bluuebunny/crossref_metadata_2025_split huggingface dataset:
Varying Effects of Prosection and Dissection Anatomy Curriculums on Confidence in the Clinical Setting
Authors: Young Stephanie , Guzman Carlos R. , Wimmers Paul F. , Byus Craig V. , Wisco Jonathan J. 
Published: June 2021

The David Geffen School of Medicine at UCLA has a prosectionbased anatomy course (PRO), and the Thomas Haider Program in Biomedical Sciences at UC Riverside has a dissection‐based anatomy course (DIS). Students from both programs converge for 3rd and 4th year clinical clerkships. We conducted the first of several annual surveys in 2010 of medical students in both PRO and DIS programs (59% response rate out of 185 surveys). 80% of DIS students and 62% of PRO students said their anatomy curriculum increased confidence in physical exam skills. However, 40% of DIS students and 86% of PRO students said their anatomy curriculum helped prepare them for the USMLE Board Exams. When asked if the anatomy curriculum helped prepare students for 3rd and 4th year clinical rotations, 96% and 91% of PRO students responded positively, respectively, while 100% of DIS students responded positively for both clerkship years. Both cohorts regarded the anatomy curriculums highly, but expressed that prosection allowed for learning of semantics while dissection was a better preamble for surgical training. This study was approved with an IRB exempt protocol.Grant Funding Source: AAA
Establishing the validity and reliability of computer‐based simulation for cerebral angiography using the ANGIO Mentor Express
Authors: Nguyen Ngan , Eagleson Roy , Deribaupierre Sandrine 
Published: June 2021

Computer‐based simulation (CBS) is increasingly used in medical education, but evidence for its efficacy has been limited and inconsistent. Deficiencies and heterogeneity in validity and reliability study methodologies have been cited as major limitations to drawing conclusions regarding the effectiveness of CBS training. Since untested assessment methodologies can lead to reporting inaccurate performance data, it is crucial to validate CBS systems and their assessment instruments before examining the effectiveness of CBS training. This study establishes the validity (face, content and construct) and reliability (test‐retest) of a CBS system (ANGIO Mentor Express) for left and right cerebral angiography (CA). Face and content validities were established by asking experienced catheter‐based physicians to judge the overall realism of the simulated CA procedures and evaluate the appropriateness of the assessment instruments. Construct validity was assessed by comparing the performance of an expert cohort (experienced physicians) to a novice cohort (medical students and residents) of subjects. Test‐retest reliability was established by correlating performances on the simulated left CA with the right CA. Confirmation of the validity and reliability of the CBS system and its assessment instruments assures the integrity of future studies evaluating the efficacy of CBS training for CA.Grant Funding Source: None
Medical student perceptions of a radiology tutorial in anatomy education
Authors: Hoover Alison , Smith Lindsay , Brian Pamela , Lazarus Michelle 
Published: June 2021

Students’ perceptions of their education influence their learning. We hypothesized that medical students would value an interactive radiology computer tutorial and that this tutorial would benefit their anatomy education. Tutorials were developed using radiologic images from two different anatomic regions and tested by first year medical students through qualitative surveys. Students overwhelmingly agreed (100%, n=22) that the tutorial was beneficial in understanding anatomic concepts and that they would recommend this tutorial to future students. All students agreed that early radiology exposure is beneficial to their medical education, and 95% agreed it would benefit their careers. In citing the source of the student's radiology knowledge, 73% of students credited the tutorial versus 38% of students who credited radiology lectures. A majority of students (86%) agreed that multiple types of imaging techniques were beneficial in learning anatomy (CT, plain film, etc.). Most students (91%) felt that they would use the tutorial later in medical training, while all agreed they would use it at least once a week during their formal anatomy course. Given the trend in decreasing anatomy instruction and vertical integration, our findings suggest that a self‐guided radiology tutorial is a promising solution for learning anatomy in a flexible environment throughout the entirety of medical school.Grant Funding Source: n/a
A Learning Strategy for the Muscles and Fascial Planes of the head and Neck
Authors: Sanders Luke E , Morton David A. , Nielsen Mark T. 
Published: June 2021

