Dissection Protocol Research Articles

First Canadian experience with same-day discharge after robot-assisted radical prostatectomy.

We aimed to evaluate the feasibility and safety of implementing a sameday discharge (SD ) protocol for robot-assisted radical prostatectomy (RARP) and pelvic lymph node dissection. We performed a prospective cohort study including all consecutive eligible patients undergoing RARP in 2021 following initiation of SDD RARP protocol in April. Baseline characteristics were compared using t-tests, Mann-Whitney U tests, and odds ratios (OR ) calculated using multiple logistic regression to assess for predictors of SD success. A total of 117 patients underwent RARP in 2021 following initiation of the SDD protocol. Fifty-seven patients were initiated on the SD pathway and 60 patients underwent surgery as an inpatient (IP-RARP). Of those on the SD pathway (SD-RARP), 33 (58%) were successfully discharged the same day of surgery, while 24 (42%) failed SD . Baseline demographics were well-balanced between cohorts. Case order, increased patient age, and distance travelled to the hospital were factors associated with selection of patients for the IP-RARP protocol. In total, 12 SD and 12 IP patients presented to the emergency department (p=1.0), and none within 24 hours of discharge. There were no hospital admissions in the SD cohort, with four readmissions in the IP cohort (p=0.1). Multiple logistic regression revealed that case order (first case) was the only predictive factor for SD success (OR 4.08, 95% confidence interval 1.59-11.62, p=0.005). Implementation of an SD pathway following RARP is feasible, with no increase in rates of complications, unscheduled visits, or readmissions.

Biomechanics of Septal L-Strut on Lamb Head Models.

It is very crucial to know the biomechanics of the septal cartilage and adjacent structures during septoplasty. The aim of this study was to investigate the strength changes of different L-strut models after mucoperichondrium elevation, application of septal extension grafts and spreader grafts on an experimental lamb model. Ten lamb heads were dissected according to a dissection protocol and septal resistances were measured with the newton meter at six zones. Three different L-strut types were designed, and all the L-strut models were created at different widths of 15mm, 10mm, and 5mm. In addition, effects of two different types of septal extension grafts and spreader grafts were compared. After mucoperichondrium elevation and harvesting the septum cartilage, there was a significant decrease in the septum resistance (p <0.05). As the width of the L-strut decreased, the septum strength decreased significantly (p <0.05). There was no significant difference between three chondrotomy types at different widths (p >0.05). There was no significant difference between the overlapping SEG and end-to-end SEG in terms of septum resistance (p >0.05). This was the first study to measure septal resistance in lamb heads. The mucoperichondrium and L-strut width were important structures for maintaining septal resistance. Chondrotomy style was not crucial, but as the width of the L-strut increased, the septal resistance increased. The septal extension grafts regardless of suturing style and the spreader grafts added strength to the caudal septum.

Laser Microdissection-Mediated Isolation of Butterfly Wing Tissue for Spatial Transcriptomics.

The assignment of specific patterns of gene expression to specific cells in a complex tissue facilitates the connection between genotype and phenotype. Single-cell sequencing of whole tissues produces single-cell transcript resolution but lacks the spatial information of the derivation of each cell, whereas techniques such as multiplex FISH localize transcripts to specific cells in a tissue but require a priori information of the target transcripts to examine. Laser dissection of tissues followed by transcriptome analysis is an efficient and cost-effective technique that provides both unbiased gene expression discovery together with spatial information. Here, we detail a laser dissection protocol for total RNA extraction from butterfly larval and pupal wing tissues, without the need of paraffin embedding or the use of a microtome, that could be useful to researchers interested in the transcriptome of specific areas of the wing during development. This protocol can bypass difficulties in extracting high quality RNA from thick fixed tissues for sequencing applications.

Anatomist Hermann Stieve used Nazi victims for his research on the menstrual cycle, but did he also fabricate facts?

