BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported...BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.展开更多
BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervisio...BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervision.It is an emerging tool in pediatric orthopedic surgery,with various promising applications.An evaluation of the current awareness and perceptions among pediatric orthopedic surgeons is necessary to facilitate AI utilization and highlight possible areas of concern.AIM To assess the awareness and perceptions of AI among pediatric orthopedic surgeons.METHODS This cross-sectional observational study was conducted using a structured questionnaire designed using QuestionPro online survey software to collect quantitative and qualitative data.One hundred and twenty-eight pediatric orthopedic surgeons affiliated with two groups:Pediatric Orthopedic Chapter of Saudi Orthopedics Association and Middle East Pediatric Orthopedic Society in Gulf Cooperation Council Countries were surveyed.RESULTS The pediatric orthopedic surgeons surveyed had a low level of familiarity with AI,with more than 60%of respondents rating themselves as being slightly familiar or not at all familiar.The most positively rated aspect of AI applications for pediatric orthopedic surgery was their ability to save time and enhance productivity,with 61.97%agreeing or strongly agreeing,and only 4.23%disagreeing or strongly disagreeing.Our participants also placed a high priority on patient privacy and data security,with over 90%rating them as quite important or highly important.Additional bivariate analyses suggested that physicians with a higher awareness of AI also have a more positive perception.CONCLUSION Our study highlights a lack of familiarity among pediatric orthopedic surgeons towards AI,and suggests a need for enhanced education and regulatory frameworks to ensure the safe adoption of AI.展开更多
In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the...In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the exploratory stage.The paper first introduces the background of AI and orthopedic diseases,addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases,draws out the advantages of deep learning and machine learning in image detection,and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years,describing the contributions,strengths and weaknesses,and the direction of the future improvements that can be made in each study.Next,the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative,intraoperative,and postoperative orthopedic surgery,scientifically discussing the advantages and prospects of AI in orthopedic surgery.Finally,the article discusses the limitations of current research and technology in clinical applications,proposes solutions to the problems,and summarizes and outlines possible future research directions.The main objective of this review is to inform future research and development of AI in orthopedics.展开更多
Objective This study aimed to evaluate and compare the effectiveness of knowledge base-optimized and unoptimized large language models(LLMs)in the field of orthopedics to explore optimization strategies for the applic...Objective This study aimed to evaluate and compare the effectiveness of knowledge base-optimized and unoptimized large language models(LLMs)in the field of orthopedics to explore optimization strategies for the application of LLMs in specific fields.Methods This research constructed a specialized knowledge base using clinical guidelines from the American Academy of Orthopaedic Surgeons(AAOS)and authoritative orthopedic publications.A total of 30 orthopedic-related questions covering aspects such as anatomical knowledge,disease diagnosis,fracture classification,treatment options,and surgical techniques were input into both the knowledge base-optimized and unoptimized versions of the GPT-4,ChatGLM,and Spark LLM,with their generated responses recorded.The overall quality,accuracy,and comprehensiveness of these responses were evaluated by 3 experienced orthopedic surgeons.Results Compared with their unoptimized LLMs,the optimized version of GPT-4 showed improvements of 15.3%in overall quality,12.5%in accuracy,and 12.8%in comprehensiveness;ChatGLM showed improvements of 24.8%,16.1%,and 19.6%,respectively;and Spark LLM showed improvements of 6.5%,14.5%,and 24.7%,respectively.Conclusion The optimization of knowledge bases significantly enhances the quality,accuracy,and comprehensiveness of the responses provided by the 3 models in the orthopedic field.Therefore,knowledge base optimization is an effective method for improving the performance of LLMs in specific fields.展开更多
BACKGROUND Open reduction and internal fixation represent prevalent orthopedic procedures,sparking ongoing discourse over whether to retain or remove asymptomatic implants.Achieving consensus on this matter is paramou...BACKGROUND Open reduction and internal fixation represent prevalent orthopedic procedures,sparking ongoing discourse over whether to retain or remove asymptomatic implants.Achieving consensus on this matter is paramount for orthopedic surgeons.This study aims to quantify the impact of routine implant removal on patients and healthcare facilities.A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University(KFHU)was conducted and subjected to statistical scrutiny.Among these cases,44%necessitated hospitalization exceeding one day,while 56%required only a single day.Adults exhibited a 55%need for extended hospital stays,contrasting with 22.8%among the pediatric