Methods and outcomes of teaching functional anatomy of the musculoskeletal system: A scoping review.

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.

Platelet-rich plasma, a biomaterial, for the treatment of anterior talofibular ligament in lateral ankle sprain.

Background: Because of the rising prevalence of anterior talofibular ligament (ATFL) damage, there is a considerable interest in developing innovative techniques to improve the biological healing response of ATFL. Platelet-rich plasma (PRP) includes several growth factors linked to a favorable healing response, however none of the studies involved both quality evaluation and clinical results to evaluate this treatment. Purpose: To determine the clinical results of PRP injections into the ATFL in lateral ankle sprain (LAS) patients, as well as the quality of the ATFL based on radiographic outcomes. Methods: Patients with clinically confirmed grade II LAS for the first time (n = 83) were examined. The clinical outcomes of three types of injection methods were evaluated: none, once within 48 h after the sprain, and once more 4 weeks later after first injection. PRP was injected into the tear site of the ATFL using ultrasound guidance, and all ankles were immobilized for 2 weeks. The American Orthopedic Foot and Ankle Score (AOFAS) ankle-hindfoot scale and the Visual Analogue Scale (VAS) were used to assess the results at 2, 6, 8, 24, and 48 weeks of follow-up. The signal/noise ratio (SNR) value of Magnetic Resonance Imaging (MRI)-based ATFL signal intensity can disclose ATFL quality. The ATFL SNR results were then assessed 8, 24 and 48 weeks following the first injection to compare ATFL quality. Results: The PRP injection groups outperformed the control group in terms of clinical outcomes, and the two injections group outperformed other groups in terms of pain reduction and functional outcome at 8 weeks. The clinical results of all groups were comparable at 6 and 12 months follow-up. ATFL SNR findings improved significantly across all groups over time. At the same follow-up time, the PRP injection groups outperformed the control group, and the best SNR result showed in the two injections group at the final follow-up. Conclusion: PRP injection helped relieve early symptoms of LAS, although all patients saw a similar development after 6 months. The two PRP injections group produced considerably better clinical results and quality of the ATFL in short-term follow-up.

Apelin/APJ system: A novel therapeutic target for locomotor system diseases.

Apelin is an endogenous ligand of G protein-coupled receptor APJ. Apelin/APJ system is widely expressed in abundant tissues, especially bone, joint and muscle tissue. This review focus on the effects of apelin/APJ system on locomotor system. An increasing number of evidence suggests that apelin/APJ system plays a crucial role in many physiological and pathological processes of locomotor system. Physiologically, apelin/APJ system promotes bone formation, muscle metabolism and skeletal muscle production. Pathologically, apelin/APJ system exacerbates osteoarthritis pathogenesis, whereas it alleviates osteoporosis. Besides, the level of apelin expression is regulated by different training modes, including continuous aerobic exercise, high-intensity interval training and resistance exercises. More importantly, exercise-induced apelin may be a potent pharmacological agent for the treatment of diseases and the regulation of physiological processes. Considering the pleiotropic effects of apelin on locomotor system, apelin/APJ system may be an important therapeutic target for locomotor system diseases.

Relationship Between Clinicopathological Features and Prognosis in Appendicular Osteosarcoma in Dogs.

