Implementing Diversity Training Targeting Faculty Microaggressions and Inclusion: Practical Insights and Initial Findings

Despite the importance of faculty diversity training for advancing an inclusive society, little research examines whether participation improves inclusion perceptions and belongingness. Integrating training and diversity education literature concepts, this study examines the effectiveness of training targeting microaggressions in six STEM (Science, Technology, Engineering, Mathematics) oriented departments at a research-intensive university. Reactions data collected at the end of face-to-face training suggested that participation generally increased inclusion understanding. Self-assessments on inclusion concepts collected from 45% of participants before and three weeks after training suggest participation increases perceptions of the importance of inclusion, microaggression allyship awareness, inclusive behaviors, and organizational identification. Compared to white men, women and minorities reported a greater increase in satisfaction with their department affiliation. While self-assessment results are exploratory and have limitations, analysis suggests that diversity training may enhance knowledge of microaggressions, allyship, inclusive behaviors, and belongingness perceptions. We provide insights for evaluating and implementing diversity training interventions.

Promoting Equity, Diversity and Social Justice Through Faculty-Led Transformative Projects

We present a transformative professional development project with a focus on equity, diversity and social justice (EDSJ) to raise cultural awareness among faculty, increase agency, and promote positive change through transformative projects. Twenty-three faculty members from nine different colleges located at a Research I university were provided with critical cultural awareness workshops and then supported to develop transformative projects related to EDSJ. Based on focus group interviews and pre-post surveys, we identified four themes and five categories: two outcome-related (Building Community and Transformative Actions) and two operational themes (Barriers and Facilitators). We conclude that faculty-centered and transformative professional development projects could significantly benefit all those interested in establishing a culturally inclusive, positive and responsive climate. Our study also contributes to the emerging research on scholar activism and provides a practical model for implementation.

Prediction of equibiaxial loading stress in collagen-based extracellular matrix using a three-dimensional unit cell model

Mechanical signals are important factors in determining cell fate. Therefore, insights as to how mechanical signals are transferred between the cell and its surrounding three-dimensional collagen fibril network will provide a basis for designing the optimum extracellular matrix (ECM) microenvironment for tissue regeneration. Previously we described a cellular solid model to predict fibril microstructure-mechanical relationships of reconstituted collagen matrices due to unidirectional loads (Acta Biomater 2010;6:1471-86). The model consisted of representative volume elements made up of an interconnected network of flexible struts. The present study extends this work by adapting the model to account for microstructural anisotropy of the collagen fibrils and a biaxial loading environment. The model was calibrated based on uniaxial tensile data and used to predict the equibiaxial tensile stress-stretch relationship. Modifications to the model significantly improved its predictive capacity for equibiaxial loading data. With a comparable fibril length (model 5.9-8μm, measured 7.5μm) and appropriate fibril anisotropy the anisotropic model provides a better representation of the collagen fibril microstructure. Such models are important tools for tissue engineering because they facilitate prediction of microstructure-mechanical relationships for collagen matrices over a wide range of microstructures and provide a framework for predicting cell-ECM interactions.

Development of a three-dimensional unit cell to model the micromechanical response of a collagen-based extracellular matrix

