Poder, patriarcado e (r)existência: notas sobre uma experiência sensível e crítica entre mulheres na academia / Power, patriarchy and (r)existence: notes on a sensitive and critical experience among women in the academy / Poder, patriarcado y (r)existencia: notas sobre una experiencia sensible y crítica entre las mujeres en la academia

Neste artigo são apresentados processos, materialidades e reflexões que envolvem a criação de uma instalação artística, desenvolvida pelas autoras do trabalho provocadas pelos silenciamentos que marcam corpos plurais. As autoras foram mobilizadas pela intencionalidade do exercício de "colocar corpo" para a ação constante de des(colonizar)patriarcalizar a si mesmas e a vida, e pelo desejo de criar na conexão entre mulheres. A obra foi alicerçada com base em suas histórias e narrativas, por meio da materialidade expressa nos elementos visuais incorporados às peças da instalação, com o objetivo de questionar as violências visíveis e invisíveis advindas de processos hegemônicos de poder e de dominação do patriarcado, do colonialismo e do capitalismo neoliberal. O convite é para a experimentação e a fruição de alguns tensionamentos e expressões que refletem formas possíveis de (r)existência.(AU)

In this article, processes, materialities and reflections involving the creation of an artistic installation are presented, developed by the authors of the work caused by the silencing that mark plural bodies. The authors were mobilized by the intentionality to exercise "giving body" to the constant action of de(colonizing) patriarchalize themselves and life itself, and by the desire to create in the connection among women. The manuscript was based on its stories and narratives, through the materiality expressed in the visual elements incorporated into the installation's pieces, with the objective of questioning the visible and invisible violence arising from hegemonic processes of power and domination of patriarchy, colonialism and neoliberal capitalism. The invitation is to experiment and enjoy some tensions and expressions that reflect possible forms of (r)existence.(AU)

En este artículo son presentados procesos, materialidades y reflexiones que involucran la creación de una instalación artística, desarrollada por las autoras, provocadas por los silenciamientos que marcan cuerpos plurales. Las autoras se movilizaron con la intención del ejercicio de "poner cuerpo" para la acción constante de des(colonizar)patriarcalizar a sí mismos y a la vida, y con deseos de crear desde la conexión entre mujeres. La obra se basó en sus historias y narrativas, a través de la materialidad expresada en los elementos visuales incorporados en las piezas de la instalación, con en lo objetivo de cuestionar las violencias visibles e invisibles resultante de los procesos hegemónicos de poder y dominación del patriarcado, del colonialismo y del capitalismo neoliberal. La invitación es a experimentar y disfrutar de algunas tensiones y expresiones que reflejan posibles formas de (r)existencia.(AU)

Charting human development using a multi-endodermal organ atlas and organoid models.

Organs are composed of diverse cell types that traverse transient states during organogenesis. To interrogate this diversity during human development, we generate a single-cell transcriptome atlas from multiple developing endodermal organs of the respiratory and gastrointestinal tract. We illuminate cell states, transcription factors, and organ-specific epithelial stem cell and mesenchyme interactions across lineages. We implement the atlas as a high-dimensional search space to benchmark human pluripotent stem cell (hPSC)-derived intestinal organoids (HIOs) under multiple culture conditions. We show that HIOs recapitulate reference cell states and use HIOs to reconstruct the molecular dynamics of intestinal epithelium and mesenchyme emergence. We show that the mesenchyme-derived niche cue NRG1 enhances intestinal stem cell maturation in vitro and that the homeobox transcription factor CDX2 is required for regionalization of intestinal epithelium and mesenchyme in humans. This work combines cell atlases and organoid technologies to understand how human organ development is orchestrated.

Hysterosalpingography findings of leiomyomas and how they look in artistic eyes: new diagnostic signs.

