World journal of methodology最新文献

This editorial offers insights from a minireview by Venkatesh et al, who explored pharmacological adjuvants for diabetic vitrectomy. Specifically, they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated complications. Herein, we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques, minimizing intraoperative challenges, and enhancing postoperative recovery. We further discuss the potential implications of this approach for clinical practice and future research directions in this evolving field. Overall, this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients' quality of life.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder affecting over 2% of the global population, marked by social communication deficits and repetitive behaviors. Kabatas et al explored the efficacy and safety of Wharton's jelly-derived mesenchymal stem cell (WJ-MSC) therapy in a 4-year-old child with ASD. Using the childhood autism rating scale and Denver II developmental screening test, significant improvements were seen after six WJ-MSC sessions, with no adverse events over 2 years. Despite promising results, the study's single-case design limits generalizability. Larger, multi-center trials are needed to validate the findings and assess long-term effects of WJ-MSC therapy in ASD.

Background: The adoption of telehealth services surged after the coronavirus disease 2019 pandemic, revolutionizing traditional healthcare delivery models. Amazon Clinic's recent nationwide launch marks a significant milestone in this trend. This study aims to offer a strengths, weaknesses, opportunities, and threats (SWOT) analysis of Amazon Clinic and compare its features with leading virtual healthcare platforms.

Aim: To evaluate Amazon Clinic's telehealth services through a SWOT analysis and compare its features with other leading virtual healthcare platforms.

Methods: The initial search terms included were, amazon clinic odds ratio (OR) amwell OR Teladoc OR Walmart virtual health service OR CVS minute clinic OR CirrusMD OR brightside health, from 2000 to 2023. This search yielded 111 articles, from which duplicates were removed, and unrelated titles were filtered out. Eight articles were retained for a final review, including comparative studies, usability research, retrospective analyses, observational studies, and review articles. The data was organized and analyzed using Rayyan software and summarized in a table and PRISMA flowcharts.

Results: The review included eight articles focusing on various aspects of telehealth. Comparative studies highlighted differences between Teladoc and traditional physician offices, noting lower diagnostic imaging orders and antibiotic prescriptions for Teladoc. User demographics for Teladoc showed younger, less engaged patients. Usability studies emphasized the importance of website design for telemedicine adoption. Tele-mental health platforms like Brightside showed superior outcomes in treating depression compared to traditional methods. Telemedicine for specialized fields like skin reconstruction demonstrated cost efficiency and reduced waiting times. The SWOT analysis identified Amazon Clinic's strengths, such as its vast consumer base and transparent pricing, and weaknesses like the lack of pediatric care. Opportunities included potential partnerships and service expansions, while threats involved competition and regulatory challenges.

Conclusion: Amazon Clinic's entry into the telehealth sector represents a significant development with various strengths and opportunities. However, it faces challenges from established healthcare providers and regulatory landscapes. The future success of Amazon Clinic will depend on strategic collaborations, addressing service gaps, and navigating competition and regulations. Telemedicine's impact will hinge on its ability to effectively leverage these opportunities and overcome inherent challenges in the ever-evolving healthcare landscape.

Background: One of the main characteristics of oral squamous cell carcinoma (OSCC) is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness. A primary feature of malignant tumors is their penetration of neighboring tissues, such as lymphatic and blood arteries, due to the tumor cells' capacity to break down the extracellular matrix (ECM). Matrix metalloproteinases (MMPs) constitute a family of proteolytic enzymes that facilitate tissue remodeling and the degradation of the ECM. MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions. MMP-13, a collagenase family member, is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens, whereas MMP-9 is thought to accelerate the growth of tumors. Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.

Aim: To assess the immunohistochemical expression of MMP-9 and MMP-13 in OSCC.

Methods: A total of 40 cases with histologically confirmed OSCC by incisional biopsy were included in this cross-sectional retrospective study. The protocols for both MMP-9 and MMP-13 immunohistochemical staining were performed according to the manufacturer's recommendations along with the normal gingival epithelium as a positive control. All the observations were recorded and Pearson's χ² test with Fisher exact test was used for statistical analysis.

Results: Our study showed no significant correlation between MMP-9 and MMP-13 staining intensity and tumor size. The majority of the patients were in advanced TNM stages (III and IV), and showed intense expression of MMP-9 and MMP-13.

Conclusion: The present study suggests that both MMP-9 and MMP-13 play an important and independent role in OSCC progression and invasiveness. Intense expression of MMP-9 and MMP-13, irrespective of histological grade of OSCC, correlates well with TNM stage. Consequently, it is evident that MMP-9 and MMP-13 are important for the invasiveness and progression of tumors. The findings may facilitate the development of new approaches for evaluating lymph node metastases and interventional therapy techniques, hence enhancing the prognosis of patients diagnosed with OSCC.

Knee osteoarthritis (OA) is a debilitating condition with limited long-term treatment options. The therapeutic potential of mesenchymal stem cells (MSCs), particularly those derived from bone marrow aspirate concentrate, has garnered attention for cartilage repair in OA. While 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 humerus. This paper reviews the impact of different harvesting sites on mesenchymal stem cell (MSC) yield, viability, and regenerative potential, emphasizing their relevance in knee OA treatment. The iliac crest consistently offers the highest MSC yield, but alternative sites within the surgical field of knee procedures offer comparable MSC characteristics with reduced morbidity. The integration of harvesting techniques into existing knee surgeries, such as total knee arthroplasty, provides a less invasive approach while maintaining therapeutic efficacy. However, variability in MSC yield from these alternative sites underscores the need for further research to standardize techniques and optimize clinical outcomes. Future directions include large-scale comparative studies, advanced characterization of MSCs, and the development of personalized harvesting strategies. Ultimately, 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.

