Background: Patients newly diagnosed with diabetes mellitus (diabetes), who require insulin must acquire diabetes "survival" skills prior to discharge home. COVID-19 revealed considerable limitations of traditional in- person, time-intensive delivery of diabetes education and survival skills training (diabetes survival skills training). Furthermore, diabetes survival skills training has not been designed to meet the specific learning needs of patients with diabetes and their caregivers, particularly if delivered by telehealth. The objective of the study was to identify and understand the needs of users (patients newly prescribed insulin and their caregivers) to inform the design of a diabetes survival skills training, specifically for telehealth delivery, through the application of user-centered design and adult learning and education principles. Methods: Users included patients newly prescribed insulin, their caregivers, and laypersons without diabetes. In semi-structured interviews, users were asked about experienced or perceived challenges in learning diabetes survival skills. Interviews were audio-recorded and transcribed. Investigators performed iterative rounds of coding of interview transcripts utilizing a constant comparative method to identify themes describing the dominant challenges users experienced. Themes were then mapped to adult learning and education principles to identify novel educational design solutions that can be applied to telehealth-based learning. Results: We interviewed 18 users: patients (N = 6, 33 %), caregivers (N = 4, 22 %), and laypersons (N = 8, 44 %). Users consistently described challenges in understanding diabetes survival skills while hospitalized; in preparing needed supplies to execute diabetes survival skills; and in executing diabetes survival skills at home. The challenges mapped to three educational strategies: (1) spiral learning; (2) repetitive goal directed practice and feedback, which have the potential to translate into design solutions supporting remote/virtual learning; and (3) form fits function organizer, which supports safe organization and use of supplies to execute diabetes survival skills independently. Conclusion: Learning complex tasks, such as diabetes survival skills, requires time, repetition, and continued support. The combination of a user-centered design approach to uncover learning needs as well as identification of relevant adult learning and education principles could inform the design of more user-centered, feasible, effective, and sustainable diabetes survival skills training for telehealth delivery.

Abstract Disclosure: S.J. Freeman: None. B. Radonski: None. L. Lecka: Employee; Self; Doximity. Stock Owner; Self; Doximity. K. Davis: None. G. Prince: None. K. Carthy: None. J.J. Seley: Speaker; Self; Lifescan Diabetes Institute. J. Song: None. J. Lee: None. S.C. Bailey: Consulting Fee; Self; Merck, Lundbeck, Sanofi-Aventis, Pfizer, Inc., Luto, University of Westminster, Gilead. Grant Recipient; Self; Merck, Eli Lilly & Company, Pfizer, Inc., Lundbeck, Gordon and Betty Moore Foundation, National Institutes of Health, Gilead. R. Khorzad: None. D. Gatchell: None. B. Ankenman: None. D.R. Lewis: Grant Recipient; Self; Pfizer, Inc., Spencer Foundation, National Institutes of Health. J. Holl: None. A. Wallia: Consulting Fee; Self; Eli Lilly & Company. Grant Recipient; Self; Novo Nordisk. Research Investigator; Self; UnitedHealth Group, Eli Lilly & Company. Patient-centered approaches for teaching diabetes mellitus (DM) survival skills are essential. Furthermore, in the peri-COVID era, interventions also need to be amenable to remote care delivery. User-Centered design (UCD) including usability testing is a key strategy to optimize adoption and engagement of interventions. We developed a Diabetes Survival Skills Toolkit (website, paper guide, and a physical Kit with simulation supplies) using UCD (> 50 sessions), followed by administration of system usability surveys (SUS) (scored as unacceptable, acceptable, or excellent) and, in a subset, additional skills testing. Skills testing included simulated blood glucose checks and insulin administration, conducted by 2 trained observers. Forty-three participants with no prior history of DM were recruited between 01/2021-07/2022 to independently learn survival skills using different Toolkit components [website only (N=11), Kit + paper guide (N=28), and Kit + website (N=4)]. Purposive sampling for age and highest education level resulted in 33% being ≥ 65 years and 35% having < 4-year degree. Overall, SUS scores were deemed excellent (N=15/43 [35%]) or acceptable (N=20/43 [47%]). Unacceptable scores were noted in 8/43 (19%) [4 website only (all > 4-year degree) and 4 Kit + paper guide (3 of 4 > 65 years, all < 4-year degree)]. Use of the website alone resulted in a higher rate of unacceptable SUS scores (37%) compared to use of the Kit with either the paper guide or website (13%). SUS-score category was not associated with age (82% acceptable/excellent among <45 years, 86% among 45-64 years, and 79% among >=65 years; Fishers’ p=1.00) nor highest education level (80% acceptable/excellent among <4-year degree and 82% among >=4-year degree; Fisher’s p=0.69). Participants who completed skills testing (N= 28 Kit + paper guide, 4 Kit + website), regardless of their SUS score, all correctly demonstrated the ability to inject insulin with simulation supplies. However, 4/32 (13%) (all SUS scores acceptable/excellent) were unable to navigate all steps independently and 9/32 (28%) (2 SUS unacceptable) did not use the recommended instructional pathway. All 4 participants (3 with > age 65 and < 4-year degree) who completed skills testing but had unacceptable SUS scores still correctly demonstrated the ability to measure blood glucose and inject insulin. In conclusion, a Survival Skills Toolkit, resulted in excellent rates of successful survival skills performance when tested with laypersons of diverse ages and education levels. Subjective usability (SUS scores) did differ among users of different Toolkit components; however, they did not align with actual skill performance. Design preferences and usability tests as well as subsequent skills testing are critical to optimally design tools for diabetes survival skills training. Presentation: Saturday, June 17, 2023

