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1.
Front Pharmacol ; 14: 1277075, 2023.
Article in English | MEDLINE | ID: mdl-37841936

ABSTRACT

Introduction: Stem cells and scaffolds are an important foundation and starting point for tissue engineering. Human dental pulp stem cells (DPSC) are mesenchymal stem cells with self-renewal and multi-directional differentiation potential, and are ideal candidates for tissue engineering due to their excellent biological properties and accessibility without causing major trauma at the donor site. Tetracycline hydrochloride (TCH), a broad-spectrum antibiotic, has been widely used in recent years for the synthesis of cellular scaffolds to reduce the incidence of postoperative infections. Methods: In order to evaluate the effects of TCH on DPSC, the metabolism of DPSC in different concentrations of TCH environment was tested. Moreover, cell morphology, survival rates, proliferation rates, cell migration rates and differentiation abilities of DPSC at TCH concentrations of 0-500 µg/ml were measured. Phalloidin staining, live-dead staining, MTS assay, cell scratch assay and real-time PCR techniques were used to detect the changes in DPSC under varies TCH concentrations. Results: At TCH concentrations higher than 250 µg/ml, DPSC cells were sequestered, the proportion of dead cells increased, and the cell proliferation capacity and cell migration capacity decreased. The osteogenic and adipogenic differentiation abilities of DPSC, however, were already inhibited at TCH con-centrations higher than 50 µg/ml. Here, the expression of the osteogenic genes, runt-related transcription factor 2 (RUNX2) and osteocalcin (OCN), the lipogenic genes lipase (LPL), as well as the peroxisome proliferator-activated receptor-γ (PPAR-γ) expression were found to be down-regulated. Discussion: The results of the study indicated that TCH in concentrations above 50 µg/ml negatively affects the differentiation capability of DPSC. In addition, TCH at concentrations above 250 µg/ml adversely affects the growth status, percentage of living cells, proliferation and migration ability of cells.

2.
Front Med (Lausanne) ; 10: 1213300, 2023.
Article in English | MEDLINE | ID: mdl-37849484

ABSTRACT

The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.

3.
Adv Health Sci Educ Theory Pract ; 28(4): 1245-1264, 2023 10.
Article in English | MEDLINE | ID: mdl-37052740

ABSTRACT

Clinical reasoning theories agree that knowledge and the diagnostic process are associated with diagnostic success. However, the exact contributions of these components of clinical reasoning to diagnostic success remain unclear. This is particularly the case when operationalizing the diagnostic process with diagnostic activities (i.e., teachable practices that generate knowledge). Therefore, we conducted a study investigating to what extent knowledge and diagnostic activities uniquely explain variance in diagnostic success with virtual patients among medical students. The sample consisted of N = 106 medical students in their third to fifth year of university studies in Germany (6-years curriculum). Participants completed professional knowledge tests before diagnosing virtual patients. Diagnostic success with the virtual patients was assessed with diagnostic accuracy as well as a comprehensive diagnostic score to answer the call for more extensive measurement of clinical reasoning outcomes. The three diagnostic activities hypothesis generation, evidence generation, and evidence evaluation were tracked. Professional knowledge predicted performance in terms of the comprehensive diagnostic score and displayed a small association with diagnostic accuracy. Diagnostic activities predicted comprehensive diagnostic score and diagnostic accuracy. Hierarchical regressions showed that the diagnostic activities made a unique contribution to diagnostic success, even when knowledge was taken into account. Our results support the argument that the diagnostic process is more than an embodiment of knowledge and explains variance in diagnostic success over and above knowledge. We discuss possible mechanisms explaining this finding.


