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Summary: Fat infiltration (FI) in the rotator cuff muscle is associated with poor clinical outcomes and failed repair of rotator cuff tears (RCTs) in patients. In this study, we aimed to investigate the function of ginsenoside Rb1 in inhibiting FI in muscles after RCT and its underlying molecular mechanism. After TT modeling, mice treated with Rb1 for 6 weeks showed lower FI in the SS muscle compared with mice in the control groups and those treated with other ginsenoside components. Mechanically, Rb1 binds to the NAD+ domain of SIRT1, activating its expression and enzyme activity. This activation stimulates the deacetylation of CPT1A at site K195, thereby promoting fatty acid β-oxidation in adipocyte cells and improving lipolysis. These findings suggest that Rb1 is a potential therapeutic component for improving the outcomes of patients with RCTs.

Surface anatomy is an important skill for students in preparation for patient care, and peer examination is often used to teach musculoskeletal and surface anatomy. An alternative pedagogical approach is to use bodies represented in artworks. Represented bodies display fictive anatomy, providing students with the opportunity to apply their musculoskeletal knowledge and to think critically when evaluating the anatomical fidelity of a represented body. An elective course at the University of Michigan enabled undergraduate students to analyze the musculoskeletal and surface anatomy depicted in Renaissance artworks. Students traveled to Italy in 2018 (n = 14) and 2022 (n = 15) to analyze the fictive anatomy portrayed in artistic sculptures and musculoskeletal structures depicted in wax anatomy models and sculpted skeletons. In assignments, students were asked to identify musculoskeletal structures as portrayed in the context of represented anatomy created by Italian Renaissance artists and to assess the fidelity of the depicted anatomy. The students also applied their knowledge of musculoskeletal anatomy to describe body position and evaluate muscle function in their assessments of the accuracy or inaccuracy of the fictive anatomy. The students reported that evaluating the anatomical fidelity of represented bodies in artworks supported their learning of musculoskeletal and surface anatomy, and that their critical thinking skills improved in the course. Evaluation of the anatomical fidelity of represented bodies in artworks is an effective pedagogical approach that can be implemented in art museums as an adjunctive learning experience to deepen students' musculoskeletal and surface anatomy knowledge and further develop their critical thinking skills. [ABSTRACT FROM AUTHOR]

BackgroundIn physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students.MethodsWe conducted an observational retrospective monocentric study in a French physiotherapy school named “X.” Ninety-two first-year students in the 2017–18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018–19 and 2019–20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X».ResultsWe observed an improvement in the success rate of the anatomy final written exam between the 2017–18 baseline group, 2018–19 and 2019–2020 experimental groups during first (Kruskal–Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal–Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% (n = 89/120) for the 2018–19 and 62% (n = 72/116) for the 2019–20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018–19 and 2019–20 experimental groups.ConclusionBlended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills.

Summary: This paper describes the development of a deep learning model for prediction of hip fractures on pelvic radiographs (X-rays). Developed using over 40,000 pelvic radiographs from a single institution, the model demonstrated high sensitivity and specificity when applied to a test set of emergency department radiographs. This study approximates the real-world application of a deep learning fracture detection model by including radiographs with sub-optimal image quality, other non-hip fractures, and metallic implants, which were excluded from prior published work. The study also explores the effect of ethnicity on model performance, as well as the accuracy of visualization algorithm for fracture localization.

Identifying key criteria of squat performance is essential to avoiding injuries and optimizing strength training outcomes. To work towards this goal, this study aimed to assess the correlation between lower limb anatomy and back squat performance during a set-to-exhaustion in resistance-trained males and females. Optical motion captures of squat performance and data from magnetic resonance imaging (MRI) of the lower limbs were acquired in eight healthy participants (average: 28.4 years, four men, four women). It was hypothesized that there is a correlation between subject-specific musculoskeletal and squat-specific parameters. The results of our study indicate a high correlation between the summed volume of the hamstrings and quadriceps and squat depth normalized to thigh length (r = −0.86), and a high correlation between leg size and one-repetition maximum load (r = 0.81), respectively. Thereby, a marked difference was found in muscle volume and one-repetition maximum load between males and females, with a trend of females squatting deeper. The present study offers new insights for trainers and athletes for targeted musculoskeletal conditioning using the squat exercise. It can be inferred that greater muscle volume is essential to achieving enhanced power potential, and, consequently, a higher 1RM value, especially for female athletes that tend to squat deeper than their male counterparts. [ABSTRACT FROM AUTHOR]

An understanding of forearm and wrist anatomy is necessary for the diagnosis and treatment of various injuries. Evidence supports the use of peer‐assisted learning (PAL) as an effective resource for teaching basic science courses. First‐year medical students across three class years participated in an optional PAL kinesthetic workshop wherein participants created anatomically accurate paper models of forearm and wrist muscles. Participants completed pre‐ and post‐workshop surveys. Participant and nonparticipant exam performances were compared. Participation ranged from 17.3% to 33.2% of each class; participants were more likely to identify as women than men (p < 0.001). Participants in cohorts 2 and 3 reported increased comfort with relevant content after the workshop (p < 0.001). Survey responses for cohort 1 were omitted due to low response rates; however, exam performances were assessed for all three cohorts. Cohort 2 participants scored higher than nonparticipants on forearm and wrist questions on the cumulative course exam (p = 0.010), while the opposite was found for cohort 3 (p = 0.051). No other statistically significant differences were observed. This is the first study to examine quantitative and qualitative results for a PAL intervention repeated for three separate cohorts. Although academic performance varied, two cohorts reported increased comfort with relevant course material after the workshop. Results of this study support the need for further exploration of PAL workshops as an instructional method in teaching anatomy and highlight the challenges associated with repeating interventions over multiple years. As more studies attempt replication across multiple years, these challenges may be addressed, thereby informing PAL best practices. [ABSTRACT FROM AUTHOR]

