VIEW – A Virtual Interactive Web-Based Learning Environment for Engineering

The use of computer-aided and web-based educational technologies such as Virtual Learning Environments (VLE) has increased significantly in the recent past. One example of such a VLE is Virtual Interactive Engineering on the Web (VIEW). VIEW is a 3D virtual, interactive, student-centered, framework of web-based modules based on the Extensible 3D standard. These modules are dedicated to the improvement of student success and learning. In this paper, an overview of the recent developments in VIEW along with associated assessment results is presented. An experimental study was also performed to compare the learning experience and performance of students in a physical dissection activity vs. that in a virtual dissection activity using a VIEW module. The results of this study show that students can meet given learning objectives and that there is limited difference in their learning and performance irrespective of a physical or virtual setting

A Different View: Virtual Interactive Engineering on the Web

Virtual laboratories and modules are used in most universities to reinforce concepts from lecture material, provide exposure to practical issues associated with experiments and present visual, realistic applications of theoretical concepts. In addition, interactive simulations and virtual environments can play a significant role in facilitating learning through engagement, immediate feedback and in creating real-world scenarios. This work presents the initial phase in the development of a set of Web based virtual laboratories and modules - Virtual Interactive Engineering on the Web (VIEW). A Virtual Tensile Testing Laboratory (VTTL) is developed to be used as a supplement in the course: Introduction to Engineering Materials. The main objective of this laboratory is to introduce students to the testing techniques required to determine mechanical properties of materials such as elastic modulus, yield strength, ductility, and toughness

A VIEW on Mechanical Dissection for Freshmen Engineering

Mechanical dissection is an engineering activity that can satisfy a student’s curiosity of how and why the components of a given device can convey specific motions to achieve a desired result. Hence, several university engineering programs have developed mechanical dissection laboratories. However, such laboratories are not always feasible due to the lack of space, personnel, time and high costs. An emerging trend to address this issue is to use multi-media technology to replace/supplement physical laboratories. The objective of this work is to develop the second phase of VIEW (Virtual Interactive Engineering on the Web) which is a virtual mechanical dissection module. Virtual dissection implemented in VIEW requires only the use of existing computer laboratories. This module is used as a supplement in the course: Introduction to Engineering. Further details including assessment results which indicate that the module was well received by students are discussed in the paper

Outcome of prophylactic endoscopic vacuum therapy for high-risk anastomosis after esophagectomy

Background: Endoscopic vacuum therapy (EVT) has become an established procedure for the treatment of anastomotic leaks (AL) in upper gastrointestinal surgery. A novel approach is the use of EVT for preventing leaks in high-risk anastomosis. The aim of this study was to analyze the outcome of prophylactic EVT (pEVT) in patients receiving surgical revision of the anastomosis after oncological Ivor-Lewis esophagectomy (ILE) due to AL. Material and methods: Between June 2016 and February 2019, all patients who underwent anastomotic revision after ILE due to a confirmed AL were included. The primary outcome was the success rate of pEVT, which was defined as absence of an AL after revision. Secondary outcome parameters were duration of treatment, inflammatory levels, and ICU/hospital stay. Results: Twenty-one patients underwent anastomotic revision due to an AL. The cause of the AL was ischemia in nine patients (42.9%) and non-ischemia (other) in 12 patients (57.1%). PEVT was performed in 14 patients (66.6%). The overall success rate of pEVT was five out of 14 patients (35.7%). Conclusions: Prophylactic EVT cannot prevent a re-leak in patients with high-risk anastomosis due to surgical revision of an AL after oncological ILE. However, pEVT might help to control the clinical condition of these patients

Functional implications of microbial and viral gut metagenome changes in early stage L-DOPA-naive Parkinson's disease patients

