Self-regulated learning of anatomy during the COVID-19 lockdown period in a low-income setting.

In March 2020, universities in Zimbabwe temporarily closed and switched to remote learning to contain the spread of SARS Cov2 infections. The sudden change to distance learning gave autonomy to students to direct their own learning. To understand how the students at the University of Zimbabwe and Midlands State University adapted to emergency remote learning, focus group discussions and a self-administered questionnaire survey based on the self-regulated learning inventory were conducted to capture cognitive, motivational, and emotional aspects of anatomy learning during the COVID-19 pandemic. Thematic analysis was used to identify patterns among these students' lived experiences. Two coders analyzed the data independently and discussed the codes to reach a consensus. The results showed that students at the two medical schools cognitively and meta-cognitively planned, executed and evaluated self-regulated strategies in different ways that suited their environments during the COVID-19 lockdown. Several factors, such as demographic location, home setting/situation, socioeconomic background and expertise in using online platforms, affected the students' self-directed learning. Students generally adapted well to the constraints brought about by the lockdown on their anatomy learning in order to learn effectively. This study was able to highlight important self-regulated learning strategies that were implemented during COVID-19 by anatomy learners, especially those in low-income settings, and these strategies equip teachers and learners alike in preparation for similar future situations that may result in forced remote learning of anatomy.

Whole-body donation through the lens of Shona culture and Christian religion in Zimbabwe.

Voluntary donation is the ethically acceptable method for whole-body acquisition for anatomy education worldwide. In Africa, educational institutions struggle with this since many people remain unwilling to donate their bodies due to the strong influence of cultural and religious beliefs in decision-making. As part of wider efforts to improve the ethical sourcing of bodies in Zimbabwean medical schools, which are heavily reliant on unclaimed bodies, this study sought to determine the influences traditional and religious beliefs have on such decisions. We ascertained traditional and religious leaders' knowledge of whole-body donation, explored cultural and religious views toward death, dying and whole-body donation as well as their underlying reasons. Semi-structured interviews were conducted with traditional chiefs and Christian leaders who are considered the custodians of Zimbabwean traditional cultural and Christian values, respectively. Thematic analysis of traditional chiefs' interviews revealed that none of the chiefs had accurate knowledge regarding whole-body donation or the processes involved. Due to set traditional practices around death, most traditional chiefs viewed the practice as foreign with possible negative repercussions to the dissectors. Most of the Christian leaders had knowledge of whole-body donation. Their views were split between support for whole-body donation and regard as a religious and cultural misfit. Overall, both traditional chiefs and Christian leaders understood the importance of whole-body donation and requested further societal sensitization and education if the practice is to become socially acceptable.

Historical trends and current experiences of anatomical body donation in two Zimbabwean medical schools.

BACKGROUND: Body donation is integral to anatomy education, but procurement can be ethically fraught. While voluntary donation is preferred, the use of unclaimed bodies, although considered unethical, is a primary means for body procurement in some countries. This mixed methods study examined historical trends and anatomy technical staff perspectives on body donation in two Zimbabwean medical schools. METHODOLOGY AND MAIN FINDINGS: In Phase 1, 194 cadaver paper records from January 1984 to January 2021 were reviewed. Unclaimed bodies accounted for 67% while 33% (all white Zimbabweans) were voluntarily donated. Most cadavers were black Africans (62.4%) followed by white Zimbabweans (34.0%). Race was not indicated in seven (3.6%) records. In Phase 2, semi-structured interviews were conducted with seven technicians responsible for sourcing cadavers at the two institutions. Data were thematically analysed resulting in the development of eight themes, arranged into three domains. Cadaver procurement themes related to (1) cadaver source, (2) adherence to procurement guidelines, (3) screening for suitability, and (4) cultural and religious beliefs. Cadaver embalmment focused on (5) embalming practices, and (6) hospital mortuary-based embalming. Finally, (7) disposal processes and (8) resource constraints were found to influence cadaver disposal practices. CONCLUSIONS: Contrary to best practice, there is continued reliance on the use of unclaimed bodies to support anatomy education in the two Zimbabwean medical schools. Improving the ethical sourcing of bodies requires increased efforts to educate all Zimbabweans, especially the black majority, about the role and importance of voluntary body donation in medical education. Additionally, well-structured, and well-resourced body donation programs could enhance ethical procurement.

