Perspectives of online anatomy teachers: A neglected study population struggles with the invisible student.

Online teachers are an under-researched population, but their perspectives are crucial to the successful implementation of online education. A fully online section of an established face-to-face (F2F) two-semester undergraduate anatomy course with a prosection laboratory commenced in 2012 at The University of Western Ontario, Canada. Professors' lectures for F2F students were broadcast in live and archived format to online students using Blackboard Collaborate (BBC) video conferencing software. Teaching assistants (TAs) delivered online laboratories using BBC and three-dimensional (3D) anatomical computer models. This study explored the common experiences and issues faced by the course teachers from 2012 to 2014. Transcripts from open-ended, individual interviews with professors (n = 4) and TAs (n = 5) were coded and analyzed thematically. The teachers' concern for their inability to see the students during sessions to assess class engagement and their teaching effectiveness, and to develop social relationships, was the main finding. However, video conferencing software and email were sufficient communication methods for the students' questions and the teachers' answers. The TAs noted usability challenges and anatomical inaccuracies in the 3D models compared to cadavers. Due to limitations of BBC's screen sharing function, live manipulation for the 3D computer models was not possible; however, the TAs found pedagogical value in using screen captures of the models for drawing activities with the students. Overall, preparation time for teaching online was longer than for F2F. The study's findings provide science educators with issues to consider when preparing for online teaching and recommendations to optimize the teaching experience.

Lung Organoids as Model to Study SARS-CoV-2 Infection.

Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic and has severely affected socio-economic conditions and people's life. The lung is the major target organ infected and (seriously) damaged by SARS-CoV-2, so a comprehensive understanding of the virus and the mechanism of infection are the first choices to overcome COVID-19. Recent studies have demonstrated the enormous value of human organoids as platforms for virological research, making them an ideal tool for researching host-pathogen interactions. In this study, the various existing lung organoids and their identification biomarkers and applications are summarized. At the same time, the seven coronaviruses currently capable of infecting humans are outlined. Finally, a detailed summary of existing studies on SARS-CoV-2 using lung organoids is provided and includes pathogenesis, drug development, and precision treatment. This review highlights the value of lung organoids in studying SARS-CoV-2 infection, bringing hope that research will alleviate COVID-19-associated lung infections.

Innovative models for vitreoretinal training during COVID-19 times.

Background: Vitreoretinal training has been badly affected during the COVID-19 times. Due to lockdown, the number of patients reaching the hospital has dwindled. Hence we propose two simple cost-effective ways to improve resident training. Purpose: To highlight two simple eye models RETILAPP and RETISURGE, and their use in resident training. This video also highlights how to make and customise laser and surgery eye models and its advantages . Synopsis: : By using 3D printing, two simple, economical and reusable eye models have been proposed to improve resident training especially during COVID-19 times. Highlights: Use of simple easily available materials and 3D printing to make sustainable eye models for practise as against the simulator based learning. Video link: https://youtu.be/dJau9N-sHUE.

A systematic review of facial plastic surgery simulation training models.

OBJECTIVES: The coronavirus disease 2019 pandemic has led to a need for alternative teaching methods in facial plastics. This systematic review aimed to identify facial plastics simulation models, and assess their validity and efficacy as training tools. METHODS: Literature searches were performed. The Beckman scale was used for validity. The McGaghie Modified Translational Outcomes of Simulation-Based Mastery Learning score was used to evaluate effectiveness. RESULTS: Overall, 29 studies were selected. These simulated local skin flaps (n = 9), microtia frameworks (n = 5), pinnaplasty (n = 1), facial nerve anastomosis (n = 1), oculoplastic procedures (n = 5), and endoscopic septoplasty and septorhinoplasty simulators (n = 10). Of these models, 14 were deemed to be high-fidelity, 13 low-fidelity and 2 mixed-fidelity. None of the studies published common outcome measures. CONCLUSION: Simulators in facial plastic surgical training are important. These models may have some training benefits, but most could benefit from further assessment of validity.

Properties and Characteristics of Three-Dimensional Printed Head Models Used in Simulation of Neurosurgical Procedures: A Scoping Review.