To reduce dependence on electric-powered incubators, a number of alternate heat sources have been proposed. Phase change materials (PCM) are one of such because of their availability and cost effectiveness in rural areas. This study intends to explore the use of phase change material (PCM) such as paraffin wax as an alternative heat source over a variety of incubator hood geometries. This study presents three incubator hood geometries and their respective effects on maximum hood temperatures and time to reach these temperatures for a mainstream incubator. The three designs, cubic, pyramidal, and oval, were created using CAD software; mathematical computations for heat transfer analysis were undertaken using COMSOL Multiphysics software. Results show the maximum temperatures reached in the hoods were 308, 314.5, and 315 K for the cubic, pyramidal, and oval-shaped geometries respectively. This offers a promising application of PCM-based as a choice material for incubator design for rural applications.

Diabetes mellitus (DM) self-care teaching is often provided at point of care, but “clinician-centered” feedback about teaching is lacking. Semi-structured, facilitated interviews of front-line clinicians involved in DM care (e.g., meter, medications, injection technique) were conducted. Clinicians were asked their perspectives on the needs of newly diagnosed DM patients, specifically during transitions of care (e.g., discharge home). Clinicians were also asked to review current DM education materials (training supplies, print handouts) and subsequently developed potential solutions. Interview transcripts were independently coded by 3 coders, using a constant comparative method, to identify themes. MAXQDA software was used. Key themes were additionally audited by a diabetologist. Eleven sessions were conducted with clinicians (N=14, 2 certified DM educators, 4 endocrinology MD fellows, 3 advanced practice providers, 1 DM nurse, 2 pharmacists, 2 internal medicine MDs). The most commonly identified theme across clinician type was simplified, understandable content (8/11 sessions). Participants identified lack of centralization of supplies and education materials as the most significant barrier (9/11 sessions) to optimal care. Other top themes were insurance coverage for diabetes supplies and medications, need for customization, and limited access to diabetes educators. The most preferred solution was use of patient simulation (repetitive practice) [7/11 sessions], followed by teaching videos (5/11 sessions). Clinicians preferred comprehensive but simplified, understandable, customizable, diabetes teaching content. The lack of centralization of supplies and content and insurance coverage for supplies/medications are major barriers for clinicians to deliver optimal DM self-care teaching. These data also suggest that use of simulation could facilitate improvement in DM teaching by front-line clinicians. Disclosure K. Coyne: None. S. Hakimian: None. T. Pollack: None. S. Karam: None. G. Prince: None. E.K. Touma: None. D.W. Gatchell: None. R. Khorzad: None. B. Ankenman: None. J.L. Holl: None. A. Wallia: Research Support; Self; Eli Lilly and Company, Novo Nordisk Inc., UnitedHealth Group. Funding American Diabetes Association (1-13-JF-54 to A.W.); Chicago Center for Diabetes Translation Research/National Institute of Diabetes and Digestive and Kidney Diseases (P30DK092949); Agency for Healthcare Research and Quality (5R18HS026143-02)

