Musculoskeletal Disorders Research Articles

Diagnosis of chronic migraine and comorbid neurological disorders in real-life clinical practice

Chronic migraine (CM) is a neurological disorder whose diagnosis requires not only knowledge of its diagnostic criteria, but also the physician's ability to differentiate between various forms of primary and secondary headache (HA), as well as to recognize comorbid neurological disorders that aggravate the course of CM. Timely and correct diagnosis of CM and comorbid disorders allows to prescribe effective treatment to a patient and convert the migraine from a chronic to an episodic form. The diagnostics of CM and comorbid neurological disorders has not been sufficiently investigated in our country, which formed the basis for this study.Objective: to evaluate the quality of diagnostics of CM and comorbid neurological disorders in real-life neurological practice.Material and methods. The study included 200 patients with CM (63 men and 137 women, mean age 33.1±7.1 years) admitted to A.Ya. Kozhevnikov Clinic of Nervous Diseases (CND) of Sechenov University, complaining of frequent headaches. They had previously been examined and treated by neurologists in other medical institutions on an outpatient and/or inpatient basis. A clinical interview was conducted with all patients to establish a diagnosis and analyze their previous treatment, and a psychometric test was performed to assess symptoms of anxiety and depression.Results. Only 6% of patients had been previously diagnosed with CM, the remaining 94% were incorrectly diagnosed with secondary HA. All patients had previously been prescribed additional examinations, mainly neuroimaging of the brain and ultrasound of the cerebral vessels, although there were no "red flags". None of the patients had been previously assessed for their emotional state, while almost all patients had high situational anxiety (n=190; 95%) and high personal anxiety (n = 180; 90%), there were symptoms of depression (n=190; 95%) of varying severity. Comorbid neurological disorders (medication overuse HA), insomnia, musculoskeletal pain etc.) were diagnosed in 91.5% of patients in CND and in only in 8% of patients in other medical centers.Conclusion. In real-life clinical practice, CM and comorbid neurological disorders are inadequately diagnosed and excessive and unjustified additional examinations are prescribed.

Atherosclerotic Cardiovascular Disease (ASCVD) in Rheumatoid Arthritis (RA)—Indian Perspective

Reduced life expectancy in rheumatoid arthritis (RA) has been recognised since the 1950s, with standardised mortality rates (SMRs) of 1.41 for females and 1.08 for males. Extensive studies worldwide, including in India, have attributed this to a high prevalence of atherosclerotic cardiovascular disease (ASCVD) in RA. The increased ASCVD risk in RA and other inflammatory rheumatic and musculoskeletal diseases (I-RMDs) is influenced not only by conventional ASCVD risk factors (such as hypertension, diabetes mellitus, obesity, smoking, physical inactivity, and family history) but also by the degree and duration of systemic inflammation, as indicated by high-sensitivity C-reactive protein (hs-CRP) levels. Therefore, preventing ASCVD in RA and other I-RMDs has become a critical responsibility for rheumatologists. A two-pronged strategy is recommended: (a) strict lipid control and (b) stringent management of systemic inflammation, measured by hs-CRP levels. This article summarises the Lipid Association of India (LAI) guidelines for preventing ASCVD in RA and other I-RMDs, which can be implemented by specialist rheumatologist-nurse-led teams in rheumatology clinics and departments.

Application prospects of urine-derived stem cells in neurological and musculoskeletal diseases

Urine-derived stem cells (USCs) are derived from urine and harbor the potential of proliferation and multidirectional differentiation. Moreover, USCs could be reprogrammed into pluripotent stem cells [namely urine-derived induced pluripotent stem cells (UiPSCs)] through transcription factors, such as octamer binding transcription factor 4, sex determining region Y-box 2, kruppel-like factor 4, myelocytomatosis oncogene, and Nanog homeobox and protein lin-28, in which the first four are known as Yamanaka factors. Mounting evidence supports that USCs and UiPSCs possess high potential of neurogenic, myogenic, and osteogenic differentiation, indicating that they may play a crucial role in the treatment of neurological and musculoskeletal diseases. Therefore, we summarized the origin and physiological characteristics of USCs and UiPSCs and their therapeutic application in neurological and musculoskeletal disorders in this review, which not only contributes to deepen our understanding of hallmarks of USCs and UiPSCs but also provides the theoretical basis for the treatment of neurological and musculoskeletal disorders with USCs and UiPSCs.

