1
|
Gitto L, Middleton FA, Reynolds ES, Thangamani S, Jaeger DA, Mihaila DM. Quantification and persistence of COVID-19 virus in recently deceased individuals before and after embalming. ANATOMICAL SCIENCES EDUCATION 2023; 16:802-813. [PMID: 37332120 DOI: 10.1002/ase.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 04/07/2023] [Accepted: 05/05/2023] [Indexed: 06/20/2023]
Abstract
The COVID-19 pandemic severely affected the medical education worldwide. The infection risk for medical students and healthcare personnel who work with COVID-19 positive cadavers or tissues remains unclear. Moreover, COVID-19 positive cadavers have been rejected by medical schools, adversely impacting the continuum of medical education. Herein, the viral genome abundance in tissues from four COVID-19 positive donors before and after embalming were compared. Tissue samples were collected from the lungs, liver, spleen, and brain both pre- and postembalming. The possible presence of infectious COVID-19 was determined by inoculating human tissue homogenates onto a monolayer of human A549-hACE2 cells and observing for cytopathic effects up to 72 h postinoculation. A real- time quantitative reverse transcription polymerase chain reaction was performed to quantify COVID-19 present in culture supernatants. Fully intact viral genome sequence was possible to obtain in samples with higher levels of virus, even several days postmortem. The embalming procedure described above substantially reduces the abundance of viable COVID-19 genomes in all tissues, sometimes even to undetectable levels. However, in some cases, COVID-19 RNA can still be detected, and a cytopathic effect can be seen both pre- and postembalmed tissues. This study suggests that embalmed COVID-19 positive cadavers might be used safely with appropriate precautions followed in gross anatomy laboratories and in clinical and scientific research. Deep lung tissue is the best specimen to test for the virus. If the tests on the lung tissues are negative, there is a very low likelihood that other tissues will show positive results.
Collapse
Affiliation(s)
- Lorenzo Gitto
- Department of Pathology, Cook County Medical Examiner's Office, Chicago, Illinois, USA
| | - Frank A Middleton
- Department of Neuroscience and Physiology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Biochemistry and Molecular Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Erin S Reynolds
- Department of Microbiology and Immunology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- State University of New York Center for Vector-Borne Diseases, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Vector Biocontainment Laboratories, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Institute for Global Health and Translational Sciences, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Saravanan Thangamani
- Department of Microbiology and Immunology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- State University of New York Center for Vector-Borne Diseases, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Vector Biocontainment Laboratories, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Institute for Global Health and Translational Sciences, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Daniel A Jaeger
- Department of Cell and Developmental Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Dana M Mihaila
- Department of Cell and Developmental Biology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Neurology, Norton College of Medicine, The State University of New York Upstate Medical University, Syracuse, New York, USA
- Department of Physical Therapy, College of Health Professions, The State University of New York Upstate Medical University, Syracuse, New York, USA
| |
Collapse
|
2
|
Karaca Bozdağ Z, Çandır BN, Gayretli Ö, Arı Z. A survey-based research of medical faculty students' experiences on anatomy education during the Covid-19 pandemic process. Morphologie 2023; 107:12-21. [PMID: 35184941 PMCID: PMC8806146 DOI: 10.1016/j.morpho.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 10/27/2022]
Abstract
PURPOSE In this study, the purpose was to uncover the views of medical students about online anatomy education adopted during the COVID-19 pandemic period. It was also aimed to determine whether medical school students found online education suitable for anatomy lectures and which materials they desired to use during teaching anatomy practice lectures in this process. METHODS A survey form that was prepared with the Google Survey application was administered to the Medical Faculty Term 1 and 2 students who received anatomy courses at Istanbul Yeni Yüzyıl University in the spring semester of the 2019-2020 academic year. RESULTS A total of 180 students, 53.89% of whom were 1st graders and 46.11% 2nd graders participated in the study, and 43.89% of the students stated that they found online education suitable for anatomy theoretical courses, and 12.78% for anatomy practice courses. Also, 43.75% of Term 1 and 41.77% of Term 2 students stated that the pandemic negatively affected the teaching of anatomy theoretical courses. It was found that students considered that anatomy practice courses were more affected by the pandemic before and during the pandemic (P<0.001). CONCLUSIONS This study uncovered that the pandemic process negatively affected anatomy education and students made more use of face-to-face education. We believe that the results obtained in the study will shed light on the views of anatomists on the teaching of anatomy in the online education process.
