bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Musculoskeletal Competency in Osteopathic Medical Students
Authors: McCarthy Sarah A. , Olson Luke , Chen Chun Cheng Andy , Kulesza Randy , Kalmey Jonathan K. 
Published: November 2023

Musculoskeletal related conditions are the second most common reason patients seek medical attention in the primary care setting and the second most costly cause of morbidity behind cardiovascular disease. Furthermore, due to the changes that occur in the musculoskeletal system during the aging process, the frequency of musculoskeletal related office visits will increase as the number of elderly patients increases in the U.S. Therefore, it is very important that physicians are thoroughly educated, competent, and confident to diagnose and treat musculoskeletal conditions. However, previous research examining a cohort of graduating osteopathic medical students and a cohort of allopathic medical residents has demonstrated that musculoskeletal knowledge retention, based on a standardized competency exam, is less than optimal. Our study evaluated first‐year osteopathic medical students before and after they had taken a Musculoskeletal System course through administration of a 25‐question examination developed by internal medicine and orthopedic residency directors utilized in previous studies. The competency examination covered a broad area of topics that were considered important by surgical and nonsurgical criteria. We administered the examination before and after the course to two separate cohorts of first year medical students, the class of 2014 and the class of 2017. We compared these two cohorts to determine if changes within our Musculoskeletal course enhanced overall performance on the competency examination. The results show that the Musculoskeletal System course significantly improved examination performance by 27.8% for the class of 2014 and 28.4% for the class of 2017. But what was more interesting was that the average post‐course score of the class of 2017 was significantly higher than the average score of students in the class of 2014 showing 23% more students demonstrated competency. Our first‐year osteopathic medical students performed similarly to graduating osteopathic medical students (32% vs. 33%) and outperformed allopathic medical residents (32% vs. 22%) in the portion of students demonstrating competence. In summary, our Musculoskeletal System course improved musculoskeletal knowledge in students, and our first‐year osteopathic medical students did as well or better compared to graduating osteopathic students and allopathic residents, respectively. This study indicates that despite first‐year students comparing favorably with more experienced students in musculoskeletal knowledge there is room for improvement within our Musculoskeletal System course. Future changes to the course may include more case study scenarios and a focus on more high impact, high frequency musculoskeletal related presentations and management.Support or Funding InformationThis work was supported by an internal grant from Lake Erie College of Osteopathic Medicine.
Extracts of the tapeworm, Hymenolepis diminuta, recruit CCR2+PDL1+ Myeloid Cells with the capacity to inhibit dextran sodium sulphate induced‐colitis
Authors: Lopes Fernando , Reyes Jose Luiz , Leung Gabriella , Mancini Nicole , Wang Arthur , McKay Derek 
Published: November 2023

BackgroundAwareness of the immunological basis of host‐parasite interactions can reveal new approaches to cure and/or treat inflammatory disease. We have shown that mice infected with the tapeworm Hymenolepis diminuta (Hd) or systemic delivery of worm antigen (HdAg) developed significantly less severe dinitrobenzene sulphonic acid (DNBS)‐induced murine colitis.AimIn ongoing analyses of this helminth‐mouse model system we assessed the effect of systemic delivery of HdAg and adoptive transfer of HdAg‐recruited peritoneal exudate cells (PECs) on the outcome of dextran sodium sulphate (DSS)‐induced colitis.MethodsColitis was induced by 5 days of DSS in drinking water and 3 days of normal water in wild‐type (WT) mice ± HdAg or adoptive transfer of HdAg‐recruited total PECs or F4/80+Ly6Glo sorted cells. Disease was assessed by colon length, weight loss, a cumulative disease activity score and histopathology. Cytokine levels were assessed by ELISA. T cell proliferation was assessed in anti‐CD3+ anti‐CD28‐treated splenic CD4+ T cells co‐cultured with PECs recruited by PBS or HdAg.ResultsHdAg suppressed DSS colitis reducing splenic IFNγ, IL‐17 and TNF α and increasing IL‐10 production. Treatment with HdAg resulted in a CCR2‐dependent recruitment of F4/80+Ly6Glo monocytic‐like myeloid‐derived suppressor cells (MDSCs) into the peritoneum. Adoptive transfer of these cells blocked DSS‐colitis. The mixed peritoneal cells recruited in response to HdAg, blocked anti‐CD3+anti‐CD28 antibody evoked T cell proliferation via nitric oxide.ConclusionInjection of an extract of adult H. diminuta inhibits DSS‐induced colitis and was accompanied by recruitment of immunosuppressive CCR2+PDL1+ monocytic‐type MDSCs. The adoptive transfer of the HdAg‐evoked MDSCs inhibits DSS‐induced colitis, demonstrating a novel aspect by which helminth‐derived molecules could suppress intestinal inflammation.Support or Funding InformationCIHRNSERC CREATE, Host‐Parasite Interactions Program
Entamoeba histolytica Stimulates the Release of the Alarmin Molecule HMGB1 upon Contact with Macrophages
Authors: Begum Sharmin , St‐Pierre Joëlle , Moreau France , Chadee Kris 
Published: November 2023

