Metabolic Power and Efficiency for an Amputee Cyclist: Implications for Cycling Technique

2020 ◽  
Author(s):  
Steven J. Elmer ◽  
James C. Martin
Keyword(s):  
Scientific Evidence ◽  
Mechanical Power ◽  
Limb Amputation ◽  
Sufficient Time ◽  
Metabolic Power ◽  
Gross Efficiency ◽  
Leg Cycling ◽  
Leg Flexion ◽  
Delta Efficiency

Cycling technique is steeped in cultural lore. One deeply held belief is that "pulling-up" to lift the leg (increased muscular leg flexion) will optimize technique and improve efficiency. In contrast, scientific evidence suggests that when cyclists are instructed to pull-up efficiency decreases. However, such interventions may not have allowed sufficient time for cyclists to adapt and refine their technique. This case study documented how a cyclist with a complete unilateral limb amputation consumed metabolic power to produce mechanical power during single-leg cycling. The cyclist was a 4-time U.S. National Paralympic Champion who performed single-leg cycling for 7yrs and thus was fully adapted to pull-up. We hypothesized that a counterweight system, which reduced the requirement to pull-up, would decrease metabolic power and increase efficiency for this cyclist. The cyclist performed submaximal cycling (100, 135, 170, 205W, 80rpm, 5min) with and without a counterweight (10kg) on the unused crank. Expired gasses were measured, and metabolic power and gross efficiency were calculated. Metabolic power decreased on average by 87±7W (p<0.001) and gross efficiency increased from 16.3±1.9 to 18.0±1.8% (p<0.001) when cycling with the counterweight. During counterweighted single-leg cycling, the metabolic power of unloaded cycling decreased (317 vs. 238W) and delta efficiency was similar (25.2 vs. 25.5%). Results demonstrated that significant metabolic power was associated with pulling-up to produce muscular leg flexion power even in a cyclist who pulled-up substantially during cycling. Our findings confirm observations from previous studies that altered pedaling technique acutely and indicate that pulling-up during cycling is less efficient.

scholarly journals Linking Scientific Evidence and Decision Making A Case Study of Hand Hygiene Interventions

2013 ◽  
Vol 34 (4) ◽  
pp. 424-429 ◽  
Author(s):  
Nicholas Graves ◽  
Kate Halton ◽  
Katie Page ◽  
Adrian Barnett
Keyword(s):  
Decision Making ◽  
Hand Hygiene ◽  
Scientific Evidence

scholarly journals Consequences of load carrying by birds during short flights are found to be behavioral and not energetic

2002 ◽  
Vol 283 (1) ◽  
pp. R249-R256 ◽  
Author(s):  
Robert L. Nudds ◽  
David M. Bryant
Keyword(s):  
Body Mass ◽  
Power Input ◽  
Mechanical Power ◽  
Zebra Finches ◽  
Mass Loading ◽  
Metabolic Power ◽  
Additional Mass ◽  
Reduced Body ◽  
Mechanical Power Output ◽  
Load Carrying

The doubly-labeled water technique and video were used to measure the effect of mass loading on energy expenditure and takeoff performance in zebra finches, Taeniopygia guttata, that were making routine (nonalarm) short flights. Finches that carried 27% additional mass did not expend more energy during flight than unloaded controls. Carrying additional mass, however, led to a reduced body mass and a decreased velocity during takeoffs (by 12%). Calculations of instantaneous mechanical power indicated that energy expended by unloaded and loaded finches at takeoff was similar, due to the observed decrease in velocity by mass-loaded finches and a lowering of their body mass. During routine short flights, zebra finches appear to maintain their metabolic power input and mechanical power output regardless of mass loading. Here, the costs of carrying additional mass during routine short flights were revealed to be behavioral and not energetic.

Mechanical and propelling efficiency in swimming derived from exercise using a laboratory-based whole-body swimming ergometer

2012 ◽  
Vol 113 (4) ◽  
pp. 584-594 ◽  
Author(s):  
Paola Zamparo ◽  
Ian L. Swaine
Keyword(s):  
Power Output ◽  
Power Input ◽  
Mechanical Power ◽  
Whole Body ◽  
Metabolic Power ◽  
Exact Simulation ◽  
Mechanical Power Output ◽  
Propelling Efficiency ◽  
Overall Efficiency ◽  
Active Drag

