bluuebunny/crossref_metadata_2025 huggingface dataset:
An Aberrant Pronator Quadratus with Possible Flexor Function at the Wrist
Authors: Tufts Kristina , Gibson Ginny , Feuchter Fred , Lewis Christina
Published: June 2021

Hand specialists rely on anatomical knowledge to properly assess and treat patients. Our study sought to describe clinically relevant variations that may facilitate accurate diagnoses and effective treatment and management of hand disorders. Forearms from 21 embalmed cadavers (n=42, ages 55‐97, mean 80) were dissected and observed for anomalous attachment points, innervations, muscle shape, and fascicle orientation. Here we report a bilateral aberrant pronator quadratus (PQ) in a single cadaver, whose features suggest its role as a wrist flexor. Typically, the PQ, a flat quadrilateral muscle spanning the distal quarter of the forearm, initiates pronation. Its superficial fibers traverse the anterior surfaces of the radius and ulna, while its deep fibers bind them together. The aberrant PQ has both superficial and deep bellies originating on the lateral surfaces of these bones with the muscle fascicles oriented obliquely (pennation=80° for radial bellies, bilaterally; 60° for left, 48° for right ulnar bellies). Each PQ has tendons from the radial (1 from right, 2 from left) and ulnar bellies (2 from right, 1 from left). In both forearms, these form a common tendon that travels distally across the radioulnar joint, through the carpal tunnel floor, and inserts onto the capitate. Collectively, these features suggest an additional function of wrist flexion, similar to a rare flexor carpi radialis brevis. Thus, the aberrant PQ may not have been the typical initiator of forearm pronation, and perhaps other muscles compensated, i.e., pronator teres, brachioradialis, and/or flexor carpi radialis. To conclude, awareness of diverse hand anatomy is critical for clinical examination and management of hand disorders.
Influence of the meniscofemoral ligaments on the morphology of the posterior cruciate ligaments ‐ an MRI assisted morphometric analysis of different phases in life.
Authors: Hirtler Lena , Röhrich Sebastian , Kainberger Franz
Published: June 2021

Purpose

The morphology of the meniscofemoral ligaments and the posterior cruciate ligament varies during different stages of life. This study shows those alterations and highlights the age in which the change to the anatomy occurs.

Material and methods

Retrospective study of 342 knee MRIs. The patients were allocated to five age groups depending on their respective age at the date of examination. The main focus laid on the incidences, the length and the cross‐sectional area of the meniscofemoral ligaments and their relationship to the posterior cruciate ligament in different phases of life.

Results

The MFLs are present in the vast majority of people and can be seen as part of the normal human anatomy. Above the age of 10 years, there is no significant difference in the incidence of the MFLs. Length growth of the MFLs is concluded below the age of 11 years, but the MFLs still keep increasing in cross‐sectional area. Single MFLs are significantly larger in cross‐sectional area than the same MFL in knees with both MFLs present. The cross‐sectional area of the PCL is significantly larger if the pMFL is missing.

Conclusion

The MFLs of the human knee are non‐dispensable structures working in synergy with other elements of the knee joint, especially the PCL. Absence is compensated by the other, present MFL or by the PCL through larger than average morphometrics. Further studies need to be conducted to ascertain if simple absence of the MFLs without compensation may be correlated with pathologies of the knee joint.
Microscopic Anatomy and Pathology Laboratories: Design of an E‐Learning Atlas as an Evolving Response to Interdisciplinary Medical Curricular Needs
Authors: Davis Michelle , Mills Alexandra , Karcher Donald , Latham Patricia , Krum Janette , Jurjus Rosalyn
Published: June 2021

E‐learning, also known as computer‐assisted learning, successfully bridges anatomical knowledge and transferrable skills, such as critical analysis, teamwork, and communication. Several institutions have integrated histology and physiology in team based laboratory approaches, but integration of histology and pathology instruction has been done to a lesser extent. Our aim was to develop an e‐learning atlas that integrates microanatomy and pathology laboratories for an interdisciplinary medical curriculum.

A multidisciplinary team developed an online atlas (microanatomyatlas.com) that includes a library of histology and histopathology images. Traditional laboratory manual instructions and study objectives were linked to specific labeled images and made interactive to allow for self‐testing. Clinical case studies involving a disease entity were incorporated, which allows students to toggle between normal as well as the pathological slides as they apply their clinical reasoning skills. Data is being collected on the number and frequency of students using the atlas. Also, a detailed survey to assess student satisfaction and learning will be administered.

Our preliminary data so far shows that student feedback has been positive and an e‐learning atlas integrating microanatomy and pathology laboratory may be an essential tool that guides the studies and enhances the performance of medical students.

