bluuebunny/crossref_metadata_2025 huggingface dataset:
Differentiation‐dependent Regulation of Intestinal Iron Absorption: Cell and Molecular Mechanisms
Authors: McLaren Gordon , Patel Khushin , Said Hyder , Anderson Gregory , Said Hamid
Published: June 2021

Differentiation of intestinal epithelial cells is associated with up‐ and down‐regulation of a variety of genes, but little is known about the differentiation‐dependent regulation of genes encoding proteins involved in intestinal iron absorption. We have addressed this issue using human‐derived intestinal epithelial Caco‐2 cells and crypt/villus epithelial cells isolated from wild‐type mice as models. We examined expression of divalent metal‐ion transporter‐1 (DMT‐1; brush border iron importer), ferroportin (FPN; basolateral iron exporter) and hephaestin (HEPH; basolateral iron oxidase). Differentiation of Caco‐2 cells was associated with a significant up‐regulation of iron uptake. This up‐regulation was associated with a significant increase in the expression of DMT‐1 and HEPH mRNA and protein, as well as increased expression of FPN mRNA, but not FPN protein. Similarly, iron uptake and the expression of DMT‐1, HEPH, and FPN mRNAs was higher in mouse villous cells than crypt cells. Promoter‐reporter constructs were used to show that the activity of the promoters of DMT‐1 and HEPH increased with differentiation of Caco‐2 cells. These studies demonstrate that differentiation of intestinal epithelial cells is associated with up‐regulation of the iron uptake process and increased expression of DMT‐1, HEPH, and FPN. The expression of all these proteins of iron transport can be mediated at the post‐transcriptional level according to intracellular iron availability, but our results indicate that up‐regulation of DMT‐1 and HEPH during differentiation appears to be mediated at least in part via transcriptional regulatory mechanisms. (Supported by funds from the Department of Veterans Affairs.)
Scleraxis Regulates the Cardiac Myofibroblast Phenotype
Authors: Roche Patricia , Bagchi Rushita , Aroutiounova Nina , Czubryt Michael
Published: June 2021

Myofibroblasts mediate cardiac remodeling, but their persistence in the heart after proper wound healing is implicated in cardiac fibrosis, for which there is no treatment. Reducing myofibroblast presence in the myocardium represents a potential avenue for impairing, or even reversing, fibrosis. The transcription factor Scleraxis (SCX) is a regulator of collagen‐rich tissues, and its expression is increased by the same stimuli that induce conversion of fibroblasts to myofibroblasts. Cyclic stretch causes increased mRNA levels of SCX and myofibroblast markers, as well as activating the human SCX promoter in a luciferase assay. Thus we hypothesized that SCX regulates the myofibroblast phenotype. We observed that SCX over‐expression in primary rat cardiac fibroblasts (rCFs) increased mRNA and protein levels of key myofibroblast markers. Functionally, myofibroblasts differ from fibroblasts in their increased contractile ability and decreased motility, both of which were observed in rCFs over‐expressing SCX. Conversely, SCX knock‐down with shRNA adenovirus caused rCFs to become less contractile and more motile. Interestingly, knockdown of SCX, but not the use of a dominant negative DNA binding‐deficient version of SCX, prevented TGFβ‐induced contraction. Thus, SCX likely acts downstream of TGFβ during conversion of fibroblasts to myofibroblasts, perhaps independently of its ability to bind DNA. This is supported by the finding that TGFβ activates the SCX promoter. These results demonstrate that SCX promotes, and may in fact be required for, the myofibroblast phenotype. Thus, SCX may provide a novel drug target for the intervention treatment of cardiac fibrosis.
Subversion of Human Intestinal Mucosa Innate Immunity by a Crohn's Disease‐associated E. coli
Authors: Jarry Anne , Crémet Lise , Caroff Nathalie , Bou‐Hanna Chantal , Mussini Jean‐Marie , Reynaud Alain , Servin Alain , Mosnier Jean‐François , Liévin‐Le Moal Vanessa , Laboisse Christian
Published: June 2021

Adherent‐invasive Escherichia coli (AIEC), associated with Crohn's disease, are likely candidate contributory factors in the disease. However, signaling pathways involved in human intestinal mucosa innate host response to AIEC remain unknown. Here we use a 3‐D model of human intestinal mucosa explant culture to explore the effects of the AIEC strain LF82, on two innate immunity platforms, i.e. the inflammasome through evaluation of caspase‐1 status, and NFkB signaling. We showed that LF82 bacteria enter and survive within a few intestinal epithelial cells and lamina propria macrophages, without altering the mucosa overall architecture. While 4h infection with a Salmonella strain caused crypt disorganization, caspase‐1 activation and mature IL‐18 production, LF82 bacteria were unable to activate caspase‐1 and induce IL‐18 production. In parallel, LF82 bacteria activated NFkB signaling in epithelial cells through IkBα phosphorylation, NFkBp65 nuclear translocation and TNFα secretion. In addition, pharmacological blockade of NFkB activation using the SN50 peptide showed that NFkB activation was crucial for the maintenance of epithelial homeostasis upon LF82 infection. In conclusion, here we decipher at the whole mucosa level the mechanisms of the LF82‐induced subversion of innate immunity that, by maintaining host cell integrity, ensure intracellular bacteria survival.
Type II muscle is more susceptible to contractile activity‐induced injury
Authors: Lin Yu‐Chieh , Chih Yu‐Mei , Chen Chiao‐Nan
Published: June 2021

