One Size Does Not Fit All in Remote Anatomy Teaching.

Anatomical knowledge is central to the advancement of biomedical research and clinical practice and provides the underpinning foundations for many clinical examinations and processes. Anatomy is a very practical and three-dimensional subject, requiring learners to be able to visualise structures within the body and how they interact with each other. Typically, this is taught through a combination of lectures and practical laboratories in which students can interact with human cadaveric material to gain an appreciation of real-life anatomy, often commenting on how these lab sessions really bring their lectures to life.Like so many things, the teaching of anatomy on university campuses became severely restricted with the arrival of the COVID-19 pandemic in March 2020. Staff and students were no longer able to attend universities and body donation programmes were halted. This brought with it both challenges and opportunities to redevelop digital anatomy education. This chapter will discuss the different teaching approaches taken to delivery anatomy education at the University of Glasgow in three different programmes: (1) Bachelor of Science Honours (BSc Hons) degree in Anatomy, (2) the Glasgow Access to Medicine Programme (GAP), and (3) the undergraduate Bachelor degree in Medicine (MBChB). These three programmes were selected as they each teach anatomy to undergraduate students but the teaching methods, class sizes, and student backgrounds for each is very different. In discussing the different approaches taken and reflecting on staff and student feedback on these experiences, we hope to provide not just a record of the unprecedented and rapid changes to education during this time but also to offer some thoughts on how lessons might be learned as we return to on-campus teaching.

Soft-tissue landmarks for tibial baseplate rotational alignment in total knee arthroplasty: A cadaveric study.

The tip of the tibial tubercle (TTT) is used to assess tibial baseplate rotation in total knee arthroplasty (TKA); however, it can be difficult to palpate and visualize intraoperatively. Several more easily accessible soft-tissue structures have been proposed as intraoperative assessments, including the patellar tendon's medial border (MBPT) and the junction of the medial third of the patellar tendon (mt-PT). No studies have described the relationship between the TTT and these proposed landmarks. The aims of the study were to (1) determine the relationship of the soft-tissue landmarks to the TTT and (2) identify any sex differences in these measures. Measurements of the position of these soft-tissue landmarks relative to the TTT were made on 56 cadaveric knees (28 female) by two observers at the level of the standard tibial cut (10 mm distal to the lateral tibial plateau). The results obtained were compared by sex and side. On average, 50.7% (SD 6.79, range 33.1%-63.1%) of the patellar tendon footprint was medial to the TTT. There were no significant differences between the sexes or left and right lower limbs. However, there was large variability in the position of all the soft-tissue landmarks relative to the TTT. The results indicate that, on average, the patellar tendon footprint is evenly spread around the TTT. However, there is a large variability in the anatomical relationship between the soft-tissue landmarks and the TTT. Caution is advised if relying on these structures intraoperatively.

Visualising the Link Between Carpal Bones and Their Etymologies.

It has been observed through published studies, as well as anecdotally, that medical students struggle with retention of anatomical knowledge. Studies have found that having an established understanding of classical Greek or Latin languages, which underpin medical terminology, can result in higher anatomy test scores by medical students. It has also been established that three-dimensional (3D) visualisation tools can aid in student learning. This chapter will examine the research conducted at the University of Glasgow, which focused on the creation of a mobile application that visualises the etymology of the carpal bones for the purpose of aiding medical students in their learning and retention of knowledge of anatomy. The chapter will first build a body of knowledge by reviewing previous studies in which a carpal bone test was used as a measure of medical students' anatomy knowledge, as well as the relevance of etymology in medicine and its use in the study of anatomy, and the current teaching methods of anatomy, with a focus on how 3D visualisation tools can aid learning. It then outlines a methodological and technical framework to create anatomically accurate 3D models of the carpal bones and develop the final mobile application. It also discusses the methodology used to carry out suitable user testing and collect user feedback. This chapter concludes by discussing the results of user testing, where feedback was analysed to improve the mobile application design for further use in anatomy teaching. Limitations and future outlooks of the study, along with the future of integrating 3D visualisation tools as teaching methods to aid in student learning of anatomy, are also explored.