Acknowledgements

American Educational Institute, University and Campus Management (AEIUCM).
The Effectiveness of Active Learning in Histotechnology and Parasitology Techniques‐based Laboratory Courses
Authors: Dubansky Brooke , Hoger Sally
Published: June 2021

Active learning, a learning style that incorporates hands‐on activities that allow the learner to interact with the course material, has been shown to improve student learning outcomes. While labs are active by nature, traditional undergraduate science laboratories are expository, requiring students to follow steps in a procedure to attain a predetermined result (i.e., “cookbook labs”). While it is well‐established that active learning has a higher educational value than passive learning, the physical act of doing a lab activity is not enough to enable students to understand concepts, make connections, and retain complex material in the long‐term. The purpose of our study was to identify ways to increase the educational value of our histotechnology and parasitology laboratories without drastically restructuring the curriculum. We used a two‐group, pre‐ and post‐quiz experimental design. In our experimental group, we incorporated three common learning activities (strip‐sequence activity, concept mapping, and clickers) into labs that had long waiting times in between procedural steps. We hypothesized that incorporating these activities would give students an opportunity to recall and internalize the conceptual information and that this would lead to a deeper understanding of the procedures, long‐term retention of the material, and the ability to think about the lab procedure at higher order levels of thinking. Preliminary results show that this is a promising strategy for lab instruction, with quiz scores in the experimental group improving for two out of the three lab activities. Students also reported feeling more engaged and having a deeper understanding of the material.
Ethical Issues in the Use of Willed Bodies in Anatomical Education
Authors: Champney Thomas
Published: June 2021

The use of willed bodies in the anatomical education of health care professionals has been shown to be a valuable and foundational component to their education. While the beneficial use of willed bodies in education has been studied in numerous settings, the ethical treatment of the donated bodies has not been as thoroughly examined. This topic was addressed at the recent International Federation of Associations of Anatomists (IFAA) meeting by members of a subcommittee of the federation, the Federative International Committee for Ethics and Medical Humanities (FICEM). This committee will issue guidelines on the proper ethical use of willed bodies in the near future and plans to act as the central site for information on ethics in anatomy.

Specific issues regarding the ethical procurement and treatment of willed bodies include 1) providing proper respect and dignity to the donors both before and after donation, 2) obtaining complete informed consent from the donors, 3) the use and distribution of images obtained from the willed bodies, 4) the distribution of donated bodies to distant sites from their original community, 5) the distribution of separate parts of willed bodies to different institutions and 6) the ability to financially profit from the willed body donors. Each of these issues will be addressed from an understanding of the ethical value of human tissue. This will ensure that those individuals who have altruistically donated their bodies will be cared for properly and ethically.
A student proposal for ethical guidelines in anatomical education: ethical and policy considerations
Authors: Kahn Peter , Gardin Tova
Published: June 2021

The recent publication of a story regarding anatomical dissection in a medical school reveals that increased attention to the ethical and policy aspects of anatomical education is required. While most of the attention devoted to these questions thus far has been focused on procedures before and after dissection, from the perspective of medical students, there are important considerations during the process of dissection itself. This proposal suggests that basic ethical guidelines should be established and monitored by an independent committee tasked with reviewing them. The guidelines proposed include:

1. A clear set of expectations regarding what is required of students throughout the course in the realms of education, ethics, and behavior.

2. The establishment of an oversight group composed of students, faculty, community members, and staff who will regularly review the anatomical education program and update these ethical guidelines as appropriate. This committee will also ensure that the students and instructors alike have ready access to all available information regarding their cadavers, should the donors wish to make this information available.

3. The use of materials that encourage students to view their donors with respect and ensure proper treatment of the donor.

4. The establishment of minimal ethical standards regarding respectful behavior toward the donor bodies.

While many of these items are already present in certain anatomy departments, the establishment of clear guidelines will permit students the freedom to fully participate in their education knowing that they have met the highest ethical standards as they prepare for a career as a humanistic physician.
How a Professional Identity is Forged in the Anatomy Lab for Medical Students
Authors: Krebs Claudia , Parhar Anita , Parhar Gurdeep
Published: June 2021

It is recognized that the development of a professional identity is significantly influenced by experiences in academic and clinical settings, and through certain rites of passage, such as, learning from cadavers. Little is known, however, about how the experiences in the cadaver lab actively shape the development of the Professional. To understand the impact the experiences in the anatomy lab have on students' professional identity formation, first year students were surveyed before and their first anatomy session. Four months after commencing their anatomy sessions, students completed another survey and focus groups were conducted. In both the survey and focus groups, students were asked to explore their perceptions of themselves as students, physicians in training, idealized physicians, and the congruency between values held and behaviors displayed. When asked to rank their own development and the perception of their peers in the anatomy lab, students positioned themselves on the pathway towards the medical professional. They ranked those students coping best with the experience as closest to the qualities of a physician they admire. The emphasis on professionalism in the course had a positive impact on their experience. While cadavers have historically been used to teach anatomy, the findings from this study indicate that the same anatomy labs significantly contribute to the formation of the professional. As medical curricula across the world continue to evolve, the goal should be to preserve the rich experience gained by cadaver dissection.
Accomdating Students Suffering from PTSD in the Gross Anatomy Laboratory
Authors: Mussell Jason
Published: June 2021