Background Identifying key musculoskeletal and biomechanical criteria that are associated with Resistance Training (RT) is essential to avoid injury and optimise training outcome. Biomechanically, so-called velocity-based RT is an objective approach to directly quantify training intensity and effect. From a musculoskeletal perspective, RT enhances muscle force, which is correlated to the muscle’s physiological cross-sectional area, and thus muscle volume. Goal The goal of this study is to find out whether there exists a correlation between the change in lifting velocity during a squat set-to-exhaustion and the Hamstring to Quadriceps Muscle Volume Ratio (H/Q Ratio) as indicator of muscle strength. Methodology Ethical approval for this study was given by the Kantonale Ethikkommission Bern. Recreationally trained RT athletes (age 20-40years) were recruited through the investigator’s network. The methodology is divided into three parts. Firstly, the hamstring and quadriceps muscle volumes are determined using Magnetic Resonance Imaging (MRI) as gold standard. Thereby, the open-source software SASHIMI with an automatic tracking function is utilised to segment the MRI data. The segmented data is further processed with the Python programming language to derive the H/Q ratios. Secondly, lifting velocity during the squat is determined using data from optical motion capture (Vicon Nexus System with 10 infrared cameras) as gold standard. Thereby, a set-to-exhaustion is performed at 80% of each individual one repetition maximum (1RM), whereby the subjects are asked to complete the concentric phase at maximum speed to comply with velocity-based RT recommendations. Lifting velocity is derived from the tracked position of two reflective markers on the bar using the Python programming language. Thirdly, a statistical correlation analysis is conducted between the musculoskeletal and the biomechanical parameters. Statistical analysis is performed with the statistical analysis software R, with the level of significance set at p = 0.05. Results To date, MRI data have been acquired in five athletes and the corresponding muscle volumes have been determined (Quadriceps: 0.00525 +/-0.00185 m3 and Hamstrings: 0.0019 +/-0.007 m3). In addition, the load-velocity profiles have been derived in the same group of subjects. The MRI-based muscle volumes are in a similar range to previously published data (Maeo et al., 2021). Furthermore, the results of the load-velocity profiles show the anticipated decrease according to velocity-based RT guidelines (Rodriguez-Rosell et al., 2020). Discussion In a next step further data will be acquired in more subjects for subsequent statistical analysis. The outcome of the present study is expected to provide new scientific insights into the relationship between musculoskeletal and biomechanical criteria that affect squat performance. The insight may help to optimize velocity-based RT recommendations for individual athletes to maximise performance and reduce injury risks. References Rodríguez-Rosell, D., Yáñez-García, J. M., Sánchez-Medina, L., Mora-Custodio, R., & González-Badillo, J. J. (2020). Relationship between velocity loss and repetitions in Reserve in the bench press and back squat exercises. Journal of Strength and Conditioning Research, 34(9), 2537–2547. https://doi.org/10.1519/JSC.0000000000002881 Maeo, S., Huang, M., Wu, Y., Sakurai, H., Kusagawa, Y., Sugiyama, T., Kanehisa, H., & Isaka, T. (2021). Greater hamstrings muscle hypertrophy but similar damage protection after training at long versus short muscle lengths. Medicine & Science in Sports & Exercise, 53(4), 825–837. https://doi.org/10.1249/MSS.0000000000002523

Identifying key criteria of squat performance is essential to avoiding injuries and optimizing strength training outcomes. To work towards this goal, this study aimed to assess the correlation between lower limb anatomy and back squat performance during a set-to-exhaustion in resistance-trained males and females. Optical motion captures of squat performance and data from magnetic resonance imaging (MRI) of the lower limbs were acquired in eight healthy participants (average: 28.4 years, four men, four women). It was hypothesized that there is a correlation between subject-specific musculoskeletal and squat-specific parameters. The results of our study indicate a high correlation between the summed volume of the hamstrings and quadriceps and squat depth normalized to thigh length (r = −0.86), and a high correlation between leg size and one-repetition maximum load (r = 0.81), respectively. Thereby, a marked difference was found in muscle volume and one-repetition maximum load between males and females, with a trend of females squatting deeper. The present study offers new insights for trainers and athletes for targeted musculoskeletal conditioning using the squat exercise. It can be inferred that greater muscle volume is essential to achieving enhanced power potential, and, consequently, a higher 1RM value, especially for female athletes that tend to squat deeper than their male counterparts.