The prevalence of occupational-related low back pain among working populations in sub-saharan Africa: a systematic review and meta-analysis

IntroductionWork-related musculoskeletal disorders represent a major public health problem, contributing significantly to the global burden of disability-adjusted life years and affecting the quality of life of all population groups. The main problem in most musculoskeletal disorders is low back pain. Therefore, our study aims to identify the overall prevalence of work-related low back pain among the working population in sub-Saharan Africa.MethodsResearch published between 2010 and 2023 in English, conducted in Sub-Saharan Africa was included in this systematic review and meta-analysis. Using Boolean logic operators and targeted keywords, we searched for publications on a number of electronic databases (Web of Science, PubMed, Google Scholar, African Journals Online (AJOL), and Science Direct). The Joanna Briggs Institute Critical Appraisal techniques were utilized to conduct a quality assessment of the papers and ascertain their relevance to the study. The degree of heterogeneity among the included studies, the 95% confidence interval, and the pooled prevalence were estimated using a random effects model. Sensitivity studies were carried out to determine the causes of heterogeneity and the impact of outliers.ResultsIn this study, a total of 970 articles were retrieved, and 35 studies were included in the systematic review and meta-analysis. The overall estimated pooled prevalence of low back pain among the working population in sub-Saharan Africa was (55.05% [95% CI: 49.34, 60.76]). Based on a sub-group analysis by countries, the higher pooled prevalence of low back pain was found in Uganda at (61.48% [95% CI: 40.39, 82.57]), while the lower pooled prevalence of low back pain was in Ghana at (34.48% [95% CI: 17.96, 51.01]).ConclusionsThis systematic review and meta-analysis found that 55.05% of the included study participants experienced low back pain in the previous years. Therefore, it is recommended that policymakers incorporate and enhance strategies for the prevention and management of low back pain within the health system management guidelines of each country.

Modulation of heteromeric glycine receptor function through high concentration clustering.

Ion channels are targeted by many drugs for treating neurological, musculoskeletal, renal and other diseases. These drugs bind to and alter the function of individual channels to achieve desired therapeutic effects. However, many ion channels function in high concentration clusters in their native environment. It is unclear if and how clustering modulates ion channel function. Human heteromeric glycine receptors (GlyRs) are the major inhibitory neurotransmitter receptors in the spinal cord and are active targets for developing chronic pain medications. We show that the α2β heteromeric GlyR assembles with the master postsynaptic scaffolding gephyrin (GPHN) into micron-sized clustered at the plasma membrane after heterologous expression. The inhibitory trans- synaptic adhesion protein neuroligin-2 (NL2) further increases both the cluster sizes and GlyR concentration. The apparent glycine affinity increases monotonically as a function of GlyR concentration but not with cluster size. We also show that ligand re-binding to adjacent GlyRs alters kinetics but not chemical equilibrium. A positively charged N- terminus sequence of the GlyR β subunit was further identified essential for glycine affinity modulation through clustering. Taken together, we propose a mechanism where clustering enhances local electrostatic potential, which in turn concentrates ions and ligands, modulating the function of GlyR. This mechanism is likely universal across ion channel clusters found ubiquitously in biology and provides new perspectives in possible pharmaceutical development.

