@article{LinHoutenbosLuetal.2021, author = {Lin, Chiao-I and Houtenbos, Sanne and Lu, Yu-Hsien and Mayer, Frank and Wippert, Pia-Maria}, title = {The epidemiology of chronic ankle instability with perceived ankle instability}, series = {Journal of foot and ankle research / Australasian Podiatry Council; Society of Chiropodists and Podiatrists (UK)}, volume = {14}, journal = {Journal of foot and ankle research / Australasian Podiatry Council; Society of Chiropodists and Podiatrists (UK)}, publisher = {BioMed Central}, address = {London}, issn = {1757-1146}, doi = {10.1186/s13047-021-00480-w}, pages = {11}, year = {2021}, abstract = {Background: Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Besides it being an ankle issue, chronic ankle instability can also cause additional injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. Therefore, the purpose of this study was to investigate the epidemiology of chronic ankle instability through valid and reliable self-reported tools in active populations. Methods: An electronic search was performed on PubMed and Web of Science in July 2020. The inclusion criteria for articles were peer-reviewed, published between 2006 and 2020, using one of the valid and reliable tools to evaluate ankle instability, determining chronic ankle instability based on the criteria of the International Ankle Consortium, and including the outcome of epidemiology of chronic ankle instability. The risk of bias of the included studies was evaluated with an adapted tool for the sports injury review method. Results: After removing duplicated studies, 593 articles were screened for eligibility. Twenty full-texts were screened and finally nine studies were included, assessing 3804 participants in total. The participants were between 15 and 32 years old and represented soldiers, students, athletes and active individuals with a history of ankle sprain. The prevalence of chronic ankle instability was 25\%, ranging between 7 and 53\%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46\%, ranging between 9 and 76\%. Five included studies identified chronic ankle instability based on the standard criteria, and four studies applied adapted exclusion criteria to conduct the study. Five out of nine included studies showed a low risk of bias. Conclusions: The prevalence of chronic ankle instability shows a wide range. This could be due to the different exclusion criteria, age, sports discipline, or other factors among the included studies. For future studies, standardized criteria to investigate the epidemiology of chronic ankle instability are required. The epidemiology of CAI should be prospective. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.}, language = {en} } @article{EngelSchraplauWochatzetal.2021, author = {Engel, Tilman and Schraplau, Anne and Wochatz, Monique and Kopinski, Stephan and Sonnenburg, Dominik and Schom{\"o}ller, Anne and Risch, Lucie and Kaplick, Hannes and Mayer, Frank}, title = {Feasability of An Eccentric Isokinetic Protocol to Induce Trunk Muscle Damage: A Pilot Study}, series = {Sports Medicine International Open}, volume = {6}, journal = {Sports Medicine International Open}, edition = {1}, publisher = {Thieme}, address = {Stuttgart}, issn = {2367-1890}, doi = {10.1055/a-1757-6724}, pages = {E9 -- E17}, year = {2021}, abstract = {Eccentric exercise is discussed as a treatment option for clinical populations, but specific responses in terms of muscle damage and systemic inflammation after repeated loading of large muscle groups have not been conclusively characterized. Therefore, this study tested the feasibility of an isokinetic protocol for repeated maximum eccentric loading of the trunk muscles. Nine asymptomatic participants (5 f/4 m; 34±6 yrs; 175±13 cm; 76±17 kg) performed three isokinetic 2-minute all-out trunk strength tests (1x concentric (CON), 2x eccentric (ECC1, ECC2), 2 weeks apart; flexion/extension, 60°/s, ROM 55°). Outcomes were peak torque, torque decline, total work, and indicators of muscle damage and inflammation (over 168 h). Statistics were done using the Friedman test (Dunn's post-test). For ECC1 and ECC2, peak torque and total work were increased and torque decline reduced compared to CON. Repeated ECC bouts yielded unaltered torque and work outcomes. Muscle damage markers were highest after ECC1 (soreness 48 h, creatine kinase 72 h; p<0.05). Their overall responses (area under the curve) were abolished post-ECC2 compared to post-ECC1 (p<0.05). Interleukin-6 was higher post-ECC1 than CON, and attenuated post-ECC2 (p>0.05). Interleukin-10 and tumor necrosis factor-α were not detectable. All markers showed high inter-individual variability. The protocol was feasible to induce muscle damage indicators after exercising a large muscle group, but the pilot results indicated only weak systemic inflammatory responses in asymptomatic adults.