Anatomage virtual dissection versus traditional human body dissection in anatomy pedagogy: insights from Ghanaian medical students.

BACKGROUND: Although traditional human body dissection has been the mainstay method for gross anatomy pedagogy, the popularity of virtual teaching methods has increased in recent years. The Anatomage table offers a life-size digital representation of the human body and allows visualization, manipulation, and virtual dissection. This study investigated the perception of medical students towards virtual dissection vis-à-vis traditional dissection in anatomy pedagogy. METHODS: The cross-sectional survey included medical students at the University of Ghana who completed an internet-based questionnaire administered using Google® Forms. The questionnaire comprised 20 close-ended questions that solicited information on demographics, experience with traditional human body dissection and virtual dissection, and perception of virtual dissection. Data was summarized as frequencies and percentages with 95% confidence intervals. RESULTS: Of the 297 participants, 295 [99.4% (95% CI = 97.3-99.9)] participated in human body dissection from which 93.2% had a positive and 6.8% had poor experiences. Whereas 223 [75.1% (95% CI = 69.7-79.8)] of the participants would participate in dissection again given the opportunity, 74 [24.9% (95% CI = 20.2-30.3)] were unwilling. Of 297 participants, 205 [69.0% (95% CI = 69.7-74.2)] had used Anatomage table, while 92 [31.0% (95% CI = 25.8-36.6)] had not. About 68% (95% CI = 60.8-74.0) of the 205 agreed with the relative ease of operation and use of the Anatomage table compared to traditional human body dissection while 9.4% disagreed. Inadequate operational skills [51% (95% CI = 48.9-53.4)] and limited accessibility [39% (95% CI = 35.2-42.3)] were limitations to Anatomage use. 66.8% (95% CI = 59.9-73.1) of participants agreed virtual dissection had a positive influence on learning anatomy while 6.6% disagreed. Of the 205, 87.9% (95% CI = 82.3-91.8) discouraged virtual anatomy dissection completely replacing traditional human body dissection. CONCLUSION: Virtual dissection is an effective supplement to traditional body dissection but not a replacement. Its use alongside traditional methods improves anatomy learning. Integrating technology into anatomy education will enhance student engagement and learning.

Cross-Sectional Study for Investigation of the Association Between Modifiable Risk Factors and Gastrointestinal Cancers at a Tertiary Hospital in Ghana.

BACKGROUND: Malignancies affecting the gastrointestinal tract are among the principal threats to global public health. In Ghana, these cancers are responsible for a significant number of hospitalizations and mortalities at major health facilities across the country. The increasing incidence of these malignancies necessitates an investigation of the association between lifestyle (modifiable risk factors) and these disorders. MAIN OBJECTIVE: To determine the association between lifestyle and gastrointestinal cancers of patients attending the Korle Bu Teaching Hospital (KBTH). STUDY DESIGN: This was a cross-sectional prospective study where demographic data were obtained from consenting patients diagnosed with gastrointestinal cancer at the oncology and surgical clinics of the KBTH. Diagnostic investigations, gastrointestinal cancer phenotype, year of diagnosis and treatment(s) received were also obtained from the participants. Information on smoking status, alcohol consumption, sources of dietary proteins, daily intake of water, and frequency of fruit intake were also obtained from the participants. Odds ratio and P-values were determined to ascertain whether there might be a significant association between gastrointestinal cancers and specified lifestyle. RESULTS: Colorectal cancers were the most prevalent form of gastrointestinal cancers among the participants. Alcohol consumption or smoking habits were not significantly associated with onset of gastrointestinal cancers among the study participants. There was a significant association but weak correlation between red meat consumption and the colorectal cancer. CONCLUSION: This study shows consumption of red meat to be a modifiable risk factor that is associated with lower gastrointestinal cancers in the study participants. Further longitudinal studies using large number of participants is needed for confirming the observations from this current study.

Teaching Cellular Architecture: The Global Status of Histology Education.

Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.

Virtual Microscopy Goes Global: The Images Are Virtual and the Problems Are Real.