Selenium nanoparticles ameliorate lumbar disc degeneration by restoring GPX1-mediated redox homeostasis and mitochondrial function of nucleus pulposus cells

Intervertebral disc degeneration (IVDD) is a prevalent musculoskeletal disorder that involves the excessive accumulation of reactive oxygen species (ROS), resulting in mitochondrial dysfunction and matrix metabolism imbalance in nucleus pulposus cells (NPCs). Selenium, an indispensable trace element, plays a crucial role in maintaining mitochondrial redox homeostasis by being incorporated into antioxidant selenoproteins as selenocysteine. In this study, we employed a straightforward synthesis method to produce selenium nanoparticles (SeNPs) with consistent size and distribution, and evaluated their potential protective effects in ameliorating IVDD. In a simulated inflammatory environment induced by interleukin-1beta (IL-1β) in vitro, SeNPs demonstrated a protective effect on the matrix synthesis capacity of NPCs through the up-regulation of aggrecan and type II collagen, while concurrently suppressing the expression of matrix degradation enzymes including MMP13 and ADAMTS5. Additionally, SeNPs preserved mitochondrial integrity and restored impaired mitochondrial energy metabolism by activating glutathione peroxidase1 (GPX1) to rebalance redox homeostasis. In a rat lumbar disc model induced by puncture, the local administration of SeNPs preserved the hydration of nucleus pulposus tissue, promoted matrix deposition, and effectively mitigated the progression of IVDD. Our results indicate that the enhancement of GPX1 by SeNPs may offer a promising therapeutic approach for IVDD by restoring mitochondrial function and redox homeostasis.

Effectiveness of gluteal control training in chronic low back pain patients with functional leg length inequality

Chronic low back pain (LBP) is a common musculoskeletal disorder and is often accompanied by functional leg length inequality (FLLI). However, little was known about the effects of gluteal muscle control training in patients with LBP and FLLI. This study was designed to investigate the effects of gluteal control training in patients with LBP and FLLI. This is a double-blinded, randomized controlled study design. Forty-eight LBP patients with FLLI were randomized to the gluteal control training (GT) (47.58 ± 9.42 years) or the regular training (RT) (47.38 ± 11.31 years) group and received allocated training for six weeks. The outcome measures were pelvic inclination (PI), ilium anterior tilt difference (IATD), FLLI, visual analogue scale (VAS), patient specific-functional scale (PSFS), Oswestry disability index (ODI), hip control ability, global rating of change scale (GRoC), and lower extremity strength and flexibility. The intervention effects were compared using two-way repeated measures analysis of variance and chi-square tests with α = 0.05. The results indicated that the GT group showed greater improvement (P < 0.01) in PI (1.03 ± 0.38∘ vs. 1.57 ± 0.51∘), IATD (0.68 ± 0.66∘ vs. 2.31 ± 0.66∘), FLLI (0.3 ± 0.22 vs. 0.59 ± 0.13 cm), VAS (1.41 ± 1.32 vs. 3.38 ± 1.51), hip control ability (2.20 ± 0.45 vs. 0.89 ± 0.74), GRoC at 3rd and 6th week as compared to the RT group. Hip strength and flexibility also improved more in the GT group (P < 0.05). In conclusion, gluteal control training was more effective in improving low back pain and dysfunctions, and should be integrated in the management plan in patients with LBP and FLLI.

Update on Ergonomics Standards in the United States

After two decades of dormancy, activity around ergonomics rulemaking has increased recently, primarily due to legislation passed at the state level. Several states have enacted laws addressing production quotas in warehouses and the impact they have on worker safety and health. Minnesota added an ergonomics program requirement for industries with known risk for work-related musculoskeletal disorders to their safe patient handling and warehouse quota regulations in response to legislation passed in 2023. In that same year, the Washington State Legislature passed laws that resulted in a warehouse quota regulation and initiated industry-specific rulemaking efforts. This paper provides an overview of current ergonomics standards at the state level and offers a national perspective from federal OSHA.

Exploring the Impact of Catechins on Bone Metabolism: A Comprehensive Review of Current Research and Future Directions.

