bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Prandial Versus Fasting Glycemia on Cardiovascular Outcomes in Type 2 Diabetes: The HEART2D trial
Authors: Raz Itamar , Wilson Peter W.F. , Strojek Krzysztof , Kowalska Irina , Bozikov Velimir , Gitt Anselm K. , Jermendy György , Campaigne Barbara N. , Kerr Lisa , Milicevic Zvonko , Jacober Scott J. 
Published: February 2009

OBJECTIVE—Hyperglycemia and Its Effect After Acute Myocardial Infarction on Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus (HEART2D) is a multinational, randomized, controlled trial designed to compare the effects of prandial versus fasting glycemic control on risk for cardiovascular outcomes in patients with type 2 diabetes after acute myocardial infarction (AMI).
RESEARCH DESIGN AND METHODS—Patients (type 2 diabetes, aged 30–75 years) were randomly assigned within 21 days after AMI to the 1) prandial strategy (PRANDIAL) (three premeal doses of insulin lispro targeting 2-h postprandial blood glucose &lt;7.5 mmol/l) or the 2) basal strategy (BASAL) (NPH twice daily or insulin glargine once daily targeting fasting/premeal blood glucose &lt;6.7 mmol/l).
RESULTS—A total of 1,115 patients were randomly assigned (PRANDIAL n = 557; BASAL n = 558), and the mean patient participation after randomization was 963 days (range 1–1,687 days). The trial was stopped for lack of efficacy. Risks of first combined adjudicated primary cardiovascular events in the PRANDIAL (n = 174, 31.2%) and BASAL (n = 181, 32.4%) groups were similar (hazard ratio 0.98 [95% CI 0.8–1.21]). Mean A1C did not differ between the PRANDIAL and BASAL groups (7.7 ± 0.1 vs. 7.8 ± 0.1%; P = 0.4) during the study. The PRANDIAL group showed a lower daily mean postprandial blood glucose (7.8 vs. 8.6 mmol/l; P &lt; 0.01) and 2-h postprandial blood glucose excursion (0.1 vs. 1.3 mmol/l; P &lt; 0.001) versus the BASAL group. The BASAL group showed lower mean fasting blood glucose (7.0 vs. 8.1 mmol/l; P &lt; 0.001) and similar daily fasting/premeal blood glucose (7.7 vs. 7.3 mmol/l; P = 0.233) versus the PRANDIAL group.
CONCLUSIONS—Treating diabetic survivors of AMI with prandial versus basal strategies achieved differences in fasting blood glucose, less-than-expected differences in postprandial blood glucose, similar levels of A1C, and no difference in risk for future cardiovascular event rates.
Trunk deformation in the trotting horse
Authors: Nauwelaerts S. , Clayton H. M. 
Published: February 2009

Summary Reasons for performing study: Estimates of the position of the centres of mass (CM) of body segments are usually extrapolated relative to bony landmarks as determined in cadaver studies. This extrapolation assumes that segments are rigid bodies. Since the trunk represents a large percentage of the total body mass in horses, violation of the rigid body assumption by the trunk segment has important consequences for studying the biomechanics of equine locomotion. Objectives: To assess the magnitude of error in CM position due to deformability of the trunk segment and the timing of these errors during the trotting stride. The hypothesis was that shape changes during a stride are repeatable and predictable. Methods: Forty skin markers were attached in a grid pattern on the trunks of 6 adult horses, with an additional marker attached to each hoof. The markers were tracked using an 8 camera motion analysis system. Each horse was tested at 10 different velocities during trotting. The CM of the trunk was calculated under the assumption of a rigid body, based on 5 spine markers and from the volume encompassed by the 40 markers. The difference between the 2 calculation methods quantifies the effect of trunk deformation on the position of the CM. Results: The trunk changed shape during locomotion in a repeatable manner resulting in cyclic changes in CM position. Amplitudes of the CM displacement due to trunk deformation were equal in magnitude in the transverse and longitudinal directions. In the vertical direction, the CM moved only at half the amplitude. Magnitudes were strongly horse‐dependent. Conclusions and potential relevance: Shape changes in the equine trunk segment in the horizontal plane should be taken into account when modelling locomotion of horses. Amplitudes are horse dependent, complicating the development of correction routines.
Effects of a synthetic all‐weather waxed track versus a crushed sand track on 3D acceleration of the front hoof in three horses trotting at high speed
Authors: Chateau H. , Robin D. , Falala S. , Pourcelot P. , Valette J.‐P. , Ravary B. , Denoix J.‐M. , Crevier‐Denoix N. 
Published: February 2009