Background: Barrett's esophagus (BE) is a known premalignant precursor to esophageal adenocarcinoma (EAC). The prevalence rates continue to rise in the United States, but many patients who are at risk of EAC are not screened. Current practice guidelines include male gender as a predisposing factor for BE and EAC. The population-based clinical evidence regarding female gender remains limited.

Aim: To study comparative trends of gender disparities in patients with BE in the United States.

Methods: A nationwide retrospective study was conducted using the 2009-2019 National Inpatient Sample (NIS) database. Patients with a primary or secondary diagnosis code of BE were identified. The major outcome of interest was determining the gender disparities in patients with BE. Trend analysis for respective outcomes for females was also reported to ascertain any time-based shifts.

Results: We identified 1204190 patients with BE for the study period. Among the included patients, 717439 (59.6%) were men and 486751 (40.4%) were women. The mean age was higher in women than in men (67.1 ± 0.4 vs 66.6 ± 0.3 years, P < 0.001). The rate of BE per 100000 total NIS hospitalizations for males increased from 144.6 in 2009 to 213.4 in 2019 (P < 0.001). The rate for females increased from 96.8 in 2009 to 148.7 in 2019 (P < 0.001). There was a higher frequency of obesity among women compared to men (17.4% vs 12.6%, P < 0.001). Obesity prevalence among females increased from 12.3% in 2009 to 21.9% in 2019 (P < 0.001). A lower prevalence of smoking was noted in women than in men (20.8% vs 35.7%, P < 0.001). However, trend analysis showed an increasing prevalence of smoking among women, from 12.9% in 2009 to 30.7% in 2019 (P < 0.001). Additionally, there was a lower prevalence of alcohol abuse, Helicobacter pylori (H. pylori), and diabetes mellitus among females than males (P < 0.001). Trend analysis showed an increasing prevalence of alcohol use disorder and a decreasing prevalence of H. pylori and diabetes mellitus among women (P < 0.001).

Conclusion: The prevalence of BE among women has steadily increased from 2009 to 2019. The existing knowledge concerning BE development has historically focused on men, but our findings show that the risk in women is not insignificant.

This editorial explores the transformative potential of artificial intelligence (AI) in identifying conflicts of interest (COIs) within academic and scientific research. By harnessing advanced data analysis, pattern recognition, and natural language processing techniques, AI offers innovative solutions for enhancing transparency and integrity in research. This editorial discusses how AI can automatically detect COIs, integrate data from various sources, and streamline reporting processes, thereby maintaining the credibility of scientific findings.

Background: Pain in the back or pelvis or fear of back pain may affect the timing or co-contraction of the core muscles. In both static and dynamic movements, the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex. Preparatory cues and images can be used to increase the activation of these muscles. To attain optimal movement patterns, it will be necessary to determine what cueing will give the most effective results for core stability.

Aim: To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.

Methods: Total 68 participants (21.83 ± 3.47 years) were randomly allocated to an external (n = 35) or internal cue group (n = 33). Participants performed the Sahrmann five-level core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue. External cue group received a pressure biofeedback unit (PBU), and the internal cue group received an audio cue. A Delsys Trigno^TM surface electromyography unit was used for muscle activation from the rectus abdominis, external oblique, and transverse abdominis/internal oblique muscles.

Results: Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation (P = 0.001); however, there was no significant difference between cue types (internal or external) (P = 0.130).

Conclusion: Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.

The success rate of apexification is primarily determined by multiple factors, including the material used, the size of the open apex compared to the length of the root, and the technique used in each case. The main objective of this review was to provide an update on the present management of open apex to identify factors and circumstances that may influence the success of apexification using different materials and techniques. Future research on apexification should focus on how to treat open apices with wide periapical lesions without surgery. Previously, the predictability of these parameters with non-surgical procedures was uncertain, but now, with the use of a dental operating microscope, it has become more predictable. Another reason could be that extra visits are no longer required due to major advances in the armamentarium and materials used for apexification.

The benefits of regular physical activity are well known. Yet, few studies have examined the effectiveness of integrating physical activity (PA) into curricula within a post-secondary setting. To investigate the incorporation of PA into medical curriculum, we developed a series of optional exercise-based review sessions designed to reinforce musculoskeletal (MSK) anatomy course material. These synchronous sessions were co-taught by a group fitness instructor and an anatomy instructor. The fitness instructor would lead students through both strength and yoga style exercises, while the anatomy instructor asked questions about relevant anatomical structures related to course material previously covered. After the sessions, participants were asked to evaluate the classes on their self-reported exam preparedness in improving MSK anatomy knowledge, PA levels, and mental wellbeing. Thirty participants completed surveys; a majority agreed that the classes increased understanding of MSK concepts (90.0%) and activity levels (97.7%). Many (70.0%) felt that the classes helped reduce stress. The majority of respondents (90.0%) agreed that the classes contributed to increased feelings of social connectedness. Overall, medical students saw benefit in PA based interventions to supplement MSK course concepts. Along with increasing activity levels and promoting health behaviours, integrating PA into medical curriculum may improve comprehension of learning material, alleviate stress and foster social connectivity among medical students.