Three-dimensional modeling in anatomy-Tool or terror?

Three-dimensional (3D) modeling is a recent, innovative approach to teaching anatomy. There is little literature, however, to suggest how 3D modeling is best used to teach students and whether or not students can gain the same level of understanding as they might use more traditional, hands-on, teaching methods. This study evaluated the use of a 3D modeling software in both a flipped classroom curriculum and as an active learning tool in comparison to traditional, physical model-based teaching. Pre- and post-course content-based assessments were used to evaluate students' learning. Our findings indicated no significant difference between standard and flipped classroom learning; however, the students who used 3D modeling software as an active learning tool significantly underperformed students in the standard group (F(2,1060) = 112.43, p < 0.0001). These findings suggest that these technologies may not yet be useful as a primary means of instruction. Possible explanations may include cognitive overload in navigating the system, intrinsic limitations of the software, or other factors. Further development and research of these technologies is necessary prior to their adoption into teaching practices in anatomy.

The role of medical illustration in the evolution of transsphenoidal pituitary surgery.

Medical illustration played a crucial, yet often overlooked, role in the evolution of pituitary surgery. From the late 1800s to the present, many preeminent surgeons, in partnership with their surgical illustrator collaborators, developed and then shifted the paradigm of pituitary surgery, from an open procedure with high mortality and morbidity, to an endonasal approach with high success rates that is widely utilized today. This work aims to highlight the role of surgical illustrators as partners to their physician colleagues, creating artistically accessible road maps that shaped the development of the transsphenoidal approach.

Using AI Text-to-Image Generation to Create Novel Illustrations for Medical Education: Current Limitations as Illustrated by Hypothyroidism and Horner Syndrome.

Our research letter investigates the potential, as well as the current limitations, of widely available text-to-image tools in generating images for medical education. We focused on illustrations of important physical signs in the face (for which confidentiality issues in conventional patient photograph use may be a particular concern) that medics should know about, and we used facial images of hypothyroidism and Horner syndrome as examples.

Ottoman plants, nature studies, and the attentiveness of translational labor.

Translations, whether in the form of text, illustration, or interpretive analysis, served knowledge-making in multiple ways. It offered a refuge, severed contexts, and concealed the various workers that created it. Over the course of the seventeenth century, European naturalists in Istanbul, such as Luigi Ferdinando Marsigli (1658-1730), procured illustrations of Ottoman nature as fundamental resources to identify, collect, and compare indigenous plants and newly bred varieties. Despite maintaining an actual mediation for cross-cultural interactions, these sources of virtual communication remain largely forgotten in modern scholarship. This article argues that this curious yet invisible corpus was not a nonagentive medium in an alienated leisure of a gentleman-scholar; instead, these illustrations were designed to call upon the viewer's constant attention in self-motivated scientific labor. Such handy tools responded and contributed to early modern scholars' modes of working, and in exchange they determined these sources' own function, position, and visibility - either as a by-product or as a derivative. It is therefore only when integrated into the labor history of science that the degrees of invisibility pertaining to both Ottoman nature studies and self-directed labor can come into a granular view.

Cover images of the Journal of Comparative Physiology A and the stories behind them.

The cover images of the 2023 issues of the Journal of Comparative Physiology A, as well as its logo image, are presented at full size and high resolution, together with the stories behind them. These images are testament to the artistic quality of the scientific illustrations published in the Journal of Comparative Physiology A.

Revisiting the History of Odontoma, with Special Reference to Its Original Illustration.

BACKGROUND: Practically every facet of the most common odontogenic tumor, odontoma, has been covered by an extensive volume of literature. However, uncertainty about its precise history has persisted. MATERIALS AND METHODS: The historical evolution of odontoma was traced with reference to the original illustrations that accompanied European and American reports published at the beginning of the 19th century and also at the turn of the century. RESULTS: The prevailing views regarding the first description of odontoma by Oudet of Paris in 1809 and the original designation "odontome" by Broca of Paris in 1867 are not entirely accurate. Before Broca's suggested term, "exostose dentaire" (dental exostosis) and "tumeur dentaire" (dental tumor) proposed by Oudet and Forget of Paris, respectively, were popular terms adopted in France, while in Briatin the terms "warty tooth" and "supernumerary teeth" proposed by Salter and Tomes of London, respectively, were widely coined. The original illustrations of complex odontoma were published by Wedl of Vienna in 1851, and in 1862 Tomes published the first drawing of compound odontoma denticles. Before the advent of diagnostic radiography in the early 1900s, spontaneous exposure or eruption of odontoma followed by secondary infection was very common. In 1887-1888, Bland Sutton of London criticized Broca's monumental research and formulated the first modern classification which, in essence, remains valid today. At that time, large osteomas of the maxilla were inappropriately classified as odontomas by many pathologists because of Bland Sutton's influential view. Interestingly, the first radiographic evidence of odontoma was published by the American oral surgeon Gilmer in 1899. CONCLUSION: In view of their fundamental achievements, the names of Wedl, Salter, Broca and Bland Sutton have been closely associated with the true history of odontoma.

