Utility of the Anatomage Virtual Dissection Table in Creating Clinical Anatomy and Radiology Learning Modules.

Purpose: During the COVID-19 pandemic, teaching has required online-learning modalities to facilitate easily accessible yet high-quality education. However, since the nature of anatomy requires hands-on experience in laboratories with cadavers, teaching anatomy in an online setting has proven especially difficult. This matter may be resolved with the Anatomage Table, an advanced anatomy visualization tool, which several studies have suggested can augment learning experiences for students in anatomy courses. Our objective was to provide accessible online modules, through utilization of the Anatomage Table, for medical students to facilitate their learning and enhance online learning experience. Materials and Methods: Ten modules were designed, consisting of a presentation, a pre- and post-self-assessment, as well as anatomical images and radiographs taken from Anatomage Table. The modules were based on a single organ system, and a clinical case pertaining to that organ system was presented. Weill Cornell Medicine-Qatar (WCM-Q) second-year medical students contributed 102 responses in total throughout the 10 modules. Using a paired t-test, the study compared the students' pre- and post-assessment scores to determine how beneficial the modules were. Results: A significant difference in scores on the pre- and post-assessments was found for all 10 modules using a paired t-test. At the end of the modules, the students completed a feedback survey to assess the quality and convenience. Most of the students agreed or strongly agreed that the modules were beneficial to their online anatomy learning and wanted to see similar anatomical modules in the future. Conclusion: The Anatomage Table is an innovative virtual resource that can significantly contribute to a more engaging and productive experience for medical students.

The Effectiveness of OsiriX and the Anatomage Virtual Dissection Table in Enhancing Neuroanatomy and Neuroradiology Teaching.

Introduction: In recent years with the advent of technology in medical education, teaching methodology has shifted towards heavy use of online-learning modalities. This has been especially the case for anatomy and radiology courses since they require students to visualize structures of the human body. Several studies indicated that Anatomage and OsiriX can be effective at enhancing students' learning experiences in anatomy and radiology. Purpose: This aim of this study is to assess the effectiveness of online case-based learning modules in teaching medical students about the anatomy and radiology of different types of brain tumors. Methods: Two online case-based learning modules were designed using Anatomage Table® and OsiriX DICOM viewer®, consisting of a clinical case and CT and MRI images. We recruited 36 fourth-year medical students that completed two 10-question quizzes (one on glioblastoma multiforme and one on pituitary adenomas). Participants were randomly assigned to either a study group that completed both modules prior to completing the quizzes, or a control group that completed the quizzes without access to the modules. The performance of both groups was compared to assess the effectiveness of the modules. Participants in the study group also completed a feedback survey to assess the quality and convenience of using the modules. Results: Students who used the case-based learning modules performed significantly better than those who did not (Quiz 1: mean = 6.56 vs 3.28, p<0.01. Quiz 2: mean = 6.67 vs 3.06, p<0.01). Students who completed the modules would like to see similar modules used in teaching anatomy and radiology in the future (64%). They found them easy to navigate (72%), useful in teaching anatomy and radiology (72%), and helpful in improving understanding of anatomical and radiological clinical correlations (77%). Conclusion: Online case-based learning modules created using Anatomage and OsiriX can be used effectively in teaching medical students about the anatomy and radiology of different types of brain tumors.

Systematic review and meta-analysis of chest radiograph (CXR) findings in COVID-19.

Chest radiography (CXR) is most likely to be the utilized modality for diagnosing COVID-19 and following up on any lung-associated abnormalities. This review provides a meta-analysis of the current literature on CXR imaging findings to determine the most common appearances of lung abnormalities in COVID-19 patients in order to equip medical researchers and healthcare professionals in their efforts to combat this pandemic. Twelve studies met the inclusion criteria and were analyzed. The inclusion criteria consisted of: (1) published in English literature; (2) original research study; (3) sample size of at least 5 patients; (4) reporting clinical characteristics of COVID-19 patients as well as CXR imaging features; and (5) noting the number of patients with each corresponding imaging feature. A total of 1948 patients were included in this study. To perform the meta-analysis, a random-effects model calculated the pooled prevalence and 95% confidence intervals of abnormal CXR imaging findings. Seventy-four percent (74%) (95% CI: 51-92%) of patients with COVID-19 had an abnormal CXR at the initial time of diagnosis or sometime during the disease course. While there was no single feature on CXR that was diagnostic of COVID-19 viral pneumonia, a characteristic set of findings were obvious. The most common abnormalities were consolidation (28%, 95% CI: 8-54%) and ground-glass opacities (29%, 95% CI: 10-53%). The distribution was most frequently bilateral (43%, 95% CI: 27-60%), peripheral (51%, 95% CI: 36-66%), and basal zone (56%, 95% CI: 37-74%) predominant. Contrary to parenchymal abnormalities, pneumothorax (1%, 95% CI: 0-3%) and pleural effusions (6%, 95% CI: 1-16%) were rare.

Cisplatin's dual-effect on the circadian clock triggers proliferation and apoptosis.

The circadian clock, which generates the internal daily rhythm largely mediated through release of melatonin, can be disrupted in various ways. Multiple factors result in a disruption of the circadian cycle in the clinical context, of interest are anti-cancer drugs such as cisplatin. Cisplatin modulates the circadian clock through two mechanisms: 1) the circadian clock control of DNA excision repair and 2) the effect of circadian clock disruption on apoptosis. Cisplatin can stimulate multiple classified molecules, including DNA repair factors, DNA damage recognition factors and transcription factors in drug resistance and cisplatin-induced signal transduction. These factors interact with each other and can be transformed by DNA damage. Hence, these molecular interactions are intimately involved in cell proliferation and damage-induced apoptosis. Cisplatin has a dual-effect on circadian genes: upregulation of CLOCK expression causes an increase in proliferation but upregulation of BMAL1 expression causes an increase in apoptosis. Therefore, the interference of circadian genes by cisplatin can have multiple, opposing effects on apoptosis and cell proliferation, which may have unintended pro-cancer effects. Melatonin and intracellular Ca2+ also have a dual-effect on cell proliferation and apoptosis and can disrupt circadian rhythms.

Anti-Cancer Agents in Proliferation and Cell Death: The Calcium Connection.

Calcium (Ca2+) signaling and the modulation of intracellular calcium ([Ca2+]i) levels play critical roles in several key processes that regulate cellular survival, growth, differentiation, metabolism, and death in normal cells. On the other hand, aberrant Ca2+-signaling and loss of [Ca2+]i homeostasis contributes to tumor initiation proliferation, angiogenesis, and other key processes that support tumor progression in several different cancers. Currently, chemically and functionally distinct drugs are used as chemotherapeutic agents in the treatment and management of cancer among which certain anti-cancer drugs reportedly suppress pro-survival signals and activate pro-apoptotic signaling through modulation of Ca2+-signaling-dependent mechanisms. Most importantly, the modulation of [Ca2+]i levels via the endoplasmic reticulum-mitochondrial axis and corresponding action of channels and pumps within the plasma membrane play an important role in the survival and death of cancer cells. The endoplasmic reticulum-mitochondrial axis is of prime importance when considering Ca2+-signaling-dependent anti-cancer drug targets. This review discusses how calcium signaling is targeted by anti-cancer drugs and highlights the role of calcium signaling in epigenetic modification and the Warburg effect in tumorigenesis.