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Annals of Anatomy = Anatomischer... Jun 2024Informed consent is critical for maintaining the ethical standards associated with the utilization of human donor bodies by tertiary education institutions. Body...
INTRODUCTION
Informed consent is critical for maintaining the ethical standards associated with the utilization of human donor bodies by tertiary education institutions. Body donation programs undertake the responsibility for procuring human donor bodies for didactic and research purposes. However, its processes require scrutiny regarding best practice guidelines and the South African National Health Act (SA-NHA) (2013). Moreover, acknowledging and addressing the current perceptions of human body donation are indispensable in bridging the gap between academia and society. This study aimed to compare informed consent documentation and procedures across South African tertiary education institutions and their affiliated human body donation programs (HBDP) in accordance with international guidelines. The findings were used to create a human body donation form template aligned to current international best practices for consideration by the South African HBDP.
METHODOLOGY
A review of information and consent forms collected from South Africa's eight HBDP was conducted. The analyses consisted of a broad evaluation of information provided, ranging from the terms of use of bodies to the commitments made by HBDP to donors. The results were considered in conjunction with the International Federation of Associations of Anatomists and other recent publications on informed consent in HBDP.
RESULTS
Only two of the eight HBDP provided information and consent forms in more than one language. Most allowed donors to select how their bodies will be utilized - education, training and/or research. Some (6/8) made provisions for the next-of-kin to receive the cremains. Only one tertiary educational institution mentioned the occurrence of a memorial service in its documentation. An HBDF template was created aligned to current international best practices for presentation and possible adaption by SA HBDP.
DISCUSSION & CONCLUSIONS
Human body donation forms (HBDF) requires thorough examination for the promotion and sustainability of HBDP. Effective communication by employing standardized non-technical terminology conveyed in language that is understandable and native to potential donors facilitates the deliverance of informed consent. Inconsistencies regarding the use and management of bodies catalyze the weakening perception of human body donation. Thus, this process of securing informed consent for body donation should be conducted in conjunction with public awareness campaigns and underpinned by the necessary policy and legislative reform.
PubMed: 38906340
DOI: 10.1016/j.aanat.2024.152292 -
Scientific Reports Jun 2024Determining the fundamental characteristics that define a face as "feminine" or "masculine" has long fascinated anatomists and plastic surgeons, particularly those...
Determining the fundamental characteristics that define a face as "feminine" or "masculine" has long fascinated anatomists and plastic surgeons, particularly those involved in aesthetic and gender-affirming surgery. Previous studies in this area have relied on manual measurements, comparative anatomy, and heuristic landmark-based feature extraction. In this study, we collected retrospectively at Cedars Sinai Medical Center (CSMC) a dataset of 98 skull samples, which is the first dataset of this kind of 3D medical imaging. We then evaluated the accuracy of multiple deep learning neural network architectures on sex classification with this dataset. Specifically, we evaluated methods representing three different 3D data modeling approaches: Resnet3D, PointNet++, and MeshNet. Despite the limited number of imaging samples, our testing results show that all three approaches achieve AUC scores above 0.9 after convergence. PointNet++ exhibits the highest accuracy, while MeshNet has the lowest. Our findings suggest that accuracy is not solely dependent on the sparsity of data representation but also on the architecture design, with MeshNet's lower accuracy likely due to the lack of a hierarchical structure for progressive data abstraction. Furthermore, we studied a problem related to sex determination, which is the analysis of the various morphological features that affect sex classification. We proposed and developed a new method based on morphological gradients to visualize features that influence model decision making. The method based on morphological gradients is an alternative to the standard saliency map, and the new method provides better visualization of feature importance. Our study is the first to develop and evaluate deep learning models for analyzing 3D facial skull images to identify imaging feature differences between individuals assigned male or female at birth. These findings may be useful for planning and evaluating craniofacial surgery, particularly gender-affirming procedures, such as facial feminization surgery.
Topics: Humans; Skull; Imaging, Three-Dimensional; Female; Male; Neural Networks, Computer; Deep Learning; Retrospective Studies; Sex Characteristics; Adult; Image Processing, Computer-Assisted
PubMed: 38877045
DOI: 10.1038/s41598-024-61879-6 -
Scientific Data Jun 2024The chondrocranium provides the key initial support for the fetal brain, jaws and cranial sensory organs in all vertebrates. The patterns of shaping and growth of the...
The chondrocranium provides the key initial support for the fetal brain, jaws and cranial sensory organs in all vertebrates. The patterns of shaping and growth of the chondrocranium set up species-specific development of the entire craniofacial complex. The 3D development of chondrocranium have been studied primarily in animal model organisms, such as mice or zebrafish. In comparison, very little is known about the full 3D human chondrocranium, except from drawings made by anatomists many decades ago. The knowledge of human-specific aspects of chondrocranial development are essential for understanding congenital craniofacial defects and human evolution. Here advanced microCT scanning was used that includes contrast enhancement to generate the first 3D atlas of the human fetal chondrocranium during the middle trimester (13 to 19 weeks). In addition, since cartilage and bone are both visible with the techniques used, the endochondral ossification of cranial base was mapped since this region is so critical for brain and jaw growth. The human 3D models are published as a scientific resource for human development.
