530 results on '"Rosemann, T."'
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2. Effects of particle size, particle density and Reynolds number on equilibrium streaks forming in a square wave serpentine microchannel: A DEM-LBM simulation study including experimental validation of the numerical framework
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Reinecke, S.R., Blahout, S., Zhang, Z., Rosemann, T., Hussong, J., and Kruggel-Emden, H.
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- 2023
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3. Treatment Patterns in Patients with Diagnostic Imaging for Low Back Pain: A Retrospective Observational Study
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Di Gangi S, Bagnoud C, Pichierri G, Rosemann T, and Plate A
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low back pain medication ,radiology ,diagnostic imaging ,nsaids ,opioids ,non-pharmacologic therapies ,Medicine (General) ,R5-920 - Abstract
Stefania Di Gangi,1 Christophe Bagnoud,2 Giuseppe Pichierri,1 Thomas Rosemann,1 Andreas Plate1 1Institute of Primary Care, University and University Hospital Zurich, Zürich, Switzerland; 2Groupe Mutuel, Martigny, SwitzerlandCorrespondence: Stefania Di GangiInstitute of Primary Care, University and University Hospital Zurich, Pestalozzistrasse 24, Zürich, CH-8091, SwitzerlandTel +41 44 255 75 02Fax +41 44 255 90 97Email Stefania.DiGangi@usz.chPurpose: Low back pain (LBP) is one of the most frequent reasons for medical consultations. Literature suggests a large evidence-performance gap, especially regarding pain management. Therefore, the monitoring of treatment patterns is important to ensure high quality of treatment. This study aimed to describe treatment patterns specific to patients with diagnostic imaging of the spine for LBP.Patients and Methods: The study was retrospective observational and based on health claims data from 2015 to 2019 provided by a Swiss health insurance company covering around 12% of the population. Patients, ≥ 18 years of age, with diagnostic imaging of the spine were included and observed 12 months before and after imaging. Patients with back surgery or comorbidities associated with the use of pain medications were excluded.Results: In total, 60,822 patients (mean age: 53.5 y, 56.1% female) were included and 85% received at least one pain medication. Of these, non-steroidal anti-inflammatory drugs, paracetamol, or opioids were prescribed in 88.6%, 70.7%, and 40.3% of patients, respectively. Strong opioids were used in 17% of patients given opioids. Patients with combinations of diagnostic imaging methods had the highest odds of receiving pain medication prescriptions (1.81, 95% CI: 1.66, 1.96, P < 0.001). Prescribed defined daily doses corresponded to short-term therapies.Conclusion: Although the majority of patients received non-opioid short-term therapies, we found a substantial use of opioids, and in particular, a relative high usage of strong opioids. Our results highlighted the importance of both patient and healthcare provider awareness regarding the prudent treatment of LBP.Keywords: low back pain medication, radiology, diagnostic imaging, NSAIDs, opioids, non-pharmacologic therapies
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- 2021
4. DEM-LBM simulation of multidimensional fractionation by size and density through deterministic lateral displacement at various Reynolds numbers
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Reinecke, S.R., Blahout, S., Rosemann, T., Kravets, B., Wullenweber, M., Kwade, A., Hussong, J., and Kruggel-Emden, H.
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- 2021
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5. Benzodiazepine and Z-Drug Use in Switzerland: Prevalence, Prescription Patterns and Association with Adverse Healthcare Outcomes
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Landolt S, Rosemann T, Blozik E, Brüngger B, and Huber CA
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anxiolytics ,sedatives ,pharmacoepidemiology ,health insurance claims data ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Salome Landolt,1 Thomas Rosemann,1 Eva Blozik,1,2 Beat Brüngger,2 Carola A Huber1,2 1Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland; 2Department of Health Sciences, Helsana Insurance Group, Zürich, SwitzerlandCorrespondence: Carola A HuberHelsana Insurance Group, P.O. 8081, Zürich, SwitzerlandTel + 41 43 340 6341Fax +41 43 340 0434Email carola.huber@helsana.chPurpose: This study aimed to give a nationwide comprehensive picture of the prevalence and prescription patterns of benzodiazepines (BZ) and Z-drugs (ZD) in Switzerland and to analyze the association with adverse health care outcomes.Patients and Methods: A population-based, cross-sectional study was conducted, using a large health insurance database in Switzerland. Records from all adult patients with ≥ 1 prescription for a benzodiazepine and/or a Z-drug in 2018 were included. We calculated the prevalence of BZ and ZD user (extrapolated to the Swiss general population), the number of prescriptions and the type of provider (among each BZ and ZD only user). Multivariate logistic regression models were performed to estimate the association between drug prescription and the risk of hospitalization in different healthcare settings.Results: Of a total of 844ʹ692 patients, 95ʹ179 had ≥ 1 BZ and/or ZD prescription in 2018. The extrapolated one-year prevalence for the general Swiss population was 8.1% for a BZ prescription, 3.5% for a ZD prescription, and 10.5% for a BZ and/or ZD prescription, and continuously increased with age. The majority of the elderly (over 65 years) had ≥ 1 prescription (BZ: 51.9%; ZD: 56.9%; BZ and/or ZD: 53.5). The proportion of patients with ≥ 6 prescriptions per year was 23.1% for BZ only user and 35.2% for ZD only user. Most patients had ≥ 1 prescription from a general practitioner. Regression models showed a higher likelihood to be admitted to acute care, psychiatry, rehabilitation, or nursing home with ≥ 1 prescription for a benzodiazepine and/or a Z-drug.Conclusion: This study is the first to give a nationwide overview of the current use of benzodiazepines and Z-drugs in Switzerland based on health insurance claims data. The results revealed a remarkably high prevalence among the general Swiss population, especially in older generations. The negative consequences of heavy BZ and ZD use are a crucial public health problem, that should be addressed.Keywords: anxiolytics, sedatives, pharmacoepidemiology, health insurance claims data
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- 2021
6. Trends in Micronutrient Laboratory Testing in Switzerland: A 7-Year Retrospective Analysis of Healthcare Claims Data
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Huber CA, Nagler M, Rosemann T, Blozik E, Näpflin M, and Markun S
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laboratory testing ,micronutrient ,claims data ,trend ,Medicine (General) ,R5-920 - Abstract
Carola A Huber,1,2 Michael Nagler,3 Thomas Rosemann,2 Eva Blozik,1,2 Markus Näpflin,1 Stefan Markun2 1Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland; 2Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland; 3University Institute of Clinical Chemistry, Inselspital Bern University Hospital, University of Bern, Bern, SwitzerlandCorrespondence: Carola A HuberDepartment of Health Sciences, Helsana Insurance Group, P.O. Box, 8081, Zürich, SwitzerlandTel +41 43 340 6341Fax +41 43 340 0434Email carola.huber@helsana.chBackground: Micronutrient laboratory tests (MLT) are increasing in many healthcare systems. This study assessed time trends of annual MLT incidence in the Swiss population and examined the frequency of specific MLT, defined as the number of yearly tests performed in individual persons.Methods: For annual time trends, we used a longitudinal design with a seven-year observation period (2012– 2018) and for yearly testing frequency we used a cross-sectional design (2018 only). The database consisted of nationwide insurance claims from adult persons.Results: Persons with MLT compared to persons without were older (mean age 57.1 years vs 48.6 years) and to a higher proportion female (65.1% vs 45.5%). Between 2012 and 2018, we included 6.7 million person years and found an increase in the proportion of persons receiving any MLT from 24.5% to 35.0%. Tests with strongest absolute increase during the observation period were vitamin D (from 7.4% of persons to 20.4%), vitamin B12 (from 9.0% to 17.6%) and ferritin (from 17.4% to 26.6%). In 2018, vitamin D and vitamin B12 tests were performed more than once in 4.5% and 3.3% of the population, respectively.Conclusion: We found that the Swiss population undergoes MLT with high and increasing frequency. Testing for vitamin D, vitamin B12 and ferritin is very common and of questionable appropriateness.Keywords: laboratory testing, micronutrient, claims data, trend
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- 2020
7. Characteristics, Preferences and Health Care Utilization in Patients Using a Dietary Supplement for Improving Sleeping Disturbances: Results from an Explorative Online Survey
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Di Gangi S, Markun S, Rosemann T, and Plate A
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supplement use ,sleeping disorders ,usage patterns ,drugs ,health care utilization. ,Medicine (General) ,R5-920 - Abstract
Stefania Di Gangi, Stefan Markun, Thomas Rosemann, Andreas Plate Institute of Primary Care, University and University Hospital of Zürich, Zürich, SwitzerlandCorrespondence: Stefania Di GangiInstitute of Primary Care, University of Zurich, Pestalozzistrasse 24, Zürich 8091, SwitzerlandTel +41 44 255 75 02Fax +41 44 255 90 97Email stefania.digangi@usz.chPurpose: Sleeping disturbances are highly prevalent in the general population, and pharmacological drug treatment harbours the risk of serious side effects. Many affected persons use dietary supplements for self-treating their symptoms, but little is known about the specific characteristics and preferences of these patients. Even less evidence exists about the consequences of a specific dietary supplement usage on health care utilization. The aim of this study was to explore characteristics, preferences and the impact on health care utilization in patients using a specific over-the-counter dietary supplement, which is promoted for improving sleeping disturbances.Patients and Methods: We conducted a structured survey and invited a sample of 297 customers of a specific dietary supplement to participate. The survey was open between June and September 2020. Participants were invited by email. All participants accepted an informed consent.Results: A total of 127 customers participated in the survey (participation rate: 42.8%). Of them, 87.7% were female and the mean age 50.5 years. Participants reported an overall good improvement of symptoms (7.66 on a ten-point Likert-scale) and showed a strong belief in the effectiveness of supplements in general; 67% of participants reported that the intake led to fever physician encounters, and 48.3% reported that they could stop the intake of other pharmaceutical sleeping drugs.Conclusion: A significant proportion of participants reported a substantial reduction in pharmaceutical drug use and health care utilization. While these self-reports lack an adequate control, they are still real consumer experiences, and the large beneficial effects – whether placebo or not – explain the popularity of such supplements and their therapeutic potential in sleeping disorders.Keywords: supplement use, sleeping disorders, usage patterns, drugs, health care utilization
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- 2020
8. Comparison of numerical schemes for 3D lattice Boltzmann simulations of moving rigid particles in thermal fluid flows
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Rosemann, T., Kravets, B., Reinecke, S.R., Kruggel-Emden, H., Wu, M., and Peters, B.