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors' self‐rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple‐choice test was utilized to measure retention of limb musculoskeletal (MSK) knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors' self‐rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self‐assessing their anatomy knowledge. This study found that Australian chiropractors' knowledge of MSK anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance. [ABSTRACT FROM AUTHOR]

Summary: Proteomics analysis of skeletal muscle has recently progressed from whole muscle tissue to single myofibers. Here, we further focus on a specific myofiber domain crucial for force transmission from muscle to tendon, the myotendinous junction (MTJ). To overcome the anatomical constraints preventing the isolation of pure MTJs, we performed in-depth analysis of the MTJ by progressive removal of the muscle component in semitendinosus muscle-tendon samples. Using detergents with increasing stringency, we quantified >3000 proteins across all samples, and identified 112 significantly enriched MTJ proteins, including 24 known MTJ-enriched proteins. Of the 88 novel MTJ markers, immunofluorescence analysis confirmed the presence of tetraspanin-24 (CD151), kindlin-2 (FERMT2), cartilage intermediate layer protein 1 (CILP), and integrin-alpha10 (ITGA10), at the human MTJ. Together, these human data constitute the first detailed MTJ proteomics resource that will contribute to advance understanding of the biology of the MTJ and its failure in pathological conditions.

Fat infiltration (FI) in the rotator cuff muscle is associated with poor clinical outcomes and failed repair of rotator cuff tears (RCTs) in patients. In this study, we aimed to investigate the function of ginsenoside Rb1 in inhibiting FI in muscles after RCT and its underlying molecular mechanism. After TT modeling, mice treated with Rb1 for 6 weeks showed lower FI in the SS muscle compared with mice in the control groups and those treated with other ginsenoside components. Mechanically, Rb1 binds to the NAD+ domain of SIRT1, activating its expression and enzyme activity. This activation stimulates the deacetylation of CPT1A at site K195, thereby promoting fatty acid β-oxidation in adipocyte cells and improving lipolysis. These findings suggest that Rb1 is a potential therapeutic component for improving the outcomes of patients with RCTs., Competing Interests: The authors have declared that no conflict of interest exists., (© 2024 The Authors. Published by Elsevier Inc.)

Although midfoot injury, especially Lisfranc sprain, is a relative rare traumatic pathology, if overlooked or treated incorrectly, the damage will develop into chronic Lisfranc injury, which is characterized by lifelong residual symptoms. The differences in injury severity, healing rates, treatment plans, and patient adherence make prospective investigations of the pathogenesis of Lisfranc injury very difficult to conduct. The development of an animal model that mimics the symptoms of humans with chronic Lisfranc injury has the potential to lessen the challenges associated with prospective human research. Previous research has successfully used a mouse model to explore the biomechanics of the human ankle joint. However, it remains to be determined if the mouse model can mimic human midfoot functions based on their similarities in anatomical structure. In this study, the anatomical structure of the mouse and human midfoot were compared by CT scan. The animal image data were obtained from 10 male C57BL/6J mice (20 feet) by micro-CT. The human data were obtained from six volunteers (six feet) by CT scanning. The three-dimensional skeletal structure of the midfoot was reconstructed, and the morphological parameters were measured by a plane projection method. There were no significant differences among the hindfoot adductus angle (mice: 28.86 ​± ​6.27°; human: 25.45 ​± ​2.70°), metatarsus adductus angle (mice: 11.34 ​± ​2.95°; human: 11.48 ​± ​3.97°), or the transverse arch angle (mice: 111.77 ​± ​4.70°; human: 111.84 ​± ​6.34°) between the mice and humans. The mice had a comparable Lisfranc joint complex architecture compared to humans in both coronal and transverse planes. The lateral cuneiform was fused with the navicular bone in mice, which would provide better intrinsic stability than in humans. Future research is necessary to evaluate the mouse midfoot injury model and the similarities of their neuro-musculo-skletal systems with humans.

Multiple‐choice (MC) anatomy "spot‐tests" (identification‐based assessments on tagged cadaveric specimens) offer a practical alternative to traditional free‐response (FR) spot‐tests. Conversion of the two spot‐tests in an upper limb musculoskeletal anatomy unit of study from FR to a novel MC format, where one of five tagged structures on a specimen was the answer to each question, provided a unique opportunity to assess the comparative validity and reliability of FR‐ and MC‐formatted spot‐tests and the impact on student performance following the change of test format to MC. Three successive year cohorts of health science students (n = 1,442) were each assessed by spot‐tests formatted as FR (first cohort) or MC (following two cohorts). Comparative question difficulty was assessed independently by three examiners. There were more higher‐order cognitive skill questions and more of the course objectives tested in the MC‐formatted tests. Spot‐test reliability was maintained with Cronbach's alpha reliability coefficients ≥ 0.80 and 80% of the MC items of high quality (having point‐biserial correlation coefficients > 0.25). These results also demonstrated guessing was not an issue. The mean final score for the MC‐formatted cohorts increased by 4.9%, but did not change for the final theory examination that was common to all three cohorts. Subgroup analysis revealed that the greatest change in spot‐test marks was for the lower‐performing students. In conclusion, our results indicate spot‐tests formatted as MC are suitable alternatives to FR tests. The increase in mean scores for the MC‐formatted spot‐tests was attributed to the lower demand of the MC format. [ABSTRACT FROM AUTHOR]

