Medical students' preferences for asynchronous online or face-to-face learning strategies in learning gross anatomy and neuroanatomy during the COVID-19 pandemic.

Gross anatomy and neuroanatomy are fundamental subjects in medical education. However, learning different anatomical terms and understanding the complexity of the subjects are often challenging for medical students. At National Taiwan University, the 2020-2021 cohort adopted a face-to-face (F2F) learning strategy for gross anatomy and neuroanatomy lecture and laboratory courses until May 17, 2021. After the aforementioned date, the same cohort learned the rest of the gross anatomy and neuroanatomy courses via asynchronous online learning. This study aimed to evaluate the benefits of and students' preferences for F2F and asynchronous online learning strategies in learning gross anatomy and neuroanatomy. A survey with closed-ended and open-ended questions was used to quantitatively and qualitatively explore medical students' learning preferences for two teaching strategies in gross anatomy and neuroanatomy. The results identified different learning preferences among students in learning gross anatomy and neuroanatomy-satisfied with both learning strategies, satisfied with only F2F learning strategy, satisfied with only asynchronous online learning strategy, and satisfied with neither learning strategy. The survey results with closed-ended and open-ended questions showed that medical students preferred F2F learning for anatomical laboratory courses but favored asynchronous online learning for neuroanatomical laboratory courses. In addition, medical students considered peer discussion more critical in learning gross anatomy than neuroanatomy. These findings provide valuable information about medical students' preference for gross anatomy and neuroanatomy courses, which anatomy teachers can consider when planning to enhance their curriculum in the future.

Implementing virtual reality technology to teach medical college systemic anatomy: A pilot study.

It can be difficult for some students to learn three-dimensional anatomical structure concepts. While virtual reality (VR) systems have been reported as helpful for learning, there has been scarce research on either VR teaching strategies or the influence of visually induced motion sickness (VIMS) in the context of large anatomy classes (i.e., over 100 students). The study thus aimed to (1) establish a VR anatomy instruction video for a large class; (2) determine how many students experience VIMS when watching a VR anatomy instruction video; (3) evaluate the influence of VIMS on VR anatomy video-based learning; and (4) examine whether a small screen size alleviates VIMS. Laboratory course students viewing a VR anatomy instruction video about the vascular system were invited to participate in the questionnaire survey. Anatomy faculty and staff participated in an experimental trial to determine whether small screen size could alleviate VIMS. The Likert scale survey revealed that students reported the VR strategy as advantageous and appropriate for large classes, but that it cannot replace practical dissection. Of the total participants, 32% reported experiencing VIMS, and 40% of those experiencing VIMS agreed that this could negatively impact their learning through a VR anatomy instruction video. Adjusting the screen size from large to small significantly delayed the onset of VIMS. In conclusion, the VR anatomy instruction video strategy is feasible and helpful for large classes, but educators should consider VIMS when planning their use of this teaching approach.

The ratio of alpha-calcitonin gene-related peptide to substance P is associated with the transition of bone metabolic states during aging and healing.

Alpha-calcitonin gene-related peptide (αCGRP) and substance P (SP) are functionally correlated sensory neuropeptides deeply involved in bone homeostasis. However, they are usually studied individually rather than as an organic whole. To figure out whether they are interdependent, we firstly recorded the real-time αCGRP and SP levels in aging bone and healing fracture, which revealed a moderate to high level of αCGRP coupled with a low αCGRP/SP ratio in an anabolic state, and a high level of αCGRP coupled with a high αCGRP/SP ratio in a catabolic state, suggesting the importance of αCGRP/SP ratio in driving aging and healing scenarios. During facture healing, increase in αCGRP/SP ratio by adding αCGRP led to better callus formation and faster callus remodeling, while simultaneous addition of αCGRP and SP resulted in hypertrophic callus and delayed remodeling. The characteristics in inflammation and osteoclast activation further confirmed the importance of high αCGRP/SP ratio during catabolic bone remodeling. In vitro assays using different mixtures of αCGRP-SP proved that the osteogenic potential of the mixtures depended mostly on αCGRP, while their effects on osteoclasts and neutrophils relied on both peptides. These results demonstrated that αCGRP and SP were spatiotemporally interdependent. The αCGRP/SP ratio may be more important than the dose of a single neuropeptide in managing age-related and trauma-related bone diseases.

Impact of modified teaching strategies used in a gross anatomy course on the academic performance of dental students during the COVID-19 pandemic.

