@article{WerkhausenWillwacherAlbracht2021,
  author    = {Werkhausen, Amelie and Willwacher, Steffen and Albracht, Kirsten},
  title     = {Medial gastrocnemius muscle fascicles shorten throughout stance during sprint acceleration},
  series = {Scandinavian Journal of Medicine \& Science in Sports},
  volume    = {31},
  journal   = {Scandinavian Journal of Medicine \& Science in Sports},
  number    = {7},
  publisher = {Wiley-Blackwell},
  address   = {Oxford},
  issn      = {0905-7188 (Druckausgabe)},
  doi       = {10.1111/sms.13956},
  pages     = {1471 -- 1480},
  year      = {2021},
  abstract  = {The compliant nature of distal limb muscle-tendon units is traditionally considered suboptimal in explosive movements when positive joint work is required. However, during accelerative running, ankle joint net mechanical work is positive. Therefore, this study aims to investigate how plantar flexor muscle-tendon behavior is modulated during fast accelerations. Eleven female sprinters performed maximum sprint accelerations from starting blocks, while gastrocnemius muscle fascicle lengths were estimated using ultrasonography. We combined motion analysis and ground reaction force measurements to assess lower limb joint kinematics and kinetics, and to estimate gastrocnemius muscle-tendon unit length during the first two acceleration steps. Outcome variables were resampled to the stance phase and averaged across three to five trials. Relevant scalars were extracted and analyzed using one-sample and two-sample t-tests, and vector trajectories were compared using statistical parametric mapping. We found that an uncoupling of muscle fascicle behavior from muscle-tendon unit behavior is effectively used to produce net positive mechanical work at the joint during maximum sprint acceleration. Muscle fascicles shortened throughout the first and second steps, while shortening occurred earlier during the first step, where negative joint work was lower compared with the second step. Elastic strain energy may be stored during dorsiflexion after touchdown since fascicles did not lengthen at the same time to dissipate energy. Thus, net positive work generation is accommodated by the reuse of elastic strain energy along with positive gastrocnemius fascicle work. Our results show a mechanism of how muscles with high in-series compliance can contribute to net positive joint work.},
  language  = {en}
}
@article{MontiWaldvogelRitzmannetal.2021,
  author    = {Monti, Elena and Waldvogel, Janice and Ritzmann, Ramona and Freyler, Kathrin and Albracht, Kirsten and Helm, Michael and De Cesare, Niccol{\`o} and Pavan, Piero and Reggiani, Carlo and Gollhofer, Albert and Narici, Marco Vincenzo},
  title     = {Muscle in variable gravity: "I do not know where I am, but I know what to do"},
  series = {Frontiers in Physiology},
  volume    = {12},
  journal   = {Frontiers in Physiology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2021.714655},
  pages     = {19 Seiten},
  year      = {2021},
  abstract  = {Performing tasks, such as running and jumping, requires activation of the agonist and antagonist muscles before (motor unit pre-activation) and during movement performance (Santello and Mcdonagh, 1998). A well-timed and regulated muscle activation elicits a stretch-shortening cycle (SSC) response, naturally occurring in bouncing movements (Ishikawa and Komi, 2004; Taube et al., 2012). By definition, the SSC describes the stretching of a pre-activated muscle-tendon complex immediately followed by a muscle shortening in the concentric push-off phase (Komi, 1984). Given the importance of SSC actions for human movement, it is not surprising that many studies investigated the biomechanics of this phenomenon; in particular, drop jumps (DJs) represent a good paradigm to study muscle fascicle and tendon behavior in ballistic movements involving the SSC. Within a DJ, three main phases [pre-activation, braking, and push-off (PO; Komi, 2000)] have been recognized and extensively studied in common and challenging conditions, such as changes in load, falling height, or simulated hypo-gravity (Avela et al., 1994; Arampatzis et al., 2001; Fukashiro et al., 2005; Ishikawa et al., 2005; Sousa et al., 2007; Ritzmann et al., 2016; Helm et al., 2020). These studies show that the timing and amount of triceps-surae muscle-tendon unit pre-activation in DJs are differentially regulated based on the load applied