Topics: Humans; Imaging, Three-Dimensional; Fetus; Female; X-Ray Microtomography; Skull; Pregnancy; Cartilage
PubMed: 38871782
DOI: 10.1038/s41597-024-03455-1 -
Folia Morphologica Jun 2024The aim of the study was to describe the comprehensive morphological and morphometric features of the foramina and canals at the base of the cranial cavity in Holstein...
BACKGROUND
The aim of the study was to describe the comprehensive morphological and morphometric features of the foramina and canals at the base of the cranial cavity in Holstein cow using CT images.
MATERIALS AND METHODS
The study was performed on fourteen adult Holstein cow head cadavers. Images taken with MSCT were transferred to the DICOM Viewer program. The MPR and 3D reconstructive tools of the program were used to analyse the foramina and canals.
RESULTS
Although they varied in shape and size, foramina and canals were found bilaterally in all animals. It was observed that the orbitorotund foramen, jugular foramen and oval foramen had a canalicular structure, with the distance between the extra-intra cranial openings measured as 15.0 mm, 5.9 mm and 6.2 mm, respectively. The hypoglossal canal, which was found to be single in 43%, double in 50% and triple in 7% in each body half, was the canal with the most variation in number and shape. The orbitorotund foramen, a canal with an area of 180.6 mm² and a diameter of 18.1 × 12.4 mm is the widest at the skull base, while the optic canal is the narrowest and longest opening with an area of 33.4 mm², a diameter of 8.4 × 5.5 and a length of 17.5 mm.
CONCLUSIONS
This study shows that our knowledge of skull base morphometry in animals is extremely limited. Although the study was conducted on a limited number of materials, it may benefit both regional anatomy knowledge in terms of the data presented and veterinary anatomists, radiologists and clinicians in terms of methodology.
PubMed: 38856316
DOI: 10.5603/fm.100461 -
Journal of Medical Education and... 2024Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This...
OBJECTIVES
Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence (AI) to personalize learning and collect data on mastery acquisition.
METHODS
The study focused on liver anatomy (microscopic and macroscopic anatomy, embryology, clinical anatomy) and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. A total of 123 first-year medicine students (55 M/68F) participated to the study. Content and resources of the module were adaptable to various digital devices. Statistics were compiled based, on the one hand, on the measurement of mastery for every single learning objective provided automatically by the platform via the student interactions with the system probes (questions); on the other hand, metacognition data were worked out by crossing mastery data with the self-awareness declared in every question and learning resource by each learner.
RESULTS AND CONCLUSIONS
At the outset of the study, students displayed a 18.11% level of conscious incompetence and a 19.43% level of unconscious incompetence. Additionally, 50.86% of students demonstrated conscious competence. By the conclusion of the learning module, the level of conscious incompetence had decreased to 1.87%, and 98.73% of students exhibited conscious mastery of the materials. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of AI-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist, and the need for individualized instruction.
PubMed: 38854913
DOI: 10.1177/23821205241248023 -
Cureus May 2024Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have...
INTRODUCTION
Anatomical preservation and functional integrity of the facial nerve (FN) are the main concerns of parotid surgery. Even though a variety of anatomical landmarks have been proposed and widely utilized, temporal or permanent postoperative FN palsy is still a significant comorbidity of parotid surgery. Therefore, the literature must fully elucidate the consistency of the anatomical relationship between the FN and the retromandibular vein (RMV).
METHODS
We conducted a cadaveric study of 24 hemifaces to map the relationship between the FN and the RMV. Three distinct patterns were identified. Fourteen of the hemifaces were males, and 10 were females. Thirteen cadaveric dissections were performed on the right side and 11 on the left side.
RESULTS
Our study found three distinct patterns and proposed a classification system. Type I (66.7%) is when the nerve lies exclusively lateral to the RMV. Type II (29.2%) is when the FN lies superficial to the RMV, but its mandibular branch lies deep to the anterior branch of the RMV, and type III (4.1%) is when the FN lies exclusively medial to the RMV.
CONCLUSION
The FN and RMV relationship is not constant, and surgeons should be aware of every anatomical variation. Especially in cases where the FN is estimated to lie more in-depth to the level of the RMV, a retrograde approach may be required to avoid a FN injury.
PubMed: 38832166
DOI: 10.7759/cureus.59637 -
Biology Open Jun 2024The supracondylar foramen with a (seemingly) osseous peripheral arch noticed on the medio-distal feline humeri had remained disputed among anatomists. Some scholars have...
