1,357 research outputs found

    Effects of saddle angle on heavy intensity time trial cycling: Implications of the UCI rule 1.3.014

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    The UCI dictates that during sanctioned events, the saddle of the bicycle may be at angle of no more than 3° of forward rotation, so as to prevent performance advantages (Rule 1.3.014). This research investigates the effect on performance when rotating the saddle beyond the mandated angle during a laboratory 4km time trial (TT). Eleven competitive male cyclists (age 26±6 (mean±SD) yrs, height 179.2±6.7 cm, body mass 72.5±6.7 kg; V̇O2max 70.9±8.6 ml∙kg-1∙min-1) completed laboratory 4km TTs using saddle angles of 0°, 3° and 6°. Completion time and mean power were recorded, in addition to lower appendage kinematics, crank torque kinetics and cardiorespiratory responses. There were no significant changes in TT time, power output, cardiorespiratory variables or crank torque kinetics as a function of saddle angle (P>0.05). There were significant effects on minimum and maximum hip angle and the horizontal displacement of the greater trochanter (P<0.05). At 6° the maximum hip angle and forward displacement of the greater trochanter was greater compared to 0° and 3°. Minimum hip angle was greater at 6° than 3° (P<0.05). In conclusion, contravening UCI rule 1.3.014 by using a saddle angle beyond 3° does not result in performance advantages during a laboratory 4 km. However, tilting the saddle does appear to cause a forward displacement of the pelvis leading to an opening of the hip angle at the top and bottom of the pedal stroke

    The effects of forward rotation of posture on heavy intensity cycling: Implications of UCI rule 1.3.013

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    UCI rule 1.3.013 limits the forward displacement of the nose of the saddle to 5cm rearward of the centre of the bottom-bracket. This study tests the effects of contravening this rule on 4km laboratory time trials and highlights biomechanical and physiological responses that could be of interest to coaches and bike fitters. Ten competitive male cyclists age 26±2 (mean±SD) yrs, height 180±5 cm, body mass 71±6 kg; V̇ O2max 70.9±8.6 ml·kg-1·min-1) completed 4km time trials and heavy intensity bouts. Riding posture was rotated forward where the nose of the saddle was 0, 2, 4, and 6cm to the rear of the bottom bracket (P0, P2, P4 and P6). End time, power, cardiorespiratory responses, lower appendage kinematics and crank torque kinetics were measured. There was no significant effect of position on 4 km time trials completion time or power. During 4 km time trials and heavy intensity bouts, gas exchange variables and lower limb range of motion were unchanged (P>0.05). Trunk lean angle, cardiac output and stroke volume were greater at P6 than other positions (P0.05). Results indicate, contravening rule 1.3.013 does not bring about improvements to 4km laboratory TTs. The rearward shift in peak crank torque most likely occurs as a function of altered muscle activation. Haemodynamic variations are possibly related to changes in peripheral resistance at the most forward position. Further work is necessary to allude to probable improvements in aerodynamics

    Underuse of coronary revascularization procedures in patients considered appropriate candidates for revascularization.

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    Background: Ratings by an expert panel of the appropriateness of treatments may offer better guidance for clinical practice than the variable decisions of individual clinicians, yet there have been no prospective studies of clinical outcomes. We compared the clinical outcomes of patients treated medically after angiography with those of patients who underwent revascularization, within groups defined by ratings of the degree of appropriateness of revascularization in varying clinical circumstances.Methods: This was a prospective study of consecutive patients undergoing coronary angiography at three London hospitals. Before patients were recruited, a nine-member expert panel rated the appropriateness of percutaneous transluminal coronary angioplasty (PTCA) and coronary-artery bypass grafting (CABG) on a nine-point scale (with 1 denoting highly inappropriate and 9 denoting highly appropriate) for specific clinical indications. These ratings were then applied to a population of patients with coronary artery disease. However, the patients were treated without regard to the ratings. A total of 2552 patients were followed for a median of 30 months after angiography.Results: Of 908 patients with indications for which PTCA was rated appropriate (score, 7 to 9), 34 percent were treated medically; these patients were more likely to have angina at follow-up than those who underwent PTCA (odds ratio, 1.97; 95 percent confidence interval, 1.29 to 3.00). Of 1353 patients with indications for which CABG was considered appropriate, 26 percent were treated medically; they were more likely than those who underwent CABG to die or have a nonfatal myocardial infarction - the composite primary outcome (hazard ratio, 4.08; 95 percent confidence interval, 2.82 to 5.93) - and to have angina (odds ratio, 3.03; 95 percent confidence interval, 2.08 to 4.42). Furthermore, there was a graded relation between rating and outcome over the entire scale of appropriateness (P for linear trend = 0.002).Conclusions: On the basis of the ratings of the expert panel, we identified substantial underuse of coronary revascularization among patients who were considered appropriate candidates for these procedures. Underuse was associated with adverse clinical outcomes. (N Engl J Med 2001;344:645-54.) Copyright (C) 2001 Massachusetts Medical Society

    Difficulties With Goals of the Dutch ICF Activity Inventory: Perceptions of Those With Retinitis Pigmentosa and of Those Who Support Them