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- 2019
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9. Shared decision making for men facing prostate cancer treatment: a systematic review of randomized controlled trials
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Martínez-González NA, Plate A, Markun S, Senn O, Rosemann T, and Neuner-Jehle S
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Cancer ,Oncology ,Review ,Systematic ,Decision Making ,Shared Decision Making ,Prostate Cancer ,Treatment ,Urology ,Controlled Clinical Trials ,Medicine (General) ,R5-920 - Abstract
Nahara Anani Martínez-González, Andreas Plate, Stefan Markun, Oliver Senn, Thomas Rosemann, Stefan Neuner-JehleInstitute of Primary Care, University of Zurich and University Hospital of Zurich, Zurich CH-8091, SwitzerlandAims: To synthesize the empirical evidence on the effectiveness of shared decision making (SDM) compared to usual care for prostate cancer (PC) treatment.Methods and results: A systematic review of academic (MEDLINE, EMBASE, Cochrane Library, CINHAL, PsychINFO, and Scopus) and grey (clinicaltrials.gov, WHO trial search, meta-Register ISRCTN, Google Scholar, opengrey, and ohri.ca) literature, also identified from contacting authors and hand-searching bibliographies. We included randomized controlled trials (RCTs): 1) comparing SDM to usual care for decisions about PC treatment, 2) conducted in primary or specialized care, 3) fulfilling the key SDM features, and 4) reporting quantitative outcome data. Four RCTs from Canada (n=3) and the USA were included and comprised 1,065 randomized men, most (89.8%) of whom were in PC stage T1-T2. The studies reported 24 outcome measures. In 62.5% study estimates, SDM was similar to usual care at improving patient satisfaction and mood, and at reducing decisional conflict and decisional regret. In 37.5% study estimates, SDM significantly improved knowledge, perception of being informed and patient-perceived quality of life (QoL) at four weeks. There was a dearth of outcome data, particularly on the adherence to treatment and on patient-important and clinically relevant health outcomes such as symptoms and mortality.Conclusion: SDM may positively influence men’s knowledge and may have a positive but short-term effect on patient-perceived QoL. The (long-term) effects of SDM on patient-related outcomes for decisions about PC treatment are unclear. Future research needs consensus about the interventions and outcomes needed to evaluate SDM and should address the absence of evidence on health outcomes.Keywords: systematic review, shared decision making, prostate cancer, treatment, controlled clinical trials, urology
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- 2019
10. Motivation in ultra-marathon runners
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Waśkiewicz Z, Nikolaidis PT, Chalabaev A, Rosemann T, and Knechtle B
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psychological profile ,questionnaire ,survey ,ultra-endurance. ,Psychology ,BF1-990 ,Industrial psychology ,HF5548.7-5548.85 - Abstract
Zbigniew Waśkiewicz,1,2 Pantelis T Nikolaidis,3,4 Aïna Chalabaev,5 Thomas Rosemann,6 Beat Knechtle6,7 1Department of Team Sports, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; 2Department of Sports Medicine and Medical Rehabilitation, Sechenov University, Moscow, Russia; 3Exercise Testing Laboratory, Hellenic Air Force Academy, Acharnes, Greece; 4Exercise Physiology Laboratory, Nikaia, Greece; 5UFR APS, Université Grenoble Alpes, Grenoble, France; 6Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland; 7Institute of Primary Care, University of Zurich, Zurich, Switzerland Background: In ultra-marathon running the proper motivation of the athlete is one of the milestones, not only during the races, but also during the practice sessions, which are long and very exhausting. Purpose: The aim of this study was to examine the relationship of sport experience (expressed as number of finishes in ultra-marathons) with motivation characteristics of ultra-marathon runners. Subjects and methods: The Motivation of Marathoners Scale examined the motivation of ultra-marathon runners compared to endurance runners of shorter distances (control group). Participants were 1,539 Polish runners, 382 women (24.7%) and 1,157 men (75.3%). Ultra-marathoners (N=425; 26.7%) finished at least one ultra-marathon, whereas the control group consisted of runners of shorter distances (N=1,114, 72.3%). Results: Ultra-marathoners had higher scores in affiliation (3.55±1.60 vs 3.34±1.62, P
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- 2018
11. Anxiety, depression symptoms, and physical activity levels of eutrophic and excess-weight Brazilian elite police officers: a preliminary study
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Vancini RL, de Lira CAB, Anceschi SA, Rosa AV, Lima-Leopoldo AP, Leopoldo AS, Rufo-Tavares W, Andrade MS, Nikolaidis PT, Rosemann T, and Knechtle B
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Depression ,Anxiety ,Habitual physical activity ,Police officers ,Psychology ,BF1-990 ,Industrial psychology ,HF5548.7-5548.85 - Abstract
Rodrigo L Vancini,1 Claudio AB de Lira,2 Sarah A Anceschi,1 André V Rosa,1 Ana P Lima-Leopoldo,1 André S Leopoldo,1 Weverton Rufo-Tavares,1 Marilia S Andrade,3 Pantelis T Nikolaidis,4 Thomas Rosemann,5 Beat Knechtle5 1Departamento de Desportos, Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil; 2Setor de Fisiologia Humana e do Exercício, Faculdade de Educação Física e Dança, Universidade Federal de Goiás, Goiânia, Goiás, Brazil; 3Departamento de Fisiologia, Universidade Federal de São Paulo, São Paulo, Brazil; 4Exercise Physiology Laboratory, Nikaia, Greece; 5Institute of Primary Care, University of Zurich, Zurich, Switzerland Background: Police officers are subjected to high work-related stress. This scenario of irregular and insalubrious working conditions may be related to an increase in psychiatric disorders and overweight. In particular, low levels of physical activity and high work stress levels may predispose police officers to obesity, poor lifestyles, and, consequently, major risk of psychological disorders. Thus, our aim was to profile the anxiety/depression symptoms and habitual physical activity (HPA) levels of Brazilian elite police officers classified by body mass index (BMI). Patients and methods: Eighty-seven male police officers classified as normal-weight (NG, BMI =18.5–24.9 kg/m2, n=34) and excess-weight (EG, BMI ≥25 kg/m2, n=53) completed (before work routine time) the questionnaires: Baecke (HPA levels), State-Trait Anxiety Inventory (anxiety), and Beck Depression Inventory (depression). Results: There was a slight trend (despite did not reach statistical significance) of the EG group (which have a significantly [P=0.0369] higher mean [8.8±7.6] of military service time [in years] when compared to NG group [5.8±6.0]) presenting higher values of anxiety-trait (+5.0%) and depression (+16.0%) and lower levels of leisure time HPA (–3.7%) than NG group. Conclusion: Although our hypothesis was not ratified, our findings have clinical relevance because we profiled the anxiety and depression symptoms and HPA levels of elite police officers. Moreover, it is possible to suppose that the military service time (years) is a relevant factor, that it needs to be studied in depth, and that it may impact the predisposition for mood disorders and low levels of physical activity of police officers. Keywords: depression, mood state, physical activity, physical exercise, physical fitness, police officers
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- 2018
12. Concept and Measurement Results of Two Decentralized Solar Thermal Feed-in Substations
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Heymann, M., Rosemann, T., Rühling, K., Tietze, T., and Hafner, B.
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- 2018
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13. The effect of physiotherapy and acupuncture on psychocognitive, somatic, quality of life, and disability characteristics in TTH patients
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Georgoudis G, Felah B, Nikolaidis PT, Papandreou M, Mitsiokapa E, Mavrogenis AF, Rosemann T, and Knechtle B
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tension type headache ,acupuncture ,physiotherapy ,stretching ,psycho-cognitive characteristics ,myofascial release ,Medicine (General) ,R5-920 - Abstract
George Georgoudis,1,2 Bledjana Felah,2 Pantelis T Nikolaidis,3 Maria Papandreou,1 Evanthia Mitsiokappa,4 Andreas F Mavrogenis,4 Thomas Rosemann,5 Beat Knechtle5,6 1Musculoskeletal and Respiratory Research Lab, Department of Physiotherapy, University of West Attica, Athens, Greece; 2PhysioPain Group, Pain Specialist & Rehabilitation Centers, Athens, Greece; 3Exercise Physiology Laboratory, Nikaia, Greece; 4First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; 5Institute of Primary Care, University of Zurich, Zurich, Switzerland; 6Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland Introduction: Nonpharmacological therapies have been widely used to treat tension-type headache (TTH); however, limited evidence exists with regards to their effectiveness. Therefore, the aim of the present study was to examine the combined effect of acupuncture, stretching, and physiotherapy (myofascial release techniques and microwave diathermy) on psychocognitive, somatic, quality of life, and disability characteristics in such patients. Subjects and methods: Patients with TTH (n=44) performed either acupuncture or stretching (control group, n=20) or acupuncture, stretching, and physiotherapy (experimental group, n=24) during a 4-week intervention period including 10 treatment sessions. They were tested for the Greek version of the Short-Form McGill Pain Questionnaire, the Greek version of the Migraine Disability Assessment Questionnaire, the Greek version of the Hospital Anxiety and Depression Scale, Short Form Health Survey 12 9 (SF-12), and Pain Catastrophizing Scale at baseline after the fifth and tenth sessions. Results: All measures were improved throughout the first to tenth session (P0.05). Conclusion: In summary, a significant beneficial role of acupuncture, stretching, and physiotherapy on cognitive, psychosomatic pain measures, disability index, quality of life, and catastrophizing in patients with TTH was observed. Keywords: tension-type headache, acupuncture, physiotherapy, stretching, psychocognitive characteristics, myofascial release