PurposeHermann Stieve (1886–1952), director of the Berlin Anatomical Institute from 1935, benefited from the rise of execution numbers during the “Third Reich”. He used organs and tissues from executed women for his histological research on the reproductive organs and investigated the influence of “nervous agitation” on the cyclical changes of endometrium and ovary. It is still controversial how he was able to acquire intimate data on the executed women and it was therefore suggested that some of his data may have been “invented”.MethodsNewly emerged dissection protocols and histological drawings from Stieve’s research, together with archived court records, enable a more detailed analysis of Stieve’s published data.ResultsWe extracted 304 case descriptions from Stieve’s publications. Of these, 88 could be linked with 33 identifiable women and related historical records. Nearly all reported causes of death and/or verdicts of executed women were false. Reported clinical data, particularly the day of the menstrual cycle and uterine bleeding shortly before death, are more difficult to verify. We found non-standardised documentation and possible confusions of cases, which may in part be attributable to war effects.ConclusionStieve actively concealed the fate of the executed women, mostly by inventing imaginary stories. This followed a request by the German and Soviet authorities after 1945 not to publish results from cases of political victims, but only from “dangerous criminals”. Scientifically relevant clinical data were not always reported correctly, but are not necessarily fraudulent as different interpretations of this finding can be suggested.

Características anatómicas del nervio mediano en el codo y antebrazo proximal

IntroductionKnowledge of anatomy of the median nerve in its course through the elbow allows understanding the origin of several pathologies; in addition, identifying the distribution and anatomical variants of the nerve branches is useful for defining surgical approaches for this nerve. Materials and methodsDissection of cadaveric specimens, convenience sample, with prior approval of the ethics committee and following a dissection protocol identifying the median nerve and its ramifications in the elbow and its relationship with vascular and myotendinous structures. ResultsTwenty elbows with an average age of 60.8 years were dissected, exploring the median nerve, its ramifications and adjacent anatomical structures in the antecubital fossa. No Struthers ligament was found, the distance to the pronator teres (PT) arcade from the interepichondyle line was 51.3mm and 74.1mm to the flexor digitorum superficialis (FDS) arch. The most frequent pattern was a trunk for PT, a proximal transverse branch with divisions for FDS, flexor carpi radialis (FCR) and palmaris longus (PL). The innervation of the FCR originated mostly from the trunk of the PT. DiscussionGreat variability of origin and distribution of the branches originated from the median nerve in the elbow was observed, the distances and morphological characteristics in the known compression sites were quantified. The FCR branch is put at risk in the exploration of the tendon arches of the PT and the FDS.

Dissection Techniques and Histological Sampling of the Heart in Large Animal Models for Cardiovascular Diseases

The standard gross examination and sampling are key elements in the reproducibility and success of experimental studies of cardiovascular diseases carried out in large animals. Considering the complex anatomy of the heart, interspecies differences, and the types of compensatory and pathological reactions, consistent protocols are challenging to implement. The utilization of multiple dissection protocols is usually adapted to suit the prosector's experience, and personal preference continues to be a source of experimental and interobserver variability. Here, the aim is to present the main anatomical features and landmarks, dissection protocols, and histological sampling standards of the heart in some commonly used species (including dogs, pigs, ruminants, and cats) as models of cardiovascular diseases. Two standard gross examination protocols are presented here. First, the inflow-outflow method, which follows the physiological blood flow direction through the heart and large vessels (frequently used in dogs, ruminants, and pigs), and second, the four-chamber dissection technique (exemplified in cats). Both techniques can be adapted to any species in certain experimental circumstances. The sampling protocols include all the areas of interest (sinoatrial node, ventricles, interventricular septum, atria, valves, and aorta), and if properly carried out, improve both the reproducibility and reliability of experimental studies.

The influence of regions of interest on tractography virtual dissection protocols: general principles to learn and to follow.

