Investigation of the Al-Mo-B(CN) coatings deposited using magnetron sputtering of Al-Mo-B4C target produced by deto-nation spray coating (preprint)

In this work, Al-Mo-B(CN) thin coatings were deposited by magnetron sputtering using composite metal-ceramic Al-Mo-B4C target. A metal-ceramic composite target for magnetron sputtering was fabricated by a robotic complex for detonation spraying of coatings equipped with a multi-chamber detonation accelerator. The powder composition (30Mo-30Al-40B4C) was sprayed onto the copper plate base of the composite target-cathode. The obtained cathode target with Al-Mo-B4C coating (thickness 280-300 μm) was used to deposit the Al-Mo-B(CN) coating (DC mode) on flat specimens of AISI 316 steels and silicon using equipment for magnetron sputtering UNICOAT 200. The Al-Mo-B4C coating has a lamella-type structure with inclusions of boron car-bide particles the elemental composition is evenly distributed in the material. The structure and morphology of coatings were studied using methods of optical, scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray analysis (XRD), and X-ray photoelectron spectros-copy (XPS). Mechanical and tribological properties of the Al-Mo-B(CN) thin coatings were determined using methods of nanoindentation, scratch testing, and tribological testing under fluid-free friction regime at room temperature. The Al-Mo-B(CN) coating (thickness ~ 1 μm) exhibited a dense uniform fine-grained structure with no columnar elements and were well-adherent to the substrates after deposition. Al-Mo-B(CN) coating has a amorphous structure. XPS analysis confirmed the formation of the MoB2 and AlN phase with an admixture of oxygen in the form of aluminum oxide, molybdenum oxide and boron oxide. Al-Mo-B(CN) coating possess hardness of 13 GPa, elasticity modulus of 114 GPa, elastic recovery of 45%, and friction coefficient of 0.8 against steel 100 Cr6 ball. The failure mode occurring in the tested coatings was fatigue and abrasive. The adhesion strength of Al-Mo-B(CN) coating amounted to about 11 N, and the failure mode was cohesive associated with plastic deformation and formation of fatigue cracks in the coating material.

Optimal Design of Laminates Orientation in a Composite Material by Genetics Algorithm and Simulated Annealing (preprint)

The present work sets out the evaluation of composite laminates through optimization objective functions. Genetic Algorithms (GA), as well as Simulated Annealing (SA), were performed in order to determine the optimal ply orientations of a fiber-reinforced polymer laminate for three given load cases: 1) in-plane loads, 2) combined moments, and 3) in-plane loads and combined moments. It searches the optimal orientation layup, which fulfills at the same time both the maximum strain criterion and the Tsai-Wu failure criterion. Construction of an objective function based on the strains and the stresses involves a minimization process to deformations and a maximization of the safety factor. For the first load case, the initial solution is [±45/0/90/±45]s, and the best solution is [(45/135)2/452]s. For the second load case, [-45/45/45/-45/0/90]s is the initial layup sequence, then the best solution obtained is [(45/-45)2/452]s, where plies at 0° and 90º are not necessary even when axial loads are applied. For the third study case, the original layup sequence is [0/45/-45/45/0/90]s; meanwhile, the best solution calculated is [21/24/145/140/45/49]s. An interesting observation is that each pair of layers has a 5º gap. The simulations show that the qualitative results from the GA are better than the SA, but with a significantly higher computational cost. These kinds of computational tools are expected to be used as a reference guide for an optimal fiber configuration with respect to the common orientations used when composite laminates are designed for a structural application.

