Anatomy Commons^™

Impact Of Physician Education And Availability Of Parameters Regarding Esophageal Pressure And Transpulmonary Pressure On Clinical Decisions Involving Ventilator Management, Lonny Ashworth

Respiratory Therapy Faculty Publications and Presentations

Purpose: This study investigated the effects of physician education and the availability of P_eso and P_L data on physicians' decisions regarding ventilator management during specific simulated clinical conditions.

Materials and methods: The study was a prospective, before–after study using a case scenario–based questionnaire and a case simulator device comprising an Avea ventilator and an artificial lung and esophagus, which was connected to a Series 1101 Electronic Breathing Simulator. The 99 physicians participating in the study were provided with five simulated cases with on-time ventilator graphics without P_eso and P_L and completed a questionnaire on decisions they …

The Effects Of A Reduced Force Aerial Bucket Control On Upper Extremity Muscular Demands As Assessed With Surface Electromyography, Casey D. Garces

Master's Theses (2009 -)

A common control for operating aerial bucket trucks for utility companies in North America is called a pistol grip control. Based upon many anecdotal reports of forearm muscle fatigue from workers using this control, Prof. Richard Marklin began an EPRI-sponsored study in 2016 using EMG to determine muscle fatigue of workers while they used the pistol grip. Muscle activity recorded by EMG is a measure of the magnitude of muscle force under controlled conditions. This study confirmed the reports of muscle fatigue in extensor digitorum communis (EDC) muscle in the right forearm. The next phase of the study was to …

The Psychology Of Neurofeedback: Clinical Intervention Even If Applied Placebo, Robert T. Thibault, Amir Raz

Psychology Faculty Articles and Research

Advocates of neurofeedback make bold claims concerning brain regulation, treatment of disorders, and mental health. Decades of research and thousands of peer-reviewed publications support neurofeedback using electroencephalography (EEG-nf); yet, few experiments isolate the act of receiving feedback from a specific brain signal as a necessary precursor to obtain the purported benefits. Moreover, while psychosocial parameters including participant motivation and expectation, rather than neurobiological substrates, seem to fuel clinical improvement across a wide range of disorders, for-profit clinics continue to sprout across North America and Europe. Here, we highlight the tenuous evidence supporting EEG-nf and sketch out the weaknesses of this …

Muscle Coordination Contributes To Function After Stroke; Proprioception Contributes To Control Of Posture, Movement, Maria Bengtson

Dissertations (1934 -)

More than half of stroke survivors experience persistent upper extremity motor impairments that can negatively impact quality of life and independence. Effective use of the upper extremity requires coordination of agonist/antagonist muscle pairs, as well as coordination of multiple control actions for stabilizing and moving the arm. In this dissertation, I present three studies in which I recorded isometric torque production, single joint movement and stabilization, and clinical measures of function and impairments after stroke to evaluate the extent to which changes in coordination of agonist/antagonist muscles and of sequential control actions contribute to deficits after stroke. In Aim 1, …

Global Respiratory Syncytial Virus-Associated Mortality In Young Children (Rsv Gold): A Retrospective Case Series, Nienke M. Scheltema, Angela Gentile, Florencia Lucion, D James Nokes, Patrick K. Munywoki, Shabir A. Madhi, Michelle J. Groome, Cheryl Cohen, Jocelyn Moyes, Syed Asad Ali

Department of Paediatrics and Child Health

Background: Respiratory syncytial virus (RSV) infection is an important cause of pneumonia mortality in young children. However, clinical data for fatal RSV infection are scarce. We aimed to identify clinical and socioeconomic characteristics of children aged younger than 5 years with RSV-related mortality using individual patient data.