Efficient communication across fields of research is challenging, especially when they are at opposite ends of the physical and digital spectrum. Neuroanatomy and neuroimaging may seem close to each other. When neuroimaging studies try to isolate structures of interest, according to a specific anatomical definition, a variety of challenges emerge. It is a non-trivial task to convert the neuroanatomical knowledge to instructions and rules to be executed in neuroimaging software. In the process called "virtual dissection" used to isolate coherent white matter structure in tractography, each white matter pathway has its own set of landmarks (regions of interest) used as inclusion and exclusion criteria. The ability to segment and study these pathways is critical for scientific progress, yet, variability may depend on region placement, and be influenced by the person positioning the region (i.e., a rater). When raters' variability is taken into account, the impact made by each region of interest becomes even more difficult to interpret. A delicate balance between anatomical validity, impact on the virtual dissection and raters' reproducibility emerge. In this work, we investigate this balance by leveraging manual delineation data of a group of raters from a previous study to quantify which set of landmarks and criteria contribute most to variability in virtual dissection. To supplement our analysis, the variability of each pathway with a region-by-region exploration was performed. We present a detailed exploration and description of each region, the causes of variability and its impacts. Finally, we provide a brief overview of the lessons learned from our previous virtual dissection projects and propose recommendations for future virtual dissection protocols as well as perspectives to reach better community agreement when it comes to anatomical definitions of white matter pathways.

Predictors of complication after groin dissection: A contemporary experience.

e21531 Background: Inguinal lymphadenectomy (ILND) has historically been associated with significant morbidity. The advent of sentinel node biopsy and selective dissection protocols have significantly decreased the frequency with which ILND is performed, reserving it for complex, recurrent disease. The study objective is to obtain contemporary morbidity rates for this complex procedure and to identify potentially preventable risk factors. Methods: Retrospective review of medical charts for all superficial, deep, and combination groin dissections performed for melanoma, sarcoma, and other rare cancers at a single, high-volume academic center between 01/2007 and 12/2020. Data points collected: patient, disease, surgery characteristics, and cancer outcomes. Outcome of interest: any complication within 30 days of surgery. Complications: wound infection, wound necrosis/disruption, seroma, drainage procedure, hematoma, lymphedema, and other. Multivariate logistic regression performed using SAS Enterprise 9.4. Results: : 139 cases were identified; type of dissection was 89, 12, and 38 for superficial, deep, and combined respectively. Melanoma accounted for 84.9% of cases, sarcoma for 8.6%. 56.1% of patients had an adverse postoperative event within 30 days. The majority of patients did not have a history of smoking, diabetes, cardiovascular disease, hypothyroidism, or radiation therapy. 61.2% were recurrent cancer cases with 56.8%, 19.4%, and 23.7% being clinically evident, radiological-only, and sentinel node positive disease respectively. Type and frequency of complications is reported in Table. Increasing age (OR: 1.04, 95CI: 1.01-1.07, P &lt; 0.01) and number of positive lymph nodes harvested (OR: 1.22, 95CI: 1.00-1.50, P = 0.05) were associated with more complications. Deep dissection showed lower likelihood of complications than those with superficial (OR: 0.15, 95CI: 0.03-0.84, P &lt; 0.05). Conclusions: A number of risk factors for complications were identified opening up opportunities for preventative intervention such as prehabilitation, use of frailty score, and neo-adjuvant therapy. Deep vein thrombosis, abscess, general deterioration, neuropathic pain, numbness. Frequency by occurrence, not patient. [Table: see text]

Cross Sectional Anatomy of the Pelvis and Perineum –A Dissection Approach to Increase Anatomical Knowledge