Injury, illness, and medication use surveillance during the 2020 COSAFA Women's championship: a prospective cohort study of football players from Southern Africa.

BACKGROUND: Systematic analyses of injuries, illnesses or medication use and their risk factors among female African athletes are scarce, which has implications for management of these athletes. AIM: This prospective cohort study analysed the incidence and characteristics of injuries, illnesses and medication use during the 2020 COSAFA Women's Championship. METHODS: The medical personnel of all participating teams reported all new injuries, illnesses and medication used by players daily. RESULTS: Sixty-three injuries were reported: 45 match and 18 training injuries; 45.5 (95% CI: 32.2 to 58.8) injuries/1000 match-hours and 21.7 (95% CI: 11.7 to 31.7) injuries/1000 training-hours, respectively. Most (n = 55, 87%) were caused by contact with another player and involved the lower extremity (n = 43; 68%). Fifty-eight illnesses were reported: 44.4 (95% CI: 33.0 to 58.8) illnesses/1000 player-days, mostly diarrhoea (n = 25; 43.1%) and dysmenorrhoea (n = 18; 31%). No cases of COVID-19 were reported. In total, 175 medications were prescribed: 168.8 (95% CI: 143.8 to 193.8) medications/1000 player-days. Non-steroidal anti-inflammatory drugs (NSAIDs) (n = 60; 34.3%) and analgesics (n = 33; 18.9%) were the most commonly prescribed drugs. CONCLUSION: Incidences of injury and illnesses were high but time loss was low, likely due to high NSAIDs use. Further studies should be conducted in order to inform appropriate prevention or management protocols in this population.

The menstrual cycle and football: The experiences of African women football players.

BACKGROUND: The menstrual cycle is a normal biological process in women and girls. However, it is often the reason why they tend to be excluded from football medicine research. Consequently, our understanding of the menstrual cycle and football performance is still limited, especially in African women football players. AIM: The study aimed to explore African women football players' current and historical menstrual cycle status, menstrual symptoms, lived experiences, and perceptions of the menstrual cycle. METHODS: Women football players at the COSAFA Women's Championship 2020 completed demographic questionnaires and the Moos Menstrual Distress Questionnaire. RESULTS: The main findings were that 90% of the players did not use contraceptives, . Most of the players had access to their preferred choice of sanitary product; however, 36% used alternatives such as old rags during their periods, . The most commonly reported symptoms during menses were abdominal cramps (53%), headache (41%), mood swings (41%) and irritability (47%). Further, players reported irritability (48%), mood swings (52%), and breast tenderness (48%) in the week before their period. CONCLUSION: The low use of contraceptives is likely due to community level socio-cultural factors. While the use of old rags as impromptu sanitary products is likely because they cannot always afford their preferred choice. Menstrual symptoms can affect training and competition; therefore, team support personnel should be aware of the menstrual cycle's implications for African women football players and their effect on athletic performance and well-being. Additionally, team support personnel ought to be mindful of African women football players' socio-economic and religio-cultural contexts and their interaction with biological processes such as the menstrual cycle and contraceptive use.

Pre-Clinical Medical Students' Use of Motivational and Cognitive Study Strategies During Anatomy Learning: A Three-Year Cross-Sectional Survey.