}, language = {en} } @article{DellepianeVaidJaladankietal.2021, author = {Dellepiane, Sergio and Vaid, Akhil and Jaladanki, Suraj K. and Coca, Steven and Fayad, Zahi A. and Charney, Alexander W. and B{\"o}ttinger, Erwin and He, John Cijiang and Glicksberg, Benjamin S. and Chan, Lili and Nadkarni, Girish}, title = {Acute kidney injury in patients hospitalized with COVID-19 in New York City}, series = {Kidney medicine}, volume = {3}, journal = {Kidney medicine}, number = {5}, publisher = {Elsevier}, address = {Amsterdam}, issn = {2590-0595}, doi = {10.1016/j.xkme.2021.06.008}, pages = {877 -- 879}, year = {2021}, language = {en} } @article{WarschburgerPetersenvonRezorietal.2021, author = {Warschburger, Petra and Petersen, Ann-Christin and von Rezori, Roman Enzio and Buchallik, Friederike and Baumeister, Harald and Holl, Reinhard and Minden, Kirsten and M{\"u}ller-​Stierlin, Annabel Sandra and Reinauer, Christina and Staab, Doris and COACH consortium,}, title = {A prospective investigation of developmental trajectories of psychosocial adjustment in adolescents facing a chronic condition - study protocol of an observational, multi-center study}, series = {BMC Pediatrics}, volume = {21}, journal = {BMC Pediatrics}, publisher = {BMC pediatrics}, address = {London}, issn = {1471-2431}, doi = {10.1186/s12887-021-02869-9}, pages = {1 -- 13}, year = {2021}, abstract = {Background Relatively little is known about protective factors and the emergence and maintenance of positive outcomes in the field of adolescents with chronic conditions. Therefore, the primary aim of the study is to acquire a deeper understanding of the dynamic process of resilience factors, coping strategies and psychosocial adjustment of adolescents living with chronic conditions. Methods/design We plan to consecutively recruit N = 450 adolescents (12-21 years) from three German patient registries for chronic conditions (type 1 diabetes, cystic fibrosis, or juvenile idiopathic arthritis). Based on screening for anxiety and depression, adolescents are assigned to two parallel groups - "inconspicuous" (PHQ-9 and GAD-7 < 7) vs. "conspicuous" (PHQ-9 or GAD-7 ≥ 7) - participating in a prospective online survey at baseline and 12-month follow-up. At two time points (T1, T2), we assess (1) intra- and interpersonal resiliency factors, (2) coping strategies, and (3) health-related quality of life, well-being, satisfaction with life, anxiety and depression. Using a cross-lagged panel design, we will examine the bidirectional longitudinal relations between resiliency factors and coping strategies, psychological adaptation, and psychosocial adjustment. To monitor Covid-19 pandemic effects, participants are also invited to take part in an intermediate online survey. Discussion The study will provide a deeper understanding of adaptive, potentially modifiable processes and will therefore help to develop novel, tailored interventions supporting a positive adaptation in youths with a chronic condition. These strategies should not only support those at risk but also promote the maintenance of a successful adaptation. Trial registration German Clinical Trials Register (DRKS), no. DRKS00025125. Registered on May 17, 2021.}, language = {en} } @article{RischMayerCassel2021, author = {Risch, Lucie and Mayer, Frank and Cassel, Michael}, title = {Doppler flow response following running exercise differs between healthy and tendinopathic Achilles tendons}, series = {Frontiers in Physiology}, volume = {12}, journal = {Frontiers in Physiology}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2021.650507}, pages = {10}, year = {2021}, abstract = {Background: The relationship between exercise-induced intratendinous blood flow (IBF) and tendon pathology or training exposure is unclear. Objective: This study investigates the acute effect of running exercise on sonographic detectable IBF in healthy and tendinopathic Achilles tendons (ATs) of runners and recreational participants. Methods: 48 participants (43 ± 13 years, 176 ± 9 cm, 75 ± 11 kg) performed a standardized submaximal 30-min constant load treadmill run with Doppler ultrasound "Advanced dynamic flow" examinations before (Upre) and 5, 30, 60, and 120 min (U5-U120) afterward. Included were runners (>30 km/week) and recreational participants (<10 km/week) with healthy (Hrun, n = 10; Hrec, n = 15) or tendinopathic (Trun, n = 13; Trec, n = 10) ATs. IBF was assessed by counting number [n] of intratendinous vessels. IBF data are presented descriptively (\%, median [minimum to maximum range] for baseline-IBF and IBF-difference post-exercise). Statistical differences for group and time point IBF and IBF changes were analyzed with Friedman and Kruskal-Wallis ANOVA (α = 0.05). Results: At baseline, IBF was detected in 40\% (3 [1-6]) of Hrun, in 53\% (4 [1-5]) of Hrec, in 85\% (3 [1-25]) of Trun, and 70\% (10 [2-30]) of Trec. At U5 IBF responded to exercise in 30\% (3 [-1-9]) of Hrun, in 53\% (4 [-2-6]) of Hrec, in 70\% (4 [-10-10]) of Trun, and in 80\% (5 [1-10]) of Trec. While IBF in 80\% of healthy responding ATs returned to baseline at U30, IBF remained elevated until U120 in 60\% of tendinopathic ATs. Within groups, IBF changes from Upre-U120 were significant for Hrec (p < 0.01), Trun (p = 0.05), and Trec (p < 0.01). Between groups, IBF changes in consecutive examinations were not significantly different (p > 0.05) but IBF-level was significantly higher at all measurement time points in tendinopathic versus healthy ATs (p < 0.05). Conclusion: Irrespective of training status and tendon pathology, running leads to an immediate increase of IBF in responding tendons. This increase occurs shortly in healthy and prolonged in tendinopathic ATs. Training exposure does not alter IBF occurrence, but IBF level is elevated in tendon pathology. While an immediate exercise-induced IBF increase is a physiological response, prolonged IBF is considered a pathological finding associated with Achilles tendinopathy.}, language = {en} } @article{LinKhajooeiEngeletal.2021, author = {Lin, Chiao-I and Khajooei, Mina and Engel, Tilman and Nair, Alexandra and Heikkila, Mika and Kaplick, Hannes and Mayer, Frank}, title = {The effect of chronic ankle instability on muscle activations in lower extremities}, series = {PLOS ONE / Public Library of Science}, volume = {16}, journal = {PLOS ONE / Public Library of Science}, number = {2}, publisher = {PLOS}, address = {San Francisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0247581}, pages = {15}, year = {2021}, abstract = {Background/Purpose Muscular reflex responses of the lower extremities to sudden gait disturbances are related to postural stability and injury risk. Chronic ankle instability (CAI) has shown to affect activities related to the distal leg muscles while walking. Its effects on proximal muscle activities of the leg, both for the injured- (IN) and uninjured-side (NON), remain unclear. Therefore, the aim was to compare the difference of the motor control strategy in ipsilateral and contralateral proximal joints while unperturbed walking and perturbed walking between individuals with CAI and matched controls. Materials and methods In a cross-sectional study, 13 participants with unilateral CAI and 13 controls (CON) walked on a split-belt treadmill with and without random left- and right-sided perturbations. EMG amplitudes of muscles at lower extremities were analyzed 200 ms after perturbations, 200 ms before, and 100 ms after (Post100) heel contact while walking. Onset latencies were analyzed at heel contacts and after perturbations. Statistical significance was set at alpha≤0.05 and 95\% confidence intervals were applied to determine group differences. Cohen's d effect sizes were calculated to evaluate the extent of differences. Results Participants with CAI showed increased EMG amplitudes for NON-rectus abdominus at Post100 and shorter latencies for IN-gluteus maximus after heel contact compared to CON (p<0.05). Overall, leg muscles (rectus femoris, biceps femoris, and gluteus medius) activated earlier and less bilaterally (d = 0.30-0.88) and trunk muscles (bilateral rectus abdominus and NON-erector spinae) activated earlier and more for the CAI group than CON group (d = 0.33-1.09). Conclusion Unilateral CAI alters the pattern of the motor control strategy around proximal joints bilaterally. Neuromuscular training for the muscles, which alters motor control strategy because of CAI, could be taken into consideration when planning rehabilitation for CAI.