[Factors Influencing Access to Follow-Up Rehabilitation]

Physiotherapists' Ethical Climate and Work Satisfaction: A STROBE-Compliant Cross-Sectional Study

(1) Background: This study aimed to examine the relationship between Spanish physical therapists' perceptions of the ethical climate, their moral sensitivity (awareness of ethical issues), and job satisfaction. (2) Methods: the study analyzed descriptive correlational data on 104 physical therapists from three Spanish metropolitan hospitals. Respondents completed a demographic data form, an ethical climate questionnaire, a job satisfaction survey, and a moral sensitivity scale. This study complies with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. (3) Results: With a mean score of 4.2, physical therapists are typically content with their jobs. The mean scores for the moral sensitivity and ethical climate questionnaires are high, at 40.1 (SD 6.3) and 96.8 (SD 17.1), respectively. There is a significant positive correlation between job satisfaction and ethical climate (r between 0.59 and 0.79) but only a weak correlation between job satisfaction and moral sensibility (r between 0 and 0.32 for the three aspects measured). (4) Conclusions: Generally speaking, physical therapists reported that they had high job satisfaction, a positive workplace environment, and excellent management support. Despite a weak relationship with moral sensibility, there is a strong association between ethical behavior, hospital organization, and higher levels of job satisfaction. It is important to encourage the development of moral sensibilities to boost psychological well-being and therapeutic decision-making.

Effect of Amniotic Membrane/Collagen-Based Scaffolds on the Chondrogenic Differentiation of Adipose-Derived Stem Cells and Cartilage Repair

Objectives: Repairing articular cartilage damage is challenging. Clinically, tissue engineering technology is used to induce stem cell differentiation and proliferation on biological scaffolds to repair defective joints. However, no ideal biological scaffolds have been identified. This study investigated the effects of amniotic membrane/collagen scaffolds on the differentiation of adipose-derived stem cells (ADSCs) and articular cartilage repair.

Methods: Adipose tissue of New Zealand rabbits was excised, and ADSCs were isolated and induced for differentiation. An articular cartilage defect model was constructed to identify the effect of amniotic membrane/collagen scaffolds on cartilage repair. Cartilage formation was analyzed by imaging and toluene blue staining. Knee joint recovery in rabbits was examined using hematoxylin and eosin, toluidine, safranine, and immunohistochemistry at 12 weeks post-operation. Gene expression was examined using ELISA, RT-PCR, Western blotting, and immunofluorescence.

Results: The adipose tissue was effectively differentiated into ADSCs, which further differentiated into chondrogenic, osteogenic, and lipogenic lineages after 3 weeks’ culture in vitro. Compared with platelet-rich plasmon (PRP) scaffolds, the amniotic membrane scaffolds better promoted the growth and differentiation of ADSCs. Additionally, scaffolds containing the PRP and amniotic membrane efficiently enhanced the osteogenic differentiation of ADSCs. The levels of COL1A1, COL2A1, COL10A1, SOX9, and ACAN in ADSCs + amniotic membrane + PRP group were significantly higher than the other groups both in vitro and in vivo. The Wakitani scores of the ADSC + amniotic membrane + PRP group were lower than that in ADSC + PRP (4.4 ± 0.44**), ADSC + amniotic membrane (2.63 ± 0.38**), and control groups (6.733 ± 0.21) at week 12 post-operation. Osteogenesis in rabbits of the ADSC + amniotic membrane + PRP group was significantly upregulated when compared with other groups. Amniotic membranes significantly promoted the expression of cartilage regeneration-related factors (SOX6, SOX9, RUNX2, NKX3-2, MEF2C, and GATA4). The ADSC + PRP + amniotic membrane group exhibited the highest levels of TGF-β, PDGF, and FGF while exhibiting the lowest level of IL-1β, IL6, and TNF-α in articular cavity.

Conclusion: Amniotic membrane/collagen combination-based scaffolds promoted the proliferation and cartilage differentiation of ADSCs, and may provide a new treatment paradigm for patients with cartilage injury.