@article{ZieglerPfitznerSchulzetal.2022, author = {Ziegler, Joceline and Pfitzner, Bjarne and Schulz, Heinrich and Saalbach, Axel and Arnrich, Bert}, title = {Defending against Reconstruction Attacks through Differentially Private Federated Learning for Classification of Heterogeneous Chest X-ray Data}, series = {Sensors}, volume = {22}, journal = {Sensors}, edition = {14}, publisher = {MDPI}, address = {Basel, Schweiz}, issn = {1424-8220}, doi = {10.3390/s22145195}, pages = {25}, year = {2022}, abstract = {Privacy regulations and the physical distribution of heterogeneous data are often primary concerns for the development of deep learning models in a medical context. This paper evaluates the feasibility of differentially private federated learning for chest X-ray classification as a defense against data privacy attacks. To the best of our knowledge, we are the first to directly compare the impact of differentially private training on two different neural network architectures, DenseNet121 and ResNet50. Extending the federated learning environments previously analyzed in terms of privacy, we simulated a heterogeneous and imbalanced federated setting by distributing images from the public CheXpert and Mendeley chest X-ray datasets unevenly among 36 clients. Both non-private baseline models achieved an area under the receiver operating characteristic curve (AUC) of 0.940.94 on the binary classification task of detecting the presence of a medical finding. We demonstrate that both model architectures are vulnerable to privacy violation by applying image reconstruction attacks to local model updates from individual clients. The attack was particularly successful during later training stages. To mitigate the risk of a privacy breach, we integrated R{\´e}nyi differential privacy with a Gaussian noise mechanism into local model training. We evaluate model performance and attack vulnerability for privacy budgets ε∈{1,3,6,10}�∈{1,3,6,10}. The DenseNet121 achieved the best utility-privacy trade-off with an AUC of 0.940.94 for ε=6�=6. Model performance deteriorated slightly for individual clients compared to the non-private baseline. The ResNet50 only reached an AUC of 0.760.76 in the same privacy setting. Its performance was inferior to that of the DenseNet121 for all considered privacy constraints, suggesting that the DenseNet121 architecture is more robust to differentially private training.}, language = {en} } @article{QuarmbyMoennigMugeleetal.2023, author = {Quarmby, Andrew James and M{\"o}nnig, Jamal and Mugele, Hendrik and Henschke, Jakob and Kim, MyoungHwee and Cassel, Michael and Engel, Tilman}, title = {Biomechanics and lower limb function are altered in athletes and runners with achilles tendinopathy compared with healthy controls: A systematic review}, series = {Frontiers in Sports and Active Living}, journal = {Frontiers in Sports and Active Living}, publisher = {Frontiers}, address = {Lausanne, Schweiz}, issn = {2624-9367}, doi = {10.3389/fspor.2022.1012471}, pages = {20}, year = {2023}, abstract = {Achilles tendinopathy (AT) is a debilitating injury in athletes, especially for those engaged in repetitive stretch-shortening cycle activities. Clinical risk factors are numerous, but it has been suggested that altered biomechanics might be associated with AT. No systematic review has been conducted investigating these biomechanical alterations in specifically athletic populations. Therefore, the aim of this systematic review was to compare the lower-limb biomechanics of athletes with AT to athletically matched asymptomatic controls. Databases were searched for relevant studies investigating biomechanics during gait activities and other motor tasks such as hopping, isolated strength tasks, and reflex responses. Inclusion criteria for studies were an AT diagnosis in at least one group, cross-sectional or prospective data, at least one outcome comparing biomechanical data between an AT and healthy group, and athletic populations. Studies were excluded if patients had Achilles tendon rupture/surgery, participants reported injuries other than AT, and when only within-subject data was available.. Effect sizes (Cohen's d) with 95\% confidence intervals were calculated for relevant outcomes. The initial search yielded 4,442 studies. After screening, twenty studies (775 total participants) were synthesised, reporting on a wide range of biomechanical outcomes. Females were under-represented and patients in the AT group were three years older on average. Biomechanical alterations were identified in some studies during running, hopping, jumping, strength tasks and reflex activity. Equally, several biomechanical variables studied were not associated with AT in included studies, indicating a conflicting picture. Kinematics in AT patients appeared to be altered in the lower limb, potentially indicating a pattern of "medial collapse". Muscular activity of the calf and hips was different between groups, whereby AT patients exhibited greater calf electromyographic amplitudes despite lower plantar flexor strength. Overall, dynamic maximal strength of the plantar flexors, and isometric strength of the hips might be reduced in the AT group. This systematic review reports on several biomechanical alterations in athletes with AT. With further research, these factors could potentially form treatment targets for clinicians, although clinical approaches should take other contributing health factors into account. The studies included were of low quality, and currently no solid conclusions can be drawn.