Methods: In this retrospective case series, we developed an online questionnaire to obtain individual patient data for clinical and socioeconomic characteristics of children aged younger than 5 years who died with community-acquired RSV infection between Jan 1, 1995, and Oct 31, 2015, through leading research groups for child pneumonia identified through a comprehensive …

Brain Encoding Of Saltatory Velocity Through A Pulsed Pneumotactile Array In The Lower Face, Rebecca Custead, Hyuntaek Oh, Yingying Wang, Steven M. Barlow

Center for Brain, Biology, and Behavior: Faculty Publications

Processing dynamic tactile inputs is a primary function of the somatosensory system. Spatial velocity encoding mechanisms by the nervous system are important for skilled movement production and may play a role in recovery of sensorimotor function following neurological insult. Little is known about tactile velocity encoding in mechanosensory trigeminal networks required for speech, suck, mastication, and facial gesture.

High resolution functional magnetic resonance imaging (fMRI) was used to investigate the neural substrates of velocity encoding in the human orofacial somatosensory system during unilateral saltatory pneumotactile stimulation of perioral and buccal hairy skin in 20 neurotypical adults. A custom multichannel, scalable …

Differential Functional Roles Of Aldh1a1 And Aldh1a3 In Mediating Metastatic Behavior And Therapy Resistance Of Human Breast Cancer Cells, Alysha K. Croker, Mauricio Rodriguez-Torres, Ying Xia, Hon Sing Leong, Siddika Pardhan, John D. Lewis, Alison L. Allan

Anatomy and Cell Biology Publications

Previous studies indicate that breast cancer cells with high aldehyde dehydrogenase (ALDH) activity and CD44 expression (ALDHhiCD44+ ) contribute to metastasis and therapy resistance, and that ALDH1 correlates with poor outcome in breast cancer patients. The current study hypothesized that ALDH1 functionally contributes to breast cancer metastatic behavior and therapy resistance. Expression of ALDH1A1 or ALDH1A3 was knocked down in MDA-MB-468 and SUM159 human breast cancer cells using siRNA. Resulting impacts on ALDH activity (Aldefluor® assay); metastatic behavior and therapy response in vitro (proliferation/adhesion/migration/colony formation/chemotherapy and radiation) and extravasation/metastasis in vivo (chick choroiallantoic membrane assay) was assessed. Knockdown of ALDH1A3 …

Suppression Of Chrn Endocytosis By Carbonic Anhydrase Car3 In The Pathogenesis Of Myasthenia Gravis, Ailian Du, Shiqian Huang, Xiaonan Zhao, Kuan Fang, Shuangyan Zhang, Jiefang Huang, Xiang Miao, Fulvio Baggi, Rennolds S. Ostrom, Yanyun Zhang, Xiangjun Chen, Congfeng Xu

Pharmacy Faculty Articles and Research

Myasthenia gravis is an autoimmune disorder of the neuromuscular junction manifested as fatigable muscle weakness, which is typically caused by pathogenic autoantibodies against postsynaptic CHRN/ AChR (cholinergic receptor nicotinic) in the endplate of skeletal muscle. Our previous studies have identified CA3 (carbonic anhydrase 3) as a specific protein insufficient in skeletal muscle from myasthenia gravis patients. In this study, we investigated the underlying mechanism of how CA3 insufficiency might contribute to myasthenia gravis. Using an experimental autoimmune myasthenia gravis animal model and the skeletal muscle cell C2C12, we find that inhibition of CAR3 (the mouse homolog of CA3) promotes CHRN …

Rehabilitation Of An Injured Golden Eagle (Aquila Chrysaetos): A Case Study, Fida Muhammad Khan, Fakhar-I- Abbas, Abu Ul Hassan Faiz

Journal of Bioresource Management

Habitat destruction and anthropogenic activities cause wild birds to migrate towards urban areas in search of food and sometimes nesting in high-roof buildings, where they are caught by local people using different techniques and are further used for hunting or recreational purposes. An injured Golden Eagle (Aquila chrysaetos) was found entangled in bushes near the vicinity of Balkasar Research Complex, Chakwal, Pakistan. After complete physical examination, a wound on the right wing and closed leg fracture was diagnosed. The successful treatment was done by anti-parasitic and anti-bacterial drugs with careful monitoring. Splint was adjusted after aligning the fractured …