Contractile activity (CA) induces changes of cellular environment in cells, such as increased oxidative stress or inflammation. The changes are double‐ edged sword. When they are subtle and transient, they serve as signals of muscle growth induced by CA. However, cells could be damaged if CA‐induced oxidative stress and inflammation are excessive and prolonged. To date, it is unknown whether the responses to aerobic CA are fiber‐type specific. The aim of the study is to determine the effects of skeletal muscle types on inflammation and oxidative stress following aerobic CA. Type I (soleus) and Type II (white gastrocnemius) muscles from stimulated and contralateral non‐stimulated limbs were collected immediately and 6 hours after 21‐mintues of aerobic CA. Markers of oxidative stress (GSH, GSH/GSSG, oxidative‐modified proteins and lipids), inflammation (TNFα, IL6), growth factors (IGF1, MGF and myostatin), myogenesis (Myf5), and protein degradation (MuRF1) were evaluated. Independent t test was used to compare parameters between groups. Compared to type I muscles, type II muscles had lower basal level of oxidative stress (less accumulation of oxidative‐modified proteins and lipids, lower GSH level and GSH/GSSG), lower inflammation state (lower TNFα and IL6 levels), and lower levels of signals that stimulate the increase of muscle mass (lower levels of IGF1, MGF and Myf5, and higher level of myostatin and MuRF1). In response to aerobic CA, type II muscles showed earlier accumulation of oxidative damages than that in type I muscles. In addition, the Myf5 level in type I muscles elevated at 6 h after CA, but this change was not observed in type II muscles. Type II muscle is more susceptible to contractile activity‐induced injury. In addition, the regeneration capacity of type II muscle following aerobic CA is weaker than type I muscle.
Aerobic Interval Training Improves Mitochondrial Quality and Biogenesis of Circulating Lymphocytes in Sedentary Men
Authors: Tsai Hsing‐Hua , Wang Jong‐Shyan
Published: June 2021

Mitochondrial quality and biogenesis are important in the regulation of lymphocyte function. The purpose of this study was to investigate the effects of aerobic interval (AIT) and moderate continuous training (MCT) on mitochondrial quality and biogenesis of circulating lymphocytes. Twenty‐four sedentary males were randomized to perform either aerobic interval training (AIT; 3‐minute intervals at 40% and 80%VO2max, n=12) or moderate continuous training (MCT; sustained 60%VO2max, n=12) for 30 minutes/day, 5 days/week for 6 weeks. At rest and immediately after hypoxic exercise test (HE, 100W under 12%O2 for 30 min), the mitochondrial count, complex IV/II ratio, membrane potential, and matrix oxidant burden in lymphocytes were measured by flow cytometry. The experimental results demonstrated that acute HE declined lymphocyte mitochondrial membrane potential while increasing matrix oxidant burden before the AIT or MCT regimen. However, AIT for 6 weeks heightened mitochondrial membrane potential and was accompanied by lowered matrix oxidant burden in lymphocytes, compared to MCT did. Furthermore, AIT rather than MCT significantly increased the ratio of mitochondrial complex IV to II in lymphocytes. Hence, we conclude that AIT is superior to MCT for improving mitochondrial quality and biogenesis of circulating lymphocytes.
Effective Danio rerio Endurance Exercise Training Model
Authors: Bronson Kevin , Freeman Edward , Boller Michael , Savage Kathleen
Published: June 2021

Exercise training as a stimulus for increased exercise performance is well studied in humans. Scientists also have used model organisms: cats, rodents, and famously; shrimp, to study exercise adaptations. The use of zebrafish (Danio rerio) as a model to study exercise is an underutilized resource, despite their lower cost, maintenance, and space requirements. Developing zebrafish as a model to study exercise would allow experimentation into a widely used vertebrate model. In order for zebrafish to be a model for exercise training studies the training dose needed to induce performance increases must be determined. Therefore, the purpose of this research was to establish a minimum exercise training dose needed to increase swimming performance. Adult zebrafish were tested for their pre‐training maximum absolute sustained swimming speed (Ucrit). The fish were then swim trained during 14 sessions over the course of 3 weeks. Each training session was 120 minutes long, with not more than 3 consecutive days of training in a row. During the first training session each fish trained against a 50 cm/s water flow rate for the first 1.5 hours, followed by 60cm/s water flow rate for the last 15 minutes. Subsequently, the duration of 50 cm/s swim speed was decreased and the duration of the 60 cm/s speed increased progressively over the course of the 3 week training period. The fish rested for a day following the last training bout and then post training Ucrit was measured. The average pre‐exercise training value was 56.8 cm/s. The average post‐exercise training Ucrit value was 63.4 cm/s. Post training Ucrit was 12% higher than pre‐training values (p<0.003). In conclusion, exercise training can increase endurance swimming ability in zebrafish, supporting the viability of using zebrafish as an animal model for studies of exercise training.
The Effects of Resistance Training on Carotid Stiffness in Patients with the Metabolic Syndrome: A Pilot Study
Authors: LeMaster Kent , DeVallance Evan , Fournier Sara , Lee Kyuwan , Bonner Daniel , Donley David , Chantler Paul
Published: June 2021