The complexity of both female &amp; male pelvic cavities and perineum is evident in the complex spatial organization of structure and function, vascular supply, innervations, and internal organs1. Given the limited dissection time, a large portion of learning has been focused on learning pelvis and perineum from prosections, hemisections, models, and resources made publicly available. Currently also, many dissection manuals detail methods that do not guarantee successful visualization of the entire pelvic cavity and perineum. Moreover, we recognize the shift towards multi‐modal teaching such as the use of interactive virtual dissections and 3‐D models visualization in anatomical education2. However, we attempt to retain the classical approach to clinical anatomy with the use of gross dissection and to maximize the experience of a first‐year medical student by relying on donors’ bodies. We suggest that a cross‐sectional modified dissection approach of the pelvic cavity and perineum would reveal anatomical landmarks, tissues, musculature, vasculature, and innervations to the same detail captured from radiological imaging and thus increase student knowledge of cross‐sectional anatomy.We created a modified dissection protocol of the pelvic cavity using a cross‐sectional anatomy approach. We used a 2‐man crosscut saw to separate the pelvic cavity from the trunk and lower limbs into cross‐sectional slices. A cross‐section above the bifurcation of the abdominal aorta highlighted structures of internal and external iliac vasculature, pelvic musculature, and sacral innervations matched to CT‐scans at the exact plane of orientation. A cross‐section below the anterior superior iliac spine (ASIS) highlighted the urogenital and anal triangle, reproductive organs, and pelvic cavity musculatures matched to MRIs at the same plane of orientation.There is promising educational advantage for first year medical students to utilizing a cross‐sectional dissection approach in conjunction with imaging to visualize spatial complexity of the pelvic cavity. This practical approach allows medical students to develop fluency in spatial organization when dissecting and to map structures on relevant imaging commonly encountered in clinical practice including CT, MRIs, and ultrasound. Though there are no publications of a similar pelvic cavity and perineum dissection approach, we anticipate a growing trend towards cross‐sectional anatomy as a teaching model for radiological imaging3. We aim to complete multiple dissections with this dissection protocol using a specialized bandsaw and to propose the integration of cross‐sectional prosections into the clinical anatomy curriculum.1Hunter, L. D. and McHugh, K.M. A Novel Approach to Dissection of the Pelvis and Perineum for Professional Students. The Federation of American Societies for Experimental Biology (FASEB) Journal. 2018.2Boscolo‐Berto, R., Tortorella, C., Porzionato, A. et al. The additional role of virtual to traditional dissection in teaching anatomy: a randomised controlled trial. Surg Radiol Anat 43, 2021.3McLachlan J. C. New path for teaching anatomy: living anatomy and medical imaging vs. dissection. Anatomical Record—Part B: New Anatomist. 2004.

Experimental Protocols and Analytical Procedures for Studying Synaptic Transmission in Rodent Spinal Cord Dorsal Horn.

Synaptic modulation and plasticity are key mechanisms underlying pain transmission in the spinal cord and supra-spinal centers. The study and understanding of these phenomena are fundamental to investigating both acute nociception and maladaptive changes occurring in chronic pain. This article describes experimental protocols and analytical methods utilized in electrophysiological studies to investigate synaptic modulation and plasticity at the first station of somatosensory processing, the spinal cord dorsal horn. Protocols useful for characterizing the nature of synaptic inputs, the site of modulation (pre- versus postsynaptic), and the presence of short-term synaptic plasticity are presented. These methods can be employed to study the physiology of acute nociception, the pathological mechanisms of persistent inflammatory and neuropathic pain, and the pharmacology of receptors and channels involved in pain transmission. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Spinal cord dissection and acute slice preparation Basic Protocol 2: Stimulation of the dorsal root and extracellular recording (compound action potentials and field potentials) Basic Protocol 3: Patch-clamp recording from dorsal horn neurons: action potential firing patterns and evoked synaptic inputs Basic Protocol 4: Analysis of parameters responsible for changes in synaptic efficacy Basic Protocol 5: Recording and analysis of currents mediated by astrocytic glutamate.

Lamb Head as a Training Model for Septoplasty and Rhinoplasty.

Septoplasty and rhinoplasty are difficult operations to learn and teach. Many modalities have been proposed to make the teaching process of these operations easier. In this study, it was investigated if lamb heads were good training models to teach septoplasty and rhinoplasty to trainees or experienced surgeons. In the first part of the study, 21 lamb heads were dissected according to a dissection protocol and several anatomical distances were measured to compare them with human cadavers. In the second part, eight lamb heads were dissected and different preservation rhinoplasty techniques were practiced. The study on 21 lamb heads used showed that the lateral crura were 17.8 × 11.6, the average interdomal distance was 8.1 mm, and the average domal width was 3.7 mm. The average length of the upper lateral cartilages was 31.1 mm laterally and 21.2 medially. The average length of the nasal bones was 63.9 mm, and the width was 16 mm. In the second part of the study, 8 lamb heads were used to experience where high-strip techniques were used in 5 and the Cottle technique in 3. This study revealed that lamb heads should be considered as an excellent training model for septoplasty and rhinoplasty. Its very low cost, ease of availability, and close similarity to the human cadavers can be counted as the main advantages. This study also proved that it was not only a tool for beginners, but also a very helpful tool for experienced surgeons to try new methods.

