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Browsing by Author "Deane, Andrew S."
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Item Caudal Vertebral Body Articular Surface Morphology Correlates with Functional Tail Use in Anthropoid Primates(http://onlinelibrary.wiley.com/doi/10.1002/jmor.20304/abstract, 2014) Deane, Andrew S.; Russo, Gabrielle A.; Muchlinski, Magdalena N.; Organ, Jason M.Prehensile tails, capable of suspending the entire body weight of an animal, have evolved in parallel in New World monkeys (Platyrrhini): once in the Atelinae (Alouatta, Ateles, Brachyteles, Lagothrix), and once in the Cebinae (Cebus, Sapajus). Structurally, the prehensile tails of atelines and cebines share morphological features that distinguish them from non-prehensile tails, including longer proximal tail regions, well-developed hemal processes, robust caudal vertebrae resistant to higher torsional and bending stresses, and caudal musculature capable of producing higher contractile forces. The functional significance of shape variation in the articular surfaces of caudal vertebral bodies, however, is relatively less well understood. Given that tail use differs considerably among prehensile and non-prehensile anthropoids, it is reasonable to predict that caudal vertebral body articular surface area and shape will respond to use-specific patterns of mechanical loading. We examine the potential for intervertebral articular surface contour curvature and relative surface area to discriminate between prehensile- and nonprehensile-tailed platyrrhines and cercopithecoids. The proximal and distal intervertebral articular surfaces of the first (Ca1), transitional (TV) and longest (LV) caudal vertebrae were examined for individuals representing 10 anthropoid taxa with differential patterns of tail-use. Study results reveal significant morphological differences consistent with the functional demands of unique patterns of tail use for all vertebral elements sampled. Prehensile-tailed platyrrhines that more frequently use their tails in suspension (atelines) had significantly larger and more convex intervertebral articular surfaces than all nonprehensile-tailed anthropoids examined here, although the intervertebral articular surface contour curvatures of large, terrestrial cercopithecoids (i.e. Papio) converge on the ateline condition. Prehensile-tailed platyrrhines that more often use their tails in tripodal bracing postures (cebines) are morphologically intermediate between atelines and nonprehensile tailed anthropoids.Item Footprint evidence of early hominin locomotor diversity at Laetoli, Tanzania(Springer, 2021-12) McNutt, Ellison J.; Hatala, Kevin G.; Miller, Catherine; Adams, James; Casana, Jesse; Deane, Andrew S.; Dominy, Nathaniel J.; Fabian, Kallisti; Fannin, Luke D.; Gaughan, Stephen; Gill, Simone V.; Gurtu, Josephat; Gustafson, Ellie; Hill, Austin C.; Johnson, Camille; Kallindo, Said; Kilham, Benjamin; Kilham, Phoebe; Kim, Elizabeth; Liutkus-Pierce, Cynthia; Maley, Blaine; Prabhat, Anjali; Reader, John; Rubin, Shirley; Thompson, Nathan E.; Thornburg, Rebeca; Williams-Hatala, Erin Marie; Zimmer, Brian; Musiba, Charles M.; DeSilva, Jeremy M.; Anatomy and Cell Biology, School of MedicineBipedal trackways discovered in 1978 at Laetoli site G, Tanzania and dated to 3.66 million years ago are widely accepted as the oldest unequivocal evidence of obligate bipedalism in the human lineage1-3. Another trackway discovered two years earlier at nearby site A was partially excavated and attributed to a hominin, but curious affinities with bears (ursids) marginalized its importance to the paleoanthropological community, and the location of these footprints fell into obscurity3-5. In 2019, we located, excavated and cleaned the site A trackway, producing a digital archive using 3D photogrammetry and laser scanning. Here we compare the footprints at this site with those of American black bears, chimpanzees and humans, and we show that they resemble those of hominins more than ursids. In fact, the narrow step width corroborates the original interpretation of a small, cross-stepping bipedal hominin. However, the inferred foot proportions, gait parameters and 3D morphologies of footprints at site A are readily distinguished from those at site G, indicating that a minimum of two hominin taxa with different feet and gaits coexisted at Laetoli.Item Investigating the Effectiveness of Case-Based Learning Sessions for Integrating Anatomy Content(2022-04-28) Merritt, Emily R.; McNulty, Margaret A.; Neal, Chemen M.; Deane, Andrew S.; Haywood, Antwion A.; Byram, Jessica N.Introduction: Adjusting to medical school can be challenging as students learn to adapt to the curriculum’s fast pace and content volume. Gross anatomy, embryology, and histology are increasingly integrated into medical curricula, with the responsibility placed on students to find and understand the relationships between these content areas. Case-based learning (CBL) is an effective and commonly used means of teaching in medical education, and its application of problem-solving skills to clinical cases make it a useful method for integrating content. Study Objective: Therefore, the goal of this research was to assess the effectiveness and value of CBL sessions in integrating gross anatomy, embryology, and histology and promoting effective study techniques. Methods: In 2021, Indiana University School of Medicine implemented a pre-matriculation program (termed “Leadership and Academic Development”, or LEAD, Scholars) targeted toward under-represented students in medicine. The program included content from the first block of the medical anatomy course and four fully