Clinical Anatomy最新文献

{"title":"Psychometric Properties of the Critical Appraisal Tool for Anatomical Meta-Analysis.","authors":"Anthony V D'Antoni, Nancy Kamel, R Shane Tubbs, Morgan G McCartan, Laine W Strobel, Kathleen C Bubb","doi":"10.1002/ca.24263","DOIUrl":"https://doi.org/10.1002/ca.24263","url":null,"abstract":"<p><p>The hallmark of evidence-based anatomy (EBA) is the anatomical meta-analysis (AMA). The Critical Appraisal Tool for Anatomical Meta-Analysis (CATAM) was recently published to enable users to appraise AMAs quickly and effectively. The tool is valuable for students and clinicians who need to judge the quality of AMAs, which informs clinical decision making and results in better patient care. Subjective measures of the tool's face and content validity have been established, but establishing its reliability provides a more objective measure of the instrument's dependability. This study investigated the interrater reliability (IRR) of the CATAM between novice and expert raters. Three graduate students and three professors (two anatomists and one pharmacist) read the original CATAM paper, and then had a post hoc meeting to discuss scoring with the tool. Three recent AMAs (published between 2017 and 2022) were randomly chosen from PubMed, and all six raters scored the papers blindly. The intraclass correlation coefficient (ICC) statistic was used to calculate the interrater reliability (IRR) between all scores, and then the ICCs between novice and expert scores were compared. Cronbach's alpha (internal consistency) of the CATAM was also calculated (SPSS 25, Armonk, NY). ICC for AMA-1 was 0.999 (95% CI, 0.997-0.999), p = 0.000, and alpha was 0.999. ICC for AMA-2 was 0.994 (95% CI, 0.988-0.998), p = 0.000, and alpha was 0.994. ICC for AMA-3 was 0.998 (95% CI, 0.995-0.999), p = 0.000, and alpha was 0.998. ANOVA showed no significant differences (p > 0.05) in mean ICCs between raters. The CATAM is a robust tool with excellent IRR (ICC > 0.990) and internal consistency (alpha > 0.990). No significant difference in ICC scores between novices and experts suggests the tool does not require prior expert knowledge to be effective. Now that the reliability of the CATAM is established, it can be more widely adopted by students and physicians worldwide to evaluate the quality of AMAs. The CATAM offers widespread applicability, and can be adopted in medical education, journal clubs, and clinical seminars to critically evaluate AMAs.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anatomical Research Projects for Medical Students: A Cross-Sectional Survey of Academic and Professional Skills, Clinical Aspirations and Appreciation of Anatomy.","authors":"Amil Sinha, Arun James Thirunavukarasu, Anosh Bonshahi, Cecilia Brassett","doi":"10.1002/ca.24259","DOIUrl":"https://doi.org/10.1002/ca.24259","url":null,"abstract":"<p><p>In the third year of pre-clinical medicine (known as Part II of the Natural Sciences Tripos at the University of Cambridge), students have the opportunity to lead a primary research project on clinically relevant anatomy, often involving donor dissection. This descriptive study used a cross-sectional survey to explore the effects of undertaking an anatomical research project on students' attitudes, interests, and a variety of academic and professional skills. Of 45 students who were invited to participate in this study, 40 responded. Of these, 30 students (75%) had performed cadaveric dissection. Projects increased students' interests in academic careers (36% or 90% agreed/strongly agreed) and scientific inquiry, with 30 students (75%) undertaking subsequent research. Many students (30/40; 75%) strongly agreed their projects highlighted the importance of considering the scientific literature when providing patient care. Most (39/40; 97.5%) felt that there was scope for further anatomical research to appreciate and explore anatomical variation. Many students (32/40; 80%) strongly agreed that projects improved their self-directed learning skills. Inductive thematic analysis of free-text answers identified themes of improved academic, practical, and professional skills such as negotiation, responding to questions, presenting at conferences, and liaising with experts and non-experts. These results suggest that anatomical primary research through this program effectively fosters academic aptitude and interest, as well as the practical and professional skills necessary to thrive in academia and clinical medicine. Aspirations for a surgical career were strengthened and valuable anatomical context was provided.