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The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

Traditionally, human anatomy is taught using cadaveric human or animal specimens, however such materials are not always available or are quite costly. Alternate instructional methods can include software, models, clay models, and illustrations. Unfortunately, while cost effective, these methods lack the ability to demonstrate the "in situ" three-dimensional relationships between anatomical structures. This study examined one alternative method of instruction, the construction of threedimensional paper models, which are currently limited in availability, and mostly designed for teaching medical anatomy programs. This study set out to determine (1) if a paper model system could be used to highlight the anatomic complexity of specific anatomic regions, (2) if a model system primarily designed for medical anatomy programs could be customized to topics and made appropriate for undergradute anatomy courses, and (3) if this low-technology and inexpensive form of instruction is an effective tool in teaching musculoskeletal anatomy. Students were given a series of four models to assemble during a time period of 4-weeks. Students were assessed with a series of paired questions before and after the model exercise relating to: number of muscles, plane of muscle, depth of structure, name and function of muscle. Comparison of the pre and post-test data demonstrated a gain in knowledge. Thus, the utilization of paper models are a viable and cost effective pedagogical tool for undergraduate anatomical education.

This paper describes how an anatomy and physiology laboratory class transitioned from a paper-based lab to an online learning platform that updated the curriculum to rely more on face-to-face small group collaboration and peer teaching. Student perceptions of the new format were positive, but halfway through the transition a global pandemic challenged the new instruction method. The face-to-face curriculum had to be adjusted to a virtual format that lacked in-person interaction between the instructor and the students. This switch to virtual labs had an adverse effect on both student perception and student performance in the second half of the semester. Our observations underscore the importance of creating an interactive community when teaching virtually.

The time, material, and staff-consuming nature of anatomy's traditional pen-and-paper assessment system, the increase in the number of students enrolling in medical schools and the ever-escalating workload of academic staff have made the use of computer-based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students' performance was designed. Additionally, students' opinions toward CBA were gathered. Second-year medical students attending a Clinical Anatomy course were randomized by clusters in two groups. The pen-and-paper group attended two sessions, each consisting of a traditional sectional anatomy steeplechase followed by a theoretical examination, while the computer group was involved in two similar sessions conducted in a computerized environment. At the end of each of the computer sessions, students in this group filled an anonymous questionnaire. In the first session, pen-and-paper group students scored significantly better than computer-group students in both the steeplechase (mean ± standard deviation: 66.00 ± 14.15% vs. 43.50 ± 19.10%; P < 0.001) and the theoretical examination (52.50 ± 12.70% vs. 39.00 ± 21.10%; P < 0.001). In the second session, no statistically significant differences were found for both the steeplechase (59.50 ± 17.30% vs. 54.50 ± 17.00%; P = 0.085) and the theoretical examination (57.50 ± 13.70% vs. 54.00 ± 14.30%; P = 0.161). Besides, an intersession improvement in students' perceptions toward CBA was registered. These results suggest that, after a familiarization period, CBA might be a performance equivalent and student accepted alternative to clinical anatomy pen-and-paper theoretical and practical examinations.

The use of technology-enhanced learning (TEL) resources is now a common tool across a variety of healthcare programs. Despite this popular approach to curriculum delivery there remains a paucity in empirical evidence that quantifies the change in learning gain. The aim of the study was to measure the changes in learning gain observed with anatomy drawing screencasts in comparison to a traditional paper-based resource. Learning gain is a widely used term to describe the tangible changes in learning outcomes that have been achieved after a specific intervention. In regard to this study, a cohort of Year 2 medical students voluntarily participated and were randomly assigned to either a screencast or textbook group to compare changes in learning gain across resource type. Using a pre-test/post-test protocol, and a range of statistical analyses, the learning gain was calculated at three test points: immediate post-test, 1-week post-test and 4-week post-test. Results at all test points revealed a significant increase in learning gain and large effect sizes for the screencast group compared to the textbook group. Possible reasons behind the difference in learning gain are explored by comparing the instructional design of both resources. Strengths and weaknesses of the study design are also considered. This work adds to the growing area of research that supports the effective design of TEL resources which are complimentary to the cognitive theory of multimedia learning to achieve both an effective and efficient learning resource for anatomical education.

The intersection of art and science is a space useful not only to communicate scientific concepts to the general public but also to allow those of us studying biology in depth to view our work in a different light. I myself enjoy playing with the universality of anatomy, that is its bits and pieces that compose every human being. In mixing these with an array of mediums, colours, and textures, I hope to evoke a multiplicity of emotions in the viewer.

