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Effective treatment of cartilage abnormalities in middle-aged individuals (aged 45-60): Bounding molecular biology with microfracture and hyalofast membrane approach show positive outcomes
No full textBackground/aims: In recent years, significant progress has been made in treating cartilage lesions, leading to various techniques aimed at articular surface regeneration. However, the impact of patient age on treatment outcomes remains understudied, despite its recognized influence on effectiveness. Many studies impose upper age limits, resulting in limited data on middle-aged patients, a group frequently undergoing cartilage repair. Age-related physiological changes, including a decline in regenerative capacity and alterations in proteoglycan composition, are believed to affect treatment success. This study investigates the clinical outcomes of cartilage repair in patients aged 45 to 60, specifically evaluating the effectiveness of microfracture combined with Hyalofast membrane implantation.
Methods: Patients aged 45-60 undergoing microfracture with Hyalofast membrane implantation were evaluated. Short- and medium-term outcomes were assessed using the KOOS and SF-36 questionnaires preoperatively and at 6- and 12-month follow-ups. Functional evaluations and MRI analyses were conducted by expert reviewers. Additionally, an intensive rehabilitation program was initiated immediately post-surgery. Statistical analysis was performed using a one-way repeated-measures ANOVA to compare preoperative, 6-month, and 12-month results, with Tukey's post-hoc test applied for multiple comparisons. Clinical significance was assessed using Cohen's d effect size, with standard thresholds for small, medium, and large effects.
Results: The combined microfracture and Hyalofast membrane approach, along with early rehabilitation, yielded promising results. Key benefits included reduced inflammation, improved membrane integration, and decreased subchondral edema.
Conclusion: These findings support the feasibility of this treatment strategy, highlighting its potential to enhance joint function, alleviate pain, and improve the overall quality of life in middle-aged patients
Predicting placebo analgesia responses in clinical trials: where to look next? A meta-analysis of individual patient data
No full textEstimating the magnitude of placebo responses across pharmacological and non�pharmacological trials is important for understanding their influence on trial outcomes. Yet, the
extent to which more intense placebo interventions like sham acupuncture yield larger analgesic
responses than placebo pills, and the factors predicting these responses, remain unclear. This
meta-analysis investigated the magnitude and predictors of placebo analgesia responses in
pharmacological versus acupuncture trials. Analyses included individual patient data from the
placebo arm of 11 randomized controlled trials (RCTs): Nine pharmacological RCTs using
placebo pills (N = 2021) and two acupuncture RCTs using sham acupuncture (N = 747). All
trials were conducted in patients with chronic nociceptive pain (osteoarthritis, N = 2068; low
back pain, N = 700). The placebo response was calculated as the change in pain intensity (0-
100) between baseline and week 12. A random effects model demonstrated that placebo pills
and patients with osteoarthritis exhibited smaller placebo responses than sham acupuncture and
patients with low back pain (both p<0.001, small effects). A mixed effects model showed that
route of administration interacted significantly with baseline pain, premature termination, and
the presence of adverse events. Predictors explained 20-25% of the individual variance in
placebo responses, while 75-80% remained unaccounted for. In summary, sham acupuncture
accounted for slightly larger placebo responses than placebo pills. While basic trial and patient
parameters explained only a small portion of this variability, we might need to start considering
the patient’s perception of the treatment – including cognition and emotions – to better predict
placebo analgesia response
Correction: Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the underrepresented groups' experiences in osteopathic training (UrGEnT) mixed methods study
No full textThe effectiveness of spinal manipulative therapy in treating spinal pain does not depend on the application procedures: A systematic review and network meta-analysis
No full textOBJECTIVE: To assess whether spinal manipulative therapy (SMT) application procedures (ie, target, thrust, and region) impacted changes in pain and disability for adults with spine pain.
DESIGN: Systematic review with network meta-analysis.
LITERATURE SEARCH: We searched PubMed and Epistemonikos for systematic reviews indexed up to February 2022 and conducted a systematic search of 5 databases (MEDLINE, EMBASE, CENTRAL [Cochrane Central Register of Controlled Trials], PEDro [Physiotherapy Evidence Database], and Index to Chiropractic Literature) from January 1, 2018, to September 12, 2023. We included randomized controlled trials (RCTs) from recent systematic reviews and newly identified RCTs published during the review process and employed artificial intelligence to identify potentially relevant articles not retrieved through our electronic database searches.
STUDY SELECTION CRITERIA: We included RCTs of the effects of high-velocity, low-amplitude SMT, compared to other SMT approaches, interventions, or controls, in adults with spine pain.
DATA SYNTHESIS: The outcomes were spinal pain intensity and disability measured at short-term (end of treatment) and long-term (closest to 12 months) follow-ups. Risk of bias (RoB) was assessed using version 2 of the Cochrane RoB tool. Results were presented as network plots, evidence rankings, and league tables.