to the muscle, being optimal in normal "Earth" gravity conditions (Avela et al., 1994), but decreased in simulated hypo-gravity, hyper-gravity (Avela et al., 1994; Ritzmann et al., 2016), or unknown conditions (i.e., unknown falling heights; Helm et al., 2020). Some authors indicated that, when falling from heights different from the optimal one [defined as the drop height giving a maximum DJ performance indicated as peak ground reaction force (GRF) or jump high], electromyographic (EMG) activity of the plantar flexors increases from lower than optimal to higher than optimal heights (Ishikawa and Komi, 2004; Sousa et al., 2007). These findings highlight the ability of the central nervous system to regulate the timing and amount of pre-activation according to different jumping conditions, thus regulating muscle fascicle length, tendon and joint stiffness as well as position, in order to safely land on the ground and quickly re-bounce. Similarly, to pre-activation, also in the braking phase, the plantar flexors are differentially regulated. In optimal height (i.e., load) jumping conditions, gastrocnemius medialis (GM) fascicles shorten at early ground contact (possibly due to the intervention of the stretch reflex; Gollhofer et al., 1992) and behave quasi-isometrically in the late braking phase, enabling tendon elongation, and storage of elastic energy (Gollhofer et al., 1992; Fukashiro et al., 2005; Sousa et al., 2007). When increasing the falling height (augmenting the impact GRF), the quasi-isometric behavior of fascicles disappears, and fast fascicle lengthening occurs (Ishikawa et al., 2005; Sousa et al., 2007). In the third and last PO phase, fascicles shorten and the tendon releases the elastic energy previously stored. Bobbert et al. (1987) reported no influence of jumping height on the work done and on the net vertical impulse assessed during PO; this observation suggests that, despite an optimal DJ performance might be achieved only in specific conditions (falling heights, loads), the central nervous system seems to be able to regulate muscle behavior in order to effectively perform the required task also in challenging situations. Although the regulation of triceps-surae muscle-tendon unit in DJs has been extensively investigated, very few studies focused on sarcomeres behavior during the performance of this SSC movement (Kurokawa et al., 2003; Fukashiro et al., 2005, 2006). Sarcomeres represent muscle contractile units and are known to express different amounts of force depending on their length (Gordon et al., 1966; Walker and Schrodt, 1974); thus, understanding the time course of their responses during DJs is fundamental to gain further insights into muscle force-generating capacity. In vivo measurement of sarcomere length in humans has been so far been performed only in static positions and under highly controlled experimental conditions (Llewellyn et al., 2008; Sanchez et al., 2015). Instead, human sarcomere length estimation (achieved by dividing GM measured fascicle length for a fixed sarcomere number) in dynamic contractions provided an indirect measure of sarcomere operating range during squat jump, countermovement jump, and DJ (Fukashiro et al., 2005, 2006; Kurokawa et al., 2003). The results of these studies showed that sarcomeres operate in the ascending limb of their length-tension (L-T) relationship in all types of jumps, and particularly so in DJ. However, most of the available observations on sarcomere and muscle fascicle behavior were made in condition of constant gravity. Thus, in order to understand how sarcomere and muscle fascicle length are regulated in variable gravity conditions, we performed experiments in a parabolic flight, involving variable gravity levels, ranging from about zero-g to about double the Earth's gravity (1 g; Waldvogel et al., 2021). Specifically, the aims of the present study were as follows: 1. To investigate the ability of the neuromuscular system in regulating fascicle length in response to conditions of variable gravity. 2. To estimate sarcomere operative length in the different DJ phases, in order to calculate its theoretical force production and its possible modulation in conditions of variable gravity. We hypothesized that muscle fascicles would be differentially regulated in different gravity conditions compared to 1 g, particularly in anticipation of landing and re-bouncing in unknown gravity levels. In addition, we hypothesized that sarcomeres would operate in the upper part of the ascending limb of their L-T relationship, possibly lengthening during the braking phase (especially in hyper-gravity) while operating quasi-isometrically in 1 g.},