The anatomical and chemical properties of a lesser known species, Kawui wood, were investigated Two trees were examined based on IAWA, ASTM and SNI. A completely randomised design was used with radial direction of the trunk (sapwood and heartwood) as the factor, in three replications. It indicated the highest to lowest cell proportions are fibres, rays, vessels and parenchyma. The highest proportion of rays was in the sapwood, while the fibre was in the heartwood. However, the average fibre length in the sapwood was higher than the heartwood, while the lumen diameter showed the reverse. Holocellulose, α-cellulose, lignin, extractives, and ash content of the sapwood was higher than the heartwood. Based on its anatomical and chemical properties, Kawui wood can be included in grade II–IV, which is suitable for medium quality pulp and paper production. [ABSTRACT FROM AUTHOR]

To investigate the geometric morphological differences of the lacrimal punctum by analyzing its shape in relation to age and sex in a normal population. 960 high-magnification slit-lamp images were obtained from 320 puncta of normal asymptomatic Indian individuals across eight decades of life. Using advanced geometric morphometric techniques, including Elliptic Fourier Analysis and Principal Component Analysis, the intricate details of the lacrimal punctum's shape in a diverse population sample were categorized by age and sex. High-resolution images of the lacrimal punctum underwent standardization for scale and orientation, followed by precise landmark identification and coordinate data extraction. The geometric morphometry of the lacrimal punctum shows significant changes as one ages. However, the gender differences, in isolation, without consideration of age, remain subtle and are not pronounced. Interestingly, detailed Principal Component scores analysis revealed potential sex- and age-related variations specifically for the left and right lower puncta, which warrant further investigation. These changes could reflect unique aging changes in the proximal lacrimal drainage system. The study is a starting point for geometric morphometric analysis of the lacrimal punctum and provides valuable insights into the punctal changes in size, orientation, and overall morphology across different age groups and between sexes. These findings highlight the significance of considering individual age-wise anatomical variations to better understand the lacrimal punctum. [ABSTRACT FROM AUTHOR]

Background: Inguinal hernias remain a challenging area of learning for medical students due to its relatively complex anatomy. Modern curriculum delivery methods are conventionally limited to didactic lectures and demonstration of anatomy intraoperatively. These strategies have limitations; lectures are inherently descriptive and based on 2-dimensional models, while intraoperative teaching is often unstructured and opportunistic. Methods: A paper-based model was developed comprising three overlapping paper panels simulating the anatomical layers of the inguinal canal which can be modified readily to further simulate various hernia pathologies and their surgical repair. These models were incorporated into a timetabled structured learning session for 3rd- and 4th-year medical students. Learners responded to fully anonymised surveys before and after the learning session. Findings: A total of 45 students participated in these sessions over a period of 6 months. Pre-learning session mean ratings for the learners' confidence in their understanding of the layers of the inguinal canal, identifying indirect and direct inguinal hernias and in naming the contents of the inguinal canal were 2.5, 3.3 and 2.9, while post-learning session mean ratings were 8.0, 9.4 and 8.2, respectively. Paired samples Student's t-tests for all three questions were statistically significant (p < 0.001). The mean rating for usefulness of the session was 9.6/10. Free comments from students emphasised the models' usefulness as a visual learning aid. Discussion and Conclusion: Our novel, low-cost paper model was associated with an improvement in learners' perceived knowledge and understanding of inguinal canal anatomy and pathology. [ABSTRACT FROM AUTHOR]

Education research is increasingly being recognized as a legitimate route for faculty development in universities. However, many anatomy faculty lack the appropriate training and access to experienced mentors who can help them develop their own education research projects. Inspired by the American Physiological Society's Institute for Teaching and Learning, the coauthors proposed and developed the inaugural Anatomy Education Research Institute (AERI 2017). Funded by an American Association of Anatomists Innovations grant, the five-day institute was held in Bloomington, Indiana in July 2017. The coauthors spent two years preparing the conference schedule, inviting speakers who could discuss education research topics and mentor applicants, reviewing applications, developing assessment instruments for the institute, and hosting the institute. A total of 62 registered participants (applicants and invited speakers) attended AERI 2017. Through a series of presentations and workshops, participants were introduced to many aspects of education research and the Scholarship of Teaching and Learning, including developing rigorous education research questions, determining appropriate methods to assess these questions, and searching the education research literature. Each day also included regular time devoted to work on their own education research project with help from more experienced mentors. Throughout the conference, participants were encouraged to post information on Twitter, using the hashtag #AERI2017. Participants had strong positive impressions of the conference and strongly requested future AERI conferences be held. Follow-up analyses will assess the institute in alignment with Kirkpatrick's Four Levels of Evaluation Model, though preliminary evaluation indicates AERI 2017 met the original aims of the proposal.

This paper focuses on the papermaking inventions that, beginning with the Flemish physician Andreas Vesalius' De humani corporis fabrica (1543), became part of anatomy books. In particular, flaps became the tactile and visual tool that allowed, by progressively lifting individual flaps of paper (lift the flap), to represent the layered arrangement of organs and apparatuses of the human body. These movable devices, along with others (e.g., volvelle) widely employed especially in astronomy texts, became the educational complements of the new science. The paper reconstructs, through some significant samples, the evolution of interactive anatomical books up to the threshold of the 20th century. [ABSTRACT FROM AUTHOR]

