Anatomy beyond the pandemic: A Q-methodology study exploring student perceptions toward a hybrid curriculum.

As a result of the COVID-19 pandemic, anatomy education was forced to adopt online modes of delivery. Previous research on student views revealed areas of strong preference (asynchronous lectures) and strong dislike (virtual specimens) in online anatomy courses. The current study seeks to compare the views of a single cohort of students experiencing both online and in-person undergraduate introductory anatomy and physiology courses. This comparison can highlight what students consider beneficial to their education and can inform future hybrid course offerings. Q-methodology was used to assess the opinions of students. Students sorted 41 statements on anatomy education in a quasi-normally distributed grid based on their degree of agreement with the statements. The rankings underwent a by-person factor analysis which categorized students with shared perceptions into groups. Data were collected from 246 students in the primarily online fall semester and 191 students in the primarily in-person winter semester. Analysis revealed three distinct factors (groups) in the cohort. Factor one (n = 113 (fall), n = 93 (winter)), was satisfied overall with the course materials and delivery. Factor two (n = 52 (fall), n = 18 (winter)) had a deep dislike of online learning, and factor three (n = 37 (fall), n = 49 (winter)) had a strong preference for online learning. While many students were comfortable in both online and in-person learning environments, this was not the case for all learners. The strengths and weaknesses of each teaching modality suggest the opportunity to explore hybrid learning as an option for future course offerings and specifically highlight valuable aspects to incorporate from each environment.

Student perceptions of hybrid delivery of interprofessional anatomy-The best of both worlds?

Interprofessional anatomy dissection (IAD) courses increase students' readiness for interprofessional education (IPE) both in-person and online. During the COVID-19 pandemic, virtual environments for anatomy learning were perceived as less effective. Hybrid instruction approaches emerged but have been scarcely evaluated. This study assessed students' experiences with a hybrid IAD course's virtual and in-person components. A hybrid IAD course consisting of virtual and in-person anatomy laboratory-based instruction was offered to 32 students from different health sciences programs. Before and after the full course, students completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). After the virtual and the in-person course components, students completed a Q-methodology survey to assess their perceptions of the course. Twenty-eight students (20 females; 24.8 ± 6.3 years old) from different programs (4 Physician Assistant; 2 Midwifery; 3 Speech-Language Pathology; 4 Physiotherapy; 3 Occupational therapy; 4 Nursing; 8 Medicine) participated. The total RIPLS score improved after the 8-week course (Median 84 interquartile range [78-87] vs. 87 [85-90]; p = 0.0145). The Q-methodology identified three factors: IPE & Virtual Enthusiasts, Introspective Learners, and IPE & Virtual Skeptics. Factors represented different levels of students' engagement with the IPE and virtual environment. The transition to in-person resulted in all factors praising the experience. Health science students showed improvements in their readiness for IPE after an 8-week hybrid IAD course. The main differences in the evaluations of the virtual and in-person components were related to engagement and the ability to learn anatomy; no differences were noted between settings regarding engagement in IPE.

The Effects of Exercise Serum From Prepubertal Girls and Women on In Vitro Myoblast and Osteoblast Proliferation and Differentiation.

PURPOSE: In girls and women, the authors studied the effects of an acute bout of low-impact, moderate-intensity exercise serum on myoblast and osteoblast proliferation in vitro. METHODS: A total of 12 pre/early pubertal girls (8-10 y old) and 12 women (20-30 y old) cycled at 60% VO2max for 1 hour followed by 1-hour recovery. Blood samples were collected at rest, mid-exercise, end of exercise, mid-recovery, and end of recovery. C2C12 myoblasts and MC3T3E1 osteoblasts were incubated with serum from each time point for 1 hour, then monitored for 24 hours (myoblasts) or 36 hours (osteoblasts) to examine proliferation. Cells were also monitored for 6 days (myoblasts) to examine myotube formation and 21 days (osteoblasts) to examine mineralization. RESULTS: Exercise did not affect myoblast or osteoblast proliferation. Girls exhibited lower cell proliferation relative to women at end of exercise (osteoblasts, P = .041; myoblasts, P = .029) and mid-recovery (osteoblasts, P = .010). Mineralization was lower at end of recovery relative to rest (P = .014) in both girls and women. Myotube formation was not affected by exercise or group. CONCLUSION: The systemic environment following one acute bout of low-impact moderate-intensity exercise in girls and women does not elicit osteoblast or myoblast activity in vitro. Differences in myoblast and osteoblast proliferation between girls and women may be influenced by maturation.

