BACKGROUND: Active back-support exoskeletons are gaining more awareness as a solution to the prevalence of work-related musculoskeletal disorders in the construction industry. This study aims to understand the factors that influence the adoption of active back-support exoskeletons in the construction industry.
METHODS: A literature review was conducted to gather relevant adoption factors related to exoskeleton implementation. Building on the TOE (Technology, Organization, and Environment) framework, two rounds of the survey via the Delphi technique were administered with 13 qualified industry professionals to determine the most important adoption factors using the relative importance index. Through semi-structured interviews, the professionals expressed their perspectives on the impact of active back-support exoskeletons on the construction industry.
RESULTS: Important factors included 18 facilitators and 21 barriers. The impact of the exoskeletons in the construction industry was categorized into expected benefits, barriers, solutions, adjustment to technology, implementation, and applicable tasks.
CONCLUSIONS: This study identified the factors to be considered in the adoption and implementation of active back-support exoskeletons in the construction industry from the perspective of stakeholders. The study also elucidates the impact of active exoskeletons on construction organizations and the broader environment.
CONCLUSIONS: This study provides useful guidance to construction companies interested in adopting active back-support exoskeletons. Our results will also help manufacturers of active back-support exoskeletons to understand the functional requirements and adjustments required for utilization in the construction industry. Lastly, the study expands the application of the TOE framework to the adoption of active back-support exoskeletons in the construction industry.

There are some non-communicable diseases (NCD) associated with arterial hypertension (AHT) that are cured after recovery from AHT. Recently confirmed the theory of centralized aerobic-anaerobic energy balance compensation (TCAAEBC) originated some NCDs with the obstructions of arterial blood flow access to the rhomboid fossa. For some sergeants, this has already been demonstrated. Since neurological NCDs are similarly considered by TCAAEBC, it is logical to analyze dynamics of such musculoskeletal neurological problem as isolated musculoskeletal chest pain (IMCP) in connection with the therapy based on TCAAEBC. We retrospectively evaluated the medical records of adult patients with AHT, simultaneously suffering from IMCP. All these patients underwent complex treatment including manual techniques that restore arterial blood flow to the rhomboid fossa, followed by therapy that strengthens the muscular corset primarily of the cervical region. This, in addition to the normalization of AHT, led to a decrease in the musculoskeletal pain syndrome. The dynamic of pain was recorded according to four questionaries - Oswestry Disability Index (ODI) Hospital Anxiety and Depression Scale (HADS), Numerical Rating Scale (NRS), and the Quality-of-life assessment questionnaire (SF-12). The collected data were analyzed with the Wilcoxon signed-rank test, which confirms the recovery of the patients from both AHT and IMCP.
Особое место в ряду хронических неинфекционных заболеваний (ХНИЗ) занимает эссенциальная артериальная гипертензия (АГ), или гипертоническая болезнь, которая может быть тесно связана с дегенеративно-дистрофическими заболеваниями опорно-двигательного аппарата (ОДА), в частности остеохондрозом (остеоартрозом) позвоночника (шейного и грудного отделов), проявления которого поддаются коррекции мануальными техниками. Недавно подтвержденная теория централизованной компенсации аэробно-анаэробного энергетического баланса (Theory of centralized aerobic-anaerobic energy balance compensation, TCAAEBC) объясняет связь некоторых ХНИЗ с затруднением доступа артериального кровотока к сосудодвигательному центру ромбовидной ямки (obstruction in arterial blood flow access to the rhomboid fossa, OABFRH), объясняя вертеброгенный характер ряда случаев АГ. Пациенты с АГ, имеющие остеохондроз шейного отдела позвоночника и, предположительно, вертеброгенный генез заболевания, прошли комплексное лечение, включающее мануальные техники, восстанавливающие артериальный кровоток к ромбовидной ямке, с последующей терапией, укрепляющей мышечный корсет прежде всего шейного отдела (методика А.Ю. Шишонина). Показано, что кроме нормализации артериального давления, использованная методика уменьшает болевой синдром со стороны ОДА, проявления тревоги, депрессии, что подтверждается данными психоневрологических шкал согласно опросникам Освестри (ODI), больничной шкале тревоги и депрессии (HADS), числовой шкале оценок (NRS) и опроснику оценки качества жизни (SF-12).