cohort.The complication rate was 6%,with all patients experiencing at least one complication.Notably,34.1%required sick leave and 4.8%exceeded 14 d.General anesthesia was predominant(88%).Routine implant removal introduces unwarranted complications,particularly in adults,potentially prolonging hospitalization.This procedure strains hospital resources,tying up the operating room that could otherwise accommodate critical surgeries.Clearly defined institutional guidelines are imperative to regulate this practice.AIM To measure the burden of routine implant removal on the patients and hospital.METHODS This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU,a tertiary hospital in Saudi Arabia.Data were collected in the orthopedic department at KFHU from February 2016 to August 2022,which includes routine asymptomatic implant removal cases across all age categories.Nonroutine indications such as infection,pain,implant failure,malunion,nonunion,restricted range of motion,and prominent hardware were excluded.Patients who had external fixators removed or joints replaced were also excluded.RESULTS Between February 2016 and August 2022,360 implants were retrieved;however,only 167 of those who met the inclusion criteria were included in this study.The remaining implants were rejected due to exclusion criteria.Among the cases,44%required more than one day in the hospital,whereas 56%required only one day.55%of adults required more than one day of hospitalization,while 22.8%of pediatric patients required more than one day of inpatient care.The complication rate was 6%,with each patient experiencing at least one complication.Sick leave was required in 34.1%of cases,with 4.8%requiring more than 14 d.The most common type of anesthesia used in the surgeries was general anesthesia(88%),and the mean(SD)surgery duration was 77.1(54.7)min.CONCLUSION Routine implant removal causes unnecessary complications,prolongs hospital stays,depletes resources and monopolizing operating rooms that could serve more critical procedures.展开更多
BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we...BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.展开更多
Li-Fraumeni syndrome(LFS)is a rare hereditary cancer predisposition syndrome characterized by a heightened risk of developing various malignancies at an early age.Emerging evidence suggests a correlation between LFS a...Li-Fraumeni syndrome(LFS)is a rare hereditary cancer predisposition syndrome characterized by a heightened risk of developing various malignancies at an early age.Emerging evidence suggests a correlation between LFS and orthopedic manifestations,underscoring the importance of orthopedic screening in individuals with this syndrome.Pediatric cancer is rare.It is estimated that more than 10%-15%of tumors are secondary to a pathogenic variant in a cancer predisposition gene.More than 100 cancer predisposition genes and their association with syndromes or isolated tumors have been identified.LFS is one of those who have been most widely described.Patients with this syndrome present a high risk of developing one or more tumors.Its knowledge enables the establishment of a follow-up protocol for the patient and affected family members,facilitating early detection of new tumors and reducing tumor and treatment-related morbidity and mortality.The primary objective of this invited editorial article is to provide a thorough review of the existing knowledge of LFS and its polymorphic spectrum of related malignancies,with a focus on aspects directly linked to orthopedic manifestations.Another objective is to offer an update on the most modern prevention,treatment and follow up guidelines that could be useful for the physicians dealing with this cohort of patients.展开更多
This review summarizes the latest progress in orthopedic nanotechnology,ex-plores innovative applications of nanofibers in tendon repair,and evaluates the potential of selenium and cerium oxide nanoparticles in osteoa...This review summarizes the latest progress in orthopedic nanotechnology,ex-plores innovative applications of nanofibers in tendon repair,and evaluates the potential of selenium and cerium oxide nanoparticles in osteoarthritis and osteo-blast differentiation.This review also describes the emerging applications of inje-ctable hydrogels in cartilage engineering,emphasizing the critical role of inter-disciplinary research and highlighting the challenges and future prospects of in-tegrating nanotechnology into orthopedic clinical practice.This comprehensive approach provides a holistic perspective on the transformative impact of nanote-chnology in orthopedics,offering valuable insights for future research and clinical applications.展开更多
Objective:The perioperative period of major orthopedic surgery is associated with a high risk of thrombosis,but the best chemopreventive agent for thrombosis prophylaxis is still inconclusive.For this reason,this pape...Objective:The perioperative period of major orthopedic surgery is associated with a high risk of thrombosis,but the best chemopreventive agent for thrombosis prophylaxis is still inconclusive.For this reason,this paper evaluated the efficacy and safety of aspirin versus low-molecular heparin using a Meta-analysis.Methods:Ten randomized controlled studies on the application of aspirin and low-molecular heparin for the prevention of deep vein thrombosis in orthopedic major surgery were retrieved by computer searches of PubMed,CochraneLibrary,WebofScience,China Knowledge Network,Wanfang,and Vipul databases according to inclusion and exclusion criteria,and