Trkb-Enhancer Facilitates Functional Recovery After Traumatic Brain Injury, John Marshall, Joanna Szmydynger-Chodobska, Mengia S. Rioult-Pedotti, Kara Lau, Andrea T. Chin, Siva K. Reddy Kotla, Rakesh Tiwari, Keykavous Parang, Steven W. Threlkeld, Adam Chodobski

Pharmacy Faculty Articles and Research

Brain-derived neurotrophic factor (BDNF), a key player in regulating synaptic strength and learning, is dysregulated following traumatic brain injury (TBI), suggesting that stimulation of BDNF signaling pathways may facilitate functional recovery. This study investigates whether CN2097, a peptidomimetic ligand which targets the synaptic scaffold protein, postsynaptic density protein 95, to enhance downstream signaling of tropomyosin-related kinase B, a receptor for BDNF, can improve neurological function after TBI. Moderate to severe TBI elicits neuroinflammation and c-Jun-N-terminal kinase (JNK) activation, which is associated with memory deficits. Here we demonstrate that CN2097 significantly reduces the post-traumatic synthesis of proinflammatory mediators and inhibits the …

Dilemma During Ultrasound-Guided Internal Jugular Venous Catheterization, Sanjay Dwarakanath, Monica Cheriyan, Annette Rebel

Anesthesiology Faculty Publications

The presence of Internal Jugular Valves can pose a diagnostic and procedural challenge during ultrasound-guided cannulation. After ruling out dissection, thrombus, or ultrasound artifacts, it can still be accessed and successfully cannulated with appropriate precautions including use of Live ultrasound, positioning, use of soft-tipped catheters, and minimizing duration of catheter placement.

Hyperfiltration-Associated Biomechanical Forces In Glomerular Injury And Response: Potential Role For Eicosanoids., Mukut Sharma, Ram Sharma, Ellen T. Mccarthy, Virginia J. Savin, Tarak Srivastava

Manuscripts, Articles, Book Chapters and Other Papers

Hyperfiltration is a well-known risk factor in progressive loss of renal function in chronic kidney disease (CKD) secondary to various diseases. A reduced number of functional nephrons due to congenital or acquired cause(s) results in hyperfiltration in the remnant kidney. Hyperfiltration-associated increase in biomechanical forces, namely pressure-induced tensile stress and fluid flow-induced shear stress (FFSS) determine cellular injury and response. We believe the current treatment of CKD yields limited success because it largely attenuates pressure-induced tensile stress changes but not the effect of FFSS on podocytes. Studies on glomerular podocytes, tubular epithelial cells and bone osteocytes provide evidence for a …

Pattern Of Pigmentation Disorder In Cosmetic Dermatology Clinic H. Adam Malik General Hospital, Medan, 2012 - 2015, Nelva Karmila Jusuf

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Abnormalities of pigmentation is a cosmetic problem which affects the overall appearance of an individual. Pigmentation disorder are caused by the increase (hypermelanosis) or the decrease (hypomelanosis) amount of melanin.

Objective: To determine the pattern of pigmentation disorder in Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012-2015.

Methods: A retrospective study using subject's medical records from the Cosmetic Dermatology Clinic H. Adam Malik General Hospital Medan in 2012 - 2015, presented descriptively.

Results: In 2012 - 2015 the number of patients who visited the Cosmetic Dermatology Clinic were respectively 210, 228, 211, 142. …

Comparison Of Efficacy Combination Oral Terbinafine Pulse-Dosed And Topical 8% Ciclopirox Olamine With Terbinafine Monotherapy For Onychomycosis: An Evidence-Based Case Report, Marsha Bianti, Teffy Nuary, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis is a fungal infection of the nails, which manifested as nail discoloration, thickening, and detachment from the nail bed. It is not life-threatening, however inappropriate treatment of onychomycosis might lead to complications and affect the patient’s quality of life; making the management of the disease a challenge for clinicians.

Objective: Investigate the efficacy of pulse-dosed oral terbinafine combined with topical 8% ciclopirox olamine to treat onychomycosis.

Methods: Literature search was performed in Pubmed and Cochrane databases using the keywords 'combination' AND 'oral terbinafine' AND 'ciclopirox' AND ‘onychomycosis treatment’ along with their synonyms and related terms.