For the last two centuries, the scholarly education of histology and pathology has been based on technology, initially on the availability of low-cost, high-quality light microscopes, and more recently on the introduction of computers and e-learning approaches to biomedical education. Consequently, virtual microscopy (VM) is replacing glass slides and the traditional light microscope as the main instruments of instruction in histology and pathology laboratories. However, as with most educational changes, there are advantages and disadvantages associated with a new technology. The use of VM for the teaching of histology and pathology requires an extensive infrastructure and the availability of computing devices to all learners, both posing a considerable financial strain on schools and students. Furthermore, there may be valid reasons for practicing healthcare professionals to maintain competency in using light microscopes. In addition, some educators may be reluctant to embrace new technologies. These are some of the reasons why the introduction of VM as an integral part of histology and pathology instruction has been globally uneven. This paper compares the teaching of histology and pathology using traditional or VM in five different countries and their adjacent regions, representing developed, as well as developing areas of the globe. We identify general and local roadblocks to the introduction of this still-emerging didactic technology and outline solutions for overcoming these barriers.

Genome-wide RNA pol II initiation and pausing in neural progenitors of the rat.

BACKGROUND: Global RNA sequencing technologies have revealed widespread RNA polymerase II (Pol II) transcription outside of gene promoters. Small 5'-capped RNA sequencing (Start-seq) originally developed for the detection of promoter-proximal Pol II pausing has helped improve annotation of Transcription Start Sites (TSSs) of genes as well as identification of non-genic regulatory elements. However, apart from the most well studied genomes of human and mouse, mammalian transcription has not been profiled with sufficiently high precision. RESULTS: We prepared and sequenced Start-seq libraries from rat (Rattus norgevicus) primary neural progenitor cells. Over 48 million uniquely mappable reads from two independent biological replicates allowed us to define the TSSs of 7365 known genes in the rn6 genome, reannotating 2503 TSSs by more than 5 base pairs, characterize promoter-associated antisense transcription, and profile Pol II pausing. By combining TSS data with polyA-selected RNA sequencing, we also identified thousands of potential new genes producing stable RNA as well as non-genic transcripts representing possible regulatory elements. CONCLUSIONS: Our study has produced the first Start-seq dataset for the rat. Apart from profiling transcription initiation, our data reaffirm the prevalence of Pol II pausing across the rat genome and indicate conservation of pausing mechanisms across metazoan genomes. We suggest that pausing location, at least in mammals, is constrained by a distance from initiation of transcription, whether it occurs at or outside of a gene promoter. Abundant antisense transcription initiation around protein coding genes indicates that Pol II recruited to the vicinity of a promoter is distributed to available start sites of transcription at either DNA strand. Transcriptome profiling of neural progenitors presented here will facilitate further studies of other rat cell types as well as other organisms.

Whole body donation for teaching in Ghana: The perspectives of medical doctors.

Historically, both donated bodies and unclaimed bodies have been the sources of human bodies for anatomy dissection globally with the latter discouraged for ethical reasons. Ghana lacks well-established body-donation programs, thus relying heavily on unclaimed bodies. Medical doctors benefit foremost from human bodies in their training and therefore should have a better disposition toward body bequeathal. This study assessed the perception, knowledge, and attitude of medical doctors in a Ghanaian institution toward body donation. As the first Ghanaian study on the subject, it provides the foundation for systematic study of the subject in Ghana. An internet-based questionnaire was administered to volunteering medical doctors requesting information on their perception of, knowledge of, and attitude toward whole-body donation. Data were summarized as frequencies. The 200 respondents comprised 1 consultant, 4 specialists, 14 residents, 63 medical officers, and 118 house officers. About 194 (97.0%) were familiar with body donation while 6 (3.0%) were not. Also, 39 (19.5%) were willing to donate their bodies, 98 (49.0%) were unwilling, and 63 (31.5%) undecided. Religion, culture, mishandling of bodies, and lack of awareness were barriers to body donation. Finally, 178 (89.0%) viewed human body dissection as relevant and should remain as part of medical curriculum. Doctors were aware of body donation though only few were willing to donate. Cultural and religious factors were major hindrances to body donation for anatomy education and research, though they were willing to persuade others to participate. Deliberate public education on the subject is required to grow body donation in Ghana.

Transcriptional responses of cancer cells to heat shock-inducing stimuli involve amplification of robust HSF1 binding.

Responses of cells to stimuli are increasingly discovered to involve the binding of sequence-specific transcription factors outside of known target genes. We wanted to determine to what extent the genome-wide binding and function of a transcription factor are shaped by the cell type versus the stimulus. To do so, we induced the Heat Shock Response pathway in two different cancer cell lines with two different stimuli and related the binding of its master regulator HSF1 to nascent RNA and chromatin accessibility. Here, we show that HSF1 binding patterns retain their identity between basal conditions and under different magnitudes of activation, so that common HSF1 binding is globally associated with distinct transcription outcomes. HSF1-induced increase in DNA accessibility was modest in scale, but occurred predominantly at remote genomic sites. Apart from regulating transcription at existing elements including promoters and enhancers, HSF1 binding amplified during responses to stimuli may engage inactive chromatin.

