"Spine to the future"-A narrative review of anatomy engagement.

Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.

Thoracolumbar transitional vertebrae: Quantitative differentiation and associated numeric variation in the vertebral column using skeletal remains.

Transitional vertebrae at the thoracolumbar region are called thoracolumbar transitional vertebrae (TLTV) and retain physical features from the thoracic and lumbar regions. Since TLTV were first classified 40 years ago, there has been much discrepancy regarding its features, identification and clinical relevance. Vertebral body levels are used in the medical field as a frame of reference to locate specific organs, vessels, nerves or landmarks. Any numeric variation or deviation in the vertebral column may lead to clinical errors. Previous findings have suggested a high association between numeric variation and the presence of TLTV. Therefore, the aim of this study was to identify the types of TLTV observed and to identify any possible associated numeric variation in the vertebral column. This study also aimed to validate the established technique to quantitatively differentiate TLTV from T12 and L1 at the thoracolumbar junction using skeletal remains from a South African population group. Skeletal remains (n = 187) remains from the Pretoria bone collection were assessed. Measurements were taken of the angle of the superior zygapophyseal processes of the last thoracic vertebra (T12), the first lumbar (L1), and identified TLTV. The results indicate a TLTV prevalence of 35% (n = 66/187). The results show that each vertebral type (T12, L1, TLTV) fall into independent confidence intervals: T12 is 188° ± 9.22 (CI: 187° < µ < 189.6°), 110° ± 7.52 (CI: 109.2° < µ < 111.3°) in L1, and 135° ± 24.51 (CI: 130.4° < µ < 139.1°) in the TLTV. This study observed that 70% of cases with TLTV was associated with numeric variation in the spine, both homeotic and meristic and that TLTV has a 35% prevalence. The results clearly show that quantitative morphometric analysis can effectively differentiate TLTV from other vertebral types at the thoracolumbar junction in skeletal remains.

Congenital malformations in the vertebral column: associations and possible embryologic origins.

Cases of associations between random spinal congenital defects have previously been reported, yet several questions remain unanswered. Firstly, why are associations between what seems to be random combinations of vertebral malformations observed? Secondly, is there a common event or pattern that connects the associated defects? Therefore, this study aimed to identify congenital defects in the vertebral column and also to determine whether any associations, if present, between vertebral malformations exist. This article consequently discusses the possible embryological disruptions that may lead to the formation of various defects in the vertebral column. A random skeletal sample (n=187) was selected from the Pretoria Bone Collection housed in the Department of Anatomy, University of Pretoria (Ethics 678/2018). The sample was evaluated to determine the frequencies of spinal congenital defects in each set of remains. Identifiable congenital malformations were observed in 48.1% (n=90/187) of the sample. The results demonstrated a high probability of association between the different defects observed in the vertebral column. Findings are of value as they provide a reasonable explanation to why seemingly random cases of associations have been reported by several authors. This study is clinically relevant as severe spinal defects have been shown to have high morbidity in patients and mortality in infants.

Vertebrae at the thoracolumbar junction: A quantitative assessment using CT scans.

The thoracolumbar junction is often associated with traumatic injuries, due to its biomechanical instability. Reasons for this instability are currently still under debate; however, contributing factors such as the rapid change in spinal curvature and facet orientation from the thoracic to lumbar transition have been implicated. Normally, the superior facet orientation in the thoracic region is angled in a coronal plane, whereas vertebrae in the lumbar region have facets angled in the sagittal plane. Distinguishing between thoracic, lumbar, and transitional vertebrae at the thoracolumbar junction based on articular facet angles, using quantitative methods on CT scans has, to the authors' knowledge, not yet been reported in the literature. Therefore, this study aimed to evaluate whether quantitative measurements can be clinically applied and used to differentiate vertebrae at the thoracolumbar junction using CT scans and, additionally, to record possible cases of congenital defects or variations observed in the spine. A sample (n = 173) of CT scans representative of the Windhoek population in Namibia was retrospectively assessed using radio-imaging software. Measurements of the angle formed by the superior facets of the vertebrae at the thoracolumbar junction (T11-L1) were recorded. Based on the results of this study, quantitative morphometry of the superior facet of vertebrae can differentiate between thoracic, lumbar,. and transitional vertebrae at the thoracolumbar junction. All individuals with identified thoracolumbar transitional vertebrae (TLTV) in this sample had at least one other congenital anomaly of the spine.

Assessment of Preparedness for Remote Teaching and Learning to Transform Health Professions Education in Sub-Saharan Africa in Response to the COVID-19 Pandemic: Protocol for a Mixed Methods Study With a Case Study Approach.