Results …

The Role Of Oral Vitamin D In Several Skin Diseases, Astri Adelia, Larisa Paramitha Wibawa, Adhimukti T. Sampurna, Windy K. Budianti, Farida Zubier

Journal of General - Procedural Dermatology and Venereology Indonesia

Vitamin D has many benefits for body and skin health. One of them is to regulate the immune system, both cellular and humoral. The pathogenesis of many skin diseases is associated with disturbance in regulation of cellular immune system. Research on the relationship between blood level of vitamin D and several diseases in dermatology is currently very advanced. Oral vitamin D is known to have many functions that play a role in the pathogenesis of several diseases of the skin. Therefore, its current use as a primary or supplemental therapy has been widely studied. Knowledge on various skin diseases with …

Segmental Zoster Paresis, Nahla Shihab, Erdina Hd Pusponegoro, Ahmad Yanuar

Journal of General - Procedural Dermatology and Venereology Indonesia

Herpes zoster is often associated with neurological manifestation but less frequently associated with motoric nerve involvement. The most common motoric involvement is paresis, seen only in 1-5% of all zoster cases. This case report a 39-year-old male, with recurrent abdominal liposarcoma under chemotherapy, presented with symptoms of fever, and painful and weak right leg for 2 weeks. Vesicles eruption was seen on his right leg nine days after these symptoms occurred. Physical examination revealed groups of haemorrhagic vesicles with erythematous base on the right lower leg. Lumbosacral spine x-ray showed spondylosis with radiculopathy. Electromyography (EMG) examination revealed lower motor neuron …

The Effectiveness Of Laser Therapy In Onychomycosis Patients: An Evidence-Based Case Report, Rizky Lendl Prayogo, Evangelina Lumban Gaol, Fitri Azizah, Lusiana Lusiana, Yenny Rachmawati, Yusnita Rahman, Siti Rizny Saldi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis may cause nail discoloration, thickening, nail bed separation, and other serious complications. For some cases, oral antifungal treatment is not tolerable because of its potential side effects and drug interactions. Laser therapy is considered as an alternative treatment, owing to the features of simple and effective, with only minor potential side effects. This EBCR was made to collect and appraise studies regarding the effectiveness of laser therapy for onychomycosis, and to suggest laser as an alternative treatment.

Methods: Literature searching strategy was performed using Pubmed and Cochrane Library database to address the clinical problem. Keywords used …

Challenge In Diagnosis And Management Of Lentigo Maligna And Lentigo Maligna Melanoma, Ika Anggraini, Elisa Miranda, Larisa Paramitha Wibawa, Roro Inge Ade Krisanti, Adhimukti T. Sampurna

Journal of General - Procedural Dermatology and Venereology Indonesia

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decades. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

Spatial And Temporal Epithelial Ovarian Cancer Cell Heterogeneity Impacts Maraba Virus Oncolytic Potential, Jessica G. Tong, Yudith Ramos Valdes, Milani Sivapragasam, John W. Barrett, John C. Bell, David Stojdl, Gabriel E. Dimattia, Trevor G. Shepherd

Anatomy and Cell Biology Publications

Background: Epithelial ovarian cancer exhibits extensive interpatient and intratumoral heterogeneity, which can hinder successful treatment strategies. Herein, we investigated the efficacy of an emerging oncolytic, Maraba virus (MRBV), in an in vitro model of ovarian tumour heterogeneity. Methods: Four ovarian high-grade serous cancer (HGSC) cell lines were isolated and established from a single patient at four points during disease progression. Limiting-dilution subcloning generated seven additional subclone lines to assess intratumoral heterogeneity. MRBV entry and oncolytic efficacy were assessed among all 11 cell lines. Low-density receptor (LDLR) expression, conditioned media treatments and co-cultures were performed to determine factors impacting MRBV oncolysis. …

Psychological Well-Being’S Link With Cardiovascular Health In Older Adults, Julia K. Boehm, Jackie Soo, Ying Chen, Emily S. Zevon, Rosalba Hernandez, Donald Lloyd-Jones, Laura D. Kubzansky

Psychology Faculty Articles and Research

Introduction

Favorable cardiovascular health (FCH) is associated with healthy longevity and reduced cardiovascular mortality risk. However, limited work has investigated the distribution of FCH in older age or considered the antecedents of FCH. Based on prior work linking psychological well-being with cardiovascular endpoints, higher psychological well-being was hypothesized to be associated with increased likelihood of maintaining FCH over time.