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical Use of Cadaveric Images in Anatomical Textbooks, Atlases, and Journals: A Consensus Response From Authors and Editors.","authors":"Joe Iwanaga, Hee-Jin Kim, Keiichi Akita, Bari M Logan, Ralph T Hutchings, Nicolás Ottone, Yoichi Nonaka, Mahindra Anand, Danny Burns, Vishram Singh, Maria Peris-Celda, Francisco Martinez-Soriano, Nihal Apaydin, Amgad Hanna, Nobutaka Yoshioka, Juan Fernandez-Miranda, Mi-Sun Hur, Mohammadali M Shoja, Farhood Saremi, Francisco Reina, Yoko Tabira, Anna Carrera, Jonathan D Spratt, S Yen Ho, Shumpei Mori, Noritaka Komune, Koichi Watanabe, Alberto Prats-Galino, Jose De Andrés, Miguel Angel Reina, Peter H Abrahams, Robert H Anderson, Soichiro Ibaragi, Marios Loukas, R Shane Tubbs","doi":"10.1002/ca.24258","DOIUrl":"https://doi.org/10.1002/ca.24258","url":null,"abstract":"<p><p>Nowadays, consent to use donor bodies for medical education and research is obtained from the body donors and their families before the donation. Recently, the International Federation of Associations of Anatomists (IFAA) published guidelines that could restrict the appearance of cadaveric images in commercial anatomical resources such as textbooks and other educational products. These guidelines state that the donor must expressly consent to using such images for this purpose. Cadaveric photos and drawings made from dissections of cadavers have been used in anatomy textbooks and atlases for hundreds of years. They are invaluable for anatomy students and clinical/surgical practitioners. The IFAA guidelines should not restrict the use of those older books; to do so would infringe the rights of those seeking knowledge from these resources. As the images in such textbooks and atlases are anonymized and are used for teaching and research, and the donors and their families are informed about this before the donation, we believe no additional consent is needed. It is impossible to separate educational from \"commercial\" usage entirely in any situation, e.g., publications from publishers and the use of cadavers in medical schools. Therefore, our best efforts to avoid unethical use of cadaveric images by following traditional consent processes are still needed so that more people will reap the benefits from them. As senior textbook/atlas authors/editors from over 10 countries, we believe that using cadaveric images in anatomy textbooks is appropriate, and no additional consent should be necessary. Such usage falls within the good faith of professionals using these invaluable gifts.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Transverse Humeral Ligament: An Anatomical Narrative Review.","authors":"Keigo Shimizu, Yoko Tabira, Tatsuya Harano, Joe Iwanaga, Shota Uchino, Keishiro Kikuchi, Kathleen Bubb, Kazzara Raeburn, R Shane Tubbs, Koichi Watanabe","doi":"10.1002/ca.24257","DOIUrl":"https://doi.org/10.1002/ca.24257","url":null,"abstract":"<p><p>Shoulder pain often involves the tendon of the long head of the biceps brachii (LHBT) and the transverse humeral ligament (THL). Traditionally, the THL is considered a ligament that prevents the LHBT from dislocating, but recent studies suggest that it may be part of the subscapularis tendon. This review evaluates the nature of the THL and its overlying structures. We reviewed the literature from PubMed and Scopus through April 2024 and selected seven studies. Four described the THL as a ligament, and three did not. THL measurements ranged from 14 to 21 mm in length and 14 to 17 mm in width. Histology was inconsistent, with some studies suggesting it is more tendon-like. Clinically, LHBT injuries are associated with rotator cuff injuries. Biomechanical studies, such as those by Kwon et al. (2009), associate the LHBT with subscapularis tendon tears. Accurate diagnosis and treatment of shoulder pain should consider these anatomical variations. The structure covering LHBT in the intertubercular sulcus is most likely the subscapularis tendon, rather than a ligament. Understanding these variations is critical to improving the management of shoulder pain.