Individuals with metabolic syndrome (MetS) have an increased arterial stiffness which is a strong independent risk factor for cardiovascular disease. Therapeutic interventions aimed at decreasing arterial stiffness is critical. However, resistance training has been shown to increase arterial stiffness in young healthy individuals. Thus, would resistance training exacerbate the arterial stiffness in individuals with MetS? We hypothesized individuals with MetS who participated in progressive resistance training of moderate intensity will not experience an increase in carotid arterial stiffness. A total of 18 individuals (8 MetS and 10 healthy control) performed resistance training exercises for 8 weeks. Resting measurements of carotid pulse wave analysis, systolic pressures, and carotid ultrasounds were taken before and after the intervention. No changes in systolic carotid diameter were found in the MetS (pre 0.65 ±0.02; post 0.66 ±0.02, p>0.5) or control (pre 0.61 ±0.01; post 0.61 ±0.01, p>0.5) group. Carotid systolic blood pressure did not significantly change in the MetS (pre 123±6; post 120±4 mmHg p>0.5) or control (pre 112 ±3; post 111±4 p>0.5) group. Regardless of group, a non‐significant (p=0.08) 16% decrease in carotid β‐stiffness was found following resistance training. In summary, individuals with MetS may safely participate in progressive hypertrophic resistance training.
Different Effects of Interval and Continuous Exercise Regimens on Capacity of Mitochondria Oxidative Phosphorylation in Lymphocyte
Authors: Chang Shao‐Chiang , Wang Jong‐Shyan
Published: June 2021

Mitochondrial biogenesis is a critical metabolic adaptation to aerobic exercise training. What kind of the exercise strategy that enhances mitochondria oxidative phosphorylation in lymphocyte and subsequently improves immune functionhas not yet been established.This study elucidates how interval and continuous exercise regimens affect capacity of mitochondria oxidative phosphorylation in lymphocytes. Twenty‐four sedentary males were randomized to perform either aerobic interval training (AIT; 3‐minute intervals at 40% and 80%VO2max, n=12) or moderate continuous training (MCT; sustained 60%VO2max, n=12) for 30 minutes/day, 5 days/week for 6 weeks. According to a novel designed SUIT (Substrate‐Uncoupler‐Inhibitor Titrations) protocol, various modes of mitochondrial respiratory control were analyzed by a high resolution respirometer (Oxygraph‐2k). The results demonstrated that both AIT and MCT regimens significantly increased ATP‐linked O2 consumption rate (OCR), elevated reserve capacity of OCR, and lowered non‐mitochondrial OCR in intact lymphocytes. Moreover, AIT modestly enhanced pyruvate plus glutamate‐mediated OCR, whereas MCT elicited predominant succinate‐ and palmitoyl carnitine‐mediated OCR in permeabilized lymphocytes. Hence, either AIT or MCT effectively enhances capacity of mitochondria oxidative phosphorylation in lymphocytes. Furthermore, AIT has a comprehensive improvement in mitochondria Complex I‐linked respiration, while MCT may shift mitochondrial energy transduction into Complex II‐ and electron transferring flavoprotein‐linked respiration.
Transcriptomic Analysis of Neonatal Lamb Hearts After Maternal Hypercortisolemia Suggests Altered Triglyceride Synthesis
Authors: Richards Elaine , Antolic Andrew , Wood Charles , Keller‐Wood Maureen
Published: June 2021

Our previous studies using a sheep model of maternal stress showed that 15 days of a maternal 1mg/kg/day infusion of cortisol to 130‐days of a 145‐day gestation caused hyperplastic fetal hearts with Purkinje fiber apoptosis while treatment to term resulted in significantly increased perinatal fetal death. Fetuses collected before death had deranged expression of genes regulating cardiac metabolism and decreased mitochondria. To study effects of increased maternal cortisol on lambs we infused 8 ewes with saline (CON) and 8 with 0.5mg/kg/day cortisol (CORT) until parturition, the lambs' hearts were collected at age 14‐days for transcriptomic analyses of the septa using 1‐color Agilent ovine 8x15k microarrays. Differentially expressed genes were determined by Jmp genomics, with pathway inference by Webgestalt and Cytoscape. qPCR validated some findings. CORT lambs had larger LV wall thickness/tibia ratios, 0.496+0.007 vs 0.445+0.006. 228 genes were down‐ and 263 upregulated in CORT vs CON. Modeling the upregulated genes suggested that CORT affected mitochondrial membranes and endoplasmic reticulum, the location of diacylglycerol O‐acyl transferase 2 (DGAT2). DGAT2 expression was significantly increased in CORT (fold change 1.05+0.13 vs 2.97+0.58, p<0.05). DGAT2 synthesizes triglycerides de novo from glycerol‐3‐phosphate and increases insulin resistance in glycolytic muscle fibers (Levi et al Am. J. Physiol. Endocrinol. Metab. 2007, 293: E1772). DGAT1 expression was not changed. Thus maternal stress may predispose the offspring to cardiomyopathy due to increased triglyceride deposition.
Adverse In utero and Postnatal Environments Promote Hepatic Microvesicular Steatosis in conjunction with Differential Alterations in Fatty Acid and Amino Acid Metabolism in Early Adulthood
Authors: Sarr Ousseynou , Dunlop Kristyn , Zhao Lin , Welch Ian , Regnault Timothy
Published: June 2021

