@article{HerssensCowburnAlbrachtetal.2022,
  author    = {Herssens, Nolan and Cowburn, James and Albracht, Kirsten and Braunstein, Bjoern and Cazzola, Dario and Colyer, Steffi and Minetti, Alberto E. and Pavei, Gaspare and Rittweger, J{\"o}rn and Weber, Tobias and Green, David A.},
  title     = {Movement in low gravity environments (MoLo) programme - the MoLo-L.O.O.P. study protocol},
  series = {PLOS ONE / Public Library of Science},
  volume    = {17},
  journal   = {PLOS ONE / Public Library of Science},
  number    = {11},
  editor    = {Cattaneo, Luigi},
  publisher = {Plos},
  address   = {San Francisco},
  issn      = {1932-6203},
  doi       = {10.1371/journal.pone.0278051},
  pages     = {e0278051},
  year      = {2022},
  abstract  = {Exposure to prolonged periods in microgravity is associated with deconditioning of the musculoskeletal system due to chronic changes in mechanical stimulation. Given astronauts will operate on the Lunar surface for extended periods of time, it is critical to quantify both external (e.g., ground reaction forces) and internal (e.g., joint reaction forces) loads of relevant movements performed during Lunar missions. Such knowledge is key to predict musculoskeletal deconditioning and determine appropriate exercise countermeasures associated with extended exposure to hypogravity.},
  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{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{UysalFiratCreutzetal.2022,
  author    = {Uysal, Karya and Firat, Ipek Serat and Creutz, Till and Aydin, Inci Cansu and Artmann, Gerhard and Teusch, Nicole and Temiz Artmann, Ayseg{\"u}l},
  title     = {A novel in vitro wound healing assay using free-standing, ultra-thin PDMS membranes},
  series = {membranes},
  volume    = {2023},
  journal   = {membranes},
  number    = {13(1)},
  publisher = {MDPI},
  address   = {Basel},
  doi       = {10.3390/membranes13010022},
  pages     = {Artikel 22},
  year      = {2022},
  abstract  = {Advances in polymer science have significantly increased polymer applications in life sciences. We report the use of free-standing, ultra-thin polydimethylsiloxane (PDMS) membranes, called CellDrum, as cell culture substrates for an in vitro wound model. Dermal fibroblast monolayers from 28- and 88-year-old donors were cultured on CellDrums. By using stainless steel balls, circular cell-free areas were created in the cell layer (wounding). Sinusoidal strain of 1 Hz, 5\% strain, was applied to membranes for 30 min in 4 sessions. The gap circumference and closure rate of un-stretched samples (controls) and stretched samples were monitored over 4 days to investigate the effects of donor age and mechanical strain on wound closure. A significant decrease in gap circumference and an increase in gap closure rate were observed in trained samples from younger donors and control samples from older donors. In contrast, a significant decrease in gap closure rate and an increase in wound circumference were observed in the trained samples from older donors. Through these results, we propose the model of a cell monolayer on stretchable CellDrums as a practical tool for wound healing research. The combination of biomechanical cell loading in conjunction with analyses such as gene/protein expression seems promising beyond the scope published here.},
  language  = {en}
}
@article{ThiebesKleinZingsheimetal.2022,
  author    = {Thiebes, Anja Lena and Klein, Sarah and Zingsheim, Jonas and M{\"o}ller, Georg H. and G{\"u}rzing, Stefanie and Reddemann, Manuel A. and Behbahani, Mehdi and Cornelissen, Christian G.},
  title     = {Effervescent atomizer as novel cell spray technology to decrease the gas-to-liquid ratio},
  series = {pharmaceutics},
  volume    = {14},
  journal   = {pharmaceutics},
  number    = {11},
  publisher = {MDPI},
  address   = {Basel},
  doi       = {10.3390/pharmaceutics14112421},
  pages     = {Artikel 2421},
  year      = {2022},
  abstract  = {Cell spraying has become a feasible application method for cell therapy and tissue engineering approaches. Different devices have been used with varying success. Often, twin-fluid atomizers are used, which require a high gas velocity for optimal aerosolization characteristics. To decrease the amount and velocity of required air, a custom-made atomizer was designed based on the effervescent principle. Different designs were evaluated regarding spray characteristics and their influence on human adipose-derived mesenchymal stromal cells. The arithmetic mean diameters of the droplets were 15.4-33.5 µm with decreasing diameters for increasing gas-to-liquid ratios. The survival rate was >90\% of the control for the lowest gas-to-liquid ratio. For higher ratios, cell survival decreased to approximately 50\%. Further experiments were performed with the design, which had shown the highest survival rates. After seven days, no significant differences in metabolic activity were observed. The apoptosis rates were not influenced by aerosolization, while high gas-to-liquid ratios caused increased necrosis levels. Tri-lineage differentiation potential into adipocytes, chondrocytes, and osteoblasts was not negatively influenced by aerosolization. Thus, the effervescent aerosolization principle was proven suitable for cell applications requiring reduced amounts of supplied air. This is the first time an effervescent atomizer was used for cell processing.},
  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{WerkhausenCroninAlbrachtetal.2019,
  author    = {Werkhausen, Amelie and Cronin, Neil J. and Albracht, Kirsten and Paulsen, G{\o}ran and Larsen, Askild V. and Bojsen-M{\o}ller, Jens and Seynnes, Olivier R.},
  title     = {Training-induced increase in Achilles tendon stiffness affects tendon strain pattern during running},
  series = {PeerJ},
  journal   = {PeerJ},
  publisher = {Peer},
  address   = {London},
  issn      = {21678359},
  doi       = {10.7717/peerj.6764},
  pages     = {18 Seiten},
  year      = {2019},
