Guinevere Granite

Background: Mature cystic teratomas are some of the most common benign ovarian germ cell tumors and are often discovered incidentally during imaging or surgery. Reports on the gross anatomical relationships for these lesions during body donor dissection are particularly limited. This case study explores an ovarian mass with gross features consistent with a mature cystic teratoma discovered during a routine donor dissection and draws attention to the academic and educational value to be gained from its integration into anatomical instruction. Methods: Routine dissection of an 89-year-old female donor revealed a unilateral, well-encapsulated ovarian mass within the mesosalpinx of the left uterine tube. Gross anatomical relationships to nearby structures were documented photographically. The lesion was measured and examined for distinguishing macroscopic features. Results: The ovarian mass measured approximately 7 × 4 × 5 cm³ and was completely contained within a smooth external capsule. After incision, it was found that the lesion contained profuse sebaceous contents and hair; all findings consistent with a mature cystic teratoma. Direct observation of the mass in situ allowed for analysis of its anatomical relationships with adjacent pelvic organs. This supported assimilation of gross anatomy, embryology, and ovarian pathology during first-year medical education. Conclusions: Discovery of ovarian masses during donor dissection provides a unique opportunity for intact pelvic anatomy education to be integrated with uncommon pathologic findings. Gross documentation of lesions exhibiting characteristics consistent with mature cystic teratomas can enhance anatomical education, while simultaneously contributing a more comprehensive description of these uncommon lesions to the currently limited literature.

Historical and post-conflict mass grave programmes increasingly recover genetic profiles from skeletal remains, yet final identification may remain limited when family reference collection, post-mortem analysis, matching and re-analysis are organised as separate projects. This evidence-informed framework development study presents the Kinship-Centred Continuous Identification Framework for settings in which the possible victim set is open or uncertain. Framework development is defined as the integration of established evidence and operational standards into a time-ordered system with explicit decision points, feedback pathways and governance requirements; individual components are not claimed as novel. A purposive evidence map covering database inception to 9 May 2026 identified recurrent operational bottlenecks across legal medicine, forensic genetics, humanitarian forensic action, archaeology, anthropology, disaster victim identification and transitional justice. The synthesis produced seven design principles and ten implementation components. The framework begins before excavation with mandate clarification, a provisional candidate-victim list, genealogical triage and prioritised family reference collection. It incorporates commingling-aware sampling, profile-informativity classification, question-led marker selection, direct and programme-wide matching, trained human interpretation and multidisciplinary reconciliation. Paterna Cemetery (Valencia, Spain), containing mass graves associated with executions during the Francoist repression, served as the case-generating example; published programme-level evidence illustrates why grave assignment, candidate lists and genealogies must remain revisable. The framework also requires periodic re-examination of direct-reference options and unresolved profiles. Its central premise is that skeletal degradation and progressive loss of highly informative relatives are coupled constraints. Legal medicine services should therefore move from episodic exhumation support toward accountable, consent-based and continuously updated identification infrastructure.

Low back pain (LBP) is the leading cause of years lived with disability globally, and a major rehabilitation priority, yet nursing education often does not translate burden evidence into first-contact actions across care settings. This article aimed to develop a nursing education and practice framework that converts global LBP evidence into competencies for assessment, education, medication safety, referral, follow-up and occupational prevention. A focused, Global Burden of Disease-informed narrative review and practice-oriented educational synthesis was conducted. PubMed/MEDLINE, CINAHL, Scopus, Google Scholar, and organisational sources were searched for burden estimates, clinical guidelines, pain education scholarship, nursing occupational health evidence and nurse-led self-management literature. Sources were selected for relevance to nurse-deliverable actions and curriculum assessment; systematic-review methods, meta-analysis and formal risk-of-bias appraisal were not used. Evidence was mapped iteratively to six nursing practice domains: red-flag triage and escalation; functional, psychosocial and contextual assessment; brief therapeutic education; medication safety and low-value-care reduction; follow-up and referral; and occupational prevention. The revised framework adds an explicit evidence-to-competency map, implementation guidance and evaluation indicators for undergraduate education, postgraduate training, continuing professional development, clinical supervision and quality improvement. LBP should be taught as a nursing-sensitive disability and rehabilitation priority, supporting nurses to screen for danger, validate pain, reduce threat, promote graded activity, monitor medicines, coordinate continuity and prevent occupational harm.