  language  = {en}
}
@article{StaeudleSeynnesLapsetal.2021,
  author    = {St{\"a}udle, Benjamin and Seynnes, Olivier and Laps, Guido and G{\"o}ll, Fabian and Br{\"u}ggemann, Gert-Peter and Albracht, Kirsten},
  title     = {Recovery from achilles tendon repair: a combination of Postsurgery Outcomes and Insufficient remodeling of muscle and tendon},
  series = {Medicine \& Science in Sports \& Exercise},
  volume    = {53},
  journal   = {Medicine \& Science in Sports \& Exercise},
  number    = {7},
  publisher = {American College of Sports Medicine},
  address   = {Philadelphia, Pa.},
  issn      = {1530-0315},
  doi       = {10.1249/MSS.0000000000002592},
  pages     = {1356 -- 1366},
  year      = {2021},
  abstract  = {Achilles tendon rupture (ATR) patients have persistent functional deficits in the triceps surae muscle-tendon unit (MTU). The complex remodeling of the MTU accompanying these deficits remains poorly understood. The purpose of the present study was to associate in vivo and in silico data to investigate the relations between changes inMTU properties and strength deficits inATR patients. Methods: Elevenmale subjects who had undergone surgical repair of complete unilateral ATR were examined 4.6 ± 2.0 (mean ± SD) yr after rupture. Gastrocnemius medialis (GM) tendon stiffness, morphology, and muscle architecture were determined using ultrasonography. The force-length relation of the plantar flexor muscles was assessed at five ankle joint angles. In addition, simulations (OpenSim) of the GM MTU force-length properties were performed with various iterations of MTU properties found between the unaffected and the affected side. Results: The affected side of the patients displayed a longer, larger, and stiffer GM tendon (13\% ± 10\%, 105\% ± 28\%, and 54\% ± 24\%, respectively) compared with the unaffected side. The GM muscle fascicles of the affected side were shorter (32\% ± 12\%) and with greater pennation angles (31\% ± 26\%). A mean deficit in plantarflexion moment of 31\% ± 10\% was measured. Simulations indicate that pairing an intact muscle with a longer tendon shifts the optimal angular range of peak force outside physiological angular ranges, whereas the shorter muscle fascicles and tendon stiffening seen in the affected side decrease this shift, albeit incompletely. Conclusions: These results suggest that the substantial changes in MTU properties found in ATR patients may partly result from compensatory remodeling, although this process appears insufficient to fully restore muscle function.},
  language  = {en}
}
@article{KetelhutBrueggeGoelletal.2020,
  author    = {Ketelhut, Maike and Br{\"u}gge, G. M. and G{\"o}ll, Fabian and Braunstein, Bjoern and Albracht, Kirsten and Abel, Dirk},
  title     = {Adaptive iterative learning control of an industrial robot during neuromuscular training},
  series = {IFAC PapersOnLine},
  volume    = {53},
  journal   = {IFAC PapersOnLine},
  number    = {2},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {2405-8963},
  doi       = {10.1016/j.ifacol.2020.12.741},
  pages     = {16468 -- 16475},
  year      = {2020},
  abstract  = {To prevent the reduction of muscle mass and loss of strength coming along with the human aging process, regular training with e.g. a leg press is suitable. However, the risk of training-induced injuries requires the continuous monitoring and controlling of the forces applied to the musculoskeletal system as well as the velocity along the motion trajectory and the range of motion. In this paper, an adaptive norm-optimal iterative learning control algorithm to minimize the knee joint loadings during the leg extension training with an industrial robot is proposed. The response of the algorithm is tested in simulation for patients with varus, normal and valgus alignment of the knee and compared to the results of a higher-order iterative learning control algorithm, a robust iterative learning control and a recently proposed conventional norm-optimal iterative learning control algorithm. Although significant improvements in performance are made compared to the conventional norm-optimal iterative learning control algorithm with a small learning factor, for the developed approach as well as the robust iterative learning control algorithm small steady state errors occur.},