Osteosarcoma is the most common primary bone neoplasm in dogs and often involves the appendicular skeleton. We report the clinicopathological and prognostic features of appendicular osteosarcomas diagnosed in 153 dogs from 2008 to 2018. The survival data for 22 dogs that underwent surgery and chemotherapy were statistically compared with the clinical, histopathological and immunohistochemical data for correlation with prognosis. The affected dogs had a mean age of 9.1 years and a mean body weight of 33.4 kg. No sex predilection was detected, although the incidence was slightly higher in females (52%). Large mixed and purebred dogs were most commonly affected. Long bones were affected in 124 cases (92.5%; 124/134). The extremities affected within long bones were the metaphysis of the proximal humerus (29%), distal radius (17.7%), distal femur (15.3%) and proximal tibia (7.2%). Histologically, osteoblastic osteosarcoma was most commonly detected (56.9%), followed by chondroblastic (13.7%), telangiectatic (11.8%), fibroblastic (7.8%), giant cell-rich (5.2%) and poorly differentiated neoplasms (4.6%). Regional lymph nodes were available for analysis in 28 out of 70 excisional biopsies from amputated entire limbs. Metastases to regional lymph nodes were observed in 14.3% (4/28) of these cases. Distant metastases were found in 75% (39/52) of cases in which diagnostic imaging or necropsy was carried out. The lungs were the most common site of metastasis (87.2%; 34/39 cases). Weight, age, sex, affected limb or bone, histological classification, mitotic count or histological grade did not influence survival (P >0.05). Neoplasms located at proximal extremities (n = 7) of affected limbs had a tendency for a poorer prognosis than those at distal extremities (n = 15) (P = 0.06). For these cases, the 1-year survival rate was 14.3% compared with 40% for neoplasms at distal extremities. There was no significant difference in the survival rate when amputation (n = 16) or limb preservation (n = 6) techniques were employed with chemotherapy (P = 0.20). The survival period of dogs that had undergone limb amputation, or limb preservation surgery, and chemotherapy was 73-1,185 days, with a mean and median of 376 and 256 days, respectively. Mild to marked cytoplasmic immunolabelling of osteopontin was found in all cases but the intensity (P = 0.66) and percentage of neoplastic cells labelled (P = 0.49) did not influence survival.

Applications and grants of National Natural Scientific Foundation of China's General Program in abnormalities and diseases of locomotor system: a ten-year review.

Translational medicine is a branch of medical research that attempts to establish a more direct link between basic research and clinical practice. The improvement of clinical management cannot be separated from the progress and breakthrough made in basic biomedical research. As one of the main funding agencies for basic research in China, National Natural Scientific Foundation of China (NSFC) plays an active role in promotion of the development of basic medical research and translational medicine. General Program mainly supports scientists to carry out basic research on bottom-up based topics within the funding scope of NSFC to conduct innovative research and promote a balanced, coordinated and sustained development of all disciplines. Musculoskeletal injury and disease is a major threat to human health worldwide and has become the major cause of disability in China. In this review, we aim to further promote the clinical transformation by summarizing the trends and hotspots of basic research in this field based on the analysis of the data of General Program in abnormalities and diseases of locomotor system over the last decade, including analyses of the number of applications received and projects funded, the distribution of the keywords in applications and grants, distribution of applications and grants of General Program in the secondary application code of H06 and in the host institution.

Acoustic Radiation Force Impulse (ARFI) elastography imaging of equine distal forelimb flexor structures / [Elastografia Acoustic Radiation Force Impulse (ARFI) das estruturas flexoras da porção distal do membro torácico de equinos]

This study set out to determine normal values for acoustic radiation force impulse (ARFI) elastography of the superficial digital flexor tendon, deep digital flexor tendon, accessory ligament of the deep digital flexor tendon and suspensory ligament in horses. Twenty-four horses were submitted to conventional sonographic assessment and elastography imaging (quantitative ARFI method) of distal forelimb tendons and ligaments at nine anatomical regions. Elastograms depicted tendons and ligaments in orange to red tones consistent with greater stiffness. Shear wave velocity was higher in the longitudinal compared to the cross-sectional plane but did not differ significantly between the left and right forelimbs. The suspensory ligament was stiffer compared to remaining structures in the cross-sectional plane. Ligaments were stiffer than tendons and the deep digital flexor tendon was stiffer than the superficial digital flexor tendon in the longitudinal plane. Target structures were stiffer in male compared to female horses and stiffness tended to increase with age. ARFI elastography proved to be a feasible and reproducible imaging modality for assessment of distal forelimb tendons and ligaments in horses. Qualitative features derived from stiffness quantification in these structures can be applied to horses with musculoskeletal disorders, as well as to other animal species.(AU)