Multisystemic Manifestation in Treacher Collins Syndrome (preprint)

Treacher Collins syndrome (TCS) is a rare congenital disorder characterized by craniofacial abnormalities due to underdeveloped facial bones. In addition to physical deformities, TCS also presents with several neurological disorders resulting from facial defects and brain malformations. This paper reviews the neurological manifestations of TCS with a focus on facial nerve paralysis, neurodevelopmental delay, intellectual disability, and autism spectrum disorder. Facial nerve hypoplasia leads to an inability to control facial muscles and expressions. Neurodevelopmental delays in motor function and language acquisition are commonly reported in infants with TCS due to hearing loss, facial impairments, poor nutrition, infections, and structural brain changes. Intellectual disability with below average IQ is also more prevalent in TCS, affecting about one third of patients. Brain imaging reveals abnormalities like white matter hypoplasia, cortical atrophy, and reduced grey matter volume which likely contribute to cognitive deficits. Additionally, the rate of autism spectrum disorder is significantly higher in TCS compared to the general population. The reasons are unclear but may involve hearing loss, facial dysmorphisms, and socio-emotional processing centers in the brain. Management is multidisciplinary, focusing on early interventions like speech, physical, feeding, and behavioral therapy to maximize developmental and functional outcomes. Further research on the neurological pathophysiology of TCS is needed to better elucidate the mechanisms linking craniofacial defects with adverse neurodevelopmental consequences.

Functional Load Capacity of Teeth with Reduced Periodontal Support: A Finite Element Analysis (preprint)

The purpose of this study was to investigate the functional load capacity of the periodontal ligament (PDL) in a full arch maxilla and mandible model using numerical simulation. The goal of was to determine the functional load pattern in multi- and single rooted teeth with full and reduced periodontal support. CBCT data were used to create 3D-models of a maxilla and mandible. The DICOM dataset was used to create a CAD-model. For a precise description of the surfaces of each structure (enamel, dentin, cementum, pulp, PDL, gingiva, bone), each tooth was segmented separately, and the biomechanical characteristics were considered. A Finite-Element-Analysis (FEA) software computed the biomechanical behavior of stepwise increased force of 700N in cranial and 350N in ventral direction of the muscle approach of the Masseter muscle. The periodontal attachment (cementum-PDL-bone contact) was subsequently reduced in 1mm increments and the simulation repeated. Quantitative (pressure, tension, and deformation) and qualitative (color-coded images) data were recorded and descriptively analyzed. The teeth with the highest load capacities were the upper and lower molars (0.4-0.6MPa), followed by the premolars (0.4-0.5MPa) and canines (0.3-0.4MPa) when vertically loaded. Qualitative data showed that the area with the highest stress in the PDL were for single rooted teeth the cervical and apical area and for molars additionally the furcation roof. In both, single- and multi rooted teeth the gradual reduction of the bone levels caused an increase of the load on the remaining PDL. Cervical and apical areas as well as the furcation roof are the zones with the highest functional stress. The more bone loss, the higher the mechanical load on the residual periodontal supporting structures.

Constitutive Modeling of Annealed OFHC with Wide Strain-Rate and Temperature Effects: Incorporating Dislocation Dynamics and Normalized Microstructural Size Evolution (preprint)

The flow stress of face-centered cubic (FCC) metals exhibits a rapid increase near a strain rate of 104 s-1 under fixed strain conditions. However, many existing constitutive models either fail to capture the mechanical characteristics of this plastic deformation or use piecewise strain rate hardening models to describe this phenomenon. Unfortunately, the piecewise models may suffer from issues such as discontinuity of physical quantities and difficulties in determining segment markers, and struggling to reflect the underlying physical mechanisms that give rise to this mutation phenomenon. In light of this, this paper proposes that the abrupt change in flow stress sensitivity to strain rate in FCC metals can be attributed to microstructural evolution characteristics. To address this, a continuous semi-empirical physical constitutive model for FCC metals is established based on the microstructural size evolution proposed by Molinari-Ravichandran and the dislocation motion slip mechanism. This model effectively describes the mutation behavior of strain rate sensitivity under fixed strain, particularly evident in the annealed OFHC. The predicted results of the model across a wide range of strain rates (10-4 − 106 s-1) and temperatures (77 − 1096 K) demonstrate relative errors generally within ±10% of the experimental values. Furthermore, the model is compared to five other models, including Mechanical Threshold Stress (MTS), Nemat-Nasser-Li (NNL), Preston-Tonks-Wallace (PTW), Johnson-Cook (JC), and Molinari-Ravichandran (MR) models. A comprehensive illustration of errors reveals that the proposed model outperforms the other five models in describing the plastic deformation behavior of OFHC. The error results offer valuable insights for selecting appropriate models for engineering applications and provide significant contributions to the field.