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    PURPOSE: To provide a comprehensive overview of the perceived difficulties with visual activities and participation by those with retinitis pigmentosa (RP), and as perceived by those who support people with RP. Further, to examine the performance of the Dutch ICF Activity Inventory (D-AI) using Rasch analysis. METHODS: Three hundred fifty people with RP and 75 supporters of people with RP provided demographic information and completed the D-AI at goal level (47 goals). RESULTS: Following removal of four goals, the D-AI behaved well in Rasch analysis, but with limitations to its unidimensionality. The most difficult goals for people with RP related to mobility and to work-related activities. Greater difficulty was associated with higher visual impairment registration status, use of mobility aids, and longer duration of visual impairment. For those with less severe visual loss, goals relating to communicating with people were relatively more difficult. In more severe loss, goals involving good central vision (e.g., dealing with correspondence) were relatively more difficult. The perceptions of supporters matched those of the people with RP relatively well, but with a tendency for supporters to overestimate the difficulty of goals, which related to administration and domestic chores, and to underestimate difficulty with goals relating to communication with people. CONCLUSIONS: The results indicate important areas of rehabilitation to address in addition to orientation and mobility in those with RP, including work-related activities and goals involving good central vision. Both people with RP and those supporting them could benefit from help addressing difficulties with communication

    A Comparison of Reach-to-Grasp and Transport-to-Place Performance in Participants With Age-Related Macular Degeneration and Glaucoma

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    PURPOSE: To compare visually guided manual prehension in participants with primarily central field loss (CFL) due to age-related macular degeneration and peripheral visual field loss (PFL) due to glaucoma. This study extends current literature by comparing directly "reach-to-grasp" performance, and presents a new task of "transport-to-place" the object accurately to a new location. Data were compared to age-matched controls. METHODS: Three-dimensional motion data were collected from 17 glaucoma participants with PFL, 17 participants with age-related macular degeneration CFL and 10 age-matched control participants. Participants reached toward and grasped a cylindrical object (reach-to-grasp), and then transported and placed (transport-to-place) it at a different (predefined) peripheral location. Various kinematic indices were measured. Correlation analyses explored relationships between visual function and kinematic data. RESULTS: In the reach-to-grasp phase, CFL patients exhibited significantly longer movement and reaction times when compared to PFL participants and controls. Central field loss participants also took longer to complete the movement and made more online movements in the latter part of the reach. During the transport-to-place phase, CFL participants showed increased deceleration times, longer movement trajectory, and increased vertical wrist displacement. Central field loss also showed higher errors in placing the object at a predefined location. A number of kinematic indices correlated significantly to central visual function indices (P < 0.05). CONCLUSIONS: Significant differences in performance exist between CFL and PFL participants. Various indices correlated significantly with loss in acuity and contrast sensitivity (CS), suggesting that performance is more dependent on central visual function irrespective of underlying pathology

    Specific Lung Mucosal and Systemic Immune-Responses After Oral Immunization of Mice with Salmonella-Typhimurium-Aroa, Salmonella-Typhi Ty21a, and Invasive Escherichia-Coli Expressing Recombinant Pertussis Toxin S1 Subunit

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    Pertussis toxin (PT) is considered an essential protective component for incorporation into new generation vaccines against Bordetella pertussis, the causative agent of whooping cough. Traditionally, antipertussis vaccination has employed an intramuscular route. An alternative to this approach is to stimulate mucosal and systemic immune responses by oral immunization with live vaccine carrier strains of Salmonella spp. or Escherichia coli. Recombinant S1 subunit of pertussis toxin was expressed in the attenuated aroA mutant of Salmonella typhimurium, SL3261, in the human typhoid vaccine strain Salmonella typhi Ty21a, and in E. coli CAG629 containing the Shigella flexneri plasmid pWR110, which encodes bacterial invasiveness of epithelial cells. Expression of recombinant PT S1 subunit (rPT-S1) did not affect in vitro invasiveness of the tested strains, which retained the ability to adhere to and invade the embryonic human intestinal cell line HI-407. Following oral immunization of mice with the live vaccine strains expressing rPT-S1, immunoglobulin G (IgG), IgA, and IgM responses were monitored. IgG specific to PT was detected in serum samples of mice, while IgG and IgA specific to PT were detected in lung washes after oral immunization with living Salmonella spp. or E. coli (pWR110) expressing rPT-S1. Utilization of live oral vaccines expressing B. pertussis antigens, which stimulate both a systemic and lung mucosal response, may provide an attractive alternative to purified component vaccines against whooping cough

    traT gene sequences, serum resistance and pathogenicity-related factors in clinical isolates of Escherichia coli and other gram-negative bacteria

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    The R6-5 plasmid-specified outer membrane protein, TraT protein, has previously been shown to mediate resistance to bacterial killing by serum. Colony hybridization with a 700 bp DNA fragment carrying most of the traT gene was used to examine the prevalence of traT in Gram-negative bacteria, particularly strains of Escherichia coli, isolated from clinical specimens. traT was found in isolates of E. coli, Salmonella, Shigella and Klebsiella, but not in Pseudomonas, Aeromonas or Plesiomonas, nor in the few isolates of Enterobacter, Proteus, Acinetobacter, Citrobacter, Serratia or Yersinia that were examined. It was detected in a significantly higher proportion of the E. coli strains isolated from the blood of patients with bacteraemia/septicaemia or from faeces of patients with enteric infections (50-70%) than in that of strains isolated from normal faeces (20-40%). The incidence of traT in strains isolated from cases of urinary tract infections was variable. traT was found to be frequently associated with production of the K1 capsule and with the carriage of ColV plasmids, but not with the carriage of R plasmids, nor with serum resistance or the production of haemolysin
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