The use of mouse models as a tool to study ankle sprain requires a basic understanding of the similarities and differences between human and mouse ankle joint anatomy. However, few studies have been conducted that address the merits and drawbacks of these differences in the functioning of joints. Twenty hindfoot specimens were obtained from 10 male C57BL/6J mice and scanned using micro-CT. The foot and ankle skeletal structures were reconstructed in three dimensions. Morphological parameters were then measured using a plane projection method and normalized data were compared with those of human ankles. There was no significant difference in the malleolar width, maximal tibial thickness, tibial arc length, trochlea tali arc length or trochlea tali width of the mouse specimens compared with the human model. However, a groove was observed on the talar dome in the mouse specimens which was not observed in humans, the talar dome being more symmetric. The mouse ankle was to a large extent able to mimic the mechanism of a human ankle and so a mouse model could be appropriate for expanding our understanding of ankle biomechanics in general. However, the structural differences in the talar dome in the mouse and human should not be ignored. Although there are some differences in the mouse and human ankle that cannot be ignored, compared to other animals, the human ankle is more similar to that of the mouse.

Introduction: In the upper there are different neural entrapment sites that can be associated with neighboring structures which in turn can mimic other neural entrapments syndromes. The objective of this study was to review the literature concerning neuromusculoskeletal anatomical variations in the upper limb and their possible clinical correlations with certain pathologies or syndromes. Methods: A systematic literature search over different databases was used to examine the relationship between anatomical variations of neuromusculoskeletal structures and pathologies in the upper limb, using the search strategy proposed by the Cochrane Handbook for Systematic Reviews of Interventions. Results: Analysis of the full text studies after the exclusion criteria had been applied showed that anatomical variations in the upper limb correlated in one third of the studies to nerve entrapment, such compressions frequently being attributable to some type of accessory muscle or variation in its insertion site. This demonstrates the importance of knowing the normal anatomy in order to investigate these structures and their possible variations, thus avoiding a non-specific differential diagnosis. Conclusions: This literature review does not address a single type of anatomical variation but gives guidelines for considering different structures of the upper limb with anatomical variations that could predispose to some type of upper limb neural entrapment.

Purpose: Although musculoskeletal anatomy is inherently related to motion, there is a lack of evidence review about the best teaching practices for the locomotor apparatus functional anatomy. We aimed to detect the strategies that have been implemented for functional musculoskeletal anatomy education, and their outcomes, with the ultimate purpose of suggesting the most effective teaching methods., Methods: The databases PubMed, Scopus, ERIC, and Cochrane Library were searched for papers with the purpose of exploring the outcomes (participants' perceptions and/or examination performance) of teaching functional musculoskeletal anatomy. From each study, the following information was extracted: author(s), number of participants, implementation method, participants' perceptions and/or examination performance after the educational intervention, and classification of the outcomes according to the Kirkpatrick hierarchy., Results: Seven papers were included. Six of them involved active learning strategies (other than seeing, listening, and taking notes). Several specific teaching methods were implemented, including physical activities, lectures, textbooks, atlases, prosected specimens, near-peer teaching, and digital and physical models. Overall, methods that involved active learning, especially some form of physical activity, had the best educational outcomes, while passive learning was not found to be significantly more effective in any case. The role of modern anatomy education technologies has been inadequately explored., Conclusions: It appears that teaching functional musculoskeletal anatomy is more successful when using active learning methods, especially involving some form of physical activity. More research is necessary to determine the best environment for these methods and investigate the role of modern technologies in functional musculoskeletal anatomy education., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Summary: Evidence showed that bad posture in adulthood is often formed from the childhood, and individuals with severe incorrect posture may be associated with the progress of scoliosis. We aimed to estimate the prevalence of incorrect posture in Chinese children and adolescents and to describe the epidemiological findings stratified by the demographic characteristics. A total of 595,057 students were screened; the overall prevalence of incorrect posture in children and adolescents was 65.3%, and around 3.7% of the students were referred to radiography. Girls had a higher prevalence of incorrect posture than boys, students aged >10 years accounted for a higher rate of incorrect posture than students aged

Members of the International Skeletal Society compiled a glossary of terms for musculoskeletal radiology. The authors also represent national radiology or pathology societies in Asia, Australia, Europe, and the USA. We provide brief descriptions of musculoskeletal structures, disease processes, and syndromes and address their imaging features. Given the abundance of musculoskeletal disorders and derangements, we chose to omit most terms relating to neoplasm, spine, intervention, and pediatrics. Consensus agreement was obtained from 19 musculoskeletal radiology societies worldwide. [ABSTRACT FROM AUTHOR]