An atlas of white matter anatomy, its variability, and reproducibility based on constrained spherical deconvolution of diffusion MRI

Virtual dissection of white matter (WM) using diffusion MRI tractography is confounded by its poor reproducibility. Despite the increased adoption of advanced reconstruction models, early region-of-interest driven protocols based on diffusion tensor imaging (DTI) remain the dominant reference for virtual dissection protocols. Here we bridge this gap by providing a comprehensive description of typical WM anatomy reconstructed using a reproducible automated subject-specific parcellation-based approach based on probabilistic constrained-spherical deconvolution (CSD) tractography. We complement this with a WM template in MNI space comprising 68 bundles, including all associated anatomical tract selection labels and associated automated workflows. Additionally, we demonstrate bundle inter- and intra-subject variability using 40 (20 test-retest) datasets from the human connectome project (HCP) and 5 sessions with varying b-values and number of b-shells from the single-subject Multiple Acquisitions for Standardization of Structural Imaging Validation and Evaluation (MASSIVE) dataset. The most reliably reconstructed bundles were the whole pyramidal tracts, primary corticospinal tracts, whole superior longitudinal fasciculi, frontal, parietal and occipital segments of the corpus callosum and middle cerebellar peduncles. More variability was found in less dense bundles, e.g., the fornix, dentato-rubro-thalamic tract (DRTT), and premotor pyramidal tract. Using the DRTT as an example, we show that this variability can be reduced by using a higher number of seeding attempts. Overall inter-session similarity was high for HCP test-retest data (median weighted-dice = 0.963, stdev = 0.201 and IQR = 0.099). Compared to the HCP-template bundles there was a high level of agreement for the HCP test-retest data (median weighted-dice = 0.747, stdev = 0.220 and IQR = 0.277) and for the MASSIVE data (median weighted-dice = 0.767, stdev = 0.255 and IQR = 0.338). In summary, this WM atlas provides an overview of the capabilities and limitations of automated subject-specific probabilistic CSD tractography for mapping white matter fasciculi in healthy adults. It will be most useful in applications requiring a reproducible parcellation-based dissection protocol, and as an educational resource for applied neuroimaging and clinical professionals.

Tractostorm 2: Optimizing tractography dissection reproducibility with segmentation protocol dissemination.

The segmentation of brain structures is a key component of many neuroimaging studies. Consistent anatomical definitions are crucial to ensure consensus on the position and shape of brain structures, but segmentations are prone to variation in their interpretation and execution. White‐matter (WM) pathways are global structures of the brain defined by local landmarks, which leads to anatomical definitions being difficult to convey, learn, or teach. Moreover, the complex shape of WM pathways and their representation using tractography (streamlines) make the design and evaluation of dissection protocols difficult and time‐consuming. The first iteration of Tractostorm quantified the variability of a pyramidal tract dissection protocol and compared results between experts in neuroanatomy and nonexperts. Despite virtual dissection being used for decades, in‐depth investigations of how learning or practicing such protocols impact dissection results are nonexistent. To begin to fill the gap, we evaluate an online educational tractography course and investigate the impact learning and practicing a dissection protocol has on interrater (groupwise) reproducibility. To generate the required data to quantify reproducibility across raters and time, 20 independent raters performed dissections of three bundles of interest on five Human Connectome Project subjects, each with four timepoints. Our investigation shows that the dissection protocol in conjunction with an online course achieves a high level of reproducibility (between 0.85 and 0.90 for the voxel‐based Dice score) for the three bundles of interest and remains stable over time (repetition of the protocol). Suggesting that once raters are familiar with the software and tasks at hand, their interpretation and execution at the group level do not drastically vary. When compared to previous work that used a different method of communication for the protocol, our results show that incorporating a virtual educational session increased reproducibility. Insights from this work may be used to improve the future design of WM pathway dissection protocols and to further inform neuroanatomical definitions.