Entamoeba histolytica (Eh) is the causative agent of amebiasis, which occurs in 10% of infected individuals when the parasite invades the underlying colonic mucosa. Parasite‐induced host pro‐inflammatory responses are critical in disease pathogenesis, but the mechanisms underlying this response is poorly illustrated. The contact between Eh and macrophages triggers a raging pro‐inflammatory response by activating NLRP3 inflammasome (IL‐1β) and other uncharacterized pathways (TNF‐α). High Mobility Group Box 1 protein (HMGB1) is a critical mediator of inflammation during infection and it shapes the magnitude and degree of the inflammatory response. HMGB1 is a non‐histone nuclear protein, which have overlapping binding side with histone H1 in the chromatin. It is released in the extracellular space during infection by activated or damaged immune cells and act as an alarmin molecule. In this study, we investigated the early release of HMGB1 upon Eh infection with macrophages and identification of the parasite virulent factors that initiated this response. Human monocytic cell line (THP‐1) and mouse bone marrow derived macrophages (BMDMs) were treated with live Eh, Eh components for different time point and western blotting was used to quantify HMGB1 secretion. Only stimulation with live Eh but not Eh components triggered robust time‐dependent (as early as 5 minutes) secretion of HMGB1. HMGB1 release from macrophage was contact‐dependent as inhibiting the Gallectin adhesion with exogenous galactose abrogated HMGB1 secretion. Another Eh surface virulent factor cysteine protease 5 (EhCP5) partially inhibited HMGB1 release, and the enzymatic activity of the CP5 was not required for the secretion. Moreover, HMGB1 protein secretion was independent of caspase‐1 activation, as secretion was not inhibited with the Pan caspase inhibitor, Z‐VAD‐fmk. Similar results were obtained using BMDMs from caspase‐1−/− mice treated with live Eh. Surprisingly, there was the simultaneous release of the nuclear protein histone H1 along with the HMGB1 upon Eh infection. These results demonstrate that the potent pro‐inflammatory mediator HMGB1 release is the earliest innate response upon Eh contact with macrophages. This mediator can act by itself or along with other molecules as a danger signal (alarmin response) to sense invasive infection that can attract bystander cells and/or promote extensive inflammation, which is critical in disease pathogenesis.Support or Funding InformationGrant Support: NSERC
Spatial Abilities, Anatomy Knowledge and Technical Skills: A Systematic Review
Authors: Langlois Jean , Bellemare Christian , Toulouse Josée , Wells George A. 
Published: November 2023