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- 2018
14. How much further for the sub-2-hour marathon?
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Sousa CV, Sales MM, Nikolaidis PT, Rosemann T, and Knechtle B
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endurance ,running ,performance ,pacing ,drafting ,Sports medicine ,RC1200-1245 - Abstract
Caio Victor Sousa,1 Marcelo Magalhães Sales,2 Pantelis Theodoros Nikolaidis,3 Thomas Rosemann,4 Beat Knechtle4,5 1Graduate Program in Physical Education, Universidade Católica de Brasília, Brasília, Brazil; 2Physical Education Department, Universidade Estadual de Goiás, Quirinópolis, Goiás, Brazil; 3Exercise Physiology Laboratory, Nikaia, Greece; 4Institute of Primary Care, University of Zurich, Zurich, Switzerland; 5Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland Abstract: The sub-2-hour marathon is a new barrier in endurance running performance, and it has been widely debated in the scientific community. In this review we present a mathematical model to estimate the possible year when a male could break through the sub-2-hour barrier, and also an estimation of when a female could break Paula Radcliffe’s marathon running record. Further, we present several aspects (ie, physiology, nationality, age, biomechanics, pacing, and drafting) that are associated with marathon running performance in elite runners and, finally, the possible characteristics of the male to break the sub-2-hour barrier. In summary, with the results of the developed equations, it is possible that a male athlete can break through the sub-2-hour barrier in the next decade (with Nike® Breaking2 performance 1920–2018 [NBP]: y =0.0417x2–14.18x +3,128; year of 2026; without NBP 1920–2018: y =0.045x2–15.12x +3,194; year of 2027). This marathoner will possibly have a maximal oxygen uptake >85 mL∙kg–1∙min–1 and should perform the race at a pacing higher than 85% of maximal oxygen uptake. In addition, this runner should pay more attention to strength training, endurance strength, speed training, and focus on running training at an intensity above the anaerobic threshold. Most likely, this runner originates from East Africa (especially from Ethiopia) and will have an age of ~27 years. For the females, there is poor evidence regarding the physiological profile of the female marathoner who will break Radcliffe’s record, but the available literature suggests that it will not happen any time soon. Keywords: endurance, running, performance, pacing, drafting
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- 2018
15. The age of peak performance in women and men duathletes – The paradigm of short and long versions in “Powerman Zofingen&rdquo
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Nikolaidis PT, Villiger E, Ardigò LP, Waśkiewicz Z, Rosemann T, and Knechtle B
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aging ,cycling ,master athletes ,running ,ultra-endurance ,Sports medicine ,RC1200-1245 - Abstract
Pantelis T Nikolaidis,1,2 Elias Villiger,3 Luca P Ardigò,4 Zbigniew Waśkiewicz,5 Thomas Rosemann,3 Beat Knechtle3,6 1Exercise Physiology Laboratory, Nikaia, Greece; 2Exercise Testing Laboratory, Hellenic Air Force Academy, Acharnes, Greece; 3Institute of Primary Care, University of Zurich, Zurich, Switzerland; 4Department of Neurosciences, Biomedicine and Movement Sciences, School of Exercise and Sport Science, University of Verona, Verona, Italy; 5Department of Team Sports, Academy of Physical Education, Katowice, Poland; 6Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland Purpose: The age of peak performance (APP) has been studied extensively in various endurance and ultra-endurance sports; however, less information exists in regard to duathlon (ie, Run1, Bike, and Run2). The aim of the present study was to assess the APP of duathletes competing either in a short (ie, 10 km Run1, 50 km Bike, and 5 km Run2) or a long distance (ie, 10 km Run1, 150 km Bike, and 30 km Run2) race. Participants and methods: We analyzed 6,671 participants (women, n=1,037, age 36.6±9.1 years; men, n=5,634, 40.0±10.0 years) in “Powerman Zofingen” from 2003 to 2017. Results: Considering the finishers in 5-year age groups, in the short distance, a small main effect of sex on race time was observed (p
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- 2018
16. Acute exacerbated COPD: room for improvement in key elements of care
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Markun S, Franzen DP, Dalla Lana K, Beyer S, Wieser S, Hess T, Kohler M, Rosemann T, Senn O, and Steurer-Stey C
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Audit ,COPD ,exacerbation ,guideline recommendations ,hospital medicine ,performance of care ,Diseases of the respiratory system ,RC705-779 - Abstract
Stefan Markun,1,* Daniel P Franzen,2,* Kaba Dalla Lana,1 Swantje Beyer,3 Stephan Wieser,4 Thomas Hess,3 Malcolm Kohler,2 Thomas Rosemann,1 Oliver Senn,1 Claudia Steurer-Stey1,5 1Institute of Primary Care, 2Department of Pneumology, University Hospital Zurich, University of Zurich, Zurich, 3Department of Pneumology, Cantonal Hospital of Winterthur, Winterthur, 4Department of Pneumology, City Hospital Waid, 5MediX Group Practice Ltd, Zurich, Switzerland *These authors contributed equally to this work Introduction: Hospitalizations because of acute exacerbated COPD (AECOPD) are a major burden to patients and the health care system. Interventions during acute and post-acute hospital care exist not only to improve short-term outcomes but also to prevent future exacerbations and disease progression. We aimed at measuring the implementation rates of acute and post-acute hospital care interventions for AECOPD.Methods: We performed 24 months (January 1, 2012, to December 31, 2013) retrospective medical chart review of consecutive cases hospitalized to one of three public hospitals in the canton of Zurich due to AECOPD. Implementation rates of five acute care and seven post-acute care interventions were assessed.Results: Data from 263 hospitalizations (61% male, mean age 68.5 years, 47% active smokers) were analyzed. The median length of stay was 9 days (interquartile range [IQR] 6–12 days). In all, 32% of hospitalizations were caused by individuals with previous hospitalizations because of AECOPD. Implementation rates of four acute care interventions were >75% (lowest was appropriate antibiotic therapy with 56%). Compared to this, implementation rates of five post-acute care interventions were
- Published
- 2017
17. Patient-provider concordance in the perception of illness and disease: a cross-sectional study among multimorbid patients and their general practitioners in Switzerland
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Neuner-Jehle S, Zechmann S, Grundmann Maissen D, Rosemann T, and Senn O
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Deprescribing – multimorbidity – patient-provider concordance – chief complaint ,Medicine (General) ,R5-920 - Abstract
Stefan Neuner-Jehle, Stefan Zechmann, Daniela Grundmann Maissen, Thomas Rosemann, Oliver Senn Institute of Primary Care, University of Zurich, Zurich, Switzerland Background: Multiple chronic health conditions are leading to multiple treatment procedures and polypharmacy. Prioritizing treatment according to patients’ needs and preferences may be helpful for deprescribing. Thus, for improving health care, it is crucial for general practitioners (GPs) to perceive the chief complaints (CCs) of patients. The primary aim of this study was to investigate the patient–provider concordance of CCs and the secondary aim was to investigate the concordance between CCs and diagnosis, in a sample of Swiss multimorbid patients. Materials and methods: A cross-sectional analysis based on a cluster randomized controlled trial (RCT) among 46 GPs, recruited between March 2015 to July 2016, and 334 multimorbid patients (≥60 years taking ≥5 drugs for at least 6 months) in Northern Switzerland was performed. CCs listed by GPs and by patients (n=128) were classified according to the International Classification of Primary Care, version 2 (ICPC-2) coding system on chapter and component level and defined as concordant if ICPC-2 codes of patients and GPs were identical. Concordance was classified into full, moderate or low, depending on the ranking of patients’ CCs on GPs’ list. As secondary outcome, we compared patients’ CCs to GPs’ diagnosis. Statistics included descriptive measures and a multivariate regression analysis of factors that are modifying concordance. Results: The mean age of patients was 76.9 (SD 8.1) years, where 38% were male, taking 7.9 (SD 2.6) drugs on the long term. The most frequent complaint was pain. Concordance of the CC was given in 101/128 (78.9%) on the ICPC-2 chapter level, whereby 86/128 (67.2%) showed full, 8/128 (6.3%) moderate and 7/128 (5.5%) low concordance; 27/128 (21.1%) were discordant. Concordance between CCs and diagnosis was 53.6%. Concordance increased with the intensity of the CC rated by patients (OR 1.48, CI 1.13–1.94, P
- Published
- 2017
18. Improvements in primary care skills and knowledge with a vocational training program – a pre–post survey
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Djalali S, Tandjung R, Rosemann T, and Markun S
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Primary Care ,Career Choice ,Physicians ,Family/trends ,Internship and Residency/trends ,Switzerland ,Surveys and Questionnaires ,Special aspects of education ,LC8-6691 ,Medicine (General) ,R5-920 - Abstract
Sima Djalali, Ryan Tandjung, Thomas Rosemann, Stefan Markun Institute of Primary Care, University of Zurich, University Hospital Zurich, Zurich, Switzerland Background: Facing the upcoming shortage of primary care physicians (PCPs), medical and governmental organizations have recently made major investments to foster vocational training programs in Switzerland, designed to provide context-specific training for trainees in primary care practices. Less is known about the impact of these programs on the skills and specific knowledge of trainees. We aimed to evaluate the Cantonal program for vocational primary care training in the Canton of Zurich, Switzerland’s largest Canton.Methods: We undertook a pretest–posttest study and surveyed physicians before and after participating in the Cantonal program for vocational primary care training in the Swiss Canton of Zurich. All trainees who participated in the program from 2013 until the end of 2015 were eligible. Primary outcome was the proportion of trainees being confident about their professional, organizational, examination and management skills before and after completing vocational training. Secondary outcomes were the proportion of trainees stating knowledge gain in entrepreneurship and the proportion of trainees being motivated to pursue a career as PCP.Results: Data of 47 trainees participating in the vocational training between 2013 and 2015 were eligible. In total, 35 (74.5%) participated in the T1 survey and 34 (72.3%) in the T2 survey. At T2, significantly more trainees (T1: 11%−89%, T2: 79%−100%) stated to be at least “slightly confident” about their skills (p
- Published
- 2017
19. A set of four simple performance measures reflecting adherence to guidelines predicts hospitalization: a claims-based cohort study of patients with diabetes
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Huber CA, Brändle M, Rapold R, Reich O, and Rosemann T
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diabetes ,adherence ,guidelines ,hospitalization ,Medicine (General) ,R5-920 - Abstract
Carola A Huber,1 Michael Brändle,2 Roland Rapold,1 Oliver Reich,1 Thomas Rosemann3 1Department of Health Sciences, Helsana Group, Zürich, 2Division of Endocrinology and Diabetes, Department of Internal Medicine, Kantonsspital St Gallen, St Gallen, 3Institute of Primary Care, University of Zürich, University Hospital Zürich, Zürich, Switzerland Background: The link between guideline adherence and outcomes is a highly demanded issue in diabetes care. We aimed to assess the adherence to guidelines and its impact on hospitalization using a simple set of performance measures among patients with diabetes. Methods: We performed a retrospective cohort study, using health care claims data for adult patients with treated diabetes (2011–2013). Patients were categorized into three drug treatment groups (with oral antidiabetic agents [OAs] only, in combination with insulin, and insulin only). Performance measures were based on international established guidelines for diabetes care. Multivariate logistic regression models predicted the probability of hospitalization (2013) by adherence level (2011) among all treatment groups. Results: A total of 40,285 patients with diabetes were enrolled in 2011. Guideline adherence was quite low: about 70% of all patients received a biannual hemoglobin A1c measurement and 19.8% had undergone an annual low-density lipoprotein cholesterol test. Only 4.8% were exposed to full adherence including all performance measures (OAs: 3.7%; insulin: 7.7%; and in combination: 7.2%). Increased guideline adherence was associated with decreased probability of hospitalization. This effect was strongest in patients using OAs and insulin in combination. Conclusion: Our study showed that measures to reflect physicians’ guideline adherence in diabetes care can easily be calculated based on already available datasets. Furthermore, these measures are clearly linked with the probability of hospitalization suggesting that a better guideline adherence by physicians could help to prevent a large number of hospitalizations. Keywords: diabetes, adherence, guidelines, hospitalization, antidiabetic agents, insulin
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- 2016
20. Feet swelling in a multistage ultraendurance triathlete: a case study
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Knechtle B, Zingg MA, Knechtle P, Rosemann T, and Rüst CA
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Medicine (General) ,R5-920 - Abstract
Beat Knechtle,1 Matthias Alexander Zingg,2 Patrizia Knechtle,1 Thomas Rosemann,2 Christoph Alexander Rüst2 1Gesundheitszentrum St Gallen, St Gallen, 2Institute of Primary Care, University of Zurich, Zurich, Switzerland Abstract: Recent studies investigating ultraendurance athletes showed an association between excessive fluid intake and swelling of the lower limbs such as the feet. To date, this association has been investigated in single-stage ultraendurance races, but not in multistage ultraendurance races. In this case study, we investigated a potential association between fluid intake and feet swelling in a multistage ultraendurance race such as a Deca Iron ultratriathlon with ten Ironman triathlons within 10 consecutive days. A 49-year-old well-experienced ultratriathlete competed in autumn 2013 in the Deca Iron ultratriathlon held in Lonata del Garda, Italy, and finished the race as winner within 129:33 hours:minutes. Changes in body mass (including body fat and lean body mass), foot volume, total body water, and laboratory measurements were assessed. Food and fluid intake during rest and competing were recorded, and energy and fluid turnovers were estimated. During the ten stages, the volume of the feet increased, percentage body fat decreased, creatinine and urea levels increased, hematocrit and hemoglobin values decreased, and plasma [Na+] remained unchanged. The increase in foot volume was significantly and positively related to fluid intake during the stages. The poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. This case report shows that the volume of the foot increased during the ten stages, and the increase in volume was significantly and positively related to fluid intake during the stages. Furthermore, the poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. The continuous feet swelling during the race was most probably due to a combination of a high fluid intake and a progressive decline in renal function (ie, continuous increase in creatinine and urea), leading to body fluid retention (ie, increase in total body water). Keywords: swimming, cycling, running, fluid