We questioned whether an adverse in utero environment, resulting in low birth weight (LBW), and postnatal Western diet (WD) feeding interact in hepatic steatosis pathogenesis in young males, with particular attention focused upon differential alterations in lipid and amino acid metabolism. LBW guinea pigs, generated via uterine artery ablation, and normal birth weight (NBW) controls were fed either a WD or control diet (CD) after weaning. At 150 days of age, livers were harvested for histologic, molecular and biochemical assessments, gas chromatography and mass spectrometry. In LBW/CD animals, steatosis was absent. NBW/WD animals however, displayed a macrovesicular steatosis whereas LBW/WD animals exhibited a microvesicular steatosis. Hepatic carnitine palmitoyltransferase I and uncoupling protein 2 mRNA, long‐chain acylcarnitines (C16, C18 and C18:1) and amino acids (Asp, Phe, Tyr and Trp) were lower in LBW/WD vs. NBW/WD. Independent of birth weight, WD resulted in increased hepatic triglycerides, fatty acid translocase (CD36) mRNA, expression of lipogenic genes and proteins (FAS, ACC, and HK2), and metabolite‐based lipogenic parameters (C16:1/C16:0, C18:1/C18:0 and C16:0/C18:2n‐6). Hepatic medium chain acylcarnitine (C12), long‐chain acylcarnitines (C14, C14:1, C14‐OH, C16:1, C16‐OH, C18‐OH, C18:1‐OH and C18:3) and amino acid concentrations (Arg, Cys, Thr and Leu) were increased in WD animals. In conclusion, WD and LBW/WD induce hepatic steatosis accompanied with environment specific lipid and amino acid profile alterations. These data imply a less favorable liver health prognosis for adversely in utero grown offspring fed a WD postnatally.
Huff and Puff or Shut'er Down: Hypoxia‐Tolerant Mammals Respond Differently to Low Oxygen
Authors: Dzal Yvonne , Pamenter Matthew , Faure Paul , Milsom William
Published: June 2021

Unlike most mammals, ground squirrels (Ictidomys tridecemlineatus), mole rats (Heterocephalus glaber), and bats (Eptesicus fuscus) are exceptionally tolerant of low oxygen (i.e. hypoxia). Unfortunately, the basis of this tolerance is not well understood. To elucidate the underlying mechanisms these animals use to match oxygen supply to demand under hypoxic conditions, we exposed animals to progressive reductions in inspired oxygen (21, 12, 9, 7, and 5% O2) at an ambient temperature within their thermoneutral zone, and measured their metabolic, thermoregulatory, and ventilatory responses. Severe hypoxia (5% O2) led to a profound depression in oxygen demand in mole rats (>85%), and bats (>65%), driven by a reduction in metabolism independent of decreases in body temperature. Mole rats and bats met these reduced demands with a combination of reductions in ventilation (45% and 20%, respectively) and increases in the amount of oxygen extracted per breath (40% and 25%, respectively). Unlike mole rats and bats, ground squirrels did not reduce oxygen demand or body temperature in hypoxia; instead they increased oxygen supply through an increase in ventilation (>250%) with no change in the amount of oxygen extracted per breath. Our results suggest that while ground squirrels match oxygen supply to demand in severe hypoxia by a brisk ventilatory response, mole rats and bats do so by reducing metabolic demands, indicating that these species employ divergent strategies to tolerate hypoxia.
Early Intervention is Preferable to Remediation; The Level of Intrinsic Motivation Predicts Academic Success for Male but not Female Medical Students
Authors: Augustyniak Robert , Guilford Philip , Ables Adrienne , Lujan Heidi , Cortright Ronald , DiCarlo Stephen
Published: June 2021

Failure in Medical School is preventable through early intervention. However predicting who is vulnerable to failure is challenging. The ability to predict academic success among medical students has powerful implications for the student, the school they attend and society as a whole. We hypothesized that the level of intrinsic motivation predicts academic success in our cardio‐respiratory physiology course. To test this hypothesis, we administered the Intrinsic Motivation Inventory, a multidimensional measurement device developed by Deci and Ryan (1991), to assess our students' intrinsic motivation. Since we have recently shown that gender influences intrinsic motivation for undergraduate students, we also examined if this relationship exists for a larger cohort of medical students. Results indicate that intrinsic motivation is predictive of academic success for male students. In contrast, this relationship did not exist for female students. We conclude that intrinsic motivation can be used as a factor to predict academic success for male but not female medical students.
Co‐Teaching the Basic Sciences, Does it Really Influence Student Outcomes?
Authors: Lee Michael , Gaard Mary Beth
Published: June 2021

Traditionally, medical school courses have consisted of team‐taught lectures with little to no integration or coordination between sessions within the same course. Team‐taught lectures generally signify that several faculty independently teach self‐enclosed topics within a course. However, many curriculums have begun to incorporate teaching modalities that increase the integration of the basic sciences. Because lectures play a role in helping students scaffold learning in tandem with small group activities many programs have sessions where faculty of different disciplines or training (different basic science disciplines or clinical medicine) co‐teach together. However, it is not clear in the literature if co‐teaching a topic is actually superior to separate, independent sessions. In this study we examined the influence of integrated co‐teaching on medical students performance in microbiology and pharmacology sessions. We present data comparing final exam score averages for four classes of first year medical school course with or without integrated co‐teaching. Student performance on integrated versus non‐integrated questions will also be presented and discussed. Finally, we will discuss data on how co‐teaching topics affects faculty and course evaluations.
Breath‐Holding: Simple Demonstrations of Complex Physiology
Authors: Skow Rachel , Fuller Jonathan , Bruce Christina , Day Trevor , Steinback Craig
Published: June 2021

The complex interaction of chemical (i.e. chemoreceptors) and mechanical (i.e. lung‐stretch receptors) factors influences breath‐holding (BH). The aim of this project was to develop a simple set of procedures to be used as class‐room demonstrations or laboratory exercises to differentiate the roles of chemical and mechanical mechanisms in regulating BH.

