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Beyond statistical significance:Embracing minimal clinically important difference for better patient care

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World Journal of Methodology 2025年第1期15卷 33-41页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji sathish Muthu Department of Orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia Department of Research Methods Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of Orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia

The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's *** comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and *** discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based ***,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical *** for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global *** steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements.

关键词： Minimal clinically important difference Patient-centered care Clinical relevance Global health

Low-dose immunotherapy as a potentiator to increase the response with neo-adjuvant chemotherapy in oral cancers

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World Journal of Clinical Cases 2023年第17期11卷 3976-3979页

作者： Narmadha Rathinasamy sathish Muthu Anand krishnan Department of Medical Oncology PSG Institute of Medical Science and ResearchCoimbatore 641004Tamil NaduIndia Department of Orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Biotechnology School of Engineering and TechnologySharda UniversityNew Delhi 201310Uttar PradeshIndia Department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of Chemical Pathology School of PathologyFaculty of Health SciencesUniversity of the Free StateBloemfontein 9300South Africa

Neo-adjuvant chemotherapy(NACT)is utilized in locally advanced oral cancers to reduce the tumor burden and downstage the tumor to be amenable for definitive surgical *** long-term results compared to upfront surgical resection was not *** has now been used not only in recurrence and metastatic setting but also in the locally advanced tumor management *** purpose of this concept paper is to bring forward the rationale to use a fixed low-dose immunotherapy agent as a potentiator to the standard NACT regimen and recommend their future investigation in oral cancer management.

关键词： Immunotherapy Neo-adjuvant chemotherapy Oral cancer

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

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World Journal of Orthopedics 2024年第3期15卷 266-284页

作者： sathish Muthu Vibhu krishnan Viswanathan Manoharan Sakthivel Mohammed Thabrez Department of Orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Biotechnology Karpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Manoharan Sakthivel Department of OrthopaedicsGovernment Medical CollegeKarur 639004Tamil NaduIndia Department of Orthopaedics Devadoss Multispecialty HospitalMadurai 625007Tamil NaduIndia Department of Medical Oncology Aster Medcity HospitalKochi 682034India

BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage *** relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely *** To comparatively analyze the functional,radiological,and histological outcomes,and complications of various generations of MFx available for the treatment of cartilage *** A systematic review was performed using PubMed,EMBASE,Web of Science,Cochrane,and *** of any age and sex with cartilage defects undergoing any form of MFx were considered for *** included only randomized controlled trials(RCTs)reporting functional,radiological,histological outcomes or complications of various generations of MFx for the management of cartilage *** meta-analysis(NMA)was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of *** Forty-four RCTs were included in the analysis with patients of mean age of 39.40(±9.46)*** comparing the results of the other generations with MFX-I as a constant comparator,we noted a trend towards better pain control and functional outcome(KOOS,IKDC,and Cincinnati scores)at the end of 1-,2-,and 5-year time points with MFx-III,although the differences were not statistically significant(P>0.05).We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture(weighted mean difference:17.44,95%confidence interval:0.72,34.16,P=0.025;without significant heterogeneity)at 1 ***,the difference was not maintained at 2 *** was a trend towards better defect filling on MRI with the second and third generation MFx,although the difference was not statistically significant(P>0.05).CONCLUSION The higher generations of traditional MFx

关键词： Cartilage injury Microfracture Mesenchymal stem cells Platelet-rich plasma Bone marrow aspiration concentrates Clinical outcome Radiological outcome Meta-analysis Network meta-analysis

Variations in quantifying patient reported outcome measures to estimate treatment effect

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World Journal of Methodology 2025年第2期15卷 44-53页

作者： sathish Muthu Srujun Vadranapu Department of Orthopaedics Orthopaedic Research GroupCoimbatore 641045Tamil NaduIndia Department of Orthopaedics Government Medical CollegeKarur 639004Tamil NaduIndia Department of Biotechnology Karpagam Academy of Higher EducationCoimbatore 641021Tamil NaduIndia Department of Orthopaedics Royal Care Super Speciality HospitalCoimbatore 641062Tamil NaduIndia

In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical *** guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment *** any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real *** structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each *** mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given *** are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their *** article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.

关键词： Patient-reported outcome measures Treatment effect Minimal clinical important difference Patient-accepted symptom state Minimum detectable change Orthopedics

Simultaneous pharmacokinetic assessment of cefadroxil and clavulanic acid in human plasma by LC-MS and its application to bioequivalence studies

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Journal of Pharmaceutical Analysis 2013年第4期3卷 285-291页

作者： Janaki Sankarachari krishnan Nagarajan Chandran sathish Vimal Renjith George Anil Dubala Department of Pharmaceutical Analysis J.S.S. College of Pharmacy

A simple, rapid and selective liquid chromatography-atmospheric pressure chemical ionization-mass spectrometry （LC-APCI-MS） assay method has been developed and fully validated for the simultaneous quantification of cefadroxil （CF） and clavulanic acid （CA） in human plasma. Analytes and internal standard （IS） were extracted from human plasma by solid- phase extraction （SPE） technique using Sam prep （3 mL, 100 mg） extraction cartridge. The extracted samples were chromatographed on a reverse phase Cls column using a mixture of methanol： acetonitrile： 2 mM ammonium acetate （pH 3.5）（25：25：50, v/v/v） as the mobile phase at a flow rate of 0.8 mL/min. Quantification of the analytes and IS were carried out using single quadrupole LC-APCI-MS through selected-ion monitoring （SIM） at m/z 362 and m/z 198, for CF and CA, respectively. Method validation was performed as per the FDA guidelines and the results met the acceptance criteria. Plasma concentration of CF and CA followed by the oral administration of CF/CA （500/125 mg） pill to healthy male volunteers （n= 12） was measured. Area under plasma concentration-time curve from 0 to 12 h （AUC0-12 h） and 0 h extrapolated to infinity （AUC0-∞） were calculated. The ratio of AUC0-12 h/AUC0-∞ was found to be 〉 85% for all the subjects, as recommended by the FDA guidelines.