Advances in surgical ergonomics are essential for the performance, health, and career longevity of surgeons. Many surgeons experience work-related musculoskeletal disorders (WMSDs) resulting from various surgical modalities, including open, laparoscopic, and robotic surgeries. To prevent WMSDs, individual differences may exist depending on the surgical method; however, the key is to maintain a neutral posture, and avoid static postures. This review aims to summarize the concepts of ergonomics and WMSDs; identify the ergonomic challenges of open, laparoscopic, and robotic surgeries; and discuss ergonomic recommendations to improve them.

OBJECTIVE: To analyse clinical outcomes of a non-medical switch from originator adalimumab (ADA) to its ABP501 biosimilar (ABP) over 6 months in patients with inflammatory rheumatic musculoskeletal diseases (RMD) in relation to comorbidity as a risk factor for therapy discontinuation.
METHODS: RMD patients switching from originator ADA to ABP were identified from a large routine database from October 2018 onwards. Documented clinical data at the time of non-medical switching (baseline), and at 3 and 6 months were collected. Comorbidities were represented by the Charlson Comorbidity Index (CCI) at baseline and patients were categorized based on CCI > 0. Differences in the ABP retention rate over 6 months between patients with CCI = 0 and patients with CCI > 0 were analysed using Bayesian exponential regression.
RESULTS: A total of 111 patients with axial spondyloarthritis (n = 68), rheumatoid arthritis (n = 23) and psoriatic arthritis (n = 15), were identified, 74.8% of whom had continued treatment with ABP after 6 months, while a smaller proportion had either switched to another ADA biosimilar (10.8%), switched back to originator ADA (7.2%), switched to a different biologic (3.6%), or dropped out (3.6%). At baseline, a CCI > 0 was found in 38% of patients. Cardiovascular comorbidities (40%) were most prevalent followed by diseases of the skin (33%), the gastrointestinal tract (20%) and the eye (20%). ABP treatment was continued after 6 months in 74% of patients with CCI = 0 and in 76% with CCI > 0. Bayesian analysis showed only a small difference (months) in the APB continuation rate between groups (estimate 0.0012, 95% credible interval (CrI) -0.0337 to 0.0361). Adjusting for age, sex, and disease subtype revealed somewhat shorter retention rates for patients with CCI > 0, but the distribution of the difference included 0 (estimate -0.0689, 95% CrI -0.2246 to 0.0234).
CONCLUSIONS: In a non-medical switch scenario of RMD patients, there was no evidence for a considerable difference in ABP retention rates over 6 months between comorbidity groups.

UNASSIGNED: This study aims to develop risk prediction models for neck and shoulder musculoskeletal disorders among healthcare professionals.
UNASSIGNED: A stratified sampling method was employed to select employees from medical institutions in Nanning City, yielding 617 samples. The Boruta algorithm was used for feature selection, and various models, including Tree-Based Models, Single Hidden-Layer Neural Network Models (MLP), Elastic Net Models (ENet), and Support Vector Machines (SVM), were applied to predict the selected variables, utilizing SHAP algorithms for individual-level local explanations.
UNASSIGNED: The SVM model excels in both Mean Absolute Error (MAE) and Root Mean Square Error (RMSE) and exhibits more stable performance when generalizing to unseen data. The Random Forest model exhibited relatively high overall performance on the training set. The MLP model emerges as the most consistent and accurate in predicting shoulder musculoskeletal disorders, while the SVM model shows strong fitting capabilities during the training phase, with occupational factors identified as the main contributors to WMSDs.
UNASSIGNED: This study successfully constructs work-related musculoskeletal disorder risk prediction models for healthcare professionals, enabling a quantitative analysis of the impact of occupational factors. This advancement is beneficial for future economical and convenient work-related musculoskeletal disorder screening in healthcare professions.

BACKGROUND: Fishers are at risk of back disorders due to their physically demanding work. The aim was to investigate risk factors for back disorders in fishers in Denmark.
METHODS: All male Danish registered fishers between 1994 and 2017 were included. ICD-10 codes classified back disorders (M40-M54* and DM99.1-4*). A multistate model on a cause-specific cox regression model was conducted.
RESULTS: Of 13,165 fishers included, 16% had a hospital contact with an incident back disorder, and 52% at least had 1 recurrent episode. Having worked in another occupation (HR 1.14; 95% CI: 1.02, 1.27) and another musculoskeletal disorder (HR 1.84; 95% CI: 1.69, 2.01) were significant risk factors for the incident back disorder. No risk factors were seen for recurrent episodes.
CONCLUSIONS: Risk factors for incident and recurrent back disorders were different; thus, episode-specific initiatives are needed to reduce back disorders among fishers.