  language  = {en}
}
@article{KetelhutKolditzGoelletal.2019,
  author    = {Ketelhut, Maike and Kolditz, Melanie and G{\"o}ll, Fabian and Braunstein, Bjoern and Albracht, Kirsten and Abel, Dirk},
  title     = {Admittance control of an industrial robot during resistance training},
  series = {IFAC-PapersOnLine},
  volume    = {52},
  journal   = {IFAC-PapersOnLine},
  number    = {19},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {2405-8963},
  doi       = {10.1016/j.ifacol.2019.12.102},
  pages     = {223 -- 228},
  year      = {2019},
  abstract  = {Neuromuscular strength training of the leg extensor muscles plays an important role in the rehabilitation and prevention of age and wealth related diseases. In this paper, we focus on the design and implementation of a Cartesian admittance control scheme for isotonic training, i.e. leg extension and flexion against a predefined weight. For preliminary testing and validation of the designed algorithm an experimental research and development platform consisting of an industrial robot and a force plate mounted at its end-effector has been used. Linear, diagonal and arbitrary two-dimensional motion trajectories with different weights for the leg extension and flexion part are applied. The proposed algorithm is easily adaptable to trajectories consisting of arbitrary six-dimensional poses and allows the implementation of individualized trajectories.},
  language  = {en}
}
@article{HeieisBoeckerD'Angeloetal.2023,
  author    = {Heieis, Jule and B{\"o}cker, Jonas and D'Angelo, Olfa and Mittag, Uwe and Albracht, Kirsten and Sch{\"o}nau, Eckhard and Meyer, Andreas and Voigtmann, Thomas and Rittweger, J{\"o}rn},
  title     = {Curvature of gastrocnemius muscle fascicles as function of muscle-tendon complex length and contraction in humans},
  series = {Physiological Reports},
  volume    = {11},
  journal   = {Physiological Reports},
  number    = {11},
  publisher = {Wiley},
  issn      = {2051-817X},
  doi       = {10.14814/phy2.15739},
  pages     = {e15739, Seite 1-11},
  year      = {2023},
  abstract  = {It has been shown that muscle fascicle curvature increases with increasing contraction level and decreasing muscle-tendon complex length. The analyses were done with limited examination windows concerning contraction level, muscle-tendon complex length, and/or intramuscular position of ultrasound imaging. With this study we aimed to investigate the correlation between fascicle arching and contraction, muscle-tendon complex length and their associated architectural parameters in gastrocnemius muscles to develop hypotheses concerning the fundamental mechanism of fascicle curving. Twelve participants were tested in five different positions (90°/105°*, 90°/90°*, 135°/90°*, 170°/90°*, and 170°/75°*; *knee/ankle angle). They performed isometric contractions at four different contraction levels (5\%, 25\%, 50\%, and 75\% of maximum voluntary contraction) in each position. Panoramic ultrasound images of gastrocnemius muscles were collected at rest and during constant contraction. Aponeuroses and fascicles were tracked in all ultrasound images and the parameters fascicle curvature, muscle-tendon complex strain, contraction level, pennation angle, fascicle length, fascicle strain, intramuscular position, sex and age group were analyzed by linear mixed effect models. Mean fascicle curvature of the medial gastrocnemius increased with contraction level (+5 m-1 from 0\% to 100\%; p = 0.006). Muscle-tendon complex length had no significant impact on mean fascicle curvature. Mean pennation angle (2.2 m-1 per 10°; p < 0.001), inverse mean fascicle length (20 m-1 per cm-1; p = 0.003), and mean fascicle strain (-0.07 m-1 per +10\%; p = 0.004) correlated with mean fascicle curvature. Evidence has also been found for intermuscular, intramuscular, and sex-specific intramuscular differences of fascicle curving. Pennation angle and the inverse fascicle length show the highest predictive capacities for fascicle curving. Due to the strong correlations between pennation angle and fascicle curvature and the intramuscular pattern of curving we suggest for future studies to examine correlations between fascicle curvature and intramuscular fluid pressure.},
  language  = {en}
}
@article{KuchlerGuenthnerRibeiroetal.2023,