Background/Objectives: Degenerative musculoskeletal diseases represent a global health problem due to the progressive deterioration of affected individuals. As a bioactive compound, catechins have shown osteoprotective properties by stimulating osteoblastic cells and inhibiting bone resorption. Thus, this review aimed to address the mechanism of action of catechins on bone tissue. Methods: The search was applied to PubMed without limitations in date, language, or article type. Fifteen articles matched the topic and objective of this review. Results: EGCG (epigallocatechin gallate) and epicatechin demonstrated action on the osteogenic markers RANKL, TRAP, and NF-κβ and expression of BMPs and ALP, thus improving the bone microarchitecture. Studies on animals showed the action of EGCG in increasing calcium and osteoprotegerin levels, in addition to regulating the transcription factor NF-ATc1 associated with osteoclastogenesis. However, it did not show any effect on osteocalcin and RANK. Regarding human studies, EGCG reduced the risk of fracture in a dose-dependent manner. In periodontal tissue, EGCG reduced IL-6, TNF, and RANKL in vitro and in vivo. Human studies showed a reduction in periodontal pockets, gingival index, and clinical attachment level. The action of EGCG on membranes and hydrogels showed biocompatible and osteoinductive properties on the microenvironment of bone tissue by stimulating the expression of osteogenic growth factors and increasing osteocalcin and alkaline phosphate levels, thus promoting new bone formation. Conclusions: EGCG stimulates cytokines related to osteogenes, increasing bone mineral density, reducing osteoclastogenesis factors, and showing great potential as a therapeutic strategy for reducing the risk of bone fractures.

Exploring the Moderating Effect of Musculoskeletal Pain on Technostress-Induced Burnout: A Cross-Sectional Study of Bank Employees.

Information and Communications Technology (ICT) advancements and high customer expectations are boosting the use of digital transformation and tech tools in business processes in a competitive environment. This trend enhances business effectiveness and efficiency but also introduces technostress as a new workplace stress factor. Technostress, defined as stress induced by using ICT in the workplace, has become increasingly prevalent in modern work environments, especially in sectors such as banking, due to digital transformation. As technology use intensifies, it raises concerns about potential adverse psychological and physiological effects on employees, particularly in relation to burnout. From a physiological perspective, musculoskeletal disorders (MSDs) are quite common among employees who use ICT for extended periods. MSDs can play a significant moderating role in the relationship between technostress and burnout. In this context, this study aimed to examine the moderating role of MSDs in the effect of technostress on burnout. This quantitative study surveyed a convenience sample of 220 bank employees, drawing on COR theory, the JD-R model, the P-E fit approach, and transactional stress theory. Data were analyzed using Structural Equation Modeling with SmartPLS 4.0 software, enabling examination of relationships between variables derived from these frameworks. The results reveal that technostress increases bank employees' burnout experience. Additionally, bank employees with MSDs experience higher burnout levels than those without MSDs. The study's findings provide valuable insights into managing workplace stress, addressing mental health problems, and promoting employee well-being in the digital age. These results have potential implications for academic understanding and practical applications in sustainable management.

Prevalence and Interrelationships of Screen Time, Visual Disorders, and Neck Pain Among University Students: A Cross-Sectional Study at Majmaah University.