A limited number of tissues can spontaneously regenerate following injury, and even fewer can regenerate to a state comparable to mature, healthy adult tissue. Mesenchymal stem cells (MSCs) were first described in the 1960s-1970s by Friedenstein et al as a small population of bone marrow cells with osteogenic potential and abilities to differentiate into chondrocytes. In 1991, Arnold Caplan coined the term \"mesenchymal cells\" after identifying these cells as a theoretical precursor to bone, cartilage, tendon, ligament, marrow stroma, adipocyte, dermis, muscle, and connective tissues. MSCs are derived from periosteum, fat, and muscle. Another attractive property of MSCs is their immunoregulatory and regenerative properties, which result from crosstalk with their microenvironment and components of the innate immune system. Collectively, these properties make MSCs potentially attractive for various therapeutic purposes. MSCs offer potential in sports medicine, aiding in muscle recovery, meniscal tears, and tendon and ligament injuries. In joint disease, MSCs have the potential for chondrogenesis and reversing the effects of osteoarthritis. MSCs have also demonstrated potential application to the treatment of degenerative disc disease of the cervical, thoracic, and lumbar spine.

BACKGROUND: The COVID-19 pandemic has led to the broad acceptance of distance education (DE), with university professors and students conducting the teaching-learning process remotely from their homes. The propose of this study to investigate the prevalence of musculoskeletal disorders (MSDs) before and during the COVID-19 pandemic and identify risk factors associated with DE that may contribute to an increased incidence of these disorders among university professors.
METHODS: This cross-sectional analytical study took a comparative approach and involved 310 university professors in Iran. Data were gathered using an online questionnaire. Initially, demographic and occupational information of the professors, hours of physical activity, and hours spent using electronic devices were recorded. Participants were then asked to report MSDs in various body areas throughout the previous year and the previous seven days. Finally, MSDs risk factors such as workstation ergonomics during computer, laptop, smartphone, and tablet use, as well as working postures during online teaching or offline content development during the COVID-19 pandemic, were examined.
RESULTS: The majority of the participants were male (66.13%), with a PhD (46.77%) and a faculty member position (74.2%). On average, the use of computers and laptops increased by 2.67 h and 2.72 h, respectively, during the pandemic compared to before the pandemic. This increase was statistically significant (P < 0.001). MSDs incidence increased significantly before and during the COVID pandemic was observed in the areas of the neck, shoulders, lower and upper back, arms, forearms, wrists and fingers (P < 0.05). The highest cumulative incidence (Cin) of MSDs was related to the neck (Cin = 24.20%), upper back (Cin = 21.29%), low back (Cin = 18.06%) and fingers (Cin = 16.13%). The prevalence of MSDs during the COVID pandemic was significantly associated with employment status (P = 0.042), work experience (P = 0.016), age (P = 0.027), increase in the use of computers/ laptops (P < 0.001), decrease of the smartphone/tablet distance from the body (P = 0.047), workstation (smartphone-tablet, computer, laptop) (P < 0.05), head position (smartphone-tablet) (P = 0.029), display height (computer/laptop) (P = 0.045) and physical activity (P = 0.006).
CONCLUSIONS: It appears that the increased duration of smartphone, computer, and laptop use, combined with decreased physical activity and detrimental changes in ergonomic conditions of workstations during the quarantine period caused by the COVID-19 pandemic, has resulted in a shift from dynamic to static tasks and an increase in the prevalence and incidence of MSDs among university professors.