The three-dimensional microstructure and mechanical properties of the collagen fibrils within the extracellular matrix (ECM) is now being recognized as a primary factor in regulating cell proliferation and differentiation. Therefore, an appreciation of the mechanical aspects by which a cell interacts with its ECM is required for the development of engineered tissues. Ultimately, using these interactions to design tissue equivalents requires mathematical models with three-dimensional architecture. In this study, a three-dimensional model of a collagen fibril matrix undergoing uniaxial tensile stress was developed by making use of cellular solids. A structure consisting of thin struts was chosen to represent the arrangement of collagen fibrils within an engineered ECM. To account for the large deformation of tissues, the collagen fibrils were modeled as hyperelastic neo-Hookean or Mooney-Rivlin materials. The use of cellular solids allowed the fibril properties to be related to the ECM properties in closed form, which, in turn, allowed the estimation of fibril properties using ECM experimental data. A set of previously obtained experimental data consisting of simultaneous measures of the fibril microstructure and mechanical tests was used to evaluate the model's capability to estimate collagen fibril mechanical property when given tissue-scale data and to predict the tissue-scale mechanical properties when given estimated fibril stiffness. The fibril tangent modulus was found to be 1.26 + or - 0.70 and 1.62 + or - 0.88 MPa when the fibril was modeled as neo-Hookean and Mooney-Rivlin material, respectively. There was no statistical significance of the estimated fibril tangent modulus among the different groups. Sensitivity analysis showed that the fibril mechanical properties and volume fraction were the two input parameters which required accurate values. While the volume fraction was easily obtained from the initial image of the gel, the fibril mechanical properties were not readily available. Therefore the fibril mechanical properties were estimated in the leave-one-out cross-validation (LOOCV) analysis. The LOOCV analysis showed that the model was able to predict the ECM stress-stretch curve with an average mean squared error of 9.71 kPa(2). The three-dimensional architecture expands on previous continuum models and two-dimensional representations to provide a useful model for studying the hierarchical effects of ECM microstructure on cell function. This model can be used as a design tool to engineer the optimum microstructure for cells to function.

Fibril microstructure affects strain transmission within collagen extracellular matrices

The next generation of medical devices and engineered tissues will require development of scaffolds that mimic the structural and functional properties of the extracellular matrix (ECM) component of tissues. Unfortunately, little is known regarding how ECM microstructure participates in the transmission of mechanical load information from a global (tissue or construct) level to a level local to the resident cells ultimately initiating relevant mechanotransduction pathways. In this study, the transmission of mechanical strains at various functional levels was determined for three-dimensional (3D) collagen ECMs that differed in fibril microstructure. Microstructural properties of collagen ECMs (e.g., fibril density, fibril length, and fibril diameter) were systematically varied by altering in vitro polymerization conditions. Multiscale images of the 3D ECM macro- and microstructure were acquired during uniaxial tensile loading. These images provided the basis for quantification and correlation of strains at global and local levels. Results showed that collagen fibril microstructure was a critical determinant of the 3D global and local strain behaviors. Specifically, an increase in collagen fibril density reduced transverse strains in both width and thickness directions at both global and local levels. Similarly, collagen ECMs characterized by increased fibril length and decreased fibril diameter exhibited increased strain in width and thickness directions in response to loading. While extensional strains measured globally were equivalent to applied strains, extensional strains measured locally consistently underpredicted applied strain levels. These studies demonstrate that regulation of collagen fibril microstructure provides a means to control the 3D strain response and strain transfer properties of collagen-based ECMs.

Local, Three-Dimensional Strain Measurements Within Largely Deformed Extracellular Matrix Constructs

The ability to create extracellular matrix (ECM) constructs that are mechanically and biochemically similar to those found in vivo and to understand how their properties affect cellular responses will drive the next generation of tissue engineering strategies. To date, many mechanisms by which cells biochemically communicate with the ECM are known. However, the mechanisms by which mechanical information is transmitted between cells and their ECM remain to be elucidated. “Self-assembled” collagen matrices provide an in vitro-model system to study the mechanical behavior of ECM. To begin to understand how the ECM and the cells interact mechanically, the three-dimensional (3D) mechanical properties of the ECM must be quantified at the micro-(local) level in addition to information measured at the macro-(global) level. Here we describe an incremental digital volume correlation (IDVC) algorithm to quantify large (>0.05) 3D mechanical strains in the microstructure of 3D collagen matrices in response to applied mechanical loads. Strain measurements from the IDVC algorithm rely on 3D confocal images acquired from collagen matrices under applied mechanical loads. The accuracy and the precision of the IDVC algorithm was verified by comparing both image volumes collected in succession when no deformation was applied to the ECM (zero strain) and image volumes to which simulated deformations were applied in both 1D and 3D (simulated strains). Results indicate that the IDVC algorithm can accurately and precisely determine the 3D strain state inside largely deformed collagen ECMs. Finally, the usefulness of the algorithm was demonstrated by measuring the microlevel 3D strain response of a collagen ECM loaded in tension.

