MSK-TIM: A Telerobotic Ultrasound System for Assessing the Musculoskeletal System.

The aim of this paper is to investigate technological advancements made to a robotic tele-ultrasound system for musculoskeletal imaging, the MSK-TIM (Musculoskeletal Telerobotic Imaging Machine). The hardware was enhanced with a force feedback sensor and a new controller was introduced. Software improvements were developed which allowed the operator to access ultrasound functions such as focus, depth, gain, zoom, color, and power Doppler controls. The device was equipped with Wi-Fi network capability which allowed the master and slave stations to be positioned in different locations. A trial assessing the system to scan the wrist was conducted with twelve participants, for a total of twenty-four arms. Both the participants and radiologist reported their experience. The images obtained were determined to be of satisfactory quality for diagnosis. The system improvements resulted in a better user and patient experience for the radiologist and participants. Latency with the VPN configuration was similar to the WLAN in our experiments. This research explores several technologies in medical telerobotics and provides insight into how they should be used in future. This study provides evidence to support larger-scale trials of the MSK-TIM for musculoskeletal imaging.

From Movements to Metrics: Evaluating Explainable AI Methods in Skeleton-Based Human Activity Recognition.

The advancement of deep learning in human activity recognition (HAR) using 3D skeleton data is critical for applications in healthcare, security, sports, and human-computer interaction. This paper tackles a well-known gap in the field, which is the lack of testing in the applicability and reliability of XAI evaluation metrics in the skeleton-based HAR domain. We have tested established XAI metrics, namely faithfulness and stability on Class Activation Mapping (CAM) and Gradient-weighted Class Activation Mapping (Grad-CAM) to address this problem. This study introduces a perturbation method that produces variations within the error tolerance of motion sensor tracking, ensuring the resultant skeletal data points remain within the plausible output range of human movement as captured by the tracking device. We used the NTU RGB+D 60 dataset and the EfficientGCN architecture for HAR model training and testing. The evaluation involved systematically perturbing the 3D skeleton data by applying controlled displacements at different magnitudes to assess the impact on XAI metric performance across multiple action classes. Our findings reveal that faithfulness may not consistently serve as a reliable metric across all classes for the EfficientGCN model, indicating its limited applicability in certain contexts. In contrast, stability proves to be a more robust metric, showing dependability across different perturbation magnitudes. Additionally, CAM and Grad-CAM yielded almost identical explanations, leading to closely similar metric outcomes. This suggests a need for the exploration of additional metrics and the application of more diverse XAI methods to broaden the understanding and effectiveness of XAI in skeleton-based HAR.

Mechanical Stimulation of Adipose-Derived Stromal/Stem Cells for Functional Tissue Engineering of the Musculoskeletal System via Cyclic Hydrostatic Pressure, Simulated Microgravity, and Cyclic Tensile Strain.

It is critical that human adipose-derived stromal/stem cell (hASC) tissue engineering therapies possess appropriate mechanical properties in order to restore the function of the load-bearing tissues of the musculoskeletal system. In an effort to elucidate hASC response to mechanical stimulation and develop mechanically robust tissue-engineered constructs, recent research has utilized a variety of mechanical loading paradigms, including cyclic tensile strain, cyclic hydrostatic pressure, and mechanical unloading in simulated microgravity. This chapter will describe the methods for applying these mechanical stimuli to hASC to direct differentiation for functional tissue engineering of the musculoskeletal system.

Revision of the muscular system in the brachiopod Novocrania anomala using 3D reconstruction: Functional and paleontological significance.

The musculature is one of the best studied organ systems in brachiopods, being approachable not only by dissecting recent species of brachiopods, but also by exploring muscle scars in fossil material. In the present study, the muscular anatomy of Novocrania anomala is studied using 3D reconstructions based on microcomputed tomography. Muscles of N. anomala may be subdivided into two groups: those related to movements of the lophophore, and those connected to movements of shell valves. Muscles, their morphology and possible functions, such as brachial protractors, elevators, and retractors, as well as anterior adductors, are described and discussed. We also provide the discussion of craniid muscle terminology, consider the valve-opening mechanism. The investigation of muscle scars on dorsal valves supports the conclusion that the shape of muscle scars should be used for description and distinction of recent and extinct species only when visible distinctness cannot be explained by substrate differences. This study, which is aimed at improving our understanding the anatomy and functioning of muscles in craniids, will be useful not only for zoologists, but also for paleontologists.

Ultrasound imaging of the transversus nuchae muscle: a potential entrapment site for the lesser occipital nerve.

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Social Work and Motivation for Rehabilitation in Children with Disorders of the Musculoskeletal System.

The relevance of the presented article is due to the lack of information on the impact of social work in the development of rehabilitation motivation in children with disorders of the musculoskeletal system. This research aimed to evaluate the role of social work in shaping rehabilitation motivation in children with musculoskeletal disorders. Using a questionnaire, the study involved 43 children and their carers who received social support and 20 who did not. Analysis revealed a significant correlation between the absence of social support and rehabilitation outcomes. The results underlined the value of rehabilitation, with a predominantly positive response to its methods and outcomes. The data also suggested that the absence of social work could increase the likelihood of unfavorable outcomes. By highlighting the need for comprehensive treatment and rehabilitation strategies, this research provides a basis for improving rehabilitation approaches. Addressing the challenges highlighted could pave the way for optimized public health strategies.