The Use of Vacuum Devices as Adjuvant Therapy before and after Penile Curvature Surgery: Results from a Comparative Study (preprint)

Background: Peyronie’s disease (PD) represents a challenging urological disease, due to not optimal post-operative surgical outcomes. We aim to evaluate if vacuum erection devices (VED) treatment before pe-nile curvature surgery is able to improve the post-operative surgical outcomes. Methods: All enrolled patients were assigned to the following groups: a) treatment group, VED treatment (3 times per week) starting 3 months before surgery and (3 times per week) one months after surgery and b) control group, VED treatment (3 times per week) one months after surgery. Follow-up urologic visits were scheduled at 3 and 6 months after surgery and the two groups were compared. Results: Thirty-eight patients have been enrolled (median age 67 years, 57-74, IQR), 20 in the treatment group and 18 in the control group. At the follow-up visits, the two groups are different in terms of IIEF-5 (26 vs 24; p=0.02), ‘yes’ to SEP2 and 3 (85% vs 55%; p<0.001, 85% vs 50%; p<0.001, respectively) and PDQ (-16 vs -11; p=0.03). Complete correction of penile curvature was achieved in 36 patients (94.7%). In the treatment group, no hourglass deformity has been reported, while in the control group 1 patient reported a mild hourglass deformity. In the treatment group, we obtained a longer total penile length (median +1.5 cm). The overall satisfaction rate was 98% in the treatment group and 96% in the control group. Conclusions: The VED treatment before penile curvature surgery in patients affected by PD is able to improve the post-operative surgery.

A Rare Case of Spondyloptosis in a 15 year Old Male: a Clinical Image (preprint)

Spondyloptosis is a condition where there is complete dislocation of L5 over sacrum. It is a form of spinal dislocation in which one spinal segment is lodged in the anterior or posterior space of another or advanced spondylolisthesis [1]. Treatment is usually spinal fusion depending on the level of lesion [2]. This clinical case is of a 15 year old male with a history of fall from auto-rickshaw followed by a blunt trauma from a heavy iron rod falling over his abdomen. There was no history of loss of consciousness, but the patient had an excruciating pain over back immediately after the incident. Patient is now paraplegic with loss of sensation below L5 along with loss bladder and bowel control since the time of injury. The T1 weighted MRI of spine revealed grade 5 anterior lysthesis of L5 over S1 level with complete spinal cord transaction. The patient was operated to restore the vertebral alignment with pedicle screws and rods. After 3 months, patient is now treated for neuro-musculoskeletal , genitourinary and genitointestinal function with biofeedback, pelvic floor exercises and timed voiding [3]. When a patient has issues with urine retention, Valsalva manoeuvres, Crede's method, suprapubic tapping, and anal stretching are employed to help them void more effortlessly [4].

Carbon Black Filling Amount on the Hyper-elastic Mechanical Behavior of Rubber (preprint)

We have particularly investigated the correlation law of the effect of different carbon black fillings on the hyper-elastic mechanical behavior of natural rubber by conducting uniaxial tensile tests over a wide range of deformations with different volume fractions of carbon black fillings (0%, 4.7%, 8.9%, 12.8%, 16.4%, 19.7%, 22.7%, 25.2%). The results show that the stress-strain curve for carbon black filled rubber increases with the amount of filling, meaning that the rubber gradually becomes "harder". We explore the correlation between the carbon black filling volume and the parameters of the Yeoh constitutive model by examining the Yeoh constitutive model to characterize the hyper-elastic mechanical behavior of rubber with different carbon black fillings. A quantitative relationship between the material parameters and the carbon black filling volume in the Yeoh constitutive model is presented. A method for calculating the material parameters of the Yeoh constitutive model is developed and it predicts the correlation between the hyper-elastic properties of rubber and the volume fraction of carbon black filling.