In tunas, the slow-twitch red muscle, which has an elevated temperature, powers thunniform locomotion, a stiff-bodied swimming style. The anatomical placement and operating temperatures of red muscle vary widely among teleosts: in tunas, the red muscle is located centrally in the body, adjacent to the spine, and maintains an elevated temperature. In the majority of ectothermic teleosts, red muscle is located laterally in the body, adjacent to the skin, and operates at ambient temperature. The specialized physiology and biomechanics of red muscle in tunas are often considered important adaptations to their high-performance pelagic lifestyle; however, the mechanics of how muscular work is transmitted to the tail remains largely unknown. The red muscle has a highly pennate architecture and is connected to the spine through a network of bones (epicentral bones) and long tendons (posterior oblique tendons). The network of long tendons has been hypothesized to enhance the power transmitted to the tail. Here, we investigate the morphology and biomechanics of the tuna’s red muscle and tendons to determine whether elasticity is exploited to reduce the cost of transport, as is the case in many terrestrial vertebrates. To address this question, we evaluate two hypotheses: (1) tendons stretch during red-muscle-actuated swimming and (2) tendons comprise the primary load transmission pathway from the red muscle to the spine. To evaluate these hypotheses, we measured the mechanical properties of the posterior oblique tendons and performed novel dissections to estimate the peak force that the red muscle can generate. The force-generating capacity of the red muscle is calculated to be much greater than the load-bearing capacity of the posterior oblique tendons. Thus, the long tendons likely stretch under force from the red muscle, but they are not strong enough to be the primary force transmission pathway. These results suggest that other pathways, such as serial load transmission through the red muscle myomeres to the great lateral tendon and/or the anterior oblique tendons to the skin, transmit appreciable force to the tail. [ABSTRACT FROM AUTHOR]

To review the importance of physical examination in the diagnostic process of musculoskeletal conditions vis-a-vis the development of sensitive and powerful technologies such as MRI and high-resolution ultrasound. Because the physical examination of the musculoskeletal system is an exercise of applied clinical anatomy, the authors tested, in one-to-one practical examinations, the basal knowledge of musculoskeletal anatomy of rheumatology trainees, rheumatologists, and other professionals of musculoskeletal medicine. The results of the authors' surveys were disappointing, with a correct response rate of 50 to 60% depending on the locales. To correct this deficit, the authors gave many active-learning, case-centered seminars throughout the Americas and some overseas that may have fostered an interest in the study of clinical anatomy. There was an increased interaction between anatomy departments and clinicians, and that daily use of clinical anatomy would make anatomy relevant, improve clinical skills, and probably reduce the overall costs of the health care system. Key Points • Knowledge of musculoskeletal anatomy is the basic diagnostic tool in the regional pain syndromes • Knowledge of musculoskeletal anatomy helps understand the musculoskeletal involvement in the regional and systemic rheumatic disorders • An active-learning methodology was used since 2006 to review the anatomy that is relevant for rheumatology trainees and practitioners of musculoskeletal medicine • A skilled, anatomy-based physical examination and a well-thought diagnostic hypothesis could reduce the use of expensive technologies that, being too sensitive, may lead the unaware clinician astray [ABSTRACT FROM AUTHOR]

Attrition of anatomy knowledge has been an area of concern in health professions curricula. To ensure safe and effective clinical practice, the study of chiropractic requires a good knowledge of musculoskeletal anatomy. In this study, musculoskeletal limb knowledge retention was investigated among students in the 5‐year chiropractic program at Macquarie University, Australia. A test of 20 multiple‐choice questions, categorized into low‐order (LO) and high‐order (HO) cognitive ability according to Bloom's Taxonomy, was developed. Students enrolled in the program were invited to participate with 257 of the 387 choosing to participate, (response rate ranging 56%–72% per year level). No attrition of knowledge across the years was observed, instead, a significant increase in knowledge, measured by total LO and HO scores (P < 0.0005), throughout the program. There were significant increases in both low and high cognitive scores which were not uniform, with high‐order scores increasing significantly in the last two year levels. The increase of knowledge, may be explained, at least partially, by the vertical and horizontal integrated curriculum. Retrieval of knowledge, especially in clinically applied formats, may have led to an enhanced ability to apply anatomy knowledge and account for the increased scores in the high‐order knowledge seen in the later clinical years. Evaluating anatomy knowledge retention at different cognitive levels seems to provide a better assessment and is worth considering in future anatomy educational research. [ABSTRACT FROM AUTHOR]

Purpose: Wikipedia is a popular online encyclopedia generating over 5.4 billion visits per month, and it is also a common resource for the general public and professionals for medical information. The goal of this study is to determine the accuracy and completeness of Wikipedia as a resource for musculoskeletal anatomy. Methods: The origin, insertion, innervation, and function of all muscles of the upper and lower extremities as detailed on Wikipedia was compared to the available corresponding information in Grant's Atlas of Anatomy (14th edition). Entries were scored for both accuracy and completeness. Descriptive statistics were calculated and associations between and within entries for accuracy and completeness were assessed by McNemar's tests. Information on Wikipedia's references was also collected. Results: Overall, data on Wikipedia was 97.6% complete and 98.8% accurate when compared to Grant's Atlas of Anatomy. 78.6% of all entries were fully complete and accurate, with 15.3% of entries containing one error and 6.1% containing two errors. There were no associations between or within entries' accuracy and completeness. Only 62% of references from Wikipedia included were from academic sources. Conclusions: Musculoskeletal anatomy entries on Wikipedia are imperfect; they have inaccurate and missing information. Furthermore, a considerable proportion of references cited in entries are from poorly identified sources. While Wikipedia is an easily accessible resource for a large number of people and much of the anatomic information is appropriate, it cannot be considered to be an equivalent resource when compared to anatomic texts. [ABSTRACT FROM AUTHOR]