Background Parkinson’s disease (PD) presently is conceptualized as a protein aggregation disease in which pathology involves both the enteric and the central nervous system, possibly spreading from one to another via the vagus nerves. As gastrointestinal dysfunction often precedes or parallels motor symptoms, the enteric system with its vast diversity of microorganisms may be involved in PD pathogenesis. Alterations in the enteric microbial taxonomic level of L-DOPA-naïve PD patients might also serve as a biomarker. Methods We performed metagenomic shotgun analyses and compared the fecal microbiomes of 31 early stage, L-DOPA-naïve PD patients to 28 age-matched controls. Results We found increased Verrucomicrobiaceae (Akkermansia muciniphila) and unclassified Firmicutes, whereas Prevotellaceae (Prevotella copri) and Erysipelotrichaceae (Eubacterium biforme) were markedly lowered in PD samples. The observed differences could reliably separate PD from control with a ROC-AUC of 0.84. Functional analyses of the metagenomes revealed differences in microbiota metabolism in PD involving the ẞ-glucuronate and tryptophan metabolism. While the abundances of prophages and plasmids did not differ between PD and controls, total virus abundance was decreased in PD participants. Based on our analyses, the intake of either a MAO inhibitor, amantadine, or a dopamine agonist (which in summary relates to 90% of PD patients) had no overall influence on taxa abundance or microbial functions. Conclusions Our data revealed differences of colonic microbiota and of microbiota metabolism between PD patients and controls at an unprecedented detail not achievable through 16S sequencing. The findings point to a yet unappreciated aspect of PD, possibly involving the intestinal barrier function and immune function in PD patients. The influence of the parkinsonian medication should be further investigated in the future in larger cohorts.ISSN:1756-994

Efficacy and feasibility of OverStitch suturing of leaks in the upper gastrointestinal tract

Background Management of upper gastrointestinal leaks is challenging. A new potential treatment option for this complication is endoscopic suturing with the OverStitch system (Apollo Endosurgery, Texas, USA), which is today mainly used for endoscopic sleeve gastroplasty. The aim of this study was to analyze the efficacy and feasibility of this new treatment option in patients with leaks in the upper gastrointestinal tract. Methods We performed a retrospective, single-center study of all patients who underwent endoscopic suturing with OverStitch of leaks in the upper gastrointestinal tract. Results Endoscopic suturing was performed on 13 patients (mean age, 59.62 +/- 16.29 years; mean leak size, 22.31 +/- 22.6 mm) over a period of 8 months. Postoperative leaks were detected in 10 patients (76.9%) after foregut surgery. Interventional success was achieved in all endoscopic attempts (n = 16, 100%) with a mean closure time of 28.0 +/- 12.36 min per patient. Follow-up technical success rate for each suture was (n = 8, 50.0%). Clinical success, including repeated suture attempts was achieved in 8 of the 13 patients (61.5%). These 8 patients had not received prior treatment for the leak. No immediate or delayed serious complications occurred as a result of OverStitch. The mean follow-up was 95 +/- 91.07 days. Conclusions Endoscopic suturing with OverStitch for leaks in the upper gastrointestinal tract is feasible and effective in patients who have not received prior treatment. This minimally invasive technique seems to be a promising option especially for patients with large leaks and significant comorbidities

Interactive 3D Web-Based Environments for Online Learning: Case Studies, Technologies and Challenges

Interactive simulations and virtual environments can play a significant role in facilitating learning through engagement, immediate feedback and by providing real-world contexts. Interactive 3D interfaces have a significant impact on the user interface usability and interactivity. We present several case-studies that have evolved from actual teaching observations and have been implemented using undergraduate and graduate student research teams. The development of such simulators poses multidisciplinary research challenges and has the advantage of bringing together a diverse group of people with complementary expertise. We present case studies covering engineering, medical sciences, physics and chemistry

In Vitro Evaluation of Mechanical Properties of Segmented Esophageal Self-Expandable Metal Stents: Innovative Test Methods Are Needed

Background: Self-expanding metal stents (SEMSs) in different geometric shapes are well established treatment options in diseases of the esophagus. Mechanical properties and stent design may have an impact on patient comfort, migration rate, and removability. In this in vitro study, we evaluated mechanical properties of three segmented SEMSs (segSEMSs) for the esophagus with regard to distinct stent sections. Materials and Methods: Radial forces were measured using a testing method distinguishing between circumferential radial and local radial force. The center parts of the segSEMSs were measured for circumferential radial forces without being affected by the flared ends. Axial forces were measured at 20 degrees bending. Results: Circumferential radial force measurements over the full stent length showed substantial differences against measurements of the center parts of the stents as the flared ends falsify test results by up to 53%. Although circumferential radial forces of the center parts were about the same (<10% variances) for all segSEMSs, local radial forces showed considerable differences of up to 26%. One segSEMS showed high axial forces, whereas the other two only needed half of the force (up to 53%) to be bent to 20 degrees. Conclusion: Flared ends of segSEMSs have a substantial impact on radial force measurements and therefore alter test results, confirmed by our separated center part test of segSEMSs. Our innovative setup whereby we compressed the stent in an asymmetric manner (local radial force) and evaluated sections of stents separately, indeed revealed differences to circumferential measurements, leading to a more in-depth knowledge of stent characteristics