integrated CBL sessions that each included anatomy, embryology, and histology content from the upper extremity and thorax. LEAD Scholars (n = 25) were divided into groups of six or seven; for each session, they completed an individual pre- and post-quiz and worked as a group to answer case questions. Cases consisted of one or more clinical scenarios and questions that required students to interpret images, complete matching exercises, and make diagrams or flow charts. Students completed a post-session survey with Likert-style questions and free responses about preparation and session effectiveness. Pre- and post-quiz scores were compared using Wilcoxon signed rank tests. Free responses were analyzed using thematic analysis. Results: Analyses revealed a significant improvement on post-quiz scores for all CBLs (p≤0.002). In the post-session survey, students strongly agreed the sessions were effective at improving their understanding of course content and appropriately connecting anatomy, embryology, and histology content. Students commented that they enjoyed the real-life application of the material, found the sessions helpful for making connections between the topic areas, and encouraged them to keep up with the material. They noted that adding more cases and providing more pre-work to guide preparations would improve the sessions. Students also discussed needing to change their study habits as the sessions progressed and noted difficulty in keeping up with the embryology and histology content in light of the volume of gross anatomy material. Conclusion: These results suggest that CBL sessions are a viable means for delivering integrated medical anatomy content to medical students and providing opportunities to practice and adapt study techniques. Session modifications will focus on expanding the sessions to provide more opportunities to practice the content and study techniques and including specific pre-work activities to guide preparation.Item Posterior interosseous nerve localization within the proximal forearm - a patient normalized parameter(Baishideng Publishing Group, 2017-04-18) Kamineni, Srinath; Norgren, Crystal R.; Davidson, Evan M.; Kamineni, Ellora P.; Deane, Andrew S.; Anatomy and Cell Biology, School of MedicineAIM: To provide a "patient-normalized" parameter in the proximal forearm. METHODS: Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm's neutral rotation position, pronation position, supination position, and the nerve width. Two individuals performed measurements using a digital caliper with inter-observer and intra-observer blinding. The results were analyzed with the Wilcoxon-Mann-Whitney test for paired samples. RESULTS: In pronation, the PIN was within two confidence intervals of 1.0 TED in 95% of cases (range 0.7-1.3 TED); in neutral, within two confidence intervals of 0.84 TED in 95% of cases (range 0.5-1.1 TED); in supination, within two confidence intervals of 0.72 TED in 95% of cases (range 0.5-0.9 TED). The mean PIN distance from the lateral epicondyle was 100% of TED in a pronated forearm, 84% in neutral, and 72% in supination. Predictive accuracy was highest in supination; in all cases the majority of specimens (90.47%-95.23%) are within 2 cm of the forearm position-specific percentage of TED. When comparing right to left sides for TEDs with the signed Wilcoxon-Mann-Whitney test for paired samples as well as a significance test (with normal distribution), the P-value was 0.0357 (significance - 0.05) indicating a significant difference between the two sides. CONCLUSION: This "patient normalized" parameter localizes the PIN crossing a line drawn between the lateral epicondyle and the radial styloid. Accurate PIN localization will aid in diagnosis, injections, and surgical approaches.Item Posterior interosseous nerve localization within the proximal forearm - a patient normalized parameter(Baishideng, 2017-04) Kamineni, Srinath; Norgren, Crystal R.; Davidson, Evan M.; Kamineni, Ellora P.; Deane, Andrew S.; Department of Anatomy & Cell Biology, IU School of MedicineAIM To provide a “patient-normalized” parameter in the proximal forearm. METHODS Sixty-three cadaveric upper extremities from thirty-five cadavers were studied. A muscle splitting approach was utilized to locate the posterior interosseous nerve (PIN) at the point where it emerges from beneath the supinator. The supinator was carefully incised to expose the midpoint length of the nerve as it passes into the forearm while preserving the associated fascial connections, thereby preserving the relationship of the nerve with the muscle. We measured the transepicondylar distance (TED), PIN distance in the forearm’s neutral rotation position, pronation position, supination position, and the nerve width. Two individuals performed measurements using a digital caliper with inter-observer and intra-observer blinding. The results were analyzed with the Wilcoxon-Mann-Whitney test for paired samples. RESULTS In pronation, the PIN was within two confidence intervals of 1.0 TED in 95% of cases (range 0.7-1.3 TED); in neutral, within two confidence intervals of 0.84 TED in 95% of cases (range 0.5-1.1 TED); in supination, within two confidence intervals of 0.72 TED in 95% of cases (range 0.5-0.9 TED). The mean PIN distance from the lateral epicondyle was 100% of TED in a pronated forearm, 84% in neutral, and 72% in supination. Predictive accuracy was highest in supination; in all cases the majority of specimens (90.47%-95.23%) are within 2 cm of the forearm position-specific percentage of TED. When comparing right to left sides for TEDs with the signed Wilcoxon-Mann-Whitney test for paired samples as well as a significance test (with normal distribution), the P-value was 0.0357 (significance - 0.05) indicating a significant difference between the two sides. CONCLUSION This “patient normalized” parameter localizes the PIN crossing a line drawn between the lateral epicondyle and the radial styloid. Accurate PIN localization will aid in diagnosis, injections, and surgical approaches.Item Three-Dimensional Visualization Technology in the Medical Curriculum: Exploring Faculty Use in Preclinical, Clinical, and Postgraduate Anatomy Education(2021-01) Helbling, Shannon Amara; Torbeck, Laura J.; Byram, Jessica N.; Deane, Andrew S.; Nelson Laird, Thomas F.Background: The advancement of three-dimensional visualization technology provides exciting new opportunities in medical education, including new methods for teaching complex anatomical relationships and promising tools for the training of postgraduate physicians. Information on how faculty use three-dimensional visualization technology for anatomy education is essential for informed discussions surrounding their effectiveness as a teaching tool and use in the medical curriculum, yet the current literature lacks necessary contextual details on how faculty integrate these technologies into actual medical curricula. Methods: Fifteen medical educators from North American medical schools and teaching hospitals completed semi-structured interviews and discussed how they use three-dimensional visualization technology for teaching in preclinical courses, clinical clerkships, and postgraduate programs. Transcripts were analyzed using the constant comparative method and resulting themes were used to inform the creation of a questionnaire. Results: The resulting themes of analysis were organized according to a curricular framework that describes how faculty use these technologies as an instructional resource and how this use is related to the purposes, content, sequence, instructional processes and evaluation of medical curricula. The results demonstrate how three-dimensional visualization technology is being is implemented in a variety of ways in the curriculum and revealed numerous similarities of use across the levels of medical education. Analyses revealed minimal use of three-dimensional visualization technology for assessment and indicated faculty face significant challenges in designing such assessment. Conclusions: Results suggest continuing assessment of the effectiveness of these technologies as a teaching tool needs to encompass broader aspects of use, such as those described in this study. Additionally, results showing similarities of use across levels suggest that educators and administrators should consider how threedimensional visualization technology can be thoughtfully integrated to address the changing needs of learners as they progress through medical education. Findings also suggest that administrators who want to support the integration of three-dimensional visualization technology into the curriculum need to provide adequate support and training to help faculty overcome time limitations and difficulties designing assessment methods.Item What's My Role Again? Cultivating Interprofessionalism, Role Knowlege, and Role Clarity Through Case-Based Learning(2024-03) Herriott, Hannah Laine; McNulty, Margaret A.; Byram, Jessica N.; Agosto, Elizabeth R.; Deane, Andrew S.; Rebman, Rebecca; Scheurich, Jim J.As healthcare has shifted away from physician-centered practice, in favor of a patient-centered model, the importance of interprofessional team-based practice was recognized. Early exposure, practice working through clinical cases in teams, and learning each profession’s roles are essential determinants of successful interprofessional collaboration (IPC). Although interprofessional role comprehension is widely accepted as one of four core competencies of interprofessional education (IPE) and lack of role comprehension is associated with medical errors; literature measuring said construct is lacking. Role knowledge and clarity are two crucial skills that encompass identifying the roles and limitations of various professions’ scopes of practice and discerning which professional is best equipped to undertake a task in a particular situation. The present study investigated a novel IPE intervention employing role centered, small group casebased learning (CBL) sessions, integrated throughout an anatomy course for firstsemester occupational therapy (OTD), physical therapy (DPT), and physician assistant (MPAS) students. Additionally, fourth-year medical (MD) students participated in the IPE intervention by serving as near-peer facilitators for each of the small groups. A sequential explanatory, mixed methods design was employed to examine participants’: 1) acquisition of role knowledge, 2) demonstration of role clarity, 3) views of IPC after engaging in CBL sessions, and 4) perceptions of the intervention itself. The present study addressed the previously mentioned gap in the literature by exploring a CBL intervention’s influence on role comprehension (a previously unquantified aspect of IPE), in addition to their IPE-related perceptions. The aforementioned CBL intervention effectively improved role knowledge and clarity when implemented in-person; however, no significant changes were demonstrated in the virtual cohort. While many positive perceptions of the intervention and IPE experience were found, some misconceptions about professions and inhibitory power dynamics were also identified. Despite the latter findings, the CBL intervention examined in this study can serve as an effective model for cultivating IPE through enhanced role knowledge and clarity among health professional students.