UNASSIGNED: The Chinese Society of Clinical Oncology Artificial Intelligence System (CSCO AI) serves as a clinical decision support system developed utilizing Chinese breast cancer data. Our study delved into the congruence between breast cancer treatment recommendations provided by CSCO AI and their practical application in clinical settings.
UNASSIGNED: A retrospective analysis encompassed 537 breast cancer patients treated at the Second Affiliated Hospital of Anhui Medical University between January 2017 and December 2022. Proficient senior oncology researchers manually input patient data into the CSCO AI system. \"Consistent\" and \"Inconsistent\" treatment categories were defined by aligning our treatment protocols with the classification system in the CSCO AI recommendations. Cases that initially showed inconsistency underwent a second evaluation by the Multi-Disciplinary Treatment (MDT) team at the hospital. Concordance was achieved when MDTs\' treatment suggestions were in the \'Consistent\' categories.
UNASSIGNED: An impressive 80.4% concurrence was observed between actual treatment protocols and CSCO AI recommendations across all breast cancer patients. Notably, the alignment was markedly higher for stage I (85.02%) and stage III (88.46%) patients in contrast to stage II patients (76.06%, P=0.023). Moreover, there was a significant concordance between invasive ductal carcinoma and lobular carcinoma (88.46%). Interestingly, triple-negative breast cancer (TNBC) exhibited a high concordance rate (87.50%) compared to other molecular subtypes. When contrasting MDT-recommended treatments with CSCO AI decisions, an overall 92.4% agreement was established. Furthermore, a logistic multivariate analysis highlighted the statistical significance of age, menstrual status, tumor type, molecular subtype, tumor size, and TNM stage in influencing consistency.
UNASSIGNED: In the realm of breast cancer treatment, the alignment between recommendations offered by CSCO AI and those from MDT is predominant. CSCO AI can be a useful tool for breast cancer treatment decisions.

Bacteria inhabiting chronic wounds form a biofilm that prolongs and slows down the healing process. Increasingly common antibiotic resistance requires clinicians to search for effective and alternative treatment methods. Defensins are the most common antimicrobial peptides capable of eradicating pathogens. Their discovery in maggot secretions allowed for a broader understanding of the healing mechanisms, and approving the use of Lucilia sericata fly larvae in the treatment of infected wounds resulted in an effective and safe procedure. The aim of the study was to present the possibility of biofilm elimination in a chronic wound by means of medical maggots (Lucilia sericata) with the example of three selected clinical cases. The observation included three women who met the inclusion criterion of having venous insufficiency ulcers with inhibited regeneration processes. Medical maggots were applied in a biobag for three days, and observation was conducted for 21 consecutive days. In 2 cases, a significant elimination of necrotic tissue from the wound bed with local granulation tissue was observed 72 h after application of a larvae colony on the wounds. In 1 case, the application of the larvae accelerated the repair process by reducing the wound area by approximately 40% at the time of observation. The formation of biofilm in a chronic wound is one of the main causes of disturbances in its effective healing. Combining procedures (scraping, antiseptic compresses, MDT, NPWT) related to wound debridement increases the effectiveness of biofilm elimination. The use of medical maggots is a safe and effective method of choice, and it enhances the processes of debridement. However, confirmed indisputable data on their effectiveness and frequency of use in the process of stimulating healing processes are still not available in the literature.

BACKGROUND: Healthcare teams often consist of geographically dispersed members. Virtual worlds can support immersive, high-quality, multimedia interaction between remote individuals; this study investigated use of virtual worlds to support remote healthcare quality improvement team meetings.
METHODS: Twenty individuals (12 female, aged 25-67 [M = 42.3, SD = 11.8]) from 6 healthcare quality improvement teams conducted collaborative tasks in virtual world or face-to-face settings. Quality of collaborative task performances were measured and questionnaires and interviews were used to record participants\' experiences of conducting the tasks and using the virtual world software.
RESULTS: Quality of collaborative task outcomes was high in both face-to-face and virtual world settings. Participant interviews elicited advantages for using virtual worlds in healthcare settings, including the ability of the virtual environment to support tools that cannot be represented in equivalent face-to-face meetings, and the potential for virtual world settings to cause improvements in group-dynamics. Reported disadvantages for future virtual world use in healthcare included the difficulty that people with weaker computer skills may experience with using the software. Participants tended to feel absorbed in the collaborative task they conducted within the virtual world, but did not experience the virtual environment as being \'real\'.
CONCLUSIONS: Virtual worlds can provide an effective platform for collaborative meetings in healthcare quality improvement, but provision of support to those with weaker computer skills should be ensured, as should the technical reliability of the virtual world being used. Future research could investigate use of virtual worlds in other healthcare settings.

