Search

This article examines four performers and the music written for them in Messiah and Handel’s other works in order to explore the unique abilities that defined their voices. Understanding how those qualities impacted Messiah in composition and concept can reshape modern performances and conceptions of performers’ roles in shaping the Western canon.

Covid‐19 disrupted the in‐person teaching format of anatomy. To study changes in gross anatomy education that occurred August‐December, 2020 compared to before the pandemic, an online survey was distributed to anatomy educators. The 191 responses received were analyzed in total and by academic program, geographic region, and institution type. Cadaver use decreased overall (before: 74.1 ± 34.1%, during: 50.3 ± 43.0%, P < 0.0001), as well as across allopathic and osteopathic medicine, therapy, undergraduate, and veterinary programs (P < 0.05), but remained unchanged for other programs (P > 0.05). Cadaver use decreased internationally and in the US (P < 0.0001), at public and private (P < 0.0001) institutions, and among allopathic medical programs in Northeastern, Central, and Southern (P < 0.05), but not Western, US geographical regions. Laboratories during Covid‐19 were delivered through synchronous (59%), asynchronous (4%), or mixed (37%) formats (P < 0.0001) and utilized digital resources (47%), dissection (32%), and/or prosection (21%) (P < 0.0001). The practical laboratory examination persisted during Covid‐19 (P = 0.419); however, the setting and materials shifted to computer‐based (P < 0.0001) and image‐based (P < 0.0001), respectively. In‐person lecture decreased during Covid‐19 (before: 88%, during: 24%, P = 0.003). When anatomy digital resources were categorized, dissection media, interactive software, and open‐access content increased (P ≤ 0.008), with specific increases in BlueLink, Acland’s Videos, and Complete Anatomy (P < 0.05). This study provided evidence of how gross anatomy educators continued to adapt their courses past the early stages of the pandemic.

To determine the relative variability and magnitude of symptomatic improvement in antidepressant-treated individuals compared to placebo-treated individuals, and to investigate moderating factors.Multiple databases and previous publications were searched through February 2019 to identify all randomized controlled trials comparing placebo and antidepressants in acute treatment of depression. Primary outcome was relative variability of change in symptom severity in antidepressant-treated individuals compared to placebo-treated patients quantified using the coefficient of variation ratio (CVR).Of 9389 identified records, 134 were found to be eligible (total n = 46,646). Antidepressant-treated patients showed a significantly greater magnitude (g = 0.28, 95% CI 0.25-0.30, p.0001) and lower variability (CVR = 0.94, 95% CI 0.93-0.95, p.0001) of change in symptom severity relative to placebo-treated patients. Compared to placebo antidepressant-related improvement was more uniform in older studies (z = 3.01, p = .003) and in studies where antidepressants showed greater efficacy (z = -7.21, p.0001). | Imipramine, moclobemide, amitriptyline and mirtazapine showed significantly lower CVR than several other antidepressants. However, no difference in CVR exists between multiple and single-neurotransmitter profile antidepressants (z = -0.01, p = .99).There is lower variability and greater magnitude of change in symptom severity with antidepressant treatment relative to placebo. This is not consistent with our hypothesis that there are distinct sub-groups of treatment-responsive and treatment-resistant patients with major depression. Our results in-stead suggest that antidepressants show a relatively uniform effect.

