,4,18]],"date-time":"2025-04-18T00:00:00Z","timestamp":1744934400000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2025,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small bowel obstruction (SBO) is a common surgical emergency associated with substantial morbidity, hospital length of stay (LOS), and healthcare cost. The World Society of Emergency Surgery (WSES) Bologna guidelines provide evidence-informed recommendations for managing adhesive SBO, promoting timely surgical intervention (or non-operative management (NOM) when ischaemia, strangulation, or peritonitis are absent). However, guideline adoption and its impact on outcomes remain under studied. Compliance with the Bologna guidelines was evaluated to determine the impact of compliance on outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>SnapSBO, a prospective, multicentre, time-bound, observational cohort study, captured data on patients with adhesive SBO across diverse healthcare settings and patient populations. Patient care was categorized into: successful NOM, surgery after an unsuccessful appropriate trial of NOM (NOM-T), and direct to surgery (DTS). Compliance with diagnostic, therapeutic, and postoperative Bologna guideline recommendations was assessed as either complete or partial. Primary outcomes included adherence to the Bologna guidelines, LOS, complications, and the incidence of the composite metric \u2018optimal outcomes\u2019 (LOS \u22645 days, discharge without complications, and no readmission within 30 days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 982 patients with adhesive SBO, successful NOM occurred in 561 (57.1%), 224 (22.8%) underwent NOM-T, and 197 (20.1%) proceeded DTS. The mean(s.d.) LOS was 5.3(9.0), 12.9(11.4), and 7.7(8.0) days respectively (P &amp;lt; 0.001). Optimal outcomes were achieved in 61.0%, 16.1%, and 37.6% respectively (P &amp;lt; 0.001) and full guideline compliance was observed in 17.2%, 10.1%, and 0.4% respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with adhesive SBO whose care was aligned with the Bologna guidelines had a shorter LOS and a greater incidence of optimal outcomes. Addressing evidence-to-practice gaps through implementation strategies that consider contextual factors will enhance guideline adoption and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf080","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T18:37:15Z","timestamp":1743359835000},"source":"Crossref","is-referenced-by-count":32,"title":["Small bowel obstruction outcomes according to compliance with the World Society of Emergency Surgery Bologna guidelines"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1514-1274","authenticated-orcid":false,"given":"Lewis J","family":"Kaplan","sequence":"first","affiliation":[{"name":"Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania 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University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Small bowel obstruction (SBO) due to hernia remains a prevalent surgical emergency disproportionately affecting elderly and co-morbid populations. Limited high-quality data exist to guide evidence-informed interventions for hernia-related SBO. This study explored the management and outcomes of hernia-related SBO (hSBO) for patients captured in European Society for Trauma and Emergency Surgery (ESTES) SnapSBO database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>SnapSBO is a prospective multicentre time-bound study that accrued consecutive inpatient admissions between November 2023 and May 2024. The present analysis was restricted to patients with abdominal wall hernias. Management pathways were categorized as direct to surgery (DTS), successful non-operative management (NOM), or surgery after trial of NOM (NOM-T). Outcomes of interest included complications, 30-day in-hospital mortality, length of hospital stay (LOS), and functional recovery assessed through patient-reported outcome measures (PROMs) using the PRO-diGI tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1737 patients, SBO due to abdominal wall hernia was noted in 386. The median patient age was 73 (range 16-98) years, with 64.8% of patients aged &amp;gt; 65 years. Primary inguinal\/abdominal wall hernias were the most common (62.2%). Of the patients, 51.6% were categorized as DTS, where 17.1% required surgery after NOM-T. NOM was successful in 31.2% of patients. Parastomal hernia management led to the highest complication rate (57.1%) and prolonged postoperative LOS (mean(standard deviation) 9.1(4.8) days; P = 0.030) compared with other hernia types. Functional recovery measured in 218 patients was significantly worse in those with parastomal hernia than in those with incisional or primary inguinal hernias (mean(standard deviation) bowel function scores 68.6(22.5) versus 83.6(17.6) and 82.0(20.3), respectively; P = 0.