The “economy of truth” – New historical sources allow new insights into Hermann Stieveʼs use of bodies of execution victims for research

IntroductionDuring the times of National Socialism, Berlin anatomist Hermann Stieve had access to many bodies of executed women for his histological research on reproductive organs. Newly emerged sources add to our knowledge of this research and allow a critical examination of some of Stieve's post-war claims. SourcesDescendants of Stieve have preserved more than 200 dissection protocols in Stieve's own hand, which are now held at the archive of Humboldt University in Berlin. In addition, a list of names of execution victims related to this research has been newly identified at the Federal Archive in Berlin. ResultsThe 207 protocols mostly relate to women executed in Berlin Plötzensee from March 1942 onwards and include two women executed after the war in January 1947. Other sources show that bodies of executed men were delivered to the institute of anatomy until November 1950. The documents confirm that Stieve did not use only the bodies of "Schwerverbrecher [felons]" as he had asserted in 1952. They do verify some of Stieve's post war claims, like that he had access to court records of the victims and likely also to information from attending doctors and family members, if only in rare cases. DiscussionThe anatomists' access to bodies of the executed continued after 1945 as this practice was not seen as something Nazi-typical by the allied authorities. Hermann Stieve's post-war defence strategy can be characterised by an "economic" handling of the truth, avoiding outright lies by making true statements on rare cases which, however, were not representative of his general course of actions.

Pathological Findings in Eurasian Otters (Lutra lutra) Found Dead between 2015-2020 in Schleswig-Holstein, Germany.

Simple SummaryWorking with protected and elusive wildlife species remains a challenge when it comes to population health investigations. Specimens found dead, such as road-killed animals, can therefore serve as a valuable source to address various questions concerning the population level. We herein describe pathological findings in Eurasian otters found dead in Schleswig-Holstein, Germany, which were obtained using a special otter dissection protocol. To actually monitor population trends and the health of otters, the continuation of post-mortem investigations is essential.In times of massive biodiversity loss and ongoing environmental crises, it is extremely important to ensure long-term conservation efforts of threatened species like Eurasian otters (Lutra lutra). To gain insights into the status of Northern Germany’s otter population, 92 otters found dead in Schleswig-Holstein between 2015−2020 were collected and underwent detailed dissection with the aim to establish a monitoring program for this population. Examinations followed a protocol especially designed for otters, including various biological data assessments and extended sampling. The finding sites showed a clear concentration in the Continental region. Seasonal concentration differed among the years, yet peaks were seen from fall to winter. Overall, more males than females were found, although this differed among the years. The majority of otters that could be aged were between 1–3 years. Placental scars and pregnancy were recorded in only few females. Nutritional status was good in most cases. Infectious diseases found included Vagococcus lutrae, Toxoplasma gondii, and Emmonsia spp. A major cause of death was roadkill. Known sample bias in studies focusing on roadkill was considered in the finding interpretation. Continuation of the population health investigations is mandatory to analyze potential trends and to establish an actual monitoring program for Eurasian otters in Schleswig-Holstein.

Adherent but Not Suspension-Cultured Embryoid Bodies Develop into Laminated Retinal Organoids.

Human induced pluripotent stem cells (iPSCs) are differentiated into three-dimensional (3D) retinal organoids to study retinogenesis and diseases that would otherwise be impossible. The complexity and low yield in current protocols remain a technical challenge, particularly for inexperienced personnel. Differentiation protocols require labor-intensive and time-consuming dissection of optic vesicles (OVs). Here we compare this method with a suspension method of developing retinal organoids. iPSCs were differentiated with standard protocols but the suspension-grown method omitted the re-plating of embryoid bodies and dissection of OVs. All other media and treatments were identical between developmental methods. Developmental maturation was evaluated with RT-qPCR and immunocytochemistry. Dissection- and suspension-derived retinal organoids displayed temporal biogenesis of retinal cell types. Differences in retinal organoids generated by the two methods of differentiation included temporal developmental and the organization of neural retina layers. Retinal organoids grown in suspension showed delayed development and disorganized retinal layers compared to the dissected retinal organoids. We found that omitting the re-plating of EBs to form OVs resulted in numerous OVs that were easy to identify and matured along a retinal lineage. While more efficient, the suspension method led to retinal organoids with disorganized retinal layers compared to those obtained using conventional dissection protocols.