Physiology is a core element of an undergraduate biomedical engineering curriculum, although programs differ in whether the biomedical engineering faculty or biology faculty teach these courses, and in whether physiology is taught in stand-alone courses or incorporated into other courses.Here we first present an analysis of the concepts and topics in physiology that are viewed by biomedical engineering faculty and by representatives of industry as being most important for biomedical engineers to learn.We also provide information on the importance of other topics in biology for the biomedical engineering curriculum.Biomedical engineering students need to be able to work with quantitative aspects of physiology and need practice applying engineering concepts to physiological systems.However, many physiology texts appropriate for undergraduates avoid quantitative analysis, and provide few problems to develop the students' use of mathematics or engineering tools in the context of physiology.As a result, we have begun the development of a resource of quantitative homework problems from which individual problems can be selected and linked to any physiology course.Table 2. Companies/

Product archaeology refers to the process of reconstructing the lifecycle of a product to understand the decisions that led to its development and has been used as an educational framework for promoting students’ consideration of the broader impacts of engineering on people, economics, and the environment. As a result, product archaeology offers students an opportunity to reconstruct and understand the customer requirements, design specifications, and manufacturing processes that led to the development and production of a product. This paper describes: 1) the identification and development of assessment tools for evaluating the impact of product archaeology, 2) the implementation of the product archaeology framework during two recent academic year semesters in undergraduate engineering courses at all levels across six universities, and 3) assessment results with evidence of the effectiveness of the product archaeology framework. This project uses existing survey instruments, including the Engineer of 2020 survey and the engineering design self-efficacy instrument to assess positive student attitudes and perceptions about engineering. Our assessment plan also uses two newly-developed design scenarios. These scenarios require students to respond to open-ended descriptions of real-world engineering problems to assess students’ ability to extend and refine knowledge of broader contexts. Emerging pre-test/post-test comparison data reveal that the product archaeology activities lead to more positive student ratings of both their own knowledge of broader contexts and their self-efficacy regarding engineering design. Analysis of the design scenarios (used to assess students’ ability to apply contextual knowledge to engineering design situations) includes results from the Spring and Fall 2013 semesters.

Employers, textbook publishers, and existing and emerging educational programs in biomedical engineering and bioengineering continue to be interested in the degree to which the undergraduate curricula of degree granting programs are similar for undergraduates in these fields, and what the similarities are. Several years ago, the VaNTH Engineering Research Center in Bioengineering Educational Technologies compiled information about required courses at 40 of the 43 programs that were ABET-accredited in bioengineering or biomedical engineering at the end of 2004, as well as 31 programs that were not accredited at that time. While these data have been presented in several forums, there has not been a publication on this topic. In the interest of providing data that can be used by different constituencies, as well as a snapshot of the curriculum at a particular point to which changes can be compared, the data from that project are presented here in full. The results from the 2004 sample concerned courses beyond freshman math, physics and chemistry, which tend to be common across engineering majors, to focus on the courses required specifically for the biomedical engineering degree. Mechanics, physiology and design were the subjects required most frequently, at 90% or more of the accredited programs. Other subjects required by 75% or more of the accredited programs were other areas of biology, circuit analysis, computing, statistics, materials, and instrumentation. Several more topics were required by more than half of the programs. There was more variation in the amount of curricular time devoted to different subjects than in the topics that were required. In comparing accredited and non-accredited programs, mechanics, thermodynamics, and materials were required more frequently at accredited programs, while computing and organic chemistry were required by a larger percentage of the non-accredited programs. Normalizing all programs to a credit-hour basis showed that beyond required courses, the median number of credit hours left for specialization or elective courses was 12, and this did not differ between accredited and non-accredited programs. Overall these results showed a high degree of similarity in the required courses across all biomedical engineering programs. The 2013 requirements at sixteen of the programs assessed earlier have been evaluated to determine shifts in the curriculum. While there have been changes in individual programs, the summary statistics reveal few overall shifts in the courses required, reinforcing the relevance of the larger 2004 dataset, and indicating stability in the BME curriculum.