Este trabalho objetivou estabelecer valores de referência por meio da elastografia ARFI ("Acoustic Radiation Force Impulse") do tendão flexor digital superficial, tendão flexor digital profundo, ligamento acessório inferior e ligamento suspensor do boleto em equinos hígidos. Vinte e quatro equinos foram submetidos aos exames ultrassonográfico e elastográfico (método ARFI quantitativo) dos tendões e ligamentos da porção distal do membro torácico, em nove regiões anatômicas diferentes. Os elastogramas mostraram tendões e ligamentos de coloração alaranjada a vermelha, que representam maior rigidez. Não houve diferenças em relação ao membro avaliado; as velocidades de cisalhamento foram maiores nos planos longitudinais. No plano transversal, os ligamentos suspensores foram mais rígidos em comparação aos demais. No plano longitudinal, os ligamentos mostraram-se mais rígidos que os tendões, e o tendão flexor digital profundo, mais rígido que o tendão flexor digital superficial. As estruturas mostraram-se mais rígidas nos machos, e houve uma tendência à maior rigidez em animais mais velhos. A elastografia ARFI comprovou ser um método viável e reprodutível para avaliação dos tendões e ligamentos dos membros torácicos de equinos. As características qualitativas obtidas a partir da rigidez dessas estruturas podem ser utilizadas para testes em equinos com distúrbios musculoesqueléticos e também em outras espécies animais.(AU)

Fetal bone development in the lowland paca (Cuniculus paca, Rodentia, Cuniculidae) determined using ultrasonography.

Studying the timing of the main events of embryonic and fetal development may clarify the strategies adopted by species to maximize neonatal survival and the consequences of these events for their life history. This study describes bone development during the fetal phase of the lowland paca (Cuniculus paca), comparing it with other precocial or altricial species, and its relationship with the species' adaptive strategies. A total of 102 embryos/fetuses obtained over the course of 17 years through collaboration with local subsistence hunters in the Amazon were analyzed. Measurements of mineralization of the axial and appendicular skeletons were performed by ultrasonography using a 10-18-MHz linear transducer. The chronological order of occurrence of mineralization in relation to the total dorsal length (TDL) was: skull (TDL = 4.1 cm); vertebral bodies (TDL = 4.6 cm); scapula, humerus, radius, ulna, ilium, ischium, femur, tibia, and fibula (TDL = 6.7 cm); ribs (TDL = 7.8 cm); clavicle (TDL = 8.5 cm); metacarpi/metatarsi (TDL = 11 cm); phalanges (TDL = 15 cm); tarsus (TDL = 18 cm); patella (TDL = 23 cm); and carpus (TDL = 27.2 cm). Secondary ossification centers first appeared in the femoral distal epiphysis (TDL = 16.6 cm) and tibial proximal epiphysis (TDL = 18.4 cm). Advanced fetuses (TDL > 30 cm, 97% gestational period) presented mineralization in all primary and most secondary centers. Compared to other species, paca neonates have a well-developed skeletal system at birth, which is important for their independent postnatal locomotion. Our results may contribute to the monitoring of bone development in other wild species, helping us to understand their life history, and serving as parameters for comparisons between precocial and altricial mammals.

Interpersonal correlates of the tendency to seek help in the situation of indebtedness in healthy people and in patients with impaired mobility, related to chronic disorders of the locomotor system - Pilot study.

INTRODUCTION: The way of functioning in everyday life and the style of coping with the challenges encountered, including the situations of financial difficulties, are shaped by various adaptation mechanisms conditioned by the state of psychophysical health, as well as social and cultural factors. They are related to the intrapsychic features, among which the personality plays a key role. MATERIAL AND METHODS: The research sample consisted of 2 groups - 50 patients with mobility impairment resulting from chronic pathologies of the locomotor system hospitalized in the Department of General and Neuro Rehabilitation, Institute of Rural Health in Lublin, and 50 healthy people. The research was carried out using the NEO-FFI Personality Inventory, Perceived Stress Scale, Self-Esteem Scale, General Self-Efficacy Scale, Impulsiveness Inventory and the APSZ Questionnaire. RESULTS: In the group of patients with impaired mobility resulting from chronic pathologies of the locomotor system, the leading correlate of the tendency to seek help in the situation of indebtedness was extraversion. In the healthy group, the leading correlates of the tendency to undertake this type of activity were the intensity of perceived stress, neuroticism, self-esteem, self- efficacy and empathy. CONCLUSIONS: In the group of patients with impaired mobility resulting from chronic diseases of the locomotor system, extroversion was the factor conducive to seeking help in the situation of indebtedness. In the group of healthy people, self-esteem, self- efficacy and empathy were the factors conducive to taking such actions, whereas intensity of perceived stress and neuroticism were the risk factors.