INTRODUCTION: Modified teaching strategies (MTS), asynchronous online teaching and smaller dissection groups, were applied to a gross anatomy course for dental students in the National Taiwan University in April 2020 in response to the COVID-19 pandemic. This study aimed to investigate the effects and perceptions of MTS on dental students. MATERIALS AND METHODS: Scores for anatomy examinations for 2018-2019 (without MTS) and 2019-2020 (with MTS) cohorts were compared to explore the effect on academic performance. Moreover, questionnaire from the 2019-2020 cohort was analysed to determine dental students' perceptions about MTS. RESULTS: The lecture performance in the final examination of the second semester for the 2019-2020 cohort was significantly higher than that of the first semester (pre-COVID-19) and that for the 2018-2019 cohort. However, the laboratory performance in the midterm examination of the second semester for the 2019-2020 cohort was significantly lower than that for the 2018-2019 cohort and showed no difference in the final examination of the first semester. The questionnaires revealed that the majority of students displayed positive attitudes towards MTS and agreed with the importance of peer discussion during laboratory dissection. CONCLUSIONS: Asynchronous online learning for anatomy lecture may be beneficial for dental students; however, a smaller dissection group accompanied by reduced peer discussion may temporarily exert negative effects on their laboratory performance at the beginning of the application. Furthermore, more dental students exhibited positive perceptions towards smaller dissection groups. These findings could illuminate the learning condition of dental students in anatomy education.

Improving Chinese College Students' Argumentative Writing: A Presentation-Assimilation-Discussion-Exercise Approach.

This study implemented the Presentation-Assimilation-Discussion-Exercise (PADE) model, a student-centered teaching model that originated in China, and examined its effect on college students' argumentative writing. Quantitative method was used in this study following a teaching practice of 14 weeks. A total of 76 Chinese first-year university students of intermediate English level with 38 students in an experimental class and 38 students in a comparison class took part in the study. Students from the experimental class received the PADE model, and the comparison class received traditional teaching. Students from both classes were asked to compose two argumentative essays before and after the treatment. At the end of the treatment, students completed questionnaires on the PADE teaching model. Students' writings were evaluated on aspects of linguistic quality and argumentative structure. The results indicated that students who learned in the PADE teaching environment outperformed students who followed traditional teaching method in the post-writing, and significant differences were shown in all aspects except organization and grammar. The questionnaire finding suggested that students from the experimental class held a welcoming attitude toward the PADE model and benefited from it from the perspectives of course design, teaching arrangement, and learning effect. The PADE teaching has implications for teaching writing in contexts that share many similarities.

Influence of bone morphology on the mechanobiological stimuli distribution of maxillary anterior labial bone: A biomechanical study.

OBJECTIVE: This study intended to ascertain the dimensional effects of labial bone thickness and height on the mechanobiological stimuli distribution of maxillary anterior labial bone through biomechanical analysis. MATERIAL AND METHODS: Twelve 3D finite element models of an anterior maxillary region with an implant were computer-simulated, including four levels of labial bone thicknesses (2, 1.5, 1.0, and 0.5 mm) and three levels of labial bone heights (normal, reduced by 1/3, reduced by 1/2). A 45° buccolingual oblique load of 100 N was applied to the implant restoration. RESULTS: Equivalent stress and principal strain mainly concentrated on crestal bone around the implant neck. The maximum equivalent stress in bone decreased as labial bone mass decreased, while the maximum principal strain and the displacement of dental implant increased as labial bone mass decreased. No significant difference of these three indicators was observed, when the labial bone thickness changed in the range of 2.0-1.0 mm with sufficient labial bone height. CONCLUSIONS: In terms of biomechanics, the thickness of labial bone plate was recommended ≥1 mm. Sufficient labial bone height was warranted to prevent the stability of the implants from being seriously affected. The labial bone heights were more effective than thicknesses on the mechanobiological stimuli response of the dental implant-bone system. CLINICAL SIGNIFICANCE: For this 3D finite element study, the biomechanical responses under different bone mass conditions were explored, in order to predict the process of bone remodeling and provide valid clinical recommendations for the decision-making process regarding the choices of tissue augmentation for some specific esthetic implantation cases for future clinical applications.

Benefits of a bilingual web-based anatomy atlas for nursing students in learning anatomy.