BackgroundClozapine is the only drug licensed for treatment-resistant schizophrenia (TRS) but the real-world clinical and cost-effectiveness of community initiation of clozapine is unclear.AimsThe aim was to assess the feasibility and cost-effectiveness of community initiation of clozapine.MethodThis was a naturalistic study of community patients recommended for clozapine treatment.ResultsOf 158 patients recommended for clozapine treatment, 88 (56%) patients agreed to clozapine initiation and, of these, 58 (66%) were successfully established on clozapine. The success rate for community initiation was 65.4%; which was not significantly different from that for in-patient initiation (58.82%, χ2(1,88) = 0.47, P = 0.49). Following clozapine initiation, there was a significant reduction in median out-patient visits over 1 year (from 24.00 (interquartile range (IQR) = 14.00–41.00) to 13.00 visits (IQR = 5.00–24.00), P < 0.001), and 2 years (from 47.50 visits (IQR = 24.75–71.00) to 22.00 (IQR = 11.00–42.00), P < 0.001), and a 74.71% decrease in psychiatric hospital bed days (z = −2.50, P = 0.01). Service-use costs decreased (1 year: –£963/patient (P < 0.001); 2 years: –£1598.10/patient (P < 0.001). Subanalyses for community-only initiation also showed significant cost reductions (1 year: –£827.40/patient (P < 0.001); 2 year: –£1668.50/patient (P < 0.001) relative to costs prior to starting clozapine. Relative to before initiation, symptom severity was improved in patients taking clozapine at discharge (median Positive and Negative Syndrome Scale total score: initial visit: 80 (IQR = 71.00–104.00); discharge visit 50.5 (IQR = 44.75–75.00), P < 0.001) and at 2 year follow-up (Health of Nation Outcome Scales total score median initial visit: 13.00 (IQR = 9.00–15.00); 2 year follow-up: 8.00 (IQR = 3.00–13.00), P = 0.023).ConclusionsThese findings indicate that community initiation of clozapine is feasible and is associated with significant reductions in costs, service use and symptom severity.

Introduction Integration has been recognized as an important aspect of medical education. After transitioning from a discipline-specific to a systems-based preclinical curriculum, we examined faculty perceptions of the integrated approach and also whether it would lead to better anatomy knowledge retention. Methods To understand faculty perspectives, we reviewed curricular materials, interviewed block directors, and observed educational sessions. We analyzed knowledge retention through a 27-question anatomy test, comparing scores from the last class of the discipline-based curriculum and the first two classes of the integrated curriculum. Results Planning integrated content involves purposeful ordering, is challenging for faculty, and requires additional resources. Evaluation of the integrated approach for anatomy content demonstrated a significant increase in knowledge retention (p = .012; 56.28% vs. 63.98% for old vs. new curriculum). Conclusions This study helps the understanding of what is required for curricular integration. Our anatomy evaluation results corroborated the view that contextually embedded information is easier to learn and retain.

Ultrasound technology is used to supplement gross anatomy instruction in many medical sciences programs. However, this technology is not common practice for anatomy instruction in nonmedical graduate-level courses. Ultrasound sessions provide a clear view of local anatomy and could help graduate students transfer anatomical content from a didactic context onto a living, moving body. This approach to instruction complements the rapidly evolving technological advances in science education and may assist with spatial understanding, knowledge retention, and student engagement. The main objective of this article was to describe the methods used to incorporate ultrasound sessions into a graduate level gross anatomy course. The goal of the curricula was to use ultrasound technology to create a supplemental hands-on and engaging method of learning anatomy that would appeal to graduate students and possibly reinforce content. Graduate students participated in three interactive, 2-h-long ultrasound sessions that corresponded to their gross anatomy lecture material. Questionnaire results showed that students overwhelmingly believed that the ultrasound sessions were beneficial and that ultrasound technology should be used for anatomical instruction in graduate programs. While students found the sessions to be helpful, they sought more and longer sessions with smaller group sizes. Overall, this article describes the methods used to incorporate multimodal learning into a graduate level anatomy course and found that students supported the methods as a potentially effective and engaging way to supplement traditional gross anatomy lectures and practical laboratory sessions.