Learning the relationships of the muscles and fascial planes of the head and neck is a difficult task for medical students, which is further complicated by the plethora of terminology that anatomists use to define the fascial sheets and compartments of these regions. This complexity in the musculofascial anatomy arises at the interfaced formed between pharyngeal arch anatomy and somitic body wall anatomy at the head‐trunk junction. Migrating muscles from cervical and occipital somites and from the pharyngeal arches establish a number of muscular and fascial layers in the head and neck that become a challenge to understand. However, a simple pattern of four musculofascial planes emerges during development as the muscles migrate from their sites of origin in the pharyngeal arches and cervical and occipital somites to their definitive positions in the head and neck. This pattern introduces a clear logic to the layers of muscles in the head and neck, while also clarifying the fascial layers and compartments of the region. Understanding the fascial planes and compartments is of significant clinical interest regarding the spread of inflammation and disease.Grant Funding Source: N/A
MeCP2_e2 does not contribute Rett syndrome phenotypes but essential for placenta
Authors: ITOH MASAYUKI , Tahimic Candice G.T. , Goto Yu‐ichi , Kurimasa Akihiro 
Published: June 2021

Methyl CpG‐binding protein 2 (MeCP2) mutations are implicated in Rett syndrome (RTT). Two MeCP2 isoforms have been reported as MeCP2_e2 and MeCP2_e1. Their expression levels vary among tissues, with MeCP2_e1 in adult brain and with MeCP2_e2 in placenta, liver, and skeletal muscle.We performed specific disruption of the MeCP2_e2 and examined the consequences of selective loss of MeCP2_e2 function in vivo. MeCP2_e2 null mice showed no RTT‐associated neurological phenotypes but confers a survival disadvantage. In addition, selective loss of MeCP2_e2 resulted in placenta defects and upregulation of peg‐1 as determined by the parental origin of the mutant allele. It is indicated a novel role for MeCP2 in normal placenta development and illustrate how X chromosome inactivation in extraembryonic tissues confers a survival disadvantage for carriers of a mutant MeCP2_e2 allele. Moreover, our findings provide an explanation for the absence of reports on MeCP2_e2‐specific exon 2 mutations in RTT. MeCP2_e2 mutations in humans may result in a phenotype that evades a diagnosis of RTT.
Paradigm change in clinical anatomical learning: lessons from students’ evaluations
Authors: Jacomo Alfredo Luiz , Akamatsu Flávia Emi , Andrade Mauro 
Published: June 2021

Teaching and learning processes are constantly changing as medical knowledge increases exponentially and general students’ behavior demands a continuous improvement of techniques and approaches. The University of São Paulo Medical School has a systematic evaluation of each discipline where students grade 38 different topics ranging to physical conditions to the quality of the classes, allowing the course coordinators to redirect to adjust the course format as needed. We analyzed the changes in the Anatomy course from 1994 to the present and their impact based on the students’ evaluations.In this study, the different methods to teach Anatomy to 2nd. And 3rd. year students of Medicine employed from 1994 to 2012 were confronted to the students’ evaluations, comparing the general appreciation of the course in different teaching approaches and, in addition, comparing with simultaneous basic disciplines, evaluated by the same questionnaire.Significant difference in students’ evaluation was observed when the course changed from Problem Based Learning technique to a more formal approach with theoretical classes and practical demonstrations. A still better evaluation was obtained as the practical demonstrations focused aspects showed in theoretical classes given by specialists trained in Anatomy. A similar improvement was not seen in other disciplines.Continuous feedback from students is essential to adequate teaching strategies to modern challenges to obtain the best results in courses of Clinical Anatomy.
Energize the anatomy lab experience with 18 minute tutorials
Authors: Benninger Brion 
Published: June 2021

ObjectiveClassically, anatomy dissection labs consist of 2 or 3 hour sessions with team dissection. The objective of this study was to investigate whether short tutorials would improve scores and diminish fatigue within lab.MethodsLiterature search was conducted on educational literature regarding adult attention span. 6 pre‐organized 18 minute tutorials were integrated into each lab session. Two cohorts, X & Y, were given identical lectures and objectives; cohort Y received integrated tutorial sessions, while cohort X did not. Cohort Y students were subdivided into two overall groups (A & B) and further subdivided into “tutorial” groups of 6–9; group A dissected while B received tutorials, the two then switched the next day.ResultsLiterature search revealed multiple studies stating attention span of 15 – 20 minutes. Lab Exam Scores: X: 67.26, 77.65, 69.83, 73.83, Y: 85.64, 88.72, 86.01, 89.3.Discussion2 to 3 hours of working on the same task, as a team, can be fatiguing. Several studies have been done on student attention span and find a common denominator of 15 to 20 minutes before attention declines. However, variation and abrupt change can re‐engage students for another 15 – 20 minutes before decline.ConclusionThis study suggests that 18 minute tutorials were integrated successfully, by means of their scores, because dissection and non‐dissection teams remained engaged throughout lab time.
Energy restricted ketogenic diet (ERKD) treatment for advanced glioblastoma multiforme (GBM): Case report
Authors: Nikolai Michele , Noel Mary , Schwartz Kenneth , Kurniali Peter , Chang Howard , Olson Lawrence Karl 
Published: June 2021