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is significant variability in practice and outcomes for hSBO management. Patients with parastomal hernias represent a high-risk subgroup. Future research should focus on PROMs and in developing evidence-based, context-specific guidelines for hSBO management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraf127","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T11:50:19Z","timestamp":1756813819000},"source":"Crossref","is-referenced-by-count":2,"title":["Management and outcome variability in hernia-related small bowel obstruction: insights from the SnapSBO study"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0838-964X","authenticated-orcid":false,"given":"Matteo Maria","family":"Cimino","sequence":"first","affiliation":[{"name":"Department of Emergency Surgery, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1918-9443","authenticated-orcid":false,"given":"Gary 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It is unclear whether a particular surgical technique provides outcome benefit or reduces complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>We undertook a pre-specified subgroup analysis of all patients who underwent laparoscopic appendectomy at index admission during SnapAppy (ClinicalTrials.gov Registration: NCT04365491). We collected routine, anonymized observational data regarding surgical technique, patient demographics and indices of disease severity, without change to clinical care pathway or usual surgeon preference. Outcome measures of interest were the incidence of complications, unplanned reoperation, readmission, admission to the ICU, death, hospital length of stay, and procedure duration. We used Poisson regression models with robust standard errors to calculate incident rate ratios (IRRs) and 95% confidence intervals (CIs).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Three-thousand seven hundred sixty-eight consecutive adult patients, included from 71 centers in 14 countries, were followed up from date of admission for 90\u00a0days. The mesoappendix was divided hemostatically using electrocautery in 1564(69.4%) and an energy device in 688(30.5%). The appendix was amputated by division of its base between looped ligatures in 1379(37.0%), with a stapler in 1421(38.1%) and between clips in 929(24.9%). The technique for securely dividing the appendix at its base in acutely inflamed (AAST Grade 1) appendicitis was equally divided between division between looped ligatures, clips and stapled transection. However, the technique used differed in complicated appendicitis (AAST Grade 2\u2009+) compared with uncomplicated (Grade 1), with a shift toward transection of the appendix base by stapler (58% vs. 38%; <jats:italic>p\u2009&lt;\u2009<\/jats:italic>0.001). While no statistical difference in outcomes could be detected between different techniques for division of appendix base, decreased risk of any [adjusted IRR (95% CI): 0.58 (0.41\u20130.82), <jats:italic>p\u2009=\u2009<\/jats:italic>0.002] and severe [adjusted IRR (95% CI): 0.33 (0.11\u20130.96), <jats:italic>p\u2009=\u2009<\/jats:italic>0.045] complications could be detected when using energy devices.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Safe mesoappendix transection and appendix resection are accomplished using heterogeneous techniques. Technique selection for both mesoappendix transection and appendix resection correlates with AAST grade. Higher grade led to more ultrasonic tissue transection and stapled appendix resection. Higher AAST appendicitis grade also correlated with infection-related complication occurrence. Despite the overall well-tolerated heterogeneity of approaches to acute appendicitis, increasing disease acuity or complexity appears to encourage homogeneity of intraoperative surgical technique toward advanced adjuncts.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-02191-8","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T18:02:35Z","timestamp":1674583355000},"page":"17-32","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Techniques for mesoappendix transection and appendix resection: insights from the ESTES SnapAppy study"],"prefix":"10.1007","volume":"49","author":[{"given":"Gary Alan","family":"Bass","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewis J.","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian 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Bmc Surg. 2019;19:110.","journal-title":"Bmc Surg"}],"container-title":["European Journal of Trauma and Emergency Surgery"],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-022-02191-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00068-022-02191-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00068-022-02191-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T16:09:01Z","timestamp":1676304541000},"score":0.31840897,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00068-022-02191-8"}},"issued":{"date-parts":[[2023,1,24]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["2191"],"URL":"https:\/\/doi.org\/10.1007\/s00068-022-02191-8","ISSN":["1863-9933","1863-9941"],"issn-type":[{"value":"1863-9933","type":"print"},{"value":"1863-9941","type":"electronic"}],"published":{"date-parts":[[2023,1,24]]},"assertion":[{"value":"6 September 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have no conflict of interest to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]},{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:09:17Z","timestamp":1789776557867,"version":"4.0.1"},"reference-count":55,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003509","name":"\u00d6rebro University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003509","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Trauma Emerg Surg"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>Acute appendicitis is a common surgical emergency, and the standard approach to diagnosis and management has been codified in several practice guidelines. Adherence to these guidelines provides insight into independent surgical practice patterns and institutional resource constraints as impediments to best practice. We explored data from the recent ESTES SnapAppy observational cohort study to determine guideline compliance in contemporary practice to identify opportunities to close evidence-to-practice gaps.