Prefrontal cortex has been shown to regulate striatal dopaminergic function via glutamatergic mechanisms in preclinical studies. Concurrent disruption of these systems is also often seen in neuropsychiatric disease. The simultaneous measurement of striatal dopamine signaling, cortical gray matter, and glutamate levels is therefore of major interest, but has not been previously reported. In the current study, twenty-eight healthy subjects underwent 2 simultaneous [11C]-( + )-PHNO PET-MRI scans, once after placebo and once after amphetamine in a double-blind randomized cross-over design, to measure striatal dopamine release, striatal dopamine receptor (D2/3R) availability, anterior cingulate glutamate+glutamine (Glx) levels, and cortical gray matter volumes at the same time. Voxel-based morphometry was used to investigate associations between neurochemical measures and gray matter volumes. Whole striatum D2/3R availability was positively associated with prefrontal cortex gray matter volume (pFWE corrected = 0.048). This relationship was mainly driven by associative receptor availability (pFWE corrected = 0.023). In addition, an interaction effect was observed between sensorimotor striatum D2/3R availability and anterior cingulate Glx, such that in individuals with greater anterior cingulate Glx concentrations, D2/3R availability was negatively associated with right frontal cortex gray matter volumes, while a positive D2/3R-gray matter association was observed in individuals with lower anterior cingulate Glx levels (pFWE corrected = 0.047). These results are consistent with the hypothesis that the prefrontal cortex is involved in regulation of striatal dopamine function. Furthermore, the observed associations raise the possibility that this regulation may be modulated by anterior cingulate glutamate concentrations.

INTRODUCTION/OBJECTIVE: Covid‐19 has led to sudden changes to gross anatomy education when traditional dissection‐based laboratories had to shift towards virtual modalities due to physical distancing and remote learning requirements. The purpose of this study was to determine how the use of digital teaching resources in gross anatomy education changed from before to during Covid‐19. MATERIAL/METHODS: Data were obtained from an IRB‐approved survey distributed to professional associations and listservs targeting anatomy educators from June to November 2020. Respondents were asked to select the digital resources they used before and during Covid‐19. Data were analyzed during the early and latter parts of the pandemic as May‐August (T1) and August‐December (T2), as well as overall (T3). T2 data were classified into five categories: 2D illustrations, dissection media, interactive software, in‐house, and open access. Total usage for each timepoint, the proportions of digital resources, and the 5 categories before and during Covid‐19 were compared using McNemar's test with alpha0.05). When data for T2 were categorized, dissection media (+44%), interactive software (+87%), and open‐access (+100%) content increased (P≤0.008), while 2D illustrations (‐3%) and in‐house content (‐23%) decreased (P>0.05). CONCLUSIONS: This study demonstrates sustained increases in digital resource usage for gross anatomy education during Covid‐19. This was particularly pronounced for interactive software, open access resources and dissection media that allowed educators to mimic features of a dissection lab. SIGNIFICANCE: These rapid shifts in both commercial and free digital resources are likely to drive innovation in anatomy education for years to come. It remains unknown if the current findings are transient Covid‐19‐related changes or if they will persist long‐term.

INTRODUCTION/OBJECTIVE Covid‐19 created immediate challenges to anatomy education. The traditional format of gross laboratory sessions experienced a direct impact and few reports documented curricular delivery changes specific to laboratory format. The purpose of this study was to assess the adaptations incorporated in gross anatomy laboratories by anatomists, during May‐August 2020, in response to Covid‐19. MATERIALS/METHODS Data were collected through the IRB‐approved Virtual Anatomy During Covid‐19 survey that consisted of 20 questions, including open‐ended prompts asking participants to describe the structure of a “typical” laboratory session during Covid‐19. Responses were solicited from professional anatomy associations during June 2020. Open‐ended responses describing anatomy laboratory teaching methods used during Covid‐19 were coded. Descriptive codes were applied to the data according to published methods to summarize verbatim responses. Responses were tabulated and converted to frequencies and percentages. Chi square test assessed differences among the responses when applicable. Alpha

Introduction/Objective Covid‐19 created challenges to anatomy education, particularly gross anatomy given the traditional in‐person format of lectures and lab. The objective of this study was to assess the changes in lecture methods and lab materials used in anatomy courses that ran between May‐August (T1) and August‐December (T2) 2020 responding to Covid‐19 restrictions. Materials/Methods A survey was distributed to anatomy educators through professional associations from June‐November 2020. Respondents indicated (1) their institution; (2) programs taught (professional health (PH), medicine (MED), or undergraduate (UG)); (3) course type (integrated or stand‐alone); (4) percentage of lab time before and during Covid‐19 that utilized cadaveric, plastic, and/or other teaching materials; and (5) lecture format. Institutions were classified as public or private via institution websites. Mann‐Whitney U and Wilcoxon signed‐rank tests with Bonferroni correction compared responses before and during Covid‐19 across programs, course type, and institution. Data are presented as percent increase (+value) or decrease (‐value). Alpha0.05), except UG decreased plastic usage during T2 (‐20%; P=0.033). During T1 and T2, use of other teaching materials increased in PH (+1180% & +278%), MED (+385% & +1000%), and UG (+285% & +246%) (P≤0.015); stand‐alone (+920% & +540%, P