Determining the efficiency of a swimming stroke is difficult because different “efficiencies” can be computed based on the partitioning of mechanical power output (Ẇ) into its useful and nonuseful components, as well as because of the difficulties in measuring the forces that a swimmer can exert in water. In this paper, overall efficiency (ηO = ẆTOT/Ė, where ẆTOT is total mechanical power output, and Ė is overall metabolic power input) was calculated in 10 swimmers by means of a laboratory-based whole-body swimming ergometer, whereas propelling efficiency (ηP = ẆD/ẆTOT, where ẆD is the power to overcome drag) was estimated based on these values and on values of drag efficiency (ηD = ẆD/Ė): ηP = ηD/ηO. The values of ηD reported in the literature range from 0.03 to 0.09 (based on data for passive and active drag, respectively). ηO was 0.28 ± 0.01, and ηP was estimated to range from ∼0.10 (ηD = 0.03) to 0.35 (ηD = 0.09). Even if there are obvious limitations to exact simulation of the whole swimming stroke within the laboratory, these calculations suggest that the data reported in the literature for ηO are probably underestimated, because not all components of ẆTOT can be measured accurately in this environment. Similarly, our estimations of ηP suggest that the data reported in the literature are probably overestimated.

scholarly journals The Use of Preliminary Scientific Evidence in Public Health: A Case Study of XMRV

PLoS Medicine ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. e1001623 ◽  
Author(s):  
Kumanan Wilson ◽  
Katherine Atkinson ◽  
Jennifer Keelan
Keyword(s):  
Public Health ◽  
Scientific Evidence

scholarly journals DECISION-MAKING METHODOLOGY BETWEEN REVITALISATION AND REHABILITATION OF WORLD HERITAGE CITY CENTERS. CASE STUDY: THE ANCIENT CITY OF ALEPPO (SYRIA)

2020 ◽  
Vol XLIV-M-1-2020 ◽  
pp. 255-262
Author(s):  
S. Ibrahim
Keyword(s):  
Decision Making ◽  
Scientific Evidence ◽  
Pilot Project ◽  
World Heritage ◽  
Conservation Action ◽  
Post Conflict ◽  
Ancient City ◽  
Directorate General ◽  
Syrian Conflict

Abstract. The ancient city of Aleppo is one of the oldest continuously inhabited cities in the world. It may have been inhabited in the sixth millennium BC and it is a World Heritage City since 1986. Aleppo was severely damaged during the Syrian conflict. Therefore, the paper explores the adequate frameworks that are needed to tackle the emerging challenges of conservation in complicated situation after conflicts. As any conservation action starts with a decision, conservation standers adopted since the early twentieth century acknowledge the need for decisions to be informed through the best available scientific evidence. This paper proposes an analysis of the methodology used for the evaluation of damages caused by war in Aleppo and suggests decision-making tools DMT validated through a pilot project to guide post-conflict revitalization efforts. Within this framework, this paper analyzed the DMT in the rehabilitation of a Souk in the historic commercial center as the pilot project implementation. The project was done by 'Aga Khan Foundation' in partnership with 'Directorate General of antiquities and museums' in Syria and different national stakeholders. The success of the pilot project within the expected timeframe, materials, cost, and the souk regaining its function and vitality was recognized as a validation of the credibility and validity of the methodology adopted. The resulted data (plans, 3d scanning, etc.) are tools for decision-makers in the field of rehabilitation. The methodology can be replicated by all actors in the fields of conservation, whether in Aleppo or any other historical site.

scholarly journals Communication of Uncertainty about Preliminary Evidence and the Spread of Its Inferred Misinformation during the COVID-19 Pandemic—A Weibo Case Study

2021 ◽  
Vol 18 (22) ◽  
pp. 11933
Author(s):  
Jiahui Lu ◽  
Meishan Zhang ◽  
Yan Zheng ◽  
Qiyu Li
Keyword(s):  
Scientific Evidence ◽  
Preliminary Evidence ◽  
Rapid Spread ◽  
Internal Sources

The rapid spread of preliminary scientific evidence is raising concerns on its role in producing misinformation during the COVID-19 pandemic. This research investigated how the communication of uncertainty about preliminary evidence affects the spread of its inferred misinformation in a Weibo case study. In total, 3439 Weibo posts and 10,380 reposts regarding the misinformation of pets transmitting COVID-19 were analyzed. The results showed that attitude ambiguity toward the preliminary evidence and the stage when the evidence was first released with uncertainty were associated with higher numbers of likes and retweets of misinformation posts. Our study highlights the internal sources of misinformation and revisits the contextual perspective in misinformation studies.