Digital devices significantly contribute to vision-related problems. In addition, prolonged postural imbalance, owing to excessive use of digital devices, can lead to the tightening of head and neck muscles, resulting in neck pain, a common musculoskeletal discomfort that significantly affects individuals with poor vision. This study aimed to evaluate the prevalence and interrelationships of screen time, visual disorders, and neck pain among students at Majmaah University. A cross-sectional study was conducted at Majmaah University, Saudi Arabia, enrolling students aged 18 to 25 years. Exclusion criteria included neurological or musculoskeletal disorders. Demographic data and information on visual and neck pain symptoms were collected. The Neck Disability Index questionnaire was used to assess neck pain, and data were analyzed using SPSS version 24.0. Among 263 participants, 53.6% were female. Nearsightedness (38.0%) and dry/itchy eyes (49.0%) were the most common visual disorders and symptoms, respectively. Visual disorders were prevalent in 62.0% of students, while neck pain was reported by 79.5%. Females and those studying for more than 5 h using electronic screens daily reported higher neck disability index scores. A significant association was found between >5 h of study duration [screen time] and neck disability (OR 3.703, 95% CI 1.500-9.144, p = 0.005). The study highlights a relationship between visual problems and neck pain among university students, emphasizing the need for addressing vision-related issues to reduce neck discomfort. High screen time could substantially increase the odds of developing neck disability. However, authors warrant cautious interpretation in the light of following limitations: cross-sectional study, small sample size, lack of statistical power, and self-reported data.

Development of a selective COX-2 inhibitor: from synthesis to enhanced efficacy via nano-formulation.

Non-steroidal anti-inflammatory drugs NSAIDs are widely used for managing various conditions including pain, inflammation, arthritis and many musculoskeletal disorders. NSAIDs exert their biological effects by inhibiting the cyclooxygenase (COX) enzyme, which has two main isoforms COX-1 and COX-2. The COX-2 isoform is believed to be directly related to inflammation. Based on structure-activity relationship (SAR) studies of known selective COX-2 inhibitors, our aim is to design and synthesize a novel series of 2-benzamido-N-(4-substituted phenyl)thiophene-3-carboxamide derivatives. These derivatives are intended to be selective COX-2 inhibitors through structural modification of diclofenac and celecoxib. The compound 2-benzamido-5-ethyl-N-(4-fluorophenyl)thiophene-3-carboxamide VIIa demonstrated selective COX-2 inhibition with an IC50 value of 0.29 μM and a selectivity index 67.24. This is compared to celecoxib, which has an IC50 value of 0.42 μM and a selectivity index 33.8. Molecular docking studies for compound VIIa displayed high binding affinity toward COX-2. Additionally, the suppression of protein denaturation with respect to albumin was performed as an indicative measure of the potential anti-inflammatory efficacy of the novel compounds. Compound VIIa showed potent anti-inflammatory activity with 93% inhibition and an IC50 value 0.54 μM. In comparison, celecoxib achieved 94% inhibition with an IC50 value 0.89 μM. Although molecule VIIa demonstrated significant in vitro anti-inflammatory activity, adhered to Lipinski's "five rules" (RO5) and exhibited promising drug-like properties, it showed indications of poor in vivo activity. This limitation is likely due to poor aqueous solubility, which impacts its bioavailability. This issue could be addressed by incorporating the drug in niosomal nanocarrier. Niosomes were prepared using the thin-film hydration technique. These niosomes exhibited a particle size of less than 200 nm, high entrapment efficiency, and an appropriate drug loading percentage. Transmission electron microscopy (TEM) and differential scanning calorimetry (DSC) studies revealed that the niosomes were spherical and demonstrated compatibility of all of its components. The drug release study indicated that the pure drug had limited practicality for in vivo use. However, incorporating the drug into niosomes significantly improved its release profile, making it more suitable for practical use.

Association Between BMI Reduction and Activities of Daily Living Improvement in Elderly Patients With Musculoskeletal Disorders in a Convalescent Rehabilitation Ward

Association Between BMI Reduction and Activities of Daily Living Improvement in Elderly Patients With Musculoskeletal Disorders in a Convalescent Rehabilitation Ward

Enhancing Workplace Safety for Disabled Farmers in Thailand: A Quasi-Experimental Study of Ergonomic Interventions in Vermicompost Production