Extracellular matrix (ECM) microstructural composition regulates local cell-ECM biomechanics and fundamental fibroblast behavior: a multidimensional perspective

The extracellular matrix (ECM) provides the principal means by which mechanical information is communicated between tissue and cellular levels of function. These mechanical signals play a central role in controlling cell fate and establishing tissue structure and function. However, little is known regarding the mechanisms by which specific structural and mechanical properties of the ECM influence its interaction with cells, especially within a tissuelike context. This lack of knowledge precludes formulation of biomimetic microenvironments for effective tissue repair and replacement. The present study determined the role of collagen fibril density in regulating local cell-ECM biomechanics and fundamental fibroblast behavior. The model system consisted of fibroblasts seeded within collagen ECMs with controlled microstructure. Confocal microscopy was used to collect multidimensional images of both ECM microstructure and specific cellular characteristics. From these images temporal changes in three-dimensional cell morphology, time- and space-dependent changes in the three-dimensional local strain state of a cell and its ECM, and spatial distribution of beta1-integrin were quantified. Results showed that fibroblasts grown within high-fibril-density ECMs had decreased length-to-height ratios, increased surface areas, and a greater number of projections. Furthermore, fibroblasts within low-fibril-density ECMs reorganized their ECM to a greater extent, and it appeared that beta1-integrin localization was related to local strain and ECM remodeling events. Finally, fibroblast proliferation was enhanced in low-fibril-density ECMs. Collectively, these results are significant because they provide new insight into how specific physical properties of a cell's ECM microenvironment contribute to tissue remodeling events in vivo and to the design and engineering of functional tissue replacements.

A comparison of suture retention strengths for three biomaterials

BACKGROUND

The suture holding capacity, suture retention strength, and burst strength of three biomaterials (Marlex), SIS, and PeriGuard) were evaluated to compare their performance characteristics in an ex vivo setting representing the immediate postoperative period.

MATERIAL/METHODS

A circular defect was created in the fascial tissue of the abdominal aponeurosis collected from normal dogs. Defects were repaired with either Marlex (polypropylene mesh), Periguard (bovine pericardium) or small intestinal submucosa (SIS) using 2-0 prolene and a 1.0-cm suture bite. The force required to induce failure at the repair site was recorded as the suture-holding capacity. Suture retention strength was calculated as the load distribution over the specimen cross-section in contact with the suture at the time of rupture. Burst strength of the raw materials was also measured.

RESULTS

The suture-holding capacity was 370.9+/-56.2 N for Marlex; 214.3+/-36.1 N for Periguard, and 287.9+/-34.3 N for SIS. The suture retention strengths were: Marlex, 413.4+/-59.7 N/mm2; Periguard, 97.0+/-20.1 N/mm2; and SIS, 106.9+/-12.7 N/mm2. The burst strength of Marlex, Periguard and SIS were 476.7+/-50.8 N, 432.12+/-82.1 N, and 433.6+/-79.5 N respectively.

CONCLUSIONS

All three materials provide adequate strength and suture-holding capacities to be of use in the repair of soft tissue defects.

Simultaneous mechanical loading and confocal reflection microscopy for three-dimensional microbiomechanical analysis of biomaterials and tissue constructs

At present, mechanisms by which specific structural and mechanical properties of the three-dimensional extracellular matrix microenvironment influence cell behavior are not known. Lack of such knowledge precludes formulation of engineered scaffolds or tissue constructs that would deliver specific growth-inductive signals required for improved tissue restoration. This article describes a new mechanical loading-imaging technique that allows investigations of structural-mechanical properties of biomaterials as well as the structural-mechanical basis of cell-scaffold interactions at a microscopic level and in three dimensions. The technique is based upon the integration of a modified, miniature mechanical loading instrument with a confocal microscope. Confocal microscopy is conducted in a reflection and/or fluorescence mode for selective visualization of load-induced changes to the scaffold and any resident cells, while maintaining each specimen in a "live," fully hydrated state. This innovative technique offers several advantages over current biomechanics methodologies, including simultaneous visualization of scaffold and/or cell microstructure in three dimensions during mechanical loading; quantification of macroscopic mechanical parameters including true stress and strain; and the ability to perform multiple analyses on the same specimen. This technique was used to determine the structural-mechanical properties of three very different biological materials: a reconstituted collagen matrix, a tissue-derived biomaterial, and a tissue construct representing cells and matrix.