ObjectiveSpatial abilities consist of visualization, orientation and manipulation of structures in space. Spatial abilities have been correlated to anatomy knowledge and the performance in technical skills in systematic reviews. The objective was to conduct a systematic review of the relationship between anatomy knowledge and performance in technical skills as related to spatial abilities.MethodsSearch criteria included ‘spatial abilities’, ‘anatomy knowledge’ and ‘technical skills’. Keywords related to these criteria were defined. A literature search was done up to December 31, 2014 in Scopus (including Medline) and in several databases on OvidSP and EBSCOhost platforms. A bank of citations was obtained and was reviewed by two independent investigators. Citations related to abstracts, literature review, thesis and books were excluded. Articles related to retained citations were obtained and a final list of articles was done. Articles were assessed for quality using Scottish Intercollegiate Guidelines Network‐50 (SIGN‐50). Data were extracted from articles and methods relating spatial abilities, anatomy knowledge and technical skills were identified.ResultsA series of 106 articles was obtained. One additional article was identified through other source. A series of 53 articles was identified after duplicates were removed. Forty‐nine articles were then excluded. Four articles were retained, fully reviewed, and excluded with reasons, yielding no eligible articles.ConclusionNo eligible articles were found in a systematic review on spatial abilities, anatomy knowledge and technical skills. Future studies will be required to assess the importance of anatomy knowledge before performing a technical skill as related to spatial abilities.Support or Funding InformationNone.
The Influence of Spatial Ability On Anatomy Examination Questions in an Integrated Medical Curriculum
Authors: Xiong Jennifer , Edmondson Anna C. , Martin Charys 
Published: November 2023

BackgroundStudents with high spatial visualization ability (Vz) have been found to outperform students with low Vz in anatomy. However, how Vz influences anatomy performance has not been established. Thus, this study aimed to assess the influence of Vz on medical student performance on different levels of anatomy questions categorized by Bloom's taxonomy levels and discrimination index (DI) and to observe the relationship between Vz and anatomy performance. We hypothesized that there would be a positive correlation between Vz and performance on more difficult exam questions categorized by DI and Bloom's taxonomy. We also hypothesized that there would be a positive correlation between Vz and anatomy written exam, anatomy lab exam, and overall anatomy performance.MethodsFirst year medical students in a systems‐based integrated medical curriculum (n=61), completed the Mental Rotations Test (MRT) prior to the start of anatomy to establish Vz. All anatomy exam questions were categorized into four Bloom's taxonomy domains of increasing difficulty level (identification, comprehension, application, and analysis). These questions were also categorized into three tiers via DI.ResultsNo significant relationship (p>0.05) was found between Vz and questions categorized by DI or Bloom's taxonomy. Data also indicated that although entrance Vz plays an insignificant role in medical student anatomy lab exam, anatomy written exam, and overall performance in the anatomy course, there is a correlation between entrance Vz and anatomy performance in the very first systems‐based module (r2=0.017, p≤0.05).DiscussionThese findings suggest that entrance Vz may influence anatomy performance at the beginning of the curriculum; however, students with lower Vz find ways to cope and increase anatomy performance throughout the curriculum. Due to the significant relationship between Vz and the first systems‐based module, further analysis was completed to assess the relationship between Vz and anatomy question difficulty. This analysis indicated that there was no significant interaction between Vz and questions categorized by DI or Bloom's taxonomy within that first systems‐based module (p>0.05), suggesting that Vz's effect on performance in anatomy may not have a relationship with question difficulty categorized by Bloom's taxonomy or DI. Further research is necessary to explore how Vz influences anatomy performance and how students’ ability to train Vz and change study strategies influences the effect of Vz on anatomy performance throughout the medical curriculum.
Stereoscopic (3D) Visualization Improves Medical Student Comprehension of Head and Neck Vascular Anatomy
Authors: Cui Dongmei , Wilson Timothy D , Rockhold Robin W , Lehman Michael N , Lynch James C 
Published: November 2023