RESULTS: We included 161 RCTs (11 849 participants). Most SMT procedures were equal to clinical guideline interventions and were slightly more effective than other treatments. When comparing inter-SMT procedures, effects were small and not clinically relevant. A general and nonspecific rather than a specific and targeted SMT approach had the highest probability of achieving the largest effects. Results were based on very low– to low-certainty evidence, mainly downgraded owing to large within-study heterogeneity, high RoB, and an absence of direct comparisons.
CONCLUSION: There was low-certainty evidence that clinicians could apply SMT according to their preferences and the patients’ preferences and comfort. Differences between SMT approaches appear small and likely not clinically relevant. J Orthop Sports Phys Ther 2025;55(2):109-122. Epub 7 January 2025. https://doi.org/10.2519/jospt.2025.1270
Comparing consecutive third-year Chiropractic Student cohorts: A successful evaluation of the Paired Junior Clinic programme
No full textIntroduction: A survey was conducted among third-year chiropractic students to evaluate the substantive effectiveness of junior clinical placements in preparing them for final-year clinical placements. The study aimed to assess the feelings towards perceived readiness and confidence levels of students who participated in the junior clinic program compared to those who did not.
Methods: The entire third-year cohort consisting of 166 students, including 42 students involved in junior clinical placements, completed an eight-question survey. Participants in the junior clinic program and non-participants were compared to determine differences in feelings towards perceived clinical preparedness.
Results: Students who participated in the junior clinic placements reported significantly higher levels of preparedness and confidence for their final-year clinical placements than non-participants.
Conclusion: The survey results showed the importance of junior clinical placements in enhancing the clinical readiness of chiropractic students in preparation for their final-year clinical placement. As indicated by the data collected, the success of these placements suggests that junior clinical placements play a critical role in developing clinical competence.
Indexing terms: Chiropractic; Education; Junior Clinic; Student confidence; Student preparedness; Student readiness
A national survey of osteopaths' conceptions of practice in France: structural validity of the Osteo-TAQfr and the tendency toward technical rationality
No full textBackground:Despite the growing popularity of osteopathy in France, little is known about how French osteopaths
conceptualise key aspects of their practice, including skills, knowledge, and decision-making. This study aimed
to adapt and validate the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) for use in a French
osteopathic population (Osteo-TAQfr) and to examine the professional profile and core elements of clinical practice
among French osteopaths. The first objective was to establish the psychometric properties of the Osteo-TAQfr within a French osteopathic population. The second aim was to explore French osteopaths’ conceptions of practice and
their approach to patient care, thereby contributing to a broader understanding of the profession in France and its
relevance within the discourse on allied health professions (AHPs).
Methods:A cross-sectional study was conducted to (1) adapt and validate the French version of the Osteopaths'
Therapeutic Approaches Questionnaire (Osteo-TAQfr) and (2) explore osteopaths’ conceptions of practice in
France. The translation and cultural adaptation process was informed by cognitive interviews to ensure linguistic
and contextual appropriateness. Exploratory Factor Analysis (EFA) was performed to assess the factor structure in
the French osteopathic context and Confirmatory Factor Analysis (CFA) was used to test the validity of previously
established constructs—Professional Artistry (PA) and Technical Rationality (TR). Internal consistency was evaluated using McDonald’s omega (ω).
Results:The survey yielded 1,703 complete responses. Analysis supported a two-factor model with PA andTR
subscales, both showing strong reliability estimations (PA ω = 0.882; TR ω = 0.873). Minor theory-informed
adjustments improved model fit. A moderate negative correlation was observed between the PA and TR subscales
(r=-0.407). Respondents with additional health professions qualifications scored lower on the PA subscale and higher
on the TR subscale
What are the commonly available street foods in Malaysia?