Summary Reasons for performing study: Inadequate track surfaces are believed to be a risk factor in the occurrence of musculoskeletal injuries, but quantification of the shocks and vibrations provoked by hoof impact on different ground surfaces (including new synthetic tracks) has been insufficiently documented in trotters under high‐speed training conditions. Objectives: To test the reliability and sensitivity of an accelerometric device to discriminate between the biomechanical effects of 2 different tracks at high speed. Methods: Three French Trotters were used and their right front hooves were equipped with one triaxial accelerometer. Two different track surfaces (crushed sand track: S and all‐weather waxed track: W) were tested when horses were trotting in a straight line. For each session of measurements, trials were repeated 3 times in a Latin square design. The speed of the runs was set at 10 m/s, controlled by the driver and recorded synchronously. Sample rate was set at 6 kHz. Acceleration of the hoof (resultant vector and 3D components), power spectral density at impact and variability (between strides, trials, sessions and horses) were analysed. Statistical differences were tested using a GLM procedure (SAS). Least square mean differences were used for comparisons between tracks (P<0.05). Results: Results showed that the deceleration of the hoof (magnitude of the resultant vector) was statistically different between the 2 tracks with an attenuation of the shock of about 50% on the all‐weather waxed track. Magnitude of the power spectral density was reduced at higher frequencies on W. Conclusions and clinical relevance: These preliminary results demonstrate the sensitivity of the tool to discriminate between the different behaviours of the hoof on the different track surfaces at high speed. Deceleration and vibration of the hoof at impact were reduced on W compared to S, suggesting a better shock‐absorbing quality of this track.
In vitroevaluation of metacarpophalangeal joint loading during simulated walk
Authors: Den Hartog S. M. , Back W. , Brommer H. , Van Weeren P. R. 
Published: February 2009

SummaryReasons for performing study: Insight into the loading pattern of the articular cartilage surface during the complete stride is important as biomechanical factors play a pivotal role in the pathogenesis of joint trauma and osteoarthritis (OA).Objectives: To determine the loading pattern in the equine MCP articulationin vitroduring simulated walk.Methods: Eight cadaveric limbs from mature Dutch Warmblood horses were loaded in a pneumatic loading device in 6 different positions (A1‐A6). The pressure distribution on the articular surface of the proximal phalanx (P1) was measured at 7 sites (S1‐7) using intra‐articularly placed pressure sensitive films, which were analysed by scanning and densitometry.Results: Pressures recorded after mid‐stance (A4, 5, 6) were significantly (P<0.05) higher than those before (A1, 2, 3) and showed the biphasic loading pattern of the walk at all sites, except for the site halfway along the sagittal groove (S7). At S7, there was a linear increase in pressure during the progress of the stance phase of the stride in most horses. Medially (S4, 5, 6) the pressure was significantly higher than laterally (S1, 2, 3) (P<0.05).Conclusions and potential relevance: The heavier medial loading coincides with the location where articular cartilage degeneration in the process of OA in the equine MCP joint is known to start. The discrepancy between the loading of the central groove and the other parts of the joint may result in large stress differences at the end of the stance phase, which might be related to the pathogenesis of stress fractures in the first phalanx and distal third metacarpal bone.
The use of force plate measurements to titrate the dosage of a new COX‐2 inhibitor in lame horses
Authors: Back W. , Macallister C. G. , van Heel M. C. V. , Pollmeier M. , Hanson P. D. 
Published: February 2009