The aim of this study was to improve the working environment for disabled farmers in vermicompost production using participatory action-oriented training (PAOT). Potential hazards were identified through Job Safety Analysis (JSA), and improvements were implemented based on the analysis. The winnowing step was found to have the highest risk, as farmers had to manually separate vermicompost and earthworms by shaking the mixture through a filter. To address this, a vermicompost winnowing machine was developed specifically for disabled farmers, reducing their working time and the risk of muscle injuries. Ergonomic assessments were conducted using Rapid Entire Body Assessment (REBA). The assessments compared the risks associated with the manual process to those when using the newly developed winnowing machine. The results indicated a reduction in musculoskeletal disorder (MSD) risk for all disabled groups. The findings of this study emphasize the importance of considering occupational health and safety for disabled individuals in agriculture. By implementing ergonomic improvements such as redesigned tools and adjusted workstations, the safety and well-being of disabled farmers can be enhanced. This contributes to creating inclusive and productive work environments. In conclusion, through the application of PAOT and ergonomic assessments, this study successfully identified potential hazards and implemented improvements in vermicompost production for disabled farmers. The development of a specialized winnowing machine reduced the risk of musculoskeletal disorders. Promoting occupational health and safety measures is crucial for supporting the participation and well-being of disabled individuals in agricultural work.

Real-world usage pattern, effectiveness and safety of oral tramadol/dexketoprofen trometamol fixed-dose combination in moderate-to-severe acute pain in Asia: a prospective, multicentre, observational study

ObjectivesThis study aims to determine the usage pattern, effectiveness and safety of oral tramadol 75 mg and dexketoprofen trometamol 25 mg fixed-dose combination (TRAM/DKP FDC) in the short-term treatment of...

Relationships between working from home, sitting postures and low back pain during COVID-19: A survey of frequent computer users.

To investigate the effects of working from home on musculoskeletal pain. An e-survey of computer workers was conducted. Multinomial logistic regression modelling examined relationships between work location (work or home office desk, dining table, other), sitting posture (diagrams with descriptors), depressive symptoms (CESD -10), sleep quality (good/average vs poor) and pain (low back pain [LBP]), other pain without LBP, asymptomatic). Of 634 respondents, most (91%, n = 578) worked partially at home and had pain (91%, n = 576; 342 LBP, 234 other pain, 58 asymptomatic). Sitting posture ("trunk a little bent forward" vs "straight up, back against back rest": OR = 2.9; 95% CI 1.3-6.5, p = .008), being female (2.2; 1.2-4.1, p = .008), and depressive symptoms (3.4; 1.7-6.6; p < .001) were associated with LBP. Poor sleep quality related to LBP but correlated with depressive symptoms. Working from home and location were not associated with pain. Sitting postures, but not working from home, are associated with LBP.

Ergonomics in bronchoscopy.

This study examines ergonomic considerations in bronchoscopic procedures, surveying existing research, injury rates, contributing factors, and practical ergonomic controls. The field of ergonomics examines the relationship between workers and their workplace to enhance productivity and minimize injuries. Bronchoscopists may face ergonomic hazards due to extended periods of maintaining fixed positions, repetitive actions, and the design of both tools and procedure spaces. Studies on the ergonomics of bronchoscopy have revealed a wide range of musculoskeletal issues among practitioners. Those new to the field, including trainees and early-career professionals, may be particularly vulnerable to injuries compared to their more experienced counterparts. Implementing a systematic approach, such as that proposed by the National Institute for Occupational Safety and Health, could help reduce physical stress, discomfort, and the likelihood of musculoskeletal disorders for bronchoscopists. Bronchoscopists increasingly face ergonomic issues in their practice. Despite available measures to address these problems, the field lacks uniform ergonomic guidelines for bronchoscopy. To safeguard bronchoscopists' health and safety from the outset of their careers, more studies and training focused on ergonomics in bronchoscopy are needed.