  abstract  = {Background During the stance phase of running, the elasticity of the Achilles tendon enables the utilisation of elastic energy and allows beneficial contractile conditions for the triceps surae muscles. However, the effect of changes in tendon mechanical properties induced by chronic loading is still poorly understood. We tested the hypothesis that a training-induced increase in Achilles tendon stiffness would result in reduced tendon strain during the stance phase of running, which would reduce fascicle strains in the triceps surae muscles, particularly in the mono-articular soleus. Methods Eleven subjects were assigned to a training group performing isometric singleleg plantarflexion contractions three times per week for ten weeks, and another ten subjects formed a control group. Before and after the training period, Achilles tendon stiffness was estimated, and muscle-tendon mechanics were assessed during running at preferred speed using ultrasonography, kinematics and kinetics. Results Achilles tendon stiffness increased by 18\% (P <0:01) in the training group, but the associated reduction in strain seen during isometric contractions was not statistically significant. Tendon elongation during the stance phase of running was similar after training, but tendon recoil was reduced by 30\% (P <0:01), while estimated tendon force remained unchanged. Neither gastrocnemius medialis nor soleus fascicle shortening during stance was affected by training. Discussion These results show that a training-induced increase in Achilles tendon stiffness altered tendon behaviour during running. Despite training-induced changes in tendon mechanical properties and recoil behaviour, the data suggest that fascicle shortening patterns were preserved for the running speed that we examined. The asymmetrical changes in tendon strain patterns supports the notion that simple inseries models do not fully explain the mechanical output of the muscle-tendon unit during a complex task like running.},
  language  = {en}
}
@article{KetelhutGoellBraunsteinetal.2018,
  author    = {Ketelhut, Maike and G{\"o}ll, Fabian and Braunstein, Bj{\"o}rn and Albracht, Kirsten and Abel, Dirk},
  title     = {Comparison of different training algorithms for the leg extension training with an industrial robot},
  series = {Current Directions in Biomedical Engineering},
  volume    = {4},
  journal   = {Current Directions in Biomedical Engineering},
  number    = {1},
  publisher = {De Gruyter},
  address   = {Berlin},
  issn      = {2364-5504},
  doi       = {10.1515/cdbme-2018-0005},
  pages     = {17 -- 20},
  year      = {2018},
  abstract  = {In the past, different training scenarios have been developed and implemented on robotic research platforms, but no systematic analysis and comparison have been done so far. This paper deals with the comparison of an isokinematic (motion with constant velocity) and an isotonic (motion against constant weight) training algorithm. Both algorithms are designed for a robotic research platform consisting of a 3D force plate and a high payload industrial robot, which allows leg extension training with arbitrary six-dimensional motion trajectories. In the isokinematic as well as the isotonic training algorithm, individual paths are defined i n C artesian s pace by sufficient s upport p oses. I n t he i sotonic t raining s cenario, the trajectory is adapted to the measured force as the robot should only move along the trajectory as long as the force applied by the user exceeds a minimum threshold. In the isotonic training scenario however, the robot's acceleration is a function of the force applied by the user. To validate these findings, a simulative experiment with a simple linear trajectory is performed. For this purpose, the same force path is applied in both training scenarios. The results illustrate that the algorithms differ in the force dependent trajectory adaption.},
  language  = {en}
}
@article{StaeudleSeynnesLapsetal.2022,
  author    = {St{\"a}udle, Benjamin and Seynnes, Olivier and Laps, Guido and Br{\"u}ggemann, Gert-Peter and Albracht, Kirsten},
  title     = {Altered gastrocnemius contractile behavior in former achilles tendon rupture patients during walking},
  series = {Frontiers in Physiology},
  volume    = {13},
  journal   = {Frontiers in Physiology},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2022.792576},
  pages     = {12 Seiten},
  year      = {2022},
  abstract  = {Achilles tendon rupture (ATR) remains associated with functional limitations years after injury. Architectural remodeling of the gastrocnemius medialis (GM) muscle is typically observed in the affected leg and may compensate force deficits caused by a longer tendon. Yet patients seem to retain functional limitations during—low-force—walking gait. To explore the potential limits imposed by the remodeled GM muscle-tendon unit (MTU) on walking gait, we examined the contractile behavior of muscle fascicles during the stance phase. In a cross-sectional design, we studied nine former patients (males; age: 45 ± 9 years; height: 180 ± 7 cm; weight: 83 ± 6 kg) with a history of complete unilateral ATR, approximately 4 years post-surgery. Using ultrasonography, GM tendon morphology, muscle architecture at rest, and fascicular behavior were assessed during walking at 1.5 m⋅s-1 on a treadmill. Walking patterns were recorded with a motion capture system. The unaffected leg served as control. Lower limbs kinematics were largely similar between legs during walking. Typical features of ATR-related MTU remodeling were observed during the stance sub-phases corresponding to series elastic element (SEE) lengthening (energy storage) and SEE shortening (energy release), with shorter GM fascicles (36 and 36\%, respectively) and greater pennation angles (8° and 12°, respectively). However, relative to the optimal fascicle length for force production, fascicles operated at comparable length in both legs. Similarly, when expressed relative to optimal fascicle length, fascicle contraction velocity was not different between sides, except at the time-point of peak series elastic element (SEE) length, where it was 39 ± 49\% lower in the affected leg. Concomitantly, fascicles rotation during contraction was greater in the affected leg during the whole stance-phase, and architectural gear ratios (AGR) was larger during SEE lengthening. Under the present testing conditions, former ATR patients had recovered a relatively symmetrical walking gait pattern. Differences in seen AGR seem to accommodate the profound changes in MTU architecture, limiting the required fascicle shortening velocity. Overall, the contractile behavior of the GM fascicles does not restrict length- or velocity-dependent force potentials during this locomotor task.},
  language  = {en}
}
@article{RichterBraunsteinStaeudleetal.2021,
  author    = {Richter, Charlotte and Braunstein, Bjoern and St{\"a}udle, Benjamin and Attias, Julia and Suess, Alexander and Weber, Tobias and Mileva, Katja N. and Rittweger, Joern and Green, David A. and Albracht, Kirsten},
  title     = {Gastrocnemius medialis contractile behavior is preserved during 30\% body weight supported gait training},
  series = {Frontiers in Sports and Active Living},
  volume    = {2021},
  journal   = {Frontiers in Sports and Active Living},
  number    = {2},
  publisher = {Frontiers},
  address   = {Lausanne},
  issn      = {2624-9367},
  doi       = {10.3389/fspor.2020.614559},
  pages     = {Artikel 614559},
  year      = {2021},