Surgical safety depends on recognition of patient‐specific anatomy when encountered structures depart from population norms. Knowledge of anatomical variations is often treated as supplemental rather than as a safety‐relevant necessity. This article aims to translate a title‐informed map of literature on anatomical variation, surgical education, and patient safety into a practical competency framework for surgical training. A targeted, title‐informed conceptual review was conducted in March 2026. PubMed was searched using anatomical‐variation terms combined with surgery, education, patient safety, curriculum, assessment, simulation, reporting, and competency terms. PubMed Central, publisher pages, DOI landing pages, and cross‐indexed scholarly sources were used for retrieval and verification. Titles and formal source descriptions were screened for signals linking anatomical variation with clinical risk, surgical error, curriculum, assessment, terminology, reporting, visualization, simulation, patient safety, or competency‐based education. This method was designed for conceptual synthesis rather than prevalence estimation, effect‐size analysis, or a complete evidence map. Six recurrent framings were identified: anatomical variation as a clinical hazard, curriculum and assessment gap, terminology and reporting problem, visualization and simulation challenge, team‐communication and systems issue, and competency‐based training target. These framings support defining variant anatomy literacy as the capability to anticipate, identify, interpret, adapt to, communicate, document and learn from clinically consequential anatomical variation before, during and after operative care. Surgical curricula should move beyond recall of rare variants and assess observable safety behavior under anatomical uncertainty. Practical implementation can integrate patient‐specific imaging, donor contrast, simulation, operative observation, briefing and debriefing, operative‐note audit, and morbidity‐and‐mortality learning.

Multiple rare vascular variations were identified in a 97-year-old female donor during the dissection of the gastrointestinal system. An anomalous middle colic artery originated from the celiac trunk alongside the three normal branches. The left hepatic artery, an accessory left hepatic artery, and the right hepatic artery all originated from the proper hepatic artery. The right hepatic artery exhibited a “caterpillar hump” and an abnormal tripod distal branching pattern, consisting of a very short cystic artery and two short right hepatic arteries (one superior and one inferior). Additionally, an accessory cystic artery arose from the inferior pancreaticoduodenal artery, ascending inferiorly to the common bile duct and cystic duct towards the gallbladder to join the cystic artery posteriorly. The right and middle colic arteries originated from a right colic middle colic common arterial trunk. The left colic artery and the sigmoidal arteries also originated from a left colic-sigmoidal common arterial trunk. Surgical and medical procedures in the pancreaticobiliary region are widespread, and cholecystectomy is one of the most common surgeries performed worldwide. A laparoscopic approach is the current ‘gold standard’ surgical approach. Knowledge of these potential gastrointestinal vascular variations is essential to ensure patient safety and avoid iatrogenic complications. The presence of an unidentified caterpillar-type right hepatic artery poses a significant risk of accidental ligation during cholecystectomy. Similarly, the presence of common colic arterial trunks alters the vascular landscape for laparoscopic colectomy. To ensure favorable surgical outcomes, comprehensive preoperative vascular imaging should be performed to identify such rare configurations. In this article, we discussed the frequency, embryology, physiology, and clinical and surgical implications of the anatomical variations present in this donor. To date, there have been no other reports in the literature describing this specific combination of variations.

Background: Cancer and its treatments frequently lead to physical and psychological symptoms that negatively affect quality of life. Massage therapy has been proposed as a complementary intervention to reduce symptom burden through its effects on stress regulation and autonomic balance. This systematic review and meta-analysis evaluated the effectiveness of massage therapy in patients with cancer. Methods: A systematic search was conducted in MEDLINE, Web of Science, Scopus, Embase, Google Scholar, and CINAHL. Search terms included “massage therapy,” “reflexology,” “massage,” and “cancer.” Randomized controlled trials comparing massage therapy with placebo or standard care and reporting quantitative outcomes were eligible. Seven studies met inclusion criteria for the meta-analysis. Results: Compared with control conditions, massage therapy was associated with significant improvements in several outcomes: Behavioral Symptoms Frequency (BSF) (MD = −12.54; 95% CI: −18.70 to −6.38; p < 0.0001), Quality of Life Questionnaire (QLQ) scores (SMD = 10.10; 95% CI: 1.21 to 19.00; p = 0.03), Spielberger State–Trait Anxiety Inventory (STAI) scores (MD = −3.97; 95% CI: −4.63 to −3.31; p = 0.0001), and Visual Analog Scale (VAS) symptom intensity (MD = −1.09; 95% CI: −2.11 to −0.07; p = 0.04). Overall certainty of evidence was limited by methodological heterogeneity and risk of bias. Conclusions: Massage therapy may provide short-term improvements in selected physical and psychological symptoms in cancer patients and may serve as a supportive complementary intervention. However, the evidence remains limited, and well-designed trials with standardized protocols are needed to strengthen the reliability of these findings.