A call for improving of musculoskeletal education on physical medicine and rehabilitation studies: a systematic review with meta-analysis

BackgroundThe incidence of musculoskeletal diseases is increasing in clinical practice, leading to a growing demand for rehabilitation medicine. However, education in musculoskeletal education is lacking in the training of physical medicine and rehabilitation students. This study aims to evaluate the impact of musculoskeletal education on medical students’ learning of rehabilitation medicine and analyze the correlation between influencing factors and education.ObjectivesThe primary objective of this study is to evaluate the impact of musculoskeletal education on medical students’ learning of rehabilitation medicine. Furthermore, the authors aim to analyze the correlation between various influencing factors and the effectiveness of this education, with the goal of informing future educational interventions and enhancing student outcomes.MethodsA comprehensive search was conducted across the Pubmed, Ovid, and Cochrane Central Register of Controlled Trials (CENTRAL) databases for relevant articles published from January 2012 to September 2024. The search focused on medical students as the research subjects and musculoskeletal education as the intervention method. Both randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) were included. The selected studies underwent a systematic review, and meta-analysis was performed using R 3.4.4 software.ResultsAfter a thorough search, 41 studies were included. The retrospective study indicated that the most common impacts were knowledge acquisition, self-confidence, and satisfaction. The subsequent meta-analysis revealed significant increases in students’ knowledge acquisition [standardized mean differences (SMD) = 2.15, 95% confidence interval [CI] (1.36, 2.94), I2 = 97%, random effect model] and self-confidence [SMD = 5.81, 95% CI (2.88, 8.75), I2 = 97%, random effect model]. Compared with the general teaching control group, the knowledge acquisition of students in the observation group improved [SMD = 0.25, 95% CI (0.00, 0.51), I2 = 83%, in the random effect model]; However, no significant difference in satisfaction occurred [SMD = 0.27, 95% CI (-0.47, 1.01), P > 0.05, I2 = 89%, in the random effects model].ConclusionMusculoskeletal education primarily impacts knowledge acquisition self-confidence, and satisfaction among physical medicine and rehabilitation students. The meta-analysis further establishes that musculoskeletal education significantly enhances knowledge acquisition and confidence in these students.Trial registrationCRD42024563899 (completed on July 17, 2024).

3D Bioprinted Chondrogenic Gelatin Methacrylate-Poly(ethylene glycol) Diacrylate Composite Scaffolds for Intervertebral Disc Restoration

Abstract Degenerative spine pathologies, including intervertebral disc (IVD) degeneration, present a significant healthcare challenge due to their association with chronic pain and disability. This study explores an innovative approach to IVD regeneration utilizing 3D bioprinting technology, specifically visible light-based digital light processing (VL-DLP), to fabricate tissue scaffolds that closely mimic the native architecture of the IVD. Utilizing a hybrid bioink composed of gelatin methacrylate (GelMA) and poly(ethylene glycol) diacrylate (PEGDA) at a 10% concentration, we achieved enhanced printing fidelity and mechanical properties suitable for load-bearing applications such as the IVD. Preconditioning rat bone marrow-derived mesenchymal stem cell (rBMSC) spheroids with chondrogenic media before incorporating them into the GelMA-PEGDA scaffold further promoted the regenerative capabilities of this system. Our findings demonstrate that this bioprinted scaffold not only supports cell viability and integration but also contributes to the restoration of disc height in a rat caudal disc model without inducing adverse inflammatory responses. The study underscores the potential of combining advanced bioprinting techniques and cell preconditioning strategies to develop effective treatments for IVD degeneration and other musculoskeletal disorders, highlighting the need for further research into the dynamic interplay between cellular migration and the hydrogel matrix.

Through the patients’ eyes: psychometric evaluation of the 64-item version of the Experienced Patient-Centeredness Questionnaire (EPAT-64)

BackgroundPatient-reported experience measures (PREMs) are valuable tools to evaluate patient-centredness (PC) from the patients’ perspective. Despite their utility, a comprehensive PREM addressing PC has been lacking. To bridge this gap,...