the literature was managed using Endnote software,and the data were analyzed using Revman 5.3 software was used to perform Meta-analysis of the extracted data,focusing on the effects of these two drugs on pulmonary embolism,deep vein thrombosis,major bleeding events,minor bleeding events,wound complications,mortality and blood loss within 90 days after major orthopedic surgery.Results:(1)Ten randomized controlled trials of high quality were included,with a total of 12,974 patients,7,026 in the aspirin group and 5,948 in the low-molecular heparin group;(2)Meta-analysis showed that aspirin had a higher incidence of pulmonary embolism(OR=1.59,95%CI:1.02 to 2.49,P=0.04)and deep vein thrombosis(OR=1.60,95%CI:1.26 to 2.02,P=0.0001)than low molecular heparin;(3)The incidence of major bleeding events(OR=0.85,95%CI:0.47 to 1.55,P=0.60),minor bleeding events(OR=0.79,95%CI:0.55 to 1.12,P=0.18),adverse wound reactions(OR=0.79,95%CI:0.48 to 1.31,P=0.36),mortality within 90 days(OR=0.69,95%CI:0.20 to 2.31,P=0.55)and perioperative blood loss(MD=0.69,95%CI:0.20 to 2.31,P=0.55)in both drug groups,mortality within 90 days(OR=0.69,95%CI:0.20 to 2.31,P=0.55)and perioperative blood loss(MD=0.69,95%CI:0.20 to 2.31,P=0.55)were not statistically significant.Conclusion:Low-molecular heparin was superior to aspirin in the prevention of pulmonary embolism and lower extremity deep vein thrombosis after major orthopedic surgery,but the safety and adverse drug reactions of both groups were basically similar.Based on this,the authors recommend that low-molecular heparin should be preferred for the prevention of deep vein thrombosis in major orthopaedic surgery;however,the inclusion of randomized controlled trials remains limited,necessitating high-quality,large-sample,long-term follow-up clinical studies.展开更多
The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone m...The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.展开更多
BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for imp...BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.展开更多
Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy set...Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.展开更多
Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent...Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.展开更多
Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness...Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.展开更多
In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative...In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.展开更多
The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilit...The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.展开更多
Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential...Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.展开更多
Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis....Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.展开更多
Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifi...Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.展开更多
This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducte...This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.展开更多
文摘BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.
文摘BACKGROUND Artificial intelligence(AI)is a branch of computer science that allows machines to analyze large datasets,learn from patterns,and perform tasks that would otherwise require human intelligence and supervision.It is an emerging tool in pediatric orthopedic surgery,with various promising applications.An evaluation of the current awareness and perceptions among pediatric orthopedic surgeons is necessary to facilitate AI utilization and highlight possible areas of concern.AIM To assess the awareness and perceptions of AI among pediatric orthopedic surgeons.METHODS This cross-sectional observational study was conducted using a structured questionnaire designed using QuestionPro online survey software to collect quantitative and qualitative data.One hundred and twenty-eight pediatric orthopedic surgeons affiliated with two groups:Pediatric Orthopedic Chapter of Saudi Orthopedics Association and Middle East Pediatric Orthopedic Society in Gulf Cooperation Council Countries were surveyed.RESULTS The pediatric orthopedic surgeons surveyed had a low level of familiarity with AI,with more than 60%of respondents rating themselves as being slightly familiar or not at all familiar.The most positively rated aspect of AI applications for pediatric orthopedic surgery was their ability to save time and enhance productivity,with 61.97%agreeing or strongly agreeing,and only 4.23%disagreeing or strongly disagreeing.Our participants also placed a high priority on patient privacy and data security,with over 90%rating them as quite important or highly important.Additional bivariate analyses suggested that physicians with a higher awareness of AI also have a more positive perception.CONCLUSION Our study highlights a lack of familiarity among pediatric orthopedic surgeons towards AI,and suggests a need for enhanced education and regulatory frameworks to ensure the safe adoption of AI.
基金This work was supported in part by the National Natural Science Foundation of China under Grants 61861007 and 61640014in part by theGuizhou Province Science and Technology Planning Project ZK[2021]303+2 种基金in part by the Guizhou Province Science Technology Support Plan under Grants[2022]017,[2023]096 and[2022]264in part by the Guizhou Education Department Innovation Group Project under Grant KY[2021]012in part by the Talent Introduction Project of Guizhou University(2014)-08.