Morphologic study of small intestinal submucosa as a body wall repair device

BACKGROUND

The extracellular matrix (ECM) derived from porcine small intestinal submucosa (SIS) has been used as a constructive scaffold for tissue repair in both preclinical animal studies and human clinical trials. Quantitative characterization of the host tissue response to this xenogeneic scaffold material has been lacking.

MATERIALS AND METHODS

The morphologic response to a multilaminate form of the SIS-ECM was evaluated in a chronic, 2-year study of body wall repair in two separate species: the dog and the rat. Morphologic response to the SIS-ECM was compared to that for three other commonly used bioscaffold materials including Marlex mesh, Dexon, and Perigard. Quantitative measurements were made of tissue consistency, polymorphonuclear cell response, mononuclear cell response, tissue organization, and vascularity at five time points after surgical implantation: 1 week, 1, 3, and 6 months, and 2 years.

RESULTS

All bioscaffold materials functioned well as a repair device for large ventral abdominal wall defects created in these two animal models. The SIS-ECM bioscaffold showed a greater number of polymorphonuclear leukocytes at the 1-week time point and a greater degree of graft site tissue organization after 3 months compared to the other three scaffold materials. There was no evidence for local infection or other detrimental local pathology to any of the graft materials at any time point.

CONCLUSIONS

Like Marlex, Dexon, and Perigard, the SIS-ECM is an effective bioscaffold for long-term repair of body wall defects. Unlike the other scaffold materials, the resorbable SIS-ECM scaffold was replaced by well-organized host tissues including differentiated skeletal muscle.

Tensile mechanical properties of three-dimensional type I collagen extracellular matrices with varied microstructure

The importance and priority of specific micro-structural and mechanical design parameters must be established to effectively engineer scaffolds (biomaterials) that mimic the extracellular matrix (ECM) environment of cells and have clinical applications as tissue substitutes. In this study, three-dimensional (3-D) matrices were prepared from type I collagen, the predominant compositional and structural component of connective tissue ECMs, and structural-mechanical relationships were studied. Polymerization conditions, including collagen concentration (0.3-3 mg/mL) and pH (6-9), were varied to obtain matrices of collagen fibrils with different microstructures. Confocal reflection microscopy was used to assess specific micro-structural features (e.g., diameter and length) and organization of component fibrils in 3-D. Microstructural analyses revealed that changes in collagen concentration affected fibril density while maintaining a relatively constant fibril diameter. On the other hand, both fibril length and diameter were affected by the pH of the polymerization reaction. Mechanically, all matrices exhibited a similar stress-strain curve with identifiable "toe," "linear," and "failure" regions. However the linear modulus and failure stress increased with collagen concentration and were correlated with an increase in fibril density. Additionally, both the linear modulus and failure stress showed an increase with pH, which was related to an increasedfibril length and a decreasedfibril diameter. The tensile mechanical properties of the collagen matrices also showed strain rate dependence. Such fundamental information regarding the 3-D microstructural-mechanical properties of the ECM and its component molecules are important to our overall understanding of cell-ECM interactions (e.g., mechanotransduction) and the development of novel strategies for tissue repair and replacement.