The increase in ventilation during rebreathing (plastic bag) was initially used to demonstrate the progressive increase in drive to breathe due to chemical factors. BH time (stopwatch) was also used as a quantifiable and intuitive metric of drive to breathe. Maximal BH's were conducted under the following conditions: 1) end‐expiratory BH (lung stretch receptor unloading), 2) end‐inspiratory BH (lung stretch receptor loading), 3) BH following 30s of hyperventilation (reduces pCO2 & isolates the influence of decreased pO2), and 4) BH following 5 breaths of pure oxygen (elevates pO2 & isolates the influence of increased pCO2). Using the end‐expiratory BH as the standard, students observed the increase in BH time with each of the other 3 maneuvers. An advanced critical thinking procedure was also introduced whereby students rebreathed in and out of a bag twice at the end of a maximal BH before attempting to hold their breath again. This procedure highlights the powerful suppression of drive to breathe by lung‐stretch receptors despite elevated chemical drive to breathe.

These procedures represent a simple method to highlight complex physiological mechanisms which contribute to the drive to breathe. Such simple activities are suitable and adaptable for use across a range of physiology curricula and teaching settings.
Impact of co‐enrollment in computer‐based Human Physiology virtual laboratory on students' final lecture course grade: a follow‐up study
Authors: Crecelius Anne , Keller Joshua
Published: June 2021

At the University of Dayton, not all students who enroll in the upper‐level Human Physiology lecture course are required to take the accompanying computer‐based virtual laboratory (lab) course. Previously we had completed a retrospective pilot study to examine if co‐enrollment in lab had an impact on the final grade received in lecture. Final lecture course grades (as a percentage), lecture instructor, major, class year, and overall grade point average (GPA) were obtained for all students enrolled in physiology lectures. This previous study suggested there was not a significant difference in lecture score based on enrollment in lab. However, two different instructors taught lecture in the semester examined whereas in Spring 2014, one instructor taught both lecture sections. Thus, here we sought to extend our previous work with a larger sample that eliminated differences in lecture instructor and accordingly, the lecture schedule. Spring 2014 enrolled 55 students in 2 lecture sections, 13 of whom were co‐enrolled in lab. Lecture score was not different (lecture only: 87.6±0.8 vs lecture+lab: 87.3±1.5; p=0.82) between the two groups. When taken together with previous semester results, similar results were found in that there is no impact of co‐enrollment in the laboratory on the lecture grade [lecture only (n=72): 86.5±0.7 vs lecture+lab (n=37):86.4 ± 0.8; p=0.93). Similar to our prior findings, overall GPA was the strongest predictor of lecture grade. Given the present results, serious consideration is warranted as to whether the current computer‐based laboratory is beneficial to student learning of human physiology.
Tracking Academic Achievement: Is Medical Student Visuo‐spatial Ability Impacted by Undergraduate Anatomy Education?
Authors: Smith Claire , Mahmoud Yasmin , Thanesan James , Bradshaw Charline
Published: June 2021

Visuospatial abilities are those related to understanding and conceptualizing visual representations and spatial relationships in learning. By its nature as a three‐dimensional subject, the process of learning anatomy requires three‐dimensional thinking. Students are expected to form, retrieve and manipulate anatomical concepts in terms that they may or may not be accustomed to, potentially based on previous education and experience. For example, research suggests that students who have studied A‐Level Physics have improved spatial ability. The aim of this study was to: 1) to identify whether second year medical students had improved visuospatial ability after learning anatomy at university level for one year 2) to identify whether individual components of the spatial ability test had improved alongside learning anatomy. 3) to apply this understanding to current anatomy teaching. A total of 47 second year medical students completed a spatial ability test at the beginning of the academic year. The results of five specific visuospatial domains were compared with the results from the same students at the beginning of their first year of medical school. Across the five domains, there was significant improvement in two tasks, no change in two tasks and a dramatic decline in one task. Each task has its own implication for understanding visuospatial learning. It is crucial to understand whether improved visuospatial ability can influence or predict academic achievement, impact on medical specialty choice and therefore change the face of learning and teaching anatomy in contemporary medical education.
Quantification of Pattern Recognition Skills Acquisition in Histology Using an Eye‐Tracking Device: First‐Step Toward Evidence‐Based Histology Education
Authors: Kahl Jessica , Carry Patrick , Lee Lisa
Published: June 2021