BACKGROUND: Registered nurses are required for high-quality healthcare. Thus, the anatomy course is essential regarding professional knowledge of the human body during the nursing training process. However, previous studies have indicated that anatomy teaching time and anatomy teachers were reduced and insufficient. Therefore, to improve the learning of practical anatomy in response to these difficulties, a bilingual National Taiwan University web-based anatomy atlas (NTU-WAA) was created as a cross-platform application and its feasibility was evaluated. METHODS: The comparison of anatomy examination scores between nursing students of two cohorts (66 from the 2018-2019 cohort, whom was without NTU-WAA application; 54 from the 2019-2020 cohort, to whom NTU-WAA was offered) and the evaluation of questionnaires collected from nursing students of the 2019-2020 cohort and 4 anatomy teachers were carried out to define the feasibility of this strategy. RESULTS: Results obtained by nursing students for the 2019-2020 cohort showed a significant increase in anatomy learning performance compared with that of the 2018-2019 cohort with reference to the laboratory midterm [2018-2019 cohort vs. 2019-2020 cohort, mean (standard deviation, SD): 77.20 (16.14) vs. 81.80 (12.03); p = 0.043], the laboratory final examination [59.68 (15.28) vs. 80.35 (13.74); p < 0.001] and the theory final examination [80.85 (10.10) vs. 84.33 (6.925); p = 0.017]. Moreover, results of the questionnaires indicated that the new bilingual cross-platform atlas was highly accepted by students and teachers. CONCLUSIONS: The NTU-WAA, a bilingual web-based atlas, was evaluated as a beneficial anatomy-learning tool that may enhance self-study of nursing students with consequent amelioration of their anatomy-related performance in both theoretical and laboratory examinations. This reflection suggests the future implementation of the bilingual web-based atlas on a large scale.

The impact of asynchronous online anatomy teaching and smaller learning groups in the anatomy laboratory on medical students' performance during the Covid-19 pandemic.

Due to the Covid-19 pandemic, National Taiwan University anatomy teachers adopted asynchronous online video teaching and reduced the size of anatomy laboratory groups in April 2020. The aim of this study was to investigate the impact of these changes on medical students' learning. Before Covid-19, the performance of the 2019-2020 cohort was significantly better than that of the 2018-2019 cohort. However, the implementation of modified teaching strategies significantly lowered the laboratory midterm score of the 2019-2020 cohort in the second semester. Conversely, the final laboratory examination score of the 2019-2020 cohort was significantly higher than that of the 2018-2019 cohort. Through correlation analysis, lecture and laboratory examination scores were highly correlated. Additionally, the difference in lecture and laboratory z-scores between two cohorts, the Likert scale survey and free-text feedback of the 2019-2020 cohort, were conducted to show the impact of modified teaching strategies. There were several important findings in this study. First, the change in teaching strategies may temporarily negatively influence medical students to learn anatomy. Besides, analyzing the performance of laboratory assessments could be a complementary strategy to evaluate online assessments. Applying lecture examination scores to predict laboratory performance was a feasible way to identify students who may have difficulty in learning practical dissection. Finally, reducing group size together with reduced peer discussion may have a negative effect on learning cadaver dissection for students with low academic performance. These findings should be taken into consideration when anatomy teachers apply new teaching strategies in anatomy courses.

Alterations in the von Ebner's gland secretion and implications for taste sensation in diabetic (db/db) mice.

The taste buds and associated glands, known as von Ebner's glands (VEGs), are involved in and augment gustatory function. The obese diabetic db/db mouse, which has defects in the leptin receptor, displays enhanced neural responses to, and an elevated behavioral preference for, sweet stimuli. However, the effect of diabetes on the morphology of circumvallate papilla (CVP) taste buds and the role of VEGs have not been investigated. The present study aimed to compare the CVP taste buds and VEGs in wildtype (Wt) and type 2 diabetic (db/db) mice. These mice were divided into control and isoproterenol-treated (at 1 h, 2 h, and 4 h after one day of fasting) groups, and were sacrificed for morphometric, immunohistochemical, and ultrastructural analyses. Morphometry revealed no significant difference in papilla size and the number of taste buds in the control and diabetic groups. Detection of PGP 9.5-immunoreactivity revealed nerve fibers in the trench wall of vallate papillae, but no significant differences were detected between groups. α-Amylase immunoreactivity levels in Wt and db/db mice were also similar. However, 1 h after isoproterenol injection, the majority of the VEG secretion of db/db mice was discharged, while the level of α-amylase was restored by 2 h after injection. The effect on α-amylase was in line with the quantitative ultrastructural analysis of the secretory granules. Our findings suggest diabetic metabolic disturbances in db/db mice do not alter the structure or innervation of CVP taste buds. However, the VEG secretory pattern was altered in db/db mice and might disrupt taste sensation.