Collapse
Affiliation(s)
- Z Karaca Bozdağ
- Department of Anatomy, Faculty of Medicine, Istanbul Yeni Yüzyıl University, Istanbul, Turkey; Department of Anatomy, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - B N Çandır
- Department of Anatomy, Faculty of Medicine, Istanbul Yeni Yüzyıl University, Istanbul, Turkey.
| | - Ö Gayretli
- Department of Anatomy, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Z Arı
- Department of Anatomy, Faculty of Medicine, Istanbul Yeni Yüzyıl University, Istanbul, Turkey
| |
Collapse
|
3
|
Shapiro L, Hobbs E, Keenan ID. Transforming musculoskeletal anatomy learning with haptic surface painting. ANATOMICAL SCIENCES EDUCATION 2023. [PMID: 36748362 DOI: 10.1002/ase.2262] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n = 7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.
Collapse
Affiliation(s)
- Leonard Shapiro
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ella Hobbs
- School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Iain D Keenan
- School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
4
|
Keenan ID, Green E, Haagensen E, Hancock R, Scotcher KS, Swainson H, Swamy M, Walker S, Woodhouse L. Pandemic-Era Digital Education: Insights from an Undergraduate Medical Programme. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1397:1-19. [DOI: 10.1007/978-3-031-17135-2_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
5
|
Ghosh SK. Evolving strategies in whirlwind mode: The changing face of anatomy education during Covid-19 pandemic. ANATOMICAL SCIENCES EDUCATION 2022; 15:1103-1119. [PMID: 35924417 PMCID: PMC9537882 DOI: 10.1002/ase.2214] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 07/22/2022] [Accepted: 08/02/2022] [Indexed: 05/28/2023]
Abstract
The Covid-19 pandemic stipulated adoption of unfamiliar strategies for delivering anatomy education in online mode. The factors which determine education strategies are variable across geographical regions. It was perceived that an overview of education strategies around the globe would be useful for anatomists. Hence this narrative review was undertaken to collate observations from different geographical regions pertaining to education strategies adopted during the pandemic. Data relevant to the topic of study were extracted from 12 articles that were selected from an initial pool of 317 articles based on search criteria set for the review. Subtle differences in core education strategies implied that baseline response from anatomists was similar across regions. It was evident that online digital tools were key elements of education strategies adopted by educators for delivering online anatomy classes across the globe. Interestingly, a considerable gap in terms of number and variety of online tools used for anatomy education (those requiring commercial purchase) was noted between economically developed and developing regions. This may have an impact on learning outcome for students and may even lead to variations in anatomical knowledge by regions. It was observed that offline human dissection sessions were incorporated into online practical classes in one region as positive cases showed a declining trend. This positive development is worth emulating elsewhere based on cautious assessment of prevailing situation. From a broad perspective timely introduction of education strategies ensured delivery of anatomy education during the pandemic and gave an evolved outlook to the fabric of anatomy education.
Collapse
|
6
|
Determination of Empirical Environmental Indices for the Location of Cemeteries—An Innovative Proposal for Worldwide Use. SUSTAINABILITY 2022. [DOI: 10.3390/su14106284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cemeteries are a source of environmental contamination, as they hold hundreds of human corpses in different stages of decomposition. Therefore, the current research developed a new tool, which is easily applied, to determine the potential environmental contamination generated by current cemeteries within their ecosystems. The linear equations developed, with a number of variables between 10 and 3, allow for obtaining empirical indices to evaluate the suitability of a site, regardless of the geographical area in which it is located, through a variety of sources. In order to obtain the equations and, therefore, the indices, a hierarchy was performed using the Saaty matrix. With such a matrix, different ranges of affectation were established for each variable and relative values were assigned that cover all probabilities quantitatively, from the least probable to the most likely. With the linear equations, three verification runs were conducted, obtaining satisfactory results compared with the location map of cemeteries obtained in previous studies. These equations will constitute a tool of fundamental use for local governments, which will allow for the evaluation of existing cemeteries and use of the methodology described in preliminary analysis, to save resources and have a starting point for an efficient land use plan.