The use of 3D stereoscopic models (3DSM) of head and neck blood vessels in anatomy education has not been studied in detail. We investigated whether 3DSM created from a prior study (Cui et al. 2015) would improve student learning of head and neck vascular anatomy. Comparisons were made between the use of 3DSM and identical but 2D flat screen images extracted from the 3D models in a first year medical gross anatomy course. Anatomical knowledge was tested via pre‐ and post‐learning session anatomy knowledge tests. In addition student fluency with mental rotation (pre‐ and post‐session rotation tests.) Results were analyzed using a Wilcoxon rank‐sum test and linear regression analysis. A total of 39 first year medical students participated in the study. Baseline pre‐learning session test scores were equivalent, 5.85±2.37 and 5.03±1.93 for 3DSM and 2D groups respectively. Students who utilized the 3DSM (n=21) scored significantly higher on the post‐learning tests compared to those using 2D images (n = 18) (11.43±2.79 vs 8.75±2.81) (p =0.0033). There was no significant difference on the mental rotation test scores between 3DSM (17.29±5.36) and 2D groups (17.39±6.42) after learning sessions (p=0.6208). In summary, the use of virtual stereoscopic 3D models improved medical student performance on knowledge tests of head and neck vascular anatomy, suggest new avenues for the use of virtual models in medical education.Support or Funding InformationFaculty Scholarship Exchange Award
Potential of “Living” Photography in an Online Anatomy Resource to Improve Students’ 3D Spatial Understanding
Authors: Pascoe Mike , Lee Lisa 
Published: November 2023

BACKGROUNDAlthough numerous online resources for gross anatomy are available, most feature two‐dimensional photographs generated by traditional digital cameras. Demonstrating the complex, three‐dimensional relations of anatomical structures in 2D images is challenging and difficult for students to understand. To that end, we developed two online learning modules on the gross anatomy of the orbit featuring photos taken by either plenoptic (allowed adjustment of the focal point between different areas within a single “living” picture) or tradition photography.OBJECTIVEThe project goal was to determine whether the incorporation of the plenoptic photographs into an online anatomy module would result in improved learning outcomes compared with a learning module containing traditional digital photographs.METHODS115 health professions students were randomly assigned into two groups and each group was allowed to view one of the two learning modules on gross anatomy of the orbit. The two modules were identical in content except for the type of photography (traditional = control; plenoptic = experimental) used to illustrate a dissected orbit. Pre‐and post‐quizzes composed of a mixture of low‐ and high‐degree of spatial difficulty were administered. A survey was also distributed to assess student evaluations of the module. Paired, parametric statistical tests were used to examine significant group differences in quiz score improvement between the two types of modules (control vs. experimental; α = 0.05).RESULTSOf the 115 students, 49 completed the study (43% participation rate) and of the participants, 26 were in control group and 23 in experimental group. All participants demonstrated improved performance in post‐quiz compared to the pre‐quiz but the increase was not significantly different between the two groups (control: 42.7%, experimental: 47.0%, P = 0.495). When quiz performance was analyzed based on degree of spatial difficulty, both groups demonstrated significant increases on questions with low‐ and high‐degrees of spatial difficulty (P<0.001). However, students in the experimental group demonstrated a larger increase (28.2%) in score for the questions with high degree of spatial difficulty compared to the control group (25.8%; P = 0.040). Qualitatively, all participants reported for both modules that they were well organized, easy to learn from, intellectually stimulating, and would recommend it to their peers.CONCLUSIONSThe results of our study demonstrate that an online learning module on gross anatomy can positively impact student learning and that plenoptic photography has potential to enhance students’ understanding of challenging 3D anatomical relations.Support or Funding InformationRymer Small Grant, Academy of Medical Educators, University of Colorado Anschutz Medical Campus
Optimization of CRISPR/Cas9 Platform‐Mediated Gene Editing of Swine Embryos for The Creation of Novel Biomedical Swine Models
Authors: Schomberg Dominic T. , Meudt Jennifer J. , Krentz Kathleen J. , Rubinstein C. Dustin , Zhang Aiying , Shanmuganayagam Dhanansayan 
Published: November 2023