The Systemic Effects of Exercise on Regulators of Muscle and Bone in Girls and Women.

PURPOSE: To assess the systemic effects of an acute bout of moderate-intensity exercise on factors that are known to regulate muscle and bone growth in prepubertal girls and women. METHODS: A total of 12 prepubertal girls (8-10 y) and 12 women (20-30 y) cycled at 60% maximal oxygen uptake for 1 hour followed by 1 hour recovery. Blood samples were collected at rest, mid-exercise, end of exercise, mid-recovery, and end of recovery. Plasma was analyzed for interleukin-6, chemokine ligand 1, fibroblast growth factor-2, total insulin growth factor-1 (IGF-1), and free IGF-1 using enzyme-linked immunosorbent assays assays. RESULTS: Both groups had similar concentrations of systemic factors at baseline with the exception of free IGF-1, which was higher in girls (P = .001). Interleukin-6 response was lower in girls versus women (P = .04), with a difference of +105.1% at end of exercise (P < .001), +113.5% at mid-recovery (P = .001), and +93.2% at end of recovery (P = .02). Girls and women exhibited significant declines in chemokine ligand 1, fibroblast growth factor-2, and total IGF-1 during recovery. CONCLUSION: Compared with women, an acute bout of moderate-intensity exercise in girls elicits a lower inflammatory response, suggesting that other mechanisms may be more important for driving the anabolic effects of exercise on muscle and bone in girls.

Effects of plyometric exercise session on markers of bone turnover in boys and young men.

INTRODUCTION: The acute exercise effects on bone markers in adults are unclear, while in children, there are no such data. PURPOSE: To investigate the acute response of biochemical markers of bone turnover to a high-impact exercise session consisting of high-mechanical loading in boys and young men. METHODS: Twelve boys (10.2 ± 0.4 years) and 14 men (22.0 ± 0.8 years) underwent a protocol of plyometric jumping exercises (total 144 jumps). Venous blood samples were collected pre-, 5 min, 1 and 24 h post-exercise, and analyzed for markers of bone formation and resorption: bone-specific alkaline phosphatase (bone ALP), osteoprotegerin (OPG), amino-terminal cross-linking telopeptide (NTx), and receptor activator of nuclear factor kappa beta ligand (RANKL). RESULTS: Boys had higher resting bone ALP (111.9 ± 29.2 vs. 30.6 ± 11.2 µg/L, p < 0.05) and NTx levels (49.8 ± 13.2 vs. 21.7 ± 5.9 nM BCE, p < 0.05) than men but no group differences were observed in resting OPG or RANKL. Following exercise (24 h), bone ALP and NTx increased in both boys and men (bone ALP: 24.1 vs. 9.9%, respectively; NTx: 23.5 vs. -5%, respectively), although the group-by-time interaction was not statistically significant. OPG increased significantly (p < 0.05) in both groups (5.7 and 16.1 %, respectively). CONCLUSION: Even one session of plyometric exercises appear to stimulate bone formation in boys and men, as reflected by the increase in bone ALP and OPG. The boys' response appears more pronounced than the men's, suggesting that during growth, cellular bone activities respond with greater magnitude to mechanical stimuli.

Response of Bone Turnover Markers and Cytokines to High-Intensity Low-Impact Exercise.