Single-Stage Debridement and Reconstruction with Trabecular Metal Cage for Active Infectious Spondylodiscitis: A Retrospective Cohort Study (preprint)

Early debridement and stabilization for pyogenic spondylodiscitis allow early mobilization of the patient and prevent subsequent spinal deformity. Tantalum (Ta) trabecular metal (TM) components have several potential advantages over conventional implant materials, such as its uniformity and structural continuity, strength, low stiffness, high porosity, high coefficient of friction and tantalum trabecular metal enhances the host defense mechanism by increasing leukocyte chemotaxis, phagocytosis, and the bacterial killing rate. A single-stage surgery with a tantalum trabecular metal cage combining two different approaches is sufficient to maintain vertebral stability. This retrospective cohort study included 57 patients, 31 (54%) patients were treated with single-stage debridement and reconstruction with trabecular metal cages, and 26 (45.6%) patients received spine surgery without trabecular metal cages received surgery between January 2018 and March 2021 in our tertiary academic teaching hospital. The CRP values dropped borderline significantly in the TM cage group compared with the non-TM cage group postoperatively. In patients with spondylodiscitis, it is advisable to perform single-stage debridement and reconstruction with a trabecular metal cage, which allows abscess drainage and rapid mobilization, prevents deformity.

Frequency and risk factors of musculoskeletal disorders in high risk occupation workers in Urban, Karachi.

OBJECTIVE: To determine the frequency and risk factors of musculoskeletal disorders in high-risk occupation workers in an urban setting. METHODS: The analytical cross-sectional study was conducted in Karachi from July to December 2020, and comprised office workers, operation theatre technicians and coolies. The presence of musculoskeletal disorders was assessed using the Nordic Musculoskeletal Questionnaire to determine factors associated with moderate to severe condition. Data was analysed using SPSS 20. RESULTS: Of the 300 male subjects, 100(33.3%) each were office workers, operation theatre technicians and coolies. The overall mean age was 33.25±6.8 years (range: 18-50 years). The overall prevalence of musculoskeletal disorders was 179(59.7%). Besides, 117(65.4%) patients with musculoskeletal disorders had intermediate stage of the disease. The lower back and neck were the most common site of trouble involved in preceding 12 months 111(43.6%) each. CONCLUSIONS: Prevalence of musculoskeletal disorders was found to be a common problem affecting high-risk occupational workers.

Facilitators and barriers for vaccination in patients with inflammatory rheumatic musculoskeletal diseases: a prospective cohort study.

INTRODUCTION: To identify facilitators and barriers towards vaccination in general and specifically against pneumococci, influenza and SARS-CoV-2 in patients with rheumatic musculoskeletal diseases (RMD). METHODS: Between February and April 2021, consecutive patients with RMD were asked to complete a structured questionnaire on general knowledge about vaccination, personal attitudes and perceived facilitators and barriers towards vaccination. General facilitators (n=12) and barriers (n=15) and more specific ones for vaccination against pneumococci, influenza and SARS-CoV-2 were assessed. Likert scales had four response options: from 1 (completely disagree) to 4 (completely agree). Patient and disease characteristics, their vaccination records and attitudes towards vaccination against SARS-CoV-2 were assessed. RESULTS: 441 patients responded to the questionnaire. Knowledge about vaccination was decent in ≥70% of patients, but <10% of patients doubted its effectiveness. Statements on facilitators were generally more favourable than on barriers. Facilitators for SARS-CoV-2 vaccination were not different from vaccination in general. Societal and organisational facilitators were more often named than interpersonal or intrapersonal facilitators. Most patients indicated that recommendations of their healthcare professional would encourage them to be vaccinated-without preference for general practitioner or rheumatologists. There were more barriers towards SARS-CoV-2 vaccination than to vaccination in general. Intrapersonal issues were most frequently reported as a barrier. Statistically significant differences in response patterns to nearly all barriers between patients classified as definitely willing, probably willing and unwilling to receive SARS-CoV-2 vaccines were noted. DISCUSSION: Facilitators towards vaccination were more important than barriers. Most barriers against vaccination were intrapersonal issues. Societal facilitators identified support strategies in that direction.