Virtual histology laboratories (VHL) are increasingly used in histology and pathology courses in medical, dental and graduate curricula across North America. With technological advancements, there is the opportunity to track the learning process to achieving histology competency. The objective of the study was to quantitatively elucidate how learning takes place specifically in a visually oriented subject such as histology. Fourteen, first year graduate students enrolled in histology course were recruited. Using an eye‐tracking device, the recruits' eye‐movements, task‐based and free interactions with the virtual tissue slides on an existing VHL program were recorded and analyzed for emerging patterns across time and evolving level of expertise. The same data points were collected for five, second year students who completed the course a year ago and three histology experts for comparison. The results show that all first‐year students decreased the amount of time it took to identify a tissue and demonstrated increase in pattern recognition skills as the course progressed. With increasing skills, the eye‐movement patterns of the first year students approached those of the experts. Quantitative analyses reveal that expert level of pattern recognition skills were characterized by longer saccadic movements over key areas of interest and overall, faster determination on tissue identity. By extracting key areas of interest and elucidating a quantitative pattern of the most effective way of approaching histological tissues, future students may benefit from implementing the evidence‐based approach presented.
Using Deep Thought Processing for Better Learning Outcomes on Human Cadavers: A Pilot Study
Authors: Gribbin Mary
Published: June 2021

Introduction

According to Chew (2014) applying deep thought processing questions as opposed to shallow learning strategy questions is more likely to lead to successful learning outcomes at the undergraduate level. Hypothesizing that the differences would be similar at the Masters level, a cohort of Human Gross Anatomy students was tested by using both cognitively active type questions and cognitively passive type questions.

Methods

Adopting a quasi‐experimental approach with non‐equivalent groups, we took 22 students and split them into two tutorial groups. Group One attended Gross lab for six hours a week and attended a one hour tutorial involving both active and passive questions.

Group Two followed the same regimen, and was given only shallow learning type questions. Both groups took a mid‐term Lab Practical exam. For the second four weeks, the procedure was reversed for each group, and then a final exam was administered. Both tests measured similar categories of knowledge.

Results/Conclusions

The results confirmed our expectations. Group 1(7 students), scored 19% higher than the students of Group 2 who received shallow type processing questions. Group 1 had a Final exam average of 81.20%, (2% lower) and Group 2 had a Final exam avg. of 70.15% ( 6% higher) on a one‐tailed Paired t‐Test, p<.05, results similar to those found by Stranger‐Hall (2014).

In conclusion, the use of deep thought processing type questions as well as surface processing questions for the Study of Human Gross Anatomy seems to improve learning outcomes significantly and may be useful as a tool to increase long term memory and mastery of the subject..

The outcomes and the limitations of our method indicate that further refinement would occur with the administration of pre‐and post‐testing and by using randomized groups in a similar experiment.
Analysis of Image‐Based and Text‐Based Medical Gross Anatomy Exam Questions Administered Using Examsoft
Authors: Williams Sutton , Notebaert Andrew , Darling Ryan , Sinning Allan
Published: June 2021

The purpose of this study is to describe the effectiveness of image based exam questions administered using ExamSoft in a medical gross anatomy course. ExamSoft questions were analyzed to determine if there are any discrepancies between performances on image‐based questions compared to text‐based questions. This study analyzed four multiple choice unit exams, one from each block of the course. Comparisons were made between each individuals' performance on image‐based questions and text‐based questions. Chi‐square tests were used to identify significant differences between the question types and the students' success on the question. The participants of the study included first year medical students at The University of Mississippi Medical Center enrolled in the medical gross anatomy course. Results of this study help to identify the effectiveness of image‐based multiple choice questions presented in Examsoft which allows professors to create more effective assessments of student learning.
Scan When You Can: Using Open Ultrasound Practice Sessions as a Venue to Encourage Interprofessional Education
Authors: Glavin Maria , Cloud Beth , Bhagra Anjali , Lachman Nirusha , Pawlina Wojciech
Published: June 2021

Recently many medical schools have introduced ultrasound education, with several institutions adopting formal teaching of ultrasound into their anatomy curricula. Additionally, medical schools nationwide have begun to incorporate various forms of interprofessional education (IPE) into their programs to prepare medical students for the teamwork necessary to serve as physicians. The Anatomy course at Mayo Medical School incorporated several IPE sessions with physical therapy students. Since the course is integrated with radiology, ultrasound imaging was recently added to complement static images and visualize living anatomy. Due to the success of prior IPE endeavors in anatomy, a new elective experience for hands‐on ultrasound practice sessions was offered to both medical and physical therapy students. The aim of this study was to assess student perception of elective ultrasound practice sessions as an opportunity for interprofessional peer‐learning. Practice sessions were scheduled once a week for 4 hours and a trained teaching assistant was available during the sessions. Students were encouraged to discuss different techniques and anatomical knowledge based on their respective experiences. A sign‐in sheet was kept to monitor how many students from both groups attended. Students were asked to fill out a survey at the end of 4 weeks to assess perceptions of the interprofessional experience. Preliminary results indicate that students appreciated the diversity of an interprofessional approach to learning ultrasound skills and enjoyed teaching each other anatomy through ultrasound.
Effectiveness of Simulation‐Based Training in Aneurysm Diagnosis & Coiling in Cerebral Angiography
Authors: Zaika Oleksiy , Nguyen Ngan , Boulton Mel , Eagleson Roy , de Ribaupierre Sandrine
Published: June 2021