Welfare and locomotor system disorders in active draft horses (cart horses) / Bem-estar e afecções do aparelho locomotor de equinos de tração (carroceiros) em atividade

Horses performing tasks is a common scene in urban centers, evidenced by the significant number of animals pulling carts along the streets (cart horses). Despite the rising concern of the population for animal welfare, as well as the creation of laws that prohibit traction activity in several Brazilian municipalities, these attitudes must be based on the impact of such activity on equine health. Locomotor system disorders are commonly observed in animals of this species, and become even more frequent when they are submitted to unhealthy working conditions. In this context, we conducted a survey on locomotor system disorders in 11 active draft horses. To this end, we performed lameness assessments and radiographic and ultrasound examinations. Information on management regarding the horses' hooves, type of harness used, and type of work performed was also obtained through the application of questionnaires to the owners. The collected data showed that, although most of the animals in the study presented critical orthopedic conditions, they were not treated and the horses did not rest for adequate time. We observed that the disorders, which are often chronic, may be directly associated with incorrect management of the animals. We emphasize the importance to disseminate information that values the welfare of traction animals in order to tackle mistreatment.(AU)

Cavalos desempenhando tarefas para o homem é ainda uma cena marcante nos centros urbanos, evidenciada pela grande quantidade de animais que tracionam carroças pelas ruas (carroceiros). Apesar da crescente preocupação da população com o bem estar animal, assim como a criação de leis que proíbem a atividade de tração em diversos municípios brasileiros, é imprescindível que estas atitudes estejam embasadas no impacto de tal atividade sobre a saúde dos equinos. Nesta espécie, afecções do aparelho locomotor são comuns, tornando-se ainda mais frequentes quando os animais são submetidos a condições insalubres de trabalho. Por conseguinte, este estudo promoveu um levantamento das afecções que acometem o aparelho locomotor de 11 equinos de tração em atividade, por meio de exames de claudicação, radiográficos e ultrassonográficos. Informações sobre manejo realizado pelos proprietários quanto aos cascos de seus animais, tipos de arreios utilizados e tipo de trabalho ao qual eram submetidos foram obtidas através de questionários. Verificou-se ao relacionar dados coletados, que a maioria dos animais do estudo apresentava afecções ortopédicas importantes, e que, entretanto, não eram tratados ou mantidos em repouso por tempo adequado. Observou-se que as afecções encontradas, muitas vezes crônicas, podem ter relação direta com o manejo incorreto dos animais, e ressalta-se a importância da disseminação de informações que prezem pelo bem estar do animal de carroça, a fim de combater maus tratos nesta categoria animal.(AU)

Regulation of Wnt signaling by physical exercise in the cell biological processes of the locomotor system.

In the past decade, researches on Wnt signaling in cell biology have made remarkable progress regarding our understanding of embryonic development, bone formation, muscle injury and repair, neurogenesis, and tumorigenesis. The study also showed that physical activity can reverse age-dependent decline in skeletal muscle, preventing osteoporosis, regenerative neurogenesis, hippocampal function, cognitive ability, and neuromuscular junction formation, and the age-dependent recession is highly correlated with Wnt signaling pathways. However, how the biological processes in cell and physical activity during/following exercise affect the Wnt signaling path of the locomotor system is largely unknown. In this study, we first briefly introduce the important features of the cellular biological processes of exercise in the locomotor system. Then, we discuss Wnt signaling and review the very few studies that have examined Wnt signaling pathways in cellular biological processes of the locomotor system during physical exercise.

Measuring limitations in activities of daily living: a population-based validation of a short questionnaire.

PURPOSE: A newly developed questionnaire assessing limitations in activity of daily living (LADL-Q) that should improve assessment of LADL is tested in a large population-based validation study. METHODS: This survey was paper-based. Overall, 16,634 individuals who were representative of the working population in the German-speaking part of Switzerland participated in the study. Item analysis was used the final version of the LADL-Q to four items per subscale that correspond to potential problems in three body regions (back and neck, upper extremities, lower extremities). Analysis included tests for reliability, internal consistency, dimensionality and convergent validity. RESULTS: Test-retest reliability coefficients after 2 weeks ranged from 0.82 to 0.99 (Mdn = 0.87), with no item having a coefficient below 0.60. The median item-total coefficients ranged between moderate and good. Correlation coefficients between LADL-Q subscales and three validated clinical instruments (Western Ontario and McMaster Universities osteoarthritis index, shoulder pain disability index, Oswestry) ranged from 0.63 to 0.81. In structural equation modeling the three subscales were significantly related with two important outcomes in occupational rehabilitation: self-reported general health and daily task performance. CONCLUSION: The new LADL-Q is a brief, reliable and valid tool for assessment of LADL in studies on musculoskeletal health.