Objective: To explore the risk factors of neck work-related musculoskeletal disorders (WMSDs) among automobile manufacturing enterprise workers, and construct the risk prediction model. Methods: In May 2022, a cluster convenience sampling method was used to selet all front-line workers from an automobile manufacturing factory in Xiangyang City as the research objects. And a questionnaire survey was conducted using the modified Musculoskeletal Disorders Questionnaire to analyze the occurrence and exposure to risk factors of neck WMSDs. Logistic regression was used to analyze the influencing factors of workers\' neck WMSDs symptoms, and Nomogram column charts was used to construct the risk prediction model. The accuracy of the model was evaluated by the receiver operating characteristic (ROC) curve, the Bootstrap resampling method was used to verify the model, Hosmer-Lemeshow goodness of fit test was used to evaluate the model, and the Calibration curve was drawn. Results: A total of 1783 workers were surveyed, and the incidence of neck WMSDs symptoms was 24.8% (442/1783). Univariate logistic regression showed that age, female, smoking, working in uncomfortable postures, repetitive head movement, feeling constantly stressed at work, and completing conflicting tasks in work could increase the risk of neck WMSDs symptoms in automobile manufacturing enterprise workers (OR=1.37, 95%CI: 1.16-1.62; OR=2.85, 95%CI: 1.56-5.20; OR=1.50, 95%CI: 1.18-1.91; OR=1.18, 95%CI: 1.02-1.37; OR=1.34, 95%CI: 1.04-1.72; OR=1.62, 95%CI: 1.21-2.17; OR=1.48, 95%CI: 1.13-1.92; P<0.05). While adequate rest time could reduce the risk of neck WMSDs symptoms (OR=0.56, 95%CI: 0.52-0.86, P<0.05). The risk prediction model of neck WMSDs of workers in automobile manutacturing factory had good prediction efficiency, and the area under the ROC curve was 0.72 (95%CI: 0.70-0.75, P<0.001) . Conclusion: The occurrence of neck WMSDs symptoms of workers in automobile manufacturing factory is relatively high. The risk prediction model constructed in this study can play a certain auxiliary role in predicting neck WMSDs symptoms of workers in automobile manufacturing enterprise workers.
目的： 探讨汽车制造业工人颈部工作相关肌肉骨骼疾患（WMSDs）的影响因素，并构建风险预测模型。 方法： 于2022年5月，采用方便抽样法，选取襄阳市1家汽车制造厂所有一线工人作为研究对象，采用改良《肌肉骨骼疾患调查问卷》调查其颈部WMSDs症状发生情况及危险因素暴露情况，采用logistic回归分析工人颈部WMSDs症状发生的影响因素，用Nomogram列线图构建风险预测模型。通过受试者工作特征（ROC）曲线评价模型准确性，运用Bootstrap重抽样的方法进行模型验证，Hosmer-Lemeshow拟合优度检验评价模型，绘制校准曲线（Calibration curve）。 结果： 共调查1 783名工人，颈部WMSDs症状发生率为24.8%（442/1 783）。多因素logistic回归分析显示，年龄、女性、吸烟、以不舒服姿势工作、头部重复动作、总是感到工作压力大、完成有矛盾的工作会增加汽车制造业工人颈部WMSDs症状的发生风险（OR=1.37，95%CI：1.16~1.62；OR=2.85，95%CI：1.56~5.20；OR=1.50，95%CI：1.18~1.91；OR=1.18，95%CI：1.02~1.37；OR=1.34，95%CI：1.04~1.72；OR=1.62，95%CI：1.21~2.17；OR=1.48，95%CI：1.13~1.92；P<0.05），而休息时间充足会降低颈部WMSDs症状的发生风险（OR=0.56，95%CI：0.52~0.86，P<0.05）。该汽车制造厂工人颈部WMSDs风险预测模型具有较好的预测效能，ROC曲线下面积（AUC）为0.72（95%CI：0.70~0.75，P<0.001）。 结论： 该汽车制造厂工人颈部WMSDs症状发生率较高，本研究构建的风险预测模型可以对汽车制造业工人颈部WMSDs症状发生起到一定的辅助预测作用。.

Platelets are crucial for thrombosis and hemostasis. Importantly, they contain mitochondria that are responsible for energy generation and therefore vital for platelet survival and activation. Activated platelets can release mitochondria that may be free or encapsulated in platelet extracellular vesicles (EVs). Extruded mitochondria are a well-known source of mitochondrial DNA, and mitochondrial antigens that can be targeted by autoantibodies forming immune complexes (IC). Interaction of IC with the platelet cell surface FcγRIIA receptor results in platelet activation and release of platelet granule components. In this review, we summarize how platelets and mitochondria may contribute to the pathogenesis of different autoimmune and musculoskeletal diseases. Targeting key drivers of mitochondrial extrusion may ultimately lead to urgently needed targeted pharmacological interventions for treating inflammation and thrombotic diathesis, and halting organ damage in some of these rheumatological conditions.