Swine are increasingly used to model complex human diseases for basic scientific discovery and for the preclinical development and validation of therapies and medical devices. The overwhelming genetic, anatomical, physiological and pathophysiological similarities to humans make swine an ideal platform for modeling the complex interplay of factors that influence human disease. The recent advances in gene editing technologies have been instrumental in opening the door to the creation of novel genetic swine models. However, in comparison to the creation of genetic rodent models, the process of creating swine models can be relatively costly, and time and labor intensive, if the techniques and experimental parameters are not optimized to allow high efficiency of edited embryos to be implanted into surrogate swine. The overarching objective of this study was to develop an optimized CRISPR/Cas9 platform for high efficiency of targeted gene editing via cytosolic microinjection of CRISPR/Cas9 components into presumptive swine embryos. We used the introduction of mutations in the neurofibromin 1 gene as the backbone for optimizing the platform. CRISPR guide RNAs (gRNA) were created for regions targeting sites both upstream and downstream of an exon within the gene for targeted cleavage by Cas9. Repair was mediated by a specific single‐stranded oligodeoxynucleotide (ssODN) template thus introducing a 2500 bp deletion. The functionality of the CRISPR/Cas9 system was validated using a plasmid‐mediated transfection of porcine kidney cells; the accuracy of editing in the target region was confirmed by Sanger sequencing. The optimization of the CRISPR/Cas9 platform was performed by the cytosolic microinjection of the editing elements into in vitro fertilized single‐celled presumptive zygotes. Varying parameters including the use of Cas9 as mRNA vs protein, Cas9 concentration, gRNA concentration, and ssoDN concentration were examined. The editing efficiencies were evaluated first with a customized multiplex nested PCR and then verified by Sanger sequencing. We found that each CRISPR concentration studied to be equally permissive of embryonic development through the blastocyst stage and that all conditions produced gene editing events at some frequency. However, the use of naked Cas9 mRNA and higher CRISPR concentrations produced greater rates of gene edit. We present our findings and optimization that allows for efficient creation of swine models.Support or Funding InformationThe research was supported by the Biomedical & Genomic Research Group Discretionary Fund (University of Wisconsin‐Madison), NF Network, NF Central Plains, NF Michigan, NF Northeast, and Washington State NF Family.
Phylogenetic Classification of Gongora Species (Orchidaceae) Based on DNA Barcode Regions matK, rpoB, rpoC1, and trn‐H‐psbA
Authors: Guardado Christopher , Rodriguez Olivia , Foss Keagan , Ludovic Daniela , Ribadeneyra Clara , Trivino Cesar , Baenziger Edward , Ribes‐Zamora Albert , Simmons Alexandra D 
Published: November 2023

ObjectivesTraditional species classification of orchids is based upon morphology, which is often hindered by inherent limitations such as species similarities. According to the American Orchid Society, the genus Gongora shows extensive morphological affinities, which result in mislabeling in the collections; however, advancements in gene sequencing technology enable the economic feasibility for species identification based on the orchid's genome. Specifically, DNA Barcoding is a molecular technique that uses “DNA barcodes”, which are short DNA regions, that can be used for species identification among other applications (Feng et al, 2015). Additionally, barcoding allows for the study of the evolutionary relationship between species examined and would therefore facilitate classification of unknown species (Singh, 2012). Our objective is to elucidate the classification of 38 Gongora species using four DNA barcode sequences.Methods and ResultsDNA was extracted from 82 individuals from 38 Gongora species. Then, PCR was employed to amplify the four DNA barcode regions of interest (matK, rpoB, rpoC1, and trn‐H‐psbA). The effectiveness of the PCR was analyzed by gel electrophoresis. Subsequently, amplicons were sent for DNA sequencing at an outside sequencing laboratory. The sequenced DNA was analyzed using MUSCLE in Mega 6.0 program. We developed a phylogenetic tree for about 32 species of orchids for each DNA barcode region. The rpoB and rpoC1 sequences provided similar phylogenetic trees thereby supporting the current classification of those Gongora as individual species. Furthermore, the phylogenetic trees also imply a possible evolutionary scheme. The highly variable trnH‐psbA provided a similar species identification but contradicting species evolution.ConclusionsDNA barcodes provide unique insights into possible Gongora species identification; however, the need to combine all four DNA barcodes into one phylogenetic tree is necessary to provide conclusive results for species classification and evolutionary relationships. The current results suggest that the rpoB and rpoC1 are useful markers for evolutionary analysis and trnH‐psbA could elucidate the differences between closely related species.Support or Funding InformationUniversity of St. Thomas Research Committee and Biology Department