Strength over time of a resorbable bioscaffold for body wall repair in a dog model

The change in strength over time of a biomaterial derived from the small intestinal submucosa (SIS) was determined in a dog model of body wall repair. Full-thickness body wall defects measuring 8 x 12 cm were surgically created and then repaired with a multilaminate eight-layer form of SIS in 40 dogs. Five dogs were sacrificed at each of the following time points: 1 day, 4 days, 7 days, 10 days, and 1, 3, 6, and 24 months. Ball burst tests that measured biaxial ultimate load-bearing capability were performed on the device prior to implantation and on the device/implant site at the time of sacrifice. The strength of the device at the time of implant was approximately 73 +/- 12 pounds. The strength of the implant site diminished to 40 +/- 18 pounds at 10 days, and then progressively increased to a value of 156 +/- 26 pounds at 24 months (P < 0.05). The clinical utility of a degradable biomaterial such as SIS depends on a balance between the rate of degradation and the rate of host remodeling. Naturally occurring extracellular matrix scaffolds such as SIS show rapid degradation with associated and subsequent remodeling to a tissue with strength that exceeds that of the native tissue when used as a body wall repair device.

Multilaminate resorbable biomedical device under biaxial loading

The design and test of a multilaminate sheet developed for a hernia repair application is presented. As biomaterial applications become more complex, characterization of uniaxial properties becomes insufficient and biaxial testing becomes necessary. A measure of the in-plane biaxial strength of the device is inferred from a ball burst test. The results of this test for different thicknesses of the device are correlated with the uniaxial strength of the material. A biaxial test such as the ball burst test is more indicative of the properties of a planar material than would be a uniaxial test. The interactions in the biaxial mode of failure are of value and can be related back to a classical uniaxial tensile test from the ball burst test. The material used in this study to fabricate the device was a resorbable biomaterial called small intestinal submucosa (SIS). The effects of rehydration on the stiffness and associated ball burst properties of the SIS device were also measured. It is shown that at a rehydration time of 5 min from a reference dry state, steady-state mechanical properties are reached.

The use of xenogeneic small intestinal submucosa as a biomaterial for Achilles tendon repair in a dog model

A study was conducted to evaluate the tissue response to a xenogeneic biomaterial when this material was used to repair an experimentally induced Achilles tendon defect in the dog. Twenty dogs had a 1.5 cm segmental defect of the Achilles tendon created surgically which was then repaired with acellular connective tissue derived from porcine small intestinal submucosa (SIS). The animals were sacrificed at 1, 2, 4, 8, 12, 16, 24, and 48 weeks and the neotendons examined for uniaxial longitudinal tensile strength, morphologic appearance, hydroxyproline (collagen) content, and disappearance of the originally implanted SIS material over time. The contralateral normal Achilles tendons served as controls as did four additional dogs that had a 1.5 cm segmental Achilles tendon defect created surgically without subsequent surgical repair with SIS. Results showed the SIS remodeled neotendons to be stronger than the musculotendinous origin or the boney insertion (> 1000 N) by 12 weeks after surgery and to consist of organized collagen-rich connective tissue similar to the contralateral normal tendons. The four dogs in which no SIS was implanted showed inferior strength at the comparable time points of 4, 8, 12, and 16 weeks. Immunohistochemical studies suggest that the SIS biomaterial becomes degraded within the first eight weeks and serves as a temporary scaffold around which the body deposits appropriate and organized connective tissue. SIS is a promising biomaterial worthy of further investigation for orthopedic soft tissue applications.

Mechanical properties of xenogeneic small-intestinal submucosa when used as an aortic graft in the dog

Small-intestinal submucosa (SIS) has been shown to induce tissue remodelling in vivo when used as a vascular graft. The present study investigated in physical and mechanical properties of remodeled aortic grafts derived from xenogeneic SIS material. Eight infrarenal aortic grafts were implanted in mongrel dogs. The grafts were explanted at 1 or 2 months and tested for compliance and hoop mechanical properties. The morphologic changes within the grafts were also characterized. The remodeling process produced graft structures which were significantly stronger than both the normal artery (P = .012) and the original SIS graft (P = .0001), and the compliance of these structures was one third that of normal artery and similar to the original SIS grafts. The remodeled grafts were > 10 times the thickness of the implanted SIS. Immunohistochemical analysis of remodeled tissues suggest that the SIS material was degraded and resorbed over time. The remodeling process transformed a material which was physically and mechanically quite different from normal aorta into a blood conduit which had the physical and mechanical properties needed to function in this mammalian arterial system.