Medical specialties are starting to turn to new technologies, such as computer simulation, in order to complement traditional teaching methods. Simulation of anatomically complex procedures, such as angiography, is becoming more practical, however, computer‐based modules require extensive research to assess their effectiveness. There is increasing support in the literature for simulation‐based training in medicine; we are exploring a novel method for alternating simulation scenarios for cerebral angiography. Eight residents (4 radiology/4 neurosurgery) and 8 anatomy graduate students were trained on the Simbionix™ angiography simulator in order to assess skill acquisition. Participants had 8 test sessions to diagnose a cerebral aneurysm with either consistent or alternating practice cases. Subjects then would have 6 sessions to treat the aneurysms by filling them with coils. We hypothesize that the participants will benefit from both training types, but when encountering a new scenario would benefit of alternating training more, and would ultimately decrease procedure time, x‐ray time, contrast used and spatial errors. Preliminary results show a trend towards speedup, consistent with our hypothesis. These findings would have a strong impact on the implementation of novel training protocols in medicine, specifically in angiography, leading to safer, individualized learning modules.
The Anatomical Basis of Acupuncture: Past, Present, and Future
Authors: Gana Karen
Published: June 2021

Acupuncture is one modality utilized in Traditional Chinese Medicine. From the Western perspective, many have heard and believe that acupuncture involves some kind of “magical” manipulation of an unseen force or energy said to percolate through the body (this “force” is known as Qi). On the contrary, Traditional Chinese Medicine is as based in experiential and empirical evidence as Western Medicine. It is interesting to note that the timeline for the development of Traditional Chinese Medicine pre‐dates the emergence of the well‐known Greek Fathers of Medicine by a few thousand years. Chinese practitioners performed post‐mortem anatomical studies, produced intricate drawings of the organs and blood vessels, measured the dimensions of bones, and even measured the size, dimensions and capacitances of the various organs. The most complete compilation of the anatomical studies is found in the text known as the Huang Di Nei Jing (Yellow Emperor's Inner Canon). Students and practitioners of Acupuncture must know the anatomy of the human body in order to define the acupuncture points and properly place the acupuncture needle when treating the patient. Clinical trials continue to be conducted in order to elucidate the biomedical processes underlying acupuncture treatments. Both NIH and WHO support the use of acupuncture for treating many conditions including headache, musculoskeletal pain, and post‐chemotherapy nausea.
Simulating the Multi‐Disciplinary Care Team Approach: Enhancing Student Understanding of Anatomy through Interprofessional Sessions with Ultrasound
Authors: Luetmer Marianne , Cloud Beth , Youdas James , Pawlina Wojciech , Lachman Nirusha
Published: June 2021

The quality of healthcare delivery is dependent on collaboration between various professional disciplines. Integrating opportunities for interprofessional learning in medical education programs will prepare future clinicians to be effective members of a multi‐disciplinary care team. We incorporated an ultrasound demonstration of the upper limb into the gross anatomy courses for first year medical (n=53) and physical therapy (n=28) students. Prior to participating in the learning experience, all students took a short individual pre‐test based on clinical concepts regarding the assigned study material. A physical medicine and rehabilitation physician demonstrated the use of ultrasound as a diagnostic and procedural tool for the shoulder and elbow. Following the demonstration, students worked within interprofessional teams (n=14 teams) to review the related anatomy on dissected specimens. At the end of the session, students worked within interprofessional teams to complete a collaborative post‐test. Team scores were compared to the mean individual score within each team using a paired t‐test. Students scored higher on the collaborative post‐test (5.7/6) than on the individual pre‐test (4.2/6), p <0.0001. Results suggest that working in interprofessional teams may enhance understanding and clinical application of anatomy, thereby reinforcing the benefit of an interdisciplinary team approach to patient care.
Pre‐Clinical Anatomy Education: An Ideal Environment for Learning Clinical Communication Skills
Authors: Lazaus Michelle , Dos Santos Jason , Haidet Paul
Published: June 2021

Multiple physician specialists are involved with patient care; thus communication between care‐givers is increasingly important. While the impact of communication on patient care is widely discussed, most physicians are not exposed to communication methods until later in their careers. Significant deficits in patient hand‐off processes (within and across specialists) are widely reported and yields negative impacts on patient care, costs and outcomes. The anatomy laboratory provides a unique and pedagogically‐appropriate setting for peer hand‐off introduction. Within the lab, students are learning anatomical concepts key to clinical practice. Utilizing a peer‐teaching infrastructure, we developed a novel approach to integrating the concept of the clinical peer‐handoff process into pre‐clinical medical education. We “translated” the SBAR (Situation, background, assessment, and recommendations) method for patient‐handoffs into a pedagogical tool which integrates anatomy learning with peer‐peer communication. We hypothesized that this method would help students become familiar with the language, methodology and approach to the essential task of collegial communication in patient care. Our mixed methods analysis shows that this approach is a useful anatomy learning pedagogy which teaches key themes associated with clinical hand‐offs such as: responsibility, preparation, and efficiency. Thusly, contextualizing peer‐teaching within the cadaver laboratory into a clinical context may increase the effectiveness of hand‐offs performed in the patient care setting. The pedagogy developed here may be applied to many preclinical courses, increasing the impact of this pedagogy on student's future clinical practice.
Using Echocardiography as a Promising Adjunctive Teaching Tool for Cardiac Anatomy and Physiology
Authors: Eladl Mohamed , Elmoselhi Adel , Seif Allah Mohamed
Published: June 2021

A transformation in medical education is currently underway which prioritizes competency and clinical integration with basic sciences. Here we are exploring the feasibility of early echocardiography (Echo) experience as an adjunct tool for teaching heart anatomy and physiology to second year medical students.