Collapse
|
7
|
Webb AL, Smyth L, Hafiz M, Valter K. The question of dissection in medical training: Not just "if," but "when"? A student perspective. ANATOMICAL SCIENCES EDUCATION 2022; 15:281-290. [PMID: 34995414 PMCID: PMC9306682 DOI: 10.1002/ase.2168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
While debate about the use of-and alternatives to-human cadaveric dissection in medical training is robust, little attention has been paid to questions about timing. This study explores the perspectives of medical students and recent graduates with regard to two key questions: when in the degree program do students prefer dissection opportunities and what are the students getting out of participating in dissection? Self-report survey data from students in preclinical years (n = 105), clinical years (n = 57), and graduates (n = 13) were analyzed. Most (89%) preferred dissection during the preclinical years, with no effect by training year (χ2 = 1.98, p = 0.16), previous anatomy (χ2 = 3.64, p = 0.31), or dissection (χ2 = 3.84, p = 0.26) experience. Three key findings emerged. First, the majority of students prefer to dissect in the preclinical years because they view dissection as important for developing foundation knowledge and delivering an opportunity for consolidation prior to transitioning to primarily clinical studies. In addition, students recognize that it is a time-consuming activity requiring specialized facilities. Second, three main understandings of the purpose of dissection were reported: depth of learning, learning experience, and real-world equivalence. Third, these student perspectives of the purpose of dissection are associated with timing preferences for dissection opportunities. The results identify the preclinical phase as the optimal time to strategically integrate dissection into medical training in order to maximize the benefits of this unique learning opportunity for students and minimize its impact upon curricular time.
Collapse
Affiliation(s)
- Alexandra L. Webb
- Medical SchoolCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Lillian Smyth
- Medical SchoolCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | | | - Krisztina Valter
- Medical SchoolCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| |
Collapse
|
8
|
Lee T, Roy A, Power P, Sembajwe G, Dropkin J. Ergonomic exposures and control measures associated with mass fatality decedent handling in morgues and body collection points in a New York healthcare system during COVID-19: A case series. INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS 2022; 88:103260. [PMID: 35039703 PMCID: PMC8755464 DOI: 10.1016/j.ergon.2022.103260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/06/2021] [Accepted: 01/01/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In April 2020, novel coronavirus SARS-CoV-2 (COVID-19) produced an ongoing mass fatality event in New York. This overwhelmed hospital morgues necessitating emergent expansion of capacity in the form of refrigerated trucks, trailers, and shipping containers referred to as body collection points (BCPs). The risks for musculoskeletal injury during routine and mass fatality mortuary operations and experiences of decedent handlers throughout the "first wave" of COVID-19 are presented along with mitigation strategies. METHODS Awareness of the high rates of musculoskeletal injury among health care workers due to ergonomic exposures from patient handling, including heavy and repetitive manual lifting, prompted safety walkthroughs of mortuary operations at multiple hospitals within a health system in New York State by workforce safety specialists. Site visits sought to identify ergonomic exposures and ameliorate risk for injury associated with decedent handling by implementing engineering, work practice, and administrative controls. RESULTS Musculoskeletal exposures included manual lifting of decedents to high and low surfaces, non-neutral postures, maneuvering of heavy equipment, and push/pull forces associated with the transport of decedents. DISCUSSION Risk mitigation strategies through participatory ergonomics, education on body mechanics, development of novel handling techniques implementing friction-reducing aides, procurement of specialized equipment, optimizing BCP design, and facilitation of communication between hospital and system-wide departments are presented along with lessons learned. After-action review of health system workers' compensation data found over four thousand lost workdays due to decedent handling related incidents, which illuminates the magnitude of musculoskeletal injury risk to decedent handlers.
Collapse
Key Words
- BCP, Body Collection Point
- Charnel
- Dead
- Deceased
- EMS, Emergency Medical Services
- Expired
- FD, Funeral Director
- FRP, Fiberglass reinforced panel
- Funeral
- ME, Medical Examiner
- Morgue
- Mortem
- Mortuary
- Musculoskeletal injury
- NA, Nursing assistant
- RN, Registered nurse
- SPHM, Safe Patient Handling & Mobility
- WC, Workers' compensation
- WFS, Workforce Safety
Collapse
Affiliation(s)
| | - Asha Roy
- Northwell Health, Lake Success, NY, USA
| | | | - Grace Sembajwe
- Northwell Health, Lake Success, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| | - Jonathan Dropkin
- Northwell Health, Lake Success, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| |
Collapse
|
9
|
Papa V, Varotto E, Galli M, Vaccarezza M, Galassi FM. One year of anatomy teaching and learning in the outbreak: Has the Covid-19 pandemic marked the end of a century-old practice? A systematic review. ANATOMICAL SCIENCES EDUCATION 2022; 15:261-280. [PMID: 34890477 PMCID: PMC9011560 DOI: 10.1002/ase.2162] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 05/21/2023]
Abstract
At the end of 2019, the Covid-19 pandemic spread caused restrictions in business and social spheres. Higher education was also severely affected: universities and medical schools moved online to distance learning and laboratory facilities closed. Questions arise about the long-term effects of this pandemic on anatomical education. In this systematic review, the authors investigated whether or not anatomical educators were able to deliver anatomical knowledge during this pandemic. They also discuss the challenges that anatomical education has faced over the last year. The search strategy was conducted between July 2020 and July 2021. Two hundred and one records were identified, and a total of 79 studies were finally included. How best to deliver anatomy to students remains a moot point. In the last years, the advent of new technologies has raised the question of the possible overcoming of dissection as the main instrument in anatomical education. The Covid-19 pandemic further sharpened the debate. Remote learning enhanced the use of technologies other than cadaveric dissection to teach anatomy. Moreover, from the analyzed records it appears that both from students' perspective as well as teachers' there is a clear tear between those who endorse dissection and those who believe it could be easily overcome or at least integrated by virtual reality and online learning. The authors strongly believe that the best anatomy teaching practice requires the careful adaptation of resources and methods. Nevertheless, they support cadaveric dissection and hope that it will not be replaced entirely as a result of this pandemic.