}, language = {en} } @article{KhalilKohlerTjaden2022, author = {Khalil, Samir and Kohler, Ulrich and Tjaden, Jasper Dag}, title = {Is There a Rural Penalty in Language Acquisition? Evidence From Germany's Refugee Allocation Policy}, series = {Frontiers in Sociology}, volume = {7}, journal = {Frontiers in Sociology}, publisher = {Frontiers}, address = {Lausanne, Schweiz}, issn = {2297-7775}, doi = {10.3389/fsoc.2022.841775}, pages = {1 -- 11}, year = {2022}, abstract = {Emerging evidence has highlighted the important role of local contexts for integration trajectories of asylum seekers and refugees. Germany's policy of randomly allocating asylum seekers across Germany may advantage some and disadvantage others in terms of opportunities for equal participation in society. This study explores the question whether asylum seekers that have been allocated to rural areas experience disadvantages in terms of language acquisition compared to those allocated to urban areas. We derive testable assumptions using a Directed Acyclic Graph (DAG) which are then tested using large-N survey data (IAB-BAMF-SOEP refugee survey). We find that living in a rural area has no negative total effect on language skills. Further the findings suggest that the "null effect" is the result of two processes which offset each other: while asylum seekers in rural areas have slightly lower access for formal, federally organized language courses, they have more regular exposure to German speakers.}, language = {en} } @article{WippertNiedererDriessleinetal.2020, author = {Wippert, Pia-Maria and Niederer, Daniel and Drießlein, David and Beck, Heidrun and Banzer, Winfried Eberhard and Schneider, Christian and Schiltenwolf, Marcus and Mayer, Frank}, title = {Psychosocial Moderators and Mediators of Sensorimotor Exercise in Low Back Pain: A Randomized Multicenter Controlled Trial}, series = {Frontiers in Psychiatry}, volume = {12}, journal = {Frontiers in Psychiatry}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-0640}, doi = {10.3389/fpsyt.2021.629474}, pages = {1 -- 16}, year = {2020}, abstract = {The effects of exercise interventions on unspecific chronic low back pain (CLBP) have been investigated in many studies, but the results are inconclusive regarding exercise types, efficiency, and sustainability. This may be because the influence of psychosocial factors on exercise induced adaptation regarding CLBP is neglected. Therefore, this study assessed psychosocial characteristics, which moderate and mediate the effects of sensorimotor exercise on LBP. A single-blind 3-arm multicenter randomized controlled trial was conducted for 12-weeks. Three exercise groups, sensorimotor exercise (SMT), sensorimotor and behavioral training (SMT-BT), and regular routines (CG) were randomly assigned to 662 volunteers. Primary outcomes (pain intensity and disability) and psychosocial characteristics were assessed at baseline (M1) and follow-up (3/6/12/24 weeks, M2-M5). Multiple regression models were used to analyze whether psychosocial characteristics are moderators of the relationship between exercise and pain, meaning that psychosocial factors and exercise interact. Causal mediation analysis were conducted to analyze, whether psychosocial characteristics mediate the exercise effect on pain. A total of 453 participants with intermittent pain (mean age = 39.5 ± 12.2 years, f = 62\%) completed the training. It was shown, that depressive symptomatology (at M4, M5), vital exhaustion (at M4), and perceived social support (at M5) are significant moderators of the relationship between exercise and the reduction of pain intensity. Further depressive mood (at M4), social-satisfaction (at M4), and anxiety (at M5 SMT) significantly moderate the exercise effect on pain disability. The amount of moderation was of clinical relevance. In contrast, there were no psychosocial variables which mediated exercise effects on pain. In conclusion it was shown, that psychosocial variables can be moderators in the relationship between sensorimotor exercise induced adaptation on CLBP which may explain conflicting results in the past regarding the merit of exercise interventions in CLBP. Results suggest further an early identification of psychosocial risk factors by diagnostic tools, which may essential support the planning of personalized exercise therapy. Level of Evidence: Level I. Clinical Trial Registration: DRKS00004977, LOE: I, MiSpEx: grant-number: 080102A/11-14. https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML\&TRIAL_ID=DRKS00004977.