@article{SchweigerMalorgioHenckertetal.2023, author = {Schweiger, Giovanna and Malorgio, Amos and Henckert, David and Braun, Julia and Meybohm, Patrick and Hottenrott, Sebastian and Froehlich, Corinna and Zacharowski, Kai and Raimann, Florian J. and Piekarski, Florian and Noethiger, Christoph B. and Spahn, Donat R. and Tscholl, David W. and Roche, Tadzio R.}, title = {Visual Blood, a 3D animated computer model to optimize the interpretation of blood gas analysis}, series = {Bioengineering}, volume = {10}, journal = {Bioengineering}, number = {3}, issn = {2306-5354}, doi = {10.3390/bioengineering10030293}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304150}, year = {2023}, abstract = {Acid-base homeostasis is crucial for all physiological processes in the body and is evaluated using arterial blood gas (ABG) analysis. Screens or printouts of ABG results require the interpretation of many textual elements and numbers, which may delay intuitive comprehension. To optimise the presentation of the results for the specific strengths of human perception, we developed Visual Blood, an animated virtual model of ABG results. In this study, we compared its performance with a conventional result printout. Seventy physicians from three European university hospitals participated in a computer-based simulation study. Initially, after an educational video, we tested the participants' ability to assign individual Visual Blood visualisations to their corresponding ABG parameters. As the primary outcome, we tested caregivers' ability to correctly diagnose simulated clinical ABG scenarios with Visual Blood or conventional ABG printouts. For user feedback, participants rated their agreement with statements at the end of the study. Physicians correctly assigned 90\% of the individual Visual Blood visualisations. Regarding the primary outcome, the participants made the correct diagnosis 86\% of the time when using Visual Blood, compared to 68\% when using the conventional ABG printout. A mixed logistic regression model showed an odds ratio for correct diagnosis of 3.4 (95\%CI 2.00-5.79, p < 0.001) and an odds ratio for perceived diagnostic confidence of 1.88 (95\%CI 1.67-2.11, p < 0.001) in favour of Visual Blood. A linear mixed model showed a coefficient for perceived workload of -3.2 (95\%CI -3.77 to -2.64) in favour of Visual Blood. Fifty-one of seventy (73\%) participants agreed or strongly agreed that Visual Blood was easy to use, and fifty-five of seventy (79\%) agreed that it was fun to use. In conclusion, Visual Blood improved physicians' ability to diagnose ABG results. It also increased perceived diagnostic confidence and reduced perceived workload. This study adds to the growing body of research showing that decision-support tools developed around human cognitive abilities can streamline caregivers' decision-making and may improve patient care.}, language = {en} } @article{GerberQuarderGreefrathetal.2023, author = {Gerber, Sebastian and Quarder, Jascha and Greefrath, Gilbert and Siller, Hans-Stefan}, title = {Promoting adaptive intervention competence for teaching simulations and mathematical modelling with digital tools}, series = {Frontiers in Education}, volume = {8}, journal = {Frontiers in Education}, issn = {2504-284X}, doi = {10.3389/feduc.2023.1141063}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323701}, year = {2023}, abstract = {Providing adaptive, independence-preserving and theory-guided support to students in dealing with real-world problems in mathematics lessons is a major challenge for teachers in their professional practice. This paper examines this challenge in the context of simulations and mathematical modelling with digital tools: in addition to mathematical difficulties when autonomously working out individual solutions, students may also experience challenges when using digital tools. These challenges need to be closely examined and diagnosed, and might - if necessary - have to be overcome by intervention in such a way that the students can subsequently continue working independently. Thus, if a difficulty arises in the working process, two knowledge dimensions are necessary in order to provide adapted support to students. For teaching simulations and mathematical modelling with digital tools, more specifically, these knowledge dimensions are: pedagogical content knowledge about simulation and modelling processes supported by digital tools (this includes knowledge about phases and difficulties in the working process) and pedagogical content knowledge about interventions during the mentioned processes (focussing on characteristics of suitable interventions as well as their implementation and effects on the students' working process). The two knowledge dimensions represent cognitive dispositions as the basis for the conceptualisation and operationalisation of a so-called adaptive intervention competence for teaching simulations and mathematical