  author    = {Kuchler, Timon and G{\"u}nthner, Roman and Ribeiro, Andrea and Hausinger, Renate and Streese, Lukas and W{\"o}hnl, Anna and Kesseler, Veronika and Negele, Johanna and Assali, Tarek and Carbajo-Lozoya, Javier and Lech, Maciej and Adorjan, Kristina and Stubbe, Hans Christian and Hanssen, Henner and Kotliar, Konstantin and Haller, Berhard and Heemann, Uwe and Schmaderer, Christoph},
  title     = {Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation},
  volume    = {26},
  publisher = {Springer Nature},
  address   = {Dordrecht},
  doi       = {10.1007/s10456-023-09885-6},
  pages     = {547 -- 563},
  year      = {2023},
  abstract  = {Background Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians. Methods In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204). Measurements and main results PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42\% ± 1.77\% vs. 4.64\% ± 2.59\%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5-190.2] vs. 189.1 [179.4-197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8-0.9] vs. 0.88 [0.8-0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = - 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters. Conclusion Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management.},
  language  = {en}
}
@article{WaldvogelFreylerHelmetal.2023,
  author    = {Waldvogel, Janice and Freyler, Kathrin and Helm, Michael and Monti, Elena and St{\"a}udle, Benjamin and Gollhofer, Albert and Narici, Marco V. and Ritzmann, Ramona and Albracht, Kirsten},
  title     = {Changes in gravity affect neuromuscular control, biomechanics, and muscle-tendon mechanics in energy storage and dissipation tasks},
  series = {Journal of Applied Physiology},
  volume    = {134},
  journal   = {Journal of Applied Physiology},
  number    = {1},
  publisher = {American Physiological Society},
  address   = {Bethesda, Md.},
  issn      = {1522-1601 (Onlineausgabe)},
  doi       = {10.1152/japplphysiol.00279.2022},
  pages     = {190 -- 202},
  year      = {2023},
  abstract  = {This study evaluates neuromechanical control and muscle-tendon interaction during energy storage and dissipation tasks in hypergravity. During parabolic flights, while 17 subjects performed drop jumps (DJs) and drop landings (DLs), electromyography (EMG) of the lower limb muscles was combined with in vivo fascicle dynamics of the gastrocnemius medialis, two-dimensional (2D) kinematics, and kinetics to measure and analyze changes in energy management. Comparisons were made between movement modalities executed in hypergravity (1.8 G) and gravity on ground (1 G). In 1.8 G, ankle dorsiflexion, knee joint flexion, and vertical center of mass (COM) displacement are lower in DJs than in DLs; within each movement modality, joint flexion amplitudes and COM displacement demonstrate higher values in 1.8 G than in 1 G. Concomitantly, negative peak ankle joint power, vertical ground reaction forces, and leg stiffness are similar between both movement modalities (1.8 G). In DJs, EMG activity in 1.8 G is lower during the COM deceleration phase than in 1 G, thus impairing quasi-isometric fascicle behavior. In DLs, EMG activity before and during the COM deceleration phase is higher, and fascicles are stretched less in 1.8 G than in 1 G. Compared with the situation in 1 G, highly task-specific neuromuscular activity is diminished in 1.8 G, resulting in fascicle lengthening in both movement modalities. Specifically, in DJs, a high magnitude of neuromuscular activity is impaired, resulting in altered energy storage. In contrast, in DLs, linear stiffening of the system due to higher neuromuscular activity combined with lower fascicle stretch enhances the buffering function of the tendon, and thus the capacity to safely dissipate energy.},
  language  = {en}
}
@article{DigelAkimbekovRogachevetal.2023,
  author    = {Digel, Ilya and Akimbekov, Nuraly and Rogachev, Evgeniy and Pogorelova, Natalia},
  title     = {Bacterial cellulose produced by Medusomyces gisevii on glucose and sucrose: biosynthesis and structural properties},
  series = {Cellulose},
  journal   = {Cellulose},
  publisher = {Springer Science + Business Media},
  address   = {Dordrecht},
  issn      = {1572-882X (Online)},
  doi       = {10.1007/s10570-023-05592-z},
  pages     = {15 Seiten},
  year      = {2023},