A qualitative biomechanics (functional anatomy) course is a typical course in kinesiology curriculum. Most evidence suggests that biomechanics learning could be improved with the inclusion of laboratory experiences. However, implementing laboratories into biomechanics curriculum is difficult due to cost and time constraints. This study was conducted to evaluate whether hands‐on activities in lecture improve qualitative biomechanics learning. A lecture format was compared to the same course with guided and unguided hands‐on activities included during lecture. Test performance and student evaluations were compared between lecture formats to determine if hands‐on experiences improve learning. The hands‐on group performed better on the same test questions and they evaluated their overall course activities as beneficial to their learning. The findings suggest that guided hands‐on experiences may improve learning compared to unguided activities. The hands‐on experiences seem to provide an embodied cognitive learning experience, facilitating retention of learned material through three‐dimensional and tactile mental representations. Findings from this research are currently shaping how biomechanics is taught to students at this university and could at other universities as well. [ABSTRACT FROM AUTHOR]

The United Kingdom is currently facing crisis due to a shortage of radiology consultants despite ever‐increasing demand for medical imaging. The specifics of how best to teach radiology has generated increasing interest. This study aims to determine whether musculoskeletal (MSK) radiology teaching at the University of Nottingham (UoN) Medical School is perceived to be satisfactory by medical students, Foundation‐Year doctors, and senior medical professionals in preparing students for the demands working as Foundation‐Year doctors. Questionnaires were distributed to all medical students and Foundation‐Year doctors that graduated from UoN (n = 307). Semi‐structured interviews were conducted with consultants and teaching staff (n = 13). Forty‐nine percent of preclinical medical students, 43% of clinical students and 27% of Foundation‐Year doctors thought MSK radiology teaching was not sufficient in preparing them for the radiology challenges Foundation‐Year doctors' face. This difference was statistically significant (P < 0.001). The consensus from senior medical professionals was that MSK Radiology teaching is currently adequate and producing competent students. Interestingly, only 5% of students were considering a career in radiology compared to 34% of Foundation‐Year doctors. Overall, there seems to be concern among students regarding MSK radiology teaching and students have a lack of confidence with MSK radiology. Foundation‐Year doctors and senior medical professionals do not share this view. This may be due to medical students' lack of clarity on what is required of them. Formal documentation of set learning objectives for MSK radiology throughout the curriculum may address this. [ABSTRACT FROM AUTHOR]

Background: In physiotherapy education, blended learning is recognized to be more effective compared to traditional teaching. The aim of this study was to assess the consequences of a musculoskeletal anatomy blended learning program on skills developed by students., Methods: We conducted an observational retrospective monocentric study in a French physiotherapy school named "X." Ninety-two first-year students in the 2017-18 baseline group (students with traditional face-to-face learning), and ninety-eight first-year students and ninety-five second-year students in the 2018-19 and 2019-20 blended learning experimental groups was included. A success rate of the anatomy final written exam, defined by the percentage of students scoring 50% or above, was analyzed between 2017 and 2020. We also evaluated the pedagogical value of musculoskeletal e-learning and its usefulness for preparing the student for their anatomy final written exam at «X»., Results: We observed an improvement in the success rate of the anatomy final written exam between the 2017-18 baseline group, 2018-19 and 2019-2020 experimental groups during first (Kruskal-Wallis = 74.06, df = 2, p < 0.001) and second semester (Kruskal-Wallis = 173.6, df = 2, p < 0.001). We obtained a data survey and questionnaire response rate of 74% ( n  = 89/120) for the 2018-19 and 62% ( n  = 72/116) for the 2019-20 experimental groups. Concerning questionnaire response, they were no significant statistical difference between 2018-19 and 2019-20 experimental groups., Conclusion: Blended learning could improve student success rate of the anatomy final written exam and learning of professional physiotherapy skills., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Delafontaine, Saiydoun, Frigout, Fabeck, Degrenne and Sarhan.)

Medical schools have traditionally used a lecture and dissection-based approach for educating students about human anatomy. There is growing interest in the adoption of alternative teaching and learning activities (TLAs) that incorporate the use of cadaveric prosection and computer-based learning into musculoskeletal (MSK) anatomy curricula. The purpose of this investigation was to examine retrospectively how different TLAs influenced student perceptions about learning, and performance on MSK anatomy examinations. Pre-clerkship students from the same medical school were compared. One group completed 15 hours of dissection-based laboratory instruction; another group completed 15 hours of prosection-based laboratory instruction. All other aspects of the curricula were the same. Information was gathered about student perceptions using a standardized survey that compared six different TLAs on eight specific learning objectives. Academic performance on examinations was compared. Ninety-three medical students (50% of first year class/34% of second year class) participated. Only 27 had taken a MSK anatomy course prior to enrolling in medicine. Both groups rated learning via medical imaging and clinical case-based scenarios highly. While each group also ranked both methods of cadaveric teaching highly, only the prosection group thought there was a significant difference. No differences in academic performance were noted between groups. Data support the inclusion of cadaveric-based teaching, medical imaging and clinical case-based scenarios as key elements of a MSK anatomy curriculum, and suggest that academic performance is not influenced by the method of cadaveric instruction. These results should help guide the selection of effective MSK anatomy TLAs within undergraduate medical programs. [ABSTRACT FROM AUTHOR]

