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Causal relationship between lipid profile and muscle atrophy:A bi-directional Mendelian randomization study

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Animal Models and Experimental Medicine 2025年第1期8卷 154-161页

作者： Kun Chen Peng Gao Xiaoxiang Fang Kexing Tang Pan Ouyang Zongchao Li Liangjun Li Zhenhan Deng department of orthopaedics The Affiliated Changsha Central HospitalHengyang Medical SchoolUniversity of South ChinaChangshaHunanChina department of Orthopaedic Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiangChina

Background:The aim of this study was to analyze the bi-directional causal relation-ship between lipid profile and characteristics related to muscle atrophy by using a bi-directional Mendelian randomization(MR)***:The appendicular lean mass(ALM),whole body fat-free mass(WBFFM)and trunk fat-free mass(TFFM)were used as genome-wide association study(GWAS)data for evaluating muscle mass;the usual walking pace(UWP)and low grip strength(LGS)were used as GWAS data for evaluating muscle strength;and the triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL),low density lipo-protein cholesterol(LDL),apolipoprotein A-1(Apo A-1),and apolipoprotein B(Apo B)were used as GWAS data for evaluating lipid *** specific investigations,we mainly employed inverse variance weighting for causal estimation and MR-Egger for pleiotropy ***:MR results showed that the lipid profile predicted by genetic variants was negatively correlated with muscle mass,positively correlated with UWP,and was not causally correlated with *** the other hand,the muscle mass predicted by genetic variants was negatively correlated with lipid profile,the UWP predicted by genetic variants was mainly positively correlated with lipid profile,while the LGS pre-dicted by genetic variants had no relevant causal relationship with lipid ***:Findings of this MR analysis suggest that hyperlipidemia may affect muscle mass and lead to muscle atrophy,but has no significant effect on muscle *** the other hand,increased muscle mass may reduce the incidence of dyslipidemia.

关键词： lipid profile Mendelian randomization muscle atrophy

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

Visualizing medicine:The case for implementing graphical abstracts in clinical reporting

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World Journal of Methodology 2025年第2期15卷 1-8页

作者： Naveen Jeyaraman Madhan Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji Arulkumar Nallakumarasamy 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 department of orthopaedics Jawaharlal Institute of Postgraduate Medical Education and Research–KaraikalPuducherry 609602India

Graphical abstracts(GAs)are emerging as a pivotal tool in medical literature,enhancing the dissemination and comprehension of complex clinical data through visual *** editorial highlights the significant advantages of GAs,including improved clarity,increased reader engagement,and enhanced visibility of research *** transforming intricate scientific data into accessible visual formats,these abstracts facilitate quick and effective knowledge transfer,crucial in clinical decision-making and patient ***,challenges such as potential data misrepresentation due to oversimplification,the skill gap in graphic design among researchers,and the lack of standardized creation guidelines pose barriers to their widespread ***,while software such as Adobe Illustrator,BioRender,and Canva are commonly employed to create these visuals,not all researchers may be proficient in their *** address these issues,we recommend that academic journals establish clear guidelines and provide necessary design training to *** proactive approach will ensure the creation of high-quality GAs,promote their standardization,and expand their use in clinical reporting,ultimately benefiting the medical community and improving healthcare outcomes.

关键词： Graphical abstracts Clinical data dissemination Visual communication Research impact Academic publishing

Navigating the ethical terrain:Off-label and experimental treatments in medical case reports

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World Journal of Methodology 2025年第1期15卷 1-5页

作者： Madhan Jeyaraman Naveen Jeyaraman Swaminathan Ramasubramanian Sangeetha Balaji department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077India department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002India

This article explores the ethical considerations surrounding the reporting of offlabel and experimental treatments in medical case reports,with a focus on fields such as oncology,psychiatry,and *** emphasizes the balance between innovation and evidence-based medicine,highlighting the critical role of case reports in disseminating clinical experiences and advancing medical *** discussion delves into the ethical framework guiding case reporting,including principles of patient autonomy,informed consent,non-maleficence,beneficence,justice,and *** such as negative outcome reporting,commercial interests,and the balance between innovation and caution are *** for ethical vigilance,the development of comprehensive guidelines,and the role of regulatory bodies are proposed to ensure patient safety and uphold scientific *** article concludes by underscoring the importance of a collaborative effort among clinicians,researchers,ethicists,and regulatory bodies to foster the responsible advancement of medical science while adhering to the highest ethical standards.

关键词： Ethical considerations Patient autonomy Informed consent Non-maleficence Beneficence Transparency Evidence-based medicine

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

Diabetic foot attack:Managing severe sepsis in the diabetic patient

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World Journal of Critical Care Medicine 2025年第1期14卷 1-13页

作者： Kisshan Raj Balakrishnan Dharshanan Raj Selva Raj Sabyasachi Ghosh Gregory AJ Robertson department of Trauma and orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom department of Trauma and orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

Diabetic foot attack(DFA)is the most severe presentation of diabetic foot disease,with the patient commonly displaying severe sepsis,which can be limb or life *** can be classified into two main categories:Typical and atypical.A typical DFA is secondary to a severe infection in the foot,often initiated by minor breaches in skin integrity that allow pathogens to enter and *** form often progresses rapidly due to the underlying diabetic pathophysiology of neuropathy,microvascular disease,and hyperglycemia,which facilitate infection spread and tissue *** form of DFA can present as one of a number of severe infective pathologies including pyomyositis,necrotizing fasciitis,and myonecrosis,all of which can lead to systemic sepsis and multiorgan *** atypical DFA,however,is not primarily *** can occur secondary to either ischemia or Charcot *** of the typical DFA involves prompt diagnosis,aggressive infection control,and a multidisciplinary *** can be guided by the current International Working Group on the Diabetic Foot/Infectious Diseases Society of America guidelines on diabetic foot infections,and the combined British Orthopaedic Foot and Ankle Society-Vascular Society *** article highlights the importance of early recognition,comprehensive management strategies,and the need for further research to establish standardized protocols and improve clinical outcomes for patients with DFA.