Beautiful vulvas: expanding illustrative visual imagery of female genital cutting types.

BACKGROUND: Visual imagery has been used to educate healthcare providers, patients, and the lay public on female genital cutting (FGC) typology and reconstructive procedures. However, culturally inclusive, diverse, and anatomically accurate representation of vulvas informed by women possessing lived experience of FGC is lacking. AIM: We sought to apply World Health Organization (WHO) FGC typology to the development of type-specific visual imagery designed by a graphic artist and culturally informed by women with lived experience of FGC alongside a panel of health experts in FGC-related care. METHODS: Over a 3-year process, a visual artist created watercolor renderings of vulvas with and without FGC across varying WHO types and subtypes using an iterative community-based approach. Somali women possessing lived experience of FGC were engaged alongside a team of clinician experts in FGC-related care. Women and clinicians provided descriptive input on skin color variation, texture, and skin tone, as well as the visual depiction of actions necessary in conducting a genital examination. OUTCOMES: A series of vulvar anatomic illustrations depicting WHO FGC typology. RESULTS: FGC types and subtypes are illustrated alongside culturally informed descriptors and clinical pearls to strengthen provider competency in the identification and documentation of FGC WHO typology, as well as facilitate patient education, counseling, shared decision making, and care. CLINICAL IMPLICATIONS: Ensuring equitable representation of race, gender, age, body type, and ability in medical illustrations may enhance patient education, counseling, and shared decision making in medical and/or surgical care. FGC provides a lens through which the incorporation of patient-informed and culturally relevant imagery and descriptors may enhance provider competency in the care of FGC-affected women and adolescents. STRENGTHS AND LIMITATIONS: The strengths of this study include the development of visual imagery through an iterative community-based process that engaged women with lived experience of FGC alongside clinicians with expertise in FGC-related care, as well as the representation of historically underrepresented bodies in the anatomical literature. Study limitations include the lack of generalizability to all possible forms or practices of FGC given the focus on one geographically distinct migrant community, as well as the reliance on self-report given the inability to clinically verify FGC status due to the community-based methodology employed. CONCLUSION: Patient-informed and culturally representative visual imagery of vulvas is essential to the provision of patient-centered sexual health care and education. Illustrations developed through this community-engaged work may inform future development of visual educational content that advances equity in diverse representation of medical illustrations.

Evaluating AI-powered text-to-image generators for anatomical illustration: A comparative study.

Medical illustration, which involves the creation of visual representations of anatomy, has long been an essential tool for medical professionals and educators. The integration of AI and medical illustration has the potential to revolutionize the field of anatomy education, providing highly accurate, customizable images. The authors evaluated three AI-powered text-to-image generators in producing anatomical illustrations of the human skulls, heart, and brain. The generators were assessed for their accurate depiction of foramina, suture lines, coronary arteries, aortic and pulmonary trunk branching, gyri, sulci, and the relationship between the cerebellum and temporal lobes. None of the generators produced illustrations with comprehensive anatomical details. Foramina, such as the mental and supraorbital foramina, were frequently omitted, and suture lines were inaccurately represented. The illustrations of the heart failed to indicate proper coronary artery origins, and the branching of the aorta and pulmonary trunk was often incorrect. Brain illustrations lacked accurate gyri and sulci depiction, and the relationship between the cerebellum and temporal lobes remained unclear. Although AI generators tended toward esoteric imagery, they exhibited significant speed and cost advantages over human illustrators. However, improving their accuracy necessitates augmenting the training databases with anatomically correct images. The study emphasizes the ongoing role of human medical illustrators, especially in ensuring the provision of accurate and accessible illustrations.

Augmented Tactile Book: Design of a Multisensory Page Prototype.