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- 2015
21. Variables that influence Ironman triathlon performance – what changed in the last 35 years?
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Knechtle B, Knechtle R, Stiefel M, Zingg MA, Rosemann T, and Rüst CA
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Sports medicine ,RC1200-1245 - Abstract
Beat Knechtle,1,2 Raphael Knechtle,2 Michael Stiefel,2 Matthias Alexander Zingg,2 Thomas Rosemann,2 Christoph Alexander Rüst21Gesundheitszentrum St Gallen, St Gallen, 2Institute of Primary Care, University of Zurich, Zurich, SwitzerlandObjective: This narrative review summarizes findings for Ironman triathlon performance and intends to determine potential predictor variables for Ironman race performance in female and male triathletes.Methods: A literature search was performed in PubMed using the terms “Ironman”, “triathlon”, and “performance”. All resulting articles were searched for related citations.Results: Age, previous experience, sex, training, origin, anthropometric and physiological characteristics, pacing, and performance in split disciplines were predictive. Differences exist between the sexes for anthropometric characteristics. The most important predictive variables for a fast Ironman race time were age of 30–35 years (women and men), a fast personal best time in Olympic distance triathlon (women and men), a fast personal best time in marathon (women and men), high volume and high speed in training where high volume was more important than high speed (women and men), low body fat, low skin-fold thicknesses and low circumference of upper arm (only men), and origin from the United States of America (women and men).Conclusion: These findings may help athletes and coaches to plan an Ironman triathlon career. Age and previous experience are important to find the right point in the life of a triathlete to switch from the shorter triathlon distances to the Ironman distance. Future studies need to correlate physiological characteristics such as maximum oxygen uptake with Ironman race time to investigate their potential predictive value and to investigate socio-economic aspects in Ironman triathlon.Keywords: swimming, cycling, running, age, body fat, sex
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- 2015
22. What predicts performance in ultra-triathlon races? – a comparison between Ironman distance triathlon and ultra-triathlon
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Knechtle B, Zingg MA, Rosemann T, Stiefel M, and Rüst CA
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Sports medicine ,RC1200-1245 - Abstract
Beat Knechtle,1,2 Matthias Alexander Zingg,1 Thomas Rosemann,1 Michael Stiefel,1 Christoph Alexander Rüst11Institute of Primary Care, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, Switzerland Objective: This narrative review summarizes recent intentions to find potential predictor variables for ultra-triathlon race performance (ie, triathlon races longer than the Ironman distance covering 3.8 km swimming, 180 km cycling, and 42.195 km running). Results from studies on ultra-triathletes were compared to results on studies on Ironman triathletes. Methods: A literature search was performed in PubMed using the terms “ultra”, “triathlon”, and “performance” for the aspects of “ultra-triathlon”, and “Ironman”, “triathlon”, and “performance” for the aspects of “Ironman triathlon”. All resulting papers were searched for related citations. Results for ultra-triathlons were compared to results for Ironman-distance triathlons to find potential differences. Results: Athletes competing in Ironman and ultra-triathlon differed in anthropometric and training characteristics, where both Ironmen and ultra-triathletes profited from low body fat, but ultra-triathletes relied more on training volume, whereas speed during training was related to Ironman race time. The most important predictive variables for a fast race time in an ultra-triathlon from Double Iron (ie, 7.6 km swimming, 360 km cycling, and 84.4 km running) and longer were male sex, low body fat, age of 35–40 years, extensive previous experience, a fast time in cycling and running but not in swimming, and origins in Central Europe. Conclusion: Any athlete intending to compete in an ultra-triathlon should be aware that low body fat and high training volumes are highly predictive for overall race time. Little is known about the physiological characteristics of these athletes and about female ultra-triathletes. Future studies need to investigate anthropometric and training characteristics of female ultra-triathletes and what motivates women to compete in these races. Future studies need to correlate physiological characteristics such as maximum oxygen uptake (VO2max) with ultra-triathlon race performance in order to investigate whether these characteristics are also predictive for ultra-triathlon race performance. Keywords: swimming, cycling, running, age, experience, ultra-endurance
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- 2015
23. Pacing strategy in male elite and age group 100 km ultra-marathoners
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Knechtle B, Rosemann T, Zingg MA, Stiefel M, and Rüst CA
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Sports medicine ,RC1200-1245 - Abstract
Beat Knechtle,1,2 Thomas Rosemann,1 Matthias A Zingg,1 Michael Stiefel,1 Christoph A Rüst11Institute of Primary Care, University of Zurich, Zurich, 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: Pacing strategy has been investigated in elite 100 km and elite 161 km (100 mile) ultra-marathoners, but not in age group ultra-marathoners. This study investigated changes in running speed over segments in male elite and age group 100 km ultra-marathoners with the assumption that running speed would decrease over segments with increasing age of the athlete. Running speed during segments in male elite and age group finishers for 5-year age groups (ie, 18–24 to 65–69 years) in the 100 km Lauf Biel in Switzerland was investigated during the 2000–2009 period. Average running speed over segment time station (TS) TS1–TS2 (56.1 km) was compared with running speed Start–TS1 (38 km) and Start–TS3 (76.7 km) and running speed TS2–TS3 was compared with running speed Start–Finish. For the top ten athletes in each edition, running speed decreased from 2000 to 2009 for TS1–TS2 and TS2–TS3 (P0.05). During TS1–TS2, athletes were running at 98.0%±2.1% of the running speed of Start–TS1. In TS2–TS3, they were running at 94.6%±3.4% of the running speed of TS1–TS2. In TS3–Finish, they were running at 95.5%±3.8% of running speed in TS2–TS3. For age group athletes, running speed decreased in TS1–TS2 and TS2–TS3. In TS3–Finish, running speed remained unchanged with the exception of the age group 40–44 years for which running speed increased. Running speed showed the largest decrease in the age group 18–24 years. To summarize, the top ten athletes in each edition maintained their running speed in the last segment (TS3–Finish) although running speed decreased over the first two segments (TS1–TS2 and TS2–TS3). The best pacers were athletes in the age group 40–44 years, who were able to achieve negative pacing in the last segment (TS3–Finish) of the race. The negative pacing in the last segment (TS3–Finish) was likely due to environmental conditions, such as early dawn and the flat circuit in segment TS3–Finish of the race.Keywords: running, men, long distance, master athlete
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- 2015
24. Performance differences between sexes in 50-mile to 3,100-mile ultramarathons
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Zingg MA, Knechtle B, Rosemann T, and Rüst CA
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Sports medicine ,RC1200-1245 - Abstract
Matthias A Zingg,1 Beat Knechtle,1,2 Thomas Rosemann,1 Christoph A Rüst1 1Institute of Primary Care, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, Switzerland Abstract: Anecdotal reports have assumed that women would be able to outrun men in long-distance running. The aim of this study was to test this assumption by investigating the changes in performance difference between sexes in the best ultramarathoners in 50-mile, 100-mile, 200-mile, 1,000-mile, and 3,100-mile events held worldwide between 1971 and 2012. The sex differences in running speed for the fastest runners ever were analyzed using one-way analysis of variance with subsequent Tukey–Kramer posthoc analysis. Changes in sex difference in running speed of the annual fastest were analyzed using linear and nonlinear regression analyses, correlation analyses, and mixed-effects regression analyses. The fastest men ever were faster than the fastest women ever in 50-mile (17.5%), 100-mile (17.4%), 200-mile (9.7%), 1,000-mile (20.2%), and 3,100-mile (18.6%) events. For the ten fastest finishers ever, men were faster than women in 50-mile (17.1%±1.9%), 100-mile (19.2%±1.5%), and 1,000-mile (16.7%±1.6%) events. No correlation existed between sex difference and running speed for the fastest ever (r2=0.0039, P=0.91) and the ten fastest ever (r2=0.15, P=0.74) for all distances. For the annual fastest, the sex difference in running speed decreased linearly in 50-mile events from 14.6% to 8.9%, remained unchanged in 100-mile (18.0%±8.4%) and 1,000-mile (13.7%±9.1%) events, and increased in 3,100-mile events from 12.5% to 16.9%. For the annual ten fastest runners, the performance difference between sexes decreased linearly in 50-mile events from 31.6%±3.6% to 8.9%±1.8% and in 100-mile events from 26.0%±4.4% to 24.7%±0.9%. To summarize, the fastest men were ~17%–20% faster than the fastest women for all distances from 50 miles to 3,100 miles. The linear decrease in sex difference for 50-mile and 100-mile events may suggest that women are reducing the sex gap for these distances. Keywords: running, sex difference, running speed, ultraendurance
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- 2015
25. Effect of two incremental intensity field tests on wellness indices, recovery state, and physical enjoyment in soccer players
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Selmi, O, Levitt, D E, Muscella, A, Ouerghi, N, Issaoui, I, Abassi, W, Hill, L, Rosemann, T, Bouassida, A, Knechtle, B, Selmi, O, Levitt, D E, Muscella, A, Ouerghi, N, Issaoui, I, Abassi, W, Hill, L, Rosemann, T, Bouassida, A, and Knechtle, B
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Soccer, Physical fitness, Motivation, Psychometrics, Aerobic testing ,human activities - Abstract
Objective: Competitive athletes must undergo fitness testing to monitor athlete progress and to create appropriate, progressive training programs. However, fitness testing adds to training stress; therefore, impacts of testing on wellness and recovery must be considered in test selection. This study investigated the effects of two incremental field tests [VAMEVAL test (T-VAM) and 20-m maximum shuttle test (20-m MST)] on wellness, total quality of recovery (TQR) and physical enjoyment (PE) in competitive soccer players. Subjects and methods: Twenty-two soccer players (20.9±1.5 years) completed two T-VAM and two 20-m MST in a randomized order on separate days with a 1-week interval between tests. TQR and wellness indices (sleep, fatigue, stress and muscle soreness) measures were collected before and 24 hours after each test. Heart rate (HR) was continuously monitored during each test. Rating of perceived exertion (RPE) and PE were assessed after each test. Results: T-VAM resulted in higher PE, TQR and wellness scores than 20-m MST (p
