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Using clinical cases to guide healthcare

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World Journal of Clinical Cases 2024年第9期12卷 1555-1559页

作者： Michael Colwill Samantha Baillie richard Pollok andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

Evidence-based practice(EBP)has been the gold standard in healthcare for nearly three centuries and aims to assist physicians in providing the safest and most effective healthcare for their *** well-established hierarchy of evidence lists systematic reviews and meta-analyses at the top however these methodologies are not always appropriate or possible and in these instances case-control studies,case series and case reports are utilised to support ***-control studies allow simultaneous study of multiple risk factors and can be performed rapidly and relatively cheaply.A recent example was during the Coronavirus pandemic where case-control studies were used to assess the efficacy of personal protective equipment for healthcare *** series and case reports also play a role in EBP and are particularly useful to study rare diseases such as inflammatory bowel disease in transgender and gender non-conforming *** are also vital in generating and disseminating early signals and encouraging further *** these methodologies have weaknesses,particularly with regards to bias and loss of patient confidentiality for rare pathologies,they have an important part to play in EBP and when appropriately utilised can significantly impact upon clinical practice.

关键词： Evidence based medicine Hierarchy of evidence Case reports Case series

Carbon dioxide enrichment affected flower numbers transiently and increased successful post-pollination development stably but without altering final acorn production in mature pedunculate oak (Quercus robur L.)

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Journal of Forestry Research 2024年第4期35卷 1-12页

作者： Ryan McClory richard H.Ellis Martin Lukac Jo Clark Carolina Mayoral Kris M.Hart andrew R.G.Plackett A.Rob MacKenzie School of Agriculture Policy and DevelopmentUniversity of ReadingAgricultureEarley GateWhiteknights RoadPO Box 237Reading RG66EUUK Faculty of Forestry and Wood Sciences Czech University of Life Sciences PraguePrague 165000Czechia Future Trees Trust Harwell Innovation CentreBuilding 173Curie AvenueHarwellOxford OX110QGUK Birmingham Institute of Forest Research University of BirminghamEdgbastonBirmingham B152TTUK School of Biosciences University of BirminghamEdgbastonBirmingham B152TTUK School of Geography Earth and Environmental SciencesUniversity of BirminghamEdgbastonBirmingham B152TTUK

Acorn production in oak(Quercus spp.)shows considerable inter-annual variation,known as masting,which provides a natural defence against seed predators but a highly-variable supply of acorns for uses such as in commercial tree planting each *** emissions of greenhouse gases have been very widely reported to influence plant growth and seed or fruit size and quantity via the‘fertilisation effect’that leads to enhanced *** examine if acorn production in mature woodland communities will be affected by further increase in CO_(2),the contents of litter traps from a Free Air Carbon Enrichment(FACE)experiment in deciduous woodland in central England were analysed for numbers of flowers and acorns of pedunculate oak(Quercus robur L.)at different stages of development and their predation levels under ambient and elevated CO_(2) ***-annual variation in acorn numbers was considerable and cyclical between 2015 and 2021,with the greatest numbers of mature acorns in 2015,2017 and 2020 but almost none in *** numbers of flowers,enlarged cups,immature acorns,empty acorn cups,and galls in the litter traps also varied amongst years;comparatively high numbers of enlarged cups were recorded in 2018,suggesting *** at this site is a fruit maturation masting species(i.e.,the extent of abortion of pollinated flowers during acorn development affects mature acorn numbers greatly).Raising the atmospheric CO_(2) concentration by 150μL L^(−1),from early 2017,increased the numbers of immature acorns,and all acorn evidence(empty cups+immature acorns+mature acorns)detected in the litter traps compared to ambient controls by 2021,but did not consistently affect the numbers of flowers,enlarged cups,empty cups,or mature *** number of flowers in the elevated CO_(2) plots’litter traps was greater in 2018 than 2017,one year after CO_(2) enrichment began,whereas numbers declined in ambient *** with CO_(2) also increased the number o