  abstract  = {Rehabilitative body weight supported gait training aims at restoring walking function as a key element in activities of daily living. Studies demonstrated reductions in muscle and joint forces, while kinematic gait patterns appear to be preserved with up to 30\% weight support. However, the influence of body weight support on muscle architecture, with respect to fascicle and series elastic element behavior is unknown, despite this having potential clinical implications for gait retraining. Eight males (31.9 ± 4.7 years) walked at 75\% of the speed at which they typically transition to running, with 0\% and 30\% body weight support on a lower-body positive pressure treadmill. Gastrocnemius medialis fascicle lengths and pennation angles were measured via ultrasonography. Additionally, joint kinematics were analyzed to determine gastrocnemius medialis muscle-tendon unit lengths, consisting of the muscle's contractile and series elastic elements. Series elastic element length was assessed using a muscle-tendon unit model. Depending on whether data were normally distributed, a paired t-test or Wilcoxon signed rank test was performed to determine if body weight supported walking had any effects on joint kinematics and fascicle-series elastic element behavior. Walking with 30\% body weight support had no statistically significant effect on joint kinematics and peak series elastic element length. Furthermore, at the time when peak series elastic element length was achieved, and on average across the entire stance phase, muscle-tendon unit length, fascicle length, pennation angle, and fascicle velocity were unchanged with respect to body weight support. In accordance with unchanged gait kinematics, preservation of fascicle-series elastic element behavior was observed during walking with 30\% body weight support, which suggests transferability of gait patterns to subsequent unsupported walking.},
  language  = {en}
}
@article{QuittmannAbelAlbrachtetal.2022,
  author    = {Quittmann, Oliver J. and Abel, Thomas and Albracht, Kirsten and Str{\"u}der, Heiko K.},
  title     = {Biomechanics of all-out handcycling exercise: kinetics, kinematics and muscular activity of a 15-s sprint test in able-bodied participants},
  series = {Sports Biomechanics},
  volume    = {21},
  journal   = {Sports Biomechanics},
  number    = {10},
  publisher = {Taylor \& Francis},
  address   = {London},
  issn      = {1752-6116 (Onlineausgabe)},
  doi       = {10.1080/14763141.2020.1745266},
  pages     = {1200 -- 1223},
  year      = {2022},
  abstract  = {This study aims to quantify the kinematics, kinetics and muscular activity of all-out handcycling exercise and examine their alterations during the course of a 15-s sprint test. Twelve able-bodied competitive triathletes performed a 15-s all-out sprint test in a recumbent racing handcycle that was attached to an ergometer. During the sprint test, tangential crank kinetics, 3D joint kinematics and muscular activity of 10 muscles of the upper extremity and trunk were examined using a power metre, motion capturing and surface electromyography (sEMG), respectively. Parameters were compared between revolution one (R1), revolution two (R2), the average of revolution 3 to 13 (R3) and the average of the remaining revolutions (R4). Shoulder abduction and internal-rotation increased, whereas maximal shoulder retroversion decreased during the sprint. Except for the wrist angles, angular velocity increased for every joint of the upper extremity. Several muscles demonstrated an increase in muscular activation, an earlier onset of muscular activation in crank cycle and an increased range of activation. During the course of a 15-s all-out sprint test in handcycling, the shoulder muscles and the muscles associated to the push phase demonstrate indications for short-duration fatigue. These findings are helpful to prevent injuries and improve performance in all-out handcycling.},
  language  = {en}
}
@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{SavitskayaZhantlessovaKistaubayevaetal.2023,
  author    = {Savitskaya, Irina and Zhantlessova, Sirina and Kistaubayeva, Aida and Ignatova, Ludmila and Shokatayeva, Dina and Sinyavsky, Yuriy and Kushugulova, Almagul and Digel, Ilya},
  title     = {Prebiotic cellulose-pullulan matrix as a "vehicle" for probiotic biofilm delivery to the host large intestine},
  series = {Polymers},
  journal   = {Polymers},
  number    = {16(1)},
  publisher = {MDPI},
  address   = {Basel},
  doi       = {10.3390/polym16010030},
  pages     = {Artikel 30},
  year      = {2023},
  abstract  = {This study describes the development of a new combined polysaccharide-matrix-based technology for the immobilization of Lactobacillus rhamnosus GG (LGG) bacteria in biofilm form. The new composition allows for delivering the bacteria to the digestive tract in a manner that improves their robustness compared with planktonic cells and released biofilm cells. Granules consisting of a polysaccharide matrix with probiotic biofilms (PMPB) with high cell density (>9 log CFU/g) were obtained by immobilization in the optimized nutrient medium. Successful probiotic loading was confirmed by fluorescence microscopy and scanning electron microscopy. The developed prebiotic polysaccharide matrix significantly enhanced LGG viability under acidic (pH 2.0) and bile salt (0.3\%) stress conditions. Enzymatic extract of feces, mimicking colon fluid in terms of cellulase activity, was used to evaluate the intestinal release of probiotics. PMPB granules showed the ability to gradually release a large number of viable LGG cells in the model colon fluid. In vivo, the oral administration of PMPB granules in rats resulted in the successful release of probiotics in the colon environment. The biofilm-forming incubation method of immobilization on a complex polysaccharide matrix tested in this study has shown high efficacy and promising potential for the development of innovative biotechnologies.},
  language  = {en}
}
@article{WerkhausenAlbrachtCroninetal.2018,
  author    = {Werkhausen, Amelie and Albracht, Kirsten and Cronin, Neil J and Paulsen, G{\o}ran and Bojsen-M{\o}ller, Jens and Seynnes, Olivier R},
  title     = {Effect of training-induced changes in achilles tendon stiffness on muscle-tendon behavior during landing},
  series = {Frontiers in physiology},
  journal   = {Frontiers in physiology},
  number    = {9},
  publisher = {Frontiers Research Foundation},
  address   = {Lausanne},
  issn      = {1664-042X},
  doi       = {10.3389/fphys.2018.00794},
  pages     = {11 Seiten},
  year      = {2018},