Simultaneous PET-MRI illustrates the relationship between striatal dopamine and cortical activity., Dopamine signaling is constrained to discrete tracts yet has brain-wide effects on neural activity. The nature of this relationship between local dopamine signaling and brain-wide neuronal activity is not clearly defined and has relevance for neuropsychiatric illnesses where abnormalities of cortical activity and dopamine signaling coexist. Using simultaneous PET-MRI in healthy volunteers, we find strong evidence that patterns of striatal dopamine signaling and cortical blood flow (an index of local neural activity) contain shared information. This shared information links amphetamine-induced changes in gradients of striatal dopamine receptor availability to changes in brain-wide blood flow and is informed by spatial patterns of gene expression enriched for genes implicated in schizophrenia, bipolar disorder, and autism spectrum disorder. These results advance our knowledge of the relationship between cortical function and striatal dopamine, with relevance for understanding pathophysiology and treatment of diseases in which simultaneous aberrations of these systems exist.

Objective. The Pharmacy Biomedical Preview program is a five-week summer academic reinforcement program held for students entering the Howard University College of Pharmacy. The objective of this study was to evaluate the impact of the program and preadmission factors on pharmacy students’ first semester academic performance. Methods. A retrospective cohort study was conducted of students entering the preview program from 2012 to 2015. The primary outcome assessed was first semester grade point average (GPA). Descriptive statistics of all study variables were conducted. Bivariable analyses were used to compare students by program status. Pearson correlations and point biserial R were conducted to evaluate which factors were associated with the first semester GPA. Multiple linear regression analysis was used to evaluate whether participation in the preview program predicted GPA during the first semester in pharmacy school after adjusting for other factors. All analyses were conducted using SPSS, version 23, at an alpha of .05. Results. Incoming overall undergraduate GPA was the strongest predictor of students’ first semester GPA in pharmacy school, followed by participation in the Pharmacy Biomedical Preview Program. After adjusting for other factors, mandatory participation in the program was associated with a higher first semester GPA, and voluntary participation in the program was also associated with a first semester GPA that was higher. Conclusion. Findings from this study indicated that implementation of a pre-matriculation success program at a college of pharmacy in a historically Black institution is a viable strategy to improve students’ academic success in the first year.

Phenomenon: Given the growing number of medical science educators, an examination of institutions' promotion criteria related to educational excellence and scholarship is timely. This study investigates the extent to which medical schools' promotion criteria align with published standards for documenting and evaluating educational activities. Approach: This document analysis systematically analyzed promotion and tenure (PT 52 of 120) documented a well-defined education-related pathway for advancement in academic rank. Across five education-specific domains, only 24% (12 of 50) of the investigated criteria were referenced by at least half of the schools. The least represented domain within P&T documents was "Educational Measurement and Evaluation." P&T documents for 47% of schools were rated as "below average" or "very vague" in their clarity/specificity. Insights: Less than 10% of U.S. medical schools have thoroughly embraced published recommendations for documenting and evaluating educational excellence. This raises concern for medical educators who may be evaluated for promotion based on vague or incomplete promotion criteria. With greater awareness of how educational excellence is currently documented and how promotion criteria can be improved, education-focused faculty can better recognize gaps in their own documentation practices, and more schools may be encouraged to embrace change and align with published recommendations.