THE CONCEPT OF A COMPREHENSIVE PROGNOSTIC MODEL OF THE EFFECTIVENESS OF IMPLEMENTATION OF MINIMALLY INVASIVE INTERVENTIONS IN THE TREATMENT OF CARIOUS PATHOLOGY

The research presents a prognostic model of the effectiveness of minimally invasive interventions in the dental patients’ treatment of carious pathology, which was developed to reduce the impact of iatrogenic interventions, increase the results of biological, biomechanical and financial feasibility of treatment.&#x0D; The aim of research is to develop a mathematical representation of a comprehensive prognostic model of the minimally invasive treatment effectiveness of carious pathology.&#x0D; Materials and methods of research. Comprehensive prognostic model of comparative efficiency of minimally invasive implementation of treatment protocols of carious pathology included consideration of relative risk indicators of biological complications (secondary caries and affected tissue pulp), decreased biomechanical forecast of the tooth (based on the performance index IROPZ and IHRKCHZ) and the financial feasibility of these methods, taking into account the ratio of material costs and unit labor intensity of the biological level and biomechanical forecast of the functioning of the dentition unit.&#x0D; Results of the research. The factors were identified during the scientific research; it was provided that the volume of iatrogenic interventions in the dental patients’ treatment of caries can be minimized. The structure of a complex prognostic model of the effectiveness of realization minimally invasive methods of treating caries of hard tooth tissues was developed. A comparative assessment of the biological, biomechanical and financial feasibility of treatment of carious pathology depending on the depth of damage to the hard tissues of the tooth using classical (invasive) and mini-invasive methods of treatment was held. The study showed that the implementation of minimally invasive approaches to the treatment of carious pathology in terms of risk and complications in secondary destructive changes of dental hard tissues and pulp tissue damage contributes to the effectiveness of limited nuclear interventions with controlled enamel reduction and determination of connection of restoration with the bottom of the formed cavity. The highest biomechanical feasibility of minimally invasive dissection protocols has been established in the defects treatment within the enamel in order to minimize unreasonable enamel reduction and dentin tissues, carious cavities treatment at the border of medium-deep types of lesions to limit the caries spreading in the cavities deep localization in order to prevent the development of associated lesions of the pulp complex, which in terms of biological prognosis can provoke the development of irreversible changes.&#x0D; Conclusion. As a result of scientific research and comparative analysis of the effectiveness of caries treatment by mini-invasive methods of intervention, the fact of improving the biological and biomechanical prognosis of the affected units of the dentition compared to the results of treatment of pathological lesions by surgery in accordance with classical protocols, confirming the developed complex prognostic model of efficiency of use of minimally invasive methods of treatment of carious pathology of dental patients. However, the creation of a unified comprehensive forecasting model, which would include the most complete reflection of all these criteria and was at the same time reliable, is impossible. Biological stacking relative risk indicators in the process of secondary development and pulpitis indicate the excess of minimally invasive treatment in all analyzed clinical cases, cases of initial treatment in relation to the risk of pulp production and cases in the center of caries relative to the risk of the previous year.

Flipping the Script – Adopting Autopsy Protocol for Cadaveric Dissection in Gross Anatomy