BACKGROUND: Intracranial surgery can be complex and high risk. Safety, ethical and financial factors make training in the area challenging. Head model 3-dimensional (3D) printing is a realistic training alternative to patient and traditional means of cadaver and animal model simulation. OBJECTIVE: To describe important factors relating to the 3D printing of human head models and how such models perform as simulators. METHODS: Searches were performed in PubMed, the Cochrane Library, Scopus, and Web of Science. Articles were screened independently by 3 reviewers using Covidence software. Data items were collected under 5 categories: study information; printers and processes; head model specifics; simulation and evaluations; and costs and production times. RESULTS: Forty articles published over the last 10 years were included in the review. A range of printers, printing methods, and substrates were used to create head models and tissue types. Complexity of the models ranged from sections of single tissue type (e.g., bone) to high-fidelity integration of multiple tissue types. Some models incorporated disease (e.g., tumors and aneurysms) and artificial physiology (e.g., pulsatile circulation). Aneurysm clipping, bone drilling, craniotomy, endonasal surgery, and tumor resection were the most commonly practiced procedures. Evaluations completed by those using the models were generally favorable. CONCLUSIONS: The findings of this review indicate that those who practice surgery and surgical techniques on 3D-printed head models deem them to be valuable assets in cranial surgery training. Understanding how surgical simulation on such models affects surgical performance and patient outcomes, and considering cost-effectiveness, are important future research endeavors.

Plateaus, rebounds and the effects of individual behaviours in epidemics.

Plateaus and rebounds of various epidemiological indicators are widely reported in Covid-19 pandemics studies but have not been explained so far. Here, we address this problem and explain the appearance of these patterns. We start with an empirical study of an original dataset obtained from highly precise measurements of SARS-CoV-2 concentration in wastewater over nine months in several treatment plants around the Thau lagoon in France. Among various features, we observe that the concentration displays plateaus at different dates in various locations but at the same level. In order to understand these facts, we introduce a new mathematical model that takes into account the heterogeneity and the natural variability of individual behaviours. Our model shows that the distribution of risky behaviours appears as the key ingredient for understanding the observed temporal patterns of epidemics.

Orthopedics and 3D technology in Turkey: A preliminary report.

OBJECTIVES: In this study, we present the use of case specific three-dimensional (3D) printed plastic models and custom-made acetabular implants in orthopedic surgery. MATERIALS AND METHODS: Between March 2018 and September 2020, surgeries were simulated using plastic models manufactured by 3D printers on the two patients with pilon fractures. Also, custom-made acetabular implants were used on two patients with an acetabular bone defect for the revision of total hip arthroplasty (THA). RESULTS: More comfortable surgeries were experienced in pilon fractures using preoperative plastic models. Similarly, during the follow-up period, the patients that applied custom-made acetabular implants showed a fixed and well-positioning in radiographic examination. These patients did not experience any surgical complications and achieved an excellent recovery. CONCLUSION: Preoperative surgical simulation with 3D printed models can increase the comfort of fracture surgeries. Also, custom-made 3D printed acetabular implants can perform an important task in patients treated with revision THA surgery due to severe acetabular defects.

Easy three-dimensional scanning technology for anatomy education using a free cellphone app.

The COVID-19 pandemic has brought difficult times to anatomy educators and medical/dental students. Under normal circumstances, gross anatomy classes give students opportunities to touch and observe human bones and cadaveric tissues, thus enhancing their understanding; such morphology is difficult to learn from textbooks alone. As many studies have shown, three-dimensional (3D) technologies used in online lectures can serve as alternatives to real specimens for providing knowledge of anatomy. However, such technologies are often expensive. The goal of this study was to create 3D anatomy models for online lectures using a free cellphone app. Free application software (Qlone) was used to create 3D anatomical models. The extracranium and intracranium of adult skull, fetal skull, mandible, temporal bone, second cervical vertebra, and ilium were all scanned and exported to the computer in 3D format. A total of 53 anatomical structures were evaluated by nine observers. Although the 53 structures used in this study did not include all the structures that students need to learn, visibility was good/acceptable for most of the 53. The free and simple 3D scanning app used in this study could enable anatomy educators to provide better content to students during online lectures.

The Application of Digital Design Combined with 3D Printing Technology in Skin Flap Transplantation for Fingertip Defects during the COVID-19 Epidemic.