Objective To quantify the 100 most frequently cited papers in CPT for predicting research hotspots for benefitting future clinical outcomes. Methods Web of Science database was searched for publications related to CPT original research from January 1, 1900 to December 31,2022. And Cited Reference Search tool was employed for retrieving articles to determine the most cited item. Then a knowledge map was generated for number of citations, publication year, publication periodical, author unit, publication country and key words. Results Top 100 selected articles were cited from 11 to 196 times and publication period started from 1928 to 2016. Clinical research was the major type ( n = 93) and only 7 studies belonged to basic research. The largest contribution came from the United States ( n = 37),followed by Republic of Korea ( n = 9), Germany ( n = 6) and Italy ( n = 6) . The frequently appearing keywords were divided into 2 groups of "Neurofibroma" and "Clinical characteristic of pseudarthrosis". And term "NFl" was the latest hot spot in the most cited article. Conclusion Current researches on CPT focuse upon clinical treatment. Basic research on the pathogenesis of CPT is still relatively lacking. In the future, investment in basic research on CPT should be strengthened to provide a more comprehensive treatment for CPT. [ABSTRACT FROM AUTHOR]

Assessment of learners in the anatomical sciences is a complex task as it not only tests students' fact knowledge, but also the analysis of visual information. Sometimes, novice histology learners must acquire image recognition skills of microscopic structures in a short time frame. This paper describes a strategy of offering first year dental students at the University of Michigan a short, non-grade contributing, formative assessment quiz in order to better prepare them for a high-stakes, final summative histology examination. Data collected over 7 years indicate that students, who made use of this formative assessment opportunity, performed significantly better in their summative examination than students, who did not. Especially early practice quiz users profited most. Students, who used the practice quiz until they achieved a perfect score, also had statistically higher final examination scores. Students, who did not use the practice quiz, had a significantly lower cumulative D1-year Grade Point Average (D1-GPA) than students, who did, indicating that academically weaker students often underuse supporting learning resources. In general, scores from the Dental Admission Test (DAT) were weak predictors of learning success in the DENT 510 histology course. In contrast, the D1-GPA values had a medium strength positive correlation with final histology examination scores. The major problem that was encountered with this practice quiz strategy was that many students waited until close to the day of the final examination before taking advantage of this feedback opportunity, thereby reducing its potential benefit for improving their overall learning strategy for histology.

3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.

Bagasse from early species of Saccharum officinerum-Co 89003 has 71.36% useful, long, and thick-walled fibers with good slenderness ratio, but the rigidity coefficient is less than that of Eucalyptus tereticornis and Leucaena leucocephala. The kink index and kink per mm length are lower in bagasse fiber than E. terticornis, which gives rise to fewer weak points in the fiber. Low alcohol–benzene soluble substances in bagasse induce less pitch problems and favor more homogeneity in the paper. Lignin content in bagasse is comparable to Eucalyptus globulus and Leucaena leucocephala, but α-cellulose, and pentosans are slightly lower. A higher proportion of carbon content compared to hydrogen and oxygen increases the energy value of bagasse. It produces 42.2% pulp yield of kappa number 28.2 at optimum cooking conditions, such as active alkali 12% (as Na2O), temperature 150oC, and time (at temperature) 60 min. An addition of 0.1% anthraquinone at the optimum condition improves pulp yield by 2.6% and mitigates kappa number by 3.9 units.

Triticum aestivum PBW-343 is grown in most of the regions of India, and it is one of the renewable sources most suitable for papermaking. Anatomical studies illustrate that vascular bundles near the periphery contain a strong sheath of sclerenchyma cells, which constitutes about 80% of the fibers. The total fibers in wheat straw are about 39.20%, and parenchyma and epidermal cells account for 32.10, and 23.56%, respectively, of the total cells. The dimensions of wheat straw fibers are: average fiber length 1.18 mm, fiber width 13.60 µm, lumen diameter 5.68 µm, and cell wall thickness 3.96 µm. The dimensions of non-fibrous cells are: parenchyma 445x124 µm, vessels 96x57 µm, and epidermal cells 390x38 µm, which lie between the corresponding values for rice straw, and bagasse. Flexibility coefficients and Runkel ratio of wheat straw fires are quite comparable to bamboo. The low lignin contents of wheat straw reflect that it requires mild cooking conditions; however, hemicelluloses are on higher side. Addition of AQ under optimum soda cooking conditions improves pulp yield by 0.75%, and lowers kappa number by 26.1%. Optimum strength properties are obtained at 45±1 oSR except tear index, which declines with increased refining. The fine contents are much higher, and relatively comparable to Eucalyptus tereticornis in terms of curl index and kinks per mm.