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We undertook a preplanned analysis of the ESTES SnapAppy observational cohort study, identifying, at a patient level, congruence with, or deviation from WSES Jerusalem guidelines for the diagnosis and management of acute appendicitis and the Surviving Sepsis Campaign in our cohort. Compliance was then correlated with the incidence of postoperative complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Four thousand six hundred and thirteen (4613) consecutive adult and adolescent patients with acute appendicitis were followed from date of admission (November 1, 2020, and May 28, 2021) for 90\u00a0days. Patient-level compliance with guideline elements allowed patients to be grouped into those with full compliance (all 5 elements: 13%), partial compliance (1\u20134 elements: 87%) or noncompliance (0 elements: 0.2%). We identified an excess postoperative complication rate in patients who received noncompliant and partially compliant care, compared with those who received fully guideline-compliant care (36% and 16%, versus 7.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The observed diagnostic and treatment practices of the participating institutions displayed variability in compliance with key recommendations from existing guidelines. In general, practice was congruent with recommendations for preoperative antibiotic surgical site infection prophylaxis administration, time to surgery, and operative approach. However, there remains opportunities for improvement in the choice of diagnostic imaging modality, postoperative antibiotic stewardship to timely discontinue prophylactic antibiotics, and the implementation of ambulatory treatment pathways for uncomplicated appendicitis in the healthy young adult.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-02208-2","type":"journal-article","created":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T16:08:05Z","timestamp":1675181285000},"page":"45-56","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Clinical practice selectively follows acute appendicitis guidelines"],"prefix":"10.1007","volume":"49","author":[{"given":"Gary 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Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged \u2265\u200915\u00a0years who underwent appendectomy for appendicitis (November 2020\u2013May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-02149-w","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T20:55:44Z","timestamp":1674161744000},"page":"57-67","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical management of acute appendicitis during the European COVID-19 second wave: safe and effective"],"prefix":"10.1007","volume":"49","author":[{"given":"Maximilian Peter","family":"Forssten","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lewis 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AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons\u2019 knowledge and perception of using AI-based tools in clinical decision-making processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society\u2019s website and Twitter profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13017-022-00467-3","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T14:54:30Z","timestamp":1672757670000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Surgeons\u2019 perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey"],"prefix":"10.1186","volume":"18","author":[{"given":"Lorenzo","family":"Cobianchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Piccolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Dal 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The manuscript does not contain data from any person.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1"},{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:29:00Z","timestamp":1790645340327,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society\u2019s website, and shared on the society\u2019s Twitter profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13017-022-00464-6","type":"journal-article","created":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T07:03:51Z","timestamp":1676617431000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Time for a paradigm shift in shared decision-making in trauma and emergency surgery? 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The manuscript does not contain data from any person.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"14"},{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:40:51Z","timestamp":1792683651283,"version":"4.5.