OBJECTIVE: We aimed to evaluate the advantages of preoperative digital design of skin flaps to repair fingertip defects during the COVID-19 pandemic. We combined digital design with a 3D-printed model of the affected finger for preoperative communication with fingertip defect patients under observation in a buffer ward. METHODS: From December 2019 to January 2021, we obtained data from 25 cases of 30 fingertip defects in 15 males and 10 females, aged 20-65 years old (mean 35 ± 5 years). All cases were treated by digitally designing preoperative fingertip defect flaps combined with a 3D-printed model. Preoperative 3D Systems Sense scanning was routinely performed, 3-matic 12.0 was used to measure the fingertip defect area ranging from 1.5 cm × 3.5 cm to 2.0 cm × 5.0 cm, and the skin flap was designed. The flap area was 1.6 cm × 3.6 cm to 2.1 cm × 5.1 cm. CURA 15.02.1 was used to set parameters, and the 3D model of the affected finger was printed prior to the operation. Full-thickness skin grafts were taken from donor areas for repair. RESULTS: No vascular crises occurred in any of the 25 cases, and all flaps survived. The postoperative follow-up occurred over 3-12 months. All patients were evaluated 3 months after operation according to the trial standard of hand function evaluation of the Chinese Hand Surgery Society. The results showed that 20 cases had excellent outcomes (80%), four cases had good outcomes (16%), and one case had a fair outcome (4%). The excellent and good rate was 96%. CONCLUSIONS: During the COVID-19 epidemic, fingertip defects were treated with preoperative digital design of fingertip defect flaps combined with 3D printing. Precision design saves surgery time and improves the success rate of surgery and the survival rates of skin flaps. In addition, 3D model simulations improve preoperative communication efficiency, and the personalized design improves patient satisfaction.

Effective design of barrier enclosure to contain aerosol emissions from COVID-19 patients.

Facing shortages of personal protective equipment, some clinicians have advocated the use of barrier enclosures (typically mounted over the head, with and without suction) to contain aerosol emissions from coronavirus disease 2019 (COVID-19) patients. There is, however, little evidence for its usefulness. To test the effectiveness of such a device, we built a manikin that can expire micron-sized aerosols at flow rates close to physiological conditions. We then placed the manikin inside the enclosure and used a laser sheet to visualize the aerosol leaking out. We show that with sufficient suction, it is possible to effectively contain aerosol from the manikin, reducing aerosol exposure outside the enclosure by 99%. In contrast, a passive barrier without suction only reduces aerosol exposure by 60%.

Conceptual evolution of 3D printing in orthopedic surgery and traumatology: from "do it yourself" to "point of care manufacturing".

BACKGROUND: 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedic Surgery and Traumatology and to identify the productive model of the point-of-care manufacturing as a paradigm of personalized medicine. METHODS: Observational, descriptive, retrospective and monocentric study of a total of 623 additive manufacturing processes carried out in a Department of Orthopedic Surgery and Traumatology from November 2015 to March 2020. Variables such as product type, utility, time or materials for manufacture were analyzed. RESULTS: The areas of expertise that have performed more processes are Traumatology, Reconstructive and Orthopedic Oncology. Pre-operative planning is their primary use. Working and 3D printing hours, as well as the amount of 3D printing material used, vary according to the type of product or material delivered to perform the process. The most commonly used 3D printing material for manufacturing is polylactic acid, although biocompatible resin has been used to produce surgical guides. In addition, the hospital has worked on the co-design of customized implants with manufacturing companies. CONCLUSIONS: The integration of 3D printing in a Department of Orthopedic Surgery and Traumatology allows identifying the conceptual evolution from "Do-It-Yourself" to "POC manufacturing".

RetiSurge - Enabling "Dry Lab" vitreoretinal surgical training during COVID-19 pandemic.

The COVID-19 pandemic has resulted in reduction of patient volumes in Ophthalmology. With only emergency surgical procedures being performed with few elective surgical procedures, surgical volumes are at an all-time low. This has resulted in decreased surgical training opportunities for trainee surgeons. We developed a simple, cost-effective, 3D printed model eye - RetiSurge - for "Dry Lab" vitreoretinal surgery training. The model incorporates a retinal film that can be changed, making it suitable for multiple uses. The RetiSurge model can be used to practice visualization, instrument manipulation and endolaser photocoagulation. RetiSurge can be sterilized by ethylene oxide and is safe for use inside the operating room. RetiSurge is a simple, cost-effective, and reusable model eye for early training in Vitreoretinal surgery.

Addressing the Pandemic Training Deficiency: Filling the Void with Simulation in Facial Reconstruction.

OBJECTIVE/HYPOTHESIS: To assess the use of a three-dimensional (3D) printed, multilayer facial flap model for use in trainee education as an alternative method of teaching surgical techniques of facial reconstruction. STUDY DESIGN: Cohort study. METHODS: A 3D printed facial flap simulator was designed from a computed tomography scan and manufactured out of silicone for low-cost, high-fidelity simulation. This simulator was tested by a group of Otolaryngology-Head and Neck Surgery trainees at a single institution. The simulator group was compared to a control group who completed an exercise on a traditional paper facial flap exercise. Both groups underwent didactic lectures prior to completing their respective exercises. Pre- and post-exercise Likert scale surveys measuring experience, understanding, effectiveness, and realism were completed by both groups. Central tendency, variability, and confidence intervals were measured to evaluate the outcomes. RESULTS: Trainees completing the facial flap simulator reported a statistically significant (p < 0.05) improvement in overall expertise in facial flap procedures, design of facial flaps, and excision of standing cutaneous deformities. No statistically significant improvement was seen in the control group. CONCLUSIONS: Trainees found the facial flap simulator to be an effective and useful training tool with a high level of realism in surgical education of facial reconstruction. Surgical simulators can serve as an adjunct to trainee education, especially during extraordinary times such as the novel coronavirus disease 2019 pandemic, which significantly impacted surgical training. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E2444-E2448, 2021.