This study aimed to evaluate a 12 week ERKD protocol for advanced GBM.A 55 year old white male with progressive GBM was hospitalized to establish ketosis and initiate ERKD. A therapeutic range was established for serum betahydroxybutyrate (BHB) of 3–6 mmol/L and serum glucose of 50–70 mg/dl. Feeding began when patient achieved BHB of ≥3 mmol/L. While he was on ERKD his BHB and glucose were measured twice daily as fasting morning (AM) and two hours post‐prandial in the evening (PM). Initial diet consisted of Ketocal® 3:1 formula, 20–25 kcals/kg. The 3:1 fat: protein + carbohydrate ratio met protein needs of 0.6–0.8 grams protein/kg. The patient and wife received instructions from a dietitian on ketogenic meal preparation.The BHB and glucose were in therapeutic range initially. As feedings advanced, AM BHB levels decreased to < 3 mmol/L and glucose ≥ 80 mg/dl. Ketosis deepened daily and PM measurements >; 3 mmol/L. BHB and glucose levels did not always correlate. Patient found Ketocal® unpalatable and changed to a food only ketogenic diet. Diet manipulation alleviated his hunger and increased AM BHB. His weight decreased by 6%. Patient withdrew from the study when GBM progressed ERKD protocols can be administered with a trained team to adults with GBM. Study is needed to determine the optimal diet to maintain therapeutic glucose and ketones. Supported by Michigan State University Clinical and Translational Sciences Institute.
Effects of a DHA rich n‐3 fatty acid supplementation on fatty acid composition in cerebrospinal fluid in Alzheimer disease. The OmegAD study
Authors: Vedin Inger , Levi Yvonne Freund , Cederholm Tommy , Basun Hans , Hjorth Erik , Irving Gerd Faxén , Schultzberg Marianne , Eriksdotter Maria , Vessby Bengt , Wahlund Lars‐Olof , Salem Norman , Palmblad Jan 
Published: June 2021

BackgroundLittle is known about the transfer of essential fatty acids (FA) across the human blood‐brain barrier (BBB) in adulthood.ObjectiveWill oral supplementation for 6 mo with omega‐3 fatty acids (n‐3 FA), high in DHA, change the FA profile in cerebrospinal fluid (CSF) in patients with Alzheimer's disease (AD)?MethodsFA in CSF were analyzed by gas chromatography and mass spectrometry in 33 patients; 18 received n‐3 FA and 15 placebo. Participants were part of the OmegAD Study, where 204 patients with mild AD received 2.3 g n‐3 FA daily or placebo for 6 mo in a randomized fashion. Correlation analyses were made with plasma FA, CSF markers of AD and of inflammation.ResultsAt 6 mo a significant increase in CSF (and plasma) EPA, DHA and total n‐3 levels were noted in the n‐3 FA group, whereas no changes were observed in the placebo group. Changes of CSF DHA levels correlated significantly to changes of total and phosphorylated Tau and soluble IL‐1RII in CSF, i.e. the more the FA increased, the more the AD biomarkers decreased.SummaryN‐3 FA supplementation conferred discrete changes of n‐3 FA in CSF, suggesting transfer over the adult BBB. Significant correlations between CSF n‐3 FA and CSF AD markers suggest possible relationships.
Oxidative stress is a key regulator of ectopic calcifications in beta‐thalassemic patients
Authors: Quaglino Daniela , Boraldi Federica , Annovi Giulia , Cianciulli Paolo 
Published: June 2021