While prior meta-analyses in anatomy education have explored the effects of laboratory pedagogies and histology media on learner performance, the effects of student-centered learning (SCL) and computer-aided instruction (CAI) have not been broadly evaluated. This research sought to answer the question, "How effective are student-centered pedagogies and CAI at increasing student knowledge gains in anatomy compared to traditional didactic approaches?" Relevant studies published within the past 51 years were searched using five databases. Predetermined eligibility criteria were applied to the screening of titles and abstracts to discern their appropriateness for study inclusion. A summary effect size was estimated to determine the effects of SCL and CAI on anatomy performance outcomes. A moderator analysis of study features was also performed. Of the 3,035 records screened, 327 underwent full-text review. Seven studies, which comprised 1,564 participants, were included in the SCL analysis. An additional 19 studies analyzed the effects of CAI in the context of 2,570 participants. Upon comparing SCL to traditional instruction, a small positive effect on learner performance was detected (standardized mean difference (SMD = 0.24; [CI = 0.07, 0.42]; P = 0.006). Likewise, students with CAI exposure moderately outscored those with limited or no access to CAI (SMD = 0.59; [CI = 0.20, 0.98]; P = 0.003). Further analysis of CAI studies identified effects (P ≤ 0.001) for learner population, publication period, interventional approach, and intervention frequency. Overall, learners exposed to SCL and supplemental CAI outperformed their more classically-trained peers as evidenced by increases in short-term knowledge gains. Anat Sci Educ. © 2018 American Association of Anatomists.

The debate regarding anatomy laboratory teaching approaches is ongoing and controversial. To date, the literature has yielded only speculative conclusions because of general methodological weaknesses and a lack of summative empirical evidence. Through a meta-analysis, this study compared the effectiveness of instructional laboratory approaches used in anatomy education to objectively and more conclusively synthesize the existing literature. Studies published between January 1965 and December 2015 were searched through five databases. Titles and abstracts of the retrieved records were screened using eligibility criteria to determine their appropriateness for study inclusion. Only numerical data were extracted for analysis. A summary effect size was estimated to determine the effects of laboratory pedagogies on learner performance and perceptions data were compiled to provide additional context. Of the 3,035 records screened, 327 underwent full-text review. Twenty-seven studies, comprising a total of 7,731 participants, were included in the analysis. The meta-analysis detected no effect (standardized mean difference = -0.03; 95% CI = -0.16 to 0.10; P = 0.62) on learner performance. Additionally, a moderator analysis detected no effects (P ≥ 0.16) for study design, learner population, intervention length, or specimen type. Across studies, student performance on knowledge examinations was equivalent regardless of being exposed to either dissection or another laboratory instructional strategy. This was true of every comparison investigated (i.e., dissection vs. prosection, dissection vs. digital media, dissection vs. models/modeling, and dissection vs. hybrid). In the context of short-term knowledge gains alone, dissection is no better, and no worse, than alternative instructional modalities. Clin. Anat. 31:122-133, 2018. © 2017 Wiley Periodicals, Inc.

Deficits in retention of anatomy knowledge from the preclinical years to clinical application on the wards have been well documented in the medical education literature. We developed and evaluated a web and laboratory-based curriculum to address deficits in anatomy knowledge retention and to increase anatomy knowledge recall through repetition and application of clinical concepts during the obstetrics and gynecology (Ob/Gyn) core clinical clerkship. Using principles of adult learning and instructional design, a curriculum was designed consisting of (1) interactive, case-based e-modules reviewing clinically relevant anatomical topics and (2) a hands-on laboratory session reinforcing the content of the e-modules, with the practice of clinical techniques using anatomical cadaveric dissections. The curriculum's effectiveness was evaluated by using multiple choice testing and comparing baseline and final test scores. For questions testing content directly covered in this curriculum, mean final scores increased by 14.3% (P