As the United States sees an increase in the number of veterans returning from conflicts abroad it would not be surprising to also see an increase in the number of veterans attempting to enter the health related fields. Specifically, given the increase of survivable combat injuries the military needs higher numbers in the nursing and allied health fields. Gross Anatomy and Physiology are often required courses in these fields and include a laboratory component. Anatomy dissection laboratories are emotionally taxing and more so for individuals, and the large number of veterans, suffering from post‐traumatic stress disorder (PTSD). The generation of an accommodation for the laboratory experience, equitable to both those suffering from PTSD and their classmates, will become a necessity for admitting institutions. The author's experience has shown the need to be proactive in this arena and to develop a virtual laboratory curriculum that emphasizes the concepts stressed in the gross laboratory as well as generating a means of assessing anatomic knowledge consistent with and comparable to those employed with students performing cadaveric dissections. Detailed dissection guidelines and anatomic relationships that can be observed in the virtual dissector will be emphasized, structure lists assigned to laboratory students will also be given to students suffering from PTSD with the intention of the student demonstrating these structures using the vetted sources provided, and in lieu of the traditional practicum, weekly presentations will be employed for all students. Assessment of this accommodation is forthcoming, but the need for this conversation is immediate.
Evaluation of Role of Dissection in Medical Education: A Case Study of Imo State University Nigeria
Authors: IHENTUGE CHURCHILL , Ugochukwu Chioma
Published: June 2021

INTRODUCTION: The medical anatomy course has become a complex and complicated educational experience, in which dissection of the human body instructs not only in structure and function, but also in psychosocial areas critical to the development of the whole physician. Dissection is being sidelined in medical education. Computers and other alternative teaching tools are replacing cadavers in the modern anatomy curriculum.

AIMS AND OBJECTIVE: To evaluate and compare the role of cadaveric dissection with other teaching tools in anatomic education.

METHOD: This study took place at the college of medicine, Imo state university Nigeria. Two hundred and sixty eight (268) preclinical medical students participated in this study. A matrix‐grid questionnaire was used and participants were asked to score five methods of anatomy teaching used in the college (lectures, dissection, prosection, models and PC software/TV packages) using a 5‐point Likert type scale on the ability to achieve learning objectives. The data was analysed using the Krusekal‐Wallis and Mann‐Whitney methods to evaluate differences in scores between teaching methods.

RESULTS: Results showed that the most suitable tool for learning anatomy is cadaveric dissection having scored highest in cumulative objectives while PC software/TV package was the least method. Prosection, lectures and models appear in between.

CONCLUSION

Traditional cadaveric dissection remains the best method of teaching anatomy. The other methods of learning play complementary roles. Efforts should be made to device means of regular supply of cadavers to medical institutions rather than withdrawing cadaveric dissection from medical curriculum.
Student Learning Outcomes and Retention of the Cardiovascular System in Cadaver‐Based and Computer‐Based Anatomy Courses: A Comparative Study
Authors: Locke Benjamin , Nusse Gloria
Published: June 2021

Human cadavers are used in universities and medical schools across the United States for the purpose of learning the human body's intricate systems. These cadavers provide students with tangible, concrete specimens that reinforce concepts covered in lecture. However many anatomy programs have begun to shift toward computer‐based lessons that use software to render images of the human body; this method is not only inexpensive, but convenient for departments. This study attempts to observe any differences in initial learning outcomes and the retention of material between cadaver‐based and computer‐based undergraduate anatomy courses learning the cardiovascular system. Both the cadaver‐based (CAD) course and the computer‐based (COMP) course completed their respective lessons on the cardiovascular system. The following week, a voluntary quiz was given to each course consisting of fifteen questions assessing students' knowledge of cardiovascular anatomy and blood circulation. Three weeks later, a follow‐up quiz will be given to the same students that is similar to the first quiz. Statistical analyses will be done to determine if significant group differences were present at either of the two time points.
LabLink: Journaling via Multimedia in Anatomical Dissections
Authors: Dudgeon Sarah , Fox Glenn , Alsup Kathleen
Published: June 2021

Thorough laboratory procedure and findings documentation is a valuable asset, as it fosters active participation and provides resources for further study outside of the classroom. We propose an electronic lab journal, LabLink, which includes a traditional journal alongside documentation via photographs and short videos. Students can document anatomical variations, pathologies and anatomical relationships via Bluetooth connected hardware. The multimedia is stored in a large‐scale database available to future students and researchers. The database is stored in SQL format and searchable with a user‐friendly interface. The electronic journal software provides analytics on student use and grade correlation. LabLink electronic journal is an asset in learning and technological advancement in anatomical dissection.

An alpha prototype was used to qualitatively test medical students' reactions to both the software and the alterations to expected lab duties. A beta prototype was then made and tested in a lab session with four groups of eight students using the journal, and four groups of eight students without. Test scores and specific anatomical understanding were then compared. Additionally, user analytics were studied post‐experimentally.

