Bioactive agents can stimulate osteogenesis, angiogenesis, and cell proliferation; therefore, their application in bone regeneration offers significant therapeutic potential. The aim of this systematic review was to evaluate strategies for applying chitosan-based scaffolds with growth factors in bone regeneration. A structured literature search was conducted in July 2025 across the PubMed, Scopus, and Web of Science databases. Search terms included combinations of (chitosan scaffold) AND (growth factor OR BMP-2 OR VEGF OR FGF OR TGF-beta OR periostin OR PDGF OR IGF-1 OR EGF OR ANG-1 OR ANG-2 OR GDF-5 OR SDF-1 OR osteopontin). The study selection process followed PRISMA 2020 guidelines and the PICO framework. Out of 367 records, 226 were screened, and 17 studies met the eligibility criteria for qualitative analysis. BMP-2 was the most frequently investigated growth factor, studied in both in vitro and in vivo models, with rats and rabbits as the most common animal models. Scaffold compositions varied, incorporating hydroxyapatite, heparin, polyethylene glycol diacrylate, octacalcium phosphate-mineralized graphene, silk fibroin, and aloe vera. Growth factors were introduced using diverse methods, including microspheres, chemical grafting, covalent coupling, protein carriers, and nanohydroxyapatite mesopores. Most studies reported enhanced bone regeneration, although differences in models, scaffold composition, and delivery methods preclude definitive conclusions. The addition of growth factors generally improved osteoblast proliferation, angiogenesis, bone density, and expression of osteogenic markers (RunX2, COL1, OPN, OCN). Combining two bioactive agents further amplified osteoinduction and vascularization. Sustained-release systems, particularly those using heparin or hydroxyapatite, prolonged biological activity and improved regenerative outcomes. In conclusion, functionalization of chitosan-based scaffolds with growth factors shows promising potential for bone regeneration. Controlled-release systems and combinations of different bioactive molecules may offer synergistic effects on osteogenesis and angiogenesis. Further research should focus on optimizing scaffold compositions and delivery methods to tailor bioactive agent release for specific clinical applications.

Wireless pressure insoles are emerging as portable, unobtrusive tools for gait analysis in both clinical and real-world settings. These systems incorporate pressure sensors and often inertial measurement units (IMUs), allowing for the collection of spatiotemporal, kinetic, and foot-level kinematic data. Although widely adopted, the measurement properties of wireless pressure insoles—specifically their concurrent validity and test–retest reliability—have not been systematically evaluated. This protocol outlines the methods for a systematic review and meta-analysis that will synthesise the current evidence on the psychometric properties of wireless pressure insoles during walking in healthy adults. This protocol follows the PRISMA-P 2015 guidelines and is registered in the Open Science Framework. We will include peer-reviewed journal articles that assess either the concurrent validity (i.e., simultaneous collection with a gold-standard comparator) or test–retest reliability (e.g., between-day, within-day, or between-rater reproducibility) of wireless pressure insoles during level walking in healthy adults (≥18 years). Outcomes of interest include spatiotemporal, kinematic and kinetic parameters. A comprehensive literature search will be conducted across MEDLINE, CINAHL, Scopus, Web of Science, SPORTDiscus, IEEE Xplore. Screening will be performed independently by two reviewers. Data extraction will follow a pre-piloted template and study quality will be assessed by two independent reviewers using a modified version of the Critical Appraisal of Study Design for Psychometric Articles. Where appropriate, meta-analyses will be conducted using random-effects models, with effect sizes (r, ICC) pooled and heterogeneity assessed via I ² . This review will provide a comprehensive synthesis of the concurrent validity and test–retest reliability of wireless pressure insoles in healthy adults, offering valuable insights for researchers, clinicians, and technology developers. While methodological heterogeneity may affect the scope of synthesis, the findings will help guide future research and clinical applications.

The intervertebral disc (IVD) is a biphasic tissue in which the extracellular matrix (ECM) acts as a structural scaffold and regulates hydration and solute transport. The influence of hydration on the swelling and mechanical properties of the IVD, particularly the annulus fibrosus (AF), is not fully described in the literature. Hydration is assumed to affect inter- and intramolecular hydrogen bonding and hydrophilic interactions, thereby modulating tissue mechanics. This study aimed to assess the effect of hydration time on free swelling of AF and its impact on mechanical performance. AF specimens were divided into five groups, hydrated for 0, 10, 20, 30, or 40 min and subjected to uniaxial tensile testing until failure. Swelling-related geometric changes were correlated with tensile properties. Results demonstrated that hydration duration significantly influenced AF’s structural and mechanical characteristics in anterior and posterior IVD regions. Hydration increases rapidly within 10–20 min, causing cross-sections to swell, stress capacity to decrease, and stiffness to remain unchanged. However, after 40 min, the tissue becomes swollen beyond physiological balance. These findings identify hydration duration as a critical factor regulating AF function and provide important insights for experimental standardization, numerical modeling, and hydrogels designed for intervertebral disc regeneration.

Purpose: Growth-guidance spinal systems are used in children with progressive spinal deformity to reduce repeated surgical lengthening while allowing continued spinal growth. Their long-term biomechanical behaviour under cyclic loading remains insufficiently characterised. This study assessed whether diamond-like carbon coating of rods and sliding screws affects axial stiffness and local kinematics in a growth-guidance spinal system. Methods: Twelve porcine Th11–L7 spine specimens were assigned to three groups: non-instrumented control, non-coated titanium alloy instrumentation, and instrumentation with diamond-like carbon-coated components. Specimens underwent 100,000 cycles of axial compression. Axial stiffness was evaluated after 100 and 100,000 cycles. Vertebral range of motion from Th12 to L6 was measured using rigid body markers, and local rod–screw interface displacements were assessed using three-dimensional digital image correlation. Results: Stiffness increased similarly in all groups up to approximately 80,000 cycles. After 100,000 cycles, construct stiffness was approximately 6% lower in diamond-like carbon coated instrumentation than in non-coated titanium alloy instrumentation. In the coated construct, segmental mobility at Th12–L1 and L5–L6 remained closer to the non-instrumented condition, whereas non-coated titanium alloy instrumentation showed reduced motion at these levels. Digital image correlation demonstrated time-dependent differences in local rod–screw interface kinematics between coated and non-coated constructs. Conclusions: Diamond-like carbon coating did not increase overall construct stiffness during cyclic axial compression, but it modified local mechanical behaviour and was associated with preservation of segmental mobility at selected levels. Further studies should determine whether these effects are maintained under multi-axis loading and in long-term tribological conditions.