文摘In recent years,Artificial Intelligence(AI)has revolutionized people’s lives.AI has long made breakthrough progress in the field of surgery.However,the research on the application of AI in orthopedics is still in the exploratory stage.The paper first introduces the background of AI and orthopedic diseases,addresses the shortcomings of traditional methods in the detection of fractures and orthopedic diseases,draws out the advantages of deep learning and machine learning in image detection,and reviews the latest results of deep learning and machine learning applied to orthopedic image detection in recent years,describing the contributions,strengths and weaknesses,and the direction of the future improvements that can be made in each study.Next,the paper also introduces the difficulties of traditional orthopedic surgery and the roles played by AI in preoperative,intraoperative,and postoperative orthopedic surgery,scientifically discussing the advantages and prospects of AI in orthopedic surgery.Finally,the article discusses the limitations of current research and technology in clinical applications,proposes solutions to the problems,and summarizes and outlines possible future research directions.The main objective of this review is to inform future research and development of AI in orthopedics.
基金supported by the National Natural Science Foundation of China(Grant No.81974355 and No.82172524).
文摘Objective This study aimed to evaluate and compare the effectiveness of knowledge base-optimized and unoptimized large language models(LLMs)in the field of orthopedics to explore optimization strategies for the application of LLMs in specific fields.Methods This research constructed a specialized knowledge base using clinical guidelines from the American Academy of Orthopaedic Surgeons(AAOS)and authoritative orthopedic publications.A total of 30 orthopedic-related questions covering aspects such as anatomical knowledge,disease diagnosis,fracture classification,treatment options,and surgical techniques were input into both the knowledge base-optimized and unoptimized versions of the GPT-4,ChatGLM,and Spark LLM,with their generated responses recorded.The overall quality,accuracy,and comprehensiveness of these responses were evaluated by 3 experienced orthopedic surgeons.Results Compared with their unoptimized LLMs,the optimized version of GPT-4 showed improvements of 15.3%in overall quality,12.5%in accuracy,and 12.8%in comprehensiveness;ChatGLM showed improvements of 24.8%,16.1%,and 19.6%,respectively;and Spark LLM showed improvements of 6.5%,14.5%,and 24.7%,respectively.Conclusion The optimization of knowledge bases significantly enhances the quality,accuracy,and comprehensiveness of the responses provided by the 3 models in the orthopedic field.Therefore,knowledge base optimization is an effective method for improving the performance of LLMs in specific fields.
文摘BACKGROUND Open reduction and internal fixation represent prevalent orthopedic procedures,sparking ongoing discourse over whether to retain or remove asymptomatic implants.Achieving consensus on this matter is paramount for orthopedic surgeons.This study aims to quantify the impact of routine implant removal on patients and healthcare facilities.A retrospective analysis of implant removal cases from 2016 to 2022 at King Fahad Hospital of the University(KFHU)was conducted and subjected to statistical scrutiny.Among these cases,44%necessitated hospitalization exceeding one day,while 56%required only a single day.Adults exhibited a 55%need for extended hospital stays,contrasting with 22.8%among the pediatric cohort.The complication rate was 6%,with all patients experiencing at least one complication.Notably,34.1%required sick leave and 4.8%exceeded 14 d.General anesthesia was predominant(88%).Routine implant removal introduces unwarranted complications,particularly in adults,potentially prolonging hospitalization.This procedure strains hospital resources,tying up the operating room that could otherwise accommodate critical surgeries.Clearly defined institutional guidelines are imperative to regulate this practice.AIM To measure the burden of routine implant removal on the patients and hospital.METHODS This is a retrospective analysis study of 167 routine implant removal cases treated at KFHU,a tertiary hospital in Saudi Arabia.Data were collected in the orthopedic department at KFHU from February 2016 to August 2022,which includes routine asymptomatic implant removal cases across all age categories.Nonroutine indications such as infection,pain,implant failure,malunion,nonunion,restricted range of motion,and prominent hardware were excluded.Patients who had external fixators removed or joints replaced were also excluded.RESULTS Between February 2016 and August 2022,360 implants were retrieved;however,only 167 of those who met the inclusion criteria were included in this study.The remaining implants were rejected due to exclusion criteria.Among the cases,44%required more than one day in the hospital,whereas 56%required only one day.55%of adults required more than one day of hospitalization,while 22.8%of pediatric patients required more than one day of inpatient care.The complication rate was 6%,with each patient experiencing at least one complication.Sick leave was required in 34.1%of cases,with 4.8%requiring more than 14 d.The most common type of anesthesia used in the surgeries was general anesthesia(88%),and the mean(SD)surgery duration was 77.1(54.7)min.CONCLUSION Routine implant removal causes unnecessary complications,prolongs hospital stays,depletes resources and monopolizing operating rooms that could serve more critical procedures.