A surprisingly high percentage of clinical complications affecting beta‐thalassemic (beta‐thal) patients is due to ectopic calcifications. Although this abnormal mineralization is similar to that described in pseudoxanthoma elasticum (PXE), ABCC6 gene mutations have been excluded from the pathogenetic mechanisms. Cultured dermal fibroblasts from beta‐thal patients with and without PXE‐like clinical manifestations have been compared for parameters of redox balance and for the expression of proteins, which have been already associated to soft connective tissue mineralization.Results demonstrate that, in beta‐thal patients, elastic fiber calcification is associated to accumulation of anion superoxide and to increased levels of oxidized proteins and lipids. Possibly, as a consequence of the oxidized environment, carboxylation of the calcification inhibitor, MGP, is impaired.Data suggest that, independently from the primary gene defect, common pathogenetic pathways are associated to ectopic calcifications in PXE and in a number of beta‐thal patients. Research supported by PXE International.
StaR engineering: GPCR stabilisation for structure‐based drug design
Authors: Wiggin Giselle , Patel Jayesh C , Kean James , Khan Samir Ali , Mould Richard , Brown Jason , Ng Irene W , Errey James C , Dore Andrew S , Zhukov Andrei , Tehan Benjamin , Christopher John A , Jazayeri Ali , Marshall Fiona H 
Published: June 2021

G‐protein‐coupled receptors (GPCRs) represent one of the largest and most important classes of membrane proteins for drug discovery. However, due to their inherent flexibility and instability outside of the membrane, they are challenging targets for structural and biophysical studies. Here we demonstrate how these challenges have been overcome through protein engineering, by identifying a minimal number of thermostabilising mutations that can lock a receptor in a single conformation and enhance its survival in a detergent environment. This has been applied to GPCRs from families A, B and C, with peptide or small molecule ligands, and to orphan receptors with no known ligand. The resulting stabilised receptors (StaRs) are more amenable to purification, crystallisation and biophysical analysis of ligand binding.Using this approach, StaRs were generated for Orexin 1 and Orexin 2, two peptide GPCRs involved in regulating the sleep‐wake cycle. The StaRs show decreased agonist signalling, whilst maintaining antagonist binding, consistent with a shift to the antagonist conformation. Structural determination, together with biophysical mapping and fragment screening using surface plasmon resonance (SPR), has led to the rapid identification of highly optimised dual Orexin receptor antagonists (DORAs) with very high affinity, good pharmacokinetics and excellent in vivo activity in models of insomnia.
Role of Gravin Scaffolding of PKC Signaling in the Heart
Authors: Singh Sonal , Guillory Ashley , Wijaya Cori , McConnell Bradley K. 
Published: June 2021

Gravin, an A kinase anchoring protein, scaffolds p r o t e i n k i n a s e A ( PKA), protein kinase C (PKC), and other signaling molecules to the β2‐adrenergic receptor (AR). Agonist stimulation of β2‐AR leads to gravin‐dependent desensitization of the receptor. Disruption of PKA/AKAP interaction or suppression of gravin expression disrupts β2‐AR desensitization by PKC phosphorylation. The objective of this study was to investigate the role of PKC on cardiac function in the absence of gravin mediated scaffolding. Total PKC activity was determined in wild‐type and gravin knockout mice stimulated with isoproterenol (30mg/kg/day) for 14‐days. Basal PKC activity was significantly increased in the KO animals. Additionally, PKC activity significantly increased in both WT and KO ISO groups compared to their respective controls. PKC activity was also found to be greater in the KO ISO group as compared to both the KO and the WT controls (p<0.0001). However, despite of the changes in PKC activity, no change in the expression of PKCα was seen in the KO mice, either before or after ISO treatment. Hence in the absence of scaffolding mediated by gravin, there is an increase in the PKC activity without a corresponding change in PKCα expression or phosphorylation. Further investigation is being carried out using PKC activators and inhibitors to determine the interplay between gravin and PKC in modulating the PKC signaling in heart.Source of research support was RO1HL085487.
Discovery of a novel enhydrazone ester (CEE‐1) that acts as a dual inhibitor of the release of pro‐inflammatory cytokines and prostanoids from human monocytes
Authors: Ezeamuzie Charles , Zamil Hanan , Al‐Baghli Hawraa , Edafiogho Ivan O 
Published: June 2021