  abstract  = {During rapid deceleration of the body, tendons buffer part of the elongation of the muscle-tendon unit (MTU), enabling safe energy dissipation via eccentric muscle contraction. Yet, the influence of changes in tendon stiffness within the physiological range upon these lengthening contractions is unknown. This study aimed to examine the effect of training-induced stiffening of the Achilles tendon on triceps surae muscle-tendon behavior during a landing task. Twenty-one male subjects were assigned to either a 10-week resistance-training program consisting of single-leg isometric plantarflexion (n = 11) or to a non-training control group (n = 10). Before and after the training period, plantarflexion force, peak Achilles tendon strain and stiffness were measured during isometric contractions, using a combination of dynamometry, ultrasound and kinematics data. Additionally, testing included a step-landing task, during which joint mechanics and lengths of gastrocnemius and soleus fascicles, Achilles tendon, and MTU were determined using synchronized ultrasound, kinematics and kinetics data collection. After training, plantarflexion strength and Achilles tendon stiffness increased (15 and 18\%, respectively), and tendon strain during landing remained similar. Likewise, lengthening and negative work produced by the gastrocnemius MTU did not change detectably. However, in the training group, gastrocnemius fascicle length was offset (8\%) to a longer length at touch down and, surprisingly, fascicle lengthening and velocity were reduced by 27 and 21\%, respectively. These changes were not observed for soleus fascicles when accounting for variation in task execution between tests. These results indicate that a training-induced increase in tendon stiffness does not noticeably affect the buffering action of the tendon when the MTU is rapidly stretched. Reductions in gastrocnemius fascicle lengthening and lengthening velocity during landing occurred independently from tendon strain. Future studies are required to provide insight into the mechanisms underpinning these observations and their influence on energy dissipation.},
  language  = {en}
}
@article{YangKriechbaumerAlbrachtetal.2014,
  author    = {Yang, Peng-Fei and Kriechbaumer, Andreas and Albracht, Kirsten and Sanno, Maximilian and Ganse, Bergita and Koy, Timmo and Shang, Peng and br{\"u}ggemann, Gert-Peter and M{\"u}ller, Lars Peter and Rittweger, J{\"o}rn},
  title     = {A novel optical approach for assessing in vivo bone segment deformation and its application in muscle-bone relationship studies in humans},
  series = {Journal of Orthopaedic Translation},
  volume    = {2},
  journal   = {Journal of Orthopaedic Translation},
  number    = {4},
  publisher = {Elsevier},
  address   = {Singapore},
  issn      = {2214-0328},
  doi       = {10.1016/j.jot.2014.07.078},
  pages     = {238 -- 238},
  year      = {2014},
  language  = {en}
}
@article{PogorelovaRogachevAkimbekovetal.2024,
  author    = {Pogorelova, Natalia and Rogachev, Evgeniy and Akimbekov, Nuraly S. and Digel, Ilya},
  title     = {Effect of dehydration method on the micro- and nanomorphological properties of bacterial cellulose produced by Medusomyces gisevii on different substrates},
  series = {Journal of materials science},
  volume    = {2024},
  journal   = {Journal of materials science},
  publisher = {Springer Science + Business Media},
  address   = {Dordrecht},
  issn      = {1573-4803 (Online)},
  doi       = {10.1007/s10853-024-09596-3},
  pages     = {13 Seiten},
  year      = {2024},
  abstract  = {Many important properties of bacterial cellulose (BC), such as moisture absorption capacity, elasticity and tensile strength, largely depend on its structure. This paper presents a study on the effect of the drying method on BC films produced by Medusomyces gisevii using two different procedures: room temperature drying (RT, (24 ± 2 °C, humidity 65 ± 1\%, dried until a constant weight was reached) and freeze-drying (FD, treated at - 75 °C for 48 h). BC was synthesized using one of two different carbon sources—either glucose or sucrose. Structural differences in the obtained BC films were evaluated using atomic force microscopy (AFM), scanning electron microscopy (SEM), and X-ray diffraction. Macroscopically, the RT samples appeared semi-transparent and smooth, whereas the FD group exhibited an opaque white color and sponge-like structure. SEM examination showed denser packing of fibrils in FD samples while RT-samples displayed smaller average fiber diameter, lower surface roughness and less porosity. AFM confirmed the SEM observations and showed that the FD material exhibited a more branched structure and a higher surface roughness. The samples cultivated in a glucose-containing nutrient medium, generally displayed a straight and ordered shape of fibrils compared to the sucrose-derived BC, characterized by a rougher and wavier structure. The BC films dried under different conditions showed distinctly different crystallinity degrees, whereas the carbon source in the culture medium was found to have a relatively small effect on the BC crystallinity.},
  language  = {en}
}
@article{SchoenrockMuckeltHastermannetal.2024,
  author    = {Schoenrock, Britt and Muckelt, Paul E. and Hastermann, Maria and Albracht, Kirsten and MacGregor, Robert and Martin, David and Gunga, Hans-Christian and Salanova, Michele and Stokes, Maria J. and Warner, Martin B. and Blottner, Dieter},
  title     = {Muscle stiffness indicating mission crew health in space},
  series = {Scientific Reports},
  volume    = {14},
  journal   = {Scientific Reports},
  number    = {Article number: 4196},
  publisher = {Springer Nature},
  address   = {London},
  issn      = {2045-2322},
  doi       = {10.1038/s41598-024-54759-6},
  pages     = {13 Seiten},
  year      = {2024},
  abstract  = {Muscle function is compromised by gravitational unloading in space affecting overall musculoskeletal health. Astronauts perform daily exercise programmes to mitigate these effects but knowing which muscles to target would optimise effectiveness. Accurate inflight assessment to inform exercise programmes is critical due to lack of technologies suitable for spaceflight. Changes in mechanical properties indicate muscle health status and can be measured rapidly and non-invasively using novel technology. A hand-held MyotonPRO device enabled monitoring of muscle health for the first time in spaceflight (> 180 days). Greater/maintained stiffness indicated countermeasures were effective. Tissue stiffness was preserved in the majority of muscles (neck, shoulder, back, thigh) but Tibialis Anterior (foot lever muscle) stiffness decreased inflight vs. preflight (p < 0.0001; mean difference 149 N/m) in all 12 crewmembers. The calf muscles showed opposing effects, Gastrocnemius increasing in stiffness Soleus decreasing. Selective stiffness decrements indicate lack of preservation despite daily inflight countermeasures. This calls for more targeted exercises for lower leg muscles with vital roles as ankle joint stabilizers and in gait. Muscle stiffness is a digital biomarker for risk monitoring during future planetary explorations (Moon, Mars), for healthcare management in challenging environments or clinical disorders in people on Earth, to enable effective tailored exercise programmes.},