Identifying essential factors for energy-efficient walking control across a wide range of velocities in reflex-based musculoskeletal systems.

Humans can generate and sustain a wide range of walking velocities while optimizing their energy efficiency. Understanding the intricate mechanisms governing human walking will contribute to the engineering applications such as energy-efficient biped robots and walking assistive devices. Reflex-based control mechanisms, which generate motor patterns in response to sensory feedback, have shown promise in generating human-like walking in musculoskeletal models. However, the precise regulation of velocity remains a major challenge. This limitation makes it difficult to identify the essential reflex circuits for energy-efficient walking. To explore the reflex control mechanism and gain a better understanding of its energy-efficient maintenance mechanism, we extend the reflex-based control system to enable controlled walking velocities based on target speeds. We developed a novel performance-weighted least squares (PWLS) method to design a parameter modulator that optimizes walking efficiency while maintaining target velocity for the reflex-based bipedal system. We have successfully generated walking gaits from 0.7 to 1.6 m/s in a two-dimensional musculoskeletal model based on an input target velocity in the simulation environment. Our detailed analysis of the parameter modulator in a reflex-based system revealed two key reflex circuits that have a significant impact on energy efficiency. Furthermore, this finding was confirmed to be not influenced by setting parameters, i.e., leg length, sensory time delay, and weight coefficients in the objective cost function. These findings provide a powerful tool for exploring the neural bases of locomotion control while shedding light on the intricate mechanisms underlying human walking and hold significant potential for practical engineering applications.

EURO-MUSCULUS/USPRM Dynamic Ultrasound Protocols for Ankle/Foot.

ABSTRACT: In this dynamic scanning protocol, ultrasound examination of the ankle is described using various maneuvers to assess different conditions. Real-time patient examination and scanning videos are used for better simulation of daily clinical practice. The protocol is prepared by several/international experts in the field of musculoskeletal ultrasound and within the umbrella of European Musculoskeletal Ultrasound Study Group in Physical and Rehabilitation Medicine/Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine.

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.

Applications of Diffusion-Weighted MRI to the Musculoskeletal System.

Diffusion-weighted imaging (DWI) is an established MRI technique that can investigate tissue microstructure at the scale of a few micrometers. Musculoskeletal tissues typically have a highly ordered structure to fulfill their functions and therefore represent an optimal application of DWI. Even more since disruption of tissue organization affects its biomechanical properties and may indicate irreversible damage. The application of DWI to the musculoskeletal system faces application-specific challenges on data acquisition including susceptibility effects, the low T2 relaxation time of most musculoskeletal tissues (2-70 msec) and the need for sub-millimetric resolution. Thus, musculoskeletal applications have been an area of development of new DWI methods. In this review, we provide an overview of the technical aspects of DWI acquisition including diffusion-weighting, MRI pulse sequences and different diffusion regimes to study tissue microstructure. For each tissue type (growth plate, articular cartilage, muscle, bone marrow, intervertebral discs, ligaments, tendons, menisci, and synovium), the rationale for the use of DWI and clinical studies in support of its use as a biomarker are presented. The review describes studies showing that DTI of the growth plate has predictive value for child growth and that DTI of articular cartilage has potential to predict the radiographic progression of joint damage in early stages of osteoarthritis. DTI has been used extensively in skeletal muscle where it has shown potential to detect microstructural and functional changes in a wide range of muscle pathologies. DWI of bone marrow showed to be a valuable tool for the diagnosis of benign and malignant acute vertebral fractures and bone metastases. DTI and diffusion kurtosis have been investigated as markers of early intervertebral disc degeneration and lower back pain. Finally, promising new applications of DTI to anterior cruciate ligament grafts and synovium are presented. The review ends with an overview of the use of DWI in clinical routine. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 3.

Using represented bodies in Renaissance artworks to teach musculoskeletal and surface anatomy.

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.

Development of the vertebra and fin skeleton in the lamprey and its implications for the homology of vertebrate vertebrae.

BACKGROUND: Although vertebrae are the defining character of vertebrates, they are found only in rudimentary form in extant agnathans. In addition, the vertebrae of agnathans possess several unique features, such as elastin-like molecules as the main matrix component and late (post-metamorphosis) differentiation of lamprey vertebrae. In this study, by tracing the developmental process of vertebrae in lamprey, we examined the homology of vertebrae between lampreys and gnathostomes. RESULTS: We found that the lamprey somite is first subdivided mediolaterally, with myotome cells differentiating medially and non-myotome cells emerging laterally. Subsequently, collagen-positive non-myotome cells surround the myotome. This pattern of somitogenesis is rather similar to that in amphioxi and sheds doubt on the presence of a sclerotome, in terms of mesenchyme cells induced by a signal from the notochord, in lamprey. Further tracing of non-myotome cell development revealed that fin cartilage develops in ammocoete larvae approximately 35 mm in body length. The development of the fin cartilage occurs much earlier than that of the vertebra whose development proceeds during metamorphosis. CONCLUSION: We propose that the homology of vertebrae between agnathans and gnathostomes should be discussed carefully, because the developmental process of the lamprey vertebra is different from that of gnathostomes.