Resistive Exercise for Arthritic Cartilage Health (REACH): A randomized double-blind, sham-exercise controlled trial

<p>Abstract</p> <p>Background</p> <p>This article provides the rationale and methodology, of the first randomised controlled trial to our knowledge designed to assess the efficacy of progressive resistance training on cartilage morphology in women with knee osteoarthritis.</p> <p>Development and progression of osteoarthritis is multifactorial, with obesity, quadriceps weakness, joint malalignment, and abnormal mechanical joint forces particularly relevant to this study. Progressive resistance training has been reported to improve pain and disability in osteoarthritic cohorts. However, the disease-modifying potential of progressive resistance training for the articular cartilage degeneration characteristic of osteoarthritis is unknown. Our aim was to investigate the effect of high intensity progressive resistance training on articular cartilage degeneration in women with knee osteoarthritis.</p> <p>Methods</p> <p>Our cohort consisted of women over 40 years of age with primary knee osteoarthritis, according to the American College of Rheumatology clinical criteria. Primary outcome was blinded measurement of cartilage morphology via magnetic resonance imaging scan of the tibiofemoral joint. Secondary outcomes included walking endurance, balance, muscle strength, endurance, power, and velocity, body composition, pain, disability, depressive symptoms, and quality of life.</p> <p>Participants were randomized into a supervised progressive resistance training or sham-exercise group. The progressive resistance training group trained muscles around the hip and knee at 80% of their peak strength and progressed 3% per session, 3 days per week for 6 months. The sham-exercise group completed all exercises except hip adduction, but without added resistance or progression. Outcomes were repeated at 3 and 6 months, except for the magnetic resonance imaging scan, which was only repeated at 6 months.</p> <p>Discussion</p> <p>Our results will provide an evaluation of the disease-modifying potential of progressive resistance training for osteoarthritis.</p> <p>Trial Registration</p> <p>ANZCTR Reference No. 12605000116628</p

OPTIMAL LOCATION OF INTERMODAL FREIGHT HUBS

A dedicated or semi-dedicated freight rail network would permit railroad operators to add new services and configurations. The incorporation of high-speed shuttle-type services, in conjunction with a hub-and-spoke network structure, for example, could reduce lead times on train routes and increase flexibility. This study presents an optimization model to address the problem of increasing the share of rail in intermodal transport through the use of hub-and-spoke type networks for freight rail. The model defined is a generalization of the hub location problem in that it allows for nonlinear and concave cost functions on different segments. A linearization procedure along with two efficient variable-reduction heuristics was developed for its resolution, making use of recent results on polyhedral properties of this class of problems. Computational experience and a qualitative analysis from a case study are provided. Findings suggest that further work on the polyhedral properties of the problem would be beneficial on medium- and large-sized problems

Port Selection and Multicriteria Analysis: An Application to the Montreal-New York Alternative

In this paper, our goal is to assess whether the accepted rationale of port selection by shipping lines – based on the combined importance of quality of infrastructures, cost, service and geographical location – is useful to account for the selection behaviour observed in the Northeast of North America, particularly the recent arrival of new global carriers in Montreal. We use a multicriteria approach in combination with scenarios where the relative importance given to selection criteria and the performance of ports are both varied across a wide range. This allows us to assess how port preference is affected by changes in criteria weight (expressing selection rationale) and by changes in evaluation (expressing relative port performance). With criteria weights set to reflect the common selection rationale, our findings suggests that shipping lines should call at New York and bypass Montreal. For Montreal to become the preferred choice, extensive hinterland coverage must be the top criterion for carriers and simultaneously the port must perform better in terms of cost and/or service. We conclude by discussing the implications for the hub-and-spoke paradigm of network evolution. Maritime Economics & Logistics (2006) 8, 169–186. doi:10.1057/palgrave.mel.9100152