Subject(s)
Curriculum , Students, Medical , Humans , Clinical Reasoning , Germany , Clinical Competence
4.
J Math Didakt ; 44(1): 59-82, 2023.
Article in English | MEDLINE | ID: mdl-36919096

ABSTRACT

To assess individual students' abilities and misconceptions in mathematics, teachers need diagnostic competencies. Although research has addressed the quality of teachers' diagnostic competencies in recent years, it is not very clear how to foster these competencies effectively in the course of prospective teachers' university education. Research suggests that simulations with instructional support are promising tools for fostering complex competencies. We have developed a simulation that aims at measuring and fostering prospective primary school teachers' competencies to assess students' mathematical abilities and misconceptions based on their written task solutions. In this study, we analysed data from prospective primary school mathematics teachers who used one of three different versions of the simulation. Two versions contained a specific type of scaffolding, while the third version did not contain scaffolding. Specifically, the two scaffolding types were content-related scaffolding that emphasized the use of specific pedagogical content knowledge, and strategic scaffolding that emphasized diagnostic activities. The results suggest that integrating scaffolding into the simulation did not substantially influence participants' overall perception of the simulation regarding presence, authenticity, or perceived cognitive load. Compared to participants in a control group without intervention, participants who used the simulation with scaffolding had higher diagnostic accuracy regarding overall assessment of students' competence level. However, only content-related scaffolding but not strategic scaffolding or no scaffolding tended to improve participants' competence in identifying students' specific misconceptions. The results provide a first empirical basis for further development of the simulation.

5.
Materials (Basel) ; 16(5)2023 Feb 22.
Article in English | MEDLINE | ID: mdl-36902913

ABSTRACT

This work introduced additively manufactured non-assembly, miniaturized pin-joints for pantographic metamaterials as perfect pivots. The titanium alloy Ti6Al4V was utilized with laser powder bed fusion technology. The pin-joints were produced using optimized process parameters required for manufacturing miniaturized joints, and they were printed at a particular angle to the build platform. Additionally, this process optimization will eliminate the requirement to geometrically compensate the computer-aided design model, allowing for even further miniaturization. In this work, pin-joint lattice structures known as pantographic metamaterials were taken into consideration. The mechanical behavior of the metamaterial was characterized by bias extension tests and cyclic fatigue experiments, showing superior levels of performance (no sign of fatigue for 100 cycles of an elongation of approximately 20%) in comparison to classic pantographic metamaterials made with rigid pivots. The individual pin-joints, with a pin diameter of 350 to 670 µm, were analyzed using computed tomography scans, indicating that the mechanism of the rotational joint functions well even though the clearance of 115 to 132 µm between the moving parts is comparable to the nominal spatial resolution of the printing process. Our findings emphasize new possibilities to develop novel mechanical metamaterials with actual moving joints on a small scale. The results will also support stiffness-optimized metamaterials with variable-resistance torque for non-assembly pin-joints in the future.

6.
Materials (Basel) ; 16(2)2023 Jan 05.
Article in English | MEDLINE | ID: mdl-36676256

ABSTRACT

This work analyses damage formation within the bulk of basalt fiber-reinforced polymers (BFRP) by means of open-source Digital Volume Correlation (DVC). Volumetric image data were obtained from conventional in-situ X-Ray computed micro-tomography (µCT) of samples loaded in tension. The open-source image registration toolkit Elastix was employed to obtain full 3D displacement fields from the image data. We assessed the accuracy of the DVC results using the method of manufactured solution and showed that the approach followed here can detect deformation with a magnitude in the order of a fiber diameter which in the present case is 17 µm. The beneficial influence of regularization on DVC results is presented on the manufactured solution as well as on real in-situ tensile testing CT data of a BFRP sample. Results of the correlation showed that conventional µCT equipment in combination with DVC can be used to detect defects which could previously only be visualized using synchrotron facilities or destructive methods.

