Influence of Different Performance Levels on Pacing Strategy During the Women's World Championship Marathon Race.

Purpose To analyse pacing strategies displayed by athletes achieving differing levels of performance during an elite level marathon race. Methods Competitors in the 2009 IAAF Women’s Marathon Championship were split into Groups 1, 2, 3, and 4 comprising the first, second, third, and fourth 25% of finishers respectively. Final, intermediate, and personal best (PB) times of finishers were converted to mean speeds, and relative speed (% of PB speed) was calculated for intermediate segments. Results Mean PB speed decreased from Group 1 to 4 and speed maintained in the race was 98.5 + 1.8%, 97.4 + 3.2%, 95.0 + 3.1% and 92.4 + 4.4% of PB speed for Groups 1-4 respectively. Group 1 was fastest in all segments and differences in speed between groups increased throughout the race. Group 1 ran at lower relative speeds than other groups for the first two 5 km segments, but higher relative speeds after 35km. Significant differences (P<0.01) in the percentage of PB speed maintained were observed between Groups 1 and 4, and 2 and 4 in all segments after 20 km, and Groups 3 and 4 from 20-25 km and 30-35 km. Conclusions Group 1 athletes achieved superior finishing times relative to their PB than athletes in other Groups who selected unsustainable initial speeds resulting in subsequent significant losses of speed. It is suggested that psychological factors specific to a major competitive event influenced decision making by athletes and poor decisions resulted in final performances inferior to those expected based on PB times

All for One and One for All! Disparity Between Overall Crew’s and Individual Rowers’ Pacing Strategies During Rowing

Purpose: This study examined individual contributions to overall pacing strategy during 2- and 5-km rowing trials in a cox-less-4 boat. Methods: A crew of 4 male rowers performed maximal-effort on-water trials over 2 and 5 km, and power output during every individual stroke was measured for each crew member. Mean overall boat and individual rower stroke power were calculated for each 25% epoch (25% of total strokes taken), and power for each individual epoch was calculated as a percentage of mean power maintained over the entire distance. The coefficient of variation was used to determine stroke-to-stroke and epoch-to-epoch variability for individual rowers and the overall boat. Results: In both trials, the overall pacing strategy consisted of a high power output in the initial 25% that decreased in the middle 50% and increased again in the final 25%. However, individual rower data indicate wide variation in individual power profiles that did not always mimic the overall boat profile. Conclusions: This study demonstrates that overall boat power profiles during 2- and 5-km rowing trials are similar to velocity profiles previously reported for individual ergometry and on-water racing events. However, this over-all profile is achieved despite considerable variation in individual rower profiles. Further research is warranted to determine the mechanisms through which individual contributions to overall pacing strategy are regulated and the effectiveness or oth-erwise of seemingly disparate individual strategies on overall performance

The Theological and Ethical Grounds against Keeping Elephants Captive

As set forth below, animal theology experts Dr. Andrew Linzey and Dr. Clair Linzey of the Oxford Centre for Animal Ethics believe that Petitioner Nonhuman Rights Project, Inc. (“NhRP”) has made a prima facie case that the elephants confined at Fresno Chaffee Zoo in Fresno, CA—Nolwazi, Amahle, and Mabu—are entitled to habeas corpus relief. Accordingly, we respectfully urge the Supreme Court of California to issue an order to show cause in this matter

Time for a Marketing Curriculum Overhaul: Developing a Digital-First Approach

Academic programs and educators face numerous challenges related to teaching digital marketing. Today, the world of marketing is digital and marketing programs have struggled to maintain pace with the changes influencing marketing practice. The authors describe the M-School program at Loyola Marymount University, a program developed to address this challenge by placing digital marketing at the center of the curriculum. Through experiential learning and project-based learning, M-School courses expose students to real-life challenges involving ways in which companies and organizations generate consumer awareness, demand, and value given the significant digital shifts taking place in technology and consumer behavior. The authors highlight the creation of a digital-first curriculum that is aligned with industry practice and helps students develop the skills needed to become future proof and real-world ready. Quantitative and qualitative assessment over a three-year period points to the success of the M-School program in preparing students for careers in marketing. Lessons for the development of marketing curricula include the role of new course development, the need to integrate digital within existing courses, the role of a project-based learning approach with measurable outcomes, and the potential for designing transdisciplinary courses to foster students’ creative, critical thinking, communication, and collaborative skills