暂无摘要。

We read with interest the recent research paper \'A study exploring the prevalence of Extremity Pain of Spinal Source (EXPOSS)\' by Rosedale et al. [1]. This study highlights some interesting opportunities for physical therapists and other clinicians practicing Mechanical Diagnosis and Therapy (MDT). However, we would like to address some issues that became apparent on reading this paper.

To better understand how quantitative sensory testing could help the clinician in the management of oxaliplatin-induced peripheral neuropathy in terms of earlier and more reliable detection, we conducted a two-year prospective study.
Thermal sensory assessment, tactile sensory assessment, neuropathic pain assessment and adverse events gradation (NCI-CTC) were performed during treatment and 6 months after treatment completion.
35 patients were enrolled and followed-up during one year. Cold and Warm Detection Thresholds were higher 6 months after treatment completion than at enrollment. Mechanical detection thresholds didn\'t change significantly. Neurotoxicity was mostly grade-1, only 18% grade-2 and no grade-3. Grade-2 patients received lower oxaliplatin cumulative dose than grade-1, which reveals effective dose adaptation and grade-2 patients were more likely to develop painful neuropathy.
Thermal thresholds impairment emerges too late to help the clinician in the prophylaxis of neuropathy. Management of OXA-treatment based on NCI-CTC, as currently recommended, remains the best way to detect neuropathy and ensure treatment adaptation.

OBJECTIVE: To evaluate the long-term tolerance of bisphosphonates proposed as an alternative therapeutic option for symptomatic unresectable benign bone tumors and to evaluate the long-term efficacy of this treatment.
METHODS: From March 2007 to March 2011, patients with unresectable symptomatic benign bone tumors were consecutively included in this institutional review board-approved study and treated with bisphosphonates. Prospectively long-term follow-up is reported. The study endpoints were to describe the long-term tolerance, the clinical evolution of pain for each patient and the radiological success defined as a complete disappearance of inflammation and ossification of the bone lesion. All complications and side effects were recorded.
RESULTS: Eight patients (mean age 16 years; range 7-42) with various tumor subtypes were included: aneurysmal bone cysts (N=5), Langerhans cell histiocytosis (N=1), osteoblastoma (N=1), and a giant cell tumor (N=1). Tumors were located in cervical (N=4) or thoracic (N=1) vertebrae, femoral shaft (N=1), acetabulum (N=1) and sacrum (N=1). Mean number of bisphosphonate cycles was 3 (range: 1-6) over a median period of 10 months. The median clinical and imaging follow-up period was 21 months (6 to 63 months). No severe complications due to treatment or lesion recurrence were reported. Pain disappeared within 6 weeks of the first cycle for all but one patient. Ossification of the bone lesion was observed for all patients but one, complete for two and partial for the five others.
CONCLUSIONS: Bisphosphonates appear to be an effective option without adverse effects for the non-operative management of symptomatic benign bone tumors.

BACKGROUND: The Royal Centre for Defence Medicine is located at University Hospitals Birmingham (UHB). Since 2001 all UK military casualties injured on active duty have been repatriated here for their initial treatment. This service evaluation was performed to quantify the work undertaken, with the aim of providing a snapshot of a year\'s military trauma work in order to inform the delivery of trauma care in both the military and civilian setting.
METHODS: Military patients admitted with traumatic injuries over a 12-month period were identified and the hospital notes and electronic records reviewed. Data were collected focusing on three areas - the details of the injury, information about the in-patient admission, and surgical interventions performed.
RESULTS: A total of 388 patients were used in the analysis. Median total length of stay was 10.5 days (IQR: 4-26, range: 0-137 days), and a median 6.0 days (IQR: 3.0-11.0, range: 1-49 days) was spent on intensive care by 125 patients. Surgical intervention was required for 278 (71.6%) patients, with a median of 2.0 operations (IQR: 1.0-4.0, range: 1-27) or 170 min (IQR: 90.0-570.0, range 20-4735 min) operating time per patient. 77% of these patients had their first procedure within 24h of arrival. Improvised explosives accounted for 50.5% of injuries seen. Spearman rank correlation between New Injury Severity Score with length of stay demonstrated significant correlation (p<0.001), with a coefficient of 0.640. A model predicting length of stay based on New Injury Severity Score was devised for patients with battle injuries.
CONCLUSIONS: This report of 12 months work at UHB demonstrates the service commitment to these casualties, describing the burden of care and resource requirements for military trauma patients.