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"abstract":"<jats:sec id=\"ab-soi230054-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Considering the lack of equipoise regarding the timing of cholecystectomy in patients with moderately severe and severe acute biliary pancreatitis (ABP), it is critical to assess this issue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi230054-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the outcomes of early cholecystectomy (EC) in patients with moderately severe and severe ABP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi230054-6\">\n                    <jats:title>Design, Settings, and Participants<\/jats:title>\n                    <jats:p>This cohort study retrospectively analyzed real-life data from the MANCTRA-1 (Compliance With Evidence-Based Clinical Guidelines in the Management of Acute Biliary Pancreatitis) data set, assessing 5304 consecutive patients hospitalized between January 1, 2019, and December 31, 2020, for ABP from 42 countries. A total of 3696 patients who were hospitalized for ABP and underwent cholecystectomy were included in the analysis; of these, 1202 underwent EC, defined as a cholecystectomy performed within 14 days of admission. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality and morbidity. Data analysis was performed from January to February 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi230054-7\">\n                    <jats:title>Main Outcomes<\/jats:title>\n                    <jats:p>Mortality and morbidity after EC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi230054-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 3696 patients (mean [SD] age, 58.5 [17.8] years; 1907 [51.5%] female) included in the analysis, 1202 (32.5%) underwent EC and 2494 (67.5%) underwent delayed cholecystectomy (DC). Overall, EC presented an increased risk of postoperative mortality (1.4% vs 0.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) and morbidity (7.7% vs 3.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) compared with DC. On the multivariable analysis, moderately severe and severe ABP were associated with increased mortality (odds ratio [OR], 361.46; 95% CI, 2.28-57 212.31;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02) and morbidity (OR, 2.64; 95% CI, 1.35-5.19;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.005). In patients with moderately severe and severe ABP (n\u2009=\u2009108), EC was associated with an increased risk of mortality (16 [15.5%] vs 0 [0%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), morbidity (30 [30.3%] vs 57 [5.5%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), bile leakage (2 [2.4%] vs 4 [0.4%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.02), and infections (12 [14.6%] vs 4 [0.4%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) compared with patients with mild ABP who underwent EC. In patients with moderately severe and severe ABP (n\u2009=\u2009108), EC was associated with higher mortality (16 [15.5%] vs 2 [1.2%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), morbidity (30 [30.3%] vs 17 [10.3%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), and infections (12 [14.6%] vs 2 [1.3%],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001) compared with patients with moderately severe and severe ABP who underwent DC. On the multivariable analysis, the patient\u2019s age (OR, 1.12; 95% CI, 1.02-1.36;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.03) and American Society of Anesthesiologists score (OR, 5.91; 95% CI, 1.06-32.78;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.04) were associated with mortality; severe complications of ABP were associated with increased mortality (OR, 50.04; 95% CI, 2.37-1058.01;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.01) and morbidity (OR, 33.64; 95% CI, 3.19-354.73;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-soi230054-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study\u2019s findings suggest that EC should be considered carefully in patients with moderately severe and severe ABP, as it was associated with increased postoperative mortality and morbidity. However, older and more fragile patients manifesting severe complications related to ABP should most likely not be considered for EC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamasurg.2023.3660","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T11:35:54Z","timestamp":1692790554000},"page":"e233660","source":"Crossref","is-referenced-by-count":46,"title":["Timing of Cholecystectomy After Moderate and Severe Acute Biliary Pancreatitis"],"prefix":"10.1001","volume":"158","author":[{"given":"Marcello","family":"Di Martino","sequence":"first","affiliation":[{"name":"Division of Hepatobiliary and Liver Transplantation Surgery, A.O.R.N. 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We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (<jats:italic>p<\/jats:italic>\u2009=\u20090.032; 95% CI 1.135\u201315.882; aOR 4.245), qSOFA (<jats:italic>p<\/jats:italic>\u2009=\u20090.005; 95% CI 1.359\u20135.879; aOR 2.828), renal failure (<jats:italic>p<\/jats:italic>\u2009=\u20090.022; 95% CI 1.138\u20135.442; aOR 2.489), and haemodynamic failure (<jats:italic>p<\/jats:italic>\u2009=\u20090.018; 95% CI 1.184\u20135.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (<jats:italic>p<\/jats:italic>\u2009=\u20090.003; 95% CI 1.598\u20139.930; aOR 3.983), abdominal compartment syndrome (<jats:italic>p<\/jats:italic>\u2009=\u20090.032; 95% CI 1.090\u20136.967; aOR 2.735), and gastrointestinal\/intra-abdominal bleeding (<jats:italic>p<\/jats:italic>\u2009=\u20090.009; 95% CI 1.286\u20135.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; 95% CI 1.912\u20137.