Students were intrigued by the alpha prototype and were particularly interested in its advanced technologic approach.

LabLink is looking forward to expansion into advanced, hands‐free hardware technologies, additional test periods with larger sample sizes and use in anatomy labs for classes other than first year medical students.
Getting Active with Musculoskeletal Anatomy Instruction
Authors: Brooks William
Published: June 2021

Educational research has shown that instructional methods utilizing active learning approaches enhance student engagement in the classroom and promote increased learning and content retention. Recent trends in medical education have included the replacement of traditional didactic instruction with a variety of active learning methods. The purpose of this study was to determine the result of replacing didactic instruction in musculoskeletal gross anatomy with one active learning approach, team‐based learning (TBL), in a pre‐clinical Musculoskeletal & Skin course. In the 2014 course gross anatomy of the lower limb was taught through five traditional lectures and six cadaveric dissections. In contrast, upper limb anatomy was taught through a set of independent learning modules, three TBL activities, and six cadaveric dissections. Students' learning was assessed by both practical laboratory examination and written, vignette‐style examination. A comprehensive final examination was administered utilizing test items from the NBME question bank at the course conclusion. We compared student performance on anatomy‐related exam items from the written examinations in the 2014 course and found that mean performance increased by five points after incorporating TBL. We further compared performance on identical upper limb exam items of the 2014 student cohort with that of the 2013 cohort, which was taught by traditional lecture; students taught by TBL scored on average 2 points higher (p=0.15). Mean performance on anatomy‐related items on the NBME final examination was identical between years. We asked students to report their preferred method of anatomy instruction on course evaluations. Forty‐eight percent reported a preference for didactic lecture while 52% preferred self‐study and TBL.
Evaluation of a Virtual 3D Learning Resource in Neuroanatomy for Undergraduate Medical Students
Authors: Allen Lauren , Eagleson Roy , de Ribaupierre Sandrine
Published: June 2021

In contrast to traditional teaching strategies, e‐learning presents the opportunity for development of learner‐centered educational tools, tailored to meet each student's distinct needs; however this has yet to be examined fully in the literature. Our study's cross‐over design divided participants into two groups, each beginning with anatomy knowledge and visuo‐spatial ability tests, followed by access to either the 3D online learning module or the gross anatomy laboratory. Participants were administered a second anatomy knowledge test, prior to switching to the other learning modality. There were no significant differences between groups in their baseline anatomy knowledge or visuo‐spatial abilities. Students who first accessed 3D online resources scored significantly better than students who accessed gross anatomy resources on the first anatomy knowledge test. After learning with both modalities, there were no significant differences between groups. No correlations were found between spatial ability and assessment score. Students responded positively to the 3D module, and their learning outcomes were equivalent or improved compared to when taught in the gross anatomy lab. Larger studies are required to confirm these preliminary results. Results may be used to help establish guiding principles to facilitate the design and implementation of effective and efficient e‐learning curricula.
E‐Learning: Effective or Defective? The Impact of Commercial E‐Learning Tools on Learner Cognitive Load and Anatomy Instruction
Authors: Van Nuland Sonya , Rogers Kem
Published: June 2021

The rising popularity of commercial anatomy e‐learning tools has occurred, in part, due to increasing class sizes and a reduction in anatomy laboratory hours at many educational institutions. Using a dual‐task methodology, we examined two anatomical e‐learning tools (Netters 3D and ADAM Interactive) to determine the effect of their design on cognitive load. We hypothesize that longer reaction times on a modified Stroop secondary task would indicate a higher cognitive load imposed by the primary task (Anatomy Software), which would interfere with learning. Learners (n=7) were assessed using a baseline anatomy knowledge test, secondary task response times, and an anatomy knowledge post‐test. Results showed that when students use ADAM, they have significantly longer reaction times on the secondary task than when they use Netters (1525ms±433 and 1060ms±56 respectively, p=0.039). Ironically, students appeared to perform better on post‐test measures when using ADAM than when using Netters (3.17±1.83 and 1.33±1.21 respectively, p=0.130). These results suggest that ADAM, which is a simplistic 2‐dimensional e‐learning tool, sustains learner attention and facilitates learning more effectively than Netters 3D, a 3‐dimensional interactive e‐learning platform. A study is underway with 50 participants to determine if the trends seen in the initial experiment are consistent within a larger student population.
Using a Multimedia Dissection Tool in Human Anatomy Lab
Authors: Zhang Xiaoming , Enders George , Alexander Ann , Ryan Jamison , Al‐Kofahi Mejalli , Cullan Jarrod , Paolo Tony , Magnifico Christina
Published: June 2021