A Methodology for Visualising Growth and Development of the Human Temporal Bone.

This chapter presents a methodological framework which could be used to produce accurate anatomical 3D models and animations of the developing skull, with a focus on the temporal bone. Initial modelling is based on information from core texts and visual references, before optimising these models for use in interactive real-time applications. A series of 3D modelling and animation workflows typically used in computer games and animation industry were tested and compared. Workflows most suitable for the production of a 3D visualisation of the developing temporal bone were documented in detail and used to produce the final 3D models. 3D models of the developing temporal bone were then implemented in an interactive mobile application, which allowed users to explore the 3D models on their Android mobile device and use augmented reality to enhance real-world information. Results of tests conducted in this research suggest that 3D modelling workflows which mimic the processes occurring during development of the temporal bone are most suitable for producing realistic 3D models. Animation workflows tested in this research have all shown potential to produce morphing animations of the developing temporal bone. The significant time required to create deformation setups and animations themselves however suggests that using scripting to automate these workflows would increase their usability in projects with a limited timeframe.

Creating a 3D Learning Tool for the Growth and Development of the Craniofacial Skeleton.

Advances in technology are facilitating wider access to delicate, and often irreplaceable, anatomy specimens for teaching. Moreover, 3-dimensional (3D) models and interactive applications may help students to understand the spatial arrangement of complex 3D anatomical structures in a way not afforded by the 2-dimensional (2D) textbook images of traditional teaching.Historical specimens from the University of Glasgow's Museum of Anatomy were digitised for the creation of a 3D learning tool to help students better understand the growth and development of the juvenile skull. The overarching goal of this project was to assess whether interactive 3D applications can provide a useful tool for teaching more complex, non-static, anatomy subjects such as growth and development.The application received positive feedback from the small test group of 12 anatomy students. The majority of participants strongly agreed that the application helped them learn more about the human skull and they positively rated the use of 3D models in helping them learn about the position and structure of anatomical features, and in comparing skulls at different stages of development. Following on from this positive feedback, further tests could be conducted to assess if this 3D application confers an advantage in student learning over traditional teaching methods.

Juvenile age estimation from facial images.

Age determination from images can be of vital importance, particularly in cases involving suspected child sexual abuse (CSA). It is imperative to determine if an individual depicted in such an image is indeed a child, with a more concise age often sought, as this may affect the severity of offender sentencing. The aims of this study were to establish the accuracy of visual age estimation of the juvenile face in children aged between 0 and 16years and to determine if varying levels of exposure to children affected an individual's ability to assess age from the face. An online questionnaire consisting of 30 juvenile face images was created using SurveyMonkey®. The overall results suggested poor accuracy for visual age estimation of juvenile faces. The age, sex, occupation and number of children of the participants did not affect the ability to estimate age from facial images. Similarly, the sex and age of the juvenile faces did not appear to affect the accuracy of age estimation. When specific age groups are considered, sex may have an influence on age estimation, with female faces being aged more accurately in the younger age groups and male faces more accurate after the age of 11years, however this is based on a small sample. This study suggests that the accuracy of juvenile age estimation from the face alone is poor using simple visual assessment of images. Further research is required to determine exactly how age is assessed from a facial image, if there are indicators, or features in particular that lead to over- or under-estimation of juvenile age.

Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Metaanalysis.

BACKGROUND/OBJECTIVES: Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. DESIGN: We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed. SETTING: Acute and rehabilitation hospitals. PARTICIPANTS: Adults hospitalized for stroke who were newly admitted directly to long-term institutional care at the time of hospital discharge. MEASUREMENTS: Factors associated with new institutionalization. RESULTS: From 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long-term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long-term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long-term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long-term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined. CONCLUSION: Age and stroke severity are important predictors of institutional long-term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long-term care setting.