One crucial component of the optical system is the ciliary body (CB). This body secretes the aqueous humour, which is essential to maintain the internal eye pressure as well as the clearness of the ...lens and cornea. The histological study was designed to provide the morphological differences of CB and iris in the anterior eye chambers of the following vertebrate classes: fish (grass carp), amphibians (Arabian toad), reptiles (semiaquatic turtle, fan‐footed gecko, ocellated skink, Egyptian spiny‐tailed lizard, Arabian horned viper), birds (common pigeon, common quail, common kestrel), and mammals (BALB/c mouse, rabbit, golden hamster, desert hedgehog, lesser Egyptian jerboa, Egyptian fruit bat). The results showed distinct morphological appearances of the CB and iris in each species, ranging from fish to mammals. The present comparative study concluded that the morphological structure of the CB and iris is the adaptation of species to either their lifestyle or survival in specific habitats.
The cover image is based on the Research Article India ink to 3D imaging: The legacy of Dr. Deepak “Dee” N. Pandya and his influence on generations of neuroanatomists by Gene J. Blatt et al., ...https://doi.org/10.1002/cne.25551.
To date (17 November 2021), there has been more than 254 million confirmed cases of COVID‐19, and more than 5 million death globally (World Health Organization. https://covid19.who.int/). The virus ...causing COVID‐19 is called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2). SARS‐CoV‐2 infects host cells by the binding of its spike protein to the cellular surface protein angiotensin‐converting enzyme 2 (ACE2). The predicted 29 amino acid residues of ACE2 that interact with SARS‐CoV‐2 spike protein receptor binding domain (RBD) vary between human ACE2 and mouse or rat ACE2. Therefore, wildtype mice and rats show lower SARS‐CoV‐2 infection rate and mild symptoms compared to what is seen in humans. Small animal models that recapitulate human COVID‐19 disease are urgently needed for better understanding the transmission and therapeutic measurement. Currently, scientists use either mouse‐adapted SAS‐CoV‐2 (SAS‐CoV‐2 MA) models or random transgenic mouse models that artificially express human ACE2 under the control of cytokeratin 18 promoter or a constitutive promoter. SAS‐CoV‐2 MA may not completely reflect all aspects of the original human‐tropic SAS‐CoV‐2 and the current transgenic human ACE2 mouse models typically have high mortality rate caused by neuroinvasion and encephalitis due to very high human ACE2 expression. To overcome these limitations, we have developed humanized ACE2 mouse and rat models using CRISPR‐Cas9. Specifically, we inserted a ~3kb human ACE2 cDNA cassette into the mouse and rat Ace2 gene loci to ensure that human ACE2 expression is under the control of rodent Ace2 promoter and regulatory elements, while simultaneously disabling the rodent Ace2 gene. To accomplish this, CRISPR gRNAs targeting close to the translation initiation site of Ace2 were screened in cultured mouse and rat cells. Then CRISPR/Cas9 complex and donor DNA were subsequently microinjected into one‐cell stage embryos which were subsequently implanted into pseudo pregnant females. Resulting pups were screened for correct knockin by junction PCR and insert PCR, and the PCR products were Sanger sequenced. Targeted Locus Amplification (TLA) further confirmed the integration sites and transgene sequence. RT‐qPCR and Western blot analysis data showed that, in our models, human ACE2 is expressed in tissues expressing endogenous Ace2 (such as lung, kidney, and GI tract), while rodent endogenous Ace2 is absent from these tissues. Further breeding data indicated that both hemizygous and homozygous humanized ACE2 animals appear to be normal and fertile. Most importantly, animals displayed symptoms after infection with SARS‐CoV‐2. In summary, these data suggest that our humanized ACE2 models can be valuable for COVID‐19 research.
Introduction
The traditional method of teaching anatomy has been through live in person lectures and dissection labs as well as textbooks and other course materials. However, during the COVID‐19 ...pandemic, these resources were no longer available due to health and safety protocols. With the advancement of technology, it was possible to create anatomy walkthrough videos for the students to supplement the traditional methods of teaching anatomy.