Editorial to the Special Issue "The Effect of Exercise Intensity and Psychological Intervention on Musculoskeletal Disorders".

Musculoskeletal disorders are responsible for the most prevalent form of pain, and necessitate a comprehensive approach to rehabilitation [...].

Influence of Vitamin D Supplementation on Bone Mineral Content, Bone Turnover Markers and Fracture Risk in South African Schoolchildren: Multicentre Double-Blind Randomised Placebo-Controlled Trial (ViDiKids) (preprint)

Background: Randomised controlled trials (RCT) to determine the influence of vitamin D on bone mineral content (BMC) and fracture risk in children of Black African ancestry are lacking.Methods: We conducted a sub-study nested within a Phase 3 RCT of weekly oral supplementation with 10,000 IU vitamin D3 in HIV-uninfected Cape Town schoolchildren of Black African ancestry aged 6-11 years. Outcomes were BMC at the whole body less head (WBLH) and lumbar spine (LS) and serum concentrations of 25-hydroxyvitamin D3 (25[OH]D3), parathyroid hormone (PTH) and bone turnover markers. Incidence of fractures was an outcome of the main trial.Findings: 1682 children were enrolled in the main trial, of whom 450 also participated in the sub-study. Among sub-study participants, end-trial serum 25(OH)D3 concentrations were higher for participants allocated to vitamin D vs. placebo (adjusted mean difference [aMD] 39.9 nmol/L, 95% CI 36.1 to 43.6, P<0.001) and serum PTH concentrations were lower (aMD -0.55 pmol/L, 95% CI -0.94 to -0.17, P=0.005). However, no interarm differences were seen for WBLH BMC (aMD -8.0 g, 95% CI -30.7 to 14.7) or LS BMC (aMD -0.3 g, 95% CI -1.3 to 0.8), or for serum concentrations of bone turnover markers (P≥0.28). In the main trial, allocation did not influence fracture risk (adjusted odds ratio 0.70, 95% CI 0.27 to 1.85, P=0.48).Interpretation: Weekly vitamin D supplementation elevated serum 25(OH)D3 concentrations and suppressed serum PTH concentrations in HIV-uninfected South African schoolchildren of Black African ancestry but did not influence BMC, bone turnover markers or fracture risk.FUNDING: Medical Research CouncilTrial Registration: Registered on the South African National Clinical Trials Register (DOH-27-0916-5527) and ClinicalTrials.gov (ref NCT02880982).Funding: This research was funded by the UK Medical Research Council (refs MR/R023050/1 and MR/M026639/1, both awarded to ARM). RJW was supported by Wellcome (104803, 203135). He also received support from the Francis Crick Institute which is funded by Cancer Research UK (FC2112), the UK Medical Research Council (FC2112) and Wellcome (FC2112). Declaration of Interest: ARM declares receipt of funding in the last 36 months to support vitamin D research from the following companies who manufacture or sell vitamin D supplements: Pharma Nord Ltd, DSM Nutritional Products Ltd, Thornton & Ross Ltd and Hyphens Pharma Ltd. ARM also declares receipt of vitamin D capsules for clinical trial use from Pharma Nord Ltd, Synergy Biologics Ltd and Cytoplan Ltd; support for attending meetings from Pharma Nord Ltd and Abiogen Pharma Ltd; receipt of consultancy fees from DSM Nutritional Products Ltd and Qiagen Ltd; receipt of a speaker fee from the Linus Pauling Institute; participation on Data and Safety Monitoring Boards for the VITALITY trial (Vitamin D for Adolescents with HIV to reduce musculoskeletal morbidity and immunopathology, Pan African Clinical Trials Registry ref PACTR20200989766029) and the Trial of Vitamin D and Zinc Supplementation for Improving Treatment Outcomes Among COVID-19 Patients in India (ClinicalTrials.gov ref NCT04641195); and unpaid work as a Programme Committee member for the Vitamin D Workshop. All other authors declare that they have no competing interests.Ethical Approval: The trial was sponsored by Queen Mary University of London, approved by the University of Cape Town Faculty of Health Sciences Human Research Ethics Committee (Ref: 796/2015) and the London School of Hygiene and Tropical Medicine Observational/Interventions Research Ethics Committee (Ref: 7450-2).