During anatomy lab dissections, paperback dissectors and atlases are frequently used tools navigating students through detailed dissection procedures and guiding them for structure identifications. Electronic devices such as computers and iPads consolidate these tools. The purpose of this project is to utilize computer technology and provide students an interactive video dissection guide so that the text descriptions are converted to spoken language and the still images are “live” to them. We hope that this will also save students time in dissection. In the past five years, with the help of a Sky‐Eye video camera, we have accumulated hundreds of hours of dissection video recordings done by our anatomy faculty for review purpose. These video recordings were reviewed and studied by three medical students in the summer of 2014. Short video clips that can be used as dissection procedure guidance were selected and composed into a dissection book on a computer. The dissection book contains brief text descriptions inserted with less than 5 minutes long video instructions for dissection. The completed dissection book was loaded onto iPads and made available to each dissection tank. Students can follow the video clip instructions throughout their dissections. The evaluation of this interactive video dissection guide is done by a post‐exam questionnaire and the answers are subjected to statistical analysis.
Enhancing Clinical Gross Anatomy through Mobile Learning and Digital Media
Authors: Krause Bentley , Riley Mark , Taylor Matthew
Published: June 2021

Mobile learning (m‐learning) enhances knowledge across multiple contexts through the use of personal electronic devices. To foster student engagement, we developed and implemented an iPad enabled gross anatomy laboratory. In this paper we will discuss how m‐learning interactive connectivity, functional application and learner control enriches the gross anatomy experience. iPad technology was integrated to help drive the dissection procedure through online dissectors; confirm the relations and functions of structures in situ using highly rated anatomy “apps”; promote student interaction in teams to solve the dissection and clinical case problems; and provide a platform to view medical imaging and clinical correlations. Real‐time video and image capture allow for shared understanding of clinical and functional anatomy. Preliminary quantitative and qualitative data indicate increases in students' assessment scores on pin practical, written and oral exams, and imaging case presentations. Over 85% of students responded positively to the iPad technology. Gross anatomy dissection is one of the most transformational experiences of graduate healthcare professions education and should NOT be replaced. Rather, m‐learning engages student‐team interaction, refines important anatomical connections and correlations, and provides contexts for the application of anatomy knowledge.
iPads in the Cadaver Lab – A Complement to Dissection and Study
Authors: Donohue Miriam , Vilburn Matthew , Conta Steencken Amanda , Stearns Susan
Published: June 2021

We developed an iBook‐based Human Anatomy lab manual with step‐by‐step dissection photos, self‐assessment quizzes, and written instructions in order to streamline the dissection procedures and provide an interactive study tool for students.

Although other anatomy labs have used iBook‐based manuals, ours (entitled 'The Anatomist's Guide: A Complement to Dissection and Study') is composed primarily of photos taken during 4 cadaveric dissections (two males and two females) completed by our faculty. We generated a photo bank of over 3600 digital images and more than 900 of these were incorporated into the 27 chapters of this iBook‐based manual. The dissection assignments in each chapter have photo galleries showing initial skin cuts, muscle reflections, nerves or blood vessels that may be at risk during the exposure process, major organs, and landmarks. All photos have captions and markers indicating caudal/rostral orientation and prone vs. supine positioning. In addition to the photos, every chapter includes written dissection instructions, a list of structures to identify, and self‐assessment quizzes.

The Anatomist's Guide iBook was successfully integrated into Gross Anatomy courses offered in our Colleges of Medicine and Health Professions. During each lab period there is one iPad provided per dissection table. There are also 4 iPads permanently secured in accessible locations throughout the lab, and 5 iPads on reserve in the library for study purposes.

We found that the addition of iPads to the cadaver lab has proven to be a successful complement to the dissection experience and a study tool well utilized by the students.

Funding was provided by our institution: Medical Alumni Association, Dean of the College of Medicine, and Educational Communications department.
Long‐term Retention and Effectiveness in a Large‐sized Flipped Gross Anatomy Course for Doctoral of Physical Therapy Students
Authors: Day Leslie
Published: June 2021

Flipped‐classroom is a blended‐learning pedagogy in which students obtain knowledge of the material before class, and utilize class time for deeper learning and comprehension as well as application. Current research suggests students obtain a higher‐level of learning and increase engagement in the material, when compared to a traditional course. However, little research has been conducted to show the effects on retention of material and application into future coursework. Across two years (2013‐2014), two cohorts of students in a Doctorate of Physical Therapy program took Gross Anatomy followed by Kinesiology in the subsequent semester. In 2013, 106 students took both a traditional Gross Anatomy course followed by a traditional Kinesiology course. In 2014, 114 students took Gross Anatomy in a flipped‐classroom model, followed by a traditional Kinesiology course. Students' answers to individual test questions, overall test scores and semester scores were compared between the two cohorts to determine the effectiveness of the flipped classroom between the two cohorts and ability to answer higher‐level learning questions in Gross Anatomy. Analysis was also conducted to assess the long‐term retention of material as demonstrated in Kinesiology, as well as the ability to apply the material to higher‐level application questions.
The flipped anatomy classroom. Principles of swimming to avoid sinking.
Authors: Morton Davd , Colbert‐Getz Jorie
Published: June 2021

