Aim of the present study was to determine the impact of the COVID-19 outbreak on anatomy teaching to medical and dental students comparing the traditional anatomy teaching with three remote teaching modalities. A cross-sectional study was conducted among undergraduate medical and dental students of the Aristotle University of Thessaloniki. Four hundred and twenty students who attended anatomy classes during COVID-19 outbreak in Greece, were asked to fill in a questionnaire of 22 questions evaluating the formats of the different courses provided. Each student was asked to complete the questionnaire anonymously via the Google Forms ® platform. A total of 200 students participated. During the lockdown, 59.5% of students attended all online anatomy lectures compared to 44.5% in the pre-pandemic year. Overall, the higher percentage of 73.5% was satisfied with the traditional anatomy teaching, instead of 56% which were satisfied with the effectiveness of online anatomy lectures. Asking whether any remote educational method can partially or completely replace the traditional anatomy teaching, the majority of students replied "no" for all the three remote modalities. The traditional anatomy teaching remains the most preferred and effective teaching modality. The students ranked online anatomy lectures and pre-recorded anatomy lectures in second place in terms of effectiveness and preference. The development of remote learning methods has increased students' active participation in anatomy lessons, but significantly negatively affected the students' performance at exams. Remote learning cannot replace the traditional anatomy teaching method, but online lectures could be incorporated into anatomy curricula as an additional tool.

In patients with varicocele-associated infertility, the effect of antioxidant supplementation on fertility is unknown. We performed a systematic review and meta-analysis to explore their role in patients with operated or non-operated varicocele. We searched major databases and sources of grey literature until May 2021 (PROSPERO: CRD42021248195). We included 14 studies (980 individuals) in the systematic review. Of the 14 studies, 2 explored the effect of antioxidant supplementation in patients with non-operated varicocele, 1 compared antioxidants versus surgical repair of varicocele, while 11 explored antioxidants after surgical repair of varicocele and were also included in the meta-analysis. Regarding pregnancy rates, no significant differences were demonstrated after treatment with antioxidants versus no treatment at three (OR: 2.28, 95% CI: 0.7–7.48) and six months (OR: 1.88, 95% CI: 0.62–5.72). Accordingly, contradictory findings were reported in sperm concentration, morphology, and motility, as well as DNA fragmentation. Our findings indicate that antioxidant supplementation does not improve pregnancy rates and semen parameters in patients with varicocele-associated infertility, in the absence of previous screening for oxidative stress. Based on the previous notion, most included studies also raised methodological concerns. Therefore, definitive conclusions about the efficacy of antioxidant supplementation in this setting cannot be drawn and further research on the field is mandatory.

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The anterior cruciate ligament (ACL) tear (Figure 1) is a common sports injury in both males and females 1 , particularly in sports that require cutting, jumping, or pivoting 2 , with more than 200.000 incidents every year in the United States 1. Likewise, ACL reconstruction is a common operation (Figure 2), both in the USA and in Europe, with more than 100.000 syndesmoplasties being performed every year in the United States and 3.500 per year in Sweden 1,3. A patient with an ACL tear who is treated conservatively, with early activity modification and a neuromuscular rehabilitation programme, may be able in a few days or a couple of weeks to have a painless knee with no oedema. Later, he may also be able to return to sports (RTS), in some extend, by executing simple sports activities that do not include cutting, jumping, or pivoting movements. This way the patients may avoid the stress of the operation, however, as studies have shown, 2/3 of those patients do not return to their pre-injury activity level 4,5. When the patient decides to undergo surgical reconstruction of the ACL tear, he complies with the stress of the operation and the long post-operative rehabilitation programme, ranging from 6 to 12 months. Patients undergo surgery not only to avoid subsequent meniscal or chondral injuries and early osteoarthritis, but especially to return to their pre-injury level of activity 6-9. According to the current literature, only 40 to 70% of the cases achieve return to the pre-injury activity level following ACL reconstruction 10-15. A recent meta-analysis, which included 48 studies with a mean follow-up of 41 months, revealed that although 90% of the patients achieved normal or nearly-normal knee function, only 63% returned to their pre-injury level of participation. Thus, 1 out of 4 patients achieves complete restoration of the knee joint function, but does not return to the pre-injury level of activity. This disparity between physical function and the ability to RTS is attributed to psychosocial factors 7,16. The psychosocial factors that may affect RTS include fear of re-injury (19%), fear of job-loss due to re-injury (11%) and a change in lifestyle or family commitments (18%), when only 13% of