Long-Term Safety Analysis of the ChAdOx1-nCoV-19 Corona Virus Vaccine: Results from a Prospective Observational Study in Priority Vaccinated Groups in North India.

INTRODUCTION: Various vaccines for protection against COVID-19 were provided emergency approval in late 2020 to early 2021. There is a scarcity of long-term safety data for many of these. OBJECTIVE: The main aim of this study is to provide the one-year safety results of the ChAdOx1-nCoV-19/AZD1222 vaccine and determine the risk factors of adverse events of special interest (AESIs) and persistent AESIs. METHODS: This was a prospective observational study conducted from February 2021 to April 2022 in a tertiary hospital in North India and its two associated centers. Health care workers, other frontline workers, and the elderly vaccinated with the ChAdOx1-nCoV-19 vaccine constituted the study population. Individuals were contacted telephonically at pre-decided intervals for one year and health issues of significant concern were recorded. Atypical adverse events developing after a booster dose of the COVID-19 vaccine were assessed. Regression analysis was conducted to determine risk factors of AESI occurrence and determinants of AESIs persisting for at least one month at the time of final telephonic contact. RESULTS: Of 1650 individuals enrolled, 1520 could be assessed at one-year post-vaccination. COVID-19 occurred in 44.1% of participants. Dengue occurred in 8% of participants. The majority of the AESIs belonged to the MedDRA® SOC of musculoskeletal disorders (3.7% of 1520). Arthropathy (knee joint involvement) was the most common individual AESI (1.7%). Endocrinal disorders such as thyroid abnormalities and metabolic disorders such as newly diagnosed diabetes developed in 0.4% and 0.3% of individuals, respectively. Regression analysis showed females, individuals with a pre-vaccination history of COVID-19, diabetes, hypothyroidism, and arthropathy had 1.78-, 1.55-, 1.82-, 2.47- and 3.9-times higher odds of AESI development. Females and individuals with hypothyroidism were at 1.66- and 2.23-times higher risk of persistent AESIs. Individuals receiving the vaccine after COVID-19 were at 2.85- and 1.94 times higher risk of persistent AESIs compared, respectively, to individuals with no history of COVID-19 and individuals developing COVID-19 after the vaccine. Among participants receiving a booster dose of the COVID-19 vaccine (n = 185), 9.7% developed atypical adverse events of which urticaria and new-onset arthropathy were common. CONCLUSION: Nearly half of the ChAdOx1-nCoV-19 vaccine recipients developed COVID-19 over one year. Vigilance is warranted for AESIs such as musculoskeletal disorders. Females, individuals with hypothyroidism, diabetes, and pre-vaccination history of COVID-19 are at higher risk of adverse events. Vaccines received after natural SARS-CoV-2 infection may increase the risk of persistence of adverse events. Sex and endocrinal differences and timing of the COVID-19 vaccine with respect to natural infection should be explored as determinants of AESIs in the future. Pathogenetic mechanisms of vaccine-related adverse events should be investigated along with comparisons with an unvaccinated arm to delineate the overall safety profile of COVID-19 vaccines.