For over 15 years our first-year engineering design program has focused on a user-centered approach to design thinking and communication, where students work with real-world clients on ill-defined problems and communicate their ideas in a variety of ways to multiple audiences. Over this time frame similar to 5,000 students have passed through the two course sequence, and addressed over 1,500 design challenges. Since students work in teams of four to address these challenges (and will be expected to work on project teams throughout the undergraduate engineering curriculum and later in industry), we are strongly committed to helping them develop greater competency in teamwork, as opposed to simply participating in an unguided team experience. To facilitate teamwork learning, we historically used two instruments: (1) an intra-quarter peer review and self-review and (2) an end-of-the-quarter reflective memo (benefits and limitations of this approach have been described elsewhere(1,2,3)).In the fall of 2011, our first-year program partnered with the university's Center on Leadership to offer students more opportunities for teamwork reflection, peer-and self-assessment and teamwork improvement throughout the two courses that comprise the program. Students used a combination of online exercises and team meetings to create a team charter, reflect on personal and team performance, provide specific feedback to team members, and use that feedback to create goals for improving their own teamwork performance-all by the middle of each course. At the end of each course, students used peer-assessment and reflective memos to determine whether they had been successful in achieving their mid-term goals. Since all assessment would be out of class, the additional workload for the design faculty was to be minimal. The students' activities would serve as a foundational experience that could be revisited by the students and the Center on Leadership in future courses utilizing teamwork.However, at the end of the year (spring 2012), when we surveyed similar to 425 students in the program (162 responded), we were disappointed to learn that, while some of the students found the leadership center's activities highly beneficial, an overwhelming number saw them simply as "busy work." In addition, a majority of the program's faculty, who had originally thought that the online reflective exercises would benefit the students while reducing their workload, were also frustrated by the new tools. Although we streamlined the process for the next academic year, survey results in spring 2013 were equally disappointing. Analysis of the survey responses and the online tools activities suggested that the problem was one of balance: since teamwork is a goal of the program, but not its primary goal, there were apparently too many exercises related to teamwork, ironically undermining their usefulness. In addition, by outsourcing the responsibility for administering the activities, faculty were less involved in teamwork pedagogy, unintentionally suggesting that teamwork was not integrally related to excellence in design.We did however learn a great deal about what students see as the main causes of team failure, what teamwork skills they most want to develop, and what students mean when they talk about teamwork habits, such as delegating tasks or improving communication. After first describing our several approaches to improving teamwork pedagogy, this study reports on lessons learned and modifications we have made to move forward. Briefly, we have streamlined the number of required teamwork activities, more carefully connected them to the project work, and brought more of the activities "in-house," making design faculty more responsible for the first and last activities. Our plan is to continue assessing these areas at the end of the 2013-2014 academic year.

Our long-term objective is to institutionalize and sustain contextual engineering education through product archaeology. Many engineering departments struggle to meet "the broad education necessary to understand the impact of engineering solutions in a global, economic, environmental, and societal context" (Outcome h) that is required for ABET. As a result, engineering students receive meaningful contextual experiences in piecemeal fashion and graduate with a lack of concrete competencies that bridge knowledge and practice in the global world in which they will live and work. By considering products as designed artifacts with a history rooted in their development, our product archaeology framework combines concepts from archaeology with advances in cyber-enhanced product dissection to implement pedagogical innovations that address the significant educational gap. In this paper, we focus on developing a sustainable and scalable foundation to support novel approaches aimed at educating engineering students to understand the global, economic, environmental, and societal context and impact of engineering solutions. We present our vision for this contextual development and present some initial results from the network of institutions in our NSF TUES-funded project.