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- 2022
26. CoCo trial: Color-coded blood pressure Control, a randomized controlled study
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Chmiel C, Senn O, Rosemann T, Del Prete V, and Steurer-Stey C
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Medicine (General) ,R5-920 - Abstract
Corinne Chmiel, Oliver Senn, Thomas Rosemann, Valerio Del Prete, Claudia Steurer-Stey Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland Background: Inadequate blood pressure (BP) control is a frequent challenge in general practice. The objective of this study was to determine whether a color-coded BP booklet using a traffic light scheme (red, >180 mmHg systolic BP and/or >110 mmHg diastolic BP; yellow, >140–180 mmHg systolic BP or >90–110 mmHg diastolic BP; green, ≤140 mmHg systolic BP and ≤90 mmHg diastolic BP) improves BP control and adherence with home BP measurement.Methods: In this two-group, randomized controlled trial, general practitioners recruited adult patients with a BP >140 mmHg systolic and/or >90 mmHg diastolic. Patients in the control group received a standard BP booklet and the intervention group used a color-coded booklet for daily home BP measurement. The main outcomes were changes in BP, BP control (treatment goal
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- 2014
27. Chancen und Herausforderungen hausärztlicher Fortbildung - ein europäischer Vergleich
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Löffler, C, Altiner, A, Blumenthal, S, Bruno, P, de Sutter, A, de Vos, B, Dinant, GJ, Duerden, M, Dunais, B, Egidi, G, Gibis, B, Melbye, H, Rouquier, F, Rosemann, T, Touboul-Lundgren, P, Feldmeier, G, Löffler, C, Altiner, A, Blumenthal, S, Bruno, P, de Sutter, A, de Vos, B, Dinant, GJ, Duerden, M, Dunais, B, Egidi, G, Gibis, B, Melbye, H, Rouquier, F, Rosemann, T, Touboul-Lundgren, P, and Feldmeier, G
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- 2022
28. Effects of aerobic and strength training on depression, anxiety, and health self-perception levels during the COVID-19 pandemic
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da Costa, Taline Santos, Seffrin, Aldo; https://orcid.org/0000-0001-8229-8565, de Castro Filho, Jonas, Togni, Gabriela, Castardeli, E, de Lira, Claudio Andre Barbosa; https://orcid.org/0000-0001-5749-6877, Vancini, Rodrigo Luiz; https://orcid.org/0000-0003-1981-1092, Knechtle, Beat; https://orcid.org/0000-0002-2412-9103, Rosemann, T, Andrade, Marilia Santos; https://orcid.org/0000-0002-7004-4565, da Costa, Taline Santos, Seffrin, Aldo; https://orcid.org/0000-0001-8229-8565, de Castro Filho, Jonas, Togni, Gabriela, Castardeli, E, de Lira, Claudio Andre Barbosa; https://orcid.org/0000-0001-5749-6877, Vancini, Rodrigo Luiz; https://orcid.org/0000-0003-1981-1092, Knechtle, Beat; https://orcid.org/0000-0002-2412-9103, Rosemann, T, and Andrade, Marilia Santos; https://orcid.org/0000-0002-7004-4565
- Abstract
OBJECTIVE: This study aimed at comparing the depression and anxiety levels, and health self-perception during the coronavirus disease 2019 pandemic among subjects who practice aerobic, strength, and mixed (aerobic and strength) exercises and nonsports participants. MATERIALS AND METHODS: We included 304 Brazilians of both sexes in this cross-sectional study. All participants were recruited through online advertisement and completed a self-administered questionnaire regarding the personal information, level of restriction adopted, physical activity, and mood state screening (Patient Health Questionnaire-9 and General Anxiety Disorder-7). We divided the participants into four groups: strength sports group (CrossFit or strength training), aerobic/endurance sports groups (running, cycling, triathlon, or swimming), mixed sports groups (individuals who practice endurance and strength sports), and nonsports group. RESULTS: The Kruskal-Wallis test showed a significant effect of the group on the depression and anxiety levels. Meanwhile, the post-hoc comparisons showed a significantly lower depression level in the mixed and aerobic sports groups than in the strength sports and nonsports groups, and a significantly lower anxiety level in the mixed and aerobic sports groups than in the nonsports group. Furthermore, participants in the mixed, strength, and aerobic sports groups presented a better level of health self-assessment than the nonsports group, and those in the mixed sports group had a better level of health self-assessment than the strength or aerobic sports groups. CONCLUSIONS: Individuals practicing aerobic exercises present lower depression and anxiety levels than those practicing strength training and are inactive. However, individuals who practice strength exercises and aerobics have the best levels of health perception.
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- 2022
29. A multifaceted intervention: no increase in general practitioners' competence to diagnose skin cancer (minSKIN) – randomized controlled trial
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Badertscher, N., Tandjung, R., Senn, O., Kofmehl, R., Held, U., Rosemann, T., Hofbauer, G. F.L., Wensing, M., Rossi, P. O., and Braun, R. P.
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- 2015
- Full Text
- View/download PDF
30. Effects of aerobic and strength training on depression, anxiety, and health self-perception levels during the COVID-19 pandemic.
- Author
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DA COSTA, T. S., SEFFRIN, A., DE CASTRO FILHO, J., TOGNI, G., CASTARDELI, E., BARBOSA DE LIRA, C. A., VANCINI, R. L., KNECHTLE, B., ROSEMANN, T., and ANDRADE, M. S.
- Abstract
OBJECTIVE: This study aimed at comparing the depression and anxiety levels, and health self-perception during the coronavirus disease 2019 pandemic among subjects who practice aerobic, strength, and mixed (aerobic and strength) exercises and nonsports participants. MATERIALS AND METHODS: We included 304 Brazilians of both sexes in this cross-sectional study. All participants were recruited through online advertisement and completed a self-administered questionnaire regarding the personal information, level of restriction adopted, physical activity, and mood state screening (Patient Health Questionnaire-9 and General Anxiety Disorder-7). We divided the participants into four groups: strength sports group (CrossFit or strength training), aerobic/endurance sports groups (running, cycling, triathlon, or swimming), mixed sports groups (individuals who practice endurance and strength sports), and nonsports group. RESULTS: The Kruskal-Wallis test showed a significant effect of the group on the depression and anxiety levels. Meanwhile, the post-hoc comparisons showed a significantly lower depression level in the mixed and aerobic sports groups than in the strength sports and nonsports groups, and a significantly lower anxiety level in the mixed and aerobic sports groups than in the nonsports group. Furthermore, participants in the mixed, strength, and aerobic sports groups presented a better level of health self-assessment than the nonsports group, and those in the mixed sports group had a better level of health self-assessment than the strength or aerobic sports groups. CONCLUSIONS: Individuals practicing aerobic exercises present lower depression and anxiety levels than those practicing strength training and are inactive. However, individuals who practice strength exercises and aerobics have the best levels of health perception. [ABSTRACT FROM AUTHOR]
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- 2022
31. The Complex Interaction Between the Major Sleep Symptoms, the Severity of Obstructive Sleep Apnea, and Sleep Quality
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Frangopoulos, F. Zannetos, S. Nicolaou, I. Economou, N.-T. Adamide, T. Georgiou, A. Nikolaidis, P.T. Rosemann, T. Knechtle, B. Trakada, G.
- Abstract
Introduction: Little information exists in the general population whether clinical presentation phenotypes of obstructive sleep apnea (OSA) differ in terms of sleep quality and comorbidities. Aim: The purpose of our study was to assess possible differences between symptomatic and asymptomatic OSA patients concerning syndrome's severity, patients' sleep quality, and comorbidities. Subjects and methods: First, in a nationwide, stratified, epidemiological survey, 4,118 Cypriot adult participants were interviewed about sleep habits and complaints. In the second stage of the survey, 264 randomly selected adults underwent a type III sleep study for possible OSA. Additionally, they completed the Greek version of Pittsburgh Sleep Quality Index (Gr-PSQI), Epworth Sleepiness Scale (ESS), Athens Insomnia Scale (AIS), and Hospital Anxiety and Depression Scale (HADS). Results: From 264 enrolled participants, 155 individuals (40 females and 115 males) were first diagnosed with OSA. Among these 155 patients, 34% had ESS ≥ 10 and 49% AIS ≥ 6. One or both symptoms present categorized the individual as symptomatic (60%) and neither major symptom as asymptomatic (40%). There were no significant statistical differences (SSDs) between the two groups (symptomatic–asymptomatic) with regard to anthropometrics [age or gender; neck, abdomen, and hip circumferences; and body mass index (BMI)]. The two groups had no differences in OSA severity—as expressed by apnea–hypopnea index (AHI), oxygen desaturation index (ODI), and mean oxyhemoglobin saturation (SaO2)—and in cardiometabolic comorbidities. Symptomatic patients expressed anxiety and depression more often than asymptomatics (p < 0.001) and had poorer subjective sleep quality (Gr-PSQI, p < 0.001). According to PSQI questionnaire, there were no SSDs regarding hours in bed and the use of sleep medications, but there were significant differences in the subjective perception of sleep quality (p < 0.001), sleep efficiency (p < 0.001), duration of sleep (p = 0.001), sleep latency (p = 0.007), daytime dysfunction (p < 0.001), and finally sleep disturbances (p < 0.001). Conclusion: According to our data, OSA patients reporting insomnia-like symptoms and/or sleepiness do not represent a more severe phenotype, by the classic definition of OSA, but their subjective sleep quality is compromised, causing a vicious cycle of anxiety or depression. © Copyright © 2021 Frangopoulos, Zannetos, Nicolaou, Economou, Adamide, Georgiou, Nikolaidis, Rosemann, Knechtle and Trakada.
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- 2021
32. Setting objective clinical assessment tools for circadian rhythm sleep-wake disorders – A community-based cross-sectional epidemiological study
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Frangopoulos, F. Nicolaou, I. Zannetos, S. Economou, N.-T. Adamide, T., III Georgiou, A. Nikolaidis, P.T. Rosemann, T. Knechtle, B. Trakada, G.