Collapse
Affiliation(s)
- Veronica Papa
- Department of Motor Sciences and WellnessSchool of Sciences, Engineering and HealthUniversity of Naples “Parthenope”NaplesItaly
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
| | - Elena Varotto
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
- Department of Humanities (DISUM)University of CataniaCataniaItaly
- Archaeology, College of Humanities, Arts and Social SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Massimo Galli
- Department of Biomedical and Clinical Sciences “Luigi Sacco”University of MilanMilanItaly
- III Division of Infectious DiseasesASST Fatebenefratelli SaccoMilanoItaly
| | - Mauro Vaccarezza
- Curtin Medical SchoolFaculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
- Curtin Health Innovation Research Institute (CHIRI), Faculty of Health SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Francesco M. Galassi
- Forensic Anthropology, Paleopathology and Bioarchaeology (FAPAB) Research CenterAvolaItaly
- Archaeology, College of Humanities, Arts and Social SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| |
Collapse
|
10
|
Dulohery K, Scully D, Longhurst GJ, Stone DM, Campbell T. Emerging from emergency pandemic pedagogy: A survey of anatomical educators in the United Kingdom and Ireland. Clin Anat 2021; 34:948-960. [PMID: 33998056 PMCID: PMC8239787 DOI: 10.1002/ca.23758] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/14/2021] [Indexed: 12/23/2022]
Abstract
It is critical that academic opinion of pandemic pedagogy is comprehensively quantified in order to inform future practices. Thus, this study examines how anatomists in the United Kingdom (UK) and Republic of Ireland (ROI) perceive the teaching adaptations made in response to COVID-19, and how these adaptations have impacted their experiences teaching, their online work environment and community. Data was collected via a questionnaire from 24 anatomists across 15 universities in the UK (11) and ROI (4). With regards to teaching, 95.6% of academics have upskilled in new technologies to meet the demands of distance teaching. Academics (95.8%) preferred face-to-face delivery of practical sessions. Most universities (80.0%) reported that practical sessions will continue in a new form that ensures social distancing. However, 50.0% of academics are uncertain if these adaptations will improve student learning. Many anatomists believe that the new adaptations may hinder student-student (66.7%) and student-tutor (45.8%) interactions. Regarding assessment, 52.6% of academics preferred traditional methods to online. Remote online assessment was difficult to protect against collusion, but provided time saving opportunities for academics. Finally, in terms of working environment, 83.3% of academics stated that their workload increased; 54.2% preferred working on site rather than remotely and 79.2% think that staff interactions are better when working on site. These results demonstrate a widespread concern amongst anatomists regarding the pandemic-induced adaptations to teaching, assessment and working environment. However, important opportunities were also identified that could ultimately serve to benefit students and educators alike.
Collapse
Affiliation(s)
- Kate Dulohery
- School of Medicine, University of SunderlandSunderlandUK
| | - Deirdre Scully
- Department of AnatomyTrinity College Dublin, the University of Dublin, School of MedicineDublinIreland
| | | | - Danya M. Stone
- Department of Medical EducationBrighton and Sussex Medical School, University of SussexBrightonUK
| | | |
Collapse
|
11
|
COVID-19 pandemic era: How risky is the continuous usage of cadavers for teaching and research? Morphologie 2021; 106:1-3. [PMID: 33648833 PMCID: PMC7896813 DOI: 10.1016/j.morpho.2021.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/18/2021] [Accepted: 02/18/2021] [Indexed: 12/23/2022]
|