Addressing unwarranted clinical variation in healthcare as a quality improvement process

The reduction of unwarranted clinical variation is a common goal of healthcare systems worldwide. However, the process of developing and implementing variation reducing interventions as a quality improvement process is often overlooked and performed sub-optimally within healthcare organizations. This gap in practice is mirrored by a gap in existing research. The development of a clinical variation specific prescriptive model will assist with the identification, development and application of healthcare specific variation reducing initiatives. Such a model should complement the existing plan, do, study, act quality (PDSA) improvement methodology and respect the learning health systems (LHS) learning cycle. Development through the lens of the quadruple aim of healthcare will ensure that the focus remains true to the core values of clinical organizations. Addressing unwarranted clinical variation is a complex task, however. With organizational support, the utilization of collaborative methodologies and the leveraging of available digital health technologies, healthcare organizations are provided the greatest opportunity for the reduction of unwarranted clinical variation and the optimization of healthcare outcomes

Designing and Facilitating Collaborative Research Design and Data Analysis Workshops: Lessons Learned in the Healthy Neighborhoods Study

One impediment to expanding the prevalence and quality of community-engaged research is a shortage of instructive resources for collaboratively designing research instruments and analyzing data with community members. This article describes how a consortium of community residents, grassroots community organizations, and academic and public institutions implemented collaborative research design and data analysis processes as part of a participatory action research (PAR) study investigating the relationship between neighborhoods and health in the greater Boston area. We report how nine different groups of community residents were engaged in developing a multi-dimensional survey instrument, generating and testing hypotheses, and interpreting descriptive statistics and preliminary findings. We conclude by reflecting on the importance of balancing planned strategies for building and sustaining resident engagement with improvisational facilitation that is responsive to residents&rsquo; characteristics, interests and needs in the design and execution of collaborative research design and data analysis processes. Keywords: participatory action research; community engagement; instrument design; data analysis; urban development; community healt

The Digital Transformation Journey of a Large Australian Hospital: A Teaching Case

With the vision of a seamless, state-wide approach to patient management, the Department of Health within the Queensland State Government of Australia embarked on a digital transformation journey. This involved the configuration and rollout of an integrated electronic medical record system (ieMR) with computerized provider order entry, ePrescribing, decision support, analytics, and research functionalities, together with new devices and work practices, to create a multi-hospital, whole-of-state digital health ecosystem. Drawing on multiple perspectives, including executives and front-line clinicians who are both optimistic and pessimistic towards the ieMR, this teaching case describes the digital transformation of the lead site, Princess Alexandra Hospital, and their experience in becoming Australia’s first large digital hospital. This case has been informed by a multi-year qualitative study involving the collection of primary (observations and interviews) and secondary data (publicly available project records) before and after the implementation. This case is relevant to undergraduate and postgraduate students in information systems, executive management, and clinical/health informatics

Adaptive Self-regulation in Cycle Time Trials: Goal Pursuit, Goal Disengagement and the Affective Experience

