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Development of a successful research program can seem daunting when looked at from the starting line. It will take years if not decades to succeed and become sustainable. It requires local partnerships and mentoring; it mandates the establishment of review boards; it requires national health policies to allow for protected time for research in salaries and for fund granting agencies to be set up; it requires training of researchers and support staff as well as a change in the mindset of clinical staff on the floor. It will almost inevitably require international support of some kind for low- and middle-income country researchers, be it university programs or other academic or private institutions. Success can occur; most likely it will occur by partnering with local research experts outside of emergency medicine in some combination with international networks and mentoring. Perhaps the most critical elements to success are intellectual curiosity and a burning flame of passion - and neither of those carry a financial cost.Statistics can be used to describe data or make inferences about populations using samples. Median values (the 50th percentile) better represent central tendency of data samples than means (averages), particularly when data have extreme values. Errors resulting from use of inferential statistics when using classical hypothesis testing include type I (finding a difference between groups when one does not exist) and type II (failure to find a true difference) errors. PRGL493 in vitro Confounding variables (those that vary with both the dependent variable and independent variable) may lead to spurious associations. Classical hypothesis testing and reporting only p-values tends to be greatly overused and overemphasized. Confidence intervals provide a range of values for a sample within a certain probability (commonly 95%). Confidence intervals can thus describe sizes of likely differences between samples, and are much more clinically useful information than only p-values. Before doing a study, the required sample size should be calculated to assess study feasibility. Doing so requires specification of the acceptable risk of type I and II errors and the size of the lowest clinically meaningful difference between groups.The specialty of Emergency Medicine continues to expand and mature worldwide. As a relatively new specialty, the body of research that underpins patient management in the emergency department (ED) setting needs to be expanded for optimum patient care. Research in the ED, however, is complicated by a number of issues including limited time and resources, urgency for some therapeutic investigations and interventions, and difficulties in obtaining truly informed patient consent. Notwithstanding these issues, many of the fundamental principles of medical research apply equally to ED research. In all medical disciplines, data needs to be collected, collated and stored for analysis and a data spreadsheet is employed for this purpose. Like other aspects of clinical research, the use of the data spreadsheet needs to be exacting and appropriate. This research primer explores the choice of available spreadsheets and a range of principles for their best-practice use. It is deliberately, not an exhaustive review of the subject. However, we aim to explore basic principles and some of the most accessible and widely used data spreadsheets.Without data, there is no new knowledge generated. There may be interesting speculation, new paradigms or theories, but without data gathered from the universe, as representative of the truth in the universe as possible, there will be no new knowledge. Therefore, it is important to become excellent at collecting, collating and correctly interpreting data. Pre-existing and new data sources are discussed; variables are discussed, and sampling methods are covered. The importance of a detailed protocol and research manual are emphasized. Data collectors and data collection forms, both electronic and paper-based are discussed. Ensuring subject privacy while also ensuring appropriate data retention must be balanced.Research is a fundamental component of the development of quality emergency care systems. Developing qualified professionals and programs to conduct emergency care research is essential to understanding epidemiology in low resource settings. link2 This leads to evaluating research outcomes, developing clinical practice guidelines and program implementation. This paper aims to introduce the reader to opportunities for research funding at various stages of one's career. We will discuss concepts necessary to obtain funding for research, a crucial step towards initiating a research program. The chapter further describes competitive funding mechanisms including governmental agencies, foundations and private industry along with organisations that offer funding for global health and emergency care research. We describe categories of grants specific to a stage of an investigator's career, developing a team for a proposal and the grant application process.Social media has changed the way we communicate. Wherever you are in the world, various forms of social media are being used by individuals to share information and connect without borders. Due to its ubiquity, social media holds great promise in linking clinicians, scientists, investigators, and the public to change the way we conduct scientific discourse. In this paper, we present a step-by-step guide on optimizing your social media strategy with regards to research/scholarly practice (discourse, collaboration, recruitment), knowledge translation, dissemination, and education. This guide also highlights key readings that provide guidance to those interested in incorporating social media into their scholarly practice.Study design is critical to ensure that research questions are answered in an appropriate and rational manner for all aspects of health, but particularly in emergency care. Appropriate study design selection is one of the most critical decisions to make at the earliest stage of a research