Conditional Deletion of Activating Rearranged During Transfection Receptor Tyrosine Kinase Leads to Impairment of Photoreceptor Ribbon Synapses and Disrupted Visual Function in Mice.

Purpose: The rearranged during transfection (RET) receptor tyrosine kinase plays a key role in transducing signals related to cell growth and differentiation. Ret mutant mice show abnormal retinal activity and abnormal levels and morphology of bipolar cells, yet die on the 21st day after birth as a result of renal underdevelopment. To extend the observation period, we generated the Ret conditional knockout Chx10-Cre;C-Ret lx/lx mouse model and analyzed the retinal function and morphological changes in mature and aging Chx10-Cre;C-Ret lx/lx mice. Methods: Retina-specific depletion of Ret was achieved using mice with floxed alleles of the Ret gene with CHX10-driven Cre recombinase; floxed mice without Cre expression were used as controls. Retinal function was examined using electroretinography (ERG), and 2-, 4-, 12-, and 24-month-old mice were analyzed by hematoxylin staining and immunohistochemistry to evaluate retinal morphological alterations. The ultrastructure of photoreceptor synapses was evaluated using electron microscopy. Results: The results of the ERG testing showed that b-wave amplitudes were reduced in Chx10-Cre;C-Ret lx/lx mice, whereas a-waves were not affected. A histopathological analysis revealed a thinner and disorganized outer plexiform layer at the ages of 12 and 24 months in Chx10-Cre;C-Ret lx/lx mice. Moreover, the data provided by immunohistochemistry showed defects in the synapses of photoreceptor cells. This result was confirmed at the ultrastructural level, thus supporting the participation of Ret in the morphological changes of the synaptic ribbon. Conclusion: Our results provide evidence of the role of Ret in maintaining the function of the retina, which was essential for preserving the structure of the synaptic ribbon and supporting the integrity of the outer plexiform layer.

Neural differentiation of glioblastoma cell lines via a herpes simplex virus thymidine kinase/ganciclovir system driven by a glial fibrillary acidic protein promoter.

Glioblastoma is a malignant brain tumor with poor prognosis that rapidly acquires resistance to available clinical treatments. The herpes simplex virus thymidine kinase/ganciclovir (HSVtk/GCV) system produces the selective elimination of HSVtk-positive cells and is a candidate for preclinical testing against glioblastoma via its ability to regulate proliferation and differentiation. Therefore, in this study, we aimed to establish a plasmid encoding the HSVtk/GCV system driven by a glial fibrillary acidic protein (GFAP) promoter and verify its possibility of neural differentiation of glioblastoma cell line under the GCV challenge. Four stable clones-N2A-pCMV-HSVtk, N2A-pGFAP-HSVtk, U251-pCMV-HSVtk, and U251-pGFAP-HSVtk-were established from neuronal N2A and glioblastoma U251 cell lines. In vitro GCV sensitivity was assessed by MTT assay for monitoring time- and dosage-dependent cytotoxicity. The capability for neural differentiation in stable glioblastoma clones during GCV treatment was assessed by performing immunocytochemistry for nestin, GFAP, and ßIII-tubulin. Under GFAP promoter control, the U251 stable clone exhibited GCV sensitivity, while the neuronal N2A clones were nonreactive. During GCV treatment, cells underwent apoptosis on day 3 and dying cells were identified after day 5. Nestin was increasingly expressed in surviving cells, indicating that the population of neural stem-like cells was enriched. Lower levels of GFAP expression were detected in surviving cells. Furthermore, ßIII-tubulin-positive neuron-like cells were identified after GCV treatment. This study established pGFAP-HSVtk-P2A-EGFP plasmids that successfully ablated GFAP-positive glioblastoma cells, but left neuronal N2A cells intact. These data suggest that the neural differentiation of glioblastoma cells can be promoted by treatment with the HSVtk/GCV system.

High through-put determination of 28 veterinary antibiotic residues in swine wastewater by one-step dispersive solid phase extraction sample cleanup coupled with ultra-performance liquid chromatography-tandem mass spectrometry.