In the framework of the LTA project, focusing on leisure reading for children with visual impairment, we present a prototype of multisensory illustration that will be used as a model for future accessible tactile interactive books. This multisensory illustration is based on two approaches to illustrate the storytelling. The first approach consists in embodying the character's legs with the index and middle fingers in order for the user to imitate actions such as walking. The second approach is to offer interactions feedback according to the readers actions. The main goal of this multisensory illustration prototype is to test and evaluate a selection of interactions and their associated sensors. These interactions help visually impaired readers to identify the environment of the story. They also help to understand actions behind the verbs. Readers are engaged to produce actions such as touching and imitating with their fingers. These interactions are developed according to hypotheses based on the literature. This multisensory illustration prototype was tested with a panel of children. The results comfort the idea that these interactions are useful for them.

Two new species of Amaurobius C.L. Koch, 1837 from China (Araneae, Amaurobiidae).

Two new species of the genus Amaurobius are described from China: A.guangwushanensissp. nov. (♂♀) from Sichuan and A.wulongdongensissp. nov. (♂♀) from Shaanxi. With the addition of two new species, the number of Amaurobius species endemic to China now reaches four. Morphological descriptions, photos, and illustrations of copulatory organs, as well as a map of distribution records, are provided.

Multi-Label Classification in Anime Illustrations Based on Hierarchical Attribute Relationships.

In this paper, we propose a hierarchical multi-modal multi-label attribute classification model for anime illustrations using a graph convolutional network (GCN). Our focus is on the challenging task of multi-label attribute classification, which requires capturing subtle features intentionally highlighted by creators of anime illustrations. To address the hierarchical nature of these attributes, we leverage hierarchical clustering and hierarchical label assignments to organize the attribute information into a hierarchical feature. The proposed GCN-based model effectively utilizes this hierarchical feature to achieve high accuracy in multi-label attribute classification. The contributions of the proposed method are as follows. Firstly, we introduce GCN to the multi-label attribute classification task of anime illustrations, enabling the capturing of more comprehensive relationships between attributes from their co-occurrence. Secondly, we capture subordinate relationships among the attributes by adopting hierarchical clustering and hierarchical label assignment. Lastly, we construct a hierarchical structure of attributes that appear more frequently in anime illustrations based on certain rules derived from previous studies, which helps to reflect the relationships between different attributes. The experimental results on multiple datasets show that the proposed method is effective and extensible by comparing it with some existing methods, including the state-of-the-art method.

A novel scale for the evaluation of physician drawn medical illustrations.

Effective communication is a crucial component of patient-centered care and individuals with low health literacy face significant challenges in managing their health, leading to longer hospital stays and worse outcomes. Visual aids, such as medical illustrations and pictograms, can enhance patient understanding and memory retention; however, there is a lack in the medical field of tools for evaluating and improving a physician's ability to draw clinical illustrations for their patient. This article explores an aesthetic scale created in collaboration between Boston University Medical School and the Boston University Fine-Arts department. The scale scores basic design elements that could reasonably be improved in a clinical setting. A pilot study demonstrated interrater reliability between trained artists scoring images of varying concepts and visual quality with a Cronbach's alpha of 0.95. This scale has potential use in medical visual education and clinical evaluation.

Development and validation of a symptom illustration scale from the patient-reported outcome common terminology criteria for adverse events for patients with breast cancer.

PURPOSE: Emojis are commonly used for daily communication and may be useful in assessing patient-reported outcomes (PROs) in breast cancer. The purpose of this study is to develop and validate a Symptom Illustration Scale (SIS) as a new PRO measurement. METHODS: Eighteen original SIS items were developed from the PRO-CTCAE. In cohort one, the SIS validity and reliability were examined in patients with breast cancer, using a semi-structured five-question survey to investigate content validity. PROs with PRO-CTCAE and SIS were examined twice to determine criteria validity and test-retest reliability. In cohort two, the responsiveness of the scales were examined in patients treated with anthracycline, docetaxel, paclitaxel, and endocrine therapy. PROs with PRO-CTCAE and SIS were investigated two or three times, depending on the therapy. RESULTS: Patients were enrolled from August 2019 to October 2020. In cohort one (n = 70), most patients had no difficulties with the SIS, but 16 patients indicated that it was difficult to understand severities in the SIS. For criterion validity, Spearman rank correlation coefficients (rs) between PRO-CTCAE and SIS items were ≥ 0.41, except for "Decreased appetite." For test-retest reliability, κ coefficients of the SIS were ≥ 0.41 for 16/18 items (88.9%). Response time was significantly shorter for the SIS than for PRO-CTCAE (p < 0.001). In cohort two (n = 106), score changes between PRO-CTCAE and SIS for relevant symptoms all had correlations with rs ≥ 0.41. CONCLUSION: An original SIS from the PRO-CTCAE for patients with breast cancer were verified the validity, reliability, and responsiveness. Further studies to improve and validate the SIS are needed.