A real-world pharmacovigilance study of FDA Adverse Event Reporting System (FAERS) events forpaxlovid and molnupiravir (preprint)

Questions have been raised about the safety of paxlovid and molnupiravir as antiviral drugs for the treatment of COVID-19 since the pandemic. We applied t he FDA Adverse Event Reporting System (FAERS) to assess the safety by performing a disproportionality analysis to identify potential risks of paxlovid and molnupiravir. The number of paxlovid signals was approximately 11 times higher than that of molnupiravir, with most signals of these two drugs overlapped. General disorders and administration site conditions (ROR: 0.52, 95% CI: 0.58- 2.18), infections and infestations (ROR: 0.18, 95% CI: 0.23-6.64), nervous system disorders (ROR: 1.41, 95% CI: 0.79-1.58) were the top 3 signals for paxlovid, with gastrointestinal disorders (ROR: 4.13, 95% CI: 0.27-4.54), skin and subcutaneous tissue disorders (ROR: 11.51, 95% CI: 0.10-12.92), nervous system disorders (ROR: 1.41, 95% CI: 0.79-1.58) for molnupiravir. Paxlovid-induced infections, skin and subcutaneous tissue disorders, and molnupiravir-induced musculoskeletal and connective tissue disorders, as well as potential safety signals on the heart, eyes and ears needlong-term observation, especially for signals not included in the instructions. The adverse events on this study confirms most of the instructional information for paxlovid and molnupiravir, both drugs need to be monitored for risk signals such as acute respiratory failure, hematologic and lymphatic system.

Postacute Sequelae of SARS-CoV-2: Musculoskeletal Conditions and Pain.

Musculoskeletal and pain sequelae of COVID-19 are common in both the acute infection and patients experiencing longer term symptoms associated with recovery, known as postacute sequelae of COVID-19 (PASC). Patients with PASC may experience multiple manifestations of pain and other concurrent symptoms that complicate their experience of pain. In this review, the authors explore what is currently known about PASC-related pain and its pathophysiology as well as strategies for diagnosis and management.

Examination of Musculoskeletal System Disorders and Ergonomic Conditions in the Work Environment of Academics Providing Distance Education During the COVID-19 Pandemic: Controlled Study.

BACKGROUND This study aimed to evaluate whether the incidence rate of musculoskeletal system disorders changed owing to the increase in the time spent on the computer by academics who did or did not provide distance education during the COVID-19 pandemic. MATERIAL AND METHODS The Cornell Musculoskeletal Discomfort Questionnaire was used to assess musculoskeletal discomfort experienced in the past 1 week. In addition, the Occupational Safety and Health Administration (OSHA) Computer Workstations Evaluation Checklist was used to assess the ergonomic structure of the work environment. The questionnaire assessed musculoskeletal system disorders and collected demographic characteristics. RESULTS The study group included 184 (101 male, 83 female) academics who provided distance education, whereas the control group included 82 (44 male, 38 female) academics who did not provide distance education. The mean ages of academics in the study group and control group were 37.46±7.34 and 41.26±10.06 years, respectively. Although computer-based work environment ergonomics were similar (P>0.05) in both groups during the pandemic, the incidence rate of musculoskeletal disorders was significantly high in the study group (P<0.001). These disorders were mostly seen in the neck, back, and waist regions (P<0.001). CONCLUSIONS The results suggested that the incidence rate of musculoskeletal disorders increased in academics who provided distance education during the COVID-19 pandemic.