基金The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital(Approval Number:Tongren Lun Audit 2022-075-01).
文摘BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.
文摘Li-Fraumeni syndrome(LFS)is a rare hereditary cancer predisposition syndrome characterized by a heightened risk of developing various malignancies at an early age.Emerging evidence suggests a correlation between LFS and orthopedic manifestations,underscoring the importance of orthopedic screening in individuals with this syndrome.Pediatric cancer is rare.It is estimated that more than 10%-15%of tumors are secondary to a pathogenic variant in a cancer predisposition gene.More than 100 cancer predisposition genes and their association with syndromes or isolated tumors have been identified.LFS is one of those who have been most widely described.Patients with this syndrome present a high risk of developing one or more tumors.Its knowledge enables the establishment of a follow-up protocol for the patient and affected family members,facilitating early detection of new tumors and reducing tumor and treatment-related morbidity and mortality.The primary objective of this invited editorial article is to provide a thorough review of the existing knowledge of LFS and its polymorphic spectrum of related malignancies,with a focus on aspects directly linked to orthopedic manifestations.Another objective is to offer an update on the most modern prevention,treatment and follow up guidelines that could be useful for the physicians dealing with this cohort of patients.
文摘This review summarizes the latest progress in orthopedic nanotechnology,ex-plores innovative applications of nanofibers in tendon repair,and evaluates the potential of selenium and cerium oxide nanoparticles in osteoarthritis and osteo-blast differentiation.This review also describes the emerging applications of inje-ctable hydrogels in cartilage engineering,emphasizing the critical role of inter-disciplinary research and highlighting the challenges and future prospects of in-tegrating nanotechnology into orthopedic clinical practice.This comprehensive approach provides a holistic perspective on the transformative impact of nanote-chnology in orthopedics,offering valuable insights for future research and clinical applications.
基金Natural Science Foundation of Xinjiang Uygur Autonomous Region(No.2019D01C244)Special Research Project for Health and Young Medical Science and Technology Talents in Xinjiang Uygur Autonomous Region(No.WJWY-202142)。
文摘Objective:The perioperative period of major orthopedic surgery is associated with a high risk of thrombosis,but the best chemopreventive agent for thrombosis prophylaxis is still inconclusive.For this reason,this paper evaluated the efficacy and safety of aspirin versus low-molecular heparin using a Meta-analysis.Methods:Ten randomized controlled studies on the application of aspirin and low-molecular heparin for the prevention of deep vein thrombosis in orthopedic major surgery were retrieved by computer searches of PubMed,CochraneLibrary,WebofScience,China Knowledge Network,Wanfang,and Vipul databases according to inclusion and exclusion criteria,and the literature was managed using Endnote software,and the data were analyzed using Revman 5.3 software was used to perform Meta-analysis of the extracted data,focusing on the effects of these two drugs on pulmonary embolism,deep vein thrombosis,major bleeding events,minor bleeding events,wound complications,mortality and blood loss within 90 days after major orthopedic surgery.Results:(1)Ten randomized controlled trials of high quality were included,with a total of 12,974 patients,7,026 in the aspirin group and 5,948 in the low-molecular heparin group;(2)Meta-analysis showed that aspirin had a higher incidence of pulmonary embolism(OR=1.59,95%CI:1.02 to 2.49,P=0.04)and deep vein thrombosis(OR=1.60,95%CI:1.26 to 2.02,P=0.0001)than low molecular heparin;(3)The incidence of major bleeding events(OR=0.85,95%CI:0.47 to 1.55,P=0.60),minor bleeding events(OR=0.79,95%CI:0.55 to 1.12,P=0.18),adverse wound reactions(OR=0.79,95%CI:0.48 to 1.31,P=0.36),mortality within 90 days(OR=0.69,95%CI:0.20 to 2.31,P=0.55)and perioperative blood loss(MD=0.69,95%CI:0.20 to 2.31,P=0.55)in both drug groups,mortality within 90 days(OR=0.69,95%CI:0.20 to 2.31,P=0.55)and perioperative blood loss(MD=0.69,95%CI:0.20 to 2.31,P=0.55)were not statistically significant.Conclusion:Low-molecular heparin was superior to aspirin in the prevention of pulmonary embolism and lower extremity deep vein thrombosis after major orthopedic surgery,but the safety and adverse drug reactions of both groups were basically similar.Based on this,the authors recommend that low-molecular heparin should be preferred for the prevention of deep vein thrombosis in major orthopaedic surgery;however,the inclusion of randomized controlled trials remains limited,necessitating high-quality,large-sample,long-term follow-up clinical studies.
