Implementation of an education-focused PhD program in anatomy and cell biology at Indiana University: Lessons learned and future challenges

In 2008, the Indiana University School of Medicine, in collaboration with the School of Education, admitted its first student to a newly approved PhD program in Anatomy and Cell Biology focusing on educational research rather than biomedical research. The goal of the program is twofold: (1) to provide students with extensive training in all of the anatomical disciplines coupled with sufficient teaching experience to assume major educational responsibilities upon graduation and (2) to train students to conduct rigorous medical education research and other scholarly work necessary for promotion and tenure. The 90 credit hour curriculum consists of biomedical courses taught within the School of Medicine and education courses taught within the School of Education, including courses in health sciences pedagogy, curriculum development, learning theory, quantitative, and qualitative research methods, statistics, and electives. To date, 16 students have entered the program, seven have passed their qualifying examinations, and five have earned their PhD degrees. Four students have received national recognition for their educational research and four graduates have obtained faculty appointments. Going forward, we must adapt the program's biomedical course requirements to incorporate the new integrated curriculum of the medical school, and we must secure additional funding to support more students. Overcoming these challenges will enable us to continue producing a small but stable supply of doctoral-level anatomy educators for a growing academic market

The Education Track PhD Program in Anatomy at Indiana University School of Medicine: A Decade Producing Anatomy Educator-Scholars

In 2008, the Indiana University School of Medicine (IUSM) admitted its first student to a newly approved PhD program focusing on anatomical education rather than biomedical research. The goal of the Education Track PhD program is twofold: (1) to provide students with extensive training in all of the anatomical sub-disciplines coupled with sufficient teaching experience to be fully prepared to assume major educational responsibilities upon graduation and (2) to train students to conduct rigorous, medical education research and other educational scholarship necessary for promotion and tenure. The 90-credit hour curriculum includes coursework in anatomy and other biomedical subjects, education, statistics, and electives. For their dissertation work, the students complete a research project about some aspect of medical education. As of December 2017, the Education Track program had admitted 23 students and produced 10 graduates. Two more students are anticipated to graduate by June 2018. All of the graduates were offered faculty appointments (8 tenure track and 2 nontenure track) immediately upon graduation at major universities and medical schools. Four of the graduates were offered positions at IUSM. Eight graduates have appointments in medical school anatomy departments, 1 in a physical therapy department, and 1 in a physician assistant department. None of the graduates have been in their faculty positions long enough yet to have achieved tenure. During the period from 2009 through 2017, the students and graduates of the program gave 84 conference presentations and authored 47 peer-reviewed publications about anatomy or other aspects of medical education. Thus, in the 10 years since its inception, the Education Track program has successfully produced a small but stable supply of doctoral-level anatomy educator-scholars for a growing academic market.American Association for Anatomy Spring Meetin

Remembering Our Past: Teaching the History of Anatomy at Indiana University

Most students pursuing careers in anatomy or related disciplines have a limited understanding of how, over the centuries, the intricate structure of the human body came to be known. To provide students with the relevant historical perspective, we developed a team-taught survey course in the history of anatomical sciences—including gross anatomy, histology, neuroanatomy, and embryology—from antiquity to the present. Taught entirely via Zoom during the Spring semester of 2021, History of Anatomy (2 semester hours credit) met once per week for approximately 2 hours. Enrollment consisted of 5 undergraduate students majoring in Biology (2), Human Biology (2), or Anthropology (1), as well as 3 graduate students pursuing either a master’s degree in Clinical Anatomy (1) or a Ph.D. in Anatomy Education (2). Three of the students had no prior coursework in anatomy. Through assigned readings, lectures, and discussions, the class explored the work of the great anatomists and their discoveries. A particular emphasis was placed on the evolution of anatomy as a discipline and the cultural influences, scientific controversies, and ethical dilemmas facing its practitioners. Syllabus topics included critical appraisals of the role of gender, race, and ethnicity in anatomical discovery. A key feature of the course was the opportunity for students to engage in robust discussions about such controversial issues as: Eurocentric biases in our understanding of human anatomy and the untold story of Muslim contributions to anatomical knowledge well before Vesalius; Competing claims of priority for who “discovered” the pulmonary circulation; The underappreciated role of women in the history of anatomy and medicine; The ethical quandary of teaching anatomy from archival fetal specimens obtained before the era of informed consent; Accusations that famed anatomist William Hunter used the bodies of murdered pregnant women to create his anatomical atlas of the gravid uterus; Complicity of Eduard Pernkopf and other Nazi-era anatomists in the unethical use of executed victims to obtain images for a renowned anatomical atlas. All students were assessed through weekly homework (written responses to study questions), a mid-term writing assignment, and a term paper about an historical topic of the student’s choosing. Graduate students had the additional requirement of a class presentation about their term paper topic. The end-of-course evaluation suggested that the course was well-received by the students (mean Likert score = 4.63 on a 5-point scale; n = 6). Based on this positive reception, we plan to offer History of Anatomy again on a recurring basis. We believe that by knowing our history, both the good and the bad, future practitioners of anatomy and related disciplines will be less likely to perpetuate the biases and ethical transgressions of earlier eras.American Association for Anatomy Spring Meetin

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. Findings In 2016, there were 27.08 million (95% uncertainty interval [UI] 24.30-30.30 million) new cases of TBI and 0.93 million (0.78-1.16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55.50 million (53.40-57.62 million) and of SCI was 27.04 million (24 .98-30 .15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8.4% (95% UI 7.7 to 9.2), whereas that of SCI did not change significantly (-0.2% [-2.1 to 2.7]). Age-standardised incidence rates increased by 3.6% (1.8 to 5.5) for TBI, but did not change significantly for SCI (-3.6% [-7.4 to 4.0]). TBI caused 8.1 million (95% UI 6. 0-10. 4 million) YLDs and SCI caused 9.5 million (6.7-12.4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. Interpretation TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe

Genome-wide association study identifies novel breast cancer susceptibility loci

Breast cancer exhibits familial aggregation, consistent with variation in genetic susceptibility to the disease. Known susceptibility genes account for less than 25% of the familial risk of breast cancer, and the residual genetic variance is likely to be due to variants conferring more moderate risks. To identify further susceptibility alleles, we conducted a two-stage genome-wide association study in 4,398 breast cancer cases and 4,316 controls, followed by a third stage in which 30 single nucleotide polymorphisms (SNPs) were tested for confirmation in 21,860 cases and 22,578 controls from 22 studies. We used 227,876 SNPs that were estimated to correlate with 77% of known common SNPs in Europeans at r2 &gt; 0.5. SNPs in five novel independent loci exhibited strong and consistent evidence of association with breast cancer (P &lt; 10(-7)). Four of these contain plausible causative genes (FGFR2, TNRC9, MAP3K1 and LSP1). At the second stage, 1,792 SNPs were significant at the P &lt; 0.05 level compared with an estimated 1,343 that would be expected by chance, indicating that many additional common susceptibility alleles may be identifiable by this approach.<br/