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Malpractice or masterful practice?Navigating vicarious liability in healthcare

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World Journal of Clinical Cases 2025年第2期13卷 10-13页

作者： Satvik N Pai Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian department of orthopaedics PES University Institute of Medical Sciences and ResearchBengaluru 560100KarnatakaIndia department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia

In the intricate landscape of healthcare,vicarious liability looms large,shaping the responsibilities and actions of healthcare practitioners and administrators *** by a poignant scenario of a medication error,this article navigates the complexities of vicarious liability in *** explains the legal basis and ramifications of this theory,emphasizing its importance in fostering responsibility,protecting patient welfare,and easing access to *** paper explores the practical effects of vicarious responsibility on day-to-day operations,leadership practices,and decision-making processes via the eyes of senior consultants,junior doctors,and hospital *** comprehensive insights and real-world examples,it underscores the imperative of fostering a culture of accountability,communication,and quality care to navigate the intricate web of liabilities inherent in modern healthcare.

关键词： Vicarious liability Healthcare Responsibility Litigation Patient welfare

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

Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand Surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand Surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

Wear particle-mediated expressions of pro-inflammatory cytokines, NF-κB and RANK were impacted by lanthanum chloride in RAW264.7 cells

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Journal of Rare Earths 2013年第5期31卷 531-540页

作者：戴闽江川刘翔李哲程细高邹飏聂涛 department of orthopaedics The First Affiliated HospitalNanchang University department of orthopaedics The Second Affiliated HospitalNanchang University

To explore the impact of different concentrations of lanthanum chloride （LaC13） on critical components of wear particle-mediated signaling pathways in inflammation and osteoclastogenesis, RAW264.7 cells were naturally divided into eight groups and analyzed by CCK-8 assay, flow cytometry, ELISA, RT-PCR and western blot after treatments. The results showed that three concentrations of LaCI3 had no influence on viability of RAW264.7 cells and down-regulated receptor activator of nuclear factor rd3 （RANK） instead of macrophage colony-stimulating factor receptor （M-CSFR）. Additionally, 2.5 and 10 pmol/L LaC13 could signifi- cantly inhibit gene and protein levels of pro-inflammatory cytokines （tumor necrosis factor-or and interleukin-113, i.e., TNF-ct and IL-113） and NF-r,B/p65, but 100 pmol/L LaC13 did not exert an obvious inflammation-inhibiting effect, and even induced inflamma- tion. In conclusion, these findings demonstrated that LaC13 was able to suppress wear particle-induced inflammation and activation of NF-rd3 in a certain range of concentrations in vitro and mainly decrease the expression of RANK, but not M-CSFR, all of which were generally recognized to play a pivotal role in osteoclastogenesis.

关键词： lanthanum chloride wear particle osteoclastogenesis inflammation pro-inflammatory cytokine NF-kB RANK M-CSFR rare earths

Isolation,Culture and Identification of Neural Stem Cells in New-born Rats

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2004年第1期24卷 75-78页

作者：谢宗平郑启新郭晓东易诚青吴永超 department of orthopaedics

The cortexes were obtained from new born rats and dissociated to single cells by triturating. The cells were cultured in neural stem cell (NSC) culture medium (DMEM supplemented with bFGF, EGF and B27) and formed primary neurospheres after 7 days. Single cells dissociated from neurosphere were cultured in 96 well plates and formed single cell cloning neurosphere 7 days later. The primary and single cell cloning neurospheres were both positive for the immunofluorescent staining of nestin and were identified as NSC. It was proved that NSC can be expanded in vitro and provide seed cells for neural tissue engineering.