BRCA1 gene polymorphism and finger dermatoglyphic patterns in Ghanaian breast cancer patients: a quantitative cross-sectional approach.

Introduction: breast cancer development is linked to mutant single nucleotide polymorphism of breast cancer type 1 (BRCA1) gene usually harboured within exon 11. It has also been linked to finger dermatoglyphics where certain patterns have been associated with breast cancer. This study suggests a possible relationship between finger dermatoglyphic patterns and single nucleotide polymorphism of BRCA1 gene. Methods: in a quantitative cross-sectional approach, finger dermatoglyphic patterns were obtained using the ink method from 70 female breast cancer patients and 70 age-matched apparently healthy females. Approximately 5 ml of venous blood was obtained from each participant from which DNA was extracted from the white blood cells collected after centrifugation. DNA was amplified and sequenced and the data aligned with the wildtype template of BRCA1 gene. Fingerprint patterns were analyzed with Chi-square. Mean frequency of fingerprint patterns was analyzed with independent student's t-test. Differences in data set with p<0.05 were statistically significant. Results: luminal B was the predominant breast cancer molecular subtype among the patients. The predominant fingerprint pattern among breast cancer participants was the loop. Six or more loops had higher frequency among breast cancer females. The predominant BRCA1 gene variant locations were c.34311, c.34320, and c.34321 with c.34311A>C being the predominant variant. Higher percentage frequency of six or more loops in relation to c.34311A>C was observed in apparently healthy females compared to breast cancer females. Conclusion: the study reports for the very first time in Ghana, BRCA1 gene variants and finger dermatoglyphics among breast cancer patients. Although the results are preliminary and inconclusive it creates an avenue for extended studies.

Role of Flavonoids as Epigenetic Modulators in Cancer Prevention and Therapy.

Epigenetic regulation involves reversible changes in histones and DNA modifications that can be inherited without any changes in the DNA sequence. Dysregulation of normal epigenetic processes can lead to aberrant gene expression as observed in many diseases, notably cancer. Recent insights into the mechanisms of DNA methylation, histone modifications, and non-coding RNAs involved in altered gene expression profiles of tumor cells have caused a paradigm shift in the diagnostic and therapeutic approaches towards cancer. There has been a surge in search for compounds that could modulate the altered epigenetic landscape of tumor cells, and to exploit their therapeutic potential against cancers. Flavonoids are naturally occurring phenol compounds which are abundantly found among phytochemicals and have potentials to modulate epigenetic processes. Knowledge of the precise flavonoid-mediated epigenetic alterations is needed for the development of epigenetics drugs and combinatorial therapeutic approaches against cancers. This review is aimed to comprehensively explore the epigenetic modulations of flavonoids and their anti-tumor activities.

Reduced Serum Circulation of Cell-Free DNA Following Chemotherapy in Breast Cancer Patients.

Breast cancer is the most common malignancy in women, with alarming mortalities. Neoadjuvant treatments employ chemotherapy to shrink tumours to a well-defined size for a better surgical outcome. The current means of assessing effectiveness of chemotherapy management are imprecise. We previously showed that breast cancer patients have higher serum circulating cell-free DNA concentrations. cfDNA is degraded cellular DNA fragments released into the bloodstream. We further report on the utility of cfDNA in assessing the response to chemotherapy and its potential as a monitoring biomarker. A total of 32 newly diagnosed and treatment-naive female breast cancer patients and 32 healthy females as controls were included. Anthropometric, demographic and clinicopathological information of participants were recorded. Each participant donated 5 mL of venous blood from which sera were separated. Blood sampling was carried out before the commencement of chemotherapy (timepoint 1) and after the third cycle of chemotherapy (timepoint 2). qPCR was performed on the sera to quantify ALU 115 and 247 levels, and DNA integrity (ALU247/ALU115) was determined. ALU 115 and 247 levels were elevated in cancer patients but were significantly decreased after the third cycle of chemotherapy (T2) compared to T1. DNA integrity increased after the third cycle. Serum cfDNA may provide a relatively inexpensive and minimally invasive procedure to evaluate the response to chemotherapy in breast cancer.

Influence of Lifestyle and Environmental Factors on Semen Quality in Ghanaian Men.