文摘The field of orthopedic and regenerative medicine is rapidly evolving with the increasing utilization of orthobiologic.These biologically derived therapies,inc-luding platelet-rich plasma,mesenchymal stem cells,bone marrow aspirate con-centrate,stromal vascular fraction(SVF),and autologous chondrocyte implanta-tion,are gaining traction for their potential to enhance the body's natural healing processes.They offer a promising alternative to traditional surgical interventions for musculoskeletal injuries and degenerative conditions.Current evidence su-ggests significant benefits of orthobiologics in treating conditions like osteoarth-ritis,tendon injuries,and spinal disorders,yet inconsistencies in treatment pro-tocols and outcomes persist.The global market for orthobiologics is projected to grow substantially,driven by advancements in biologic therapies such as adipose-derived stem cells and SVF,and the demand for minimally invasive treatments.Despite their promise,regulatory and ethical challenges,as well as the need for high-quality,standardized research,remain significant obstacles.Future dire-ctions in the field include advancements in delivery systems,personalized medi-cine approaches,and the exploration of novel sources like induced pluripotent stem cells,aiming for more targeted and effective treatments.Collaborative efforts are crucial to overcoming these challenges and ensuring the safe and effective application of orthobiologics in clinical practice.
文摘BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.
文摘Purpose research on nursing sensitive indicators in tumor Patients application effect in immune-related skin toxicity management. Method select our hospital April to June, 202360 cases patients with immune therapy settings as the control group. August-October, 2023 60 cases the patients treated with immune therapy were the experimental group. The control group adopted regular nursing methods, while the experimental group sensitive Indicators, evidence-based give preventive care. The social situation, psychological state, physical function, quality of life score, incidence of skin toxicity caused by immune checkpoint inhibitors, moderate and above of the two groups of patients were compared. Incidence of skin toxicity. Result: experience group SAS score, SDS score higher than the control group, the difference was statistically significant (P < 0.05);The incidence of skin toxic reactions caused by immune checkpoint inhibitors and the incidence of moderate and above skin toxic reactions in the experimental group are lower than those in the control group, and the difference is statistically significant (P < 0.05). Conclusion: sensitive indicator guidance evidence-based preventive care can reduce the degree of immune-related skin toxicity, improve the psychological state and quality of life of tumor patients treated with immune therapy and reduce the incidence of adverse reactions, improve nursing quality and patient satisfaction.
文摘Objective: To explore the nursing effect of evidence-based PDCA cycle management mode in accelerated rehabilitation of patients undergoing thoracoscopic lung cancer radical surgery. Methods: 104 patients who underwent thoracoscopic lung cancer radical surgery in our hospital from June 2022 to February 2023 were randomly divided into control group and intervention group, with 52 cases in each group. The control group implemented evidence-based ERAS clinical pathway management, while the intervention group implemented evidence-based PDCA cycle quality management. The postoperative recovery of the two groups of patients was compared. Results: The postoperative recovery of the intervention group was significantly better than that of the control group. The first time to get out of bed, the first time to eat, the duration of chest drainage tube placement, and the length of hospital stay were significantly shorter than those of the control group. The incidence of postoperative chest complications and hospitalization costs were significantly lower than those of the control group, and patient satisfaction was significantly higher than that of the control group (P Conclusion: Evidence-based PDCA cycle quality management mode can effectively improve the implementation quality of accelerated rehabilitation nursing for patients undergoing thoracoscopic lung cancer radical surgery, and it is worthy of clinical promotion.
文摘Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.