Goal
To investigate the effectiveness of a video based guide to learning gross anatomy of the boney pelvis and the viscera.
Methods
Two videos were created covering the boney pelvis and the viscera for the first and second year medical students. The videos were presented by an anatomy professor and filmed and edited by Medical Students. The video covers the curriculum outline, labels relevant parts of the anatomy, and provides extra information relating to form and function. The videos included a quiz at the end for students to test their knowledge. The videos were made available online on Youtube to an international audience, along with a feedback survey.
Results
Feedback was collected on the boney pelvis and the viscera videos. The respondents watched the videos for the purpose of preparing for anatomy labs and dissections, preparing for anatomy lectures and preparing for examinations. The majority of respondents agreed or strongly agreed that the videos presented assisted them in fulfilling their indicated purpose (89.1%), that a combination of video and written materials should be used for effective learning of anatomy (95.7%), and that they would like to see videos for other anatomical regions (95.7%).
Conclusion
In summary, digital media in the form of video‐based anatomy guides may be useful in instances when in person teaching is not possible and may be a useful tool to be incorporated into the educational curriculum in combination with traditional teaching methods. Future goals include implementing student feedback and reaching a broader audience.
INTRODUCTION
Inequities faced by women in academic medicine before the COVID‐19 pandemic are well‐known, yet there are little formal data on exactly how the pandemic has affected faculty, ...particularly in academic medicine. The purpose of this cross‐sectional study was to elucidate the impact of the pandemic on faculty in academic medicine and identify whether it is disproportionately affecting populations, focusing specifically on responsibilities at home, work, and mental health according to gender identification, faculty rank, and faculty appointment.
METHODS
An online questionnaire was distributed in February 2021 to faculty at academic medicine centers. This questionnaire asked respondents to provide demographic data, answer questions about their responsibilities at home and work, and indicate whether and how the pandemic has affected both. Respondents were also asked questions on self‐care and mental health and to document how their institution(s) can assist faculty in mitigating struggles associated with the pandemic. Responses were analyzed via quantitative (Pearson’s chi‐square tests) and qualitative (thematic analysis) means.
RESULTS
Women, mid‐, and early‐career faculty were more likely to be responsible for the care of others (p=0.014), and the impact of the pandemic on caring for others was negative, especially for early career faculty (p=0.019). Research, teaching, and clinical practice were negatively impacted by the pandemic, with women feeling this more severely in clinical practice (p=0.003), as a result of an increased teaching load (p=0.042), and inadequate work environment (p=0.013). Women (p<0.01), early career‐faculty (p<0.01), and clinical faculty (p=0.029) were also more negatively impacted by the pandemic in the areas of self‐care and mental health. While there was no significant difference in who requested a leave of absence or tenure clock extension, early‐career and women faculty were more likely to fear retribution for such requests. Faculty provided actionable suggestions to combat these negative effects under five themes, including Flexible Expectations, Support, Mental Health, Compensation, and Communication.
CONCLUSION
Pre‐pandemic stress and burnout among faculty in academic medicine has been well documented, and this study demonstrates that academic medicine faculty, particularly women and early‐career faculty, continue to feel additional burdens secondary to the COVID‐19 pandemic. These data can be utilized by administrations and future studies to make informed decisions regarding policies and programs created to assist those populations who are most vulnerable to the effects of the pandemic.
SIGNIFICANCE
To the authors’ knowledge, this is the first study to provide both quantitative and qualitative data demonstrating a negative impact of the COVID pandemic on academic medicine faculty, particularly women and early career faculty. These data are necessary to create change to improve recruitment and retention of quality faculty.
Introduction & Objective
In March 2020, medical schools around the country had to quickly transition from in person cadaveric anatomy curricula to an online distance learning format due to the ...COVID‐19 pandemic. This posed a challenge for students who had acclimated to learning anatomy inside the laboratory for the majority of their first year of medical school. The purpose of this study was to assess student perceptions of the abrupt transition from in person anatomy dissections and practical exams to an exclusively online format.