关键词： Quercus robur L. Acorns Masting Pedunculate oak Carbon dioxide

Biofabrication of nanocomposite-based scaffolds containing human bone extracellularmatrix for the differentiation of skeletal stem and progenitor cells

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Bio-Design and Manufacturing 2024年第2期7卷 121-136页

作者： Yang-Hee Kim Janos M.Kanczler Stuart Lanham andrew Rawlings Marta Roldo Gianluca Tozzi Jonathan I.Dawson Gianluca Cidonio richard O.C.Oreffo Faculty of Medicine Bone and Joint Research GroupCentre for Human DevelopmentStem Cells and RegenerationInstitute of Developmental SciencesUniversity of SouthamptonSouthampton SO166YDUK School of Pharmacy and Biomedical Science University of PortsmouthPortsmouth PO12DTUK School of Engineering Faculty of Engineering and ScienceUniversity of GreenwichGreenwich ME44TBUK Center for Life Nano-and Neuro-Science(CLN2S) Italian Institute of Technology00161 RomeItaly

Autograft or metal implants are routinely used in skeletal ***,they fail to provide long-term clinical resolution,necessitating a functional biomimetic tissue engineering *** use of native human bone tissue for synthesizing a biomimeticmaterial inkfor three-dimensional(3D)bioprintingof skeletal tissueis anattractivestrategyfor ***,human bone extracellular matrix(bone-ECM)offers an exciting potential for the development of an appropriate microenvironment for human bone marrow stromal cells(HBMSCs)to proliferate and differentiate along the osteogenic *** this study,we engineered a novel material ink(LAB)by blending human bone-ECM(B)with nanoclay(L,Laponite®)and alginate(A)polymers using extrusion-based *** inclusion of the nanoﬁller and polymeric material increased the rheology,printability,and drug retention properties and,critically,the preservation of HBMSCs viability upon *** composite of human bone-ECM-based 3D constructs containing vascular endothelial growth factor(VEGF)enhanced vascularization after implantation in an ex vivo chick chorioallantoic membrane(CAM)*** inclusion of bone morphogenetic protein-2(BMP-2)with the HBMSCs further enhanced vascularization and mineralization after only seven *** study demonstrates the synergistic combination of nanoclay with biomimetic materials(alginate and bone-ECM)to support the formation of osteogenic tissue both in vitro and ex vivo and offers a promising novel 3D bioprinting approach to personalized skeletal tissue repair.

关键词： Extracellular matrix Nanoclay Bone 3D bioprinting

Outcomes following minimally invasive dorsal cheilectomy for hallux rigidus:A systematic review

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World Journal of Orthopedics 2024年第6期15卷 585-592页

作者： Katherine Esser James J Butler Mackenzie Roof Nathaniel P Mercer Michael C Harrington Alan P Samsonov andrew J Rosenbaum John G kennedy Department of Orthopaedic Surgery University of Toledo Medical Center University of Toledo College of Medicine and Life SciencesToledoOH 43614United States Department of Orthopedic Surgery NYU Langone HealthNew YorkNY 10002United States Department of Orthopedic Surgery Albany Medical CenterAlbanyNY 12208United States

BACKGROUND Cheilectomy of the 1^(st)metatarsophalangeal joint(MTPJ)is one of the most common procedures for the management of hallux ***,there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy(MIDC)for the management of hallux *** To evaluate outcomes following MIDC for the management of hallux *** During November 2023,the PubMed,EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux *** Six studies were *** total,348 patients(370 feet)underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9±16.5 *** distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows:Ⅰ(58 patients,27.1%),Ⅱ(112 patients,52.3%),Ⅲ(44 patients,20.6%).Three studies performed an additional 1^(st)MTPJ arthroscopy and debridement following *** intra-articular bone debris was observed in 100%of patients in 1 *** weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9±3.2 to a postoperative score of *** complication rate was 8.4%,the most common of which was persistent joint pain and ***-two failures(8.7%)were ***-three secondary procedures(8.9%)were performed at a weighted mean time of 8.6±3.2 months following the index *** This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up.A moderate reoperation rate at short-term follow-up was *** marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.