BACKGROUND: The current COVID-19 pandemic is affecting all aspects of society worldwide. To combat the pandemic, measures such as face mask-wearing, hand-washing and -sanitizing, movement restrictions, and social distancing have been introduced. These measures have significantly disrupted education, particularly health professions education, which depends on student-patient contact for the development of clinical competence. The wide-ranging consequences of the pandemic are immense, and health professions education institutions in sub-Saharan Africa have not been spared. OBJECTIVE: This paper describes a protocol for assessing the preparedness of selected health professions education institutions in sub-Saharan Africa for remote teaching and learning during the COVID-19 pandemic. METHODS: A mixed-methods design with a case study approach will be used. The awareness, desire, knowledge, ability, and reinforcement model of change was selected as the conceptual framework to guide the study. Eight higher education institutions in 6 sub-Saharan countries have participated in this study. Data will be collected through electronic surveys from among whole populations of academic staff, students, and administrators in undergraduate medicine and nursing programs. Qualitative and quantitative data from each institution will be analyzed as a case study, which will yield an inventory of similar cases grouped for comparison. Quantitative data will be analyzed for each institution and then compared to determine associations among variables and differences among programs, institutions, or countries. RESULTS: Our findings will provide information to higher education institutions, particularly those offering health professions education programs, in Africa regarding the preparedness for remote teaching and learning to influence efforts related to web-based teaching and learning, which is envisaged to become the new normal in the future. CONCLUSIONS: This study has not received any funding, and any costs involved were borne by individual consortium members at the various institutions. Ethics approval from the institutional review board was obtained at various times across the participating sites, which were free to commence data collection as soon as approval was obtained. Data collection was scheduled to begin on October 1, 2020, and end on February 28, 2021. As of this submission, data collection has been completed, and a total of 1099 participants have been enrolled. Data analysis has not yet commenced. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/28905.

Development of a Virtual Journal Club in Anatomy: a Responsive Pandemic Pedagogy.

The COVID-19 pandemic forced changes to online teaching worldwide. The Clinical Anatomy journal club (JC) is key in the Bachelor of Science Honours (BScHons) programme and aims to improve scientific appraisal and communication abilities in anatomical research. An online JC through synchronous contact between members was deemed fitting as it could bridge the newly enforced geographical limitations due to the national lockdown in South Africa. Although common in clinical specialties, there are no published reports of anatomy themed online JCs. This project aimed to develop, implement, and appraise a synchronous virtual JC for Clinical Anatomy during the COVID-19 South African lockdown. A qualitative exploratory study design within an interpretive/constructivist paradigm was followed and aimed to explore students' perceptions of a virtual anatomy JC during the lockdown. The study was conducted at a South African institution, within the BScHons programme, and all enrolled students were invited to participate. Upon receipt of informed consent, an anonymous questionnaire was administered via Moodle for the BScHons students. The responses were analysed by thematic analysis, codes were developed, and themes were generated. Two main themes were generated from the results: the first related to the virtual format of the JC and the second focused on the content and topics covered during the JC sessions. The Clinical Anatomy staff and students adapted rapidly to the virtual JC and formed a community of practice. The benefits of teaching and learning within JC were maintained during the virtual format. It is envisioned that the JC will continue in a hybrid format (face-to-face and virtual) in future academic years. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01325-8.

Novel bilateral bifurcation of the coronary vasculature.

Multiple variants and anomalies in the coronary vasculature have been reported. Some variants, particularly those with duplication, can be advantageous, many are insignificant and some are ultimately lethal. Many of these variants and anomalies are not identified until imaged or post-mortem. A novel bilateral bifid variation of the coronary arteries was observed in 49-year-old male cadaver. The respective origins were associated with the left and right aortic cusps from single ostia. Immediate bifurcation followed on either side. A right sided accessory branch supplied the pulmonary trunk and right ventricle. A more standard branch continued to form the posterior interventricular artery. The left sided variation demonstrated a solitary circumflex artery (towards the posterior interventricular septum) and, left marginal and anterior interventricular branches shortly after bifurcation. This case may be beneficial in surviving adverse cardiac events, particularly those associated with lifestyle. They also present a 'double' challenge for clinicians.

Using Technology to Engage the Public in Biomedical Sciences.

Biomedical research is a diverse and rapidly evolving subject area. The research and development that takes place as part of the field is aimed at understanding subjects such as diseases, disease progression, their treatment(s), treatment impact on patients as well as the general increase in understanding of the advancement of health sciences. The money and time invested in research is vast and discovery of novel data and production of publication(s) is seen as success. However in today's connected world scientists have to do more to ensure that their research and the impact thereof, is better communicated to the wider audiences. One of the major means to do this is via public engagement, of which there are many ways to achieve this. Advances in technology have led to interactive and immersive visual technologies that enable the next phase of public engagement to be available to a greater audience.