modelling with digital tools. In our article, we present a domain-specific process model and distinguish different types of teacher interventions. Then we describe the design and content of a university course at two German universities aiming to promote this domain-specific professional adaptive intervention competence, among others. In a study using a quasi-experimental pre-post design (N = 146), we confirm that the structure of cognitive dispositions of adaptive intervention competence for teaching simulations and mathematical modelling with digital tools can be described empirically by a two-dimensional model. In addition, the effectiveness of the course is examined and confirmed quantitatively. Finally, the results are discussed, especially against the background of the sample and the research design, and conclusions are derived for possibilities of promoting professional adaptive intervention competence in university courses.}, language = {en} } @article{DuekingGiessingFrenkeletal.2020, author = {D{\"u}king, Peter and Giessing, Laura and Frenkel, Marie Ottilie and Koehler, Karsten and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Wrist-Worn Wearables for Monitoring Heart Rate and Energy Expenditure While Sitting or Performing Light-to-Vigorous Physical Activity: Validation Study}, series = {JMIR mhealth and uhealth}, volume = {8}, journal = {JMIR mhealth and uhealth}, number = {5}, doi = {10.2196/16716}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-229413}, year = {2020}, abstract = {Background: Physical activity reduces the incidences of noncommunicable diseases, obesity, and mortality, but an inactive lifestyle is becoming increasingly common. Innovative approaches to monitor and promote physical activity are warranted. While individual monitoring of physical activity aids in the design of effective interventions to enhance physical activity, a basic prerequisite is that the monitoring devices exhibit high validity. Objective: Our goal was to assess the validity of monitoring heart rate (HR) and energy expenditure (EE) while sitting or performing light-to-vigorous physical activity with 4 popular wrist-worn wearables (Apple Watch Series 4, Polar Vantage V, Garmin Fenix 5, and Fitbit Versa). Methods: While wearing the 4 different wearables, 25 individuals performed 5 minutes each of sitting, walking, and running at different velocities (ie, 1.1 m/s, 1.9 m/s, 2.7 m/s, 3.6 m/s, and 4.1 m/s), as well as intermittent sprints. HR and EE were compared to common criterion measures: Polar-H7 chest belt for HR and indirect calorimetry for EE. Results: While monitoring HR at different exercise intensities, the standardized typical errors of the estimates were 0.09-0.62, 0.13-0.88, 0.62-1.24, and 0.47-1.94 for the Apple Watch Series 4, Polar Vantage V, Garmin Fenix 5, and Fitbit Versa, respectively. Depending on exercise intensity, the corresponding coefficients of variation were 0.9\%-4.3\%, 2.2\%-6.7\%, 2.9\%-9.2\%, and 4.1\%-19.1\%, respectively, for the 4 wearables. While monitoring EE at different exercise intensities, the standardized typical errors of the estimates were 0.34-1.84, 0.32-1.33, 0.46-4.86, and 0.41-1.65 for the Apple Watch Series 4, Polar Vantage V, Garmin Fenix 5, and Fitbit Versa, respectively. Depending on exercise intensity, the corresponding coefficients of variation were 13.5\%-27.1\%, 16.3\%-28.0\%, 15.9\%-34.5\%, and 8.0\%-32.3\%, respectively. Conclusions: The Apple Watch Series 4 provides the highest validity (ie, smallest error rates) when measuring HR while sitting or performing light-to-vigorous physical activity, followed by the Polar Vantage V, Garmin Fenix 5, and Fitbit Versa, in that order. The Apple Watch Series 4 and Polar Vantage V are suitable for valid HR measurements at the intensities tested, but HR data provided by the Garmin Fenix 5 and Fitbit Versa should be interpreted with caution due to higher error rates at certain intensities. None of the 4 wrist-worn wearables should be employed to monitor EE at the intensities and durations tested."}, language = {en} } @article{DuekingTaflerWallmannSperlichetal.2020, author = {D{\"u}king, Peter and Tafler, Marie and Wallmann-Sperlich, Birgit and Sperlich, Billy and Kleih, Sonja}, title = {Behavior Change Techniques in Wrist-Worn Wearables to Promote Physical Activity: Content Analysis}, series = {JMIR Mhealth and Uhealth}, volume = {8}, journal = {JMIR Mhealth and Uhealth}, number = {11}, doi = {10.2196/20820}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230556}, year = {2020}, abstract = {Background: Decreasing levels of physical activity (PA) increase the incidences of noncommunicable diseases, obesity, and mortality. To counteract these developments, interventions aiming to increase PA are urgently needed. Mobile health (mHealth) solutions such as wearable sensors (wearables) may assist with an improvement in PA. Objective: The aim of this study is to examine