Leiomyomas are benign lesions of the uterine smooth muscles that contain various amounts of fibrous connective tissue. Hystrosalpingography is not a method of diagnosing uterine fibroids, and other methods such as ultrasound and MRI are preferred, but during hystrosalpingography, especially in infertile females, uterine fibroids may be seen frequently. Leiomyomas have a wide range of appearances depending on their number, size and location. Leiomyomas may enlarge, elongate, displace, distort or rotate the uterine cavity and can be detected by such changes showing in hysterosalpingograms. These changes may be symmetric or asymmetric. Leiomyomas may result in uterine atony which can be locolized or generalized. Leiomyomas also may appear as one or multiple filling defects in different sizes which can be smooth or irregular. Some of the noted findings may create similar and frequent appearances looking like some patterns in nature and can be considered "excellent signs" for better detecting and enabling differential diagnosis. This study aims to improve the process of training on the diagnostic appearances of leiomyomas in hysterosalpingography by aligning the images with patterns found in nature that can be easily remembered by radiologists.

From Ancient Texts to Digital Imagery: A Brief History on the Evolution of Anatomic Illustrations.

In a time when social isolation heavily relies on the use of digital representation, photography, and e-books, it is easy to take for granted the impact imagery has on our society and the pedagogical purposes of illustration, particularly in the teaching of surgery. Illustrations after all are the basis of all anatomical atlases and are quintessential tools that allow for an expedient and thorough understanding of concepts underlying the fabric of the human body. Yet, surgery has not always been taught with an atlas. Illustrations, much like surgery, have seen an incredible transformative process spanning across the ages to achieve their status in modern medicine. Through this brief review, we will not only glean an understanding of the evolution of anatomical illustrations but also the social context in which surgery has also evolved throughout history.

Oral and maxillofacial surgeons' assessment of the role of Pernkopf's atlas in surgical practice.

BACKGROUND: The use of the Pernkopf atlas of human anatomy in surgery presents ethical challenges due to the author's association with the Nazi regime and the potential depiction of victims of this regime. The atlas was of particular utility to two surgical specialties: nerve surgeons and oral and maxillofacial surgeons. The representation of peripheral nerves and complex head and neck anatomy is probably unequaled in any other atlas of anatomy. While the ethical implications of the use of Pernkopf's atlas among nerve surgeons have been previously assessed, this study focuses on the volume dedicated to detailed images of head and neck dissections, and the ethical implications of using this atlas by oral and maxillofacial surgeons. OBJECTIVE: To (1) assess the role of the Pernkopf atlas in oral and maxillofacial surgeons' current practice and (2) determine whether a proposal of four conditions would provide ethical guidance for use in surgery and education. METHODS: Members of three American oral and maxillofacial surgical societies (ACOMS, ASTMJS, AAOMS) were surveyed and 181 responses collected. The survey introduced the historical origin of the Pernkopf atlas, and respondents were asked whether they would use the atlas under specific conditions that could be a recommendation for its ethical handling. An anatomical plate comparison between Netter's and Pernkopf's atlases was performed to compare accuracy and surgical utility. RESULTS: Forty-nine percent of respondents were aware of the Pernkopf atlas, and 9% of respondents were currently using it. Amongst those aware of the historical facts, 42% were comfortable using the atlas, 33% uncomfortable, and 25% undecided. The four conditions involving disclosure, bioethical and religious considerations, and remembrance led to 75% of those "uncomfortable" and "undecided" becoming "comfortable" with use. CONCLUSIONS: Amid recent developments and controversy regarding the Pernkopf atlas, a proposal detailing conditions for an ethical approach may provide guidance in surgical planning and education. Furthermore, this approach has implications for the future preparation and publication of anatomical atlases and their use.

A single cell atlas of the human liver tumor microenvironment.

Malignant cell growth is fueled by interactions between tumor cells and the stromal cells composing the tumor microenvironment. The human liver is a major site of tumors and metastases, but molecular identities and intercellular interactions of different cell types have not been resolved in these pathologies. Here, we apply single cell RNA-sequencing and spatial analysis of malignant and adjacent non-malignant liver tissues from five patients with cholangiocarcinoma or liver metastases. We find that stromal cells exhibit recurring, patient-independent expression programs, and reconstruct a ligand-receptor map that highlights recurring tumor-stroma interactions. By combining transcriptomics of laser-capture microdissected regions, we reconstruct a zonation atlas of hepatocytes in the non-malignant sites and characterize the spatial distribution of each cell type across the tumor microenvironment. Our analysis provides a resource for understanding human liver malignancies and may expose potential points of interventions.

The science of art: Leonardo Da Vinci and facial plastic surgery.