SummaryReasons for performing study: Lameness is a highly prevalent condition in horses and the principal cause of removal from athletic activity. In clinical studies to evaluate nonsteroidal anti‐inflammatory drug therapies, force plates are commonly used to assess improvement of lameness objectively.Hypothesis: To use a force plate to determine the optimal dose of a new COX‐2 inhibitor (firocoxib) that will reduce lameness, when administered orally to horses once daily.Methods: Sixty‐four horses that exhibited chronic lameness presumed due to osteoarthritis, including navicular disease, in at least one of the frontlimbs and at a stable level of severity, were included. Horses were treatedper oss.i.d. for 7 days as follows: vehicle control, firocoxib at 0.05, 0.1 or 0.25 mg/kg bwt. Force plate analysis of each horse was done for the selected (most) lame frontlimb at trot. Once between Days −19 and −4 (initial examination), and again on Day −2 or −1 (baseline), pretreatment force plate assessments were performed, and thereafter horses were assessed on Days 0, 2 and 6, approximately 10 h post treatment each time. Peak vertical force (PVF) and lameness grades at initial examination and at baseline, and their change from baseline in the 4 different treatment groups were analysed statistically at a significance level of P<0.05.Results: The PVF results were found to be superior to vehicle control already at Day 0 for 0.25 mg/kg bwt and at Days 2 and 6 for 0.1 and 0.25 mg/kg bwt (P<0.05). Mean clinical lameness for both concentrations decreased >1 grade at Day 6.Conclusions and clinical relevance: With the dosage of 0.25 mg/kg bwt lameness did not improve more than with 0.1 mg/kg bwt. Thus, 0.1 mg/kg bwt s.i.d. was considered to be the effective dose at reducing chronic lameness in horses presumed due to osteoarthritis, including navicular disease.
Kinetics and kinematics of the horse comparing left and right rising trot
Authors: Roepstorff L. , Egenvall A. , Rhodin M. , Byström A. , Johnston C. , van Weeren P. R. , Weishaupt M. 
Published: February 2009

Summary Reasons for performing study: At rising trot the rider sits alternately down on one diagonal pair of limbs and rises up on the other. The possible effects on asymmetry of locomotion induced by rising trot have rarely been studied. Objectives: To demonstrate whether, and if so to what extent, rising trot causes asymmetrical loading in the vertical ground reaction force (VGRF) and/or asymmetrical effects on the locomotion pattern, comparing left and right side. Methods: Seven elite horses were ridden in left and right rising trot on a treadmill, while VGRF and kinematics were measured, with the horses' neck raised, the poll high and the bridge of the nose slightly in front of the vertical. Results: Force loading was generally increased in the limbs of the sitting diagonal. The lumbar back was lower between mid‐stances of the sitting and nonsitting stance, pelvic roll was limited and the tuber coxae heights were lower on the sitting side. Maximal hindlimb protraction was decreased. Forelimb retraction was increased and the T6 height decreased. Conclusion: The rider movement induces an uneven biphasic load that affects the back, pelvis and limb kinematics and VGRF. Potential relevance: The generally advocated technique of alternating limbs when riding in rising trot is supported. The VGRF changes between rising on the left or right diagonal were distinct, but minor in absolute terms and therefore unlikely to have direct impact on the occurrence of locomotor injuries. Knowledge of an increase of asymmetry in rising trot is potentially useful for riders/trainers.
Relationship between the forces acting on the horse's back and the movements of rider and horse while walking on a treadmill
Authors: von Peinen K. , Wiestner T. , Bogisch S. , Roepstorff L. , Van Weeren P. R. , Weishaupt M. A. 
Published: February 2009

Summary Reasons for performing study: The exact relationship between the saddle pressure pattern during one stride cycle and the movements of horse and rider at the walk are poorly understood and have never been investigated in detail. Hypothesis: The movements of rider and horse account for the force distribution pattern under the saddle. Method: Vertical ground reaction forces (GRF), kinematics of horse and rider as well as saddle forces (FS) were measured synchronously in 7 high level dressage horses while being ridden on an instrumented treadmill at walk. Discrete values of the total saddle forces (FStot) were determined for each stride and related to kinematics and GRF. The pressure sensitive mat was divided into halves and sixths to assess the force distribution over the horse's back in more detail. Differences were tested using a one sample t test (P<0.05). Results: FStot of all the horses showed 3 peaks (P1‐P3) and 3 minima (M1‐M3) in each half‐cycle, which were systematically related to the footfall sequence of the walk. Looking at the halves of the mat, force curves were 50% phase‐shifted. The analysis of the FS of the 6 sections showed a clear association to the rider's and horse's movements. Conclusion: The saddle force distribution during an entire stride cycle has a distinct pattern although the force fluctuations of the FStot are small. The forces in the front thirds were clearly related to the movement of the front limbs, those in the mid part to the lateral flexion of the horse's spine and the loading of the hind part was mainly influenced by the axial rotation and lateral bending of the back. Potential relevance: These data can be used as a reference for comparing different types of saddle fit.
Evaluation of discriminant analysis based on dorsoventral symmetry indices to quantify hindlimb lameness during over ground locomotion in the horse
Authors: Church E. E. , Walker A. M. , Wilson A. M. , Pfau T. 
Published: February 2009