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical etiology of bunny lines based on cadaveric dissection and ultrasonographic evaluation.","authors":"Haeryun Ahn, Hyewon Hu, Soo-Bin Kim, Ji-Hyun Lee, You-Jin Choi, Kyung-Seok Hu, Sabrina Shah-Desai, Shinichi Abe, Hee-Jin Kim","doi":"10.1002/ca.24249","DOIUrl":"https://doi.org/10.1002/ca.24249","url":null,"abstract":"<p><p>Bunny lines are vertical and diagonal wrinkles attributed to contractions of the nasalis muscle. Common management involves botulinum toxin (BoNT) injections into wrinkles immediately below the nasal bridge. Here, we investigated the anatomical structures underneath bunny lines and their relationships with adjacent muscular structures. The area between the medial canthus and nasal dorsum was examined by ultrasonography in 13 adult volunteers (mean age, 29.4 years) and dissected in 39 cadavers. The findings consistently showed a non-muscular area (bunny triangle) between the borders of the procerus, nasalis, orbicularis oculi (OOc), and levator labii superioris alaeque nasi (LLSAN) muscles. The size and shape of the bunny triangle vary according to the width of the procerus and nasalis muscles. The muscles neighboring the bunny lines affect the thinning of the thin skin between the medial canthus and nasal dorsum. Our results indicate that conventional BoNT injection into bunny line wrinkles is likely to target connective tissue rather than a muscle, potentially producing suboptimal results. Therefore, the BoNT injection points probably need to target the borders of the procerus, nasalis, OOc, and LLSAN muscles to be most efficient.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology discovered in the \"first patient\" can be the silent teacher of self-directed learning.","authors":"Mary Leupold, Daniel Topping, R John Cork, Robin McGoey, Guenevere Rae","doi":"10.1002/ca.24256","DOIUrl":"https://doi.org/10.1002/ca.24256","url":null,"abstract":"<p><p>Pathology found during cadaveric dissection has been used to model integrative teaching methods for medical students at several institutions. Recent evidence has shown that pathology found during dissection can be used in the design of self-directed learning (SDL) activities with standards that are difficult to meet. This study presents a novel method for providing formative feedback, one of the most challenging aspects for LCME accreditation of SDL activities. Three practitioners (two board certified pathologists and one board certified family physician) reviewed and rated pathological findings during routine dissection by first year medical students in the gross anatomy laboratory in New Orleans, Louisiana. The students also rated the findings, and a comparative score was given that provided quick, individualized formative feedback with no additional faculty time burden. The inter-rater reliability (IRR) among the clinical expert panel (n = 3) was adequate (IRR = 0.85). The students' percentage agreement with the expert panel was just under 57%. There was no significant correlation between the score on the Gift formative feedback instrument (FFI) and the students' performances in their gross anatomy course (p > 0.05). This study describes a FFI that allows for the variety of clinical presentations in cadavers dissected in the gross anatomy laboratory, while protecting faculty time that would otherwise be used for scoring individuals in large cohorts of medical students. This instrument can be used to integrate pathology and gross anatomy and provide a practical way of implementing self-directed learning.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphology of the sternoclavicular joint and its microanatomical changes in response to osteoarthritic degeneration.","authors":"Sophie Mok, Yousef Almajed, Abdulaziz Alomiery, Roger Soames, Abduelmenem Alashkham","doi":"10.1002/ca.24253","DOIUrl":"https://doi.org/10.1002/ca.24253","url":null,"abstract":"<p><p>Although the sternoclavicular joint shares structural similarities with the knee and hip joints as a diarthrodial joint, its biomechanics differ significantly due to its non-weight-bearing nature. Nevertheless, it is subject to considerable loading, leading to increased susceptibility to osteoarthritis, a prevalent condition characterized by the degeneration of the joint's articular surfaces and fibrocartilaginous intra-articular disc. The osteoarthritic degeneration of the fibrocartilaginous and cartilaginous surfaces of the sternoclavicular joint has been investigated, considering multiple factors. These include cell count, collagen alignment, surface fibrillation, cyst formation, and glycosaminoglycan content, with the findings deemed significant. However, current treatments for osteoarthritis of the sternoclavicular joint tend to focus on symptom management rather than active prevention of disease progression. Therefore, a detailed understanding of the anatomy, biomechanics, and morphological changes of the sternoclavicular joint during all stages of the osteoarthritic disease is essential for effective management to allow for maximum patient outcomes. This review explores the current literature on the anatomy of the sternoclavicular joint, starting with its structure and comparison to surrounding joints, biomechanics, and morphology, before considering the microanatomical changes that occur due to osteoarthritic degeneration. Early identification of osteoarthritic changes within this joint can enhance treatment and management outcomes before advancing joint degeneration, improving the quality of life for those affected.