CEE‐1 (ethyl 4‐phenylhydrazinocyclohex‐3‐en‐2‐oxo‐6‐phenyl‐1‐oate) ‐ a novel enhydrazone ester, was synthesized and tested in vitro for anti‐inflammatory activity against the release of pro‐inflammatory cytokine and prostanoid from activated human monocytes. The effects were compared with those of standard anti‐inflammatory drugs dexamethasone and indomethacin. CEE‐1 potently and strongly inhibited the release of both TNF‐α and PGE2. The IC50 values were 2.6 μM and 4.5 μM for TNF‐α and PGE2, respectively. At 30 μM, the drug achieved almost complete inhibition of both mediators. Dexamethasone had similar effects but indomethacin inhibited only the PGE2 release, and although CEE‐1 was less potent than these two drugs, it had comparable efficacy. The compound appeared to act, at least, in part by inhibiting the up‐regulation of the mRNA for TNF‐α as well as that of the prostanoid‐synthetic enzyme, COX‐2. However, like dexamethasone, but unlike indomethacin, CEE‐1 did not affect COX‐2 enzyme function. Thus, CEE‐1 acts more like steroids rather than the non‐steroidal anti‐inflammatory drugs. Structure‐activity study showed that the presence of a simple aromatic ring attached via an NH‐NH group was critical for activity. At the concentrations that completely inhibited mediator release, the compound displayed no significant in vitro toxicity on the cells. These results show that CEE‐1 is a dual inhibitor of the release of cytokines and prostanoids, and therefore could be a potential alternative to steroids in the treatment of inflammatory diseases.This work was supported by Kuwait University, Research Sector grant # MR 03/09.
Transcriptional regulation of cardiac cell death and survival signaling by helium postconditioning in a rat model of regional cardiac ischemia/reperfusion
Authors: Oei Gezina T.M.L. , Heger Michal , van Golen Rowan F. , Preckel Benedikt , Hollmann Markus W. , Weber Nina C. 
Published: June 2021

Helium is a non‐anesthetic, noble gas, which has long been used in humans without deleterious side effects. In animal models of regional myocardial ischemia/reperfusion (I/R), helium inhalation during early reperfusion (postconditioning) reduces infarct size. To gain mechanistic insight into this process we investigated the expression of genes involved in cell death and survival pathways after helium postconditioning.Male rats (n=8 per group) were subjected to ischemia, I/R, or I/R and 15 min of 70% helium at the onset of reperfusion. The sham group (Sham) did not undergo I/R. Gene expression profiles related to necrosis, apoptosis and autophagy were assayed with qRT‐PCR using PCR arrays. Data were expressed as fold increase or decrease versus the I/R group.Helium postconditioning caused upregulation of genes involved in necrosis (17 of 23) and pro‐apoptosis (18 of 25). Simultaneously, 4 of 23 (necrosis) and 7 of 25 genes (pro‐apoptosis) were downregulated. The majority of anti‐apoptotic genes (9 of 11) and genes involved in autophagy (24 of 32) was upregulated after helium postconditioning.These data suggest that helium postconditioning induces cell survival pathways to such an extent that execution of cell death programs is partially abrogated or offset, leading to a reduction in infarct size.
Effects of angiotensin II type 2 receptor agonist on stretch‐induced ANP secretion via PI 3K/PKG/NO pathway
Authors: Gao Shan , Park Bung Mun , Cha Seung Ah , Park Woo Hyun , Kim Suhn Hee 
Published: June 2021

Angiotensin II (Ang II) is well‐known a major peptide of renin‐angiotensin system (RAS) as regulating blood pressure and body fluid volume. It is already known that the AT1 receptor mediates the major cardiovascular effects of Ang II. However, effects mediated via AT2 receptor are still controversial. The aim of the present study is to define the effect of AT2 receptor agonist, CGP 42112A on high stretch‐induced ANP secretion and its mechanism using in vitro and in vivo experiments. CGP 42112A stimulated high stretch‐induced ANP secretion and concentration from isolated perfused rat atria. The augmented effect of CGP42112A (0.1 μM) on high stretch‐induced ANP secretion was attenuated by the pretreatment with AT2 receptor antagonist or inhibitor for phosphoinositol 3‐kinase (PI3K), nitric oxide (NO), soluble guanylyl cyclase (sGC), or protein kinase G (PKG). However antagonist for AT1 or Mas receptor tended to augment the effect of CGP 42112A on high stretch‐induced ANP secretion. In vivo study, acute infusion of CGP 42112A for 10 min increased plasma ANP level without blood pressure change and pretreatment with losartan for 10 min followed by CGP 42112A infusion increased plasma ANP level more than CGP 42112A alone. In hypertensive atria, AT2 receptor mRNA and protein level were up‐regulated. The response of plasma ANP level by acute infusion of CGP 42112A in hypertensive rat augmented. Therefore, we suggest that AT2 receptor agonist stimulates high stretch‐induced ANP secretion through PI3K/NO/sGC/PKG pathway.Supported by the National Research Foundation (2012–0009322)