A rare combined variation of the coeliac trunk, renal and testicular vasculature.

The authors report a rare variation of the coeliac trunk, renal and testicular vasculature in a 27-year-old male cadaver. In the present case, the coeliac trunk and superior mesenteric artery was replaced by a modified coeliacomesenteric trunk formed by hepato-gastric and superior mesenteric arteries. Here the hepato-gastric artery or trunk contributed towards the total hepatic inflow as well as a gastro-duodenal artery. A separate right gastric artery and an additional superior pancreatico-duodenal artery was also found in addition with a retro-aortic left renal vein and a bilateral double renal arterial supply. The aforementioned coeliac trunk variation, to our knowledge, has never been reported before and this variation combined with the renal vasculature requires careful surgical consideration.

What do the public know about anatomy? Anatomy education to the public and the implications.

Public knowledge of the anatomical "self" is lacking and evidence points towards a growing need for anatomy education to the wider public. The public were offered the opportunity to learn human anatomy and complete an anatomical knowledge survey afterwards. Sixty-three participants volunteered to attempt to place 20 anatomical structures on a blank human body template. Responses were scored independently and then collated. A mixed effects logistic model was used to examine any associations with participants' as a random effect and all other factors as fixed effects. Results showed a statistically significant quadratic trend with age. Participants in health-related employment scored significantly higher than those not in health-related employment. There was a significant interaction between gender and organ type with males scoring higher than females in identifying muscles, but not in identifying internal organs. The current study demonstrates the general public's eagerness to learn anatomy despite their limited knowledge of the human body, and the need for widening participation. Furthermore, it raises an awareness of the anatomical literacy needs of the general public, especially in school children and young adults. Furthermore, it emphasizes the value of health literacy as a focus in undergraduate medical education. Anatomy literacy appears to be neglected, and this experience provides an example of a possible mode of public engagement in anatomy. Anat Sci Educ 11: 117-123. © 2017 American Association of Anatomists.

Sir William Turner (1832-1916) - Lancastrian, anatomist and champion of the Victorian era.

Sir William Turner, a Lancastrian, was renowned as a scientist, anatomist and a great reformer of medical education. His students became anatomists at various international institutions, which consequently shaped the future of anatomy as a subject matter both in the United Kingdom and in South Africa. Although Turner's accomplishments have been documented, little is known about the details that determined his career path and the individuals that shaped his future. Here the authors aim to highlight some aspects of Turner's academic achievements and his personal life as well as how he crossed paths with other great minds of the Victorian era including Richard Owen, Charles Darwin, James Paget and Joseph Lister.

Development and ultra-structure of an ultra-thin silicone epidermis of bioengineered alternative tissue.

Burn wound care today has a primary objective of temporary or permanent wound closure. Commercially available engineered alternative tissues have become a valuable adjunct to the treatment of burn injuries. Their constituents can be biological, alloplastic or a combination of both. Here the authors describe the aspects of the development of a siloxane epidermis for a collagen-glycosaminoglycan and for nylon-based artificial skin replacement products. A method to fabricate an ultra-thin epidermal equivalent is described. Pores, to allow the escape of wound exudate, were punched and a tri-filament nylon mesh or collagen scaffold was imbedded and silicone polymerisation followed at 120°C for 5 minutes. The ultra-structure of these bilaminates was assessed through scanning electron microscopy. An ultra-thin biomedical grade siloxane film was reliably created through precision coating on a pre-treated polyethylene terephthalate carrier.

Engineered alternative skin for partial and full-thickness burns.

Engineered alternative skin in all its forms and shapes serve to provide temporary or permanent wound closure such as in the case of partial and full-thickness burns. The need for collagen-based regeneration templates is motivated by the fact that dermal regeneration of full-thickness injuries does not occur spontaneously and is inundated by contraction and scarring. Partial-thickness burns in turn can regress as a result of infection and improper treatment and require appropriate treatment. Nylon-silicone laminates such as Biobrane(®), and more recently AWBAT(®), address this by serving as a temporary barrier. Enhanced collagen-based scaffolds today, although not perfect, remain invaluable. Our initial approach was to characterize the design considerations and explore the use of collagen in the fabrication of a dermal regeneration matrix and a silicone-nylon bilaminate. Here we expand our initial research on scaffold fabrication and explore possible strategies to improve the outcome of collagen-scaffold medicated wound healing.

Anatomical evidence for an endocrine activity of the vomeronasal organ in humans.