关键词： Minimally invasive dorsal cheilectomy Hallux rigidus The first metatarsophalangeal joint Cheilectomy Minimally invasive surgery

Research surveys and their evolution:Past,current and future uses in healthcare

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World Journal of Methodology 2024年第4期14卷 91-95页

作者： Michael Colwill richard Pollok andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

Research surveys are believed to have originated in antiquity with evidence of them being performed in ancient Egypt and *** the past century,their use has grown significantly and they are now one of the most frequently employed research methods including in the field of *** validation techniques and processes have allowed researchers to broaden the scope of qualitative data they can gather through these surveys such as an individual’s views on service quality to nationwide surveys that are undertaken regularly to follow healthcare *** article focuses on the evolution and current utility of research surveys,different methodologies employed in their creation,the advantages and disadvantages of different forms and their future use in healthcare *** also review the role artificial intelligence and the importance of increased patient participation in the development of these surveys in order to obtain more accurate and clinically relevant data.

关键词： Research surveys Methodology Sampling Artificial intelligence

Biobanks and biomarkers:Their current and future role in biomedical research

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World Journal of Methodology 2024年第4期14卷 77-83页

作者： Michael Colwill Samantha Baillie richard Pollok andrew Poullis Department of Gastroenterology St George's University Hospital NHS Foundation TrustLondon SW170QTUnited Kingdom

The importance and utility of biobanks has increased exponentially since their inception and *** used as part of translational research,they now contribute over 40%of data for all cancer research papers in the United States of America and play a crucial role in all aspects of *** classification systems exist but a simplified approach is to either classify as population-based or disease-oriented *** historically publicly funded institutions,there has been a significant increase in industry funded entities across the world which has changed the dynamic of biobanks offering new possibilities but also new *** face legal questions over data sharing and intellectual property as well as ethical and sustainability questions particularly as the world attempts to move to a low-carbon *** collaboration is required to address some of these challenges but this in itself is fraught with complexity and *** review will examine the current utility of biobanks in the modern healthcare setting as well as the current and future challenges these vital institutions face.

关键词： Biobanks Biomarkers Biomedical research Research methodology Research ethics

Anal cancer screening in women with a history of human papillomavirusrelated lower genital tract cancers:a pilot study

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 88-93页

作者： Isobel Mary Poynten Fengyi Jin Rhonda Farrell Trevor Tejada-Berges Carmella Law richard Hillman Jennifer Roberts andrew Grulich The Kirby Institute University of New South WalesSydneyNew South WalesAustralia Chris O'Brien Lifehouse SydneyNew South WalesAustralia Prince of Wales Private Hospital RandwickNew South WalesAustralia Dysplasia and Anal Cancer Services St Vincent's Hospital SydneyDarlinghurstNewSouthWalesAustralia Douglass Hanly Moir Pathology SydneyNew South WalesAustralia

Objectives Women diagnosed with a history of lower genital tract cancer(LGTC)and precancer are at increased risk of anal *** for anal cancer in a manner analogous to cervical cancer may detect precursor anal high-grade squamous intraepithelial lesions(HSILs)and prevent progression to *** In a pilot study of anal cancer screening,women with previous LGTC and aged≥18 years in Sydney,Australia underwent a digital anorectal examination,anal swab for human papillomavirus(HPV)and p16/Ki67 testing and completeda *** with positive HPV and/or p16/Ki67 results were referred for a high-resolution anoscopy(HRA)and evaluation of their *** Of 52 participants,46 agreed to screening and 6 provided demographic information *** age was 46.5 years(IQR:36.059.0).Anal high-risk HPV(HRHPV)was detected in only seven(15.2%)participants(three HPV16).Eight(17.4%)had positive p16/Ki67 dual staining,with invalid results for 25(54.4%).0f 10 women referred for HRA,9 attended and 3 had HSILs,representing 6.5%of the screened *** were completed by 41 participants(89.1%).The majority reported that being screenedwas reassuring(97.5%)and was positive for their health(95.1%).Conclusion This pilot study demonstrated a lower-than-expected prevalence of anal *** with HRHPV and p16/Ki67 staining identified anal HSILs in 6.5%of ***,screeningwas viewed as beneficial by almost all *** utility of p16/Ki67dual staining was low,suggesting it may not be a suitable anal cancer screening methodology.

