The transition from fee-for-service to value-based payment (VBP) drives quality improvement and cost reduction. 1 To ensure VBP programs consider how patients and family caregivers define "high-value" care, stakeholders have advanced the use of quality measures that assess and amplify patient perspectives. 2 Integrating patient voices in VBP is particularly relevant for oncology, where patients are challenged by high symptom burden, psychologic and financial stress, and complicated care pathways. However, incorporating patient perspectives is undermined by barriers, which this paper explores in detail, to implementing meaningful, methodologically sound patient-reported measures (PRMs) and patient-reported performance measures (PR-PMs). PRMs are tools that directly capture patients' perceptions of their experiences and outcomes, whereas PR-PMs are measures
Tissue engineering (TE) was initially designed to tackle clinical organ shortage problems. Although some engineered tissues have been successfully used for non-clinical applications, very few (e.g., reconstructed human skin) have been used for clinical purposes. As the current TE approach has not achieved much success regarding more broad and general clinical applications, organ shortage still remains a challenging issue. This very limited clinical application of TE can be attributed to the constraints in manufacturing fully functional tissues via the traditional top–down approach, where very limited cell types are seeded and cultured in scaffolds with equivalent sizes and morphologies as the target tissues. The newly proposed developmental engineering (DE) strategy towards the manufacture of fully functional tissues utilises a bottom–up approach to mimic developmental biology processes by implementing gradual tissue assembly alongside the growth of multiple cell types in modular scaffolds. This approach may overcome the constraints of the traditional top–down strategy as it can imitate in vivo-like tissue development processes. However, several essential issues must be considered, and more mechanistic insights of the fundamental, underpinning biological processes, such as cell–cell and cell–material interactions, are necessary. The aim of this review is to firstly introduce and compare the number of cell types, the size and morphology of the scaffolds, and the generic tissue reconstruction procedures utilised in the top–down and the bottom–up strategies; then, it will analyse their advantages, disadvantages, and challenges; and finally, it will briefly discuss the possible technologies that may overcome some of the inherent limitations of the bottom–up strategy.
also joined the "new" trend in experiencing this ancient modality. Those blotchy red or purple marks and perfect circles are the telltale of the cupping procedures familiar to practitioners of Asian and traditional bodywork and folk medicine, used for centuries. History indicates cupping was used centuries ago in ancient Asia, China, (Ge Hong) Egypt, (Ebers Papyrus), and Greece Not just folk medicine: myofascial cupping in the tech age!
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