  language  = {en}
}
@article{ZhenLiangStaatetal.2024,
  author    = {Zhen, Manghao and Liang, Yunpei and Staat, Manfred and Li, Quanqui and Li, Jianbo},
  title     = {Discontinuous fracture behaviors and constitutive model of sandstone specimens containing non-parallel prefabricated fissures under uniaxial compression},
  series = {Theoretical and Applied Fracture Mechanics},
  volume    = {131},
  journal   = {Theoretical and Applied Fracture Mechanics},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0167-8442},
  doi       = {10.1016/j.tafmec.2024.104373},
  pages     = {Artikel 104373},
  year      = {2024},
  abstract  = {The deformation and damage laws of non-homogeneous irregular structural planes in rocks are the basis for studying the stability of rock engineering. To investigate the damage characteristics of rock containing non-parallel fissures, uniaxial compression tests and numerical simulations were conducted on sandstone specimens containing three non-parallel fissures inclined at 0°, 45° and 90° in this study. The characteristics of crack initiation and crack evolution of fissures with different inclinations were analyzed. A constitutive model for the discontinuous fractures of fissured sandstone was proposed. The results show that the fracture behaviors of fissured sandstone specimens are discontinuous. The stress-strain curves are non-smooth and can be divided into nonlinear crack closure stage, linear elastic stage, plastic stage and brittle failure stage, of which the plastic stage contains discontinuous stress drops. During the uniaxial compression test, the middle or ends of 0° fissures were the first to crack compared to 45° and 90° fissures. The end with small distance between 0° and 45° fissures cracked first, and the end with large distance cracked later. After the final failure, 0° fissures in all specimens were fractured, while 45° and 90° fissures were not necessarily fractured. Numerical simulation results show that the concentration of compressive stress at the tips of 0°, 45° and 90° fissures, as well as the concentration of tensile stress on both sides, decreased with the increase of the inclination angle. A constitutive model for the discontinuous fractures of fissured sandstone specimens was derived by combining the logistic model and damage mechanic theory. This model can well describe the discontinuous drops of stress and agrees well with the whole processes of the stress-strain curves of the fissured sandstone specimens.},
  language  = {en}
}
@article{HacklBuessKammerlohretal.2021,
  author    = {Hackl, Michael and Buess, Eduard and Kammerlohr, Sandra and Nacov, Julia and Staat, Manfred and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian},
  title     = {A "comma sign"-directed subscapularis repair in anterosuperior rotator cuff tears yields biomechanical advantages in a cadaveric model},
  series = {The american journal of sports medicine},
  volume    = {49},
  journal   = {The american journal of sports medicine},
  number    = {12},
  publisher = {Sage},
  address   = {London},
  issn      = {1552-3365},
  doi       = {10.1177/03635465211031506},
  pages     = {3212 -- 3217},
  year      = {2021},
  abstract  = {Background: Additional stabilization of the "comma sign" in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign-directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading. Clinical Relevance: The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome.},
  language  = {en}
}
@article{SchierenKleinschmidtSchmutzetal.2019,
  author    = {Schieren, Mark and Kleinschmidt, Joris and Schmutz, Axel and Loop, Torsten and Gatzweiler, Karl-Heinz and Staat, Manfred and Wappler, Frank and Defosse, Jerome},
  title     = {Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study},
  series = {Anaesthesia},
  volume    = {74},
  journal   = {Anaesthesia},
  number    = {12},
  publisher = {Wiley-Blackwell},
  address   = {Oxford},
  isbn      = {1365-2044},
  doi       = {10.1111/anae.14815},
  year      = {2019},
  language  = {en}
}
@article{AngermannGuenthnerHanssenetal.2022,
  author    = {Angermann, Susanne and G{\"u}nthner, Roman and Hanssen, Henner and Lorenz, Georg and Braunisch, Matthias C. and Steubl, Dominik and Matschkal, Julia and Kemmner, Stephan and Hausinger, Renate and Block, Zenonas and Haller, Bernhard and Heemann, Uwe and Kotliar, Konstantin and Grimmer, Timo and Schmaderer, Christoph},
  title     = {Cognitive impairment and microvascular function in end-stage renal disease},
  series = {International Journal of Methods in Psychiatric Research (MPR)},
  volume    = {31},
  journal   = {International Journal of Methods in Psychiatric Research (MPR)},
  number    = {2},
  publisher = {Wiley},
  issn      = {1049-8931 (Print)},
  doi       = {10.1002/mpr.1909},
  pages     = {1 -- 10},
  year      = {2022},
  abstract  = {Objective Hemodialysis patients show an approximately threefold higher prevalence of cognitive impairment compared to the age-matched general population. Impaired microcirculatory function is one of the assumed causes. Dynamic retinal vessel analysis is a quantitative method for measuring neurovascular coupling and microvascular endothelial function. We hypothesize that cognitive impairment is associated with altered microcirculation of retinal vessels. Methods 152 chronic hemodialysis patients underwent cognitive testing using the Montreal Cognitive Assessment. Retinal microcirculation was assessed by Dynamic Retinal Vessel Analysis, which carries out an examination recording retinal vessels' reaction to a flicker light stimulus under standardized conditions. Results In unadjusted as well as in adjusted linear regression analyses a significant association between the visuospatial executive function domain score of the Montreal Cognitive Assessment and the maximum arteriolar dilation as response of retinal arterioles to the flicker light stimulation was obtained. Conclusion This is the first study determining retinal microvascular function as surrogate for cerebral microvascular function and cognition in hemodialysis patients. The relationship between impairment in executive function and reduced arteriolar reaction to flicker light stimulation supports the involvement of cerebral small vessel disease as contributing factor for the development of cognitive impairment in this patient population and might be a target for noninvasive disease monitoring and therapeutic intervention.},
