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Variations in quantifying patient reported outcome measures to estimate treatment effect

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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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