Background: The use of filter paper as a simple, inexpensive tool for storage and transportation of blood, ‘Dried Blood Spots’ or Guthrie cards, for diagnostic assays is well-established. In contrast, there are a paucity of diagnostic evaluations of dried cerebrospinal fluid (CSF) spots. These have potential applications in low-resource settings, such as Laos, where laboratory facilities for central nervous system (CNS) diagnostics are only available in Vientiane. In Laos, a major cause of CNS infection is Japanese encephalitis virus (JEV). We aimed to develop a dried CSF spot protocol and to evaluate its diagnostic performance using the World Health Organisation recommended anti-JEV IgM antibody capture enzyme-linked immunosorbent assay (JEV MAC-ELISA). Methodology and Principal Findings: Sample volumes, spotting techniques and filter paper type were evaluated using a CSF-substitute of anti-JEV IgM positive serum diluted in Phosphate Buffer Solution (PBS) to end-limits of detection by JEV MAC-ELISA. A conventional protocol, involving eluting one paper punch in 200μl PBS, did not detect the end-dilution, nor did multiple punches utilising diverse spotting techniques. However, pre-cut filter paper enabled saturation with five times the volume of CSF-substitute, sufficiently improving sensitivity to detect the end-dilution. The diagnostic accuracy of this optimised protocol was compared with routine, neat CSF in a pilot, retrospective study of JEV MAC-ELISA on consecutive CSF samples, collected 2009–15, from three Lao hospitals. In comparison to neat CSF, 132 CSF samples stored as dried CSF spots for one month at 25–30°C showed 81.6% (65.7–92.3 95%CI) positive agreement, 96.8% (91.0–99.3 95%CI) negative agreement, with a kappa coefficient of 0.81 (0.70–0.92 95%CI). Conclusions/Significance: The novel design of pre-cut filter paper saturated with CSF could provide a useful tool for JEV diagnostics in settings with limited laboratory access. It has the potential to improve national JEV surveillance and inform vaccination policies. The saturation of filter paper has potential use in the wider context of pathogen detection, including dried spots for detecting other analytes in CSF, and other body fluids. [ABSTRACT FROM AUTHOR]

Neuroanatomy is a notoriously challenging subject for medical students to learn. Due to the coronavirus disease-19 (COVID-19) pandemic, anatomical education transitioned to an online format. We assessed student performance in, and attitudes toward, an online neuroanatomy assessment compared to an in-person equivalent, as a marker of the efficacy of remote neuroanatomy education. Participants in the National Undergraduate Neuroanatomy Competition (NUNC) 2021 undertook two online examinations: a neuroanatomically themed multiple-choice question paper and anatomy spotter. Students completed pre- and post-examination questionnaires to gauge their attitudes toward the online competition and prior experience of online anatomical teaching/assessment. To evaluate performance, we compared scores of students who sat the online (2021) and in-person (2017) examinations, using 12 identical neuroradiology questions present in both years. Forty-six percent of NUNC 2021 participants had taken an online anatomy examination in the previous 12 months, but this did not impact examination performance significantly (p > 0.05). There was no significant difference in examination scores between in-person and online examinations using the 12 neuroradiology questions (p = 0.69). Fifty percent of participants found the online format less enjoyable, with 63% citing significantly fewer networking opportunities. The online competition was less stressful for 55% of participants. This study provides some evidence to suggest that student performance is not affected when undertaking online examinations and proposes that online neuroanatomy teaching methods, particularly for neuroradiology, may be equally as effective as in-person approaches within this context. Participants perceived online examinations as less stressful but raised concerns surrounding the networking potential and enjoyment of online events.

Recent studies have reported incipient morphological caste dimorphism in the Van der Vecht organ size of some temperate Polistes paper wasps. Whether species other than the temperate ones show a similar pattern remains elusive. Here, we have studied some Neotropical Polistes species. By comparing females collected through the year, we showed caste related differences in the size of the Van der Vecht organ in P. ferreri (body size corrected Van der Vech organ size of queens = 0.45 ± 0.06, workers = 0.38 ± 0.07 mm2, p = 0.0021), P. versicolor (body size corrected Van der Vech organ size of queens = 0.54 ± 0.11, workers = 0.46 ± 0.09 mm2, p = 0.010), but not P. simillimus (body size corrected Van der Vech organ size of queens = 0.52 ± 0.05, workers = 0.49 ± 0.06 mm2, p = 0.238). Therefore, it seems that queens and workers of some Neotropical Polistes have diverged in their ontogenic trajectory of the Van der Vecht organ size, providing clear evidence for incipient morphological caste dimorphism. As Polistes are distributed mostly in the tropics, we propose that physical caste differences may be widespread in the genus. Also, we highlight that morphological divergence in the queen–worker phenotypes may have started through differential selection of body structures, like the Van der Vecht organ. [ABSTRACT FROM AUTHOR]

This paper describes how an anatomy and physiology laboratory class transitioned from a paper-based lab to an online learning platform that updated the curriculum to rely more on face-to-face small group collaboration and peer teaching. Student perceptions of the new format were positive, but halfway through the transition a global pandemic challenged the new instruction method. The face-to-face curriculum had to be adjusted to a virtual format that lacked in-person interaction between the instructor and the students. This switch to virtual labs had an adverse effect on both student perception and student performance in the second half of the semester. Our observations underscore the importance of creating an interactive community when teaching virtually. [ABSTRACT FROM AUTHOR]