}, language = {en} } @article{BuschBlasimannMayeretal.2021, author = {Busch, Aglaja and Blasimann, Angela and Mayer, Frank and Baur, Heiner}, title = {Alterations in sensorimotor function after ACL reconstruction during active joint position sense testing. A systematic review}, series = {PLOS ONE}, volume = {16}, journal = {PLOS ONE}, number = {6}, publisher = {PLOS}, address = {San Francisco}, issn = {1932-6203}, doi = {10.1371/journal.pone.0253503}, pages = {14}, year = {2021}, abstract = {Background The anterior cruciate ligament (ACL) rupture can lead to impaired knee function. Reconstruction decreases the mechanical instability but might not have an impact on sensorimotor alterations. Objective Evaluation of the sensorimotor function measured with the active joint position sense (JPS) test in anterior cruciate ligament (ACL) reconstructed patients compared to the contralateral side and a healthy control group. Methods The databases MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Library and SPORTDiscus were systematically searched from origin until April 2020. Studies published in English, German, French, Spanish or Italian language were included. Evaluation of the sensorimotor performance was restricted to the active joint position sense test in ACL reconstructed participants or healthy controls. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data was descriptively synthesized. Results Ten studies were included after application of the selective criteria. Higher angular deviation, reaching significant difference (p < 0.001) in one study, was shown up to three months after surgery in the affected limb. Six months post-operative significantly less error (p < 0.01) was found in the reconstructed leg compared to the contralateral side and healthy controls. One or more years after ACL reconstruction significant differences were inconsistent along the studies. Conclusions Altered sensorimotor function was present after ACL reconstruction. Due to inconsistencies and small magnitudes, clinical relevance might be questionable. JPS testing can be performed in acute injured persons and prospective studies could enhance knowledge of sensorimotor function throughout the rehabilitative processes.}, language = {en} } @article{KuerschnerSchererRadchuketal.2021, author = {K{\"u}rschner, Tobias and Scherer, C{\´e}dric and Radchuk, Viktoriia and Blaum, Niels and Kramer-Schadt, Stephanie}, title = {Movement can mediate temporal mismatches between resource availability and biological events in host-pathogen interactions}, series = {Ecology and evolution}, volume = {11}, journal = {Ecology and evolution}, number = {10}, publisher = {Wiley}, address = {Hoboken}, issn = {2045-7758}, doi = {10.1002/ece3.7478}, pages = {5728 -- 5741}, year = {2021}, abstract = {Global change is shifting the timing of biological events, leading to temporal mismatches between biological events and resource availability. These temporal mismatches can threaten species' populations. Importantly, temporal mismatches not only exert strong pressures on the population dynamics of the focal species, but can also lead to substantial changes in pairwise species interactions such as host-pathogen systems. We adapted an established individual-based model of host-pathogen dynamics. The model describes a viral agent in a social host, while accounting for the host's explicit movement decisions. We aimed to investigate how temporal mismatches between seasonal resource availability and host life-history events affect host-pathogen coexistence, that is, disease persistence. Seasonal resource fluctuations only increased coexistence probability when in synchrony with the hosts' biological events. However, a temporal mismatch reduced host-pathogen coexistence, but only marginally. In tandem with an increasing temporal mismatch, our model showed a shift in the spatial distribution of infected hosts. It shifted from an even distribution under synchronous conditions toward the formation of disease hotspots, when host life history and resource availability mismatched completely. The spatial restriction of infected hosts to small hotspots in the landscape initially suggested a lower coexistence probability due to the critical loss of susceptible host individuals within those hotspots. However, the surrounding landscape facilitated demographic rescue through habitat-dependent movement. Our work demonstrates that the negative effects of temporal mismatches between host resource availability and host life history on host-pathogen coexistence can be reduced through the formation of temporary disease hotspots and host movement decisions, with implications for disease management under disturbances and global change.