Actividades sobre los conjuntos esqueléticos de cada segmento corporal en la carrera de Cultura Física / Activities on the skeletal assemblies of each body segment in the Physical Culture course

RESUMEN El presente trabajo investigativo surge debido a la necesidad de crear un medio de enseñanza con actividades que les permita a los estudiantes comprobar, de manera sistémica, el aprendizaje de los conocimientos relacionados con los conjuntos esqueléticos de cada segmento corporal del Sistema Locomotor Humano, recibidos en la asignatura Morfología Funcional II, la cual se imparte en el 1er año de la carrera de Cultura Física. El libro de texto de la asignatura no brinda esta posibilidad. Para realizar el estudio se aplicaron fundamentalmente métodos a nivel empíricos, tales como la revisión de documentos, la encuesta y la entrevista. Se trabajó con una muestra de 115 estudiantes de primer año de la carrera y tres profesores, quienes imparten la materia. Las actividades contenidas están organizadas por cada segmento corporal del sistema locomotor humano, según el programa de la asignatura, acompañadas de esquemas y figuras para marcar, identificar, seleccionar, caracterizar y clasificar detalles anatómicos que se precisen, aumentando su nivel de complejidad. Estas actividades se ofrecen además como herramienta para ser utilizada en otras asignaturas del ciclo biológico y del ejercicio de la profesión.

ABSTRACT The research work Activities on skeletal sets of each body segment of the Human Locomotor System in the 1st year of the career of Physical Culture, arises due to the need for a teaching medium for the subject of Functional Morphology II that contains systemically activities that allows the students to check the learning of the knowledge related to the skeletal assemblies of each body segment of the Human Locomotor System, since the subject's textbook does not provide this possibility, which hinders the consolidation of knowledge about sets skeletal of each body segment of the Human Locomotor System, the programmed activities are necessary and essential for the understanding of the work object of the professional of our career and facilitates the acquisition, deepening and consolidation of knowledge about the locomotor system, activities on joint skiing Elastics of each body segment of the Human Locomotor System are also offered as a tool to be used in other subjects of the biological cycle and the exercise of the profession. The activities that are presented are organized by each body segment of the human locomotor system according to the program of the subject, accompanied by diagrams and figures to mark, identify, select, characterize, classify anatomical details that are needed, increasing their level of complexity. It gives solution to the insufficiency of activities that for the teaching and learning process of the skeletal groups of each body segment of the human locomotor system presents the subject of Functional Morphology II and its application in professional work.

[Peripheral limb pareses in cattle. Part 2: Diagnostics, prognosis and therapy]. / Lähmungen vom peripheren Typ im Gliedmaßenbereich des Rindes. Teil 2: Diagnostik, Prognose und therapeutisches Vorgehen.

This two-part review presents an overview of peripheral-limb pareses in cattle, which represent the most frequent bovine neurologic disorder and are mostly caused by trauma of specific peripheral nerves. Occurrence, etiology, diagnosis, prognosis and therapy are presented. The second part of the review describes neuroanatomical details important for diagnostics, localization of the neuronal lesion within the lower motor neuron and classification of the grade of peripheral-nerve injury. Furthermore additional diagnostic tools are presented and prognosis, therapy and prevention of peripheral limb pareses in cattle are discussed.

Anatomy of the long peroneal muscle of the leg.

BACKGROUND: The aim of the work was to perform a morphometric analysis of the long peroneal muscle (LPM) of the leg and explore the relationship between muscle belly and tendon. MATERIALS AND METHODS: Ten lower limbs (8 right and 2 left) were fixed in formaldehyde and dissected using standard technique. The LPM was exposed from the proximal attachment to the top of a lateral malleolus. RESULTS: The tendon was subsequently freed and various measurements were taken. The tendon of the LPM enters deep into the muscle belly. Muscle fibres surround the tendon and descend as far down as 4 cm above the lateral malleolus. Muscle fibres insert mainly along posterior border of the tendon and on its medial surface, leaving lateral surface only partly covered. CONCLUSIONS: The LPM contains a long intramuscular segment of the tendon and area of the musculotendinous junction varies along the LPM. It makes the idea of uniform pennation pattern of the LPM unlikely.