PURPOSE OF REVIEW: Leonardo Da Vinci possessed one of humanity's greatest minds, known for exploring the boundaries of art and science. The discipline of facial plastic surgery also relies on art and science for its advancement. This review focuses on key elements of Leonardo Da Vinci's work, and how they relate to concepts within facial plastic surgery. RECENT FINDINGS: Leonardo Da Vinci was a self-taught creative genius. Common themes that permeated his art were those of proportion, perspective, light and shadow, anatomy, and science. These principles are reflected in key aspects of facial plastic surgery, such as facial analysis, human gaze, facial subunits, surgery of the craniofacial skeleton, and evidence-based medicine. SUMMARY: Leonardo Da Vinci's approach to scientific inquiry and artistic beauty strikes a balance from which facial plastic surgeons have much to learn. In depth study of how Leonardo Da Vinci viewed the world furthers the analytical and creative sides of a facial plastic surgeon as well as informs their personal development.

Anatomy theaters in the history and teaching of surgery.

The study of anatomy has played a large part in the progress of scientific observation throughout the centuries and was pivotal in elevating anatomy from the magical thinking of the Hippocrates era and freeing it from subservience to medicine which was all-powerful in the past. Anatomy theaters appeared in Northern Italy in the 14th century and developed in Western Europe from the early 16th century to the beginning of the 19th century. Anatomy theaters lived their golden age in France during the 18th century when the Royal Academy of Surgery (Académieroyaledechirurgie) was created in 1743. These theaters were open to the public, and therefore offered the double vocation of teaching and public entertainment: they were used to teach anatomy and surgery to students and surgeons and offered distraction for the well-informed public that was fascinated by death, ever-present and familiar to all. Anatomical dissection accomplished a double ritual: the "profane" ritual of valorization of scientific knowledge and the "sacred" ritual, where mankind, obsessed with death, respected the human body considered as a divine image. Anatomy theaters declined as they became overshadowed by progress in anatomical teaching using well-illustrated works in well-equipped medical schools while exhibition of anatomic oddities for public amusement was relegated to fairs and circus sideshows. Nonetheless they opened the way to modern anatomo-clinical methods and surgery.

Medical Illustration in the Era of Cardiac Surgery.

This article reviews the collaboration between clinician and illustrator throughout the ages while highlighting the era of cardiac surgery. Historical notes are based on Professor Sanjib Kumar Ghosh's extensive review, literature searches, and the archives of the Johns Hopkins University Department of Art as related to Medicine in Baltimore. Personal communications were explored with medical illustrators and medical practitioners, many of whom are colleagues and trainees, to further chronicle the history of medical illustration and education in the era of cardiac surgery. Medical illustrators use their talents and expressive ideas to demonstrate procedures and give them life. These methods are (1) hovering technique; (2) hidden anatomy, ghosted views, or transparency; (3) centrally focused perspective; (4) action techniques to give life to the procedure; (5) use of insets to highlight one part of the drawing; (6) human proportionality using hands or known objects to show size; and (7) step-by-step educational process to depict the stages of a procedure. Vivid examples showing these techniques are demonstrated. The result of this observational analysis underscores the importance of the collaboration between clinician and illustrator to accurately describe intricate pathoanatomy, three-dimensional interrelated anatomic detail, and complex operations. While there are few data to measure the impact of the atlas on medical education, it is an undeniable assertion that anatomical and surgical illustrations have helped to educate and train the modern-day surgeon, cardiologist, and related health-care professionals.

Pernkopf's atlas: Should unethically obtained life-saving data be discarded?

Dr Pernkopf's Topographische anatomie des menschen (Topographical anatomy of man), in four volumes, was originally published in German. It had taken the author and his colleagues over twenty years to produce it, the first volume being published in 1937. It was translated into English in 1964. The atlas was received with uniform acclaim in Europe and America and praised for its accuracy and the quality of its illustrations. A recent study compared its utility with that of Dr Frank Netter's Atlas of human anatomy, first published in 1989, with its 7th edition out in 2018. "The respondents (nerve surgeons) found Pernkopf 's atlas having both greater anatomical detail (range 79%-91%) and greater utility for surgery (range 66%- 82%) when compared with Netter's (P < .001) in all plate comparisons." (1) Internationally renowned and respected neurosurgeon, Dr M Gazi Yasargil - not given to handing out praise lightly - said in 2004 of this atlas, "Pernkopf's work, in particular … Vol. 4 (800 pages, 218 figures) is of fantastic quality and is appreciated worldwide." (2) Surgeons continue to use Dr. Pernkopf's atlas to plan their operations (3). A recent example is its use in the treatment of a 13-year-old Israeli schoolboy (4). This essay discusses whether it is rational to refuse to use data and publications that are accurate and likely to help in treating patients. Since such information can save lives, should we spurn it because it was based on information obtained unethically?