A Simple Method for Creating Medical Illustrations Using Tablets.

Medical illustrations are defined as illustrations that contain and convey medical information. Illustrations in surgical records play a pivotal role not only in recording medical information but also in sharing surgical information, improving own surgical skills, and teaching young doctors. However, we believe that creating a medical illustration from a blank sheet of paper is challenging for beginners. The computer-assisted illustration technique proposed in this article not only saves time but also provides accurate and easy-to-understand medical illustrations. This technical note aims to introduce a simple and easy method for creating medical illustrations by tracing intraoperative photographs using an iPad™ and an Apple Pencil™. We believe that "anyone can draw" detailed, easy-to-understand medical illustrations using the present method, and we hope that many young doctors will actively create medical illustrations.

Use of visual aids in general practice consultations: A questionnaire-based survey.

Objectives: Visual aids (VAs) seem effective to improve doctor-patient communication. The objective was to describe how VAs are used in consultation and what French general practitioners (GPs) expect of them. Methods: Cross-sectional study using a self-administered questionnaire among French GPs in 2019. Descriptive and multinominal logistic regression analyses were performed. Results: Of the 376 respondents, 70% used VAs at least weekly and 34% daily; 94% considered VAs useful/very useful; 77% felt they did not use VAs enough. Sketches were the most used VAs and considered the most useful. Younger age was significantly associated with a higher rate of use of simple digital images. VAs were mainly used to describe anatomy and facilitate patient comprehension. Main reasons for not using VAs more often were time spent searching, lack of habit and poor quality of available VAs. Many GPs requested a database of good quality VAs. Conclusions: GPs use VAs regularly in consultations but would like to use them more often. Informing GPs of the usefulness of VAs, training them to draw adapted sketches and creating a good quality databank are some possible strategies to increase the use of VAs. Innovation: This study described in detail the use of VAs as tool for doctor-patient communication.

A. K. Wollstonecraft: una ilustradora botánica del siglo XIX en la isla de Cuba. Principales datos biográficos y una aproximación a su obra Specimens of the plants and fruits of the Island of Cuba (1826) / A. K. Wollstonecraft: a botanical illustrator from the 19th century on the island of cuba. Main biographical notes and an approximation to her work specimens of the plants and fruits of the island of cuba (1826)

Nancy Anne Kingsbury Wollstonecraft nació en octubre de 1781. Los primeros datos que tenemos sobre ella la sitúan en Estados Unidos, desde donde viajaría a Matanzas (Cuba), residiendo varios años allí y trabajando en una gran obra de botánica ilustrada, hasta su muerte, el 16 de mayo de 1828. La obra de Nancy Anne Kingsbury Wollstonecraft -a partir de ahora, A. K. Wollstonecraft- comprende observaciones sobre más de cien especies vegetales de la Isla de Cuba, datos sobre la etimología de su nomenclatura, usos y aplicaciones de las plantas, así como datos sobre los hechos históricos que la rodean y sus propias reflexiones personales. Esto convierte a esta obra en un manuscrito extraordinario que transita entre la ciencia, el arte y el relato de viajes. En este artículo se presentan las principales referencias de los datos biográficos conocidos hasta el momento y un análisis introductorio a su obra botánica ilustrada.(AU)

Nancy Anne Kingsbury Wollstonecraft was born in October 1781. The first information we have about her places her in the United States, where she would travel to Matanzas (Cuba), residing there for several years and working on a great manuscript on illustrated botany, until her death. death, May 16, 1828. The work of Nancy Anne Kingsbury Wollstonecraft -A. K. Wollstonecraft- includes observations on more than one hundred types of plants on the Island of Cuba through botanical classification, it also includes data on the etymology of its nomenclature, uses and applications, and data on the historical facts that surrounding their own personal reflections; which makes this work an extraordinary manuscript that travels through science, art, and travelogues. This paper explores the main references of the biographical data known to date and an introductory analysis of her illustrated botanical work.(AU)

An empirical study of consistency in the judgments of Feng Shui scholars and practitioners regarding taboos for residential space.