project; once this is clear, much of the methodology and sample size estimations should be straightforward. Selection of an appropriate study design is fundamental to good research and deserves careful consideration at the outset of any research project. The classic gold standard for study design is the double-blind randomised clinical trial, but it is often not possible to achieve this ideal in the busy clinical emergency environment or with the resources available. Descriptive studies are common in emergency care; they include retrospective clinical records reviews, prospective cohort studies and case-control studies. Case reports and surveys can be a useful introduction to research for novice researchers. When sufficient empirical evidence on a topic exists, results of similar studies can be combined in systematic reviews and/or meta-analyses to pool the results from multiple studies to determine stronger evidence for or against an intervention or treatment, but these techniques require specialist expertise and statistical skills.As demand for emergency care (EC) systems in low- and middle-income countries (LMICs) grows, there is an urgent need to expand the evidence base for clinical and systems interventions in resource limited EC settings. Clinicians are well placed to identify, define and address unanswered research questions using both quantitative and qualitative approaches. This paper summarises established research priorities for global EC and provides a step-wise approach to developing a research question. link3 Research priorities for global EC broadly fall into two categories systems-based research and research with a clinical care focus. Systems research is integral to understanding the essential components of safe and effective EC delivery, while clinical research aims to answer questions related to particular disease states, presentations or population groups. Developing a specific research question requires an enquiring, questioning and critical approach to EC delivery. In quantitative research, use of the PECO formula (Population, Exposure, Comparator, Outcome) can help frame a research question. Qualitative research, which aims to understand, explore and examine, often requires application of a theoretical framework. Writing a brief purpose statement can be a helpful tool to clarify the objectives of a qualitative study. This paper includes lists of tips, pitfalls and resources to assist EC clinical researchers in developing research questions. Application of these tools and frameworks will assist EC clinicians in resource limited settings to perform impactful research and improve outcomes for patients with acute illness and injury.As emergency and acute care systems develop, the ability to broadly engage key stakeholders becomes paramount for success. Collaborating with emergency medicine clinicians as well as other providers who have already developed their specialties, administrative leadership, as well as networking locally and regionally would maximise the success of developing a sustainable emergency care system.Effective critical appraisal of medical research requires training and practice. Evidence-based medicine provides a framework for standardised review of manuscripts of nearly any research design. Online resources and communities exist to provide free access to electronic search engines and critical appraisal of emergency medicine and non-emergency medicine research. An emerging array of Free Online Open Access medical education (FOAMed) resources also provide opportunities to observe Evidence-based medicine critical appraisal in written or audio format and to actively participate as a learner. This chapter will highlight accessible resources that provide both methodological background and virtual mentoring for readers to develop EBM skills.Hypoxia is a serious impediment to current treatments of many malignant tumors. Catalase, an antioxidant enzyme, is capable of decomposing endogenous hydrogen peroxide (H2O2) into oxygen for tumor reoxygenation, but suffered from in vivo instability and limited delivery to deep interior hypoxic regions in tumor. Herein, a deep-penetrated nanocatalase-loading DiIC18 (5, DiD) and soravtansine (Cat@PDS) were provided by coating catalase nanoparticles with PEGylated phospholipids membrane, stimulating the structure and function of erythrocytes to relieve tumor hypoxia for enhanced chemo-photodynamic therapy. After intravenous administration, Cat@PDS preferentially accumulated at tumor sites, flexibly penetrated into the interior regions of tumor mass and remarkably relieved the hypoxic status in tumor. Notably, the Cat@PDS + laser treatment produced striking inhibition of tumor growth and resulted in a 97.2% suppression of lung metastasis. Thus, the phospholipids membrane-coated nanocatalase system represents an encouraging nanoplatform to relieve tumor hypoxia and synergize the chemo-photodynamic cancer therapy.The clinical application of triptolide (TPL) in tumor therapy has been greatly limited by its toxicity and inefficient delivery. Herein, a localized and sustained-release thermo-sensitive hydrogel was developed for the intra-tumor administration of TPL. Based on the amphiphilic structure of poly (N-isopropylacrylamide-co-acrylic acid)-g-F68 copolymer, it was able to form nano-micelles to efficiently encapsulate TPL, and then turn into a hydrogel at 37 °C. TPL@nano-gel exhibited a sustained drug release profile in vitro and a stronger anticancer effect caused by "two strikes". The "first strike" was its enhanced cytotoxicity compared to free TPL, due to the enhanced pro-apoptosis effect observed in both MDA-MB-231 and MCF-7 cells caused by the regulation of endogenous mitochondrial pathways. Furthermore, TPL@nano-gel exhibited a "second-strike" through its anti-angiogenesis capabilities mediated through VEGFR-2 signaling inhibition. As expected, after intra-tumoral injection at a 0.45 mg/kg TPL-equivalent dose three times over 14 days in 4T1 tumor-bearing mice, TPL@nano-gel led to lower systemic toxicity and higher antitumor efficacy compared to multiple injections of TPL.