Summary Reasons for performing study: Advances in gait analysis techniques have led to assessment tools that can aid in detecting and quantifying lameness; here, bilateral tuberà coxae and pelvic movement during over ground locomotion are compared in order to investigate a practical method to assess hindlimb lameness in the horse. Objectives: To evaluate which parameters from anatomical landmarks on trunk and proximal hindlimbs are the best indicators of degree and side of hindlimb lameness. Methods: Fifteen horses (age 11–23 years, 6 nonlame and 9 unilaterally hindlimb lame horses 1/10 to 2/10 lame) were fitted with 4 inertial sensors: tuber sacrale, left and right tubera coxae and withers; 889 strides were collected from 6 trot trials per horse. Horses were assessed for lameness by a qualified equine orthopaedic surgeon from videos. Vertical displacement data for each sensor were used to calculate symmetry indices as well as published Fourier analysis based parameters. Linear discriminant analysis was used to determine the most discriminative parameters for 2 scenarios: grading of severity of lameness and identification of the affected limb. Results: Pelvic energy ratio gave the best indication for the degree of lameness. Directional symmetry index of the tubera coxae sensors yielded the highest discriminative power for identification of the lame limb. Conclusions and potential relevance: A good indication of the degree of hindlimb lameness can be obtained from vertical displacement data of the pelvic midline, collected from inertial sensors during over ground locomotion. The trunk mounted inertial sensor system allows for a time efficient collection of a representative database from horses with differing grade and site of lameness in a clinical setting. This is crucial for future work on a robust definition of the best parameters for lameness classification under practical conditions.
Back kinematics of healthy trotting horses during treadmill versus over ground locomotion
Authors: Álvarez C. B. Gómez , Rhodin M. , Byström A. , Back W. , van Weeren P. R. 
Published: February 2009

Summary Reasons for performing study: Treadmill locomotion is frequently used for training of sport horses, for diagnostic purposes and for research. Identification of the possible biomechanical differences and similarities between the back movement during treadmill (T) and over ground (O) locomotion is essential for the correct interpretation of research results. Objectives: To compare the kinematics of the thoracolumbar vertebral column in treadmill and over ground locomotion in healthy horses. Methods: Six sound Dutch Warmblood horses trotted on a T and O during 10 s at their own preferred velocity (mean ± s.d. 3.6 ± 0.3 m/s T and 3.6 ± 0.1 m/s O), which was the same in both conditions. Kinematics of the vertebral column was captured by infrared cameras using reflective skin markers attached over the spinous processes of selected vertebrae and other locations. Flexion‐extension and lateral bending range of motion (ROM), angular motion pattern (AMP) and intravertebral pattern symmetry (IVPS) of 5 vertebral angles (T6‐T10‐T13, T10‐T13‐T17, T13‐T17‐L1, T17‐L1‐L3 and L1‐L3‐l5) were calculated. Neck angle, linear and temporal stride parameters and protraction‐retraction angles of the limbs were also calculated. Results: The vertical ROM (flexion‐extension) was similar in both conditions, but the horizontal ROM (lateral bending) of the lumbar angles T17‐L1‐L3 and L1‐L3‐L5 was less during T locomotion (mean ± s.d. difference of 1.8 ± 0.6 and 1.7 ± 0.9°, respectively, P>0.05). During O locomotion, the symmetry pattern of the lumbar vertebral angles was diminished from 0.9 to 0.7 (1 = 100% symmetry) indicating increased irregularity of the movement (P>0.05). No differences were found in the basic linear and temporal stride parameters and neck angle. Potential relevance: Vertebral kinematics during treadmill locomotion is not identical to over ground locomotion, but the differences are minor. During treadmill locomotion lumbar motion is less, and caution should be therefore taken when interpreting lumbar kinematics.
Influence of different head‐neck positions on vertical ground reaction forces, linear and time parameters in the unridden horse walking and trotting on a treadmill
Authors: Waldern N. M. , Wiestner T. , von Peinen K. , Álvarez C. G. Gómez , Roepstorff L. , Johnston C. , Meyer H. , Weishaupt M. A. 
Published: February 2009

