Embedding art in histology teaching: Visual thinking strategies (VTS) to enhance visual literacy

BACKGROUND/AIMS Histology is a visually challenging subject for novice students. Visual thinking strategies (VTS) uses the viewing of art to improve visual literacy in classroom settings (Housen, 2002), including medical programmes (Reilly, Ring, & Duke, 2005), but has not been evaluated in histology. This project assessed the impact of VTS on students' observational skills, perceptions of histological images, and practical report marks. METHODS Participants were third-year biomedical students (n=133) studying histology in 2021. Students were shown a novel histology image and wrote their observations (pre-VTS). An experienced VTS facilitator guided students through an approximately 20-minute session exploring a never-before-seen artwork. After the VTS-activity, students were shown a new histology image and wrote their observations (post-VTS). Pre- and post-VTS descriptions were scored for measures of observational richness and compared. Responses to open-ended reflective questions were analysed by inductive thematic analysis. Report marks were compared with those from a previous year. RESULTS/CONCLUSIONS While there was no significant effect of the VTS activity on the students’ pre-/post-VTS descriptions, nor on their practical report marks, 46% of students reported that VTS changed how they viewed histological images and improved their observational skills. This study suggests that a one-off VTS activity at the beginning of a histology class can benefit students’ experience of unfamiliar microscopic images and improve enjoyment of this challenging subject. REFERENCES Housen, A.C. (2002) Aesthetic thought, critical thinking and transfer. Arts and Learning Research Journal, 18, 99-132. Reilly, J. M., Ring, J., & Duke, L. (2005) Visual thinking strategies: a new role for art in medical education. Family Medicine, 37, 250-252

Control of oocyte release by progesterone receptor-regulated gene expression

The progesterone receptor (PGR) is a nuclear receptor transcription factor that is essential for female fertility, in part due to its control of oocyte release from the ovary, or ovulation. In all mammals studied to date, ovarian expression of PGR is restricted primarily to granulosa cells of follicles destined to ovulate. Granulosa cell expression of PGR is induced by the pituitary Luteinizing Hormone (LH) surge via mechanisms that are not entirely understood, but which involve activation of Protein Kinase A and modification of Sp1/Sp3 transcription factors on the PGR promoter. Null mutations for PGR or treatment with PGR antagonists block ovulation in all species analyzed, including humans. The cellular mechanisms by which PGR regulates ovulation are currently under investigation, with several downstream pathways having been identified as PGR-regulated and potentially involved in follicular rupture. Interestingly, none of these PGR-regulated genes has been demonstrated to be a direct transcriptional target of PGR. Rather, in ovarian granulosa cells, PGR may act as an inducible coregulator for constitutively bound Sp1/Sp3 transcription factors, which are key regulators for a discrete cohort of ovulatory genes

Adverse Health Outcomes in Offspring Associated With Fetal Alcohol Exposure: A Systematic Review of Clinical and Preclinical Studies With a Focus on Metabolic and Body Composition Outcomes

Prenatal alcohol exposure (PAE) results in well-characterized neurological, behavioral, and cognitive deficits in offspring. However, the effects on other health outcomes have not been comprehensively described. We used a systematic review methodology to survey published clinical and preclinical studies investigating a broad range of health outcomes in offspring with PAE. This study specifically reports on outcomes related to metabolism and body composition. The literature was systematically searched across 4 electronic databases (PubMed, CINAHL, Embase, and Web of Science), resulting in 3,230 articles following duplicate removal. Titles and abstracts were reviewed against specific inclusion/exclusion criteria, with 242 articles meeting the criteria for full-text assessment of eligibility. Articles with ineligible study type were removed (127) and articles added from reference lists (15) and an updated search closer to submission (9) for a total of 139 studies. Although 5 health domains were identified, here we focus on metabolism and body composition. Details of alcohol exposure, offspring demographics, and sample sizes were tabulated and quality of reporting assessed. Findings were summarized for body composition (percentage fat mass), physiological and molecular outcomes related to glucose metabolism, and outcomes related to lipid metabolism. There were 32 included studies (2 case-control, 1 prospective longitudinal cohort, and 29 preclinical). Studies had a range of alcohol exposures, both dosage and timing, although all clinical studies had heavy PAE and/or evidence of fetal alcohol syndrome in offspring. The preclinical studies provided evidence of glucose intolerance and/or insulin resistance; dyslipidemia and/or hypercholesterolemia; and increased adiposity in offspring with PAE. Due to the paucity of clinical studies, we recommend further studies be conducted to obtain a complete assessment of long-term metabolic health outcomes in children and adults with PAE, particularly in those diagnosed with fetal alcohol spectrum disorder

Adverse health outcomes associated with fetal alcohol exposure: a systematic review focused on cardio-renal outcomes

OBJECTIVE: The purpose of this study was to undertake a comprehensive review to identify all the available preclinical and clinical literature investigating cardiovascular and renal outcomes in offspring with prenatal alcohol exposure (PAE). METHOD: We used a systematic review methodology to survey published clinical and preclinical studies investigating cardio-renal outcomes in offspring with PAE. Literature was systematically searched across four electronic databases and titles/abstracts screened against specific inclusion/exclusion criteria. RESULTS: A total of 22 studies (9 clinical and 13 preclinical) were included. It was found that PAE can affect aspects of cardiovascular and renal function, including blood pressure, heart rate control, heart function, and urinary excretion. However, there remain very few clinical studies in this area, and those contained in this review were typically of poor quality and/or had small sample sizes. CONCLUSIONS: Despite the limited research and variable findings across studies, current studies provide preliminary evidence of cardio-renal dysfunction in offspring with PAE