  abstract  = {In this work, the effects of carbon sources and culture media on the production and structural properties of bacterial cellulose (BC) synthesized by Medusomyces gisevii have been studied. The culture medium was composed of different initial concentrations of glucose or sucrose dissolved in 0.4\% extract of plain green tea. Parameters of the culture media (titratable acidity, substrate conversion degree etc.) were monitored daily for 20 days of cultivation. The BC pellicles produced on different carbon sources were characterized in terms of biomass yield, crystallinity and morphology by field emission scanning electron microscopy (FE-SEM), atomic force microscopy and X-ray diffraction. Our results showed that Medusomyces gisevii had higher BC yields in media with sugar concentrations close to 10 g L-1 after a 18-20 days incubation period. Glucose in general lead to a higher BC yield (173 g L-1) compared to sucrose (163.5 g L-1). The BC crystallinity degree and surface roughness were higher in the samples synthetized from sucrose. Obtained FE-SEM micrographs show that the BC pellicles synthesized in the sucrose media contained densely packed tangles of cellulose fibrils whereas the BC produced in the glucose media displayed rather linear geometry of the BC fibrils without noticeable aggregates.},
  language  = {en}
}
@article{AlnemerKotliarNeuhausetal.2023,
  author    = {Alnemer, Momin Sami Mohammad and Kotliar, Konstantin and Neuhaus, Valentin and Pape, Hans-Christoph and Ciritsis, Bernhard D.},
  title     = {Cost-effectiveness analysis of surgical proximal femur fracture prevention in elderly: a Markov cohort simulation model},
  series = {Cost Effectiveness and Resource Allocation},
  journal   = {Cost Effectiveness and Resource Allocation},
  number    = {21, Article number: 77},
  publisher = {Springer Nature},
  issn      = {1478-7547},
  doi       = {10.1186/s12962-023-00482-4},
  pages     = {12 Seiten},
  year      = {2023},
  abstract  = {Background Hip fractures are a common and costly health problem, resulting in significant morbidity and mortality, as well as high costs for healthcare systems, especially for the elderly. Implementing surgical preventive strategies has the potential to improve the quality of life and reduce the burden on healthcare resources, particularly in the long term. However, there are currently limited guidelines for standardizing hip fracture prophylaxis practices. Methods This study used a cost-effectiveness analysis with a finite-state Markov model and cohort simulation to evaluate the primary and secondary surgical prevention of hip fractures in the elderly. Patients aged 60 to 90 years were simulated in two different models (A and B) to assess prevention at different levels. Model A assumed prophylaxis was performed during the fracture operation on the contralateral side, while Model B included individuals with high fracture risk factors. Costs were obtained from the Centers for Medicare \& Medicaid Services, and transition probabilities and health state utilities were derived from available literature. The baseline assumption was a 10\% reduction in fracture risk after prophylaxis. A sensitivity analysis was also conducted to assess the reliability and variability of the results. Results With a 10\% fracture risk reduction, model A costs between \$8,850 and \$46,940 per quality-adjusted life-year (\$/QALY). Additionally, it proved most cost-effective in the age range between 61 and 81 years. The sensitivity analysis established that a reduction of ≥ 2.8\% is needed for prophylaxis to be definitely cost-effective. The cost-effectiveness at the secondary prevention level was most sensitive to the cost of the contralateral side's prophylaxis, the patient's age, and fracture treatment cost. For high-risk patients with no fracture history, the cost-effectiveness of a preventive strategy depends on their risk profile. In the baseline analysis, the incremental cost-effectiveness ratio at the primary prevention level varied between \$11,000/QALY and \$74,000/QALY, which is below the defined willingness to pay threshold. Conclusion Due to the high cost of hip fracture treatment and its increased morbidity, surgical prophylaxis strategies have demonstrated that they can significantly relieve the healthcare system. Various key assumptions facilitated the modeling, allowing for adequate room for uncertainty. Further research is needed to evaluate health-state-associated risks.},
  language  = {en}
}