Investigation of musculoskeletal disorders, physical activity level, sleep quality, and fatigue in health professionals with and without a history of COVID-19.

BACKGROUND: Healthcare workers belong to an occupational group that is at high risk during the coronavirus 2019 (COVID-19) pandemic. The increased workload of healthcare workers and the accompanying psychosocial stress caused by the pandemic can affect musculoskeletal system disorders, physical activity status, sleep quality, and fatigue in this group. OBJECTIVE: To investigate musculoskeletal system disorders, physical activity level, sleep quality, and fatigue in healthcare workers with and without a COVID-19. METHODS: A total of 200 healthcare professionals aged 18-65 years with and without a history of COVID-19 were in the study. Data were collected between January and March 2021. A "Preliminary Evaluation Form", "Extended version of the Nordic Musculoskeletal System Questionnaire (NMQ-E)", "the International Physical Activity Questionnaire-Short Form (IPAQ-SF)" and "the Pittsburgh Sleep Quality Index (PSQI) were used for data collection". RESULTS: It was determined that musculoskeletal system disorders did not differ significantly between healthcare workers with and without a COVID-19 history (p > 0.05). It was found that the number of people with problems in the low-back region was higher in those with a COVID-19 history (p = 0.002). In the sleep duration component, the scores of those who did not have a COVID-19 history were found to be significantly higher than those who did (p = 0.10). In other comparisons, it was determined that there was no significant difference. CONCLUSIONS: It was found that the number of people with problems in the low-back region was higher in those with a COVID-19 history. Those without a COVID-19 history had higher scores in sleep duration parameter.

Digital health in musculoskeletal care: where are we heading?

BMC Musculoskeletal Disorders launched a Collection on digital health to get a sense of where the wind is blowing, and what impact these technologies are and will have on musculoskeletal medicine. This editorial summarizes findings and focuses on some key topics, which are valuable as digital health establishes itself in patient care. Elements discussed are digital tools for the diagnosis, prognosis and evaluation of rheumatic and musculoskeletal diseases, coupled together with advances in methodologies to analyse health records and imaging. Moreover, the acceptability and validity of these digital advances is discussed. In sum, this editorial and the papers presented in this article collection on Digital health in musculoskeletal care will give the interested reader both a glance towards which future we are heading, and which new challenges these advances bring.

Emerging role of mesenchymal stem/stromal cells (MSCs) and MSCs-derived exosomes in bone- and joint-associated musculoskeletal disorders: a new frontier.

Exosomes are membranous vesicles with a 30 to 150 nm diameter secreted by mesenchymal stem/stromal cells (MSCs) and other cells, such as immune cells and cancer cells. Exosomes convey proteins, bioactive lipids, and genetic components to recipient cells, such as microRNAs (miRNAs). Consequently, they have been implicated in regulating intercellular communication mediators under physiological and pathological circumstances. Exosomes therapy as a cell-free approach bypasses many concerns regarding the therapeutic application of stem/stromal cells, including undesirable proliferation, heterogeneity, and immunogenic effects. Indeed, exosomes have become a promising strategy to treat human diseases, particularly bone- and joint-associated musculoskeletal disorders, because of their characteristics, such as potentiated stability in circulation, biocompatibility, low immunogenicity, and toxicity. In this light, a diversity of studies have indicated that inhibiting inflammation, inducing angiogenesis, provoking osteoblast and chondrocyte proliferation and migration, and negative regulation of matrix-degrading enzymes result in bone and cartilage recovery upon administration of MSCs-derived exosomes. Notwithstanding, insufficient quantity of isolated exosomes, lack of reliable potency test, and exosomes heterogeneity hurdle their application in clinics. Herein, we will deliver an outline respecting the advantages of MSCs-derived exosomes-based therapy in common bone- and joint-associated musculoskeletal disorders. Moreover, we will have a glimpse the underlying mechanism behind the MSCs-elicited therapeutic merits in these conditions.