Physical and Mental Health in FASD

There is mounting evidence that prenatal alcohol exposure can contribute to a range of health conditions apart from the well-known effects on the brain and neurobehavior. This has led to the idea that fetal alcohol spectrum disorder (FASD) should be considered as a “whole-body” condition. A small number of studies and health surveys have found that people living with FASD experience a range of chronic health issues, including mental health conditions, at much higher rates than the general population. Preclinical studies in animals have shown that prenatal alcohol exposure can result in offspring with high blood pressure, poor glucose homeostasis (indicating diabetes), and altered immune function and behavior. This fits with the developmental origins of health and disease (DOHaD) hypothesis which suggests that a range of other prenatal exposures including maternal stress or a poor diet may increase the risk for developing chronic conditions in adult life. Understanding the full range of health problems faced by individuals exposed to prenatal alcohol is important to enable them to access appropriate healthcare throughout their lives and for healthcare professionals to be able to advise of potential prevention or intervention measures

The Impacts of Periconceptional Alcohol on Neonatal Ovaries and Subsequent Adult Fertility in the Rat

Maternal exposures during pregnancy can impact the establishment of the ovarian reserve in offspring, the lifetime supply of germ cells that determine a woman’s reproductive lifespan. However, despite alcohol consumption being common in women of reproductive age, the impact of prenatal alcohol on ovarian development is rarely investigated. This study used an established rat model of periconceptional ethanol exposure (PCEtOH; 12.5% v/v ethanol) for 4 days prior to 4 days post-conception. Ovaries were collected from neonates (day 3 and day 10), and genes with protein products involved in regulating the ovarian reserve analyzed by qPCR. Adult offspring had estrous cycles monitored and breeding performance assessed. PCEtOH resulted in subtle changes in expression of genes regulating apoptosis at postnatal day (PN) 3, whilst those involved in regulating growth and recruitment of primordial follicles were dysregulated at PN10 in neonatal ovaries. Despite these gene expression changes, there were no significant impacts on breeding performance in adulthood, nor on F2-generation growth or survival. This contributes additional evidence to suggest that a moderate level of alcohol consumption exclusively around conception, when a woman is often unaware of her pregnancy, does not substantially impact the fertility of her female offspring

Spinal cord injury-induced plasticity in the mouse-the crossed phrenic phenomenon

The crossed phrenic phenomenon (CPP) describes respiratory functional plasticity that arises following spinal cord injury. Cervical spinal cord hemisection rostral to the phrenic nucleus paralyzes the ipsilateral hemidiaphragm by interrupting the descending flow of respiratory impulses from the medulla to phrenic motoneurons in the spinal cord. This loss of activity converts some synapses on phrenic motoneurons from a "functionally ineffective" state pre-hemisection to a "functionally latent" state post-hemisection. If the animal is subjected to respiratory stress by transecting the contralateral phrenic nerve, this latent respiratory pathway is activated and function is restored to the paralyzed hemidiaphragm. The mechanisms underlying this plasticity are not well-defined, particularly at the molecular level. Therefore, we explored whether it was possible to demonstrate the CPP in mice, a species amenable to a molecular genetic approach. We show the CPP qualitatively in mice using electromyographic (EMG) recordings from the diaphragm. Interestingly, our data also suggest that in the mouse latent fibers in the ventral funiculus ipsilateral to an anatomically incomplete hemisection may also play a role in the CPP. In particular, we examined the inter-operative delay time between the spinal cord injury and contralateral phrenicotomy required for a response. As the inter-operative delay was reduced, the proportion of mice displaying the CPP decreased from 95% for overnight animals, 86% in 4-8\ua0h, to 77% for 1-2\ua0h mice, and less than 28% for animals receiving a phrenicotomy under 0.5\ua0h post-spinal cord lesion. This is the first study to demonstrate the CPP in mice

Prenatal alcohol exposure programs offspring disease: insulin resistance in adult males in a rat model of acute exposure

Alcohol consumption is highly prevalent amongst women of reproductive age. Given that approximately 50% of pregnancies are unplanned, alcohol has the potential to affect fetal development and program chronic disease in offspring. We examined the effect of an acute but moderate prenatal alcohol exposure (PAE) on glucose metabolism, lipid levels and dietary preference in adolescent and/or adult rat offspring. Pregnant Sprague-Dawley rats received an oral gavage of ethanol (1\ua0g kg maternal body weight, n\ua0=\ua09 dams) or an equivalent volume of saline (control, n\ua0=\ua08 dams) at embryonic days 13.5 and 14.5. PAE resulted in a blood alcohol concentration of 0.05-0.06% 1\ua0h post-gavage in dams. Fasting blood glucose concentration was not affected by PAE in offspring at any age, nor were blood glucose levels during a glucose tolerance test (GTT) in 6-month old offspring (P\ua0>\ua00.5). However, there was evidence of insulin resistance in PAE male offspring at 6 months of age, with significantly elevated fasting plasma insulin (P\ua0=\ua00.001), a tendency for increased first phase insulin secretion during the GTT and impaired glucose clearance following an insulin challenge (P\ua0=\ua00.007). This was accompanied by modest alterations in protein kinase B (AKT) signalling in adipose tissue. PAE also resulted in reduced calorie consumption by offspring compared to controls (P\ua0=\ua00.04). These data suggest that a relatively low-level, acute PAE programs metabolic dysfunction in offspring in a sex-specific manner. These results highlight that alcohol consumption during pregnancy has the potential to affect the long-term health of offspring