Mechanical stimulation of human dermal fibroblasts regulates pro-inflammatory cytokines: potential insight into soft tissue manual therapies

Objective Soft tissue manual therapies are commonly utilized by osteopathic physicians, chiropractors, physical therapists and massage therapists. These techniques are predicated on subjecting tissues to biophysical mechanical stimulation but the cellular and molecular mechanism(s) mediating these effects are poorly understood. Previous studies established an in vitro model system for examining mechanical stimulation of dermal fibroblasts and established that cyclical strain, intended to mimic overuse injury, induces secretion of numerous pro-inflammatory cytokines. Moreover, mechanical strain intended to mimic soft tissue manual therapy reduces strain-induced secretion of pro-inflammatory cytokines. Here, we sought to partially confirm and extend these reports and provide independent corroboration of prior results. Results Using cultures of primary human dermal fibroblasts, we confirm cyclical mechanical strain increases levels of IL-6 and adding long-duration stretch, intended to mimic therapeutic soft tissue stimulation, after cyclical strain results in lower IL-6 levels. We also extend the prior work, reporting that long-duration stretch results in lower levels of IL-8. Although there are important limitations to this experimental model, these findings provide supportive evidence that therapeutic soft tissue stimulation may reduce levels of pro-inflammatory cytokines. Future work is required to address these open questions and advance the mechanistic understanding of therapeutic soft tissue stimulation

Experience with and perception of research among third year osteopathic medical students

There is a lack of data regarding real and perceived barriers to research participation among osteopathic medical students (OMS’s). We have previously addressed this open question by surveying incoming first-year OMS1’s and found that the possibility of negative impact upon performance in coursework was the predominant concern among respondents at MU-COM. Here, we held a series of three focus groups with third-year OMS’s (n=23), which have completed preclinical training, to gather current perceptions and evaluate how those perceptions may have shifted throughout their preclinical experience. Focus group sessions were facilitated by two OMS2’s and audio recorded for transcription; participants were anonymized and the transcripts analyzed for themes. Participation was voluntary and incentivized by a raffle for Amazon gift cards. This study was deemed exempt by the MU Institutional Review Board. Focus group participants expressed that the importance of research relied heavily upon intrinsic motivations for research or the desire to further their career via establishment of a professional network with their mentor or improving competitiveness for residency positions. Unlike our prior survey findings among incoming OMS1’s, OMS3’s reported monetary compensation was of little importance and possibly would discourage them from performing research due to the perceived added pressure that money would generate. Some perceptions, however, remained consistent throughout the medical training thus far. Both incoming and post-preclinical students placed a great deal of value upon time and establishing themselves academically. This proved to possibly preclude students from undertaking research. Another robust theme observed between both incoming OMS1’s and OMS3’s is the strong desire for clinical research opportunities. This longitudinal approach to research perceptions will prove valuable in enacting change to the research culture and opportunities provided here at MUCOM

Addressing Motivations and Barriers to Research Involvement during Medical School among Osteopathic Medical Students in the United States

Involvement in research is regarded as a high-impact educational practice, which, for medical professionals, is associated with sharpened critical thinking and life-long learning skills, greater appreciation for evidence-based medicine, and better clinical competence scores. However, there are limited data regarding the research experience and/or interest among osteopathic medical students in the United States despite a rapidly increasing enrollment and expansion of the number of osteopathic medical schools. Thus, we administered an electronic survey examining prior research experience, interests, and perceptions about research participation during medical school to four successive classes of incoming first-year osteopathic medical students. We also performed focus groups with rising third-year osteopathic medical students around the topic of perceived barriers to and potential enablers of promoting research participation. This yielded a survey addendum where first-year osteopathic medical students provided feedback on the likelihood of specific incentives/enablers to encourage participation in research during medical school. Overall, osteopathic medical students are interested in research, view research experience as valuable, and perceive research experience as beneficial to future career development. Students perceive that the primary barrier to involvement in research is a potential negative impact upon performance in coursework. Feedback on the likelihood of specific enablers/incentives was also garnered. Our findings from a single institution may have important implications in defining the prior experiences and perceptions held by first-year osteopathic medical students. Specifically, our study indicates that research experiences intentionally designed with (1) a strong likelihood of gaining a publication, (2) financial compensation, and (3) the opportunity for short-term involvement, a flexible time commitment, and/or a dedicated time period are most likely to encourage research participation by osteopathic medical students