The study was conducted on 100 students in a problem‐based learning curriculum. Students were introduced to cardiac anatomy and physiology as well as the basic principles of ultrasonography before the Echo sessions. A pretest was conducted at the beginning of the Echo theoretical session, consisting of 10 questions on Echo images. The practical sessions included hands‐on experience on standardized patients with a checklist of structures that are commonly demonstrated in left parasternal and apical four chamber windows. A post‐test with the same questions was repeated after the clinical sessions.

The post‐test outcome revealed a significant improvement in identifying the cardiac structures and function in comparison to the pre‐test (P value 蠄 0.0001)

image

Although the students were very accurate in identifying heart chambers and valves without assistance, the pulmonary artery and valve in the parasternal short axis were mostly able to be identified with assistance. Furthermore 95% of students admitted that prior basic knowledge is essential for Echo images identification and 86% stated that integrating this experience is helpful in consolidating different phases of the cardiac cycle.

Conclusion

Spatial orientation offered by Echo with prior basic knowledge seems to provide an effective tool in consolidating medical student's understanding of heart anatomical relations and cardiac physiology.
Un‐embalmed Cadaveric Computed Tomography Imaging for Use in Undergraduate Anatomy Education
Authors: Tollemache Nicholas , Johnston Malcolm , Clifford Tom , Smith Claire
Published: June 2021

Many UK medical schools use full‐body dissection in anatomy education for undergraduate medical training; by imaging the same cadaver as is going to be dissected, it is possible to directly integrate clinical radiology and anatomy to enhance the student learning experience. The embalming process, necessary for specimen preservation, causes significant degradation of computed tomography scan images when compared to ‘in vivo’ scans, therefore imaging must be performed on a pre‐embalmed specimen. An 87‐year old, male donor was obtained by way of the London Anatomy Office (LAO) body donation scheme; this was the first locally available donor which met our inclusion criteria and where appropriate consent had been given. The donor was transported from the local (<50 miles) funeral directors to the Clinical Imaging Sciences Centre at the university. A whole body CT scan was performed <48 hours post‐mortem using a SIEMENS Biograph 64‐slice scanner; a 0.6mm slice thickness was used on a 0.45 mm pitch. The cadaver was immediately transported by the undertakers to the LAO for embalming and subsequently returned to the research university's anatomy laboratory, where it was placed in secure storage in preparation for teaching. The quality of images produced was at a very high level and will enhance the integration of gross anatomy and imaging.
Toward the Development of an Accurate 3D Human Body Model Implemented in a Real‐Time, Interactive Application to Enhance Anatomy Teaching
Authors: Poyade Matthieu , Clunie Lauren , McGeough Brian , Lysakowski Anna , Rea Paul , Anderson Paul
Published: June 2021

There are many multi‐media applications to support human anatomy education. These applications complement traditional teaching by providing opportunities for learners to interact with 3D anatomical models, encouraging self‐paced learning. Anatomical accuracy may be compromised, however, in some models that rely more on artistic interpretation than on objective data acquisition. This paper presents the research project “Head and Neck Anatomy”, commissioned by National Health Service Education for Scotland (NES) and conducted by a multi‐disciplinary team of digital specialists and anatomy experts. The model also has a haptic (sensory feedback) component intended for training dental students in simple procedures. We will also present a revisited methodological framework to support the workflow of the new Scottish Funding Council/NES funded project, “3D Definitive Human Body”. This new framework uses the acquisition of data from cadaveric dissections via photogrammetry, volumetric data via MRI and CT, and 3D modelling of this anatomical data. Our goal is to achieve a highly accurate 3D human body model in a real‐time, interactive application.
From the Slices to the Loaf: Using 3‐D Design and Printing Software to Enhance Learning and Interpretation of 3‐D Structures Within MRI Slices and the Clinical Application to Diagnostic Imaging
Authors: Sikes Robert , Markowski Alycia , Fraley Cari , Kim Soo , McAdow Kenneth , Overmyer Kelly , Rate Samantha , Smith Renee
Published: June 2021

A robust understanding of the human anatomy is essential in the Physical Therapy (PT) profession. Cadaver dissection provides our students with important direct experience with the location, size, shape and spatial relations of anatomical structures. Cross‐sectional anatomy is also important since treatment often requires an understanding of medical images such as magnetic resonance imaging (MRI). Unfortunately interpreting 3‐D relations from two‐dimensional (2‐D) images is one of the most difficult skills to learn and teach. To address this problem, we have developed a process allowing students to create a virtual 3‐D model of a structure in a series of MRI slices. The student outlines a structure of interest in the MRI slices with easy to use software. These outlines are lofted together to produce a virtual model of the structure. The model can be rotated and viewed simultaneously with MRI slices, thus providing a powerful connected visualization of the structure and MRI images. Furthermore, to gain a tactile sense of size and shape, these models can be 3‐D printed at low cost. This process has proven valuable for learning complex neuroanatomical structures such as the ventricular system and for understanding pathologies such as the structural implication of labral tears of the hip. This project is supported by the Northeastern University Center for Advancing Teaching and Learning Through Research.