- Abstract
Introduction: Circadian rhythm sleep-wake disorder (CRSWD) is an often-misdiagnosed group of sleep disturbances with limited data concerning diagnostic and therapeutic algorithms in the general population. Therefore, reported prevalence varies in the literature due to different case definitions, methodological, and environmental factors. Objectives: The purpose of our cross-sectional study was to estimate the prevalence of CRSWD in the general population of Cyprus and to suggest clinical parameters for the assessment of atypical sleep schedules. The estimation was carried out by introducing normal preset sleep time limits, according to the imposed local environment and by administering well-established questionnaires for symptoms and consequence dysfunction, as objective evaluation tools. Methods: In a nationwide epidemiological survey, 4118 Cypriot adult participants, selected and stratified to represent the general population, were interviewed on sleep habits and complaints by computer-assisted telephone interviewing (CATI). In the second stage, 250 adults were randomly selected from the initial representative sample, for a CRSWD assessment. According to the proposed diagnostic criteria, patients were interviewed about sleepiness and/or insomnia, and daytime dysfunction (fatigue, anxiety, and depression). They were also assessed by a weekly sleep diary for sleep schedules. Finally, all participants underwent a Type III Sleep Study, to rule out obstructive sleep apnea. Results: From 195 enrolled participants (response rate 78%), 25 individuals (12.8%) met the criteria for CRSWD. The two most prevalent disorders were delayed sleep-wake phase disorder (DSWPD) (10pts, 5.1%) and shift work sleep disorder (SWD) (13, 6.7%). Less prevalent disorders included irregular sleep-wake rhythm disorder (ISWRD) (1, 0.5%) and advanced sleep-wake phase disorder (ASWPD) (1, 0.5%). Conclusions: According to our data, CRSWDs are common in the general population of Cyprus, especially DSWPD and SWD. Affected individuals usually suffer from sleep deprivation and complain about insomnia, sleepiness and depression. © 2021 Frangopoulos et al.
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- 2021
33. Comparison of particle-resolved DNS (PR-DNS) and non-resolved DEM/CFD simulations of flow through homogenous ensembles of fixed spherical and non‐spherical particles
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Kravets, B., primary, Schulz, D., additional, Jasevičius, R., additional, Reinecke, S.R., additional, Rosemann, T., additional, and Kruggel-Emden, H., additional
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- 2021
- Full Text
- View/download PDF
34. Predictors of Sleep Duration and Sleep Disturbance in Children of a Culturally Diverse Region in North-Eastern Greece
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Nena, E. Cassimos, D. Kaditis, A. Kourantzi, M. Trakada, G. Economou, N.-T. Nikolaidis, P.T. Rosemann, T. Knechtle, B. Steiropoulos, P. Tsalkidis, A.
- Abstract
Background Aim: The aim of this study was to examine the sleep characteristics of children and explore associations with various socio-demographic factors in an area of Greece characterized by cultural diversity. Methods: A questionnaire about children's sleep habits had been distributed to parents of children who visited the pediatric outpatient clinic of University General Hospital of Alexandroupolis for a medical examination and to get a health certificate for participation in sports activities. Children with chronic health conditions were excluded. Results: In the study, 449 children (27.1% belonging to minorities) were included, aged 7.6 ± 2.9 years. Most of them (81.7%) slept after 10 p.m., with a mean nocturnal sleep duration of 9.4 ± 1.2 h. The most commonly reported disturbance was snoring (26.2%). Age and high educational level of the mother were both important determinants for sleeping late [OR 1.139 (1.033–1.255); p = 0.009 and OR 1.086 (1.004–1.175); p = 0.040, respectively]. The latter was also associated with an absence of any reported sleep disorder in children [OR 0.934 (0.877–0.994); p = 0.031]. A longer sleep duration was reported among Roma children (p = 0.022), which was more overt in girls (mean sleep duration 10.4 ± 1.6 h). In the Roma group also, the prevalence of sleep disorders was higher. Conclusion: Age progression and maternal educational level, along with cultural background, seem to be correlated with variations in the sleep characteristics of children in a culturally diverse population in Greece. © Copyright © 2020 Nena, Cassimos, Kaditis, Kourantzi, Trakada, Economou, Nikolaidis, Rosemann, Knechtle, Steiropoulos and Tsalkidis.
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- 2020
35. Prices and clinical benefit of cancer drugs in the USA and Europe: a cost–benefit analysis
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Vokinger K.N., Hwang T.J., Grischott T., Reichert S., Tibau A., Rosemann T., and Kesselheim A.S.
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Cost-Benefit Analysis ,afatinib ,lenvatinib ,Medical Oncology ,abiraterone ,Germany ,Neoplasms ,vismodegib ,cost benefit analysis ,pazopanib ,radium chloride ra 223 ,ipilimumab ,eribulin ,antineoplastic agent ,trametinib ,enzalutamide ,adult ,aflibercept ,Food and Drug Administration ,cohort analysis ,Europe ,England ,priority journal ,oncology ,vemurafenib ,pembrolizumab ,France ,Switzerland ,vandetanib ,palbociclib ,ramucirumab ,axitinib ,drug cost ,Antineoplastic Agents ,olaparib ,body surface ,Article ,Drug Costs ,body weight ,cabozantinib ,pertuzumab ,unindexed drug ,ceritinib ,Humans ,controlled study ,human ,dabrafenib ,correlation coefficient ,nivolumab ,trastuzumab emtansine ,calculation ,crizotinib ,sonidegib ,prescription ,cabazitaxel ,scoring system ,economics ,everolimus ,United States ,regorafenib ,neoplasm - Abstract
Background: Increasing cancer drug prices are a challenge for patients and health systems in the USA and Europe. By contrast with the USA, national authorities in European countries often directly negotiate drug prices with manufacturers. The American Society of Clinical Oncology (ASCO) and the European Society for Medical Oncology (ESMO) developed frameworks to evaluate the clinical value of cancer therapies: the ASCO-Value Framework (ASCO-VF) and the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS). We aimed to assess the association between the clinical benefit of approved cancer drugs based on these frameworks and their drug prices in the USA and four European countries (England, Switzerland, Germany, and France). Methods: For this cost–benefit analysis, we identified all new drugs with initial indications for adult cancers that were approved by the US Food and Drug Administration between Jan 1, 2009, and Dec 31, 2017, and by the European Medicines Agency up until Sept 1, 2019. For drugs indicated for solid tumours, we assessed clinical benefit using ASCO-VF and ESMO-MCBS. We compared monthly drug treatment costs between benefit levels using hierarchical linear regression models, and calculated Spearman's correlation coefficients between costs and benefit levels for individual countries. Findings: Our cohort included 65 drugs: 47 (72%) drugs were approved for solid tumours and 18 (28%) were approved for haematological malignancies. The monthly drug treatment costs in the USA were a median of 2·31 times (IQR 1·79–3·17) as high as in the assessed European countries. There were no significant associations between monthly treatment costs for solid tumours and clinical benefit in all assessed countries, using the ESMO-MCBS (p=0·16 for the USA, p=0·98 for England, p=0·54 for Switzerland, p=0·52 for Germany, and p=0·40 for France), and for all assessed countries except France using ASCO-VF (p=0·56 for the USA, p=0·47 for England, p=0·26 for Switzerland, p=0·23 for Germany, and p=0·037 for France). Interpretation: Cancer drugs with low or uncertain clinical benefit might be prioritised for price negotiations. Value frameworks could help identify therapies providing high clinical benefit that should be made rapidly available across countries. Funding: Swiss Cancer Research Foundation (Krebsforschung Schweiz). © 2020 Elsevier Ltd
- Published
- 2020
36. Validity of Prediction Equations of Maximal Heart Rate in Physically Active Female Adolescents and the Role of Maturation
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Papadopoulou, S D, Papadopoulou, S K, Alipasali, F, Hatzimanouil, D, Rosemann, T, Knechtle, B, Nikolaidis, P T, University of Zurich, and Knechtle, B
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11035 Institute of General Practice ,610 Medicine & health ,2700 General Medicine ,General Medicine - Published
- 2019
37. Effect of two incremental intensity field tests on wellness indices, recovery state, and physical enjoyment in soccer players.
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SELMI, O., LEVITT, D. E., MUSCELLA, A., OUERGHI, N., ISSAOUI, I., ABASSI, W., HILL, L., ROSEMANN, T., BOUASSIDA, A., and KNECHTLE, B.
- Abstract
OBJECTIVE: Competitive athletes must undergo fitness testing to monitor athlete progress and to create appropriate, progressive training programs. However, fitness testing adds to training stress; therefore, impacts of testing on wellness and recovery must be considered in test selection. This study investigated the effects of two incremental field tests [VAMEVAL test (T-VAM) and 20-m maximum shuttle test (20-m MST)] on wellness, total quality of recovery (TQR) and physical enjoyment (PE) in competitive soccer players. SUBJECTS AND METHODS: Twenty-two soccer players (20.9±1.5 years) completed two T-VAM and two 20-m MST in a randomized order on separate days with a 1-week interval between tests. TQR and wellness indices (sleep, fatigue, stress and muscle soreness) measures were collected before and 24 hours after each test. Heart rate (HR) was continuously monitored during each test. Rating of perceived exertion (RPE) and PE were assessed after each test. RESULTS: T-VAM resulted in higher PE, TQR and wellness scores than 20-m MST (p<0.05). T-VAM and 20-m MST resulted in similar HR and maximal aerobic speed. For T-VAM, TQR was correlated (p<0.01) with RPE and wellness indices. For 20-m MST, TQR was correlated (p<0.01) with wellness indices. HRmax and RPE were not correlated with wellness indices, TQR or PE. CONCLUSIONS: Overall, T-VAM and 20-m MST produced similar aerobic fitness testing results, but athletes responded more favorably to T-VAM. Coaches can use T-VAM for evaluating aerobic fitness while maximizing well-being and physical enjoyment among soccer players. [ABSTRACT FROM AUTHOR]
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- 2022
38. Clinical characteristics of obstructive sleep apnea in psychiatric disease
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Knechtle, B. Economou, N.-T. Nikolaidis, P.T. Velentza, L. Kallianos, A. Steiropoulos, P. Koutsompolis, D. Rosemann, T. Trakada, G.