  language  = {en}
}
@article{KotliarOrtnerConradietal.2022,
  author    = {Kotliar, Konstantin and Ortner, Marion and Conradi, Anna and Hacker, Patricia and Hauser, Christine and G{\"u}nthner, Roman and Moser, Michaela and Muggenthaler, Claudia and Diehl-Schmid, Janine and Priller, Josef and Schmaderer, Christoph and Grimmer, Timo},
  title     = {Altered retinal cerebral vessel oscillation frequencies in Alzheimer's disease compatible with impaired amyloid clearance},
  series = {Neurobiology of Aging},
  volume    = {120},
  journal   = {Neurobiology of Aging},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0197-4580},
  doi       = {10.1016/j.neurobiolaging.2022.08.012},
  pages     = {117 -- 127},
  year      = {2022},
  abstract  = {Retinal vessels are similar to cerebral vessels in their structure and function. Moderately low oscillation frequencies of around 0.1 Hz have been reported as the driving force for paravascular drainage in gray matter in mice and are known as the frequencies of lymphatic vessels in humans. We aimed to elucidate whether retinal vessel oscillations are altered in Alzheimer's disease (AD) at the stage of dementia or mild cognitive impairment (MCI). Seventeen patients with mild-to-moderate dementia due to AD (ADD); 23 patients with MCI due to AD, and 18 cognitively healthy controls (HC) were examined using Dynamic Retinal Vessel Analyzer. Oscillatory temporal changes of retinal vessel diameters were evaluated using mathematical signal analysis. Especially at moderately low frequencies around 0.1 Hz, arterial oscillations in ADD and MCI significantly prevailed over HC oscillations and correlated with disease severity. The pronounced retinal arterial vasomotion at moderately low frequencies in the ADD and MCI groups would be compatible with the view of a compensatory upregulation of paravascular drainage in AD and strengthen the amyloid clearance hypothesis.},
  language  = {en}
}
@article{NeumaierWeissVeldemanetal.2021,
  author    = {Neumaier, Felix and Weiss, Miriam and Veldeman, Michael and Kotliar, Konstantin and Wiesmann, Martin and Schulze-Steinen, Henna and H{\"o}llig, Anke and Clusmann, Hans and Schubert, Gerrit Alexander and Albanna, Walid},
  title     = {Changes in endogenous daytime melatonin levels after aneurysmal subarachnoid hemorrhage - preliminary findings from an observational cohort study},
  series = {Clinical Neurology and Neurosurgery},
  volume    = {208},
  journal   = {Clinical Neurology and Neurosurgery},
  number    = {Article No.: 106870},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0303-8467},
  doi       = {10.1016/j.clineuro.2021.106870},
  year      = {2021},
  abstract  = {Aneurysmal subarachnoid hemorrhage (aSAH) is associated with early and delayed brain injury due to several underlying and interrelated processes, which include inflammation, oxidative stress, endothelial, and neuronal apoptosis. Treatment with melatonin, a cytoprotective neurohormone with anti-inflammatory, anti-oxidant and anti-apoptotic effects, has been shown to attenuate early brain injury (EBI) and to prevent delayed cerebral vasospasm in experimental aSAH models. Less is known about the role of endogenous melatonin for aSAH outcome and how its production is altered by the pathophysiological cascades initiated during EBI. In the present observational study, we analyzed changes in melatonin levels during the first three weeks after aSAH.},
  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{KuertenKotliarFuestetal.2021,
  author    = {Kuerten, David and Kotliar, Konstantin and Fuest, Matthias and Walter, Peter and Hollstein, Muriel and Plange, Niklas},
  title     = {Does hemispheric vascular regulation differ significantly in glaucoma patients with altitudinal visual field asymmetry? A single-center, prospective study},
  series = {International Ophthalmology},
  volume    = {41},
  journal   = {International Ophthalmology},
  number    = {41},
  editor    = {Neri, Piergiorgio},
  publisher = {Springer},
  address   = {Berlin},
  isbn      = {1573-2630},
  doi       = {10.1007/s10792-021-01876-0},
  pages     = {3109 -- 3119},
  year      = {2021},
  abstract  = {Purpose Vascular risk factors and ocular perfusion are heatedly discussed in the pathogenesis of glaucoma. The retinal vessel analyzer (RVA, IMEDOS Systems, Germany) allows noninvasive measurement of retinal vessel regulation. Significant differences especially in the veins between healthy subjects and patients suffering from glaucoma were previously reported. In this pilot-study we investigated if localized vascular regulation is altered in glaucoma patients with altitudinal visual field defect asymmetry. Methods 15 eyes of 12 glaucoma patients with advanced altitudinal visual field defect asymmetry were included. The mean defect was calculated for each hemisphere separately (-20.99 ± 10.49 pro- found hemispheric visual field defect vs -7.36 ± 3.97 dB less profound hemisphere). After pupil dilation, RVA measurements of retinal arteries and veins were conducted using the standard protocol. The superior and inferior retinal vessel reactivity were measured consecutively in each eye. Results Significant differences were recorded in venous vessel constriction after flicker light stimulation and overall amplitude of the reaction (p \ 0.04 and p \ 0.02 respectively) in-between the hemispheres spheres. Vessel reaction was higher in the hemisphere corresponding to the more advanced visual field defect. Arterial diameters reacted similarly, failing to reach statistical significance. Conclusion Localized retinal vessel regulation is significantly altered in glaucoma patients with asymmetri altitudinal visual field defects. Veins supplying the hemisphere concordant to a less profound visual field defect show diminished diameter changes. Vascular dysregulation might be particularly important in early glaucoma stages prior to a significant visual field defect.},
  language  = {en}
}
@article{AlbannaConzenWeissetal.2021,
  author    = {Albanna, Walid and Conzen, Catharina and Weiss, Miriam and Seyfried, Katharina and Kotliar, Konstantin and Schmidt, Tobias Philip and Kuerten, David and Hescheler, J{\"u}rgen and Bruecken, Anne and Schmidt-Trucks{\"a}ss, Arno and Neumaier, Felix and Wiesmann, Martin and Clusmann, Hans and Schubert, Gerrit Alexander},
  title     = {Non-invasive assessment of neurovascular coupling after aneurysmal subarachnoid hemorrhage: a prospective observational trial using retinal vessel analysis},
  series = {Frontiers in Neurology},
  volume    = {12},