Objectives Sexual dimorphism in the human bony pelvis is commonly assumed to be related to the intensity of obstetrical selective pressures. With intense obstetrical selective pressures, there should be greater shape dimorphism; with minimal obstetrical selective pressures, there should be reduced shape dimorphism. This pattern is seen in the nondimorphic anterior spaces and highly dimorphic posterior spaces. Decoupling sexual dimorphism in these spaces may in turn be related to the differential influence of other selective pressures, such as biomechanical ones. Materials and Methods The relationship between sexual dimorphism and selective pressures in the human pelvis was examined using five skeletal samples (total female n = 101; male n = 103). Pelvic shape was quantified by collecting landmark coordinate data on articulated pelves. Euclidean distance matrix analysis was used to extract the distances that defined the anterior and posterior pelvic spaces. Sex and body mass were used as proxies for obstetrical and biomechanical selective pressures, respectively. Results MANCOVA analyses demonstrate significant effects of sex and body mass on distances in both the anterior and the posterior spaces. A comparison of the relative contribution of shape variance attributed to each of these factors suggests that the posterior space is more influenced by sex, and obstetrics by proxy, whereas the anterior space is more influenced by body mass, and biomechanics by proxy. Conclusions Although the overall shape of the pelvis has been influenced by obstetrical and biomechanical selective pressures, there is a differential response within the pelvis to these factors. These results provide new insight into the ongoing debate on the obstetrical dilemma hypothesis. Am J Phys Anthropol 157:428–440, 2015. © 2015 Wiley Periodicals, Inc.

This chapter contributes to important conversations about accessibility in higher education by examining legal issues that shape experiences of students with autism spectrum disorder (ASD). The chapter begins by outlining the relationship between reasonable accommodations and academic success. Then, it provides an overview of ASD in relation to postsecondary education. A substantive portion of the chapter delineates current legal topics, including federal law, case law, and Office of Civil Rights (OCR) letters. Functional limitations associated with ASD are social or sensory in nature. However, legal precedent in the United States defines the major life activity of learning in a manner that does not usually include these components, thereby limiting access to sensory and social accommodations. The chapter concludes by discussing Title IX and students with ASD that experience sexual assault, the value of neurodiversity, and future implications for accessibility as the number of students with ASD in postsecondary education increases.

The debate regarding anatomy laboratory teaching approaches is ongoing and controversial. To date, the literature has yielded only speculative conclusions because of general methodological weaknesses and a lack of summative empirical evidence. Through a meta-analysis, this study compared the effectiveness of instructional laboratory approaches used in anatomy education to objectively and more conclusively synthesize the existing literature. Studies published between January 1965 and December 2015 were searched through five databases. Titles and abstracts of the retrieved records were screened using eligibility criteria to determine their appropriateness for study inclusion. Only numerical data were extracted for analysis. A summary effect size was estimated to determine the effects of laboratory pedagogies on learner performance and perceptions data were compiled to provide additional context. Of the 3,035 records screened, 327 underwent full-text review. Twenty-seven studies, comprising a total of 7,731 participants, were included in the analysis. The meta-analysis detected no effect (standardized mean difference = -0.03; 95% CI = -0.16 to 0.10; P = 0.62) on learner performance. Additionally, a moderator analysis detected no effects (P ≥ 0.16) for study design, learner population, intervention length, or specimen type. Across studies, student performance on knowledge examinations was equivalent regardless of being exposed to either dissection or another laboratory instructional strategy. This was true of every comparison investigated (i.e., dissection vs. prosection, dissection vs. digital media, dissection vs. models/modeling, and dissection vs. hybrid). In the context of short-term knowledge gains alone, dissection is no better, and no worse, than alternative instructional modalities. Clin. Anat. 31:122-133, 2018. © 2017 Wiley Periodicals, Inc.

Libraries of nonpurified resorcinol amide derivatives were screened by surface plasmon resonance (SPR) to determine the binding dissociation constant (off-rate, kd) for compounds binding to the pyruvate dehydrogenase kinase (PDHK) enzyme. Parallel off-rate measurements against HSP90 and application of structure-based drug design enabled rapid hit to lead progression in a program to identify pan-isoform ATP-competitive inhibitors of PDHK. Lead optimization identified selective sub-100-nM inhibitors of the enzyme which significantly reduced phosphorylation of the E1α subunit in the PC3 cancer cell line in vitro.