Materials and Methods
An anonymous survey was distributed to medical students from the Class of 2023 at the Medical College of Georgia at Augusta University (n=191) in February 2021. The survey assessed student perceptions of the impact of COVID‐19 shutdowns on their medical education. In total, 45 responses were recorded, and survey data was analyzed using SPSS software. Nonparametric methods were used due to the ordinal nature of the Likert scale responses. A Wilcoxon signed rank test was performed. In addition, focus groups were conducted with 11 medical students who had completed the survey.
Results
A majority of respondents (82.55%) stated that their learning and understanding of anatomy was worse after cancellation of in person anatomy lab dissections. In contrast, understanding of didactic lecture material was split, with 37.5% stating that online lectures had no impact on their learning and understanding of the material, 31.25% stating understanding was worse, and 25% stating it was better following transition to online‐only lectures. The results from the Wilcoxon signed rank test of Likert scale responses indicated that students perceived impact of cancelling in person anatomy lab as significantly worse compared to the impact of cancelling in person lectures (p<0.001). Focus group responses echoed this theme, with the loss of 3‐dimensional visual and tactile learning in laboratory cited most frequently by participants as a challenge with the transition to online anatomy.
Conclusion
Medical student respondents in the class of 2023 perceived online anatomy as inferior to in person laboratory sessions after the COVID‐19 shut‐down in March 2020. The transition from in person to online anatomy was more impactful on student understanding of material than the transition from in person to online didactic lectures. Of note, the students surveyed had completed the majority of their anatomy curriculum in person prior to the transition online.
Significance/Implication
The medical school shutdowns that occurred in March 2020 due to the COVID‐19 pandemic highlighted the importance of in person interaction with cadaveric specimens in anatomy education, especially in the context of how students were initially exposed to content. When possible, consideration should be given to learning approaches that students are familiar with and how changes to the curriculum will impact them.
The COVID‐19 pandemic has had a detrimental impact on healthcare education. With restricted access to traditional teaching aids such as the cadaver, educators had to adapt their teaching practise to ...minimise disruptions to students’ educational process. However, cadaveric dissection is highly regarded as a key component of anatomical and surgical education. This was particularly challenging when teaching was purely online due to pandemic restrictions. To accommodate the shift to online delivery only, the Anatomy Department at Brighton and Sussex Medical School (BSMS) adopted a variety of synchronous and asynchronous teaching methods. As part of this strategy, the department extended its provision of anatomy teaching by live streaming cadaver dissections to first year medical students (n=220). BSMS was the first UK medical school to use this innovative digital tool. A Virtual Reality in Medicine and Surgery (VRiMS) course was also developed to provide training to surgeons worldwide. This work explores the place of cadaver‐based education in a true blended learning provision.
Cadaver dissections were live streamed from the dissection room using operating theatre lights and a 4K camera via Microsoft Teams. These sessions were also interactive in nature, allowing students to ask questions throughout the dissection. Student feedback was collected through module and end of year evaluations. The VRiMS course provided a platform to demonstrate surgical procedures on cadavers using live streaming with virtual reality or 360 cameras. Surgeons were able to choose multiple camera angle perspectives through virtual reality headsets. Course participation data was used to determine the useability of this novel method of teaching and training.
Module evaluation showed that the overall quality of delivery for anatomy practical sessions was rated as good and very good by 86% of the cohort. Moreover, 93% of students found the material to be just right. In the end of year evaluation, students have indicated that live streamed dissection sessions were one of their favourite aspects and has had a positive impact on their time at BSMS. In total, 1354 participants from around the world have watched 923 hours of live broadcasted content across four VRiMS courses to date. The course has seen a 52% increase in participation rate since its launch.
The evaluation findings suggest that a hybrid learning approach with the use of live streaming for anatomical education has had a positive outcome on student satisfaction. Furthermore, VRiMS course participation data indicates that virtual reality has a promising future in surgical training. Live streaming and virtual reality have proved successful in bringing the dissection room to medical students and surgical trainees during unprecedented circumstances. This approach has the potential to prevent the complete loss of interactive cadaver‐based education and a probable solution to cadaver scarcity.