INTRODUCTION: Low-impact, high-intensity interval exercise (HIE) was used to investigate the postexercise response in bone turnover markers and cytokines. METHODS: Twenty-three recreationally active males (21.8 ± 2.4 yr) performed one HIE bout on a cycle ergometer at 90% maximum workload. The total duration of the exercise was 12 min and included six 1-min high-intensity exercise intervals separated by 1-min rest intervals. Blood samples were collected before exercise, 5 min, 1 h, and 24 h after exercise and were analyzed for serum levels of anti- and pro-inflammatory cytokines (interleukin 10 [IL-10], interleukin 6 [IL-6], interleukin 1-alpha [IL-1α], interleukin 1-beta [IL-1ß], and tumor necrosis factor alpha [TNF-α]) and markers of bone formation (bone alkaline phosphatase [BAP], osteoprotegerin [OPG]) and resorption (amino-terminal cross-linking propeptide [NTX], receptor activator of NF-κB ligand [RANKL]). RESULTS: There was a significant (P < 0.05) time effect for all bone turnover markers. Post hoc analysis showed that BAP, OPG, and RANKL significantly increased from baseline to 5 min after exercise (10.9%, 13.5%, and 34.2%, P < 0.05). At 1 h after exercise, only BAP was significantly higher than baseline (9.5%, P = 0.010) and remained higher than baseline at 24 h (10.9%, P = 0.001). NTX was significantly lower than baseline 24 h after exercise (-14.6%, P = 0.046). Significant (P < 0.05) time effects were also observed for IL-1α, IL-1ß, IL-6, and TNF-α, with all four significantly increasing 5 min after exercise and returning to baseline levels 1 h after exercise. The postexercise changes in bone formation markers correlated positively with the anti-inflammatory cytokine (IL-10) and negatively with the pro-inflammatory cytokines while NTX correlated positively with a pro-inflammatory cytokine, TNF-α (P < 0.05). CONCLUSIONS: These results suggest that HIE stimulates a response in bone turnover markers and cytokines and that a correlation exists between immune and skeletal responses to this form of exercise. This type of exercise may benefit individuals for whom high-impact exercise might be contraindicated.

Acute versus chronic supplementation of sodium citrate on 200 m performance in adolescent swimmers.

BACKGROUND: A double-blinded, placebo-controlled, cross-over design was used to investigate whether two different sodium citrate dihydrate (Na-CIT) supplementation protocols improve 200 m swimming performance in adolescent swimmers. METHODS: Ten, male swimmers (14.9 ± 0.4 years of age; 63.5 ± 4 kg) performed four 200 m time trials with the following treatments: acute (ACU) supplementation (0.5 g kg(-1) administered 120 min pre-trial), acute placebo (PLC-A), chronic (CHR) supplementation (0.1 g∙kg(-1) for three days and 0.3 g kg(-1) on the forth day 120 min pre-trial), and chronic placebo (PLC-C). The order of the trials was randomized, with at least a six-day wash-out period between trials. Blood samples were collected by finger prick pre-ingestion, 100 min post-ingestion, and 3 min post-trial. Performance time, rate of perceived exertion, pH, base excess, bicarbonate and lactate concentration were measured. RESULTS: Post-ingestion bicarbonate and base excess were higher (P < 0.05) in both the ACU and CHR trials compared to placebo showing adequate pre-exercise alkalosis. However, performance time, rate of perceived exertion as well as post-trial pH and lactate concentration were not significantly different between trials. Further analysis revealed that five swimmers, identified as responders, improved their performance time by 1.03% (P < 0.05) and attained higher post-trial lactate concentrations in the ACU versus PLC-A trial (P < 0.05). They also had significantly higher post-trial lactate concentrations compared to the non-responders in the ACU and CHR trials. CONCLUSIONS: Acute supplementation of Na-CIT prior to 200 m swimming performance led to a modest time improvement and higher blood lactate concentrations in only half of the swimmers while the chronic Na-CIT supplementation did not provide any ergogenic effect in this group of adolescent swimmers. TRIAL REGISTRATION: Clinicaltrials.gov NCT01835912.