Our experience working with junior and senior students in a two-quarter, interdisciplinary project-based design course taught by teams of engineering and communication faculty suggests that providing students with instruction and coaching in communication—particularly internal, team-based communication—contributes directly to students’ mastery and understanding of the design process. In the course, students receive instruction in many facets of communication: writing, presenting, interacting with experts and clients. However, one hallmark of the course is that students write and talk about design decisions beginning very early in the design process. Because the course requires our students to articulate their ideas so often and so early, the students perceive gaps in their own reasoning and design work that they must then address. When teams must communicate, critique, and then rework their own ideas, it leads to stronger, better thought-out designs.

Robert Linsenmeier, Northwestern University Robert A. Linsenmeier has a joint appointment in Biomedical Engineering in the Robert R. McCormick School of Engineering and Applied Science, and in Neurobiology and Physiology in the Weinberg College of Arts and Sciences. His primary teaching is in human and animal physiology. He is the Associate Director of the VaNTH Engineering Research Center in Bioengineering Educational Technologies, former chair of the Biomedical Engineering Department at Northwestern, and a fellow of the American Institute of Medical and Biological Engineering and the Biomedical Engineering Society. His research interests are in the role of retinal oxygen transport and metabolism in both normal physiological conditions and disease, and in bioengineering and physiology education.

ClusPro (http://nrc.bu.edu/cluster) represents the first fully automated, web-based program for the computational docking of protein structures. Users may upload the coordinate files of two protein structures through ClusPro's web interface, or enter the PDB codes of the respective structures, which ClusPro will then download from the PDB server (http://www.rcsb.org/pdb/). The docking algorithms evaluate billions of putative complexes, retaining a preset number with favorable surface complementarities. A filtering method is then applied to this set of structures, selecting those with good electrostatic and desolvation free energies for further clustering. The program output is a short list of putative complexes ranked according to their clustering properties, which is automatically sent back to the user via email.

MOTIVATION:Predicting protein interactions is one of the most challenging problems in functional genomics. Given two proteins known to interact, current docking methods evaluate billions of docked conformations by simple scoring functions, and in addition to near-native structures yield many false positives, i.e. structures with good surface complementarity but far from the native.RESULTS:We have developed a fast algorithm for filtering docked conformations with good surface complementarity, and ranking them based on their clustering properties. The free energy filters select complexes with lowest desolvation and electrostatic energies. Clustering is then used to smooth the local minima and to select the ones with the broadest energy wells-a property associated with the free energy at the binding site. The robustness of the method was tested on sets of 2000 docked conformations generated for 48 pairs of interacting proteins. In 31 of these cases, the top 10 predictions include at least one near-native complex, with an average RMSD of 5 A from the native structure. The docking and discrimination method also provides good results for a number of complexes that were used as targets in the Critical Assessment of PRedictions of Interactions experiment.AVAILABILITY:The fully automated docking and discrimination server ClusPro can be found at http://structure.bu.edu

Two structure‐based potentials are used for both filtering (i.e., selecting a subset of conformations generated by rigid‐body docking), and rescoring and ranking the selected conformations. ACP (atomic contact potential) is an atom‐level extension of the Miyazawa–Jernigan potential parameterized on protein structures, whereas RPScore (residue pair potential score) is a residue‐level potential, based on interactions in protein–protein complexes. These potentials are combined with other energy terms and applied to 13 sets of protein decoys, as well as to the results of docking 10 pairs of unbound proteins. For both potentials, the ability to discriminate between near‐native and non‐native docked structures is substantially improved by refining the structures and by adding a van der Waals energy term. It is observed that ACP and RPScore complement each other in a number of ways (e.g., although RPScore yields more hits than ACP, mainly as a result of its better performance for charged complexes, ACP usually ranks the near‐native complexes better). As a general solution to the protein‐docking problem, we have found that the best discrimination strategies combine either an RPScore filter with an ACP‐based scoring function, or an ACP‐based filter with an RPScore‐based scoring function. Thus, ACP and RPScore capture complementary structural information, and combining them in a multistage postprocessing protocol provides substantially better discrimination than the use of the same potential for both filtering and ranking the docked conformations. Proteins 2003. © 2003 Wiley‐Liss, Inc.