Evidence based medicine should underpin the practice of all orthopaedic surgeons. Spinal pathology should be considered in the differential diagnosis for pain in every upper and lower limbs region and an understanding of spinal anatomy and physiology is vital in the management of the trauma patient. We present ten key articles, which have been selected for their impact within the field. They encompass trauma, degenerative, inflammatory, deformity and emergency spinal disorders. The articles range from level I randomized control trials to level V expert opinion. An understanding of their methodology and key findings should be part of the core knowledge encompassing spinal surgery and will, in particular, be of benefit for those preparing for final professional examinations. [ABSTRACT FROM AUTHOR]

Concept maps help detect misconceptions and provide revision exercises to assess comprehension once a topic has been introduced. A concept map is a schematic drawing used to show the connection among the concepts in propositional form. A concept map is a helpful tool for illustrating the relationships between main concepts and sub-concepts. The main objective of the study was to identify misconceptions about the human digestive system among higher secondary students using concept maps. The data was collected from higher secondary students XI class students) (N = 388) with the help of students' preliminary concept maps and researcher-made concept map tools. Findings of the study showed that secondary school students hold misconceptions related to the human digestive system, i.e. few (22.68%) students have misconceptions such as 'Human Digestive System is the process by which hard food is converted into simple diffusible assimilable nutrients', few (19.32%) students have misconceptions such as 'Alimentary Canal starts with the throat," etc. The present paper will help use concept maps for the identification and remediation of students' misconceptions.

Poster presentations to communicate scientific knowledge/understanding are a commonly used assessment tool. It can be a challenge for students (and staff!) to deliver clear information with minimal text on the poster. We have found that this format did not encourage imaginative project topics or posters. To enhance communication skills, imagination, and student engagement, we adapted an existing physiology research project and increased the emphasis on communication skills with the use of infographics. This paper describes how students may produce their own biomedical infographics and discusses the issues that educators may need to consider when integrating infographic assessments into their teaching.

In our changing world there are many challenges that students face, one of them being temporary inability to attend face-to-face classes. This paper presents a perspective on how to best meet the needs of online learners, including such topics as course design, student engagement, challenges, and solutions. The information in this article may be helpful in this time of having to move our courses online.

Extra credit assignments are often viewed with disdain by educators as opportunities to earn points for students that lack the study skills to do well on exams and quizzes. However, these assignments can serve as a platform for students to apply the course material to their own lives, optimizing their strengths and creativity, and encouraging them to take ownership of their learning. In this paper we discuss how we used extra credit assignments in a two-semester Human Anatomy and Physiology course to develop community outreach, art exhibits, and education events to empower our students and make science accessible to the public.

Anatomy and Physiology (A&P) is a foundational sequence of courses required for students to complete as a prerequisite prior to admission to a range of graduate health programs and degrees, some of which include medical schools, nursing, occupational and physical therapy, exercise science, cardiovascular technologist, diagnostic medical sonography, dental hygienist, respiratory care, and radiography. While undergraduate A&P course content is fairly standard, differences in curricula, as well as differences in the student populations within these classes exist. In this paper we examine ways in which a more inclusive teaching environment can be created to support an increased sense of belonging for LGBTQIA+ students within anatomy and physiology courses, potentially leading to higher retention and success rates (Fenaughty et al. 2019; Garvey et al. 2017; National Academy of Sciences 2017; Snapp et al. 2015). Inclusive teaching has largely been absent within STEM disciplines, leading to negative perceived classroom experiences within STEM courses (Snapp et al. 2015; Garvey and Rankin 2015). Faculty can help to reduce barriers to success faced by gender and sexual minority students by growing in cultural competency, using inclusive vocabulary, and infusing their courses with accurate content that allows all students to see themselves in the curriculum.

The use of electronic media in the classroom was prevalent during the height of the COVID-19 global pandemic because it afforded the health and safety of students in blended course modalities. This project aimed to quantify the effectiveness of a three-dimensional computer-based human anatomical online platform in a blended synchronous course design. We asked our students to self-report the learning efficacy and overall student engagement of the online learning platform. We found that with intentional course design utilizing in-person anchored Zoom Buddy blended classes and a 3-D anatomy software, students reported high levels of learning efficacy and engagement in anatomy & physiology courses. The course design presented in this paper provides a viable option should we be faced with similar emergency learning situations or when course enrollments are high and class spaces are limited.

Background: The lack of information regarding the burden of acute bacterial meningitis in Latin America leads to a reduction in the estimated incidence rates of the disease, and impairs public health decisions on the use and follow-up of preventive interventions, particularly, the evaluation of existing vaccination policies. The use of the real-time PCR in diagnostic routine procedures has resulted in a substantial increase in confirmed bacterial meningitis cases. However, in resource-poor countries, these assays are only available in reference laboratories. Sample transportation to these laboratories is a critical constraint, as it requires specialized, high cost courier services. To overcome this barrier we evaluated the use of FTATM Elute filter paper cards for the conservation and processing of samples under normal environmental conditions, as they would be when transported from remote and under-equipped healthcare facilities to the reference centers. A total of 401 samples received in 2015 as part of Sao Paulo’s national surveillance for routine diagnosis were selected for this study. Methods: The sensitivity and specificity of real-time PCR were evaluated using fresh serum and cerebrospinal fluid (CSF) samples processed using our laboratory’s standard DNA extraction, and processing the same samples after being dried and stored on FTATM card, and DNA extracted following the manufacturer’s instructions. Results: The sensitivities for detection of Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae from CSF dried and stored on FTATM cards were 98%, 92%, and 100%, respectively, and with serum samples were 73%, 88%, and 100%, respectively. When compared to our laboratory’s standard methodology, results showed high concordance, with Kappa index ranges of 0.9877–1.00 for CSF, and 0.8004–1.00 for serum samples. Conclusion: The use of FTATM cards for CSF and serum conservation and transport represents a rapid, reliable, and cost-effective alternative that will allow obtaining valuable epidemiological information that would otherwise be lost. [ABSTRACT FROM AUTHOR]