关键词： Diabetic foot attack Diabetic foot infection Diabetes mellitus Sepsis Systemic sepsis

Optimizing bone marrow harvesting sites for enhanced mesenchymal stem cell yield and efficacy in knee osteoarthritis treatment

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World Journal of Methodology 2025年第2期15卷 92-107页

作者： Arulkumar Nallakumarasamy Sandeep Shrivastava Ravi Velamoor Rangarajan Naveen Jeyaraman Avinash Gandi Devadas Swaminathan Ramasubramanian Madhan Jeyaraman department of orthopaedics Datta Meghe Institute of Higher Education and ResearchWardha 442004MaharashtraIndia department of Regenerative Medicine Mother Cell Regenerative CentreTiruchirappalli 620017Tamil NaduIndia department of orthopaedics Government Medical CollegeOmandurar Government EstateChennai 600002Tamil NaduIndia department of orthopaedics ACS Medical College and HospitalDr MGR Educational and Research InstituteChennai 600077Tamil NaduIndia

Knee osteoarthritis(OA)is a debilitating condition with limited long-term treatment *** therapeutic potential of mesenchymal stem cells(MSCs),particularly those derived from bone marrow aspirate concentrate,has garnered attention for cartilage repair in *** the iliac crest is the traditional site for bone marrow harvesting(BMH),associated morbidity has prompted the exploration of alternative sites such as the proximal tibia,distal femur,and proximal *** paper reviews the impact of different harvesting sites on mesenchymal stem cell(MSC)yield,viability,and regenerative potential,emphasizing their relevance in knee OA *** iliac crest consistently offers the highest MSC yield,but alternative sites within the surgical field of knee procedures offer comparable MSC characteristics with reduced *** integration of harvesting techniques into existing knee surgeries,such as total knee arthroplasty,provides a less invasive approach while maintaining thera-peutic ***,variability in MSC yield from these alternative sites underscores the need for further research to standardize techniques and optimize clinical *** directions include large-scale comparative studies,advanced characterization of MSCs,and the development of personalized harvesting ***,the findings suggest that optimizing the site of BMH can significantly influence the quality of MSC-based therapies for knee OA,enhancing their clinical utility and patient outcomes.

关键词： Knee Osteoarthritis Mesenchymal stem cells Bone marrow harvest Regenerative medicine

Voices that matter:The impact of patient-reported outcome measures on clinical decision-making

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World Journal of Methodology 2025年第2期15卷 54-61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 InstituteChennaiTN 600077India department of Research Methods Orthopaedic Research GroupCoimbatoreTN 641045India department of orthopaedics Government Medical CollegeOmandurar Government EstateChennaiTN 600002India department of Biotechnology Faculty of EngineeringKarpagam Academy of Higher EducationCoimbatoreTN 641021India department of orthopaedics Government Medical CollegeKarurTN 639004India

The critical role of patient-reported outcome measures(PROMs)in enhancing clinical decision-making and promoting patient-centered care has gained a profound significance in scientific *** encapsulate a patient's health status directly from their perspective,encompassing various domains such as symptom severity,functional status,and overall quality of *** integrating PROMs into routine clinical practice and research,healthcare providers can achieve a more nuanced understanding of patient experiences and tailor treatments *** deployment of PROMs supports dynamic patient-provider interactions,fostering better patient engagement and adherence to tre-atment ***,PROMs are pivotal in clinical settings for monitoring disease progression and treatment efficacy,particularly in chronic and mental health ***,challenges in implementing PROMs include data collection and management,integration into existing health systems,and acceptance by patients and *** these barriers necessitates technological advancements,policy development,and continuous education to enhance the acceptability and effectiveness of *** paper concludes with recommendations for future research and policy-making aimed at optimizing the use and impact of PROMs across healthcare settings.

关键词： Patient-reported outcome measures Clinical decision-making Patient-centered care Healthcare technology Data management Policy development

Honey Dressing of Cutaneous Wounds on Limbs in the Traumatology orthopaedics department of Bouaké University Hospital

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Open Journal of Orthopedics 2024年第9期14卷 411-420页

作者： Achié Jean-Régis Akobe Aya Adélaide Natacha Kouassi Ibrahim Soumahoro Zolopégué Marcel Soro Sedy Louess De Randolphe Akpro Bakary Traoré Almamy Kamate Axel Fabrice Essehin Yao Aboh Ganyn Robert Arnaud Assere Lanciné Kaba Kouamé Innocent M’bra Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah Michel Kodo orthopaedics-Traumatology department of the University Hospital of Bouak Bouak Ivory Coast Plastic and Reconstructive Surgery department of the University Hospital of Bouak Bouak Ivory Coast

The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.

关键词： Healing Honey Limbs Loss of Substances