- Abstract
Patients with serious psychiatric diseases (major depressive disorder (MDD), bipolar disorder (BD), and schizophrenia and psychotic disorder) often complain about sleepiness during the day, fatigue, low energy, concentration problems, and insomnia; unfortunately, many of these symptoms are also frequent in patients with Obstructive Sleep Apnea (OSA). However, existing data about the clinical appearance of OSA in Psychiatric Disease are generally missing. The aim of our study was a detailed and focused evaluation of OSA in Psychiatric Disease, in terms of symptoms, comorbidities, clinical characteristics, daytime respiratory function, and overnight polysomnography data. We examined 110 patients (56 males and 54 females) with stable Psychiatric Disease (Group A: 66 with MDD, Group B: 34 with BD, and Group C: 10 with schizophrenia). At baseline, each patient answered the STOP–Bang Questionnaire, Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and Hospital Anxiety and Depression Scale (HADS) and underwent clinical examination, oximetry, spirometry, and overnight polysomnography. Body Mass Index (BMI), neck, waist, and hip circumferences, and arterial blood pressure values were also measured. The mean age of the whole population was 55.1 ± 10.6 years. The three groups had no statistically significant difference in age, BMI, hip circumference, and systolic and diastolic arterial blood pressure. Class II and III obesity with BMI > 35 kg/m2 was observed in 36 subjects (32.14%). A moderate main effect of psychiatric disease was observed in neck (p = 0.044, η2 = 0.064) and waist circumference (p = 0.021, η2 = 0.078), with the depression group showing the lowest values, and in pulmonary function (Forced Vital Capacity (FVC, %), p = 0.013, η2 = 0.084), with the psychotic group showing the lowest values. Intermediate to high risk of OSA was present in 87.37% of participants, according to the STOP–Bang Questionnaire (≥3 positive answers), and 70.87% responded positively for feeling tired or sleepy during the day. An Apnea–Hypopnea Index (AHI) ≥ 15 events per hour of sleep was recorded in 72.48% of our patients. AHI was associated positively with male sex, schizophrenia, neck, and waist circumferences, STOP–Bang and ESS scores, and negatively with respiratory function. A large main effect of psychiatric medications was observed in waist circumference (p = 0.046, η2 = 0.151), FVC (%) (p = 0.027, η2 = 0.165), and in time spend with SaO2 < 90% (p = 0.006, η2 = 0.211). Our study yielded that patients with Psychiatric Disease are at risk of OSA, especially men suffering from schizophrenia and psychotic disorders that complain about sleepiness and have central obesity and disturbed respiratory function. Screening for OSA is mandatory in this medical population, as psychiatric patients have significantly poorer physical health than the general population and the coexistence of the two diseases can further negatively impact several health outcomes. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
- Published
- 2019
39. Subjective and objective outcomes in patients with COPD after pulmonary rehabilitation-The impact of comorbidities
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Charikiopoulou, M. Nikolaidis, P.T. Knechtle, B. Rosemann, T. Rapti, A. Trakada, G.
- Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with multiple systemic manifestations and comorbidities, which contribute independently to its total morbidity and mortality. Pulmonary rehabilitation is an evidence-based intervention that is indicated for COPD patients who remain symptomatic, despite optimal pharmacological therapy. Although it is well documented in pure COPD, the role of pulmonary rehabilitation is uncertain in coexisting comorbidities. The aim of the present study was to clarify the effect of a pulmonary rehabilitation program in COPD patients with concomitant comorbidities. Methods: Thirty two patients with COPD were evaluated before and after a comprehensive pulmonary rehabilitation program, in terms of dyspnea, quality of life (QOL), pulmonary function tests and exercise capacity. The patients were also divided into two groups, according to the presence or the absence of comorbidities. Patients with none or only one comorbidity (Group 1, n = 11) were compared to those who had two or more comorbidities (Group 2, n = 21). Results: All patients significantly improved in dyspnea, as expressed by modified Medical Research Council scale and the COPD assessment Test (p 0.001), QOL as assessed by the St. George respiratory questionnaire (p 0.001) and exercise tolerance in six minute walking test (p 0.001). Peak oxygen uptake relatively increased and body mass decreased in Group 1 compared to Group 2 (p 0.05). Conclusion: Pulmonary rehabilitation in COPD seems to be beneficial for all patients, independently of the presence, the number or the nature of their comorbidities. Thus, the presence of comorbidities must not represent an exclusion criterion for patients that are referred to pulmonary rehabilitation programs. © 2019 Charikiopoulou, Nikolaidis, Knechtle, Rosemann, Rapti and Trakada.
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- 2019
40. Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries
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Ploeg, M.A., Streit, S., Achterberg, W.P., Beers, E., Bohnen, A.M., Burman, R.A., Collins, C., Franco, F.G., Gerasimovska-Kitanovska, B., Gintere, S., Bravo, R. Gomez, Hoffmann, K., Iftode, C., Pestic, S.K., Koskela, T.H., Kurpas, D., Maisonneuve, H., Mallen, C.D., Merlo, C., Mueller, Y., Muth, C., Petrazzuoli, F., Rodondi, N., Rosemann, T., Sattler, M., Schermer, T.R., Ster, M.P., Svadlenkova, Z., Tatsioni, A., Thulesius, H., Tkachenko, V., Torzsa, P., Tsopra, R., Tuz, C., Vaes, B., Viegas, R.P.A., Vinker, S., Wallis, K.A., Zeller, A., Gussekloo, J., Poortvliet, R.K.E., Ploeg, M.A., Streit, S., Achterberg, W.P., Beers, E., Bohnen, A.M., Burman, R.A., Collins, C., Franco, F.G., Gerasimovska-Kitanovska, B., Gintere, S., Bravo, R. Gomez, Hoffmann, K., Iftode, C., Pestic, S.K., Koskela, T.H., Kurpas, D., Maisonneuve, H., Mallen, C.D., Merlo, C., Mueller, Y., Muth, C., Petrazzuoli, F., Rodondi, N., Rosemann, T., Sattler, M., Schermer, T.R., Ster, M.P., Svadlenkova, Z., Tatsioni, A., Thulesius, H., Tkachenko, V., Torzsa, P., Tsopra, R., Tuz, C., Vaes, B., Viegas, R.P.A., Vinker, S., Wallis, K.A., Zeller, A., Gussekloo, J., and Poortvliet, R.K.E.
- Abstract
Contains fulltext : 208370.pdf (publisher's version ) (Open Access), BACKGROUND: Statins are widely used to prevent cardiovascular disease (CVD). With advancing age, the risks of statins might outweigh the potential benefits. It is unclear which factors influence general practitioners' (GPs) advice to stop statins in oldest-old patients. OBJECTIVE: To investigate the influence of a history of CVD, statin-related side effects, frailty and short life expectancy, on GPs' advice to stop statins in oldest-old patients. DESIGN: We invited GPs to participate in this case-based survey. GPs were presented with 8 case vignettes describing patients > 80 years using a statin, and asked whether they would advise stopping statin treatment. MAIN MEASURES: Cases varied in history of CVD, statin-related side effects and frailty, with and without shortened life expectancy (< 1 year) in the context of metastatic, non-curable cancer. Odds ratios adjusted for GP characteristics (ORadj) were calculated for GPs' advice to stop. KEY RESULTS: Two thousand two hundred fifty GPs from 30 countries participated (median response rate 36%). Overall, GPs advised stopping statin treatment in 46% (95%CI 45-47) of the case vignettes; with shortened life expectancy, this proportion increased to 90% (95CI% 89-90). Advice to stop was more frequent in case vignettes without CVD compared to those with CVD (ORadj 13.8, 95%CI 12.6-15.1), with side effects compared to without ORadj 1.62 (95%CI 1.5-1.7) and with frailty (ORadj 4.1, 95%CI 3.8-4.4) compared to without. Shortened life expectancy increased advice to stop (ORadj 50.7, 95%CI 45.5-56.4) and was the strongest predictor for GP advice to stop, ranging across countries from 30% (95%CI 19-42) to 98% (95% CI 96-99). CONCLUSIONS: The absence of CVD, the presence of statin-related side effects, and frailty were all independently associated with GPs' advice to stop statins in patients aged > 80 years. Overall, and within all countries, cancer-related short life expectancy was the strongest independent predictor of GPs' advice
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- 2019
41. Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries
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Ploeg, M.A. (Milly) van der, Streit, S., Achterberg, W.P., Beers, E., Bohnen, A.M. (Arthur), Burman, R.A., Collins, C. (Colin), Franco, F.G., Gerasimovska-Kitanovska, B., Gintere, S., Bravo, R.G., Hoffmann, K., Iftode, C., Pestic, S.K., Koskela, T.H., Kurpas, D., Maisonneuve, H., Mallen, C.D., Merlo, C., Mueller, Y., Muth, C., Petrazzuoli, F., Rodondi, N, Rosemann, T., Sattler, M., Schermer, T., Ster, M.P., Svadlenkova, Z., Tatsioni, A., Thulesius, H., Tkachenko, V. (Valery), Torzsa, P., Tsopra, R., Tuz, C., Vaes, B., Viegas, R.P.A., Vinker, S., Wallis, K.A., Zeller, A., Gussekloo, J. (Jacobijn), Poortvliet, R.K.E., Ploeg, M.A. (Milly) van der, Streit, S., Achterberg, W.P., Beers, E., Bohnen, A.M. (Arthur), Burman, R.A., Collins, C. (Colin), Franco, F.G., Gerasimovska-Kitanovska, B., Gintere, S., Bravo, R.G., Hoffmann, K., Iftode, C., Pestic, S.K., Koskela, T.H., Kurpas, D., Maisonneuve, H., Mallen, C.D., Merlo, C., Mueller, Y., Muth, C., Petrazzuoli, F., Rodondi, N, Rosemann, T., Sattler, M., Schermer, T., Ster, M.P., Svadlenkova, Z., Tatsioni, A., Thulesius, H., Tkachenko, V. (Valery), Torzsa, P., Tsopra, R., Tuz, C., Vaes, B., Viegas, R.P.A., Vinker, S., Wallis, K.A., Zeller, A., Gussekloo, J. (Jacobijn), and Poortvliet, R.K.E.