文摘In the realm of orthopedics,the adoption of enhanced recovery after surgery(ERAS)protocols marks a significant stride towards enhancing patient well-being.By embracing a holistic approach that encompasses preoperative counseling,dietary optimization,minimally invasive procedures,and early postoperative mobilization,these protocols have ushered in a new era of surgical care.Despite encountering hurdles like resistance to change and resource allocation challenges,the efficacy of ERAS protocols in improving clinical outcomes is undeniable.Noteworthy benefits include shortened hospital stays and bolstered improved patient-safety measures.Looking ahead,the horizon for ERAS in orthopedics appears bright,with an emphasis on tailoring care to individual needs,integrating cutting-edge technologies,and perpetuating research endeavors.This shift towards a more personalized,streamlined,and cost-efficient model of care underscores the transformative potential of ERAS in reshaping not only orthopedic surgery but also the journey to patient recovery.This editorial details the scope and future of ERAS in the orthopedic specialty.
文摘The aim of the article is to explore the influence of the water landscape design of a rehabilitation garden for patients with mental disorders on the recovery effect of patients,intending to provide a better rehabilitation environment for patients with mental disorders.Based on literature research,this article reviews three aspects of evidence-based design theory,the concept of water landscape in rehabilitation gardens,and the types of water features in rehabilitation gardens.The results show that well-designed water features can significantly improve patients’psychological state and reduce anxiety and stress,and that water landscape design in rehabilitation gardens is an effective rehabilitation tool that can facilitate the recovery process of patients with mental disorders.Future designs should take into full consideration patients’needs and preferences,as well as best practices in waterscape design,to maximize its positive impact on patients’recovery.
文摘Objective To sort out the problems in the selection model of essential medicines in China,and to put forward some suggestions to optimize the selection model to ensure the rationality of the medicines in the essential medicines list.Methods The domestic and foreign literature on the selection of essential medicines was reviewed.Then,the opinions on the selection methods and results of essential medicines from foreign literature were investigated to make a comparison with the selection of essential medicines in China.Finally,the general and special laws of the selection process of the essential medicines were explored.Results and Conclusion It is recommended that the selection model of essential medicines in China should be further optimized,and the evidence-based thinking and methods should be utilized to enhance the scientific nature of the selection process.
文摘Objective: To explore the application research of evidence-based nursing in the care of patients with severe acute pancreatitis. Methods: This study focuses on evidence-based nursing care of severe acute pancreatitis. Patients with severe acute pancreatitis who received treatment in our hospital were selected, from which 80 cases were chosen for detailed analysis. The patients were randomly grouped into a control group (conventional nursing care) and a study group (evidence-based nursing care), with 40 patients each. Relevant research data were recorded during the nursing process, analyzed, and used as research indicators. Results: The hospitalization time and morbidity and mortality rate of the research group were shorter than those of the control group, and the recovery rate was higher than that of the control group (P < 0.05). Patient satisfaction with nursing care in the observation group was higher than in the control group (P < 0.05). Conclusion: For patients with severe acute pancreatitis, the use of evidence-based nursing methods effectively reduced the patient’s mortality rate, improved its curative effect, and also shortened the patient’s hospitalization time.
文摘Statistical literacy is crucial for cultivating well-rounded thinkers.The integration of evidence-based strategies in teaching and learning is pivotal for enhancing students’statistical literacy.This research specifically focuses on the utilization of Share and Model Concepts and Nurturing Metacognition as evidence-based strategies aimed at improving the statistical literacy of learners.The study employed a quasi-experimental design,specifically the nonequivalent control group,wherein students answered pre-test and post-test instruments and researcher-made questionnaires.The study included 50 first-year Bachelor in Secondary Education majors in Mathematics and Science for the academic year 2023-2024.The results of the study revealed a significant difference in the scores of student respondents,indicating that the use of evidence-based strategies helped students enhance their statistical literacy.This signifies a noteworthy increase in their performance,ranging from very low to very high proficiency in understanding statistical concepts,insights into the application of statistical concepts,numeracy,graph skills,interpretation capabilities,and visualization and communication skills.Furthermore,the study showed a significant difference in the post-test scores’performance of the two groups in understanding statistical concepts and visualization and communication skills.However,no significant difference was found in the post-test scores of the two groups concerning insights into the application of statistical concepts,numeracy and graph skills,and interpretation capabilities.Additionally,students acknowledged that the implementation of evidence-based strategies significantly contributed to the improvement of their statistical literacy.
文摘This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.