7.
Ann Hepatol ; 28(2): 100887, 2023.
Article in English | MEDLINE | ID: mdl-36646168

ABSTRACT

INTRODUCTION AND OBJECTIVES: Recent translational research indicated a bidirectional relationship between NASH (non-alcoholic steatohepatitis) and periodontitis; however, few clinical cohorts have studied this in detail. Thus we investigated this assumed association in a well-defined cohort. MATERIALS AND METHODS: Data were generated prospectively for 132 patients (32 patients with NASH and 100 unselected, consecutively collected, anonymized controls from a local dental practice): detailed periodontal parameters, i.e., pocket-probing-depths (PPD), bleeding-on-probing (BOP), plaque-index, and utilization of dental care were assessed and correlated with relevant hepatic parameters (liver stiffness via fibroscan, AST, ALT, bilirubin, and MELD-score). Gingiva samples were tested for Porphyromonas gingvalis (P.g.) and Actinobacillus actinomyctemcomitans (A.a.) by PCR. RESULTS: 87.5% of NASH patients and 47% of controls suffered from moderate to severe periodontitis (p=0.01). Liver stiffness was significantly correlated with elevated PPD (p=0.02) and BOP (p=0.03). 34 % of the NASH patients did not make use of regular dental health care. In these patients, AST (p=0.04), MELD score (p<0.01), and liver stiffness (p=0.01) were significantly elevated compared to those who see a dentist regularly. The severity of NASH was not associated with the intraoral detection of P.g. and A.a. CONCLUSIONS: The present study suggests that NASH might be associated with periodontitis, irrespective of the intraoral presence of P.g. and A.a. Moreover, regular dental care utilization might mitigate the course of NASH, and patients should be reminded by their hepatologists of the importance of regular dental visits. Future studies should investigate the role of regular dental care and additional anti-inflammatory treatments of the oral cavity.


Subject(s)
Non-alcoholic Fatty Liver Disease , Periodontal Diseases , Periodontitis , Humans , Prevalence , Porphyromonas gingivalis , Periodontal Diseases/diagnosis , Periodontal Diseases/epidemiology , Periodontal Diseases/complications , Periodontitis/diagnosis , Periodontitis/epidemiology , Periodontitis/complications , Non-alcoholic Fatty Liver Disease/diagnosis , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/complications
8.
World J Hepatol ; 15(12): 1325-1332, 2023 Dec 27.
Article in English | MEDLINE | ID: mdl-38223419

ABSTRACT

BACKGROUND: Periodontitis has been associated with various liver diseases. However, the relevance of periodontitis in the progression of decompensated cirrhosis remains inconclusive. In particular, it is unclear whether the common periodontitis pathogens, Porphyromonas gingivalis (P. gingivalis) and Actinobacillus actinomycetemcomitans (A. actinomycetemcomitans), can be detected not only in the oral mucosa but also in ascites and stool. AIM: To investigate the significance of periodontitis, P. gingivalis, and A. actinomycetemcomitans in cirrhosis patients with ascitic decompensation. METHODS: This prospective study was conducted at the University Hospital Hamburg-Eppendorf, a tertiary center in Northern Germany. A cohort of 27 patients with ascitic decompensated liver cirrhosis underwent dental examinations to assess the association between periodontitis and various clinical parameters of cirrhosis, as well as patient outcomes. PCR was used to test gingival samples, ascites, and stool for the presence of P. gingivalis and A. actinomycetemcomitans. Gingival samples were collected by probing the deepest gum pocket of a sextant and wiping them on a cotton swab. RESULTS: Periodontitis was diagnosed in 22 out of 27 (82%) ascite patients, which is significantly more common than in a control cohort of 100 unselected patients (59%, P = 0.04). P. gingivalis was detected in the gingiva of six patients, and one of them also had P. gingivalis in their stool. However, P. gingivalis was not found in the ascites of any patient. Five out of six patients with P. gingivalis had periodontitis (83%). A. actinomycetemcomitans was not detected in any sample. Patients without periodontitis had a significantly higher mortality rate compared to those with periodontitis, and survival (Kaplan-Meier analysis) was longer in patients with periodontitis (P = 0.02). Transplant-free survival was also more common in patients with periodontitis compared to those without (63% vs 0%, P = 0.02). CONCLUSION: Decompensated cirrhotic patients frequently suffer from periodontitis. However, there was no evidence of the translocation of P. gingivalis or A. actinomycetemcomitans into ascites. The survival of cirrhotic patients with periodontitis was not reduced.