Background: The radial artery (RA) is one of the terminal branches of the brachial artery, extending along the lateral forearm, crossing the anatomical snuffbox, and contributing to the palmar arches. Anatomical variations in the RA are of great clinical relevance due to their implications in procedures such as transradial catheterization, arterial cannulation, and bypass grafting. These variants may alter the course, branching pattern, or origin of the vessel, potentially increasing procedural complexity and the risk of iatrogenic injury. In critically ill patients and in surgical or interventional settings, accurate identification of RA anatomy is essential. The objective of this study was to systematically identify and describe RA variants reported in the scientific literature and to analyze their clinical relevance. Methods: A systematic search was conducted across six electronic databases: Medline, Scopus, Web of Science, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Latin American and Caribbean Literature in Health Sciences (LILACS), covering publications up to July 2025. Eligible studies included anatomical, radiological, and surgical investigations reporting RA variants. Study quality was evaluated using the Assessment of Quality in Anatomical Studies (AQUA) tool. Quantitative synthesis was performed using a random-effects model to estimate the pooled prevalence of RA variants and subgroup differences. Twenty-three studies met the inclusion criteria, and eleven were included in the meta-analysis, encompassing a total of 6320 participants. Results: Radial artery variants were categorized into three main types: variations in origin, course, and branching pattern. The pooled global prevalence of RA variants was 12% (95% CI: 6–18%), with substantial heterogeneity (I² = 97.7%). Higher prevalence was found in imaging-based studies (14%) compared with donor-based studies (12%). Sex-based subgroup analysis revealed a higher prevalence in females (18%; CI: 9–28%) compared with males (3%; CI: 3–4%), with moderate heterogeneity (I² = 61.3%). Regionally, European populations demonstrated a higher prevalence (20%) than Asian populations (11%), both showing high heterogeneity (I² > 98%). Notably, only one study from the Americas and none from Africa or Oceania were identified, representing a major geographical limitation in the available data. The findings of this study highlight the considerable variability in RA anatomy across populations. Such variations hold significant clinical importance, particularly in the context of transradial interventions, arterial cannulation, and reconstructive procedures where vascular integrity is critical. The high degree of heterogeneity observed may reflect differences in population genetics, sample size, and imaging or dissection methodologies. The limited representation of certain regions underscores the need for further anatomical and radiological studies to obtain a more comprehensive understanding of global RA variability. Preoperative or pre-procedural imaging using Doppler ultrasonography or computed tomography angiography is recommended to identify anomalous patterns and minimize iatrogenic complications. Conclusions: Radial artery variants are frequent and diverse. Their recognition is fundamental for the safety and success of invasive and surgical procedures in the upper limb. A standardized approach to vascular evaluation, particularly through preoperative imaging, is essential to improve procedural outcomes and reduce the risk of arterial injury in clinical practice.

Background: The arcuate foramen (AF) is a bony bridge formed by the ossification of the atlantooccipital ligament that covers the groove of the vertebral artery (VA). It contains the VA, the suboccipital nerve and the vertebral venous plexus. Objectives: We aimed to assess and compare the frequency of the complete AF in a Chalcolithic and a contemporary Iberian Peninsula sample. Methods: We analyzed in situ the presence or absence of the AF in 34 adult Iberian Peninsula Chalcolithic skeletons and in 120 Iberian Peninsula adult present-day subjects that underwent a computed tomography study. Results: The AF prevalence was 11.6% for the current subjects and 11.8% for Chalcolithic remains (p = 0.927). No significant difference was observed in AF presence between males and females in both the present-day (p = 0.757) and Chalcolithic samples (p = 0.580). Conclusions: There were no AF prevalence differences between the Iberian Peninsula Chalcolithic and the present-day Iberian Peninsula samples analyzed. This information will serve to provide pertinent knowledge regarding the presence of the AF in Iberian Peninsula Chalcolithic samples in comparison to Iberian Peninsula present-day subjects.