No full textVariety types of street foods that are available in other Asian, African, and European countries has been scientifically studied due to the nutritional contribution. The foods in these studies vary from local to non-local foods, and from homemade to industrial foods being prepared as street foods. Although street food has become a phenomenon in Malaysia, there is limited research that identifies the different types of street foods that are available in this country. Hence, this study aims to identify 820 types of street foods that are commonly available in Malaysia, the classification of the foods prepared as street foods for three food categories, and the preparation methods used. We conducted a field survey of street food stalls in all 14 states of Malaysia using a survey form. Then, the surveyed street foods were ranked from the highest to lowest frequency by food category for each state and the whole of Malaysia. From a total of 10 520 surveyed street foods across all states, there were 820 different types of street foods in the whole of Malaysia which comprised of 42.6 % main meals, 35 % snacks, and 22.4 % desserts. Most of the main meals and desserts were classified as local cooked dishes (80.2 %) and local desserts (84.2 %), respectively. Snacks were classified as local cooked dishes (35.5 %), local snacks (28.6 %), and processed foods (20.3 %). Most of the street foods were prepared by steaming (23.2 %) and deep-frying (21.1 %). In this study, the commonly available street foods in Malaysia existed in wide range of options and preparation methods
Physioethology: a post-humanist perspective on physiotherapy
No full textPhysiotherapy faces mounting challenges in an era of planetary crisis. This paper proposes a reorientation of physiotherapy through the philosophy of Gilles Deleuze and Félix Guattari, specifically their concept of ethology, which foregrounds affect, relation, and immanence. We argue that contemporary physiotherapy remains tethered to anthropocentric, essentialist, and representational assumptions that limit its capacity to respond to complex ecological entanglements. Drawing on ethology, we explore how bodies, human and non-human, can be understood not as stable entities but as dynamic assemblages defined by what they can do. We consider the implications of this approach for practice, education, and planetary health, suggesting that physiotherapy shift from its traditional forms of praxis toward a dynamic composition of capacities. In doing so, the profession might cultivate an ecologically attuned, affectively sensitive, and experimentally oriented practice capable of engaging in the world
An artificial intelligence road map to unlocking future technologies and transforming radiology practice
No full textToday, artificial intelligence (AI) is one of the hottest buzzwords in technology. It is at the center of the global technological revolution, envisaged to replace or enhance human capabilities in the coming times. With AI projected to be one of the major disrupting forces in the future, this article engages with several scientific sources to highlight the step-by-step progress made since the inception of AI from the Turing test to the much-celebrated ChatGPT’s (generative pre-trained transformer) launch, evolution in medical imaging (from early X-ray techniques to sophisticated AI-driven systems), and current research landscape, examining how AI gain can revolutionize radiology practice, while also pointing out pitfalls and future research directions. AI was found to be very useful across every aspect of the radiology work chain (diagnostic and therapeutic components all encompassing), such as scheduling and worklist management, image segmentation and classification, diagnosis, image measurement and assessment, image acquisition and reconstruction, and prediction. However, ongoing concerns were seen around cost, hardware limitations, data quality and quantity, bias, data privacy, training of users, transparency, and regulatory oversight. Several recommendations were then made to include extensive model training on large, diverse datasets/validation, creative research to address the black box phenomenon, AI integration with both virtual and augmented reality to improve models’ robustness, regular user trainings and interdisciplinary collaborations, and developing regulatory frameworks (on data governance, transparency, cybersecurity, ethical issues, and post-market surveillance). It is foreseen that concerned authorities, now thoroughly furnished with knowledge on the historical antecedents upon review of this article, will take the necessary action to address these concerns, putting into consideration AI strategy, AI engineering, stakeholders’ engagement, and regulatory/ethical concerns
Translation and Cross-Cultural Adaptation into French of the Mother-to-Infant Bonding Scale
No full textPurpose: Patient-reported outcome measures (PROMs) are relevant for assessing the bond between a mother and her child, both before and after childbirth. Several questionnaires have been developed with the Mother-to-Infant Bonding Scale (MIBS) prominent among them, as it is a valid and easy-to-administer questionnaire owing to its length. Even though, this PROM has been adapted in Japanese, Indonesian and Swedish, it remains to be translated into French. The objective of this study was to translate and cross-culturally adapt the MIBS into French (MIBS-Fr).
Patients and Methods: The translation and cultural-adaptation of the questionnaire were performed following a 10-step process as recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). During the cognitive debriefing, each item of the questionnaire was rated between 1 to 10 according to the comprehension level by 11 mothers.
Results: The French version was very well understood with a mean level of comprehension of 9.7 ± 1.4 out of 10. The one-word descriptor used to express feelings in the original version was replaced by phrases in the French version for a better language adaptation. Slight modifications were made by the original developer, and back translations were found to be very consistent.
Conclusion: This study reports the development of a French version of the MIBS (MIBS-Fr) following the ISPOR’s recommendations for the translation and intercultural adaptation of a questionnaire. The MIBS-Fr provides French-speaking healthcare professionals with a practical and standardized tool to assess mother-to-infant bonding, facilitating early identification of bonding difficulties and supporting appropriate interventions in postpartum care.
Plain Language Summary: Understanding the emotional bond between a mother and her newborn is important because it can impact the child’s development and well-being. Healthcare professionals use different questionnaires to measure this bond, but one commonly used tool, the Mother-to-Infant Bonding Scale (MIBS), was not yet available in French. Our study aimed to create a French version of the MIBS (MIBS-Fr) so it can be used by French-speaking mothers. To do this, we followed an internationally recognized process for translation and cultural adaptation. This included translating the questionnaire, reviewing it with experts, and testing it with 11 mothers in a maternity unit to ensure clarity and accuracy. The final French version was well understood, with an average comprehension score of 9.7 out of 10. Some words were adjusted to better reflect emotions in French while keeping the meaning of the original scale. This new version of the MIBS allows French-speaking mothers to accurately express their feelings about their bond with their baby. It will help healthcare professionals assess and support mother-infant relationships in French-speaking communities