Elastic modulus of prepared canine jejunum, a new vascular graft material

The submucosal connective tissue of the jejunum has been shown to be suitable for use as a vascular graft in preliminary dog studies. To partially characterize the mechanical properties of this new graft material, longitudinal stress (sigma)-strain (epsilon)-data were obtained on 13 specimens of canine jejunum, stripped of its mucosal and external smooth-muscle layers. The ratio of stress to strain is the modulus of elasticity (E). It was found that the stress sigma-strain epsilon-data fitted the expression sigma = K epsilon alpha very well. For a typical specimen sigma = 2.69 x 10(6) epsilon 2.33. The modulus of elasticity (E = sigma 1-1/alpha K1/alpha) was found to increase with increasing stress, ranging from about 2,000 to 9,000 mmHg. For the average specimen E = 573 sigma 0.57, where sigma is in mmHg, (1 mmHg = 133.3 Pascals).

Directional porosity of porcine small-intestinal submucosa

Small-intestinal submucosa (SIS) has been shown to be a promising biomaterial for vascular graft applications. This study examines the directionality property of SIS porosity using 35 SIS specimens from 13 pigs. In addition, the effects of the weight of the donor pig, pre-conditioning of 13 additional SIS specimens, and the duration of the test of five additional SIS specimens on such porosity are reported. The porosity from serosal to mucosal direction was found to be four times greater than the porosity in the opposite direction. The weight of the donor pig was not found to be an important factor in SIS porosity. Preconditioning served to increase the average serosal porosity index at 120 mm Hg static water pressure from 2.99 to 8.33 mL/(min cm2). The porosity in the mucosal direction was not affected by preconditioning. Porosity in both directions decreased with increasing test duration. The directionality property of SIS porosity may be an important factor in its success as a vascular graft. The term 'porosity' is used throughout this article, but current standards also refer to the term 'permeability' to describe the passage of liquid through a vascular graft.

Small intestinal submucosa as a vascular graft: a review

Continuing investigations of vascular graft materials suggest that unacceptable graft complications continue and that the ideal graft material has not yet been found. We have developed and tested a biologic vascular graft material, small intestine submucosa (SIS), in normal dogs. This material, when used as an autograft, allograft, or xenograft has demonstrated biocompatibility and high patency rates in aorta, carotid and femoral arteries, and superior vena cava locations. The grafts are completely endothelialized at 28 days post-implantation. At 90 days, the grafts are histologically similar to normal arteries and veins and contain a smooth muscle media and a dense fibrous connective tissue adventitia. Follow-up periods of up to 5 years found no evidence of infection, intimal hyperplasia, or aneurysmal dilation. One infection-challenge study suggested that SIS may be infection resistant, possibly because of early capillary penetration of the SIS (2 to 4 days after implantation) and delivery of body defenses to the local site. We conclude that SIS is a suitable blood interface material and is worthy of continued investigation. It may serve as a structural framework for the application of tissue engineering technologies in the development of the elusive ideal vascular graft material.

Porosity of porcine small-intestinal submucosa for use as a vascular graft

The porosity of a vascular graft material has been suggested as a major factor affecting the rate and degree of neovascularization of newly implanted grafts, with higher porosities generally associated with better performance. The objective of this study was to determine the water porosity of a new vascular graft material, small-intestinal submucosa (SIS), and to compare the values to those reported for other common vascular graft materials. In addition, the porosity of SIS was investigated with respect to applied pressure and applied uniaxial tension. Both rectangular, flat specimens and tubular specimens of SIS were subjected to static water pressure, and water was collected as it passed through the SIS material. SIS has a typical porosity of 0.52 mL/min.cm-2 at an applied pressure of 120 mm Hg. Although porosity appeared to be unaffected by uniaxial tension, it increased in proportion to applied pressure at a rate of 4.8 x 10(-3) mL/min.cm-2/mm Hg. These low porosity values and the past success of SIS as a vascular graft material suggest that high-porosity materials are not required for implant success.