Introduction: Colon perforation caused by the intrauterine device (IUD) migration is rare, but severe complication that can occur years after the insertion. Depending on the location of the injured intestine, the different methods for extracting migrated IUD raging from colonoscopy to laparotomy can be chosen. Case presentation: A 41-year-old female presented with the discomfort in the epigastric area went to the outpatient clinic. A doctor performed gastroscopy and found a polyp. During a colonoscopy, we found a small solid object protruding through the intestinal wall. CT scan showed IUD like “T” shape foreign body, which longest part was protruding a wall of the colon. After these CT findings, the patient informed us that she had IUD inserted almost ten years ago. We found the device with the laparoscopic approach. IUD was removed and the intestinal damage was repaired during the mini-laparotomy. Conclusions: Perforation of IUD can be asymptomatic, although sometimes it can cause short-term or long-term symptoms. Penetrated IUDs should be removed whenever identified. For intra-abdominal penetrations, the laparoscopic or mini-laparotomy approach is a safe and appropriate method. Highlights:

Introduction. Both mesenteric cysts and cystic lymphangiomas are scarce and clinically and radiologically almost identical derivatives, but their histological structure is fundamentally different. Case Presentation. A 52-year-old woman was consulted by a surgeon for a derivative felt in her abdomen. The patient said she felt a growing derivative in the abdomen about a month ago. After consulting and testing, a sigmoid colon mesenteric cyst (13 cmx11 cmx10 cm) was found. Complete excision of the cyst within healthy tissues was performed through laparotomy. The surgery had no complications. The initial pathological answer was a simple mesothelial cyst (a rare histological finding). However, immunohistochemical tests were performed that showed that diagnosis was mesenteric cystic lymphangioma (ML). Cystic lymphangiomas that have a link to the mesentery have been described less than 200 times. Conclusions. Final differential diagnosis between different cystic derivatives is possible only based on histopathological examinations. Mesenteric lymphangioma is most common at a very young age, but in rare cases, it also occurs in adults. All clinicians should increase their awareness of the disease.

Research on emerging technologies such as AI-driven health interventions, extended reality (XR) systems, biobanks, and genome editing poses novel ethical challenges that traditional ethics governance models struggle to address. This article explores various models of research ethics governance within the European Union (EU) context, starting from traditional one-time research ethics committee (REC) reviews, REC review with post-approval monitoring, as well as alternative models such as ethics self-assessment, and ethics-by-design approaches. Based on literature analysis and a survey of European research ethics experts, the study identifies prevalent models of research ethics oversight, research ethics expert perceptions of their sufficiency, and challenges such as insufficient technical and ethics expertise, lack of specific guidelines, and unclear boundaries of REC responsibilities. Findings also indicate that traditional REC reviews remain dominant but have limitations in effectively managing rapidly evolving technologies. Research ethics experts highlighted the feasibility of continuous oversight mechanisms to better integrate ethical reflection throughout the research lifecycle. The article concludes by recommending a shift towards proportional, risk-based oversight, development of clearer, technology-specific guidelines, enhanced REC training, and improved harmonization across EU ethics governance systems to address current gaps.

Background: Academic medicine often struggles to balance leadership duties with maintaining research productivity. The impact of holding a position of power on authorship practices in a hierarchical environment remains underexplored. We addressed this gap by examining how leadership roles influence publication and collaboration patterns in Lithuanian medical academia. Methods: We performed a bibliometric analysis of ten-year publication records for 633 Lithuanian medical researchers in formal leadership positions (department heads, center directors, and similar formal roles), comparing their output and authorship patterns to those of peers without such roles. Publication data were collected from PubMed and a national academic library, capturing total publications, author order (first/middle/last author positions), and co-authorship counts. We used statistical tests to compare groups and applied the Gini coefficient to assess inequality in research output. Results: Leaders showed distinct authorship roles and collaboration patterns. Compared to equally productive non-leaders, leaders had significantly fewer first-authored papers (10.79% vs 36.31%) and more last-authored (36.42% vs 23.57%) and middle-authored contributions (52.78% vs 40.12%). Leaders published more papers (average 78.42 vs 49.41), in Web of Science–indexed journals (average 49.44 vs 27.68), and had higher h-indices (19.66 vs 12.59) (all p < 0.001). They also more frequently co-authored in larger teams (>5 co-authors: 58.76% vs 51.79%, p < 0.001). Output inequality among leaders was high (Gini = 0.718). Gender trends differed: prolific leaders were mostly men, while prolific non-leaders were mostly women. Importantly, these authorship patterns remained consistent across leader subgroups with varying productivity levels. Conclusions: Leadership position significantly impacts authorship practices and research productivity in Lithuanian medical academia -leaders display different patterns of collaboration and authorship positions, along with considerable institutional and gender disparities. The results illustrate how hierarchical power dynamics shape academic publishing in Lithuanian medical institutions. This evaluation could lead to important changes for organizational development and policies that ensure authorship credit accurately reflects actual contributions to research. From a research ethics perspective, authorship involves both accountability and recognition. The leadership-related shifts we observe require ethical scrutiny; our bibliometric analysis reveals structural patterns but cannot determine whether specific papers meet ICMJE authorship criteria.

Research ethics committees (RECs) help uphold ethical research, but little is known about how their funding affects their capacity, especially in crises. Via survey data from 324 REC representatives in 80 countries, we examine funding sources, perceived compensation adequacy, and operational challenges during the COVID-19 pandemic. About one-fifth reported having no funding for operations or compensation, and only around one-third viewed their compensation as adequate. Funding constraints were more pronounced in low- and middle-income countries and may be associated with greater reported challenges. Our findings suggest that REC resilience during crises depends on stable support, especially from policymakers and institutional leaders.