Anatomy transformed.

This paper arose from exhibitions in Oxford and Dublin and comprises three experiments which look at the relationship between anatomy and art. In the first experiment, a passport photograph, photographic portrait and portrait in oils, all of the same sitter, show how artistic input transforms anatomy from a mere likeness into works of art. In the second, the reverse is true, as computer techniques render idealized old master images anatomically accurate. The third experiment addresses the biomechanical consequences of anatomical variation and shows that vehicular design is based on mean body shapes, and so it is the average, rather than the idealized, form that is safer in a collision.

Leonardo Da Vinci, investigador anatomista, a 500 años de su muerte (1452-1519) / Leonardo Da Vinci, anatomist researcher, 500 years after his death (1452-1519)

Leonardo Da Vinci fue autor de ilustraciones científicas. Se lo considera un pionero en el estudio de la anatomía humana en el siglo XV. Sus dibujos elevan la disección al nivel de una obra de arte. (AU)

Leonardo was author of scientific illustrates. He was a Pioneer in anatomy human study in the XV century. His drawing elevated the dissection to a level of art work. (AU)

Independent Left Ventricular Morphometric Atlases Show Consistent Relationships with Cardiovascular Risk Factors: A UK Biobank Study.

Left ventricular (LV) mass and volume are important indicators of clinical and pre-clinical disease processes. However, much of the shape information present in modern imaging examinations is currently ignored. Morphometric atlases enable precise quantification of shape and function, but there has been no objective comparison of different atlases in the same cohort. We compared two independent LV atlases using MRI scans of 4547 UK Biobank participants: (i) a volume atlas derived by automatic non-rigid registration of image volumes to a common template, and (ii) a surface atlas derived from manually drawn epicardial and endocardial surface contours. The strength of associations between atlas principal components and cardiovascular risk factors (smoking, diabetes, high blood pressure, high cholesterol and angina) were quantified with logistic regression models and five-fold cross validation, using area under the ROC curve (AUC) and Akaike Information Criterion (AIC) metrics. Both atlases exhibited similar principal components, showed similar relationships with risk factors, and had stronger associations (higher AUC and lower AIC) than a reference model based on LV mass and volume, for all risk factors (DeLong p < 0.05). Morphometric variations associated with each risk factor could be quantified and visualized and were similar between atlases. UK Biobank LV shape atlases are robust to construction method and show stronger relationships with cardiovascular risk factors than mass and volume.

Sandro Botticelli's Madonna of the Pomegranate: the hidden cardiac anatomy.

Sandro Botticelli was one of the most renowned artists of the 15th century. He was based in Florence during the flourishing of the Renaissance, a time when anatomical knowledge of ancient times was reclaimed through cadaveric dissection. This report proposes that such knowledge enabled Botticelli to enhance the iconography of his masterpieces, Madonna of the Pomegranate, by incorporating a concealed image of the heart and cardiac anatomy within it.

Nerve Surgeons' Assessment of the Role of Eduard Pernkopf's Atlas of Topographic and Applied Human Anatomy in Surgical Practice.

BACKGROUND: Pernkopf's atlas of Anatomy contains anatomical plates with detailed images of the peripheral nerves. Its use is controversial due to the author's association with the "Third Reich" and the potential depiction of victims of the Holocaust. The ethical implications of using this atlas for informing surgical planning have not been assessed. OBJECTIVE: To (1) assess the role of Pernkopf's atlas in nerve surgeons' current practice and (2) determine whether a proposal for its ethical handling may provide possible guidance for use in surgery and surgical education. METHODS: Members of American Society for Peripheral Nerve and PASSIO Education (video-based learning platform) were surveyed and 182 responses collected. The survey introduced the historical origin of Pernkopf's atlas, and respondents were asked whether they would use the atlas under specific conditions to serve as a recommendation for its ethical handling. An anatomical plate comparison between Netter's and Pernkopf's atlases was performed to compare anatomical accuracy and surgical utility. RESULTS: Fifty-nine percent of respondents were aware of Pernkopf's atlas, with 13% currently using it. Aware of the historical facts, 69% were comfortable using the atlas, 15% uncomfortable, and 17% undecided. Additional information on conditions for an ethical approach to the use of the atlas led 76% of those "uncomfortable" and "undecided" to becoming "comfortable" with use. CONCLUSION: While the use of Pernkopf's atlas remains controversial, a proposal detailing conditions for an ethical approach in its use provides new guidance in surgical planning and education.