The flipped classroom (FC) experience has been described in literature in a variety of ways. Additionally, research on the FC is mixed in terms of its effectiveness. One possibility for the mixed results could be how the FC was implemented in each study. Studies that have shown positive results of the FC have the following key elements (a) pre‐assigned work often in the form of readings or videos, (b) application and/or synthesis of material during class time, (c) the professor acting as a facilitator, and (d) motivated students. We proposed that what enables faculty and students to sink or swim in the FC depends upon the effective implementation of all 4 elements acting in a system, not just one or two good elements in isolation. The University of Utah School of Medicine (UofUSOM) implemented the FC approach to replace first and second year anatomy lectures. Outcomes of the FC were assessed for the first level of Kirkpatrick's framework for evaluation‐ participation and reaction. The outcomes were used to design best practices guidelines for the four key elements on the FC. Principles learned from this past year will be relayed during this presentation.
Two years of experience with near‐peer anatomists in a new medical school's setting
Authors: Barash Alon , Dickman Nomy , Reis Shmuel , Karasik David
Published: June 2021

In response to the shortage of medical doctors in Israel, a new Faculty of Medicine was established in a remote locale (Galilee). Here we report on a 2 years of our near‐peer teaching program of cooperative learning. Our near‐peer teacher course was designed for 1st year medical students who successfully finished the Anatomy block, in order to develop their anatomy teaching skills, mostly for dissection, and their didactic ability, to be applied in the next academic year. In a debriefing questionnaire administered at the end of the course, on the five‐point Likert scale the overall rating for the “elective course” was 4.33. Learning prosection and anatomy demonstration skills scored 4.3 and 4.15, respectively. Importantly, the participants appeared at ease in the dissecting room amongst their peers; they were able to prepare and confidentially lead a case‐based learning session. The top course graduates (selected based on their peer evaluations to serve as near‐peer teachers) were then evaluated by their more junior peers (first‐year students), at the end of the next year's Anatomy block. On the Likert scale, the average score was 4.10, somewhat lower than the general satisfaction score for the preclinical teachers during the first‐year classes (4.22). We conclude that students as peer teachers can make a valuable contribution to the teaching faculty, especially in a new school. Personal gain in terms of confidence, focus and motivation are at least as important as practical dissection and teaching skills.
Ultrastructure and Histological Analyses of Cardiac Injury in Ciona intestinalis
Authors: Evans‐Anderson Heather
Published: June 2021

Ciona intestinalis is a well‐characterized invertebrate model system presenting many advantages to understanding evolutionarily conserved regulatory mechanisms in chordates. Interestingly, the Ciona myocardium is reported to regenerate throughout the life cycle, making Ciona a good candidate for studying heart formation and myocardial repair mechanisms. In order to evaluate the cardiac regenerative response to injury, Ciona hearts were ligated and fixed for TEM or immunohistochemical analysis following 24 or 48 hour recovery periods. Ultrastructure analysis via TEM showed increased sarcomeric disorganization; changes in the sarcolemma; increased intracellular space; increased thickness of an extracellular matrix in the heart lumen, and increased mitochondrial area as time progressed. Modified Movat's Pentachrome staining identified distinct layers of extracellular matrix in the Ciona heart. Specifically, a low collagen contribution as well as punctuate muscle‐specific bodies within the pericardial layer. The luminal extracellular matrix was identified as having a mucin composition. The changes observed in the Ciona myocardium are similar to those observed in zebrafish; however, there are distinct differences in the cellular composition and matrix organization in Ciona. The changes seen in the Ciona intestinalis heart provide an injury model in which further molecular studies could be performed in order to elucidate the regulatory mechanisms of cardiac repair and regeneration in higher order organisms.
The epiploic flow‐through flap: preoperative evaluation of right gatroepiploic artery on multidetector computed tomography.
Authors: Settembre Nicla , Malikov Sergueï , Bouziane Zakariyae , Braun Marc
Published: June 2021

The gastroepiploic artery (GEA) and the greater omentum are nowadays commonly used in many reconstructive surgeries including cardiac, vascular and plastic surgery. There are cases in which the GEA is found to be unsuitable only after partial harvesting following an upper laparotomy, and an improved method of preoperative evaluation is required to eliminate the need for intraoperative small laparotomy

Methods

Multidetector computed tomography was performed for 30 consecutive patients admitted for lower limb ischemia in a routine preoperative evaluation of lower limb atherosclerotic arteritis. The origin of the GEA was checked on coronal and sagital slices, its pathway was identified on the three‐dimensional rendering. We assessed length and mean diameter of the distal and proximal right GEA, and the mean distances between the origins of GEA and the omental branches.

Results

30 patients were included in our study. Routine pre operative MCDT during lower limb artherosclerotic arteritis workup enabled identification of GEA in all cases

The mean internal diameter of the GEA at its origin was 3.28mm (±3.3). The mean internal diameter of the distal GEA was 1.26mm (±0.29). The mean length of GEA was 23,22cm (± 5,28). At least one omental descending branch was detected and in 63% (19 patients) at least two branches were visualised.