The efficacy of videos in anatomy education is still being debated. It appears that one of the major factors discouraging learners to use videos has been their length. To counteract this, 24 short videos (the longest lasting 1 minute and 13 seconds), were created for a course on musculoskeletal anatomy. Videos focused on identification of muscles of the limbs and their relations by area. The aim of this preliminary study was to assess students' perception of value of the videos and their utilisation. The number of views for each video was recorded. A questionnaire based survey was carried out focusing on students' perception of the educational usefulness of the videos. On average, each video had 339.5 views. Out of 312 students enrolled in the course, 210 completed the survey (67.3% response rate). A total of 181 respondents (86.2%) watched the videos and a majority perceived them useful in: Learning about the anatomy of the limbs (68%), preparation for the laboratory (56.9%), post-laboratory revision (65.6%) and preparation for the practical test (66.3%). Asked for feedback, students requested an increase in the number of videos to include structures other than muscles. Students reported to perceive videos as a useful resource in their musculoskeletal anatomy course. The shortness of the videos made them easy to access and use repeatedly. Future, more in-depth studies, based on the utilisation of the existing and newly produced videos, might throw more light on their full educational potential. [ABSTRACT FROM AUTHOR]

Objective: Recent changes in undergraduate medical curricula have resulted in time constraints that are particularly challenging when students must learn large blocks of content. Musculoskeletal anatomy is one such blocks, and students may resort to rote memorization to cope. In an effort to help students learn both concepts and content, a "consolidation carnival" was developed. Methods: For a 6-week musculoskeletal course, two consolidation carnivals were scheduled: one on week 3 and the other on week 6, following the completion of the upper and lower limb contents, respectively. These largely self-directed speeddating- styled review sessions consisted of 6 to 7 students rotating through 7 to 8 clinical cases with corresponding cadaveric specimens every ten minutes. Results: Ninety-four per cent of the 103 students who participated in this study agreed that the consolidation carnival provided a helpful overview of musculoskeletal anatomy content, including other positive reviews. Student performance on the short, open-ended, case-based musculoskeletal examination showed no significant difference on shoulder, hand, hip, thigh, or leg questions. There was however a statistically significant decrease in the students' scores on a forearm question in 2021 compared to 2019. Conclusion: This study shows that the consolidation carnival was positively received by students as having value in reviewing the musculoskeletal content and enhancing their problem-solving and critical thinking skills, while promoting peer collaboration. [ABSTRACT FROM AUTHOR]

Research on the benefits of visual learning has relied primarily on lecture-based pedagogy, but the potential benefits of combining active learning strategies with visual and verbal materials on learning anatomy has not yet been explored. In this study, the differential effects of text-based and image-based active learning exercises on examination performance were investigated in a functional anatomy course. Each class session was punctuated with an average of 12 text-based and image-based active learning exercises. Participation data from 231 students were compared with their examination performance on 262 questions associated with the in-class exercises. Students also rated the helpfulness and difficulty of the in-class exercises on a survey. Participation in the active learning exercises was positively correlated with examination performance ( r = 0.63, P < 0.001). When controlling for other key demographics (gender, underrepresented minority status) and prior grade point average, participation in the image-based exercises was significantly correlated with performance on examination questions associated with image-based exercises ( P < 0.001) and text-based exercises ( P < 0.01), while participation in text-based exercises was not. Additionally, students reported that the active learning exercises were helpful for seeing images of key ideas (94%) and clarifying key course concepts (80%), and that the image-based exercises were significantly less demanding, less hard and required less effort than text-based exercises ( P < 0.05). The findings confirm the positive effect of using images and active learning strategies on student learning, and suggest that integrating them may be especially beneficial for learning anatomy. Anat Sci Educ 10: 444-455. © 2017 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

This paper describes the development of a deep learning model for prediction of hip fractures on pelvic radiographs (X-rays). Developed using over 40,000 pelvic radiographs from a single institution, the model demonstrated high sensitivity and specificity when applied to a test set of emergency department radiographs. This study approximates the real-world application of a deep learning fracture detection model by including radiographs with sub-optimal image quality, other non-hip fractures, and metallic implants, which were excluded from prior published work. The study also explores the effect of ethnicity on model performance, as well as the accuracy of visualization algorithm for fracture localization., Competing Interests: The authors declare no competing interests., (© 2023 The Author(s).)