Methods

Data were from the English Longitudinal Study of Ageing. The first study wave (2002–2003) included men and women aged ≥50 years. The analytic sample (N=4,925) was restricted to individuals without baseline cardiovascular disease and with clinical data from three follow-ups …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Understanding The Chondrogenic Potential Of Articular Chondrocytes, Krishna Sarma

Theses & Dissertations

Articular cartilage is a smooth, visco-elastic, aneural, avascular tissue made of water, an exquisitely organized framework of proteoglycans, glycosaminoglycans, and collagen fibrils and articular chondrocytes. It’s beautiful organization and composition provide it with the flexibility and strength to cover, protect and lubricate the ends of long bones in a diarthrodial joint. Cartilage homeostasis relies on articular chondrocytes to translate the mechanical forces of daily activity into efficient remodeling of the extracellular matrix. Age, joint injury, or other insulting factors can progressively incapacitate articular chondrocytes, resulting in cartilage lesions that devolve to degenerative joint disease. Therefore, the central idea explored in …

Maternal Intuition Of Fetal Gender, Michael Mcfadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, Joe Grundle

Journal of Patient-Centered Research and Reviews

Purpose: Fetal gender speculation is a preoccupation of many expecting parents, and pregnant women commonly profess to intuitively know the gender of their unborn babies. This study objectively compared pregnant mothers’ perceptions of fetal gender to sonographically proven gender determinations. Also, success rates from previously published studies, noninvasive prenatal testing and a myriad of gender determination methods were observed and reported for context.

Methods: All pregnant women presenting for second-trimester screening ultrasound (at 17–23 weeks gestation) in the obstetrics department of a single health center were asked to participate. A medical sonographer described the ultrasound examination, obtained appropriate consent and …

Influence Of Differential Calcification In The Descending Thoracic Aorta On Aortic Pulse Pressure, Mirza Mujadil Ahmad, Syed Haris Ahmed Pir, Mustafa Noor Muhammad, Sharmeen Hussaini, Immad Arif Kiani, Mirza Nubair Ahmad, Imaad Razzaque, Muhammad Nabeel Syed, Rafath Ullah, Suhail Allaqaband, Anjan Gupta, Steven C. Port, Khawaja Afzal Ammar

Journal of Patient-Centered Research and Reviews

Purpose: Multiple studies have shown pulse pressure (PP) to be a strong predictor of aortic calcification. However, no studies are available that correlate PP with aortic calcification at the segmental level.

Methods: We identified 37 patients with aortic PP measured during cardiac catheterization. Their noncontrast chest computed tomography scans were evaluated for the presence of calcium in different segments (ascending aorta, arch of aorta [arch], descending aorta) and quantified. Patients with calcification (Calcified Group A) were compared against patients without calcification (Noncalcified Group B) in terms of PP, calcification and compliance.

Results: The mean of the total calcium score was …

Body Size Predicts Cardiac And Vascular Resistance Effects On Men's And Women's Blood Pressure, Joyce M. Evans, Siqi Wang, Christopher Greb, Vladimir Kostas, Charles F. Knapp, Qingguang Zhang, Eric S. Roemmele, Michael B. Stenger, David C. Randall

Biomedical Engineering Faculty Publications

Key Points Summary

• We report how blood pressure, cardiac output and vascular resistance are related to height, weight, body surface area (BSA), and body mass index (BMI) in healthy young adults at supine rest and standing.
• Much inter-subject variability in young adult's blood pressure, currently attributed to health status, may actually result from inter-individual body size differences.
• Each cardiovascular variable is linearly related to height, weight and/or BSA (more than to BMI).
• When supine, cardiac output is positively related, while vascular resistance is negatively related, to body size. Upon standing, the change in vascular resistance is positively related to size. …