}, language = {en} } @article{WochatzSchraplauEngeletal.2022, author = {Wochatz, Monique and Schraplau, Anne and Engel, Tilman and Zecher, Mahli Megan and Sharon, Hadar and Alt, Yasmin and Mayer, Frank and Kalron, Alon}, title = {Application of eccentric training in various clinical populations}, series = {PLoS ONE}, volume = {17}, journal = {PLoS ONE}, number = {12}, publisher = {Public Library of Science}, address = {San Francisco, California, USA}, issn = {1932-6203}, doi = {10.1371/journal.pone.0270875}, pages = {15}, year = {2022}, abstract = {Physical activity and exercise are effective approaches in prevention and therapy of multiple diseases. Although the specific characteristics of lengthening contractions have the potential to be beneficial in many clinical conditions, eccentric training is not commonly used in clinical populations with metabolic, orthopaedic, or neurologic conditions. The purpose of this pilot study is to investigate the feasibility, functional benefits, and systemic responses of an eccentric exercise program focused on the trunk and lower extremities in people with low back pain (LBP) and multiple sclerosis (MS). A six-week eccentric training program with three weekly sessions is performed by people with LBP and MS. The program consists of ten exercises addressing strength of the trunk and lower extremities. The study follows a four-group design (N = 12 per group) in two study centers (Israel and Germany): three groups perform the eccentric training program: A) control group (healthy, asymptomatic); B) people with LBP; C) people with MS; group D (people with MS) receives standard care physiotherapy. Baseline measurements are conducted before first training, post-measurement takes place after the last session both comprise blood sampling, self-reported questionnaires, mobility, balance, and strength testing. The feasibility of the eccentric training program will be evaluated using quantitative and qualitative measures related to the study process, compliance and adherence, safety, and overall program assessment. For preliminary assessment of potential intervention effects, surrogate parameters related to mobility, postural control, muscle strength and systemic effects are assessed. The presented study will add knowledge regarding safety, feasibility, and initial effects of eccentric training in people with orthopaedic and neurological conditions. The simple exercises, that are easily modifiable in complexity and intensity, are likely beneficial to other populations. Thus, multiple applications and implementation pathways for the herein presented training program are conceivable.}, language = {en} } @article{StieglerLinsDammhahnetal.2022, author = {Stiegler, Jonas and Lins, Alisa and Dammhahn, Melanie and Kramer-Schadt, Stephanie and Ortmann, Sylvia and Blaum, Niels}, title = {Personality drives activity and space use in a mammalian herbivore}, series = {Movement Ecology}, volume = {10}, journal = {Movement Ecology}, publisher = {BioMed Central (BMC), Springer Nature}, address = {London}, issn = {2051-3933}, doi = {10.1186/s40462-022-00333-6}, pages = {12}, year = {2022}, abstract = {Background Animal personality has emerged as a key concept in behavioral ecology. While many studies have demonstrated the influence of personality traits on behavioral patterns, its quantification, especially in wild animal populations, remains a challenge. Only a few studies have established a link between personality and recurring movements within home ranges, although these small-scale movements are of key importance for identifying ecological interactions and forming individual niches. In this regard, differences in space use among individuals might reflect different exploration styles between behavioral types along the shy-bold continuum. Methods We assessed among-individual differences in behavior in the European hare (Lepus europaeus), a characteristic mammalian herbivore in agricultural landscapes using a standardized box emergence test for captive and wild hares. We determined an individuals' degree of boldness by measuring the latencies of behavioral responses in repeated emergence tests in captivity. During capture events of wild hares, we conducted a single emergence test and recorded behavioral responses proven to be stable over time in captive hares. Applying repeated novel environment tests in a near-natural enclosure, we further quantified aspects of exploration and activity in captive hares. Finally, we investigated whether and how this among-individual behavioral variation is related to general activity and space use in a wild hare population. Wild and captive hares were treated similarly and GPS-collared with internal accelerometers prior to release to the wild or the outdoor enclosure, respectively. General activity was quantified as overall dynamic body acceleration (ODBA) obtained from accelerometers. Finally, we tested whether boldness explained variation in (i) ODBA in both settings and (ii) variation in home ranges and core areas across different time scales of GPS-collared hares in a wild population. Results We found three behavioral responses to be consistent over time in captive hares. ODBA was positively related to boldness (i.e., short latencies to make first contact with the new environment) in both captive and wild hares. Space use in wild hares also varied with boldness, with shy individuals having smaller core areas and larger home ranges than bold conspecifics (yet in some of the parameter space, this association