The use of drawing as an assessment tool to reveal students' conceptions in biology specifically on human organs and organ systems is not new, however, there is a deficit in the literature that attempted to explore and reflect on its usefulness and relevance specifically, in eliciting students' preconceptions related thereto. Making use of a convergent mixed methods design, this paper presents the first phase of a sequential study on the development and implementation of a teaching sequence on human organ systems, that is the use of drawing in aggregating preconceptions on human organs and organ systems from among 138 pre-service teachers. The drawings underwent content and thematic analysis informed by the level of the biological quality of drawings. Results showed that a great majority of the participants possess limited and inconsistent conceptions that needed to be addressed systematically. Taking into consideration the purpose of eliciting and nature of students' preconceptions, as well as the inherent strengths and limitations of drawing as a tool for assessment, a reflection on the relevance of drawing as a tool in eliciting students' preconceptions is provided.

At the University of Bristol, we established a novel dissection course to complement our anatomy degree. Students enrolled in this undergraduate course are trained as comparative anatomists, with equal time given to both human and veterinary anatomy. Historically, students opted to dissect either human or veterinary donors as part of the course. To fully reflect the comparative nature of the degree, the dissection course was redesigned so students could dissect both human and veterinary specimens as part of the same course. This facilitated a wide-ranging experience of anatomy, encouraging detailed knowledge of a multitude of species and allowing for multifaceted anatomy graduates to be ready for employment in a wide and competitive job market. Across three iterations of the amended version of the course, median marks ranged from 58.7% to 62.0%, with between 22 and 39 students enrolled. In comparison to the course prior to the introduction of the change, median marks ranged from 59.8% to 62.8%, with between 16 and 24 students enrolled. There was no significant difference between marks before or after the introduction of the concurrently comparative aspect. This paper describes the course, with learning materials and assessments considered, along with some reflection on its value. The course offers benefits to students by widening their perspective on anatomical knowledge and making them more equipped for the job market. It also broadens their understanding of form-function relationships. However, student feedback implied that having the choice between human or veterinary dissection was preferable, and this may outweigh the perceived benefits of the course.

This paper reports the relationship between the difficulty index and the discrimination index of one-best answer type multiple-choice questions (MCQ's) in an anatomy paper for the students of year I of an undergraduate medical program. We included in this study the MCQ paper from the two partial examination of academic year 2008/2009. There were 52 students who attended the 2 partial examination in year 2008/2009. This examination covered anatomy of cardiovascular and respiratory systems. There was a wide distribution of item difficulty indices in all the MCQ papers analyzed. Mean difficulty index was 50.84 ± 17.30 with range 21.4 - 85.7 and mean discrimination index was 0.40 ± 0.21 with range -0.07 - 0.71. On average, 13.3 % of the MCQ items in anatomy paper were "very easy" (difficulty index > 70), while 13.3 were „very difficult” (difficulty index < 30). About 75 % of these very easy/difficult items had "very poor" or even negative discrimination. Our finding indicate that 73.4 % of studied MCQ's have recommended difficulty index and 76.7 % of questions have good or excellent discrimination index. 26.6 % of analyzed questions are too easy or too difficult and 13.3 % of questions have poor discrimination. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has forced all dentistry faculties to quickly shift to the online supplementation or replacement of traditional modules to pursue education. However, there is limited research evaluating the effectiveness of this education modality on student performance in dental anatomy and manipulation module. Accordingly, it was aimed to compare the influence of different education modalities on the performances of the students enrolled in this module. The students were requested to perform 11 practical assignments throughout the fall term. A total of 220 face-to-face-educated (F2F) and 138 screen-to-screen-educated (S2S) students were included. To evaluate the influence of education modality on the performances of the students, cumulative success scores were calculated and compared using an independent t-test. The grades of the first (maxillary central), sixth (maxillary premolar), and eleventh assignments (mandibular first molar) were also analyzed to understand the manipulation-skill progress of each student within the same year. The grades of above-mentioned three assignments were converted into nominal data (excellent, very good, good, acceptable, and fail) based on certain thresholds, and a chi-square test was conducted. The cumulative success scores in F2F group were significantly lower than those in S2S group (P = 0.02). Differences between the first and eleventh tasks in both education modalities were significant (P < 0.05). The S2S-educated students achieved significantly higher achievement points in the sixth and eleventh assignments (P < 0.001). The S2S education can be suggested as an applicable modality for teaching dental anatomy and manipulation module. However, further work is needed to ascertain whether this result is replicable throughout dental anatomy education. [Paper presented at the International Dental Education Congress (1st, Ankara, Turkey, Jan 11-15, 2021).]