关键词： pilot Sydney screening

CD8+T cell metabolic flexibility elicited by CD28-ARS2 axisdriven alternative splicing of PKM supports antitumor immunity

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Cellular & Molecular Immunology 2024年第3期21卷 260-274页

作者： G.Aaron Holling Colin A.Chavel Anand P.Sharda Mackenzie M.Lieberman Caitlin M.James Shivana M.Lightman Jason H.Tong Guanxi Qiao Tiffany R.Emmons Thejaswini Giridharan Shengqi Hou andrew M.Intlekofer richard M.Higashi Teresa W.M.Fan andrew N.Lane Kevin H.Eng Brahm H.Segal Elizabeth A.Repasky Kelvin P.Lee Scott H.Olejniczak Department of Immunology Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Department of Medicine Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Human Oncology and Pathogenesis Program Memorial Sloan Kettering Cancer CenterNew YorkNY 10065USA Center for Environmental Systems Biochemistry Department of Toxicology and Cancer Biology and Markey Cancer CenterLexingtonKY 40536USA Department of Cancer Genetics and Genomics Roswell Park Comprehensive Cancer CenterBuffaloNY 14263USA Present address:University of Colorado Boulder BoulderCO 80309USA Present address:Dana Farber Cancer Institute BostonMA 02215USA Present address:Massachusetts Institute of Technology BostonMA 02139USA Present address:Melvin and Bren Simon Comprehensive Cancer Center Indiana University School of MedicineIndianapolisIN 46202USA

Metabolic flexibility has emerged as a critical determinant of CD8+T-cell antitumor activity,yet the mechanisms driving the metabolic flexibility of T cells have not been *** this study,we investigated the influence of the nuclear cap-binding complex(CBC)adaptor protein ARS2 on mature T *** doing so,we discovered a novel signaling axis that endows activated CD8+T cells with flexibility of glucose ***2 upregulation driven by CD28 signaling reinforced splicing factor recruitment to pre-mRNAs and affected approximately one-third of T-cell activation-induced alternative splicing *** these effects,the CD28-ARS2 axis suppressed the expression of the M1 isoform of pyruvate kinase in favor of PKM2,a key determinant of CD8+T-cell glucose utilization,interferon gamma production,and antitumor effector ***,PKM alternative splicing occurred independently of CD28-driven PI3K pathway activation,revealing a novel means by which costimulation reprograms glucose metabolism in CD8+T cells.

关键词： Immunometabolism mRNA splicing CD8 T cells ARS2 PKM2

Trochanteric bursitis information on the internet;can we trust the information presented?

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World Journal of Orthopedics 2020年第10期11卷 473-474页

作者： richard Tyrrell Martin Kelly Cian kennedy Department of Trauma and Orthopaedics University Hospital LimerickLimerick V94 F858Ireland

Trochanteric bursitis is one of the most common causes of lateral hip pain in *** prevalence of unilateral trochanteric bursitis is 15.0%in women and 8.5%in *** to internet based information has increased dramatically and health related information is now one of the most popular searches in online activity,despite this the quality of information can *** objective of this paper is to examine the quality and readability of internet based information of trochanteric ***,we have found a high variability among not only the quality but also the readability of information *** that appeared first on each search engine for trochanteric bursitis did not necessarily score better,demonstrating the importance of providing patients with high quality *** articles should use more critical appraisal tools in order to provide the reader with more high quality and readable information.

关键词： Internet Quality Readability DISCERN Journal of American Medical Association Flesh Reading Ease