Experimental tracking and numerical mapping of novel coronavirus micro-droplet deposition through nasal inhalation in the human respiratory system.

It is essential to study the viral droplet's uptake in the human respiratory system to better control, prevent, and treat diseases. Micro-droplets can easily pass through ordinary respiratory masks. Therefore, the SARS-COV-2 transmit easily in conversation with a regular mask with 'silent spreaders' in the most physiological way of breathing through the nose, indoor and at rest condition. The results showed that the amount of deposited micro-droplets in the olfactory epithelium area is low. Also, due to receptors and long droplet residence time in this region, the possibility of absorption increases in the cribriform plate. This phenomenon eventually could lead to brain lesion damage and, in some cases, leads to stroke. In all inlet flow rates lower than 30 L/min inlet boundary conditions, the average percentage of viral contamination for upper respiratory tract is always less than 50% and more than 50% for the lungs. At 6L/min and 15L/min flow rates, the average percentage of lung contamination increases to more than 87%, which due to the presence of the Coronavirus receptor in the lungs, the involvement of the lungs increases significantly. This study's other achievements include the inverse relationship between droplets deposition efficiency in some parts of the upper airway, which have the most deformation in the tract. Also, the increased deformities per minute applied to the trachea and nasal cavity, which is 1.5 times more than usual, could lead to chest and head bothers.

A new option for education during surgical procedures and related clinical anatomy in a virtual reality workspace.

The COVID-19 pandemic and mandatory social distancing has brought challenges to anatomy educators who generally need in-person classes. The purpose of this study is to share the experience of a distant online lecture on a surgical procedure and related anatomy in a three-dimensional (3D) virtual reality (VR) workspace and to compare it with reported teaching methods, that is, an in-person class and a Zoom online class. The lecture was delivered by three authors of this article in a VR workspace that enables people to meet through VR. The lectures were about combinations of dental surgical procedures and related clinical anatomy. Physically, the attendees could have been located anywhere in the world, so lecturers joined from the United States and the attendees were all from Japan. VR environment and its flexibility enabled attendees to join the lecture actively, helping them to gain understanding of the surgical procedure and anatomy more efficiently. The use of VR technology with a live communication tool demonstrated in this study has several advantages over previous education methods, although there are still technical issues or disadvantages that need to be addressed. Development of the technology and app/software is required so that more data can be processed at higher speed. Use of VR technology with a live communication tool could be an alternative teaching method. Its overall advantages are a closer look at the slides/monitor and concurrent observation of the multiple assets in various directions by multiple attendees. These advantages cannot be achieved by any other teaching method without VR assets with the workspace provided by Spatial. Even during the mandatory social distancing due to the COVID-19 pandemic, this could enable us to foster 3D understanding of surgery and related anatomy. Further study is now needed to evaluate the effectiveness of this newly proposed teaching method by comparing it with traditional in-person and online classes with a live communication tool.

Droplet and bone dust contamination from high-speed drilling during mastoidectomy.

OBJECTIVES: The aim of this study was to examine contamination from otolaryngologic procedures involving high-speed drilling, specifically mastoid surgery, and to assess the adequacy of PPE in such procedures. DESIGN AND SETTING: Mastoid surgery was simulated in a dry laboratory using a plastic temporal bone, microscope and handheld drill with irrigation and suction. Comparisons of distance of droplet and bone dust contamination and surgeon contamination were made under differing conditions. Irrigation speed, use of microscope and drill burr size and type were compared. MAIN OUTCOME MEASURES: Measurement of the distance of field contamination while performing simulated mastoidectomy and location of surgeon contamination. RESULTS: There was a greater distance field contamination and surgeon contamination without the use of the microscope. Contamination was reduced by using a smaller drill burr and by using a diamond burr when compared to a cutting burr. The use of goggles and a face mask provided good protection for the surgeon. However, the microscope alone may provide sufficient protection to negate the need for goggles. CONCLUSIONS: While the risks of performing mastoid surgery during the coronavirus pandemic cannot be completely removed, they can be mitigated. Such factors include using the microscope for all drilling, using smaller size drill burrs and creating a safe zone around the operating table.