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (<jats:italic>p<\/jats:italic>\u2009=\u20090.018; 95% CI 0.138\u20130.834; aOR 0.339) and enteral nutrition (p\u2009=\u20090.003; 95% CI 0.143\u20130.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990).<\/jats:p>\n                <jats:p><jats:bold>Graphical abstract<\/jats:bold><\/jats:p>","DOI":"10.1007\/s13304-023-01488-6","type":"journal-article","created":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T17:38:15Z","timestamp":1678556295000},"page":"493-522","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Infected pancreatic necrosis: outcomes and clinical predictors of mortality. 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Ethics Committee approval was obtained from the coordinating centre in Italy (Acceptance Code: Independent Ethics Committee of the University of Cagliari, Prot. P.G.\/2021\/7108). All the investigators conducted the study according to the rules of the local ethics committee regarding the retrospective collection of data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]},{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:06:30Z","timestamp":1793073990364,"version":"4.5.0"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Emerg Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann\u2019s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>564 patients (43.1%) were females. The mean age was 65.9\u2009\u00b1\u200915.6\u00a0years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo\u2009\u2265\u20093b) were higher in the HP group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (<jats:italic>P<\/jats:italic>\u2009=\u20090.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (\u2264\u20093), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>After 100\u00a0years since the first Hartmann\u2019s procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment\u2019s choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13017-024-00543-w","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T09:01:56Z","timestamp":1713258116000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago"],"prefix":"10.1186","volume":"19","author":[{"given":"Gennaro","family":"Perrone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Giuffrida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fikri","family":"Abu-Zidan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitor F.","family":"Kruger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Livrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele Luciano","family":"Petracca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Rossi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Tarasconi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian W. 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Indocyanine green (ICG) fluorescence and flexible endoscopy (FE) are used to assess perfusion and anastomotic integrity. We aimed to evaluate global practice patterns and intersurgeon variability to inform structured recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This international survey was conducted between April and November 2024 within the EAES Rising Stars Academy 2023\u20132024. In a Delphi-like process, 53 questions addressing surgeon characteristics, institutional practice, and the use of ICG and FE were developed and distributed worldwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1367 respondents from 80 countries participated (mean age 64\u2009\u00b1\u200910\u00a0years). ICG was available at 76% of institutions, and 67% of surgeons reported using it. Timing varied: before transection 40%, after transection 7%, before anastomosis 17%, after anastomosis 25%, and both before and after 11%. A fixed dose was used by 71% and weight-based dosing by 29%. FE was performed by 51% of surgeons, with 23% reporting routine intraoperative use. Key barriers included gastroenterologist-led practice (28%), reliance on alternative techniques (20%), and lack of training (19%). Substantial variability was observed across all domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This survey revealed significant heterogeneity in the use of ICG and FE in colorectal surgery. Although ICG is more widely implemented, both techniques lack standardized protocols. Moreover, FE adoption remains limited by training and access. Training should be enhanced and could represent a key area of focus for future EAES programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12974-4","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:14:29Z","timestamp":1783973669000},"page":"7885-7901","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Colorectal anastomotic safety assessment using ICG fluorescence and flexible endoscopy (COLOSSEUM): a global survey of 1367 surgeons"],"prefix":"10.1007","volume":"40","author":[{"given":"A.","family":"Belvedere","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Licardie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Sochorova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Boni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Chand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Perretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Wexner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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Wexner is a consultant for Activ Surgical, Arthrex, Baxter, Becton Dickinson and Company, GlaxoSmithKline, Intuitive Surgical, OstomyCure, Polypid, Seikagaku, and Takeda; has consulting agreements with stock options with OstomyCure and Polypid; and receives royalties from Intuitive Surgical, Karl Storz Endoscopy America Inc., and Unique Surgical Solutions LLC. Dr. Luigi Boni has received consulting fees from Karl Storz, Arthrex, Olympus, CMR Surgical, and Intuitive Surgical. Dr. Mark Chand, Dr. Silvana Perretta, Dr. T.H.A. Arulampalam, Dr. Salvador Morales-Conde, Dr. A. Belvedere, Dr. E. Licardie, Dr. D. Sochorova, and Dr. S.F. Hardon have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]},{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T06:40:18Z","timestamp":1784011218073,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P\u2009=\u20090.