was just marginally significant). Conclusions Against our prediction, shy individuals occupied relatively large home ranges but with small core areas. We suggest that this space use pattern is due to them avoiding risky, and energy-demanding competition for valuable resources. Carefully validated, activity measurements (ODBA) from accelerometers provide a valuable tool to quantify aspects of animal personality along the shy-bold continuum remotely. Without directly observing—and possibly disturbing—focal individuals, this approach allows measuring variability in animal personality, especially in species that are difficult to assess with experiments. Considering that accelerometers are often already built into GPS units, we recommend activating them at least during the initial days of tracking to estimate individual variation in general activity and, if possible, match them with a simple novelty experiment. Furthermore, information on individual behavioral types will help to facilitate mechanistic understanding of processes that drive spatial and ecological dynamics in heterogeneous landscapes.}, language = {en} } @article{RischStollSchomoelleretal.2020, author = {Risch, Lucie and Stoll, Josefine and Schom{\"o}ller, Anne and Engel, Tilman and Mayer, Frank and Cassel, Michael}, title = {Intraindividual Doppler Flow Response to Exercise Differs Between Symptomatic and Asymptomatic Achilles Tendons}, series = {Frontiers in physiology}, volume = {12}, journal = {Frontiers in physiology}, publisher = {Frontiers Research Foundation}, address = {Lausanne, Schweiz}, issn = {1664-042X}, doi = {10.3389/fphys.2021.617497}, pages = {1 -- 8}, year = {2020}, abstract = {Objective: This study investigated intraindividual differences of intratendinous blood flow (IBF) in response to running exercise in participants with Achilles tendinopathy. Design: This is a cross-sectional study. Setting: The study was conducted at the University Outpatient Clinic. Participants: Sonographic detectable intratendinous blood flow was examined in symptomatic and contralateral asymptomatic Achilles tendons of 19 participants (42 ± 13 years, 178 ± 10 cm, 76 ± 12 kg, VISA-A 75 ± 16) with clinically diagnosed unilateral Achilles tendinopathy and sonographic evident tendinosis. Intervention: IBF was assessed using Doppler ultrasound "Advanced Dynamic Flow" before (Upre) and 5, 30, 60, and 120 min (U5-U120) after a standardized submaximal constant load run. Main Outcome Measure: IBF was quantified by counting the number (n) of vessels in each tendon. Results: At Upre, IBF was higher in symptomatic compared with asymptomatic tendons [mean 6.3 (95\% CI: 2.8-9.9) and 1.7 (0.4-2.9), p < 0.01]. Overall, 63\% of symptomatic and 47\% of asymptomatic Achilles tendons responded to exercise, whereas 16 and 11\% showed persisting IBF and 21 and 42\% remained avascular throughout the investigation. At U5, IBF increased in both symptomatic and asymptomatic tendons [difference to baseline: 2.4 (0.3-4.5) and 0.9 (0.5-1.4), p = 0.05]. At U30 to U120, IBF was still increased in symptomatic but not in asymptomatic tendons [mean difference to baseline: 1.9 (0.8-2.9) and 0.1 (-0.9 to 1.2), p < 0.01]. Conclusion: Irrespective of pathology, 47-63\% of Achilles tendons responded to exercise with an immediate acute physiological IBF increase by an average of one to two vessels ("responders"). A higher amount of baseline IBF (approximately five vessels) and a prolonged exercise-induced IBF response found in symptomatic ATs indicate a pain-associated altered intratendinous "neovascularization."}, language = {en} } @article{HeringHauptfleischJagoetal.2022, author = {Hering, Robert and Hauptfleisch, Morgan and Jago, Mark and Smith, Taylor and Kramer-Schadt, Stephanie and Stiegler, Jonas and Blaum, Niels}, title = {Don't stop me now: Managed fence gaps could allow migratory ungulates to track dynamic resources and reduce fence related energy loss}, series = {Frontiers in Ecology and Evolution}, journal = {Frontiers in Ecology and Evolution}, publisher = {Frontiers}, address = {Lausanne, Schweiz}, issn = {2296-701X}, doi = {10.3389/fevo.2022.907079}, pages = {1 -- 18}, year = {2022}, abstract = {In semi-arid environments characterized by erratic rainfall and scattered primary production, migratory movements are a key survival strategy of large herbivores to track resources over vast areas. Veterinary Cordon Fences (VCFs), intended to reduce wildlife-livestock disease transmission, fragment large parts of southern Africa and have limited the movements of large wild mammals for over 60 years. Consequently, wildlife-fence interactions are frequent and often result in perforations of the fence, mainly caused by elephants. Yet, we lack knowledge about at which times fences act as barriers, how fences directly alter the energy expenditure of native herbivores, and what the consequences of impermeability are. We studied 2-year ungulate movements in three common antelopes (springbok, kudu, eland) across a perforated part of Namibia's VCF separating a wildlife reserve and Etosha National Park using GPS telemetry, accelerometer measurements, and satellite imagery. We identified 2905 fence interaction events which