Studies of the reliability and validity of Feng Shui using empirical and quantitative methods remain lacking. The purpose of this study is, therefore, to quantitatively examine the consistency of the judgments of Feng Shui scholars and practitioners regarding 108 Feng Shui taboos for residential space. This study also investigates whether these judgments are inconsistent or different with respect to gender, occupation, education, and Feng Shui school. Furthermore, this study examines the effect of time intervals, Feng Shui experience, and the presence or absence of taboo illustrations in the judgments. To perform the study, two questionnaire surveys were conducted at six-month intervals to collect the judgments of Feng Shui scholars and practitioners. A total of 11 Feng Shui scholars and 67 practitioners participated in the first survey, while 10 Feng Shui scholars and 32 practitioners participated in the second survey. The results showed that: (1) Feng Shui scholars and practitioners had very good internal consistency reliability of their judgments regarding residential taboos. There were no significant differences in judgments, regardless of gender, occupation, education, and Feng Shui school; (2) The influence of Feng Shui experience on the judgments of Feng Shui scholars and practitioners as a whole was relatively weak; (3) Although the test-retest reliability of Feng Shui scholars and practitioners was not satisfactory, there were no significant differences between their first and second judgments; and (4) The influence of the illustrations of residential taboos on the judgments of Feng Shui scholars and practitioners as a whole was relatively weak. Although the illustrations had a greater influence on the judgments of Feng Shui practitioners than of scholars, these illustrations did not change their judgments.

Teamwork for complex clinical situations in psychotherapy: Introduction to the issue.

This in-session issue is focused on psychotherapists involved in and performing teamwork practices. Specifically, five teamwork-based psychotherapy interventions are illustrated as solutions for complex clinical situations drawing from multiple theoretical approaches (narrative, systemic, cognitive behavioral, and integrative) and applied in different health care provision settings, ranging from psychotherapy private office to a multidisciplinary oncological service. The contributions try to cover a diversity of presenting problems: separating couples, gang involvement, schizophrenia, cancer and suicidal ideation, bipolar disorder; and formats of delivery such as couple therapy supervision, family therapy, multidisciplinary team formulation and interprofessional health psychology. Three main shared coordinates underlie the diversity of interventions: (1) Considering that psychotherapy is just a piece of a broader network of interactions and meanings generated around a given problem/solution and, thus, it is part of an ecology of ideas (ecological dimension), (2) Assuming interdependence and collaboration as the best strategies to interact with professionals and significant others involved with a given problem or solution (collaborative dimension), and (3) fostering a strengths-based case formulation (epistemological dimension). The issue aims at enriching practitioners' toolbox willing to incorporate team-based interventions as part of their range of professional competences.

Can Negation Be Depicted? Comparing Human and Machine Understanding of Visual Representations.

There is a widely held view that visual representations (images) do not depict negation, for example, as expressed by the sentence, "the train is not coming." The present study focuses on the real-world visual representations of photographs and comic (manga) illustrations and empirically challenges the question of whether humans and machines, that is, modern deep neural networks, can recognize visual representations as expressing negation. By collecting data on the captions humans gave to images and analyzing the occurrences of negation phrases, we show some evidence that humans recognize certain images as expressing negation. Furthermore, based on this finding, we examined whether or not humans and machines can classify novel images as expressing negation. The humans were able to correctly classify images to some extent, as expected from the analysis of the image captions. On the other hand, the machine learning model of image processing was only able to perform this classification at about the chance level, not at the same level of performance as the human. Based on these results, we discuss what makes humans capable of recognizing negation in visual representations, highlighting the role of the background commonsense knowledge that humans can exploit. Comparing human and machine learning performances suggests new ways to understand human cognitive abilities and to build artificial intelligence systems with more human-like abilities to understand logical concepts.

The interplay between therapeutic relationship and therapeutic technique: "It takes two to tango".

The idea that the therapeutic relationship is at the core of psychotherapy is shared by most therapeutic approaches. Also, an increasing variety of therapeutic approaches, consider experiential techniques as central tools to promote effective therapeutic change. Commonly, it is argued that the creation of a positive, empathic, safe, and solid therapeutic alliance should be a prerequisite for administering these techniques. However, recent evidence is beginning to challenge this cautious stance showing that the introduction of experiential work early in therapy can be safe and effective. So, the quality of the therapeutic relationship may either facilitate or hinder the use of experiential techniques, but the use of these techniques may also strengthen or cause ruptures in the therapeutic alliance. So how do we balance the attention to the therapeutic relationship and the use of active, emotionally arousing techniques? In this paper, we present an issue of the Journal of Clinical Psychology: In Session exploring the complex interplay between therapeutic relationship and experiential practices in light of different psychotherapeutic approaches. We do so by first providing an initial overview of the topic. Next, we introduce the five papers of the issue along with some thoughts on how authors from diverse psychotherapeutic orientations contributed to illustrate and reflect on this multifaceted "dance" between therapeutic relationship and techniques.