Combinations of perceptual fluency and sense-making competencies contribute synergistically to learning gains in undergraduate science, technology, engineering, and math (STEM) education. However, instructional principles depend on the target of instruction, and in many fields, the targets of instruction are quite different from undergraduate STEM education. Professional learning often involves the application of previously acquired conceptual knowledge in a perceptually complex reality. This paper focuses on the field of surgery, specifically the recognition of surgical anatomy, in which the target of instruction is perceptual ability rather than conceptual knowledge. We conducted two experiments in which 42 and 44 surgical trainees participated in perceptual-fluency and sense-making interventions, followed by tests of their ability to recognize surgical anatomy in real operative images. The results showed that perceptual-fluency interventions contributed to gains in perceptual knowledge relating to surgical anatomy, whereas sense-making interventions did not. We discuss our findings in terms of alignment between instructional design and instructional goals, and the application of advances in learning sciences to adult learning of complex skills.

Bisphenol A (BPA) is an endocrine disrupting chemical used in a wide range of consumer products including photoactive dyes used in thermal paper. Recent studies have shown that dermal absorption of BPA can occur when handling these papers. Yet, regulatory agencies have largely dismissed thermal paper as a major source of BPA exposure. Exposure estimates provided by agencies such as the European Food Safety Authority (EFSA) are based on assumptions about how humans interact with this material, stating that ‘typical’ exposures for adults involve only one handling per day for short periods of time (<1 minute), with limited exposure surfaces (three fingertips). The objective of this study was to determine how individuals handle thermal paper in one common setting: a cafeteria providing short-order meals. We observed thermal paper handling in a college-aged population (n = 698 subjects) at the University of Massachusetts’ dining facility. We find that in this setting, individuals handle receipts for an average of 11.5 min, that >30% of individuals hold thermal paper with more than three fingertips, and >60% allow the paper to touch their palm. Only 11% of the participants we observed were consistent with the EFSA model for time of contact and dermal surface area. Mathematical modeling based on handling times we measured and previously published transfer coefficients, concentrations of BPA in paper, and absorption factors indicate the most conservative estimated intake from handling thermal paper in this population is 51.1 ng/kg/day, similar to EFSA’s estimates of 59 ng/kg/day from dermal exposures. Less conservative estimates, using published data on concentrations in thermal paper and transfer rates to skin, indicate that exposures are likely significantly higher. Based on our observational data, we propose that the current models for estimating dermal BPA exposures are not consistent with normal human behavior and should be reevaluated. [ABSTRACT FROM AUTHOR]

The need to complete multiple tasks concurrently is a common occurrence both daily life and in occupational activities, which can often include simultaneous cognitive and physical demands. As one example, there is increasing availability of head-worn display technologies that can be employed when a user is mobile (e.g., while walking). This new method of information presentation may, however, introduce risks of adverse outcomes such as a decrement to gait performance. The goal of this study was thus to quantify the effects of a head-worn display (i.e., smart glasses) on motor variability during gait and to compare these effects with those of other common information displays (i.e., smartphone and paper-based system). Twenty participants completed four walking conditions, as a single task and in three dual-task conditions (three information displays). In the dual-task conditions, the information display was used to present several cognitive tasks. Three different measures were used to quantify variability in gait parameters for each walking condition (using the cycle-to-cycle standard deviation, sample entropy, and the “goal-equivalent manifold” approach). Our results indicated that participants used less adaptable gait strategies in dual-task walking using the paper-based system and smartphone conditions compared with single-task walking. Gait performance, however, was less affected during dual-task walking with the smart glasses. We conclude that the risk of an adverse gait event (e.g., a fall) in head-down walking conditions (i.e., the paper-based system and smartphone conditions) were higher than in single-task walking, and that head-worn displays might help reduce the risk of such events during dual-task gait conditions. [ABSTRACT FROM AUTHOR]

In this paper, we present and discuss an explorative study on the use of a social 360° virtual reality (360VR) for supporting case-based Problem Based Learning (case-PBL) in clinical medical education. In the context of case-PBL, we argue that our social 360VR learning space extends the design and application of cases in medical education by including elements from project-PBL. Three groups tested the learning design as a part of the clinical exercises in their 5. Semester bachelor course. After the social 360VR activity, the students performed a physical examination of the collateral and cruciate ligaments of the knee like the one in the training material. Our preliminary findings indicate that the students immersed in social 360VR collaboratively establish a mutual understanding of how to perform the examination through identifying problems related to the examination and by taking responsibility for their own and the other group members learning.