Musculoskeletal modelling has become a valuable tool with which to understand how neural, muscular, skeletal and other tissues are integrated to produce movement. Most musculoskeletal modelling work has to date focused on humans or their close relatives, with few examples of quadrupedal animal limb models. A musculoskeletal model of the mouse hindlimb could have broad utility for questions in medicine, genetics, locomotion and neuroscience. This is due to this species' position as a premier model of human disease, having an array of genetic tools for manipulation of the animal in vivo, and being a small quadruped, a category for which few models exist. Here, the methods used to develop the first three-dimensional (3D) model of a mouse hindlimb and pelvis are described. The model, which represents bones, joints and 39 musculotendon units, was created through a combination of previously gathered muscle architecture data from microdissections, contrast-enhanced micro-computed tomography ( CT) scanning and digital segmentation. The model allowed muscle moment arms as well as muscle forces to be estimated for each musculotendon unit throughout a range of joint rotations. Moment arm analysis supported the reliability of musculotendon unit placement within the model, and comparison to a previously published rat hindlimb model further supported the model's reliability. A sensitivity analysis performed on both the force-generating parameters and muscle's attachment points of the model indicated that the maximal isometric muscle moment is generally most sensitive to changes in either tendon slack length or the coordinates of insertion, although the degree to which the moment is affected depends on several factors. This model represents the first step in the creation of a fully dynamic 3D computer model of the mouse hindlimb and pelvis that has application to neuromuscular disease, comparative biomechanics and the neuromechanical basis of movement. Capturing the morphology and dynamics of the limb, it enables future dissection of the complex interactions between the nervous and musculoskeletal systems as well as the environment. [ABSTRACT FROM AUTHOR]

Background: Students often strategically adopt surface approaches to learning anatomy in order to pass this necessarily content-heavy subject. The consequence of this approach, without understanding and contextualisation, limits transfer of anatomical knowledge to clinical applications. Encouraging deep approaches to learning is challenging in the current environment of lectures and laboratory-based practica. A novel interactive anatomy workshop was proposed in an attempt to address this issue. Methods: This workshop comprised of body painting, clay modelling, white-boarding and quizzes, and was undertaken by 66 health science students utilising their preferred learning styles. Performance was measured prior to the workshop at the mid-semester examination and after the workshop at the end-semester examination. Differences between mid- and end-semester performances were calculated and compared between workshop attendees and non-attendees. Baseline, post-workshop and follow-up surveys were administered to identify learning styles, goals for attendance, useful aspects of the workshop and self-confidence ratings. Results: Workshop attendees significantly improved their performance compared to non-attendees (p = 0.001) despite a difference at baseline (p = 0.05). Increased self-confidence was reported by the attendees (p < 0.001). To optimise their learning, 97 % of attendees reported utilising multi-modal learning styles. Five main goals for participating in the workshop included: understanding, strategic engagement, examination preparation, memorisation and increasing self-confidence. All attendees reported achieving these goals. The most useful components of the workshop were body painting and clay modelling. Conclusions: This interactive workshop improved attendees' examination performance and promoted engagedenquiry and deeper learning. This tool accommodates varied learning styles and improves self-confidence, which may be a valuable supplement to traditional anatomy teaching. [ABSTRACT FROM AUTHOR]

Current undergraduate medical school curricular trends focus on both vertical integration of clinical knowledge into the traditionally basic science-dedicated curricula and increasing basic science education in the clinical years. This latter type of integration is more difficult and less reported on than the former. Here, we present an outline of a course wherein the primary learning and teaching objective is to integrate basic science anatomy knowledge with clinical education. The course was developed through collaboration by a multi-specialist course development team (composed of both basic scientists and physicians) and was founded in current adult learning theories. The course was designed to be widely applicable to multiple future specialties, using current published reports regarding the topics and clinical care areas relying heavily on anatomical knowledge regardless of specialist focus. To this end, the course focuses on the role of anatomy in the diagnosis and treatment of frequently encountered musculoskeletal conditions. Our iterative implementation and action research approach to this course development has yielded a curricular template for anatomy integration into clinical years. Key components for successful implementation of these types of courses, including content topic sequence, the faculty development team, learning approaches, and hidden curricula, were developed. We also report preliminary feedback from course stakeholders and lessons learned through the process. The purpose of this report is to enhance the current literature regarding basic science integration in the clinical years of medical school. Anat Sci Educ 7: 379-388. © 2014 American Association of Anatomists. [ABSTRACT FROM AUTHOR]

The trunk muscle in fish is organized as longitudinal series of myomeres which are separated by sheets of connective tissue called myoseptum to which myofibers attach. In this study we show in the trout that the myoseptum separating two somites is initially acellular and composed of matricial components such as fibronectin, laminin and collagen I. However, myoseptal cells forming a continuum with skeletogenic cells surrounding axial structures are observed between adjacent myotomes after the completion of somitogenesis. The myoseptal cells do not express myogenic markers such as Pax3, Pax7 and myogenin but express several tendon-associated collagens including col1a1, col5a2 and col12a1 and angiopoietin-like 7, which is a secreted molecule involved in matrix remodelling. Using col1a1 as a marker gene, we observed in developing trout embryo an initial labelling in disseminating cells ventral to the myotome. Later, labelled cells were found more dorsally encircling the notochord or invading the intermyotomal space. This opens the possibility that the sclerotome gives rise not only to skeletogenic mesenchymal cells, as previously reported, but also to myoseptal cells. We furthermore show that myoseptal cells differ from skeletogenic cells found around the notochord by the specific expression of Scleraxis, a distinctive marker of tendon cells in amniotes. In conclusion, the location, the molecular signature and the possible sclerotomal origin of the myoseptal cells suggest that the fish myoseptal cells are homologous to the axial tenocytes in amniotes. [ABSTRACT FROM AUTHOR]