Malignant Hyperthermia, Brandon Kinnamon

Nursing Student Class Projects (Formerly MSN)

Common anesthetic agents can trigger a pathological response in patients resulting in intracellular calcium release and hyper-metabolism. This condition is known as Malignant Hyperthermia (MH). It is vital for anesthesia professionals and critical care nurses to recognize MH and act quickly to limit rapid shifts of electrolytes which can ultimately lead to death. As soon as cardinal signs of malignant hyperthermia are identified, the medication dantrolene should be administered along with intensive nursing care. Significant signs and symptoms, the pathophysiology of MH, and implications for nursing care are all examined in greater detail.

Increased Expression Of The Tight Junction Protein Tjp1/Zo-1 Is Associated With Upregulation Of Taz-Tead Activity And An Adult Tissue Stem Cell Signature In Carfilzomib-Resistant Multiple Myeloma Cells And High-Risk Multiple Myeloma Patients, Irene Riz, Robert G. Hawley

Anatomy and Regenerative Biology Faculty Publications

Tight junction protein 1 (TJP1) has recently been proposed as a biomarker to identify multiple myeloma (MM) patients most likely to respond to bortezomiband carfilzomib-based proteasome inhibitor regimens. Herein we report increased expression of TJP1 during the adaptive response mediating carfilzomib resistance in the LP-1/Cfz MM cell line. Moreover, increased TJP1 expression delineated a subset of relapsed/refractory MM patients on bortezomib-based therapy sharing an LP-1/Cfzlike phenotype characterized by activation of interacting transcriptional effectors of the Hippo signaling cascade (TAZ and TEAD1) and an adult tissue stem cell signature. siRNA-mediated knockdown of TJP1 or TAZ/TEAD1 partially sensitized LP-1/Cfz cells to carfilzomib. …

Lessons To Be Learned: How A Comprehensive Neurobiological Framework Of Atypical Reading Development Can Inform Educational Practice, Ola Ozernov-Palchik, Xi Yu, Yingying Wang, Nadine Gaab

Center for Brain, Biology, and Behavior: Faculty Publications

Dyslexia is a heritable reading disorder with an estimated prevalence of 5–17%. A multiple deficit model has been proposed that illustrates dyslexia as an outcome of multiple risks and protective factors interacting at the genetic, neural, cognitive, and environmental levels. Here we review the evidence on each of these levels and discuss possible underlying mechanisms and their reciprocal interactions along a developmental timeline. Current and potential implications of neuroscientific findings for contemporary challenges in the field of dyslexia, as well as for reading development and education in general, are then discussed.

Biomechanical Testing Of An Exercise For Strengthening The Proximal Femur., Alyssa Osbourne

Electronic Theses and Dissertations

Based on the principles of cutting edge bone remodeling research, a unique therapeutic exercise device was designed specifically to improve bone quality at the most critical location of the proximal femur prone to fracture: the superior-lateral femoral neck where the fracture first initiates during a fall. The exercise/device is intended to work by inducing enough strain in the bone to stimulate the body’s natural bone remodeling mechanisms to increase bone density in the proximal femur and consequently prevent a fracture from arising if a fall to the side does occur.

In order to test the proposed exercise, experiments simulating the …

Utilizing Modular Labs In Human Anatomy And Physiology: Lessons Learned From A First Time Experience, Jennifer Zitzner

Biology: Faculty Publications and Other Works

Anatomy and physiology laboratory experiences build upon concepts that are presented in the lecture part of the course. Our anatomy and physiology laboratory class meets weekly for approximately three hours and includes a compilation of activities that are to be completed during the laboratory period. While exercises are built off of topics presented in lecture and predominantly hands-on in nature, many students were not taking advantage of the self-directed learning experiences, especially those employing anatomical models. Some students were content to simply take photographs of models with their cell phones and complete only the graded portions of the laboratory assignment …