关键词： neural stem cell cell culture tissue engineering

Dose-dependent effects of lanthanum chloride on wear particle-induced aseptic inflammation in a murine air-pouch model

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Journal of Rare Earths 2013年第4期31卷 420-427页

作者：江川邹飏刘翔尚江荫子程明戴闽 department of orthopaedics the First Affiliated HospitalNanchang University

To investigate the effects of local injection of different doses of lanthanum chloride （LaCl3） on aseptic inflammation in mice stimulated by wear particles from artificial joints, the particles were prepared by vacuum ball mill in vitro and air-pouch models were performed with 45 male BALB/c mice that were randomly divided into blank control group, wear particle group and wear parti- cle ＋ LaCl3 （0.1, 0.9 and 8.1 μmol） group. All animals were sacrificed and tissue specimens were harvested 7 days after treatment. Hematoxylin and eosin （H＆E） staining, enzyme-linked immunosorbent assay （ELISA）, reverse transcription-polymerase chain reac- tion （RT-PCR） and western blot were applied to observe inflammatory reaction and detect the expression of pro-inflammatory cyto- kines （TNF-et, IL-1β） and nuclear factor-κB （NF-κB） in mRNA and protein levels in air-pouch membrances. The results showed that wear particles could stimulate aseptic inflammation in vivo effectively; 0.9 μmol LaCl3 could significantly inhibit wear parti- cle-induced gene and protein expression of pro-inflammatory cytokines and NF-Id3 （P〈0.05）; 0.1 and 8. 1 μmol LaCl3 did not exert an inflammation-inhibiting effect and even caused adverse effects at 8.1 μmol. In conclusion, LaC13 played a protective role against wear particle-induced aseptic inflammation dose-dependently, which was involved in NF-κB related signaling pathways.

关键词： lanthanum chloride wear particle aseptic inflammation pro-inflammatory cytokine nuclear factor-KB air-pouch model

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

A Green Biocompatible Fabrication of Highly Porous Functional Ceramics with High Strength and Controllable Pore Structures

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Journal of Materials Science & Technology 2016年第8期32卷 729-732页

作者： Changlu Xu Haoran Liu Huilin Yang Lei Yang Orthopaedic Institute and department of orthopaedics The First Affiliated Hospital Soochow University International Research Center for Translational orthopaedics (IRCTO) Soochow University

A green biocompatible foaming method utilizing natural coconut oil and cornstarch was developed to fabricate highly porous functional ceramics with controllable strengths and pore structures. The poros- ity of A1203 ceramics prepared via this method reached 79.6%-86.9% while these ceramics maintained high compressive strengths of 2.2-5.5 MPa. More importantly, porous A1203 ceramic with a pore size gra- dient was also readily fabricated by casting serial layers of foams that were set for different time periods. The potential applications of porous Al2O3 and HA ceramics fabricated by this green foaming method in- cluding scaffolds for oil cleaning and cell culture, respectively, were also demonstrated.

关键词： Porous ceramic Pore structure Bioceramics Hydroxyapatite Alumina

Application of Acetabular Reinforcement Ring with Hook for Correction of Segmental Acetabular Rim Defects during Total Hip Arthroplasty Revision

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Journal of Bionic Engineering 2018年第1期15卷 154-159页

作者： Jianlin Xiao Xin Zhao Yiming Wang Yuhui Yang Jianhui Zhao Zhongli Gao Jianlin Zuo department of orthopaedics China-Japan Union Hospital of Jilin University Changchun 130033 China department of orthopaedics The 2nd Hospital of Jilin University Changchun 13004 l China

This study investigated the biomechanical micro-motion associated with the application of acetabular reinforcement ring with hook （Ganz ring） for the correction of segmental acetabular rim defects, by finite element analysis. The objective was to determine whether the Ganz ring is suitable for correcting segmental acetabular rim defects at different regions during total hip arthroplasty revision as well as the number of screws required to fix the Ganz ring. A finite element model of the hip joint was generated to simulate and evaluate the insertion and fixation of the Ganz ring and acetabular cup in the context of segmental rim defects in the anterior column, superior portion, and posterior column. Micro-motion was the greatest in the posterior column defect and the least in the anterior column defect. However, the peak stress distribution on the remaining portion of the acetabular rim was the highest in the superior portion defect, following the pos- terior column defect and anterior column defect. Increasing the number of fixations of the Ganz ring did not decrease the micro-motion. We found that the Ganz ring effectively provided biomechanical stability during the reconstruction of the segmental rim defect as long as the screws fixed the Ganz ring well to the host bone.

关键词： segmental acetabular rim defect Ganz ring biomechanics finite element method total hip arthroplasty revision