[Peripheral-limb pareses in cattle. Part 1: General causes and specific pareses of the fore- and hindlimbs]. / Lähmungen vom peripheren Typ im Gliedmaßenbereich des Rindes. Teil 1: Allgemeine Ursachen und spezielle Lähmungen an Vorder- und Hintergliedmaßen.

This two-part review presents an overview of peripheral-limb pareses in cattle, which represent the most frequent bovine neurologic disorder and are mostly caused by trauma of specific peripheral nerves. Occurrence, etiology, diagnosis, prognosis and therapy are presented. The first part of the review describes general causes for peripheral limb pareses in cattle. Furthermore, a detailed overview of specific peripheral nerve damages of the fore- and hindlimbs is presented.

Integration of the musculature in the course "functional anatomy of the locomotor system"-Preparing medical students for the dissection course.

PURPOSE: To enhance the efficacy of the preclinical first-year course for medical and dental students 'functional anatomy of the locomotor system' (demo course) which serves as a preparation for the dissection course at the Friedrich-Alexander University of Erlangen-Nürnberg, Germany. METHODS: The muscular system was integrated into the curriculum of the demo course. Moreover, the number of tutors was increased from around 5 to 15 for approximately 120 students. A detailed course agenda, which had been lacking hitherto, was developed for each course day. Extensive preparation and briefing of course tutors was introduced. Self-prepared questionnaires were applied to compare student attitudes towards the demo course before and after the restructuring process. Surveys were conducted at the end of the unchanged demo course, at the end of the dissection course in the following term (same students) and at the end of the restructured demo course. RESULTS: The mark given for overall course quality improved from 3 ("satisfactory") to 2 ("good"). The students felt significantly better prepared for the dissection course after the restructuring process, although they perceived the work load as more challenging in relation to the limited time available. They assessed the new course as better structured and stated that the muscular system had been important for the functional comprehension of the locomotor system. CONCLUSIONS: According to student opinion, the attempt to improve the demo course quality by providing a detailed course agenda and enhanced tutelage had been successful. As expected, the musculature is critical to functional understanding of the locomotor system.

The evaluation of i-SIDRA - a tool for intelligent feedback - in a course on the anatomy of the locomotor system.

OBJECTIVE: This paper presents an empirical study of a formative mobile-based assessment approach that can be used to provide students with intelligent diagnostic feedback to test its educational effectiveness. METHOD: An audience response system called SIDRA was integrated with a neural network-based data analysis to generate diagnostic feedback for guided learning. A total of 200 medical students enrolled in a General and Descriptive Anatomy of the Locomotor System course were taught using two different methods. Ninety students in the experimental group used intelligent SIDRA (i-SIDRA), whereas 110 students in the control group received the same training but without employing i-SIDRA. RESULTS: In the students' final exam grades, a statistically significant difference was found between those students that used i-SIDRA as opposed to a traditional teaching methodology (T(162)=2.597; p=0.010). The increase in the number of correct answers during the feedback guided learning process from the first submission to the last submission in four multiple choice question tests was also analyzed. There were average increases of 20.00% (Test1), 11.34% (Test2), 8.88% (Test3) and 13.43% (Test4) in the number of correct answers. In a questionnaire rated on a five-point Likert-type scale, the students expressed satisfaction with the content (M=4.2) and feedback (M=3.5) provided by i-SIDRA and the methodology (M=4.2) used to learn anatomy. CONCLUSIONS: The use of audience response systems enriched with feedback such as i-SIDRA improves medical degree students' performance as regards anatomy of the locomotor system. The knowledge state diagrams representing students' behavior allow instructors to study their progress so as to identify what they still need to learn.

What's New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids.

Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n = 116) with that in equids ≥20 years of age (n = 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous system (7.9%), cardiovascular system (4.6%), urinary system (4.6%), reproductive system (4.2%), respiratory system (4.2%), integumentary system (4.2%), lymphoid system (2.5%), liver (2.5%), or systemic neoplasia (1.2%). Nervous system disease was more common in the 15- to 19-year group; urinary tract disease was more common in the ≥20-year group. Neoplastic disease, regardless of systemic location, was the basis for death or euthanasia in 18.7% of all equids. Squamous cell carcinoma, lymphoma, and melanoma were the most common malignant neoplasms. PPID was the most common specific diagnosis, based on the postmortem presence of hyperplasia or adenoma, and was the reason for euthanasia in 47.7% of 65 equids with PPID. The most common nonpituitary causes for death or euthanasia in equids with PPID were colic, lameness, cancer, and spinal cord disease. Coexisting conditions in equids with PPID that were not considered the basis for euthanasia included neoplasms, infections, lameness, and recurrent airway obstruction.