After COVID‐19 vaccination a number of currently and formerly menstruating people reported changes in menstrual bleeding and menstrual symptoms. Media highlighted these experiences, but much of the ...focus was on changes in regularly menstruating cis‐gendered women and unnecessary concerns about fertility. This was despite ample evidence of vaccine safety for people who were currently pregnant or conceived after vaccination. An overlooked phenomenon was reports of periods, spotting, or other unexpected vaginal bleeding in people who usually do not menstruate, including people assigned female at birth who are transmasculine, trans men, agender, non‐binary, and other gender diverse identities. We present preliminary descriptions of post‐vaccine menstrual experiences of a vaccinated, non‐menstruating, gender diverse sample.
Methods
We conducted an online survey to characterize the menstrual experiences of a diverse group of currently and formerly menstruating people from April 7, 2021 through Oct 7, 2021. From over 160,000 responses, we identified 552 people between the ages of 18 and 45 who 1) reported they usually do not menstruate; 2) reported using testosterone and/or gender‐affirming hormones (some did not specify testosterone); and 3) were not cis women. In addition to demographic characteristics (e.g., age, gender), we asked multiple‐choice and open‐ended questions about current menstrual status (including why they do not menstruate), hormone medications, contraceptive use, and menstrual symptoms after being vaccinated. Here, we combine experiences for both doses of the vaccine for analysis and group period, spotting, and other menstrual bleeding into one category called “breakthrough bleeding”.
Results
In this sample (n=552, age=25.6 +/‐ 5.7 (mean +/‐SD)), most respondents (84%, 463/552) selected more than one gender, with the most common for this subsample being transgender (n=460), man or man identified (n=373), non‐binary (n=241), and genderqueer/gender non‐conforming (n=124). 33% of respondents (180/552) reported breakthrough bleeding after vaccination, 9% (52/552) reported chest or breast soreness, and 46% (254/552) reported having other symptoms they would usually associate with a period. In response to the open‐ended question about other period related symptoms, respondents reported common symptoms such as cramping and bloating. A number of respondents also used the open‐ended text boxes to report negative mental health in response to their period symptoms, including anxiety, depression, gender dysphoria, panic attacks, and suicidal ideation.
Conclusions
Many gender diverse people who received vaccines for COVID‐19 experienced symptoms that are usually associated with menstruation, including unexpected bleeding. Because menstruation is usually considered in relation to fertility, other important aspects of this physiology are overlooked and this impacts people beyond fertile women. Attentiveness to menstruation beyond fertility and more inclusive use of gender in clinical trials is important to prepare people for potential side effects, address medically underserved populations, and reduce vaccine hesitancy.
OBJECTIVE
The aim of this study was to evaluate students’ perceptions of the educational value of online, interactive anatomy radiology laboratories.
HYPOTHESIS
Digital dissection is performed with ...computed tomography (CT) scans on near life‐size anatomy visualization tables and has been used to teach radiology anatomy at our institution. These sessions were pivoted to online delivery in response to COVID‐19. With the ongoing movement towards technology integration in medical education, if home access to these online laboratories is made available then we hypothesize the perceived learning experience should be preserved.
METHODS
290 first‐year medical students participated in 10 weekly digital radiology anatomy laboratories, which employed 3D CT scans to emphasize the clinical applications of anatomy. Students reviewed the cases at home prior to the lab on a mobile platform and labs were delivered synchronously via the Zoom platform in a facilitated large‐group format. After the course, a voluntary anonymous online survey was distributed assessing learner satisfaction, task value, emotional achievement, and cognitive load.
RESULTS
Survey response rate was 44%. Most participants reported the labs improved their knowledge of anatomy (82%), disease (81%) and clinical decision making (65%), including surgical knowledge (76%). The large group, synchronous learning format was found to be the most effective (68%). Positive emotional achievement was reported (mean 2.98). The extraneous cognitive load of the at‐home mobile technology and lack of time were perceived as the greatest programmatic challenges.
CONCLUSION
Synchronous digital dissection labs were perceived as a valuable addition to the first‐year medical curriculum, enhancing learners’ clinical decision making and preparation for medical sub‐specialties. This format of radiology anatomy education can be integrated into blended learning environments to provide students with additional learning opportunities.