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P\u2009=\u20090.121).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. 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History"}},{"value":"https:\/\/doi.org\/10.1007\/s13304-025-02277-z","URL":"https:\/\/doi.org\/10.1007\/s13304-025-02277-z","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"\u00a0Dr. S.D.W. is a Consultant for ActivSurgical, Baxter, Becton, Dickinson and Co., Glaxo Smith Kline, Intuitive Surgical, Medtronic, OstomyCure, Stryker, Takeda, Virtual Ports, is a member of the Data Safety Monitoring Board of JSR\/WCG\/ACI (chair), Polypoid (chair), and Boomerang and receives royalties from Intuitive Surgical, Karl Storz Endoscopy America Inc., and Unique Surgical Solutions, LLC.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent from all participants was obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"All authors approved the publication of the manuscript in the Journal.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Informed consents from participants have been obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"All procedures performed in studies involving humans participants were in accordance with the ethical standards of the institutional and\/or national research committee and with 1964 Helsinki declaration and its later amendments or comparable ethical 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From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS<jats:sup>\u00ae<\/jats:sup> v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6\u2009\u00b1\u20098.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7\u2009\u00b1\u20094.9 on-call shifts per month, with European and North American surgeons experiencing 6.5\u2009\u00b1\u20094.9 and 7.8\u2009\u00b1\u20094.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7\u2009\u00b1\u20096.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity\u2009&gt;\u2009400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI.<\/jats:p>","DOI":"10.1007\/s13304-024-01859-7","type":"journal-article","created":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T19:02:05Z","timestamp":1714417325000},"page":"1615-1633","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Global disparities in surgeons\u2019 workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study"],"prefix":"10.1007","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-0883","authenticated-orcid":false,"given":"Mauro","family":"Podda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Di 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Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"110049"},{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T21:50:27Z","timestamp":1792273827715,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"published-print":{"date-parts":[[2023,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low\u2013middle-income countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of \u2018single-use\u2019 consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low\u2013middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high\u2013 and low\u2013middle\u2013income countries.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znad092","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T20:10:24Z","timestamp":1682021424000},"page":"804-817","source":"Crossref","is-referenced-by-count":51,"title":["Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 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surgery, yet how it is recognized and managed in women across different surgical pathways is unknown. This study aimed to evaluate anaemia prevalence in women and its management across surgical pathways and life stages, examine associations with 30-day outcomes, and estimate the potential benefit of anaemia correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A secondary analysis was conducted of a prospective cohort study from 427 hospitals in 29 countries, including women having elective major abdominal surgery. The primary exposure was surgical pathway (gynaecology versus non-gynaecology), used as a pragmatic proxy for pathway design. Preoperative anaemia and perioperative iron therapy were conceptualized as mediators; menopausal status (pre- versus postmenopausal, by age) was a prespecified effect modifier. Coprimary outcomes were 30-day unplanned readmission and days alive and out of the hospital 30 days from surgery (DAOH30). Mixed-effects logistic regression was used with a hospital random intercept for readmission, and quantile regression for DAOH30. A 2000-iteration cluster bootstrap