Conclusion

Routine preoperative MDCT imaging is an effective tool to assess precisely the different anatomical properties of the GEA. This exam could be useful for both diagnosis of lower limb arteritis and evaluation of the GEA suitability for flow‐through flap lower limb revascularisation.
Lymphangioma: Differential diagnosis of a cadaveric nodular pigmented lesion
Authors: Alavalapadu Aparna , Bhandari Ankit , Schlegel Elisabeth , Kirera Francis
Published: June 2021

Proper examination of the gross anatomy and histopathology of skin lesions such as lymphangiomas allow physicians to correctly identify and diagnose medical conditions. Objective of this study was to histologically examine a cadaveric nodular, pigmented lesion harvested from a formalin‐embalmed cadaver provided by the Department of Anatomy. Histological techniques such as embedding in paraffin, hematoxylin and eosin staining and light microscopy were used to characterize the lesion.

Histologically, widely spaced irregular vascular channels lined by a very thin wall of endothelial cells were observed. This finding provided evidence to discard the working hypothesis of a melanoma and correctly diagnose the lesion as lymphangioma. Relying solely on the gross features of the skin lesion made it difficult to accurately determine the pathology and prognosis of a lesion, resulting in misdiagnosis. Failure to diagnose a lymphangioma can put a patient's health in jeopardy if the lesion cannot be identified and a proper course of treatment not provided. Therefore, it is imperative that physicians biopsy skin lesions examining beyond the gross anatomy features.
The Effects of Green Tea on the Adrenal Cortex of Aged Rats, a Histological Study
Authors: Othman Manal
Published: June 2021

Background

Green tea is well known for its anti oxidant and anti inflammatory properties. In this study we sought to analyze the protective effects of prolonged consumption of green tea on the adrenal cortex of aged rats.

Material and Methods

Thirty female albino rats were divided into three groups of ten animals each. Group I: the control group, 6 months‐old rats. Group II: aged, 18‐month‐old rats. Group III: Green tea treated rats, which included 12 month‐old rats that consumed green tea at a dose of 300 mg/Kg body weight orally by a gastric tube for a duration of 6 months. The adrenal gland was obtained from the three assigned groups and processed for light microscopic evaluation.

Results

In the aged rats, the adrenal cortex appeared to have some degenerative changes in the three layers of the adrenal cortex, namely zona glomerulosa, fasciculata, and reticularis. The changes ranged from increase in the vacuolizations of the cytoplasm of the cells, and darkening of their nuclei. With the administration of green tea, there was improvement of some of these histological changes.

Conclusion

Aging resulted in some degenerative changes in the rat adrenal cortex which were ameliorated by the administration of green tea.
BMP‐pSmad1/5/8 Pathway Activation in Calcific Aortic Valve Disease
Authors: Gomez Maria , Yutzey Katherine
Published: June 2021

Calcific Aortic Valve Disease (CAVD) affects >2% of the elderly population for whom the standard of care is valve replacement surgery. Unfortunately, the pathogenic mechanisms of CAVD, which could serve as potential therapeutic targets, remain unknown. Klotho‐null mice exhibit accelerated aging and aortic valve (AoV) calcification similar to human CAVD. Notably, phosphorylation of Smads1/5/8, Bone Morphogenetic Protein (BMP) pathway effectors essential for bone calcification, precedes and later localizes with calcific nodules in Klotho‐null AoV. Our hypothesis is that BMP pathway activation promotes AoV calcification. Our goal is to determine the role of the BMP pathway in the pathogenesis of CAVD and to use a pharmacologic inhibitor of BMP signaling as a potential treatment for CAVD in vivo. Our current studies demonstrate that osteochondrogenic factors involved in bone and cartilage formation are significantly increased in Klotho‐null AoV. In addition, BMP pathway components, including BMP2/4, Smad6 and Noggin, are significantly up‐regulated in Klotho­‐null AoV. Moreover, in porcine AoV interstitial cells cultured in vitro, osteogenic media treatment induces osteochondrogenic gene expression and activation of the BMP‐pSmad1/5/8 pathway, as well as formation of calcific nodules. Interestingly, treatment with LDN‐193189, a BMP pathway inhibitor, decreases osteochondrogenic gene induction and prevents calcific nodule formation in the presence of osteogenic media. Together these data support an active role for BMP signaling during osteochondrogenic gene induction and the development of AoV calcification.