Surgical anatomy is taught early in medical school training. The literature shows that many physicians, especially surgical specialists, think that anatomical knowledge of medical students is inadequate and nesting of anatomical sciences later in the clinical curriculum may be necessary. Quantitative data concerning this perception of an anatomical knowledge deficit are lacking, as are specifics as to what content should be reinforced. This study identifies baseline areas of strength and weakness in the surgical anatomy knowledge of medical students entering surgical rotations. Third-year medical students completed a 20–25-question test at the beginning of the General Surgery and Obstetrics and Gynecology rotations. Knowledge of inguinal anatomy (45.3%), orientation in abdominal cavity (38.8%), colon (27.7%), and esophageal varices (12.8%) was poor. The numbers in parentheses are the percentage of questions answered correctly per topic. In comparing those scores to matched test items from this cohort as first-year students in the anatomy course, the drop in retention overall was very significant (P = 0.009) from 86.9 to 51.5%. Students also scored lower in questions relating to pelvic organs (46.7%), urogenital development (54.0%), pulmonary development (17.8%), and pregnancy (17.8%). These data showed that indeed, knowledge of surgical anatomy is poor for medical students entering surgical clerkships. These data collected will be utilized to create interactive learning modules, aimed at improving clinically relevant anatomical knowledge retention. These modules, which will be available to students during their inpatient surgical rotations, connect basic anatomy principles to clinical cases, with the ultimate goal of closing the anatomical knowledge gap. Anat Sci Educ 7: 461–468. © 2014 American Association of Anatomists.

The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists. Hands-on interactive ultrasound sessions were scheduled as part of the gross anatomy course following principles of adult learning and instructional design. Seven teachers (three anatomists and four clinicians) taught in each session. Before each session, anatomists were trained in ultrasound by clinicians. Students were divided into groups, rotated teachers between sessions, and completed evaluations. Results indicated students perceived the two groups as comparable for all factors except for knowledge organization and the helpfulness of ultrasound for understanding anatomy (P

Freshwater ice is an integral part of the hydrologic regimes of cold environments. It controls the ecology of related aquatic systems and is important economically, through the facilitation of winter transport and via generation of extreme hydrologic events. Given projected changes in future climate, concern has been raised about related changes in freshwater ice. This paper reviews the status and trends in records of lake and river ice around the circumpolar North from traditional observations, remote sensing and paleo-sources. The temporal and spatial variability in trends are evaluated with relation to climatic conditions. Rapid changes experienced in freeze-up and break-up timing for high-latitude lakes, compared to those at more southerly locations, are particularly notable. Also considered are the nature and implications of changes in future freshwater-ice regimes that will have cascading effects on cold-region hydrology and a suite of hydro-ecological conditions including UV radiation receipts, habitat quality and availability, fisheries productivity and contaminant pathways. Overall, the duration and event timing of river and lake ice are proving to be useful indicators of climate change. Considering the scope and significance of ice-cover changes on northern hydro-ecology, a recommendation is made to place more emphasis on long-term and spatially diverse monitoring of freshwater ice.

Deficits in retention of anatomy knowledge from the preclinical years to clinical application on the wards have been well documented in the medical education literature. We developed and evaluated a web and laboratory-based curriculum to address deficits in anatomy knowledge retention and to increase anatomy knowledge recall through repetition and application of clinical concepts during the obstetrics and gynecology (Ob/Gyn) core clinical clerkship. Using principles of adult learning and instructional design, a curriculum was designed consisting of (1) interactive, case-based e-modules reviewing clinically relevant anatomical topics and (2) a hands-on laboratory session reinforcing the content of the e-modules, with the practice of clinical techniques using anatomical cadaveric dissections. The curriculum's effectiveness was evaluated by using multiple choice testing and comparing baseline and final test scores. For questions testing content directly covered in this curriculum, mean final scores increased by 14.3% (P 0.001). In contrast, for questions not directly addressed in this curriculum, mean final scores did not increase significantly, only by 6.0% (P = 0.31). Questions related to the uterus showed the greatest gains in final scores (30.3% improvement, P = 0.002). A curriculum with web-based preparatory material and a hands-on gross anatomy laboratory session effectively addresses deficits in anatomy retention and improves anatomical knowledge recall for medical students on a clinical clerkship. In the future, the authors plan to conduct a multicenter study to further evaluate the ability of this curriculum to improve clinically relevant anatomical knowledge. Anat Sci Educ 9: 337-343. © 2015 American Association of Anatomists.