9.
Front Artif Intell ; 5: 868249, 2022.
Article in English | MEDLINE | ID: mdl-35757295

ABSTRACT

Vossian Antonomasia (VA) is a well-known stylistic device based on attributing a certain property to a person by relating them to another person who is famous for this property. Although the morphological and semantic characteristics of this phenomenon have long been the subject of linguistic research, little is known about its distribution. In this paper, we describe end-to-end approaches for detecting and extracting VA expressions from large news corpora in order to study VA more broadly. We present two types of approaches: binary sentence classifiers that detect whether or not a sentence contains a VA expression, and sequence tagging of all parts of a VA on the word level, enabling their extraction. All models are based on neural networks and outperform previous approaches, best results are obtained with a fine-tuned BERT model. Furthermore, we study the impact of training data size and class imbalance by adding negative (and possibly noisy) instances to the training data. We also evaluate the models' performance on out-of-corpus and real-world data and analyze the ability of the sequence tagging model to generalize in terms of new entity types and syntactic patterns.

10.
BMC Med Educ ; 21(1): 523, 2021 Oct 07.
Article in English | MEDLINE | ID: mdl-34620156

ABSTRACT

BACKGROUND: Simulation-based learning with virtual patients is a highly effective method that could potentially be further enhanced by including reflection phases. The effectiveness of reflection phases for learning to diagnose has mainly been demonstrated for problem-centered instruction with text-based cases, not for simulation-based learning. To close this research gap, we conducted a study on learning history-taking using virtual patients. In this study, we examined the added benefit of including reflection phases on learning to diagnose accurately, the associations between knowledge and learning, and the diagnostic process. METHODS: A sample of N = 121 medical students completed a three-group experiment with a control group and pre- and posttests. The pretest consisted of a conceptual and strategic knowledge test and virtual patients to be diagnosed. In the learning phase, two intervention groups worked with virtual patients and completed different types of reflection phases, while the control group learned with virtual patients but without reflection phases. The posttest again involved virtual patients. For all virtual patients, diagnostic accuracy was assessed as the primary outcome. Current hypotheses were tracked during reflection phases and in simulation-based learning to measure diagnostic process. RESULTS: Regarding the added benefit of reflection phases, an ANCOVA controlling for pretest performance found no difference in diagnostic accuracy at posttest between the three conditions, F(2, 114) = 0.93, p = .398. Concerning knowledge and learning, both pretest conceptual knowledge and strategic knowledge were not associated with learning to diagnose accurately through reflection phases. Learners' diagnostic process improved during simulation-based learning and the reflection phases. CONCLUSIONS: Reflection phases did not have an added benefit for learning to diagnose accurately in virtual patients. This finding indicates that reflection phases may not be as effective in simulation-based learning as in problem-centered instruction with text-based cases and can be explained with two contextual differences. First, information processing in simulation-based learning uses the verbal channel and the visual channel, while text-based learning only draws on the verbal channel. Second, in simulation-based learning, serial cue cases are used to gather information step-wise, whereas, in text-based learning, whole cases are used that present all data at once.


Subject(s)
Clinical Competence , Students, Medical , Computer Simulation , Humans , Knowledge , Learning
13.
Sci Rep ; 11(1): 7565, 2021 04 07.
Article in English | MEDLINE | ID: mdl-33828115

ABSTRACT

Collagen fibers and their orientation play a major role in the mechanical behavior of soft biological tissue such as skin. Here, we present a proof-of-principle study correlating mechanical properties with collagen fiber network morphologies. A dedicated multiphoton stretching device allows for mechanical deformations in combination with a simultaneous analysis of its collagen fiber network by second harmonic generation imaging (SHG). The recently introduced Fiber Image Network Evaluation (FINE) algorithm is used to obtain detailed information about the morphology with regard to fiber families in collagen network images. To demonstrate the potential of our method, we investigate an isotropic and an anisotropic ex-vivo dorsal pig skin sample under quasi-static cyclic stretching and relaxation sequences. Families of collagen fibers are found to form a partially aligned collagen network under strain. We find that the relative force uptake is accomplished in two steps. Firstly, fibers align within their fiber families and, secondly, fiber families orient in the direction of force. The maximum alignment of the collagen fiber network is found to be determined by the largest strain. Isotropic and anisotropic samples reveal a different micro structural behavior under repeated deformation leading to a similar force uptake after two stretching cycles. Our method correlates mechanical properties with morphologies in collagen fiber networks.