Background: Identification of the source of mosquito blood meals is an important component for disease control and surveillance. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) profiling has emerged as an effective tool for mosquito blood meal identification, using the abdomens of freshly engorged mosquitoes. In the field, mosquito abdomens are crushed on Whatman filter papers to determine the host feeding patterns by identifying the origin of their blood meals. The aim of this study was to test whether crushing engorged mosquito abdomens on Whatman filter papers was compatible with MALDI-TOF MS for mosquito blood meal identification. Both laboratory reared and field collected mosquitoes were tested. Material and methods: Sixty Anopheles gambiae Giles were experimentally engorged on the blood of six distinct vertebrate hosts (human, sheep, rabbit, dog, chicken and rat). The engorged mosquito abdomens were crushed on Whatman filter papers for MALDI-TOF MS analysis. 150 Whatman filter papers, with mosquitoes engorged on cow and goat blood, were preserved. A total of 77 engorged mosquito abdomens collected in the Comoros Islands and crushed on Whatman filter papers were tested with MALDI-TOF MS. Results: The MS profiles generated from mosquito engorged abdomens crushed on Whatman filter papers exhibited high reproducibility according to the original host blood. The blood meal host was correctly identified from mosquito abdomens crushed on Whatman filter papers by MALDI-TOF MS. The MS spectra obtained after storage were stable regardless of the room temperature and whether or not they were frozen. The MS profiles were reproducible for up to three months. For the Comoros samples, 70/77 quality MS spectra were obtained and matched with human blood spectra. This was confirmed by molecular tools. Conclusion: The results demonstrated that MALDI-TOF MS could identify mosquito blood meals from Whatman filter papers collected in the field during entomological surveys. The application of MALDI-TOF MS has proved to be rapid and successful, making it a new and efficient tool for mosquito-borne disease surveillance. [ABSTRACT FROM AUTHOR]

Type 1 diabetes (T1D) is increasing in incidence and predictable with measurement of serum islet autoantibodies (iAb) years prior to clinical disease onset. Identifying iAb positive individuals reduces diabetic ketoacidosis and identifies individuals for T1D prevention trials. However, large scale screening for iAb remains challenging as assays have varying sensitivities and specificities, insulin autoantibodies remain difficult to measure and venipuncture is generally required to obtain serum. We developed an approach to reliably measure all four major iAb, including insulin autoantibodies, from dried blood spots (DBS) on filter-paper. By spiking iAb positive serum into iAb negative whole blood in a dose titration, we optimized the conditions for autoantibody elution from filter paper as measured by fluid phase radioimmunoassays. After assessing stability of measuring iAb from DBS over time, we then screened iAb from DBS and the corresponding serum in new-onset T1D (n = 52), and controls (n = 72) which included first-degree relatives of T1D patients. iAb measured from eluted DBS in new-onset T1D strongly correlated with serum measurements (R2 = 0.96 for mIAA, GADA = 0.94, IA-2A = 0.85, ZnT8A = 0.82, p<0.01 for each autoantibody). There were no false positives in control subjects, and 5/6 with previously unknown iAb positivity in sera were detected using DBS. With further validation, measuring iAb from DBS can be a reliable method to screen for T1D risk. [ABSTRACT FROM AUTHOR]

India has the highest burden of Tuberculosis (TB) and multidrug-resistant TB (MDR-TB) worldwide. Innovative technology is the need of the hour to identify these cases that remain either undiagnosed or inadequately diagnosed due to the unavailability of appropriate tools at primary healthcare settings. We developed and evaluated 3 kits, namely ‘TB Detect’ (containing BioFM-Filter device), ‘TB Concentration and Transport’ (containing Trans-Filter device) and ‘TB DNA Extraction’ kits. These kits enable bio-safe equipment-free concentration of sputum on filters and improved fluorescence microscopy at primary healthcare centres, ambient temperature transport of dried inactivated sputum filters to central laboratories and molecular detection of drug resistance by PCR and DNA sequencing (Mol-DST). In a 2-site evaluation (n = 1190 sputum specimens) on presumptive TB patients, BioFM-Filter smear exhibited a significant increase in positivity of 7% and 4% over ZN smear and LED-FM smear (p<0.05), respectively and an increment in smear grade status (1+ or 2+ to 3+) of 16% over ZN smear and 20% over LED-FM smear. The sensitivity of Mol-DST in presumptive MDR-TB and XDR-TB cases (n = 148) was 90% for Rifampicin (95% confidence interval [CI], 78–96%), 84% for Isoniazid (95% CI, 72–92%), 83% for Fluoroquinolones (95% CI, 66–93%) and 75% for Aminoglycosides (95% CI, 35–97%), using phenotypic DST as the reference standard. Test specificity was 88–93% and concordance was ~89–92% (κ value 0.8–0.9). The patient-friendly kits described here address several of the existing challenges and are designed to provide ‘Universal Access’ to rapid TB diagnosis, including drug-resistant disease. Their utility was demonstrated by application to sputum at 2 sites in India. Our findings pave the way for larger studies in different point-of-care settings, including high-density urban areas and remote geographical locations. [ABSTRACT FROM AUTHOR]