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Aranovich D, Goldman YF, Tchernin N, Alfici R, Dudkiewicz M, Khan M, Ohana Y, Kessel B. Specialized educational program for high-grade liver injury management: a three-dimensional printed model approach. Surg Today 2024:10.1007/s00595-024-02911-0. [PMID: 39126494 DOI: 10.1007/s00595-024-02911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 07/09/2024] [Indexed: 08/12/2024]
Abstract
PURPOSE The study aims to present a specialized educational program using a 3D printed model for managing Grade IV and V liver injuries. Hepatic packing, a common technique, may not always achieve sufficient hemostasis in these cases, warranting alternative solutions such as mesh liver wrapping. However, mastering this procedure is challenging due to limited teaching resources and the need for repeated practice. METHODS A computer-based model was created from an abdominal CT scan to produce a real-sized injured liver model using thermoplastic elastomer TPU-95. Trainees received systematic instruction from an instructor, allowing them to perform the procedure under supervision and independently. RESULTS Eight surgical residents at Hillel Yaffe Medical Center participated in the program, with the majority successfully completing the procedure under supervision. Furthermore, trainees demonstrated reduced procedure times when performing independently, indicating improved proficiency. CONCLUSION This educational approach offers a simple and repeatable method for continuous training in managing high-grade liver injuries, holding potential for enhanced patient outcomes.
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Affiliation(s)
- David Aranovich
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel.
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | | | - Neev Tchernin
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ricardo Alfici
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel
| | - Mickey Dudkiewicz
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Hospital Administration, Hillel Yaffe Medical Center, Hadera, Israel
| | - Mansoor Khan
- Brighton and Sussex Medical School, Brighton, UK
| | - Yoram Ohana
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- 3D Segmentation Laboratory, Hillel Yaffe Medical Center, Hadera, Israel
| | - Boris Kessel
- Surgical Division, Hillel Yaffe Medical Center, Hadera, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Pistollato F, Madia F, Corvi R, Munn S, Grignard E, Paini A, Worth A, Bal-Price A, Prieto P, Casati S, Berggren E, Bopp SK, Zuang V. Current EU regulatory requirements for the assessment of chemicals and cosmetic products: challenges and opportunities for introducing new approach methodologies. Arch Toxicol 2021; 95:1867-1897. [PMID: 33851225 PMCID: PMC8166712 DOI: 10.1007/s00204-021-03034-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/18/2021] [Indexed: 12/28/2022]
Abstract
The EU Directive 2010/63/EU on the protection of animals used for scientific purposes and other EU regulations, such as REACH and the Cosmetic Products Regulation advocate for a change in the way toxicity testing is conducted. Whilst the Cosmetic Products Regulation bans animal testing altogether, REACH aims for a progressive shift from in vivo testing towards quantitative in vitro and computational approaches. Several endpoints can already be addressed using non-animal approaches including skin corrosion and irritation, serious eye damage and irritation, skin sensitisation, and mutagenicity and genotoxicity. However, for systemic effects such as acute toxicity, repeated dose toxicity and reproductive and developmental toxicity, evaluation of chemicals under REACH still heavily relies on animal tests. Here we summarise current EU regulatory requirements for the human health assessment of chemicals under REACH and the Cosmetic Products Regulation, considering the more critical endpoints and identifying the main challenges in introducing alternative methods into regulatory testing practice. This supports a recent initiative taken by the International Cooperation on Alternative Test Methods (ICATM) to summarise current regulatory requirements specific for the assessment of chemicals and cosmetic products for several human health-related endpoints, with the aim of comparing different jurisdictions and coordinating the promotion and ultimately the implementation of non-animal approaches worldwide. Recent initiatives undertaken at European level to promote the 3Rs and the use of alternative methods in current regulatory practice are also discussed.
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Affiliation(s)
- Francesca Pistollato
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Federica Madia
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Raffaella Corvi
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Sharon Munn
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Elise Grignard
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Alicia Paini
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Andrew Worth
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Anna Bal-Price
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Pilar Prieto
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Silvia Casati
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Elisabet Berggren
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Stephanie K Bopp
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy
| | - Valérie Zuang
- Directorate F-Health, Consumers and Reference Materials, Unit F3 Chemicals Safety and Alternative Methods, European Commission, Joint Research Centre (JRC), Via E. Fermi, 2749. TP126, 21027, Ispra, VA, Italy.
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Bressers S, van den Elzen H, Gräwe C, van den Oetelaar D, Postma PHA, Schoustra SK. Policy driven changes in animal research practices: mapping researchers' attitudes towards animal-free innovations using the Netherlands as an example. Res Integr Peer Rev 2019; 4:8. [PMID: 31024742 PMCID: PMC6477718 DOI: 10.1186/s41073-019-0067-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/18/2019] [Indexed: 11/10/2022] Open
Abstract
Background Reducing the number of animals used in experiments has become a priority for the governments of many countries. For these reductions to occur, animal-free alternatives must be made more available and, crucially, must be embraced by researchers. Methods We conducted an international online survey for academics in the field of animal science (N = 367) to explore researchers’ attitudes towards the implementation of animal-free innovations. Through this survey, we address three key questions. The first question is whether scientists who use animals in their research consider governmental goals for animal-free innovations achievable and whether they would support such goals. Secondly, responders were asked to rank the importance of ten roadblocks that could hamper the implementation of animal-free innovations. Finally, responders were asked whether they would migrate (either themselves or their research) if increased animal research regulations in their country of residence restricted their research. Results While nearly half (40%) of the responders support governmental goals, the majority (71%) of researchers did not consider such goals achievable in their field within the near future. In terms of roadblocks for implementation of animal-free methods, ~ 80% of the responders considered ‘reliability’ as important, making it the most highly ranked roadblock. However, all other roadblocks were reported by most responders as somewhat important, suggesting that they must also be considered when addressing animal-free innovations. Importantly, a majority reported that they would consider migration to another country in response to a restrictive animal research policy. Thus, governments must consider the risk of researchers migrating to other institutes, states or countries, leading to a ‘brain-drain’ if policies are too strict or suitable animal-free alternatives are not available. Conclusion Our findings suggest that development and implementation of animal-free innovations are hampered by multiple factors. We outline three pillars concerning education, governmental influence and data sharing, the implementation of which may help to overcome these roadblocks to animal-free innovations. Electronic supplementary material The online version of this article (10.1186/s41073-019-0067-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- S Bressers
- Radboud Honours Academy, Radboud University, Nijmegen, the Netherlands
| | - H van den Elzen
- Radboud Honours Academy, Radboud University, Nijmegen, the Netherlands
| | - C Gräwe
- Radboud Honours Academy, Radboud University, Nijmegen, the Netherlands
| | | | - P H A Postma
- Radboud Honours Academy, Radboud University, Nijmegen, the Netherlands
| | - S K Schoustra
- Radboud Honours Academy, Radboud University, Nijmegen, the Netherlands
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