INTRODUCTION: Male infertility is known to contribute about half of all infertility cases. In Ghana, the prevalence of male infertility is higher (15.8%) than in females (11.8%). Sperm quality is associated with the likelihood of pregnancy and known to be the cause of male fertility problems 90% of the time. Exposure to certain environmental factors reduces semen quality in men. The study examined the effects of environmental and lifestyle factors on semen quality in Ghanaian men. MATERIALS AND METHODS: This was a cross-sectional study involving 80 apparent healthy adult males in their reproductive age. Participants were males referred to the laboratory (Immunology Unit of the Korle-Bu Teaching Hospital) for semen analysis test and/or culture and sensitivity. Participants were made to fill out a questionnaire which entailed selected environmental factors (accidents or trauma, exposure to chemicals, radiation, and heat) and lifestyle habits (including alcohol consumption, smoking, and whether participants sat more or less than 4 hours per day). Semen samples were then collected by masturbation into sterile containers and analysed in accordance with WHO guidance for semen analysis within 60 minutes after ejaculation and collection. RESULTS: About 69% of participants had semen pH within the normal range compared to 15% whose pH were lower than 7.2. There was a significantly high number of immotile sperm cells (p value = 0.017) in participants who sat for more than 4 hours as compared to those that sat for less than 4 hours in a day. Active sperm motility and viability showed significant increase (p value = 0.002 and 0.009, respectively) in participants who kept their cell phones in their side pockets. Smoking produced a twofold decrease in sperm count as smokers had a significantly lower sperm count (12.28 ± 10.95 × 106/ml) compared to the smoke-free (23.85 ± 22.14 × 106/ml). For exposure to STDs, no significant differences were recorded among study groups concerning semen quality. CONCLUSION: Sperm quality in Ghanaian men is associated with lifestyle habits. Smoking and sitting for long hours influenced sperm motility and count, respectively. Knowledge of the factors that influence sperm quality in this geographical region can contribute to informed decisions on effective management of infertility in Ghanaian men.

Percutaneous Removal of a Cardiac Mass in a Patient with Infective Endocarditis: A Case Report.

Infective endocarditis (IE) in the pediatric population is uncommon and presents with nonspecific signs. Nonetheless, prompt diagnosis and management are critical given its high mortality rate. We present the case of a 15-year-old boy who initially presented with bilateral multifocal pneumonia and was found to have IE with a right ventricular vegetation. The vegetation was removed percutaneously, obviating a more invasive surgical approach. The patient tolerated the procedure well and rapidly improved following removal of the vegetation. This case report highlights the utility of a novel, minimally invasive approach for the management of cardiac masses.

Caval Thrombus Management: The Data, Where We Are, and How It Is Done.

Thromboses of the superior and inferior vena cava, either isolated or associated with distal deep venous thrombosis, are uncommon, but confer potentially serious morbidity and mortality. Incidence is increasing, especially with the prominence of intravascular devices. The range of treatment options is also expanding to include medical management, surgery, and endovascular techniques which are now frequently considered first line therapy due to lower reintervention rates and decreased periprocedural morbidity. Currently, there are no official guidelines for screening or treatment. This article reviews the etiology, diagnosis, and management of caval thromboses, including equipment, procedural steps, outcomes, and complications, particularly with regard to endovascular techniques, such as catheter-directed thrombolysis, pharmacomechanical catheter-directed thrombolysis, angioplasty, and stenting.

Patients Want to Meet With Imaging Experts.

PURPOSE: The evolving health care landscape demands a multidisciplinary approach to care and increased emphasis on patient engagement. Radiologists may play an important role in this respect, by improving patient agency and understanding through direct patient interaction. The purpose of this study is to assess patient preferences and perceptions regarding direct communication with radiologists, focusing on a medically underserved demographic. METHODS: Our institutional review board approved this HIPAA-compliant study. English- and/or Spanish-speaking adults undergoing imaging studies across two tertiary-care hospitals and a busy outpatient center were surveyed over a consecutive two-month period, to assess knowledge of the role of a radiologist, interest in, and perceived benefits of reviewing examination results with imaging experts. RESULTS: A total of 628 surveys were completed: 20% of total respondents accurately identified the role of radiologists; 28% identified radiologists as doctors. A total of 68% of respondents expressed an interest in receiving imaging results immediately, or whenever results became available, regardless of when referring physicians received results. An interest in reviewing imaging results with an expert was indicated by 81% of respondents; 88% anticipated that reviewing imaging results with an expert would be beneficial. Although 58% of respondents indicated that they might be willing to pay out of pocket for such a service, 50% selected $0 when asked to indicate an amount. CONCLUSIONS: Although most patients do not know the role of radiologists, they want immediate results, and perceive value in consulting directly with imaging experts.