  journal   = {Frontiers in Neurology},
  number    = {12},
  issn      = {1664-2295},
  doi       = {10.3389/fneur.2021.690183},
  pages     = {1 -- 15},
  year      = {2021},
  abstract  = {Delayed cerebral ischemia (DCI) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) and can lead to infarction and poor clinical outcome. The underlying mechanisms are still incompletely understood, but animal models indicate that vasoactive metabolites and inflammatory cytokines produced within the subarachnoid space may progressively impair and partially invert neurovascular coupling (NVC) in the brain. Because cerebral and retinal microvasculature are governed by comparable regulatory mechanisms and may be connected by perivascular pathways, retinal vascular changes are increasingly recognized as a potential surrogate for altered NVC in the brain. Here, we used non-invasive retinal vessel analysis (RVA) to assess microvascular function in aSAH patients at different times after the ictus.},
  language  = {en}
}
@article{WerfelGuenthnerHapfelmeieretal.2022,
  author    = {Werfel, Stanislas and G{\"u}nthner, Roman and Hapfelmeier, Alexander and Hanssen, Henner and Kotliar, Konstantin and Heemann, Uwe and Schmaderer, Christoph},
  title     = {Identification of cardiovascular high-risk groups from dynamic retinal vessel signals using untargeted machine learning},
  series = {Cardiovascular Research},
  volume    = {118},
  journal   = {Cardiovascular Research},
  number    = {2},
  editor    = {Guzik, Tomasz J.},
  publisher = {Oxford University Press},
  address   = {Oxford},
  issn      = {0008-6363},
  doi       = {10.1093/cvr/cvab040},
  pages     = {612 -- 621},
  year      = {2022},
  abstract  = {Dynamic retinal vessel analysis (DVA) provides a non-invasive way to assess microvascular function in patients and potentially to improve predictions of individual cardiovascular (CV) risk. The aim of our study was to use untargeted machine learning on DVA in order to improve CV mortality prediction and identify corresponding response alterations.},
  language  = {en}
}
@article{MalanHamerKaeneletal.2020,
  author    = {Malan, Leone and Hamer, Mark and K{\"a}nel, Roland von and Kotliar, Konstantin and Wyk, Roelof D. van and Lambert, Gavin W. and Vilser, Walthard and Ziemssen, Tjalf and Schlaich, Markus P. and Smith, Wayne and Magnusson, Martin and Wentzel, Annemarie and Myburgh, Carlien E. and Steyn, Hendrik S. and Malan, Nico T.},
  title     = {Delayed retinal vein recovery responses indicate both non-adaptation to stress as well as increased risk for stroke: the SABPA study},
  series = {Cardiovascular Journal of Africa},
  volume    = {26},
  journal   = {Cardiovascular Journal of Africa},
  number    = {31},
  publisher = {Clinics Cardive Publishing},
  address   = {Durbanville},
  issn      = {1680-0745},
  doi       = {10.5830/CVJA-2020-031},
  pages     = {1 -- 12},
  year      = {2020},
  language  = {en}
}
@article{StreeseKotliarDeiserothetal.2020,
  author    = {Streese, Lukas and Kotliar, Konstantin and Deiseroth, Arne and Infanger, Denis and Gugleta, Konstantin and Schmaderer, Christoph and Hanssen, Henner},
  title     = {Retinal endothelial function in cardiovascular risk patients: A randomized controlled exercise trial},
  series = {Scandinavian Journal of Medicine and Science in Sports},
  volume    = {30},
  journal   = {Scandinavian Journal of Medicine and Science in Sports},
  number    = {2},
  publisher = {Wiley},
  address   = {Oxford},
  issn      = {1600-0838},
  doi       = {10.1111/sms.13560},
  pages     = {272 -- 280},
  year      = {2020},
  abstract  = {The aim of this study was to investigate, for the first time, the effects of high-intensity interval training (HIIT) on retinal microvascular endothelial function in cardiovascular (CV) risk patients. In the randomized controlled trial, middle-aged and previously sedentary patients with increased CV risk (aged 58 ± 6 years) with ≥ two CV risk factors were randomized into a 12-week HIIT (n = 33) or control group (CG, n = 36) with standard physical activity recommendations. A blinded examiner measured retinal endothelial function by flicker light-induced maximal arteriolar (ADmax) and venular (VDmax) dilatation as well as the area under the arteriolar (AFarea) and venular (VFarea) flicker curve using a retinal vessel analyzer. Standardized assessments of CV risk factors, cardiorespiratory fitness, and retinal endothelial function were performed before and after HIIT. HIIT reduced body mass index, fat mass, and low-density lipoprotein and increased muscle mass and peak oxygen uptake (VO2peak). Both ADmax (pre: 2.7 ± 2.1\%, post: 3.0 ± 2.2\%, P = .018) and AFarea (pre: 32.6 ± 28.4\%*s, post: 37.7 ± 30.6\%*s, P = .016) increased after HIIT compared with CG (ADmax, pre: 3.2 ± 1.8\%, post: 2.9 ± 1.8\%, P = .254; AFarea, pre: 41.6 ± 28.5\%*s, post: 37.8 ± 27.0\%*s, P = .186). Venular function remained unchanged after HIIT. There was a significant association between ∆-change VO2peak and ∆-changes ADmax and AFarea (P = .026, R² = 0.073; P = .019, R² = 0.081, respectively). 12-weeks of HIIT improved retinal endothelial function in middle-aged patients with increased CV risk independent of the reduction in classical CV risk factors. Exercise has the potential to reverse or at least postpone progression of small vessel disease in older adults with increased CV risk under standard medication. Dynamic retinal vessel analysis seems to be a sensitive tool to detect treatment effects of exercise interventions on retinal microvascular endothelial function in middle-aged individuals with increased CV risk.},
  language  = {en}
}
@article{HamouKotliarTanetal.2020,
  author    = {Hamou, Hussam Aldin and Kotliar, Konstantin and Tan, Sonny Kian and Weiß, Christel and Blume, Christian and Clusmann, Hans and Schubert, Gerrit Alexander and Albanna, Walid},
  title     = {Surgical nuances and placement of subgaleal drains for supratentorial procedures—a prospective analysis of efficacy and outcome in 150 craniotomies},
  series = {Acta Neurochirurgica},
  volume    = {2020},
  journal   = {Acta Neurochirurgica},
  number    = {162},
  publisher = {Springer Nature},
  address   = {Cham},
  issn      = {0942-0940},
  doi       = {10.1007/s00701-019-04196-6},
  pages     = {729 -- 736},
  year      = {2020},