Changeability of tissue's magnetic remanence after galvanic-magnetostimulation in upper-back pain treatment.

OBJECTIVE: Research was conducted on parametric profiles of healthy subjects and patients with cervico-brachial pain syndrome resulting from C4/5 and/or C5/6 discopathy, including magnetic remanence of tissues in marker points 1-12 (L+R) and functional parameters, and their subsequent change after treatment in group A, using method of push-pull galvanic magnetostimulation (GMT 2.0). DESIGN: GMT 2.0 device, comprised of one air solenoid and three galvanic solenoids in electrolytic tubs, was designed for push-pull magnetostimulation of the head, coupled with simultaneous stimulation of the limbs. SETTING: Clinical trial was conducted in Outpatient Private Clinic "VIS" under the auspices of Silesian Higher Medical School in Katowice, Poland. PATIENTS: 55 subjects participated in the study: control group K consisted of 23 healthy individuals, whereas 33 patients in group A were treated using GMT 2.0. INTERVENTION: Only patients in group A were treated with GMT 2.0 during 40-min sessions over a period of 10 days. MAIN OUTCOME MEASURES: Parametric profile of the patients was defined using various measurements: electronic SFTR test (C-Th-shoulders), HR, RR, BDI and VAS tests, magnetic remanence in marker points 1-12 (L+R) and blood parameters: HB, ER, CREA, BIL, K(+), Na(+), Cl(-) Fe(2+), Ca(2+) and Mg(2+). RESULTS: There was a significant reduction in pain (VAS), increase in the range of motion (SFTR), lower depression symptoms (BDI), slower heart rate (HR), lower blood pressure (RR), greater concentration of Mg(2+), K(+), Ca(2+)ions and reduction in the concentration of BIL, CREA Fe(2+) after GMT 2.0 treatment in group A. Evaluation of magnetic remanence in marker points M1-12 (L+R) initially showed higher values in group K, which after treatment were normalized to values similar to those in group K. CONCLUSION: GMT 2.0 treatment in group A resulted in normalization of magnetic remanence, synergically with increased range of motion (SFTR test), decreased HR and RR parameters, smaller depressive trends (BDI test), as well as increased ion levels (K(+), Mg(2+), Ca(2+)) and better functional parameters of kidneys and liver.

Muscle and bone, two interconnected tissues.

As bones are levers for skeletal muscle to exert forces, both are complementary and essential for locomotion and individual autonomy. In the past decades, the idea of a bone-muscle unit has emerged. Numerous studies have confirmed this hypothesis from in utero to aging works. Space flight, bed rest as well as osteoporosis and sarcopenia experimentations have allowed to accumulate considerable evidence. Mechanical loading is a key mechanism linking both tissues with a central promoting role of physical activity. Moreover, the skeletal muscle secretome accounts various molecules that affect bone including insulin-like growth factor-1 (IGF-1), basic fibroblast growth factor (FGF-2), interleukin-6 (IL-6), IL-15, myostatin, osteoglycin (OGN), FAM5C, Tmem119 and osteoactivin. Even though studies on the potential effects of bone on muscle metabolism are sparse, few osteokines have been identified. Prostaglandin E2 (PGE2) and Wnt3a, which are secreted by osteocytes, osteocalcin (OCN) and IGF-1, which are produced by osteoblasts and sclerostin which is secreted by both cell types, might impact skeletal muscle cells. Cartilage and adipose tissue are also likely to participate to this control loop and should not be set aside. Indeed, chondrocytes are known to secrete Dickkopf-1 (DKK-1) and Indian hedgehog (Ihh) and adipocytes produce leptin, adiponectin and IL-6, which potentially modulate bone and muscle metabolisms. The understanding of this system will enable to define new levers to prevent/treat sarcopenia and osteoporosis at the same time. These strategies might include nutritional interventions and physical exercise.