We present results from the prediction of protein complexes associated with the first Critical Assessment of PRediction of Interactions (CAPRI) experiment. Our algorithm, SmoothDock, comprises four steps: (1) we perform rigid body docking using the program DOT, keeping the top 20,000 structures as ranked by surface complementarity; (2) we rerank these structures according to a free energy estimate that includes both desolvation and electrostatics and retain the top 2000 complexes; (3) we cluster the filtered complexes using a pairwise root‐mean‐square deviation (RMSD) criterion; (4) the 25 largest clusters are subject to a smooth docking discrimination algorithm where van der Waals forces are taken into account. We predicted targets 1, 6, and 7 with RMSDs of 9.5, 2.4, and 2.6 Å, respectively. More importantly, from the perspective of biological applications, our approach consistently ranked the correct model first (i.e., with highest confidence). For target 5 we identified the binding region but not the correct orientation. Although we were able to find reasonable clusters for all targets, low‐affinity complexes (Kd < nM) were harder to discriminate. For four of seven targets, the top models predicted by our automated procedure were among the best communitywide predictions. Proteins 2003;52:92–97. © 2003 Wiley‐Liss, Inc.

Free energy potentials, combining molecular mechanics with empirical solvation and entropic terms, are used to discriminate native and near-native protein conformations from slightly misfolded decoys. Since the functional forms of these potentials vary within the field, it is of interest to determine the contributions of individual free energy terms and their combinations to the discriminative power of the potential. This is achieved in terms of quantitative measures of discrimination that include the correlation coefficient between RMSD and free energy, and a new measure labeled the minimum discriminatory slope (MDS). In terms of these criteria, the internal energy is shown to be a good discriminator on its own, which implies that even well-constructed decoys are substantially more strained than the native protein structure. The discrimination improves if, in addition to the internal energy, the free energy expression includes the electrostatic energy, calculated by assuming non-ionized side chains, and an empirical solvation term, with the classical atomic solvation parameter model providing slightly better discrimination than a structure-based atomic contact potential. Finally, the inclusion of a term representing the side chain entropy change, and calculated by an established empirical scale, is so inaccurate that it makes the discrimination worse. It is shown that both the correlation coefficient and the MDS value (or its dimensionless form) are needed for an objective assessment of a potential, and that together they provide much more information on the origins of discrimination than simple inspection of the RMSD-free energy plots.

Rigid-body methods, particularly Fourier correlation techniques, are very efficient for docking bound (co-crystallized) protein conformations using measures of surface complementarity as the target function. However, when docking unbound (separately crystallized) conformations, the method generally yields hundreds of false positive structures with good scores but high root mean square deviations (RMSDs). This paper describes a two-step scoring algorithm that can discriminate near-native conformations (with less than 5 Angstrom RMSD) from other structures. The first step includes two rigid-body filters that use the desolvation free energy and the electrostatic energy to select a manageable number of conformations for further processing, but are unable to eliminate all false positives. Complete discrimination is achieved in the second step that minimizes the molecular mechanics energy of the retained structures, and re-ranks them with a combined free-energy function which includes electrostatic, solvation, and van der Waals energy terms, After minimization, the improved fit in near-native complex conformations provides the free-energy gap required for discrimination, The algorithm has been developed and tested using docking decoys, i.e., docked conformations generated by Fourier correlation techniques. The decoy sets are available on the web for testing other discrimination procedures, Proteins 2000;40:525-537, (C) 2000 Wiley-Liss, Inc.