which behavior change techniques (BCTs) are incorporated in currently available commercial high-end wearables that target users' PA behavior. Methods: The BCTs incorporated in 5 different high-end wearables (Apple Watch Series 3, Garmin V{\´i}voactive 3, Fitbit Versa, Xiaomi Amazfit Stratos 2, and Polar M600) were assessed by 2 researchers using the BCT Taxonomy version 1 (BCTTv1). Effectiveness of the incorporated BCTs in promoting PA behavior was assessed by a content analysis of the existing literature. Results: The most common BCTs were goal setting (behavior), action planning, review behavior goal(s), discrepancy between current behavior and goal, feedback on behavior, self-monitoring of behavior, and biofeedback. Fitbit Versa, Garmin V{\´i}voactive 3, Apple Watch Series 3, Polar M600, and Xiaomi Amazfit Stratos 2 incorporated 17, 16, 12, 11, and 11 BCTs, respectively, which are proven to effectively promote PA. Conclusions: Wearables employ different numbers and combinations of BCTs, which might impact their effectiveness in improving PA. To promote PA by employing wearables, we encourage researchers to develop a taxonomy specifically designed to assess BCTs incorporated in wearables. We also encourage manufacturers to customize BCTs based on the targeted populations.}, language = {en} } @article{DuekingZinnerReedetal.2020, author = {D{\"u}king, Peter and Zinner, Christoph and Reed, Jennifer L. and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Predefined vs data-guided training prescription based on autonomic nervous system variation: A systematic review}, series = {Scandinavian Journal of Medicine \& Science in Sports}, volume = {30}, journal = {Scandinavian Journal of Medicine \& Science in Sports}, number = {12}, doi = {10.1111/sms.13802}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-217893}, pages = {2291 -- 2304}, year = {2020}, abstract = {Monitoring variations in the functioning of the autonomic nervous system may help personalize training of runners and provide more pronounced physiological adaptations and performance improvements. We systematically reviewed the scientific literature comparing physiological adaptations and/or improvements in performance following training based on responses of the autonomic nervous system (ie, changes in heart rate variability) and predefined training. PubMed, SPORTDiscus, and Web of Science were searched systematically in July 2019. Keywords related to endurance, running, autonomic nervous system, and training. Studies were included if they (a) involved interventions consisting predominantly of running training; (b) lasted at least 3 weeks; (c) reported pre- and post-intervention assessment of running performance and/or physiological parameters; (d) included an experimental group performing training adjusted continuously on the basis of alterations in HRV and a control group; and (e) involved healthy runners. Five studies involving six interventions and 166 participants fulfilled our inclusion criteria. Four HRV-based interventions reduced the amount of moderate- and/or high-intensity training significantly. In five interventions, improvements in performance parameters (3000 m, 5000 m, Loadmax, Tlim) were more pronounced following HRV-based training. Peak oxygen uptake (VO\(_{2peak}\)) and submaximal running parameters (eg, LT1, LT2) improved following both HRV-based and predefined training, with no clear difference in the extent of improvement in VO\(_{2peak}\). Submaximal running parameters tended to improve more following HRV-based training. Research findings to date have been limited and inconsistent. Both HRV-based and predefined training improve running performance and certain submaximal physiological adaptations, with effects of the former training tending to be greater.}, language = {en} } @article{GenslerLeikeimMoellmannetal.2020, author = {Gensler, Marius and Leikeim, Anna and M{\"o}llmann, Marc and Komma, Miriam and Heid, Susanne and M{\"u}ller, Claudia and Boccaccini, Aldo R. and Salehi, Sahar and Groeber-Becker, Florian and Hansmann, Jan}, title = {3D printing of bioreactors in tissue engineering: A generalised approach}, series = {PLoS One}, volume = {15}, journal = {PLoS One}, number = {11}, doi = {10.1371/journal.pone.0242615}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-231368}, year = {2020}, abstract = {3D printing is a rapidly evolving field for biological (bioprinting) and non-biological applications. Due to a high degree of freedom for geometrical parameters in 3D printing, prototype printing of bioreactors is a promising approach in the field of Tissue Engineering. The variety of printers, materials, printing parameters and device settings is difficult to overview both for beginners as well as for most professionals. In order to address this problem, we designed a guidance including test bodies to elucidate the real printing performance for a given printer