Practice-based skill acquisition of pushrim-activated power-assisted wheelchair propulsion versus regular handrim propulsion in novices

BACKGROUND: Regular handrim wheelchair (RHW) propulsion is straining for the upper extremities and wheelchair users often experience overuse problems. A recent advancement in wheelchair technology that could assist users is the pushrim-activated power-assisted wheelchair (PAPAW). PAPAWs are challenging to control, yet it is unclear how people learn to use a PAPAW. The purpose of this study is to examine early skill acquisition through practice in PAPAWs and compare it with RHWs. METHODS: Twenty-four able-bodied novices were randomly allocated to either the RHW group or the PAPAW group. The experiment consisted of five sessions with three blocks of 4 min steady-state practice at 1.11 m/s and 0.21 W/kg. Finally, a transfer to the other mode was made. Data were collected with a drag-test, breath-by-breath spirometry, and a motion capture system. The last minute of each four-minute block was used for analysis. A mixed analysis of variance (ANOVA) was used to test for group, time, and interaction effects. RESULTS: Both groups improved their (assisted) mechanical efficiency, reduced their stroke rate, right-left and forward-backward deviation on the treadmill, and had a lower rate of perceived exertion (RPE) over time. (Assisted) mechanical efficiency was higher for the PAPAW group than for the RHW group and RPE was lower. However, left-right and forward-backward deviation was also found to be higher in the PAPAW group. CONCLUSIONS: At the group level the energetic cost of RHW and PAPAW propulsion can be lowered through low-intensity practice in novice users. The PAPAW is more 'efficient' than the RHW given the reduced energy requirement of the user from the motor assist, but more difficult to control. Future studies on PAPAWs should focus on the control needs of the user and their interaction with the power-assist technology

Cyclo19,31[D-Cys19]-uPA19-31 is a potent competitive antagonist of the interaction of urokinase-type plasminogen activator with its receptor (CD87)

Urokinase-type plasminogen activator (uPA) represents a central molecule in pericellular proteolysis and is implicated in a variety of physiological and pathophysiological processes such as tissue remodelling, wound healing, tumor invasion, and metastasis. uPA binds with high affinity to a specific cell surface receptor, uPAR (CD87), via a well defined sequence within the N-terminal region of uPA (uPA(19-31)). This interaction directs the proteolytic activity of uPA to the cell surface which represents an important step in tumor cell proliferation, invasion, and metastasis. Due to its fundamental role in these processes, the uPA/uPAR-system has emerged as a novel target for tumor therapy. Previously, we have identified a synthetic, cyclic, uPA-derived peptide, cyclo(19,31)uPA(19-31), as a lead structure for the development of low molecular weight uPA-analogues, capable of blocking uPA/uPAR-interaction {[}Burgle et al., Biol. Chem. 378 (1997), 231-237]. We now searched for peptide variants of cyclo(19,31)uPA(19-31) with elevated affinities for uPAR binding. Among other tasks, we performed a systematic D-amino acid scan of quPA(19-31), in which each of the 13 L-amino acids was individually substituted by the corresponding D-amino acid. This led to the identification of cyclo(19,31) {[}D-Cys(19)]-uPA(19-31) as a potent inhibitor of uPA/uPAR-interaction, displaying only a 20 to 40-fold lower binding capacity as compared to the naturally occurring uPAR-ligands uPA and its amino-terminal fragment. Cyclo(19,31)[D-Cys(19)]-uPA(19-31) not only blocks binding of uPA to uPAR but is also capable of efficiently displacing uPAR-bound uPA from the cell surface and to inhibit uPA-mediated, tumor cell-associated plasminogen activation and fibrin degradation. Thus, cyclo(19,31)[D-Cys(19)]-uPA(19-31) represents a promising therapeutic agent to significantly affect the tumor-associated uPA/uPAR-system

Intraoperative cone beam computed tomography for detecting residual stones in percutaneous nephrolithotomy:a feasibility study