- Abstract
BACKGROUND: Statins are widely used to prevent cardiovascular disease (CVD). With advancing age, the risks of statins might outweigh the potential benefits. It is unclear which factors influence general practitioners’ (GPs) advice to stop statins in oldestold patients. OBJECTIVE: To investigate the influence of a history of CVD, statin-related side effects, frailty and short life expectancy, on GPs’ advice to stop statins in oldest-old patients. DESIGN: We invited GPs to participate in this case-based survey. GPs were presented with 8 case vignettes describing patients > 80 years using a statin, and asked whether they would advise stopping statin treatment. MAIN MEASURES: Cases varied in history of CVD, statinrelated side effects and frailty, with and without shortened life expectancy (< 1 year) in the context of metastatic, noncurable cancer. Odds ratios adjusted for GP characteristics (ORadj) were calculated for GPs’ advice to stop. KEY RESULTS: Two thousand two hundred fifty GPs from 30 countries participated (median response rate 36%). Overall, GPs advised stopping statin treatment in 46% (95%CI 45–47) of the case vignettes; with shortened life expectancy, this proportion increased to 90% (95CI% 89–90). Advice to stop was more frequent in case vignettes without CVD compared to those with CVD (ORadj 13.8, 95%CI 12.6–15.1), with side effects compared to without ORadj 1.62 (95%CI 1.5–1.7) and with frailty (ORadj 4.1, 95%CI 3.8–4.4) compared to without. Shortened life expectancy increased advice to stop (ORadj 50.7, 95%CI 45.5–56.4) and was the strongest predictor for GP advice to stop, ranging across countries from 30% (95%CI 19– 42) to 98% (95% CI 96–99). CONCLUSIONS: The absence of CVD, the presence of statin-related side effects, and frailty were all independently associated with GPs’ advice to stop statins in patients aged > 80 years. Overall, and within all countries, cancer-related short life expectancy was the strongest independent predictor of GPs’ advice t
- Published
- 2019
- Full Text
- View/download PDF
42. Comparison of boundary treatments in thermal Lattice Boltzmann simulations of moving particles in fluids
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Rosemann, T, Kravets, B, Kruggel-Emden, H, Wu, Mingqiu, Peters, Bernhard, Rosemann, T, Kravets, B, Kruggel-Emden, H, Wu, Mingqiu, and Peters, Bernhard
- Abstract
Various numerical schemes have been developed in recent years to simulate particle-laden flows. The Lattice Boltzmann method (LBM) has emerged as an efficient tool for direct numerical simulations in which the flow field around the particles can be fully resolved. In the thermal Lattice Boltzmann method not only the flow field but also the temperature field is calculated by using one distribution function for the fluid density and one for the fluid temperature. The treatment of curved solid-fluid boundaries is crucial for the simulation of particulate flows with this method. While several aspects of moving boundaries have been discussed in previous studies for the non-thermal LBM, it remains unknown to what extend these findings are transferable to the thermal LBM. In this work, we consider a 3D thermal LBM with a multiple-relaxation-time (MRT) collision operator and compare different techniques that can be applied to handle the moving boundary. There are three key aspects in the LBM that need to be considered at the boundary: the momentum exchange method calculating the drag force acting upon particles, the bounce-back scheme determining the bounce-back of density distribution functions at a boundary, and the refilling algorithm assigning a value to the unknown density distribution functions at lattice nodes uncovered by the particle. First, we demonstrate how the choice of the technique to address these problems in the flow field impacts the results for the temperature field in the thermal LBM. In a second step, we focus on the thermal side where similar techniques need to be applied. We compare different refilling strategies and bounce-back schemes for the temperature distribution functions and assess heat transfer calculation methods for the particle surface. The performance of these implementations is evaluated by comparing the simulation results in terms of accuracy and stability for a moving particle in a channel flow with a Galilean invariant reference syste
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- 2019
43. Comparison of numerical schemes for 3D Lattice Boltzmann simulations of moving rigid particles in thermal fluid flows
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Fonds National de la Recherche - FnR [sponsor], Rosemann, T, Kruggel-Emden, H, Wu, Mingqiu, Peters, Bernhard, Fonds National de la Recherche - FnR [sponsor], Rosemann, T, Kruggel-Emden, H, Wu, Mingqiu, and Peters, Bernhard
- Abstract
The Lattice Boltzmann method is an efficient numerical method for direct numerical simulations of particulate flows. For a variety of applications not only the flow but also the heat transfer between particle and fluid plays an important role. While for non-thermal flows numerous techniques to handle the moving boundaries of particles have been developed, appropriate techniques for the thermal Lattice Boltzmann method are still lacking. The following three issues are of special importance. First, the thermal boundary conditions (Dirichlet or Neumann) have to be fulfilled on the particle surface. Second, reasonable values have to be found for temperature distributions in grid nodes that are uncovered by moving particles. Third, the heat transfer between particulate and fluid phase has to be evaluated in many application, since it is an essential quantity of interest. In this work, we present new numerical schemes for all of these three key aspects. They rely to a great degree on existing schemes for the non-thermal Lattice Botzmann method. In four benchmark cases we assess which of them are the most favourable and we also show to what extend schemes based on the same principles behave similarly or differently in the flow and heat transfer simulation. The results demonstrate that the proposed techniques deliver accurate results and allow us to recommend the most advantageous approach.
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- 2019
44. Patient Characteristics and General Practitioners' Advice to Stop Statins in Oldest-Old Patients: a Survey Study Across 30 Countries
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Ploeg, Milly, Streit, S, Achterberg, WP, Beers, E, Bohnen, Arthur, Burman, RA, Collins, C, Franco, FG, Gerasimovska-Kitanovska, B, Gintere, S, Bravo, RG, Hoffmann, K, Iftode, C, Pestic, SK, Koskela, TH, Kurpas, D, Maisonneuve, H, Mallen, CD, Merlo, C, Mueller, Y, Muth, C, Petrazzuoli, F, Rodondi, N, Rosemann, T, Sattler, M, Schermer, T, Ster, MP, Svadlenkova, Z, Tatsioni, A, Thulesius, H, Tkachenko, V, Torzsa, P, Tsopra, R, Tuz, C, Vaes, B, Viegas, RPA, Vinker, S, Wallis, KA, Zeller, A, Gussekloo, J, Poortvliet, RKE, Ploeg, Milly, Streit, S, Achterberg, WP, Beers, E, Bohnen, Arthur, Burman, RA, Collins, C, Franco, FG, Gerasimovska-Kitanovska, B, Gintere, S, Bravo, RG, Hoffmann, K, Iftode, C, Pestic, SK, Koskela, TH, Kurpas, D, Maisonneuve, H, Mallen, CD, Merlo, C, Mueller, Y, Muth, C, Petrazzuoli, F, Rodondi, N, Rosemann, T, Sattler, M, Schermer, T, Ster, MP, Svadlenkova, Z, Tatsioni, A, Thulesius, H, Tkachenko, V, Torzsa, P, Tsopra, R, Tuz, C, Vaes, B, Viegas, RPA, Vinker, S, Wallis, KA, Zeller, A, Gussekloo, J, and Poortvliet, RKE
- Published
- 2019
45. Zürich weitet sein erfolgreiches Hausarzt - Curriculum aus
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Rosemann, T, University of Zurich, and Rosemann, T
- Subjects
11035 Institute of General Practice ,610 Medicine & health - Published
- 2017
46. No case of exercise-associated hyponatraemia in top male ultra-endurance cyclists: the ‘Swiss Cycling Marathon'
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Rüst, C A, Knechtle, B, Knechtle, P, Rosemann, T, University of Zurich, and Knechtle, B
- Subjects
11035 Institute of General Practice ,2732 Orthopedics and Sports Medicine ,2737 Physiology (medical) ,610 Medicine & health ,2739 Public Health, Environmental and Occupational Health ,human activities - Abstract
The prevalence of exercise-associated hyponatraemia (EAH) has been investigated in endurance athletes such as runners and Ironman triathletes, but not in ultra-endurance road cyclists. We assessed fluid intake and changes in body mass, urine specific gravity and plasma sodium concentration ([Na+]) in 65 ultra-endurance road cyclists in a 720-km ultra-cycling marathon, the ‘Swiss Cycling Marathon'. The cyclists lost 1.5 (1.7)% body mass (P
- Published
- 2018
47. Exercise, Telomeres, and Cancer: 'The Exercise-Telomere Hypothesis'
- Author
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Nomikos, N.N. Nikolaidis, P.T. Sousa, C.V. Papalois, A.E. Rosemann, T. Knechtle, B.
- Abstract
Telomeres are genomic complex at the end of chromosomes that protects the DNA and telomere length (TL) is related to several age-related diseases, lifespan, and cancer. On the other hand, cancer is a multifactorial disease that is responsible for reduce the quality of life and kills millions of people every year. Both, shorter TL and cancer are related and could be treated or prevented depending of the lifestyle. In this review we discuss the possible role of exercise in the relationship between shorter telomeres, telomerase activity, and cancer. In summary, there is evidence that exercise leads to less telomere attrition and exercise also may diminish the risk of cancer, these two outcomes are possible intermediated by a reduction in oxidative stress, and chronic inflammation. Although, there is evidence that shorter TL are associated with cancer, the possible mechanisms that one may lead to the other remains to be clarified. We assume that humans under cancer treatment may suffer a great decrease in quality of life, which may increase sedentary behavior and lead to increased telomere attrition. And those humans with already shorter TL likely lived under a poor lifestyle and might have an increased risk to have cancer. © Copyright © 2018 Nomikos, Nikolaidis, Sousa, Papalois, Rosemann and Knechtle.
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- 2018
48. The effect of physiotherapy and acupuncture on psychocognitive, somatic, quality of life, and disability characteristics in TTH patients
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Georgoudis, G. Felah, B. Nikolaidis, P.T. Papandreou, M. Mitsiokappa, E. Mavrogenis, A.F. Rosemann, T. Knechtle, B.
- Abstract
Introduction: Nonpharmacological therapies have been widely used to treat tension-type headache (TTH); however, limited evidence exists with regards to their effectiveness. Therefore, the aim of the present study was to examine the combined effect of acupuncture, stretching, and physiotherapy (myofascial release techniques and microwave diathermy) on psychocognitive, somatic, quality of life, and disability characteristics in such patients. Subjects and methods: Patients with TTH (n=44) performed either acupuncture or stretching (control group, n=20) or acupuncture, stretching, and physiotherapy (experimental group, n=24) during a 4-week intervention period including 10 treatment sessions. They were tested for the Greek version of the Short-Form McGill Pain Questionnaire, the Greek version of the Migraine Disability Assessment Questionnaire, the Greek version of the Hospital Anxiety and Depression Scale, Short Form Health Survey 12 9 (SF-12), and Pain Catastrophizing Scale at baseline after the fifth and tenth sessions. Results: All measures were improved throughout the first to tenth session (P0.05). Conclusion: In summary, a significant beneficial role of acupuncture, stretching, and physiotherapy on cognitive, psychosomatic pain measures, disability index, quality of life, and catastrophizing in patients with TTH was observed. © 2018 Georgoudis et al.
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- 2018
49. A new drag force and heat transfer correlation derived from direct numerical LBM-simulations of flown through particle packings
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Kravets, B., primary, Rosemann, T., additional, Reinecke, S.R., additional, and Kruggel-Emden, H., additional
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- 2019
- Full Text
- View/download PDF
50. Swimming in ice cold water
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Knechtle, B., Christinger, N., Kohler, G., Knechtle, P., Rosemann, T., Knechtle, B., Christinger, N., Kohler, G., Knechtle, P., and Rosemann, T.
- Abstract
Introduction: We investigated two athletes swimming in 4°C for 23min (1.3km, swimmer 1) and 42min (2.2km, swimmer 2), respectively. Materials and methods: Pre swim, percent body fat was determined; post swim, core temperature was measured. Results: The core temperature of swimmer 2 was: 37.0°C immediately before the start, 32°C 20min after getting out of the water, and 35.5°C 80min after finishing the swim. Conclusion: We assume that the higher skin-fold thickness and body fat of swimmer 2 enabled him to perform longer. In addition to this, mental power and experience in cold water swimming must be considered. In any athlete aiming at swimming in water of less than 5°C, body core temperature and heart rate should be continuously monitored in order to detect a body core temperature below 32°C and arrhythmia to pull the athlete out of the water before life-threatening circumstances occur
- Published
- 2018
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