The supracondylar foramen with a (seemingly) osseous peripheral arch noticed on the medio-distal feline humeri had remained disputed among anatomists. Some scholars have argued in favor of homology between this foramen and the supracondyloid foramen formed in presence of the ligament of Struthers in humans. Other theories include its presence as a retinaculum holding the median nerve and brachial artery to their anatomical position in a flexed elbow. Unfortunately, these theories lack investigative rigor. The emergence of non-invasive imaging modalities, such as micro-computed tomography, has enabled researchers to inspect the internal anatomy of bones without dismantling them. Thus, a micro-computed tomographic investigation was conducted on three feline (Felis catus) humeri specimens while the internal anatomy of the supracondylar foramina was examined. Unlike the humerus, the thin peripheral arch of the feline supracondylar foramen failed to elicit any osseous trabeculae or foci of calcification. While adhering to the humeral periosteum at its origin, the non-osseous arch, typical of a muscular tendon, attaches into the bony saddle related to the medial humeral epicondyle suggestive of a tendon or aponeurotic extension of a (vestigial) brachial muscle, with the coracobrachialis longus emerging to be the most likely candidate.
Topics: Animals; Cats; Humerus; Biological Evolution; X-Ray Microtomography
PubMed: 38818877
DOI: 10.1242/bio.060420 -
Cureus Apr 2024Background This study aimed to identify morphological variations, conduct morphometry of the liver, and present its clinical implications. Methodology The study was...
Background This study aimed to identify morphological variations, conduct morphometry of the liver, and present its clinical implications. Methodology The study was conducted on 35 preserved cadaveric livers without macroscopic abnormalities. Morphological features such as shape and size were studied and variations such as the absence of lobe, accessory fissures, or accessory lobes were noted in all specimens. Results The caudate lobe was absent in one liver, and the quadrate lobe was absent in six livers. Moreover, seven livers had accessory fissures, and accessory lobes were seen in six livers. The left lobe with a lingular process was seen in three livers, and diaphragmatic grooves were present in seven livers. Conclusions The present research is helpful to radiologists, surgeons, and anatomists as it demonstrates the different morphological variations in the liver.
PubMed: 38813305
DOI: 10.7759/cureus.59275 -
Journal of Korean Medical Science May 2024Anatomy is a foundational subject in medicine and serves as its language. Hippocrates highlighted its importance, while Herophilus pioneered human dissection, earning... (Review)
Review
Anatomy is a foundational subject in medicine and serves as its language. Hippocrates highlighted its importance, while Herophilus pioneered human dissection, earning him the title of the founder of anatomy. Vesalius later established modern anatomy, which has since evolved historically. In Korea, formal anatomy education for medical training began with the introduction of Western medicine during the late Joseon Dynasty. Before and after the Japanese occupation, anatomy education was conducted in the German style, and after liberation, it was maintained and developed by a small number of domestic anatomists. Medicine in Korea has grown alongside the country's rapid economic and social development. Today, 40 medical colleges produce world-class doctors to provide the best medical care service in the country. However, the societal demand for more doctors is growing in order to proactively address to challenges such as public healthcare issues, essential healthcare provision, regional medical service disparities, and an aging population. This study examines the history, current state, and challenges of anatomy education in Korea, emphasizing the availability of medical educators, support staff, and cadavers for gross anatomy instruction. While variations exist between Seoul and provincial medical colleges, each manages to deliver adequate education under challenging conditions. However, the rapid increase in medical student enrollment threatens to strain existing anatomy education resources, potentially compromising educational quality. To address these concerns, we propose strategies for training qualified gross anatomy educators, ensuring a sustainable cadaver supply, and enhancing infrastructure.
Topics: Humans; Anatomy; Cadaver; Education, Medical; History, 20th Century; Republic of Korea; Schools, Medical
PubMed: 38804009
DOI: 10.3346/jkms.2024.39.e159 -
The American Journal of Case Reports May 2024BACKGROUND The brachial plexus is a complex neural structure providing motor and sensory innervation to structures of the arm, shoulder, and upper chest. The anatomical...
BACKGROUND The brachial plexus is a complex neural structure providing motor and sensory innervation to structures of the arm, shoulder, and upper chest. The anatomical structure is typically divided into roots, trunks, divisions, and cords. Due to the presence of multiple nerve roots and branches, anatomical variations are common. Awareness of variations from normal anatomy is important in imaging, administration of nerve blocks, and surgical procedures of the neck and shoulder region. CASE REPORT We present a case of multiple anatomic variations of the right brachial plexus identified in a cadaver during routine dissection. To summarize, we identified a prefixed plexus with anomalous contributions from the C4 nerve root. Nerve roots C4 and C5 emerged anterior to the anterior scalene muscle. Furthermore, 4 trunks, rather than the typical 3, gave rise to multiple anomalies in the branching pattern of the distal divisions and cords. To the best of our knowledge, this is the first such case reported in the published literature. CONCLUSIONS The current case report presents a combination of brachial plexus anomalies not previously described in the medical literature - specifically, a prefixed (C4-T1) brachial plexus positioned anterior to the anterior scalene muscle with anomalies of the trunks, divisions, cords, and terminal branches. The variations presented have implications in neurogenic compression, interscalene blocks, and trauma to the upper limb. Knowledge of these anomalies may better equip anatomists and clinicians to understand pathology and intervention of the upper limb.
Topics: Humans; Brachial Plexus; Cadaver; Male; Anatomic Variation
PubMed: 38797983
DOI: 10.12659/AJCR.943866