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Horst Oertel and the Russell Sage Institute of Pathology: Impacts on vital statistics and the origins of the short-lived heyday of autopsies in America.","authors":"James R Wright","doi":"10.1002/ca.24241","DOIUrl":"https://doi.org/10.1002/ca.24241","url":null,"abstract":"<p><p>Horst Oertel was an early 20th century pathologist who began his career as an instructor of clinical pathology at the New York University and Bellevue Hospital Medical College in 1899. In 1903, he was appointed pathologist for City Hospital, an institution for indigent patients on New York City's Blackwell's Island. In 1907, Oertel became the first director of the Russell Sage Institute of Pathology, a unique new blended public-private entity based at City Hospital, that was named after a wealthy benefactor. The Institute was established to utilize the Island's indigent population to perform anatomical pathology research on diseases of aging. Oertel and the Institute thrived until 1911, when a newly-appointed New York City bureaucrat seeking patronage and graft began meddling in the Institute's governance. After press coverage of a vitriolic one-week-long exchange of charges and counter-charges between the Institute's Board of Directors and the bureaucrat, the Institute imploded. While these events meant that the Institute's tenure on Blackwell's Island would soon be coming to an end, Oertel continued to work and submit articles from the Institute throughout 1912. In May 1913, he published \"The Inaccuracy of American Mortality Statistics\" in American Underwriter, a bombshell article documenting low autopsy rates and high clinical diagnostic error rates at Bellevue Hospital during 1912. This, along with similar studies by Richard Cabot at Massachusetts General Hospital in Boston, highlighted fundamental problems in hospital care and medical education across America. Simultaneously, Oertel led the Public Health, Hospital and Budget Committee of the New York Academy of Medicine which reported that, in a selected series of large American hospitals, the autopsy percentage when compared to the number of deaths was one-eighth the rates in Canada, Great Britain, Austria, and Germany. This paper addresses how American autopsy rates skyrocketed and then plummeted again during the mid-20th century.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Benefits of Gamification in Medical Education\".","authors":"","doi":"10.1002/ca.24250","DOIUrl":"https://doi.org/10.1002/ca.24250","url":null,"abstract":"","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring student acceptance of learning technologies in anatomy education: A mixed-method approach.","authors":"Jason Wen Yau Lee, Dennis Wenhui Ong, Reuben Chee Chong Soh, Jai Prashant Rao, Fernando Bello","doi":"10.1002/ca.24254","DOIUrl":"https://doi.org/10.1002/ca.24254","url":null,"abstract":"<p><p>Anatomical education is transitioning from the time-honored cadaveric dissection to a blend of learner-centered and technology-enhanced learning approaches. In view of the increased use of various technologies for teaching and learning human anatomy, the aim of this study is to explore students' acceptance of four learning technologies using the technology acceptance model (TAM). This work was conducted at a graduate medical school in Singapore with first-year MD Program students. The acceptances of the four learning technologies were compared in two studies. In Study 1 (n = 46), we compared a 3D-printed (3DP) model with Primal Pictures to answer a clinical question in a Spine Anatomy Tutorial; in Study 2 (n = 55), we compared the Anatomage Table and Primal VR for a Brain Anatomy tutorial. There was a statistically significant preference (p < 0.05) for 3DP models over Primal Pictures for learning Spine Anatomy, and for Primal VR over Anatomage for learning Brain Anatomy. The perceived ease of use of any technology does not appear to influence the behavioral intention to use it. Qualitative feedback suggests that visualization and spatial relationships were among the most important facilitators of learning. Technology should be an enabler in learning but some technologies have a steeper learning curve than others. Therefore, to increase its perceived usefulness, educators must leverage the affordances of the technology when designing learning activities.</p>","PeriodicalId":50687,"journal":{"name":"Clinical Anatomy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}