We developed a QuEChERS (quick, easy, cheap, effective, rugged and safe) method for the high through-put determination of 28 common veterinary antibiotics in swine wastewater using one-step dispersive solid-phase extraction (d-SPE) for sample cleanup and ultra-performance liquid chromatography-tandem mass spectrometry for detection. The orthogonal test method was used to systematically investigate the parameters that might influence d-SPE efficiency. The optimal d-SPE procedure utilized 40 mg primary secondary amine sorbent and 3 g L-1 Na2EDTA. The recoveries ranged from 50 to 100% with relative standard deviations <20% for all target analytes except for enrofloxacin and chlortetracycline. The limits of detection and limits of quantification for all the analytes ranged from 0.002 to 0.200 ng mL-1 and 0.005-0.500 ng mL-1, respectively. The developed method was successfully applied to the analysis of 28 antibiotic residues in swine wastewater from 10 pig farms located in central China. Fourteen antibiotics including 4 sulfonamides (sulfadiazine, sulfamerazine, sulfamonomethoxine and trimethoprim), 5 fluoroquinolones (norfloxacin, ciprofloxacin, pefloxacin, enrofloxacin, and ofloxacin), 1 lincosamide (lincomycin) and 4 tetracyclines (doxycycline, tetracycline, oxytetracycline, and chlortetracycline) were detected at levels ranging from 0.0560 to 1793 ng mL-1. Our results demonstrated that the optimized method is a simple but reliable analytical technique for the routine monitoring of veterinary antibiotics in swine wastewater. Swine wastewater samples that we analyzed from 10 pig farms in Jiangxi Province, China were highly contaminated and pose a serious threat to ecosystems and to public health.

Distribution patterns of the zebrafish neuronal intermediate filaments inaa and inab.

It has been reported that the neuronal intermediate filament (IF) α-internexin may plays a role in the formation of the neuronal cytoskeleton during mammalian development. From a phylogenetic viewpoint, zebrafish express inaa and inab as homologs of mammalian α-internexin. However, the distribution patterns of the inaa and inab proteins throughout zebrafish development have not been well-characterized. We generated antibodies specific for zebrafish inaa and inab and analyzed the distribution of these two proteins in developing zebrafish. Inaa was identified in the major subdivisions of embryonic and larval brains as early as 1 day postfertilization (dpf), including the telencephalon, optic tectum, and cerebellum, and inab was also detected in the same regions from 3 dpf to the adult stage. Moreover, we demonstrated for the first time that inaa was distinctively expressed in the photoreceptor-like cells of the pineal gland, where inab was sparsely detected. Besides, the expression of inaa in male adult fish was found to be stable under different photoperiod conditions. Thus, we suggest that inaa is one of useful markers for studies of zebrafish cone photoreceptors not only in the retina but also in the pineal gland. In conclusion, we report that the distribution patterns of inaa and inab are phylogenetically conserved in the telencephalon, optic tectum, and cerebellum. Moreover, inaa and inab had different expression patterns in the pineal gland and retina during zebrafish development. Both inaa and inab are neuronal IFs and their functional roles may be different in various aspects of zebrafish neuronal development.

Developmental pattern of the neuronal intermediate filament inaa in the zebrafish retina.

α-Internexin is a member of the neuronal intermediate filament (nIF) protein family, which also includes peripherin and neurofilament (NF) triplet proteins. Previous studies found that expression of α-internexin precedes that of the NF triplet proteins in mammals and suggested that α-internexin plays a key role in the neuronal cytoskeleton network during development. In this study, we aimed to analyze the expression patterns and function of internexin neuronal intermediate filament protein-alpha a (inaa), the encoding gene of which is a homolog of the mammalian α-internexin, during retinal development in zebrafish. Via in vitro and in vivo studies, we demonstrated that zebrafish inaa is an α-internexin homolog that shares characteristics with nIFs. An immunohistochemical analysis of zebrafish revealed that inaa was distributed dynamically in the developing retina. It was widely localized in retinal neuroepithelial cells at 1 day postfertilization (dpf), and was mainly found in the ganglion cell layer (GCL) and inner part of the inner nuclear layer (INL) from 3-9 dpf; after 14 dpf, it was restricted to the outer nuclear layer (ONL). Moreover, we demonstrated for the first time that inaa acted distinctively from the cytoskeletal scaffold of zebrafish cone photoreceptors during development. In conclusion, we demonstrated the morphological features of a novel nIF, inaa, and illustrated its developmental expression pattern in the zebrafish retina. J. Comp. Neurol. 524:3810-3826, 2016. © 2016 Wiley Periodicals, Inc.