}, language = {en} } @article{KahlKappelJoshietal.2021, author = {Kahl, Sandra and Kappel, Christian and Joshi, Jasmin Radha and Lenhard, Michael}, title = {Phylogeography of a widely distributed plant species reveals cryptic genetic lineages with parallel phenotypic responses to warming and drought conditions}, series = {Ecology and Evolution}, volume = {11}, journal = {Ecology and Evolution}, number = {20}, publisher = {John Wiley \& Sons, Inc.}, address = {Hoboken}, issn = {2045-7758}, doi = {10.1002/ece3.8103}, pages = {13986 -- 14002}, year = {2021}, abstract = {To predict how widely distributed species will perform under future climate change, it is crucial to understand and reveal their underlying phylogenetics. However, detailed information about plant adaptation and its genetic basis and history remains scarce and especially widely distributed species receive little attention despite their putatively high adaptability. To examine the adaptation potential of a widely distributed species, we sampled the model plant Silene vulgaris across Europe. In a greenhouse experiment, we exposed the offspring of these populations to a climate change scenario for central Europe and revealed the population structure through whole-genome sequencing. Plants were grown under two temperatures (18°C and 21°C) and three precipitation regimes (65, 75, and 90 mm) to measure their response in biomass and fecundity-related traits. To reveal the population genetic structure, ddRAD sequencing was employed for a whole-genome approach. We found three major genetic clusters in S. vulgaris from Europe: one cluster comprising Southern European populations, one cluster of Western European populations, and another cluster containing central European populations. Population genetic diversity decreased with increasing latitude, and a Mantel test revealed significant correlations between FST and geographic distances as well as between genetic and environmental distances. Our trait analysis showed that the genetic clusters significantly differed in biomass-related traits and in the days to flowering. However, half of the traits showed parallel response patterns to the experimental climate change scenario. Due to the differentiated but parallel response patterns, we assume that phenotypic plasticity plays an important role for the adaptation of the widely distributed species S. vulgaris and its intraspecific genetic lineages.}, language = {en} } @article{DattaSachsFreitasdaCruzetal.2021, author = {Datta, Suparno and Sachs, Jan Philipp and Freitas da Cruz, Harry and Martensen, Tom and Bode, Philipp and Morassi Sasso, Ariane and Glicksberg, Benjamin S. and B{\"o}ttinger, Erwin}, title = {FIBER}, series = {JAMIA open}, volume = {4}, journal = {JAMIA open}, number = {3}, publisher = {Oxford Univ. Press}, address = {Oxford}, issn = {2574-2531}, doi = {10.1093/jamiaopen/ooab048}, pages = {10}, year = {2021}, abstract = {Objectives: The development of clinical predictive models hinges upon the availability of comprehensive clinical data. Tapping into such resources requires considerable effort from clinicians, data scientists, and engineers. Specifically, these efforts are focused on data extraction and preprocessing steps required prior to modeling, including complex database queries. A handful of software libraries exist that can reduce this complexity by building upon data standards. However, a gap remains concerning electronic health records (EHRs) stored in star schema clinical data warehouses, an approach often adopted in practice. In this article, we introduce the FlexIBle EHR Retrieval (FIBER) tool: a Python library built on top of a star schema (i2b2) clinical data warehouse that enables flexible generation of modeling-ready cohorts as data frames. Materials and Methods: FIBER was developed on top of a large-scale star schema EHR database which contains data from 8 million patients and over 120 million encounters. To illustrate FIBER's capabilities, we present its application by building a heart surgery patient cohort with subsequent prediction of acute kidney injury (AKI) with various machine learning models. Results: Using FIBER, we were able to build the heart surgery cohort (n = 12 061), identify the patients that developed AKI (n = 1005), and automatically extract relevant features (n = 774). Finally, we trained machine learning models that achieved area under the curve values of up to 0.77 for this exemplary use case. Conclusion: FIBER is an open-source Python library developed for extracting information from star schema clinical data warehouses and reduces time-to-modeling, helping to streamline the clinical modeling process.}, language = {en} }