The mammalian vomeronasal organ (VNO) is a well-adjusted chemosensory structure that facilitates social and reproductive behavior in mammals. The existence, locality, and function of this organ in human adults remain a matter of discussion. Most authors now agree that a neuroreceptive function of the adult human VNO can be excluded due to the absence of both neural receptive cells associated with the VNO in other mammals despite the enigmatic reports on the effects of pheromones on human behavior. Adult cadavers form European (Caucasoid) descent were used in this article and parasagittal dissection of the heads allowed access to the nasal septa, which were grossly examined for the VNO openings. Tissue samples were collected, embedded in gelatin and serially sectioned through cryomicrotomy. Nissl staining was performed as well as immunohistochemically stained with an antibody against calcium-binding protein. The findings presented here confirm the bilateral presence of the VNO in adult cadavers and demonstrate morphological connections of VNO receptor cells with the underlying capillaries. In addition, possible endocrine activity associated with the epithelium of this chemosensory structure has been demonstrated by the expression of calcium-binding protein in a part of these receptor cells.

The potential of a niacinamide dominated cosmeceutical formulation on fibroblast activity and wound healing in vitro.

Knowledge on the intrinsic mechanisms involved in wound healing provides opportunity for various therapeutic strategies. The manipulation of dermal fibroblast proliferation and differentiation might prove to beneficially augment wound healing. This study evaluated the combined effects of niacinamide, L-carnosine, hesperidin and Biofactor HSP(®) on fibroblast activity. The effects on fibroblast collagen production, cellular proliferation, migration and terminal differentiation were assessed. In addition, the authors determined the effects on in vitro wound healing. The optimal concentrations of actives were determined in vitro. Testing parameters included microscopic morphological cell analysis, cell viability and proliferation determination, calorimetric collagen detection and in vitro wound healing dynamics. Results show that 0·31 mg/ml niacinamide, 0·10 mg/ml L-carnosine, 0·05 mg/ml hesperidin and 5·18 µg/ml Biofactor HSP® proved optimal in vitro. The results show that fibroblast collagen synthesis was increased alongside with cellular migration and proliferation.

Reflecting on interprofessional education in the design of space and place: lessons from Namibia.

Education at the University of Namibia, School of Medicine and School of Pharmacy relies on a community-centred curriculum. The aim is to nurture "7-star" doctors and pharmacists that will address the current social and health needs within the country. A sound understanding of the interplay between learning and the learning environment is said to improve interprofessional educational activities. This relationship is dependent on constrictive alignment of not only the aspects of pedagogy, but also that of educational leadership in context of the current and social health needs. In this report, we reflect on the interprofessional-learning environment that was created out of necessity within a Namibian context.

Anatomy education in Namibia: balancing facility design and curriculum development.

The anatomy curriculum at Namibia's first, and currently only, medical school is clinically oriented, outcome-based, and includes all of the components of modern anatomical sciences i.e., histology, embryology, neuroanatomy, gross, and clinical anatomy. The design of the facilities and the equipment incorporated into these facilities were directed toward simplification of work flow and ease of use by faculty, staff, and students. From the onset, the integration of state of the art technology was pursued to facilitate teaching and promote a student-centered pedagogical approach to dissections. The program, as realized, is comprised of three 16-week semesters with seven hours of contact time per week, namely three hours of lectures and four hours of dissection laboratory and microscopy time. Set outcomes were established, each revolving around clinical cases with integrated medical imaging. The design of the facility itself was not constrained by a legacy structure, allowing the School of Medicine, in collaboration with architects and contractors, to design the building from scratch. A design was implemented that allows for the sequential processing of cadaveric material in a unidirectional flow from reception, to preparation, embalming, storage, dissection, and maceration. Importantly, the odor of formaldehyde typically associated with anatomy facilities was eliminated outside of the dissection areas and minimized within via a high-performance ventilation system. By holistically incorporating an integrated curriculum, facility design, and teaching at an early stage, the authors believe they have created a system that might serve as a model for new anatomy programs.

Comparative in vitro study of honey based and silver based wound preparations on cell viability.

BACKGROUND: Since the early 1980s a plethora of dressings has been developed to promote wound healing. The objective of this study was to compare the effects of silver based dressings and honey based dressings on cell viability. MATERIALS AND METHODS: In this blinded study, keratinocyte cultures were exposed to prepared extracts of each of the following wound dressings for 40 h: Silver based dressings: Acticoat, Actisorb, Askina, Atrauman-Ag and Contreet. Honey based dressings: Melladerm gel, Melladerm mesh, Melladerm plus and Mellarsorb. Controls consisted of cells that were cultured in the same medium, and under the same conditions as those exposed to extracts. RESULTS: All dressing extracts had an effect on cell viability. Changes in cell morphology from different wound dressing extracts were noted and compared with control groups after 24 h of incubation. CONCLUSIONS: In the silver based extracts group, Atrauman-silver and Acticoat had the most viable cells. For the honey based group, the most viable cells were seen with Melladerm mesh and Mellasorb. There was no significant difference between the best performing silver and honey based wound preparations with regard to cell viability.