Subject(s)
Collagen/chemistry , Collagen/physiology , Skin Physiological Phenomena , Skin/chemistry , Algorithms , Animals , Anisotropy , Biomechanical Phenomena , Collagen/ultrastructure , Female , Humans , In Vitro Techniques , Microscopy, Fluorescence, Multiphoton , Proof of Concept Study , Skin/ultrastructure , Stress, Mechanical , Sus scrofa
14.
J Med Internet Res ; 23(3): e21196, 2021 03 04.
Article in English | MEDLINE | ID: mdl-33661122

ABSTRACT

BACKGROUND: Standardized patients (SPs) have been one of the popular assessment methods in clinical teaching for decades, although they are resource intensive. Nowadays, simulated virtual patients (VPs) are increasingly used because they are permanently available and fully scalable to a large audience. However, empirical studies comparing the differential effects of these assessment methods are lacking. Similarly, the relationships between key variables associated with diagnostic competences (ie, diagnostic accuracy and evidence generation) in these assessment methods still require further research. OBJECTIVE: The aim of this study is to compare perceived authenticity, cognitive load, and diagnostic competences in performance-based assessment using SPs and VPs. This study also aims to examine the relationships of perceived authenticity, cognitive load, and quality of evidence generation with diagnostic accuracy. METHODS: We conducted an experimental study with 86 medical students (mean 26.03 years, SD 4.71) focusing on history taking in dyspnea cases. Participants solved three cases with SPs and three cases with VPs in this repeated measures study. After each case, students provided a diagnosis and rated perceived authenticity and cognitive load. The provided diagnosis was scored in terms of diagnostic accuracy; the questions asked by the medical students were rated with respect to their quality of evidence generation. In addition to regular null hypothesis testing, this study used equivalence testing to investigate the absence of meaningful effects. RESULTS: Perceived authenticity (1-tailed t81=11.12; P<.001) was higher for SPs than for VPs. The correlation between diagnostic accuracy and perceived authenticity was very small (r=0.05) and neither equivalent (P=.09) nor statistically significant (P=.32). Cognitive load was equivalent in both assessment methods (t82=2.81; P=.003). Intrinsic cognitive load (1-tailed r=-0.30; P=.003) and extraneous load (1-tailed r=-0.29; P=.003) correlated negatively with the combined score for diagnostic accuracy. The quality of evidence generation was positively related to diagnostic accuracy for VPs (1-tailed r=0.38; P<.001); this finding did not hold for SPs (1-tailed r=0.05; P=.32). Comparing both assessment methods with each other, diagnostic accuracy was higher for SPs than for VPs (2-tailed t85=2.49; P=.01). CONCLUSIONS: The results on perceived authenticity demonstrate that learners experience SPs as more authentic than VPs. As higher amounts of intrinsic and extraneous cognitive loads are detrimental to performance, both types of cognitive load must be monitored and manipulated systematically in the assessment. Diagnostic accuracy was higher for SPs than for VPs, which could potentially negatively affect students' grades with VPs. We identify and discuss possible reasons for this performance difference between both assessment methods.