Recent studies suggest that chromosomal rearrangements play a significant role in speciation by preventing recombination and maintaining species persistence despite interspecies gene flow. Factors conferring adaptation or reproductive isolation are maintained in rearranged regions in the face of hybridization, while such factors are eliminated from collinear regions. As a direct test of this rearrangement model, we evaluated the genetic basis of hybrid male sterility in a sympatric species pair, Drosophila pseudoobscura pseudoobscura and D. persimilis, and an allopatric species pair, D. pseudoobscura bogotana and D. persimilis. Our results are consistent with the proposed model: virtually all of the sterility factors in the former pair are associated with three inverted regions, whereas sterility factors are present in the collinear regions in the latter pair. These findings indicate recombination and selection may have eliminated sterility factors outside the inverted regions between D. p. pseudoobscura and D. persimilis, suggesting chromosomal rearrangements may facilitate species persistence despite hybridization.

A common assumption among anatomy educators is that students take upper-level undergraduate anatomy courses to excel in post-graduate work in the health sciences; however, the motivations of these ...

The utilization of bedside ultrasound by an increasing number of medical specialties has created the need for more ultrasound exposure and teaching in medical school. Although there is a widespread support for more vertical integration of ultrasound teaching throughout the undergraduate curriculum, little is known about whether the quality of ultrasound teaching differs if performed by anatomists or clinicians. The purpose of this study is to compare medical students' evaluation of ultrasound anatomy teaching by clinicians and anatomists. Hands-on interactive ultrasound sessions were scheduled as part of the gross anatomy course following principles of adult learning and instructional design. Seven teachers (three anatomists and four clinicians) taught in each session. Before each session, anatomists were trained in ultrasound by clinicians. Students were divided into groups, rotated teachers between sessions, and completed evaluations. Results indicated students perceived the two groups as comparable for all factors except for knowledge organization and the helpfulness of ultrasound for understanding anatomy (P 0.001). However, results from unpaired samples t-tests demonstrated a nonstatistically significant difference between the groups within each session for both questions. Moreover, students' test performance for both groups was similar. This study demonstrated that anatomists can teach living anatomy using ultrasound with minimal training as well as clinicians, and encourage the teaching of living anatomy by anatomists in human anatomy courses using ultrasound. Repeating this study at a multicenter level is currently being considered to further validate our conclusion.

The objective of this study was to determine whether the three-dimensional shape of the bony pelvis differs between women with and without pelvic floor disorders (PFDs). We predict that the levator ani attachment points for the pelvic floor are further displaced from one another in affected relative to unaffected women.Pelvic shape was quantified by collecting coordinate data from landmarks located on three-dimensional reconstructions of magnetic resonance images of 19 PFD cases and 16 matched controls. Euclidean distance matrix analysis (EDMA) was used to quantify and compare pelvic shape using these landmark data.There were no significant group differences in age, parity, body mass, racial attribution, cesarean section, or hysterectomy status. After controlling for size as a confounding factor, EDMA results identified significant differences (p = 0.05) in the bispinous diameter (4 % proportionally larger) and distances defining lateral displacement of ischia from pubis (5-6 % proportionally larger) in cases compared to controls.Pelvic shape in women with PFDs is characterized by the proportional mediolateral enlargement of the pelvic midplane and ischial eversion near the subpubic arch, consistent with inferolateral migration of the attachment points for the levator ani and correspondingly lateral displacement. These movements may result in increased strain on the pelvic floor's muscular and connective tissues, increasing the risk of failure over a woman's lifetime.

Care of acutely ill psychiatric patients is a problematic area for the NHS. This article charts the development of the specialty of psychiatric intensive care and discusses the major issues for staff and patients.