  abstract  = {Background For supratentorial craniotomy, surgical access, and closure technique, including placement of subgaleal drains, may vary considerably. The influence of surgical nuances on postoperative complications such as cerebrospinal fluid leakage or impaired wound healing overall remains largely unclear. With this study, we are reporting our experiences and the impact of our clinical routines on outcome in a prospectively collected data set. Method We prospectively observed 150 consecutive patients undergoing supratentorial craniotomy and recorded technical variables (type/length of incision, size of craniotomy, technique of dural and skin closure, type of dressing, and placement of subgaleal drains). Outcome variables (subgaleal hematoma/CSF collection, periorbital edema, impairment of wound healing, infection, and need for operative revision) were recorded at time of discharge and at late follow-up. Results Early subgaleal fluid collection was observed in 36.7\% (2.8\% at the late follow-up), and impaired wound healing was recorded in 3.3\% of all cases, with an overall need for operative revision of 6.7\%. Neither usage of dural sealants, lack of watertight dural closure, and presence of subgaleal drains, nor type of skin closure or dressing influenced outcome. Curved incisions, larger craniotomy, and tumor size, however, were associated with an increase in early CSF or hematoma collection (p < 0.0001, p = 0.001, p < 0.01 resp.), and larger craniotomy size was associated with longer persistence of subgaleal fluid collections (p < 0.05). Conclusions Based on our setting, individual surgical nuances such as the type of dural closure and the use of subgaleal drains resulted in a comparable complication rate and outcome. Subgaleal fluid collections were frequently observed after supratentorial procedures, irrespective of the closing technique employed, and resolve spontaneously in the majority of cases without significant sequelae. Our results are limited due to the observational nature in our single-center study and need to be validated by supportive prospective randomized design.},
  language  = {en}
}
@article{RamoshabaHuismanLammertynetal.2020,
  author    = {Ramoshaba, Nthai E. and Huisman, Hugo W. and Lammertyn, Leandi and Kotliar, Konstantin and Schutte, Aletta E. and Smith, Wayne},
  title     = {Retinal microvasculature and masked hypertension in young adults: the African-PREDICT study},
  series = {Hypertension Research},
  journal   = {Hypertension Research},
  number    = {43},
  publisher = {Springer Nature},
  address   = {Osaka},
  issn      = {1348-4214},
  doi       = {10.1038/s41440-020-0487-0},
  pages     = {1231 -- 1238},
  year      = {2020},
  abstract  = {Masked hypertension is known to induce microvascular complications. However, it is unclear whether early microvascular changes are already occurring in young, otherwise healthy adults. We therefore investigated whether retinal microvascular calibers and acute responses to a flicker stimulus are related to masked hypertension. We used the baseline data of 889 participants aged 20-30 years who were taking part in the African Prospective study on the Early Detection and Identification of Cardiovascular Disease and Hypertension. Clinic and 24-h ambulatory blood pressure were measured. The central retinal artery equivalent (CRAE) and central retinal vein equivalent were calculated from fundus images, and retinal vessel dilation was determined in response to flicker light-induced provocation. A smaller CRAE was observed in those with masked hypertension vs. those with normotension (157.1 vs. 161.2 measuring units, P < 0.001). In forward multivariable-adjusted regression analysis, only CRAE was negatively related to masked hypertension [adjusted R² = 0.267, β = -0.097 (95\% CI = -0.165; -0.029), P = 0.005], but other retinal microvascular parameters were not associated with masked hypertension. In multivariable logistic regression analyses, masked hypertension [OR = 2.333, (95\% CI = 1.316; 4.241), P = 0.004] was associated with a narrower CRAE. In young healthy adults, masked hypertension was associated with retinal arteriolar narrowing, thereby reflecting early microvascular alterations known to predict cardiovascular outcomes in later life.},
  language  = {en}
}
@article{SmithKotliarLammertynetal.2020,
  author    = {Smith, Wayne and Kotliar, Konstantin and Lammertyn, Leandi and Ramoshaba, Nthai E. and Vilser, Walthard and Huisman, Hugo W. and Schutte, Aletta E.},
  title     = {Retinal vessel caliber and caliber responses in true normotensive black and white adults: The African-PREDICT study},
  series = {Microvascular Research},
  volume    = {128},
  journal   = {Microvascular Research},
  number    = {Article 103937},
  publisher = {Elsevier},
  address   = {Amsterdam},
  issn      = {0026-2862},
  doi       = {10.1016/j.mvr.2019.103937},
  year      = {2020},
  abstract  = {Purpose Globally, a detrimental shift in cardiovascular disease risk factors and a higher mortality level are reported in some black populations. The retinal microvasculature provides early insight into the pathogenesis of systemic vascular diseases, but it is unclear whether retinal vessel calibers and acute retinal vessel functional responses differ between young healthy black and white adults. Methods We included 112 black and 143 white healthy normotensive adults (20-30 years). Retinal vessel calibers (central retinal artery and vein equivalent (CRAE and CRVE)) were calculated from retinal images and vessel caliber responses to flicker light induced provocation (FLIP) were determined. Additionally, ambulatory blood pressure (BP), anthropometry and blood samples were collected. Results The groups displayed similar 24 h BP profiles and anthropometry (all p > .24). Black participants demonstrated a smaller CRAE (158 ± 11 vs. 164 ± 11 MU, p < .001) compared to the white group, whereas CRVE was similar (p = .57). In response to FLIP, artery maximal dilation was greater in the black vs. white group (5.6 ± 2.1 vs. 3.3 ± 1.8\%; p < .001). Conclusions Already at a young age, healthy black adults showed narrower retinal arteries relative to the white population. Follow-up studies are underway to show if this will be related to increased risk for hypertension development. The reason for the larger vessel dilation responses to FLIP in the black population is unclear and warrants further investigation.},
  language  = {en}
}
@article{NeumaierKotliarHaerenetal.2021,
  author    = {Neumaier, Felix and Kotliar, Konstantin and Haeren, Roel Hubert Louis and Temel, Yasin and L{\"u}ke, Jan Niklas and Seyam, Osama and Lindauer, Ute and Clusmann, Hans and Hescheler, J{\"u}rgen and Schubert, Gerrit Alexander and Schneider, Toni and Albanna, Walid},
  title     = {Retinal Vessel Responses to Flicker Stimulation Are Impaired in Ca v 2.3-Deficient Mice—An in- vivo Evaluation Using Retinal Vessel Analysis (RVA)},
  series = {Frontiers in Neurology},
  volume    = {12},
  journal   = {Frontiers in Neurology},
  publisher = {Frontiers},
  doi       = {10.3389/fneur.2021.659890},
  pages     = {1 -- 11},
  year      = {2021},
  language  = {en}
}