we used to evaluate critical times of encounters and direct fence effects on energy expenditure. Using vegetation type-specific greenness dynamics, we quantified what animals gained in terms of high quality food resources from crossing the VCF. Our results show that the perforation of the VCF sustains herbivore-vegetation interactions in the savanna with its scattered resources. Fence permeability led to peaks in crossing numbers during the first flush of woody plants before the rain started. Kudu and eland often showed increased energy expenditure when crossing the fence. Energy expenditure was lowered during the frequent interactions of ungulates standing at the fence. We found no alteration of energy expenditure when springbok immediately found and crossed fence breaches. Our results indicate that constantly open gaps did not affect energy expenditure, while gaps with obstacles increased motion. Closing gaps may have confused ungulates and modified their intended movements. While browsing, sedentary kudu's use of space was less affected by the VCF; migratory, mixed-feeding springbok, and eland benefited from gaps by gaining forage quality and quantity after crossing. This highlights the importance of access to vast areas to allow ungulates to track vital vegetation patches.}, language = {en} } @article{HeroldTheobaldGronwaldetal.2022, author = {Herold, Fabian and Theobald, Paula and Gronwald, Thomas and Rapp, Michael A. and M{\"u}ller, Notger Germar}, title = {Going digital - a commentary on the terminology used at the intersection of physical activity and digital health}, series = {European review of aging and physical activity}, volume = {19}, journal = {European review of aging and physical activity}, publisher = {Springer}, address = {Berlin ; Heidelberg}, issn = {1861-6909}, doi = {10.1186/s11556-022-00296-y}, pages = {7}, year = {2022}, abstract = {In recent years digital technologies have become a major means for providing health-related services and this trend was strongly reinforced by the current Coronavirus disease 2019 (COVID-19) pandemic. As it is well-known that regular physical activity has positive effects on individual physical and mental health and thus is an important prerequisite for healthy aging, digital technologies are also increasingly used to promote unstructured and structured forms of physical activity. However, in the course of this development, several terms (e.g., Digital Health, Electronic Health, Mobile Health, Telehealth, Telemedicine, and Telerehabilitation) have been introduced to refer to the application of digital technologies to provide health-related services such as physical interventions. Unfortunately, the above-mentioned terms are often used in several different ways, but also relatively interchangeably. Given that ambiguous terminology is a major source of difficulty in scientific communication which can impede the progress of theoretical and empirical research, this article aims to make the reader aware of the subtle differences between the relevant terms which are applied at the intersection of physical activity and Digital Health and to provide state-of-art definitions for them.}, language = {en} } @article{PerezChaparroSchuchZechetal.2021, author = {P{\´e}rez Chaparro, Camilo Germ{\´a}n Alberto and Schuch, Felipe Barreto and Zech, Philipp and Kangas, Maria and Rapp, Michael A. and Heißel, Andreas}, title = {Recreational exercising and self-reported cardiometabolic diseases in German people living with HIV}, series = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International}, volume = {18}, journal = {International journal of environmental research and public health : IJERPH / Molecular Diversity Preservation International}, number = {21}, publisher = {MDPI}, address = {Basel, Schweiz}, issn = {1660-4601}, doi = {10.3390/ijerph182111579}, pages = {1 -- 10}, year = {2021}, abstract = {Exercise is known for its beneficial effects on preventing cardiometabolic diseases (CMDs) in the general population. People living with the human immunodeficiency virus (PLWH) are prone to sedentarism, thus raising their already elevated risk of developing CMDs in comparison to individuals without HIV. The aim of this cross-sectional study was to determine if exercise is associated with reduced risk of self-reported CMDs in a German HIV-positive sample (n = 446). Participants completed a self-report survey to assess exercise levels, date of HIV diagnosis, CD4 cell count, antiretroviral therapy, and CMDs. Participants were classified into exercising or sedentary conditions. Generalized linear models with Poisson regression were conducted to assess the prevalence ratio (PR) of PLWH reporting a CMD. Exercising PLWH were less likely to report a heart arrhythmia for every increase in exercise duration (PR: 0.20: 95\% CI: 0.10-0.62, p < 0.01) and diabetes mellitus for every increase in exercise session per week (PR: 0.40: 95\% CI: 0.10-1, p < 0.01). Exercise frequency and duration are associated with a decreased risk of reporting arrhythmia and diabetes mellitus in PLWH. Further studies are needed to elucidate the mechanisms underlying exercise as a protective factor for CMDs in PLWH.}, language = {en} }