Medical students' motivation and study strategies are crucial in determining academic performance. This study aimed to assess the motivation and learning strategies of medical students as well as their association with performance in anatomy examinations. The Motivated Strategies for Learning Questionnaire, two focus group discussions, and students' current anatomy cumulative grade point average (cGPA) were used. Generally, the medical students strongly felt that anatomy is fundamental to the practice of medicine and surgery. This result was consistent with high task value scores of 5.99 ± 1.25. They were also driven by extrinsic goal orientation (5.59 ± 1.42) and intrinsic goal orientation (5.08 ± 1.26). Most medical students typically relied on elaboration (5.35 ± 1.25) ahead of other cognitive strategies namely rehearsal (5.30 ± 1.11), organization (5.15 ± 1.34), and lowest-rated critical thinking (4.77 ± 1.19). The students also relied on resource management strategies, effort regulation (5.15 ± 1.20) and time and study environment regulation (5.03 ± 1.03) more than the moderately scored peer learning (4.95 ± 1.50) and help-seeking (4.95 ± 1.09). In the focus group discussions, students reported that they often narrate or explain to each other what they would have read and understood from anatomy lectures, tutorials, and textbooks. They also bemoaned the lack of institutional support for stress burdens. The motivation and learning strategies subscales were not correlated with anatomy cGPA. Males were driven by extrinsic goals and experienced significantly higher levels of test anxiety than females (P < 0.05). Knowing the motivation and learning strategies students employ early in the medical curriculum can be leveraged to promote self-directed learning and academic achievement.

Zimbabwean PreClinical Medical Students Use of Deep and Strategic Study Approaches to Learn Anatomy at Two New Medical Schools.

Anatomy is a challenging preclinical subject owing to the vast amount of information that students need to master. The adoption of relevant study approaches is key to the development of a long-lasting understanding of anatomical subject matter. Phenomenographic educational research describes the medical students as using a variable mix of deep, strategic, and surface approaches to study. Continually assessing students' learning preferences and approaches is crucial for achieving the desired learning outcomes. The approaches to studying anatomy in two groups of first-year Zimbabwean medical students from two newly established medical schools were collected using the Approaches and Study Skills Inventory for Students (ASSIST) instrument and than analyzed. At least 90% of the students believed that anatomy involved reproducing knowledge or personal understanding and development. Overall, the majority of the students adopted deep and strategic approaches, while a distant minority used the surface approach. There was no significant correlation between either the students' sex or age and their preference for a specific approach to studying. The mean anatomy grades for students using a strategic approach were significantly higher than those using deep or surface approaches. The number of strategic learners was double that of deep learners among the high achievers subgroup. The strategic approach positively correlated with performance in examinations. Generally, the students shared a common understanding of the concept of anatomy learning. Studies such as this can assist with the identification of students at risk of failure and empower lecturers to recommend the adoption of more beneficial strategic and deep learner traits.

Detection and monitoring of the neuroprotective behavior of curcumin micelles based on an AIEgen probe.

In recent years, the role of mitochondrial injury in the pathogenesis of Alzheimer's disease (AD) has attracted extensive attention. Studies have shown that curcumin (Cur) can protect nerve cells from beta-amyloid (Aß)-induced mitochondrial damage. However, natural Cur encounters limited application due to its poor biocompatibility and bioavailability. To improve the solubility and biocompatibility of natural Cur, we prepared water-soluble curcumin micelles (CurM). Furthermore, the mitochondria-specific aggregation-induced emission (AIE) probe (TPE-Ph-In) was employed to observe the protective effect of CurM on the damage of mitochondrial morphology, distribution, and membrane potential caused by Aß. Results showed that CurM had higher solubility, stronger stability and retention effect, and better cellular uptake than that of natural Cur. Furthermore, the inhibitory effects of CurM on mitochondrial morphology, distribution, and membrane potential damage induced by Aß25-35 were observed utilizing TPE-Ph-In as an indicator of mitochondrial morphology and membrane potential. Thus, this method provides a useful strategy for experimental research and clinical treatment of AD with mitochondrial damage as the pathogenic mechanism.

Retinal involvement in Alzheimer's disease (AD): evidence and current progress on the non-invasive diagnosis and monitoring of AD-related pathology using the eye.