system. Therefore, performance parameters such as accuracy or mechanical stability of the test bodies are systematically analysed. Moreover, post processing steps such as sterilisation or cleaning are considered in the test procedure. The guidance presented here is also applicable to optimise the printer settings for a given printer device. As proof of concept, we compared fused filament fabrication, stereolithography and selective laser sintering as the three most used printing methods. We determined fused filament fabrication printing as the most economical solution, while stereolithography is most accurate and features the highest surface quality. Finally, we tested the applicability of our guidance by identifying a printer solution to manufacture a complex bioreactor for a perfused tissue construct. Due to its design, the manufacture via subtractive mechanical methods would be 21-fold more expensive than additive manufacturing and therefore, would result in three times the number of parts to be assembled subsequently. Using this bioreactor we showed a successful 14-day-culture of a biofabricated collagen-based tissue construct containing human dermal fibroblasts as the stromal part and a perfusable central channel with human microvascular endothelial cells. Our study indicates how the full potential of biofabrication can be exploited, as most printed tissues exhibit individual shapes and require storage under physiological conditions, after the bioprinting process.}, language = {en} } @article{DuekingHolmbergSperlich2017, author = {D{\"u}king, Peter and Holmberg, Hans-Christer and Sperlich, Billy}, title = {Instant Biofeedback Provided by Wearable Sensor Technology Can Help to Optimize Exercise and Prevent Injury and Overuse}, series = {Frontiers in Physiology}, volume = {8}, journal = {Frontiers in Physiology}, number = {167}, doi = {10.3389/fphys.2017.00167}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-158044}, year = {2017}, language = {en} } @article{ZwinkJenetzkySchmiedekeetal.2012, author = {Zwink, Nadine and Jenetzky, Ekkehart and Schmiedeke, Eberhard and Schmidt, Dominik and M{\"a}rzheuser, Schmidt and Grasshoff-Derr, Sabine and Holland-Cunz, Stefan and Weih, Sandra and Hosie, Stuart and Reifferscheid, Peter and Ameis, Helen and Kujath, Christina and Rissmann, Anke and Obermayr, Florian and Schwarzer, Nicole and Bartels, Enrika and Reutter, Heiko and Brenner, Hermann}, title = {Assisted reproductive techniques and the risk of anorectal malformations: a German case-control study}, series = {Orphanet Journal of Rare Diseases}, volume = {7}, journal = {Orphanet Journal of Rare Diseases}, number = {65}, organization = {CURE-Net Consortium}, doi = {10.1186/1750-1172-7-65}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134036}, year = {2012}, abstract = {Background: The use of assisted reproductive techniques (ART) for treatment of infertility is increasing rapidly worldwide. However, various health effects have been reported including a higher risk of congenital malformations. Therefore, we assessed the risk of anorectal malformations (ARM) after in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: Data of the German Network for Congenital Uro-REctal malformations (CURE-Net) were compared to nationwide data of the German IVF register and the Federal Statistical Office (DESTATIS). Odds ratios (95\% confidence intervals) were determined to quantify associations using multivariable logistic regression accounting for potential confounding or interaction by plurality of births. Results: In total, 295 ARM patients born between 1997 and 2011 in Germany, who were recruited through participating pediatric surgeries from all over Germany and the German self-help organisation SoMA, were included. Controls were all German live-births (n = 10,069,986) born between 1997 and 2010. Overall, 30 cases (10\%) and 129,982 controls (1\%) were born after IVF or ICSI, which translates to an odds ratio (95\% confidence interval) of 8.7 (5.9-12.6) between ART and ARM in bivariate analyses. Separate analyses showed a significantly increased risk for ARM after IVF (OR, 10.9; 95\% CI, 6.2-19.0; P < 0.0001) as well as after ICSI (OR, 7.5; 95\% CI, 4.6-12.2; P < 0.0001). Furthermore, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed strong associations with ART (ORs 4.9, 11.9 and 7.9, respectively). After stratification for plurality of birth, the corresponding odds ratios (95\% confidence intervals) were 7.7 (4.6-12.7) for singletons and 4.9 (2.4-10.1) for multiple births. Conclusions: There is a strongly increased risk for ARM among children born after ART. Elevations of risk were seen after both IVF and ICSI. Further, separate analyses of patients with isolated ARM, ARM with associated anomalies and those with a VATER/VACTERL association showed increased risks in each group. An increased risk of ARM was also seen among both singletons and multiple births.}, language = {en} }