Autopsy is a postmortem investigation of the body to determine the cause of death or extent of disease, also serving a quality assurance role by evaluating diagnostic and therapeutic procedures and outcomes in clinical medicine. Autopsy also holds promise in medical education as a focal point for integration and correlation of basic & clinical medical knowledge. Unfortunately, the vast educational potential goes unrealized due to several barriers such as clinicolegal risks, potential exposure to biohazardous materials, limited time, space, and negative stigma. On the other hand, cadaveric dissection in gross anatomy is in rapid decline in medical education as sweeping curricular changes continue to reduce contact hours in favor of systemic and clinical integration. The situation was exacerbated by the COVID-19 pandemic, which demanded expeditious online migration of classes and will likely have a long lasting and transformative impact on the educational landscape. At this time, a unique opportunity exists to adopt an autopsy protocol for cadaveric dissection in gross anatomy to actualize the untapped potential of clinical practice. Therefore, in a pilot project, the feasibility and perceived value of adopting autopsy protocol in cadaveric dissection were evaluated. Four students with regional gross anatomy dissection experience and faculty (n=2) completed dissections of four cadavers using an en masse autopsy protocol. First, external examination of the whole body noting all surface anatomy including scars, abrasions, contusions, and tumors, provided an opportunity to make acquaintance with the body donor. Second, thoracic and abdominopelvic organs were removed en masse (Figure 1) with minimal disruption to the musculoskeletal framework, preserving most neurovascular supply and anatomic relationships of multiple organ systems. The en masse organ block was further dissected into organ system blocks to demonstrate relationships of individual organs. Finally, the musculoskeletal system of the main body frame was regionally dissected. Unstructured interviews of faculty and students were conducted to gauge experience and perceptions of autopsy protocol in cadaveric dissection. A survey of student dissectors (n=4) and observers (n=4) was conducted to qualitatively assess educational value. All participants unanimously reported that autopsy protocol and the en masse organ blocks would benefit gross anatomy education. Students reported new knowledge gained on the boundary of the peritoneum, retroperitoneal structures, ligaments of the visceral organs, and spatial relationships of organ systems that are lost in regional dissections. These outcomes suggest that integrating an en masse autopsy protocol in a gross anatomy course is a viable option that offers a clinical approach to learning gross anatomy. Taken together, adopting autopsy protocol in some form in medical education holds ample opportunity to integrate multiple basic science subjects and clinical practice. Educational value of the autopsy protocol in gross anatomy education will be investigated in the future studies.

Participation in an Advanced Anatomy Capstone Project Facilitates Student Involvement in the Development of an Instructional Tool for Novel Dissection

Introduction. Student-driven design of instructional tools within basic sciences curricula in general, and in anatomy in particular, has been shown to be both a positive educational experience for the student developers and a viable way to create quality materials for future courses. We present here a description of a student collaboration arising from participation in an advanced anatomy capstone research project, resulting in the creation of a new dissection protocol for the thoracolumbar junction dorsal primary rami and their branches. Materials and Methods. This project was initiated by two third-year doctor of physical therapy (DPT) students and involved participation from faculty and other DPT students of varying experience levels, in order to pilot and refine the tool over a two-year period. We describe the process by which the tool was developed, from the genesis of the original idea through the piloting stage. Results and Discussion. This collaboration resulted in a new instructional tool to be launched within our first-year DPT gross anatomy labs in 2022. Evaluation of the project through qualitative interviews demonstrated the learning impact on student participants. Conclusions. The success of this project shows the potential for students to be meaningfully involved in instructional tool design. The complete dissection guide, along with photos, is included and will be of particular relevance for medical and health science educators with an interest in orthopedics, neurosurgery, pain management, or physical therapy.

Intact in situ Preparation of the Drosophila melanogaster Lymph Gland for a Comprehensive Analysis of Larval Hematopoiesis.

Blood cells have a limited lifespan and are replenished by a small number of hematopoietic stem and progenitor cells (HSPCs). Adult vertebrate hematopoiesis occurs in the bone marrow, liver, and spleen, rendering a comprehensive analysis of the entire HSPC pool nearly impossible. The Drosophila blood system is well studied and has developmental, molecular, and functional parallels with that of vertebrates. Unlike vertebrates, post-embryonic hematopoiesis in Drosophila is essentially restricted to the larval lymph gland (LG), a multi-lobed organ that flanks the dorsal vessel. Because the anterior-most or primary lobes of the LG are easy to dissect out, their cellular and molecular characteristics have been studied in considerable detail. The 2-3 pairs of posterior lobes are more delicate and fragile and have largely been ignored. However, posterior lobes harbor a significant blood progenitor pool, and several hematopoietic mutants show differences in phenotype between the anterior and posterior lobes. Hence, a comprehensive analysis of the LG is important for a thorough understanding of Drosophila hematopoiesis. Most studies focus on isolating the primary lobes by methods that generally dislodge and damage other lobes. To obtain preparations of the whole LG, including intact posterior lobes, here we provide a detailed protocol for larval fillet dissection. This allows accessing and analyzing complete LG lobes, along with dorsal vessel and pericardial cells. We demonstrate that tissue architecture and integrity is maintained and provide methods for quantitative analysis. This protocol can be used to quickly and effectively isolate complete LGs from first instar larval to pupal stages and can be implemented with ease.