Comparison of the automatic segmentation of multiple organs at risk in CT images of lung cancer between deep convolutional neural network-based and atlas-based techniques.

BACKGROUND: In this study, a deep convolutional neural network (CNN)-based automatic segmentation technique was applied to multiple organs at risk (OARs) depicted in computed tomography (CT) images of lung cancer patients, and the results were compared with those generated through atlas-based automatic segmentation. MATERIALS AND METHODS: An encoder-decoder U-Net neural network was produced. The trained deep CNN performed the automatic segmentation of CT images for 36 cases of lung cancer. The Dice similarity coefficient (DSC), the mean surface distance (MSD) and the 95% Hausdorff distance (95% HD) were calculated, with manual segmentation results used as the standard, and were compared with the results obtained through atlas-based segmentation. RESULTS: For the heart, lungs and liver, both the deep CNN-based and atlas-based techniques performed satisfactorily (average values: 0.87 < DSC < 0.95, 1.8 mm < MSD < 3.8 mm, 7.9 mm < 95% HD <11 mm). For the spinal cord and the oesophagus, the two methods had statistically significant differences. For the atlas-based technique, the average values were 0.54 < DSC < 0.71, 2.6 mm < MSD < 3.1 mm and 9.4 mm < 95% HD <12 mm. For the deep CNN-based technique, the average values were 0.71 < DSC < 0.79, 1.2 mm < MSD <2.2 mm and 4.0 mm < 95% HD < 7.9 mm. CONCLUSION: Our results showed that automatic segmentation based on a deep convolutional neural network enabled us to complete automatic segmentation tasks rapidly. Deep convolutional neural networks can be satisfactorily adapted to segment OARs during radiation treatment planning for lung cancer patients.

Towards a universal MRI atlas of the prostate and prostate zones : Comparison of MRI vendor and image acquisition parameters.

BACKGROUND AND PURPOSE: The aim of this study was to evaluate an automatic multi-atlas-based segmentation method for generating prostate, peripheral (PZ), and transition zone (TZ) contours on MRIs with and without fat saturation (±FS), and compare MRIs from different vendor MRI systems. METHODS: T2-weighted (T2) and fat-saturated (T2FS) MRIs were acquired on 3T GE (GE, Waukesha, WI, USA) and Siemens (Erlangen, Germany) systems. Manual prostate and PZ contours were used to create atlas libraries. As a test MRI is entered, the procedure for atlas segmentation automatically identifies the atlas subjects that best match the test subject, followed by a normalized intensity-based free-form deformable registration. The contours are transformed to the test subject, and Dice similarity coefficients (DSC) and Hausdorff distances between atlas-generated and manual contours were used to assess performance. RESULTS: Three atlases were generated based on GE_T2 (n = 30), GE_T2FS (n = 30), and Siem_T2FS (n = 31). When test images matched the contrast and vendor of the atlas, DSCs of 0.81 and 0.83 for T2 ± FS were obtained (baseline performance). Atlases performed with higher accuracy when segmenting (i) T2FS vs. T2 images, likely due to a superior contrast between prostate vs. surrounding tissue; (ii) prostate vs. zonal anatomy; (iii) in the mid-gland vs. base and apex. Atlases performance declined when tested with images with differing contrast and MRI vendor. Conversely, combined atlases showed similar performance to baseline. CONCLUSION: The MRI atlas-based segmentation method achieved good results for prostate, PZ, and TZ compared to expert contoured volumes. Combined atlases performed similarly to matching atlas and scan type. The technique is fast, fully automatic, and implemented on commercially available clinical platform.