关键词： Cefadroxil Clavulanic acid LC-MS A_PCI Pharmacokinetics Bioequivalence

Efficient Resource Allocation in Fog Computing Using QTCS Model

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Computers, Materials & Continua 2022年第2期70卷 2225-2239页

作者： M.Iyapparaja Naif Khalaf Alshammari M.sathish Kumar S.Siva Rama krishnan Chiranji Lal Chowdhary School of Information Technology and Engineering Vellore Institute of TechnologyVellore632014India Mechanical Engineering University of HailSaudi Arabia

Infrastructure of fog is a complex system due to the large number of heterogeneous resources that need to be *** embedded devices deployed with the Internet of Things(IoT)technology have increased since the past few years,and these devices generate huge amount of *** devices in IoT can be remotely connected and might be placed in different locations which add to the network *** time applications require high bandwidth with reduced latency to ensure Quality of Service(QoS).To achieve this,fog computing plays a vital role in processing the request locally with the nearest available resources by reduced *** of themajor issues to focus on in a fog service is managing and allocating *** theory is one of the most popular mechanisms for task *** this work,an efficient model is designed to improve QoS with the efficacy of resource allocation based on a Queuing Theory based Cuckoo Search(QTCS)model which will optimize the overall resource management process.

关键词： Queuing theory Cuckoo search QoS resource allocation energy efficiency

FogQSYM: An Industry 4.0 Analytical Model for Fog Applications

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Computers, Materials & Continua 2021年第12期69卷 3163-3178页

作者： M.Iyapparaja M.sathish Kumar SSiva Rama krishnan Chiranji Lal Chowdhary Byungun Yoon Saurabh Singh Gi Hwan Cho School of Information Technology and Engineering Vellore Institute of TechnologyVellore632014India Department of Industrial and System Engineering Dongguk UniversitySeoulKorea Division of Computer Science Jeonbuk National UniversityJeonjuKorea

Industry 4.0 refers to the fourth evolution of technology development,which strives to connect people to various industries in terms of achieving their expected outcomes ***,resource management in an Industry 4.0 network is very complex and *** manage and provide suitable resources to each service,we propose a FogQSYM(Fog—Queuing system)model;it is an analytical model for Fog Applications that helps divide the application into several layers,then enables the sharing of the resources in an effective way according to the availability of memory,bandwidth,and network *** follows theMarkovian queuing model that helps identify the service rates of the devices,the availability of the system,and the number of jobs in the Industry 4.0 systems,which helps applications process data with a reasonable response *** experiment is conducted using a Cloud Analyst simulator with multiple segments of datacenters in a fog application,which shows that the model helps efficiently provide the arrival resources to the appropriate services with a low response *** implementing the proposed model with different sizes of fog services in Industry 4.0 applications,FogQSYM provides a lower response time than the existing optimized response time *** should also be noted that the average response time increases when the arrival rate increases.

关键词： Fog computing industry 4.0 fog layer Markovian queuing model

Evolution of World Journal of Clinical Cases over the past 5 years

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World Journal of Clinical Cases 2022年第24期10卷 8432-8435页

作者： sathish Muthu Department of Orthopaedics Government Medical CollegeDindigul 624001Tamil NaduIndia Orthopaedic Research Group Coimbatore 641045Tamil NaduIndia Department of Biotechnology Sharda UniversityNew Delhi 201310Uttar PradeshIndia

Analysis of the articles published in any journal is necessary to ascertain the performance of the journal in the *** author made a scientometric analysis of the articles published in the World Journal of Clinical Cas... 详细信息

关键词： World Journal of Clinical Cases Scientific journal Research publication Keywords Scientometrics Trend analysis

Power system reconfiguration and loss minimization for a distribution systems using ＂Catfish PSO＂ algorithm

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Frontiers in Energy 2014年第4期8卷 434-442页

作者： K sathish KUMAR S NAVEEN School of Electrical Engineering VIT University Vellore 632014 India

One of the very important ways to save electrical energy in the distribution system is network reconfiguration for loss reduction. Distribution networks are built as interconnected mesh networks; however, they are arranged to be radial in operation. The distribution feeder reconfiguration is to find a radial operating structure that optimizes network performance while satisfying operating constraints. The change in network configuration is performed by opening sectionalizing （normally closed） and closing tie （normally opened） switches of the network. These switches are changed in such a way that the radial structure of networks is maintained, all of the loads are energized, power loss is reduced, power quality is enhanced, and system security is increased. Distribution feeder reconfiguration is a complex nonlinear combinator- ial problem since the status of the switches is non- differentiable. This paper proposes a new evolutionary algorithm （EA） for solving the distribution feeder reconfiguration （DFR） problem for a 33-bus and a 16- bus sample network, which effectively ensures the loss minimization.

关键词： distribution system reconfiguration (DFR),power loss reduction catfish particle swarm optimization(catfish PSO) radial structure