Self-regulation research analyses behaviour and emotion through goal progress (Carver and Scheier 2013). Goal disengagement is advocated as an adaptive self-regulatory strategy for unattainable goals to reduce distress (Wrosch et al. 2003a; 2003b). In an attempt to further understand ongoing goal pursuit and emotions on endurance athletes, this paper applies adaptive self-regulation theory to interpret and explain the experiences of three cyclists in case studies which display variations in success and failure. Following criterion sampling methods we analysed positive and negative affect, goal expectancy and power output from three male participants (triathletes or cyclists; age range 26-50 yrs) who either successfully achieved their goal (Participant 1), were unsuccessful yet recalculated their goal (Participant 2) or failed to achieve their goal (Participant 3) in a 20 km laboratory cycle time trial. Post trial qualitative data provided explanations regarding pacing, perceptions of achievement and feeling states (self-chosen adjectives). Positive affect tracked goal expectancy with increases in positive affect when power output exceeded previous trial averages and goal expectations were high evidencing successful goal striving (Participant 1). Reductions in positive affect occurred where goal progress was below expectations. This reduction was dramatic in the unsuccessful trial (Participant 3). Low levels of positive affect and high levels of negative affect were reported from 12 – 20 km together with disappointment, unexpected feelings of a loss of control and fatigue, suggesting unsuccessful goal striving. Supporting goal disengagement theory, a relinquishment of goal commitment was evident for participant 2 who recalculated his goal. Despite being unsuccessful in achieving his original goal participant 2 reported positive feeling states and perceptions of control post trial indicating adaptive self-regulation strategies were effective in his specific situation. These findings emphasise the need to examine practical adaptive self-regulation strategies in sport and relationships between affect, decision making and goal striving

Gating mechanism of elongating β-ketoacyl-ACP synthases.

Carbon-carbon bond forming reactions are essential transformations in natural product biosynthesis. During de novo fatty acid and polyketide biosynthesis, β-ketoacyl-acyl carrier protein (ACP) synthases (KS), catalyze this process via a decarboxylative Claisen-like condensation reaction. KSs must recognize multiple chemically distinct ACPs and choreograph a ping-pong mechanism, often in an iterative fashion. Here, we report crystal structures of substrate mimetic bearing ACPs in complex with the elongating KSs from Escherichia coli, FabF and FabB, in order to better understand the stereochemical features governing substrate discrimination by KSs. Complemented by molecular dynamics (MD) simulations and mutagenesis studies, these structures reveal conformational states accessed during KS catalysis. These data taken together support a gating mechanism that regulates acyl-ACP binding and substrate delivery to the KS active site. Two active site loops undergo large conformational excursions during this dynamic gating mechanism and are likely evolutionarily conserved features in elongating KSs

Integrated Clinical and Magnetic Resonance Imaging Assessments Late After Fontan Operation

BACKGROUND Several clinical and cardiac magnetic resonance (CMR)-derived parameters have been shown to be associated with death or heart transplant late after the Fontan operation. OBJECTIVES The objective of this study was to identify the relative importance and interactions of clinical and CMR-based parameters for risk stratification after the Fontan operation. METHODS Fontan patients were retrospectively reviewed. Clinical and CMR parameters were analyzed using univariable Cox regression. The primary endpoint was time to death or (listing for) heart transplant. To identify the patients at highest risk for the endpoint, classification and regression tree survival analysis was performed, including all significant variables from Cox regression. RESULTS The cohort consisted of 416 patients (62% male) with a median age of 16 years (25th, 75th percentiles: 11, 23 years). Over a median follow-up of 5.4 years (25th, 75th percentiles: 2.4, 10.0 years) after CMR, 57 patients (14%) reached the endpoint (46 deaths, 7 heart transplants, 4 heart transplant listings). Lower total indexed end-diastolic volume (EDVi) was the strongest predictor of transplant-free survival. Among patients with dilated ventricles (EDVi >= 156 ml/BSA(1.3)), worse global circumferential strain (GCS) was the next most important predictor (73% vs. 44%). In patients with smaller ventricles (EDVi = II was the next most important predictor (30% vs. 4%). CONCLUSIONS In this cohort of patients late after Fontan operation, increased ventricular dilation was the strongest independent predictor of death or transplant (listing). Patients with both ventricular dilation and worse GCS were at highest risk. These data highlight the value of integrating CMR and clinical parameters for risk stratification in this population. (C) 2021 by the American College of Cardiology Foundation