estimated absolute risk reduction and number needed to treat (NNT\u202f=\u202f1\/absolute risk difference) for counterfactual anaemia correction in key subgroups. Natural-effects models assessed whether recorded perioperative iron therapy partly explained the pathway differences in readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 10\u202f114 women (median age 57.6 years (interquartile range 48.0\u201369.0)) were included; 3590 (35.5%) were premenopausal and 3214 (31.8%) underwent gynaecological surgery. Preoperative anaemia was present in 29.0% and was more frequent in non-gynaecology than gynaecology (31.9% versus 22.8%). Thirty-day unplanned readmission occurred in 7.2%. In adjusted models, the gynaecology pathway had lower odds of readmission than non-gynaecology (adjusted odds ratio 0.78, 95% confidence interval 0.62 to 0.97), whereas preoperative anaemia was associated with higher readmission (adjusted odds ratio 1.28, 1.06 to 1.56). Lower perioperative iron use in non-gynaecology partly mediated the pathway gap (indirect effect odds ratio 1.06, 1.02 to 1.09; proportion mediated 15.2%). The largest model-based absolute risk difference was observed among women of premenopausal age undergoing non-gynaecological surgery: predicted readmission was 11.8% with anaemia versus 6.4% without anaemia, corresponding to an absolute risk difference of 5.32% and an NNT estimand of 19. Median DAOH30 was 26\u2005days (interquartile range 23\u201328). Anaemia was associated with fewer days at home, with the largest decrement among those with poorest recovery (10th percentile \u03b2 \u22123.0 days, 95% confidence interval \u22124.0 to \u22122.0), a smaller reduction at the median (\u03b2 \u22121.0 days, \u22121.3 to \u22120.72), and no difference at the 90th percentile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For women, pathway design, not only patient risk, shapes whether anaemia is recognized and treated. The greatest avoidable harm falls on premenopausal women outside gynaecology. Health systems should embed universal screening and optimization, adopt standardized iron protocols across all pathways, and track life-stage-stratified performance metrics to close this gap and increase days at home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag125","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:51:23Z","timestamp":1784116283000},"source":"Crossref","is-referenced-by-count":0,"title":["Disparities in pathways for anaemia care and recovery among women after major abdominal surgery: secondary analysis of a prospective cohort study in 29 countries"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2748-0011","authenticated-orcid":false,"given":"Sivesh Kathir","family":"Kamarajah","sequence":"first","affiliation":[{"name":"Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham , Birmingham 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The aim of this study was to determine the efficacy and safety of extended prophylaxis after major abdominopelvic surgery for the prevention of clinically relevant venous thromboembolism after hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CArdiovaSCulAr outcomes after major abDominal surgEry (CASCADE) was a prospective, international, cohort study into which consecutive adult patients undergoing major abdominopelvic surgery were enrolled (January\u2013May 2022). Extended prophylaxis was considered at least 28 days of anticoagulant prescription after surgery. The primary efficacy outcome was clinically relevant venous thromboembolism and the primary safety outcome was clinically relevant bleeding within 30 days after surgery (European Medicines Agency definitions). The independent association of these outcomes with extended prophylaxis was explored using mixed-effects logistic regression and propensity score weighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11 571 patients (median age of 58.0 years; 6399 (55.3%) women) from 29 countries were included. The extended prophylaxis prescription rate was 31.7% (3670 patients). The post-discharge venous thromboembolism and bleeding rates were 0.1% (12 patients) and 0.7% (85 patients) respectively. After weighting, extended prophylaxis was not significantly associated with increased bleeding risk (OR 1.07 (95% c.i. 0.64 to 1.81); P = 0.792) or decreased venous thromboembolism incidence, both in the overall cohort (OR 1.13 (95% c.i. 0.33 to 3.90); P = 0.848) and in a subgroup analysis of patients undergoing complex major surgery and with active cancer (OR: 1.36 (95% c.i. 0.33 to 5.57); P = 0.669).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In modern practice, the incidence of postoperative venous thromboembolism is low. Extended prophylaxis appears safe, yet the clinical efficacy remains uncertain. Further work is required to define patients who stand to benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf005","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T23:18:46Z","timestamp":1736378326000},"source":"Crossref","is-referenced-by-count":6,"title":["Extended pharmacological thromboprophylaxis and clinically relevant venous thromboembolism after major abdominal and pelvic surgery: international, prospective, propensity score-weighted cohort study"],"prefix":"10.1093","volume":"112","author":[{"name":"EuroSurg Collaborative and STARSurg 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