Alzheimer's disease (AD) is a common form of age-related dementia that mostly affects the aging population. Clinically, it is a disease characterized by impaired memory and progressive cognitive decline. Although the pathological hallmarks of AD have been traditionally described with a general confinement in the brain, recent studies have shown similar pathological changes in the retina, which is a developmental outgrowth of the forebrain. These AD-related neurodegenerative changes in the retina have been implicated to cause early visual problems in AD even before cognitive impairment becomes apparent. With recent advances in research, the commonly held view that AD-related cerebral pathology causes visual dysfunction through disruption of central visual pathways has been re-examined. Currently, several studies have already explored how AD manifests in the retina and the possibility of using the same retina as a window to non-invasively examine AD-related pathology in the brain. Non-invasive screening of AD through the retina has the potential to improve on early detection and management of the disease since the majority of AD cases are usually diagnosed very late. The purpose of this review is to provide evidence on the involvement of the retina in AD and to suggest a possible direction for future research into the non-invasive screening, diagnosis, and monitoring of AD using the retina.

Non-invasive optical imaging of retinal Aß plaques using curcumin loaded polymeric micelles in APPswe/PS1ΔE9 transgenic mice for the diagnosis of Alzheimer's disease.

Alzheimer's disease (AD) is a neurodegenerative disease clinically characterized by impaired memory and progressive cognitive decline. Despite the advances in AD research, an effective method to timely diagnose AD has remained elusive, and until now, most AD patients receive the available symptomatic treatments late. Although the pathological hallmarks of AD have been traditionally described in the brain, recent studies have shown similar pathological changes in the retina which is developmentally an extension of the forebrain. Interestingly, retinal beta-amyloid (Aß) accumulation preceded that of the brain in a transgenic mouse model of AD. In the quest of finding an early reliable biomarker for AD, researchers have targeted the optical imaging of retinal Aß plaques as a method of diagnosing AD. One promising polyphenol compound that has found application in this area is curcumin due to its natural binding affinity to Aß fibrils and oligomers while giving out a strong fluorescence signal. However, the clinical applications of curcumin have been difficult due to problems related to its bioavailability and retention in the body since it is a hydrophobic molecule. To address these limitations, we herein report the development of anionic and water-soluble DSPE-PEG2000 curcumin polymeric micelles (also referred to as curcumin micelles) that can label both brain and retinal Aß plaques ex vivo. Following their intravitreal injection in the APPswe/PS1ΔE9 transgenic mouse model of AD, green-labeled retinal deposits were optically imaged live using a rodent retinal microscope. Furthermore, these micelles had excellent intraocular biocompatibility, low hemolytic ratio, and were safe for use in two key retinal cell lines (ARPE-19 and 661W cells). Taken together, these findings provide an alternative insight into the optical imaging of Aß plaques for the diagnosis of AD using the eyes. More importantly, this study can be translated to humans in the future to improve on early diagnosis and timely management of the disease.

Clinico-radiological features and next generation sequencing of pulmonary epithelioid hemangioendothelioma: A case report and review of literature.

Epithelioid hemangioendothelioma is a very rare, vascular, low-grade malignant tumor found in the lungs, liver, bone, and other soft tissues. Most patients with pulmonary epithelioid hemangioendothelioma (PEH) are asymptomatic but usually present with multiple bilateral nodular lesions in the lungs. Currently, surgical lung biopsy, histology, and immunohistochemical methods are essential for diagnosis. However, there is no standard therapy for the treatment for PEH. Our paper describes the clinico-radiologic features and genomics of PEH based on next-generation sequencing (NGS) in a 43-year-old male we encountered. The patient came to the hospital with right chest pain. After investigation, a lesion in the middle lobe of the right lung was found, together with smaller multiple lesions in both lungs. After resection of the lesion, histopathological analysis showed positive findings for PEH. The patient's blood and tumor tissue were sent for NGS analysis for further investigation. Results from the analysis revealed mutations of multiple genes. The information obtained from the genomic analysis of PEH using NGS may be significant for the planning and monitoring of treatment for this disease.