AHA Pre‐doctoral Fellowship 13PRE1623006 ‐MVG

NIH R01 HL114682 ‐KEY.
High Intensity Interval Grip (HIIG) Exercise Does Not Induce Post‐Exercise Hypotension in Older Women
Authors: Bentley Danielle , Thomas Scott
Published: June 2021

Handgrip has been used as an exercise stimulus to perturbate blood pressure over the long‐term (2‐16mmHg reduction) and short‐term (1‐3mmHg reduction). Majority of previous research has been completed using a commercial device (Zona) with a preset exercise protocol of 4x2min @ 30%MVC with 1min rest intervals. Acute exercise using ZONA modestly reduces SBP and increases HR shortly following exercise cessation in mixed samples of middle aged to older men and women. The purpose of this research was to compare the acute cardiovascular impact of Zona exercise to an in‐house accessible protocol of 32x5sec @ 100%MVC with 5sec rest intervals (High Intensity Interval Grip: HIIG) in older (age:57.7±5.2yrs), normotensive (109±9.4/73.1±7.8mmHg), post‐menopausal (8.4±5.6yrs) women. Nineteen women completed 5 laboratory visits; familiarization, baseline, and three randomly assigned experimental conditions: Zona, HIIG, and Control. For each experimental visit, resting SBP, DBP, and HR were made every 2min for 10mins, exercise was completed, and then post‐exercise SBP, DBP, and HR were made every 3min for 30mins. There were two calculations of post‐exercise hemodynamics; a 30min average change and a 6min rolling average change. There were no statistically significant changes from rest in the 30mins post‐exercise for all variables. As a description, based on 30min average change values Zona resulted in increased SBP (+1.6mmHg), increased DBP (+1.4mmHg), and reduced HR (‐2.1bpm) while HIIG resulted in slightly reduced SBP (‐0.2mmHg), slightly increased DBP (+0.2mmHg), and reduced HR (‐2.2bpm). The absence of BP reduction with either acute stimulus suggests cardiovascular regulation differs in this cohort of normotensive, post‐menopausal women. Canadian Institutes of Health Research, CGS Doctoral Award.
Zeb2: A novel regulator of cardiac fibroblast to myofibroblast transition
Authors: Jahan Fahmida , Rattan Sunil , Dixon Ian , Wigle Jeffrey
Published: June 2021

Cardiac fibroblast to myofibroblast phenoconversion is a critical step in cardiovascular disease progression. Myofibroblasts contribute to cardiac fibrosis by chronic extracellular matrix remodelling and scar formation which subsequently results in myocardial stiffening, impaired contraction, cardiac dysfunction and eventually to heart failure. Previously we showed that Meox2, a homeobox transcription factor, is highly expressed in fibroblasts compared to myofibroblasts. As well we demonstrated that Meox2 can inhibit myofibroblast phenoconversion by down‐regulating a set of myofibroblast markers. Here we report for the first time that Zeb2, a repressor of Meox2 and an epithelial‐mesenchymal transition inducer, may play a crucial role during this phenoconversion process. Using rat cardiac fibroblasts, we have shown that Zeb2 overexpression causes an up‐regulation of a set of myofibroblast markers‐ SMemb, ED‐A fibronection and α‐SMA. We showed that Zeb2 is highly expressed in myofibroblast nuclei whereas it is only minimally expressed in fibroblasts as observed by immunoblotting and confocal microscopy. Moreover, ectopic Zeb2 expression results in a less migratory phenotype‐ characteristic of mature myofibroblasts. We also showed that Zeb2 overexpression represses Meox2 expression in endothelial cells. We will investigate the role of Zeb2 in myofibroblast proliferation, apoptosis and function in vitro. Thus findings from our study will provide insight to understand the mechanism behind myofibroblast phenoconversion and may provide a basis for developing a Zeb2‐based novel anti‐fibrotic drug in the future.
Growth Dynamics and Mononucleation of the Ventricular Conduction System
Authors: Sedmera David , Gourdie Robert
Published: June 2021

During embryonic development, mammalian myocyte size does not change significantly. The switch from hyperplastic to hypertrophic growth occurs during the neonatal period. All previous studies have focused on working myocytes, which form 99% of ventricular mass; little is known about developmental changes in cell size, shape, and nucleation of cells of the ventricular conduction system (VCS). Hearts from Cx40:GFP transgenic mice were sampled at embryonic day 14, postnatal day 10, and adulthood (6 months). The ventricles were dissected, nuclei stained whole mount with Hoechst 33342, and specimens cleared in Scale/2 and flat mounted for confocal microscopy. Z‐series were acquired using a 40x oil immersion lens spanning at least 50 mm. Cell dimensions, nuclear count and volumes were measured separately for working and VCS myocytes. At the embryonic stage, green (Cx40‐expressing VCS cells) were larger than negative myocytes. This difference was reversed at postnatal day 10, where there was also differences in size between left bundle branch cells and Purkinje myocytes. The difference in cell volume was most pronounced at the adult stage. The transverse diameter was significantly smaller in adult VCS cells, giving them more elongated shape. Binucleated VCS cells were observed only rarely (<5%) during embryonic and neonatal stages; none (0/82) were seen in the adult. In conclusion, we show that the VCS in mouse is formed by a morphometrically distinct mononucleated cells with shape and size significantly different from working myocytes

Supported by AAA travel grant and GACR P302/11/1308 and 13‐12412S.