Subject(s)
Patient Simulation , Students, Medical , Clinical Competence , Humans , Medical History Taking
15.
Skin Res Technol ; 27(4): 589-598, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33511672

ABSTRACT

OBJECTIVE: A mobile handheld snapshot hyperspectral imaging device was developed and tested for in vivo skin evaluation using a new spectral imaging technology. METHODS: The device is equipped with four different LED light sources (VIS, 810 nm, 850 nm, and 940 nm) for illumination. Based on a diffractive optical element (DOE) combined with a CMOS sensor chip, a snapshot hyperspectral imager is achieved for the application on human skin. The diffractive optical element (DOE) consists of a two-dimensional array of identically repeated diffractive microstructures. One hyperspectral image for all wavelength regions is taken within a few seconds. Complex recalculation of the VIS spectral distribution and image information from the received DOE image requires several minutes, depending on computing performance. A risk assessment on the irradiation sources shows no risk of harm due to the LED radiation. RESULTS: Skin tone color patches experiments reproducibly deliver images and spectra of different skin tones. First in vivo use of the device identified pigmentation changes within the field of view. CONCLUSION: We present a working mobile snapshot hyperspectral imaging tool based on diffractive optical elements. This device or future developments thereof can be used for broad skin evaluation in vivo.


Subject(s)
Hyperspectral Imaging , Skin Pigmentation , Diagnostic Imaging , Humans , Lighting , Skin/diagnostic imaging
16.
Skin Res Technol ; 27(4): 486-493, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33231349

ABSTRACT

OBJECTIVE: A handheld device was developed and qualified for in vivo human skin evaluation using laser speckle imaging technology. METHODS: Each laser speckle device prototype allows the choice of up to three different laser wavelengths in the range of 400 nm to 800 nm in total. Speckle pattern analysis gives various speckle parameters, for example, speckle contrast, speckle size, speckle modulation or fractal dimension. The developed laser speckle device prototypes were evaluated investigating three skin issues. RESULTS: We receive reproducible results from the speckle imaging device. For skin ageing, we found significant changes within three age groups. The effect of a methyl nicotinate treatment was clearly visible and quantifiable using a moorFLPI device as well as our speckle imaging device. In terms of basal cell carcinoma diagnosis, we found significant differences between normal and diseased skin, even though the number of samples was limited. CONCLUSION: As shown with first application examples, it was possible to demonstrate the potential of the method for skin evaluation in vivo.


Subject(s)
Skin Aging , Skin , Humans , Laser Speckle Contrast Imaging , Lasers , Skin/diagnostic imaging
17.
Front Psychol ; 11: 562665, 2020.
Article in English | MEDLINE | ID: mdl-33192833

ABSTRACT

In this article, we investigate diagnostic activities and diagnostic practices in medical education and teacher education. Previous studies have tended to focus on comparing knowledge between disciplines, but such an approach is complicated due to the content specificity of knowledge. We compared 142 learners from medical education and 122 learners from teacher education who were asked to (a) diagnose eight simulated cases from their respective discipline in a simulation-based learning environment and (b) write a justificatory report for each simulated case. We coded all justificatory reports regarding four diagnostic activities: generating hypotheses, generating evidence, evaluating evidence, and drawing conclusions. Moreover, using the method of Epistemic Network Analysis, we operationalized diagnostic practices as the relative frequencies of co-occurring diagnostic activities. We found significant differences between learners from medical education and teacher education with respect to both their diagnostic activities and diagnostic practices. Learners from medical education put relatively more emphasis on generating hypotheses and drawing conclusions, therefore applying a more hypothesis-driven approach. By contrast, learners in teacher education had a stronger focus on generating and evaluating evidence, indicating a more data-driven approach. The results may be explained by different epistemic ideals and standards taught in higher education. Further research on the issue of epistemic ideals and standards in diagnosing is needed. Moreover, we recommend that educators think beyond individuals' knowledge and implement measures to systematically teach and increase the awareness of disciplinary standards.

