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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

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

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

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

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

Monogenic gene therapy for glaucoma and optic nerve injury

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Neural Regeneration research 2025年第3期20卷 815-816页

作者： Chikako Harada Xiaoli Guo Takayuki Harada Visual research Project Tokyo Metropolitan Institute of Medical ScienceTokyoJapan

The prevalence of glaucoma, the second leading cause of global blindness, is increasing due to aging populations. In glaucoma, degeneration of the optic nerve and retinal ganglion cells(RGCs) causes visual field defec... 详细信息

关键词： visual glaucoma degeneration

Asking one mechanism in glial cells during neuroinflammation

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Neural Regeneration research 2025年第4期20卷 1077-1078页

作者： Xiaoli Guo Chikako Harada Takayuki Harada Visual research Project Tokyo Metropolitan Institute of Medical ScienceTokyoJapan

Multiple sclerosis(MS),which is characterized by inflammatory demyelination in the central nervous system(CNS),is the most common neurological disease in the young adult *** autoimmune encephalomyelitis(EAE),an animal model of MS,is often used in preclinical *** data indicate that in addition to immune cells such as T cells and dendritic cells,CNS resident microglia and astrocytes play important roles in demyelinating neuroinflammation(Healy et al.,2022).In particular,microglia are key immune-competent cells that can respond to environmental *** depletion of transforming growth factor-β-activated kinase 1,a mitogen-associated protein kinase kinase kinase,in microglia is reported to reduce CNS inflammation and diminish axonal and myelin damage *** suggests that elucidating the mechanisms of microglia-specific responses during pathologies may help in the development of treatments that reduce EAE/MS disease severity(Goldmann et al.,2013).

关键词： inflammation clinical

Glia-to-neuron reprogramming to the rescue?

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Neural Regeneration research 2025年第5期20卷 1395-1396页

作者： Jack W.Hickmott Cindi M.Morshead Department of Surgery University of TorontoTorontoONCanada Donnelly Centre for Cellular and Biomolecular research TorontoONCanada institute of Biomedical Engineering University of TorontoTorontoONCanada The KITE research institute Toronto Rehabilitation InstituteUniversity Health NetworkTorontoONCanada

Over the last two decades,the dogma that cell fate is immutable has been increasingly challenged,with important implications for regenerative *** brea kth rough discovery that induced pluripotent stem cells could be generated from adult mouse fibroblasts is powerful proof that cell fate can be *** exciting extension of the discovery of cell fate impermanence is the direct cellular reprogram ming hypothesis-that terminally differentiated cells can be reprogrammed into other adult cell fates without first passing through a stem cell state.

关键词： programming passing proof