Cone beam computed tomography (CBCT) provides multiplanar cross-sectional imaging and three-dimensional reconstructions and can be used intraoperatively in a hybrid operating room. In this study, we investigated the feasibility of using a CBCT-scanner for detecting residual stones during percutaneous nephrolithotomy (PCNL). Intraoperative CBCT-scans were made during PCNL procedures from November 2018 until March 2019 in a university hospital. At the point where the urologist would have otherwise ended the procedure, a CBCT-scan was made to image any residual fragments that could not be detected by either nephroscopy or conventional C-arm fluoroscopy. Residual fragments that were visualized on the CBCT-scan were attempted to be extracted additionally. To evaluate the effect of this additional extraction, each CBCT-scan was compared with a regular follow-up CT-scan that was made 4 weeks postoperatively. A total of 19 procedures were analyzed in this study. The mean duration of performing the CBCT-scan, including preparation and interpretation, was 8 min. Additional stone extraction, if applicable, had a mean duration of 11 min. The mean effective dose per CBCT-scan was 7.25 mSv. Additional extraction of residual fragments as imaged on the CBCT-scan occurred in nine procedures (47%). Of the follow-up CT-scans, 63% showed a stone-free status as compared to 47% of the intraoperative CBCT-scans. We conclude that the use of CBCT for the detection of residual stones in PCNL is meaningful, safe, and feasible

Oral Communication Competency Across the Virginia Community College System: A Faculty-Designed Assessment

A full-scale oral communication assessment was conducted by the Virginia Community College System (VCCS) during the academic year 2013-14. Key components of this assessment included faculty involvement at all stages of assessment and collaboration with assessment coordinators and lead staff personnel. The VCCS Office of Institutional Research and Effectiveness partnered with CST faculty experts to design the assessment. The Competent Speaker Speech Evaluation Form, a standardized and tested instrument used to assess public speaking competency in higher education, was used to evaluate student speeches. Designed by the National Communication Association, this instrument identifies eight competencies for measurement. The results of this assessment indicate that over 70% of students assessed who graduated with an associate degree from a Virginia community college have proficient oral communication skills. This project demonstrates that assessment can be a shared endeavor in which results can be understood and used to inform curricular planning by all major stakeholders

Learning of Wheelchair Racing Propulsion Skills Over Three Weeks of Wheeling Practice on an Instrumented Ergometer in Able-Bodied Novices

The acquisition of daily handrim wheelchair propulsion skill as a multi-layered phenomenon has been studied in the past. Wheelchair racing, however, is considerably different from daily handrim wheelchair propulsion in terms of propulsion technique, as well as the underlying equipment and interface. Understanding wheelchair racing skill acquisition is important from a general motor learning and skill acquisition perspective, but also from a performance and injury prevention perspective. The aim of the current lab-based study was 2-fold: to investigate the evolution of racing wheelchair propulsion skill among a sample of novices and to compare them with an experienced wheelchair racer under similar conditions. A convenience sample of 15 able-bodied novices (8 male, 7 female) completed a standardized three-week submaximal uninstructed practice protocol (3 weeks, 3 sessions per week, 3x4 min per session) in a racing wheelchair on an ergometer. Required wheeling velocity was set at 2.78 m/s (10 km/h) and a rolling friction coefficient of 0.011 (resulting in a mean target load of 21W) was used. For comparison, an experienced T54 Paralympic athlete completed one block of the same protocol. Kinetics, kinematics, and physiological data were captured. A mixed effects regression analysis was used to examine the effect of practice for the novices, while controlling for speed. All participants finished the protocol successfully. However, not all participants were able to achieve the target speed during the first few sessions. Statistically significant improvements over time were found for all outcome measures (i.e., lower metabolic strain, longer push and cycle times) with the exception of mean power and torque per push. The athlete used a significantly greater contact angle and showed “better” outcomes on most metabolic and kinetic variables. While the athlete used a semi-circular propulsion technique, most participants used a double looping over technique. Three weeks of uninstructed wheelchair racing practice significantly improved efficiency and skill among a group of novices, in line with previous studies on daily handrim wheelchair propulsion. The comparison with an experienced athlete expectedly showed that there is still a large performance (and knowledge) gap to be conquered

Continuous melting of compact polymers

The competition between chain entropy and bending rigidity in compact polymers can be addressed within a lattice model introduced by P.J. Flory in 1956. It exhibits a transition between an entropy dominated disordered phase and an energetically favored crystalline phase. The nature of this order-disorder transition has been debated ever since the introduction of the model. Here we present exact results for the Flory model in two dimensions relevant for polymers on surfaces, such as DNA adsorbed on a lipid bilayer. We predict a continuous melting transition, and compute exact values of critical exponents at the transition point.Comment: 5 pages, 1 figur