Articular cartilage, as a mechanosensitive tissue, supports and distributes various mechanical forces—including compression, shear, hydrostatic pressure, and tensile strain—during joint loading and motion. These external forces deform not only the chondrocytes but also their pericellular matrix and the surrounding extracellular matrix (ECM). Those mechanical cues are detected by mechanosensors on the plasma membrane (e.g., integrins) and transmitted through the cytoskeleton, ultimately being converted into biochemical signals. These signals activate key mechanoresponsive intracellular pathways—including TGF-β-induced SMAD, Rho-GTPase, MAPKs (ERK, JNK, p38), PI3K/AKT/mTOR, MRTF-SRF, and YAP/TAZ—that regulate chondrogenic differentiation and cartilage-specific matrix synthesis. This field of study is known as mechanobiology. Over the past decades, it has gained increasing recognition, particularly with the emergence of tissue-engineering constructs as a novel strategy for cartilage repair. However, progress in chondrogenic mechanobiology has primarily centred on intrinsic substrate- or matrix-derived cues, while overlooking the role of extrinsic mechanical forces. This review therefore provides an updated perspective on chondrogenic mechanobiology, with a particular focus on the cellular responses to external mechanical stimuli. It also emphasizes the therapeutic potential of incorporating mechanical stimulation into tissue-engineering strategies for cartilage repair, an emerging filed referred to as Regenerative Rehabilitation (RR). Since this concept has so far been investigated mainly in vitro, we highlight only those studies and refer to it as In vitro Regenerative Rehabilitation. Moreover, this review also addresses post-traumatic osteoarthritis (PTOA), a common joint disorder that frequently results from traumatic cartilage damage. It explores the mechanobiological mechanisms underlying OA and discusses in vitro regenerative rehabilitation studies, highlighting how external forces could serve as an alternative to conventional biochemical treatments for preventing OA progression.
Postoperatives Delir (POD) ist eine häufige und klinisch hochrelevante Komplikation nach herzchirurgischen Eingriffen, die mit erhöhter Morbidität und Mortalität sowie verlängerten Aufenthalten auf der Intensivstation und im Krankenhaus assoziiert ist. Der Einfluss intra- und früher postoperativer Faktoren auf das Auftreten eines POD bei herzchirurgischen Patienten ist bislang nicht eindeutig geklärt. Ziel der prospektiven Beobachtungsstudie FINd DElirium RIsk factors (FINDERI) war es daher, diese Faktoren sowie ihre prädiktiven Werte systematisch zu untersuchen. Eingeschlossen wurden Patienten im Alter ≥ 50 Jahren mit Indikation für eine elektive herzchirurgische Operation, bei denen das POD mittels Confusion Assessment Method erfasst wurde. Zur Identifikation potentieller Prädiktoren kamen uni- und multivariable logistische Regressionsanalysen sowie Machine-Learning(ML)-Verfahren zum Einsatz. Von insgesamt 490 Patienten entwickelten 106 (21,6
Mobile health (mHealth) interventions may improve HIV care in the context of healthcare professional shortages. Here, we evaluate the performance of four mHealth components implemented during the Viral Load Triggered ART Care in Lesotho (VITAL) cluster randomised trial. VITAL enrolled adults with HIV receiving antiretroviral therapy (ART) at rural nurse-led clinics in Lesotho, Southern Africa. This secondary analysis includes the nine intervention clinics where participants were offered the following tailored mHealth support: (1) short message services (SMS): viral load result communication, visit and adherence reminders; (2) adherence counselling by phone; (3) callback service; and (4) automated remote tuberculosis screening. The aim of the study was to assess the technical feasibility and uptake of four mHealth support options offered to people with HIV taking ART in Lesotho. Between 14 October 2020 and 7 August 2024, 376,168 SMS notifications were sent to 2,520 participants, with 288,886 (76.8
Although the Woven EndoBridge (WEB) device is increasingly used for the treatment of wide-neck intracranial aneurysms, including in the acute rupture setting, comparative evidence assessing the impact of rupture status remains limited. This study compared angiographic, safety, and clinical outcomes between ruptured and unruptured intracranial aneurysms treated with WEB. We conducted a retrospective analysis of prospectively collected data from the multicenter cohort registry WorldWideWEB, including consecutive adult patients with intracranial aneurysms treated with the WEB. Patients were stratified into groups of ruptured and unruptured aneurysms. Propensity score matching was used to balance baseline characteristics between both groups. Retreatment rate was the primary outcome. Secondary outcomes included mRS, safety events (thromboembolic complications) and angiographic outcomes (periprocedurally and last follow-up). Among 1,220 patients, 342 (28.0
Dieser Beitrag zum Themenheft ‘Expert:innen und Organisation’ der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) befasst sich mit dem tendenziell spannungsreichen Verhältnis von Ärzt:innen zu ihren Organisationen im Zusammenhang mit Notwendigkeiten und Herausforderungen ärztlicher Führungsentwicklung. Er beleuchtet Ambivalenzen gegenüber solchen Maßnahmen und kontextualisiert sie mit Bezug zur ärztlichen professionellen Sozialisation sowie zu kulturellen Faktoren, Identitätskonflikten und Aspekten von Macht und Selbstwirksamkeit. Das Gesundheitswesen braucht ärztliche Führungspersonen, die nicht nur exzellente Mediziner:innen sind, sondern auch mit organisationaler Komplexität und Widersprüchen umgehen und Systeme im Sinne besserer Versorgung, Forschung und Lehre weiterentwickeln können. Der Beitrag diskutiert, warum es jedoch Teilen der Ärzteschaft schwerfällt, die Organisation als immanenten Bestandteil ihres professionellen Handelns zu sehen und welche Implikationen sich daraus für ärztliche Führungsentwicklung ergeben.