18.
Nanoscale ; 12(46): 23831-23837, 2020 Dec 08.
Article in English | MEDLINE | ID: mdl-33237101

ABSTRACT

Flexible and conductive silver-nanowire photopolymer composites are fabricated and studied under mechanical strain. The initial resistances of the unstretched flexible composites are between 0.27 Ω mm-1 and 1.2 Ω mm-1 for silver-nanowire concentrations between 120 µg cm-2 and 40 µg cm-2. Stretching of the samples leads to an increased resistance by a factor of between 72 for 120 µg cm-2 and 343 for 40 µg cm-2 at elongations of 23%. In order to correlate network morphology and electrical properties, micrographs are recorded during stretching. The Fiber Image Network Evaluation (FINE) algorithm determines morphological silver-nanowire network properties under stretching. For unstretched and stretched samples, an isotropic nanowire network is found with only small changes in fiber orientation. Monte-Carlo simulations on 2D percolation networks of 1D conductive wires and the corresponding network resistance due to tunneling of electrons at nanowire junctions confirm that the elastic polymer matrix under strain exhibits forces in agreement with Hooke's law. By variation of a critical force distribution the resistance curves are accurately reproduced. This results in a model that is dominated by quantum-mechanical tunneling at nanowire junctions explaining the electrical behavior and the sensitivity of nanowire-composites with different filler concentrations under mechanical strain.

19.
GMS J Med Educ ; 37(5): Doc51, 2020.
Article in English | MEDLINE | ID: mdl-32984510

ABSTRACT

Objectives: Physicians with different professional backgrounds often diagnose a patients' problem collaboratively. In this article, we first introduce a process model for collaborative diagnosing (CDR model), describe the development of a simulation used to empirically examine the facilitation of collaborative diagnostic reasoning. Based on a contemporary validity framework [1], we further suggest indicators for validity and collect initial evidence with respect to the scoring, generalization, extrapolation, and implication inferences to assess the validity of the simulation when used to assess effects of learning interventions. Method: In a quasi-experimental study, we assessed objectivity and reliability of the simulation and compared medical students with low and advanced prior knowledge to practitioners with high prior knowledge with respect to their diagnostic accuracy, diagnostic efficiency, information sharing skills, and their intrinsic cognitive load. Additionally, we obtained authenticity ratings from practitioners with high prior knowledge. Results: The results yielded satisfying initial evidence for the validity of the scoring and the extrapolation inferences as ratings are objective, and the simulation and the collaborative process is perceived as rather authentic. Additionally, participants on different levels of prior knowledge differ with respect to their diagnostic accuracy, diagnostic efficiency, information sharing skills, and their reported intrinsic cognitive load. With one exception (information sharing skills), the generalization inference seems to be valid as well. Conclusions: We conclude that collecting validity evidence for the simulation was an important step towards a better interpretation of the simulation. We found that the simulation is an authentic and valid representation of the chosen collaborative situation and that the collected validity evidence offers sufficient evidence for an initial validation of the simulation. Nevertheless, the validation process highlighted some important gaps that need further consideration. We further conclude that applying a validation model to the context of empirical research is promising and encourage other researchers to follow the example.


Subject(s)
Education, Medical , Patient Simulation , Students, Medical , Teaching , Adult , Child, Preschool , Clinical Competence , Education, Medical/methods , Female , Humans , Pilot Projects , Reproducibility of Results , Teaching/standards , Young Adult
20.
Sci Rep ; 10(1): 10888, 2020 07 02.
Article in English | MEDLINE | ID: mdl-32616723

ABSTRACT

Fiber structures play a major role for the function of fiber-reinforced materials such as biological tissue. An objective classification of the fiber orientations into fiber families is crucial to understand its mechanical properties. We introduce the Fiber Image Network Evaluation Algorithm (FINE algorithm) to classify and quantify the number of fiber families in scientific images. Each fiber family is characterized by an amplitude, a mean orientation, and a dispersion. A new alignment index giving the averaged fraction of aligned fibers is defined. The FINE algorithm is validated by realistic grayscale Monte-Carlo fiber images. We apply the algorithm to an in-vivo depth scan of second harmonic generation images of dermal collagen in human skin. The derived alignment index exhibits a crossover at a critical depth where two fiber families with a perpendicular orientation around the main tension line arise. This strongly suggests the presence of a transition from the papillary to the reticular dermis. Hence, the FINE algorithm provides a valuable tool for a reliable classification and a meaningful interpretation of in-vivo collagen fiber networks and general fiber reinforced materials.

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