SummaryReasons for performing study: It is believed that the head‐neck position (HNP) has specific effects on the loading pattern of the equine locomotor system, but very few quantitative data are available.Objective: To quantify the effects of 6 different HNPs on forelimb‐hindlimb loading and underlying temporal changes.Methods: Vertical ground reaction forces of each limb and interlimb coordination were measured in 7 high level dressage horses walking and trotting on an instrumented treadmill in 6 predetermined HNPs:HNP1‐ unrestrained;HNP2‐ elevated neck, bridge of the nose in front of the vertical;HNP3‐ elevated neck, bridge of the nose behind the vertical;HNP4‐ low and flexed neck;HNP5‐ head and neck in extreme high position; andHNP6‐ forward downward extension of head and neck.HNP1served as a velocity‐matched control.Results: At the walk, the percentage of vertical stride impulse carried by the forehand (Izfore) as well as stride length and overreach distance were decreased inHNP2, HNP3, HNP4andHNP5when compared toHNP1.At the trot, Izforewas decreased inHNP2, HNP3, HNP4andHNP5.Peak forces in the forelimbs increased inHNP5and decreased inHNP6.Stance duration in the forelimbs was decreased inHNP2andHNP5.Suspension duration was increased inHNP2, HNP3andHNP5.Overreach distance was shorter inHNP4and longer inHNP6.Conclusions: In comparison toHNP1andHNP6, HNPs with elevation of the neck with either flexion or extension at the poll as well as a low and flexed head and neck lead to a weight shift from the forehand to the hindquarters.HNP5had the biggest effect on limb timing and load distribution. At the trot, shortening of forelimb stance duration inHNP5increased peak vertical forces although Izforedecreased.Potential relevance: Presented results contribute to the understanding of the value of certain HNPs in horse training.
Use of a 3D dynamometric horseshoe to assess the effects of an all‐weather waxed track and a crushed sand track at high speed trot: Preliminary study
Authors: Robin D. , Chateau H. , Pacquet L. , Falala S. , Valette J.‐P. , Pourcelot P. , Ravary B. , Denoix J.‐M. , Crevier‐Denoix N. 
Published: February 2009

Summary Reasons for performing study: Track surface quality is considered a risk factor of musculoskeletal injuries. Ground reaction force (GRF) measurement is a relevant approach to study the interaction between the hoof and the ground. Force plates are not adapted to compare different surfaces at high speed. A 3D dynamometric horseshoe (DHS), using 4 triaxial piezoelectric sensors, has been developed and validated. Objectives: To use the DHS to compare the effects of 2 track surfaces, an all‐weather waxed track and a crushed sand track, on the GRF in trotter horses under training conditions. Methods: The right forelimb of 3 French Trotters was equipped with the DHS. Two tracks were tested in a straight line: a crushed sand track (S) and an all‐weather waxed track (W). For each session, trials were repeated 3 times in a Latin square design. The speed of the runs was set at 10 m/s and recorded synchronously. For each trial, data acquisition was performed at 600 Hz and 10 consecutive strides were analysed. Statistical differences were tested using a general linear model procedure. Results: The amplitude of the maximal longitudinal braking force (Fx) was significantly lower on W compared to S. This event happened about 6% later in the stance phase on W. The magnitude of the GRF at impact decreased on W. The average speed and the mean stance phase duration were not statistically different on both surfaces. The stride length was about 6 cm longer on S. Conclusion and potential relevance: This study demonstrates the ability and sensitivity of the DHS to discriminate track surfaces by measuring the GRF at high speed. These preliminary results show that the loading rate, the amplitude of horizontal braking and shock at impact are attenuated on W, which suggests a reduction of stresses in the distal limb.
Use of standing low‐field magnetic resonance imaging to diagnose middle phalanx bone marrow lesions in horses
Authors: Olive J. , Mair T. S. , Charles B. 
Published: February 2009

SummaryBone marrow lesions (BMLs) (also known as ‘bone bruises’, ‘bone oedema’, ‘bone contusions’ and ‘occult fractures’) within the middle phalanx were diagnosed by standing low field magnetic resonance imaging (MRI) in 7 horses. The lesions were characterised by low signal intensity on T1‐ and T2*‐weighted gradient echo sequences, mildly increased signal intensity on T2 fast spin echo sequences, and high signal intensity on short tau inversion recovery (STIR) sequences. Four distinct patterns of abnormal signal were identified: BML associated with osteoarthritis of either the proximal or distal interphalangeal joints; BML associated with soft tissue injury; BML associated with acute trauma; and BML unassociated with any other injury or lameness (assumed to represent bone response to biomechanical stress). Repeat MRI was undertaken in 4 cases. In most cases the BML resolved with rest and time, although lameness was persistent in 2 horses (one of which had an associated osteoarthritis of the proximal interphalangeal joint).