scholarly journals ECONOMIC ASPECTS OF THE CITY TRAFFIC NOISE: CASE STUDY // EKONOMSKI ASPEKTI BUKE OD GRADSKOG SAOBRAĆAJA: STUDIJA SLUČAJA

2018 ◽  
Vol 15 (1) ◽  
Author(s):  
Jelena Božić ◽  
Predrag Ilić ◽  
Ljiljana Stojanović Bjelić
Keyword(s):  
Noise Level ◽  
Road Traffic ◽  
Scientific Evidence ◽  
Traffic Noise ◽  
Noise Pollution ◽  
Common Denominator ◽  
Economic Implications ◽  
The Impact ◽  
The City

Noise pollution is one of the main environmental problems today.The main source of environmental noise is traffic noise, especially the noise of road vehicles. The continuing expansion of motorized transport in Europe and Republic of Srpska today, and especially the sharp increase in the use of private cars raises concerns about the health risks.The aim of the case study was to determine the noise level at the location „Borik“ in Banja Luka. The measured values indicate that the noise level in this street is alarming. This paper discusses health and well-being related impacts of traffic noise pollution as well as the economic and social benefits associated with its reduction. It summarizes the latest scientific evidence on the impact of road traffic-induced noise on physical and mental health as a reaction to the high level of traffic noise risks. According to the scientific evidence, road traffic is the main source of noise pollution in Europe that cause harmful health such as impaired communication and disturbed sleep, as well as adverse after effects such as fatigue and decreased performance, annoyance, hearing impairment, ischemic heart disease and hypertension. The effects of unhealthy noise level are reflected on living and working conditions, consequently affecting the economy.This paper highlights economic implications and health benefits linked to cross-functionalities in the process of noise reduction in urbanism, architecture and vehicle design and methods for its evaluation. Cost-benefit analysis would be a pivotal decision-making tool for the city road traffic and land-use decisions. Economic valuation is about identifying all preferences and translating them into a money measure, to create a common denominator for comparing the pros and cons. Any decision implicitly include a money value into health effects. A holistic approach is crucial, considering the various health and economic consequences together.

scholarly journals The response of clinical medical librarians to the COVID-19 pandemic: a case study

2020 ◽  
Vol 16 (3) ◽  
pp. 12-17
Author(s):  
Amanda Damasceno de Souza ◽  
Anna Carolina Leite Cota ◽  
Mariana Ribeiro Fernandes
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Private Hospital ◽  
Scientific Evidence ◽  
Health Technology ◽  
Sources Of Information ◽  
Public And Private ◽  
Belo Horizonte ◽  
Medical Teams

The COVID-19 pandemic has changed the world with a large part of the population in lockdown for months. Given the need medical teams have for information, clinical medical librarians have played an important role in searching for the best scientific evidence. The objective of this paper is to describe the role of librarians in Brazil during the pandemic in public and private hospital libraries and in the Health Technology Assessment Service. This is a case study report of the work of clinical medical librarians during the COVID-19 pandemic. The paper is drawing on experience from three clinical medical librarians acting in the private hospital, philanthropic hospital and Health Technology Assessment Service in the city of Belo Horizonte, Minas Gerais, Brazil. The report describes the activities of clinical librarians in providing clinicians with information on how to care for patients with COVID-19. In Brazil clinical medical librarians play an important role in supporting medical teams by identifying reliable sources of information and assisting with research.

scholarly journals Transplante de Células-Tronco Hematopoéticas: estudo de caso de um paciente com mucosite severa

2018 ◽  
Vol 86 (24) ◽  
Author(s):  
Ana Cristina da Silva Rangel ◽  
Adriana Gomes da Silva de Freitas ◽  
Alice Andrade Antunes ◽  
Cecilia Ferreira da Silva Borges ◽  
Cláudia Valéria Ramos Ribeiro ◽  
...  
Keyword(s):  
Medical Records ◽  
Scientific Evidence ◽  
Signs And Symptoms ◽  
Nursing Process ◽  
Clinical Practices ◽  
Hematopoietic Stem ◽  
Nursing Diagnosis ◽  
Nursing Diagnoses ◽  
Severe Mucositis

Estima-se que 50% a 80% dos pacientes submetidos ao transplante de células-tronco hematopoéticas (TCTH)desenvolveram mucosite oral com significativa gravidade e acentuada morbidade. As complicações e a complexidadedesta afecção exigem da equipe de enfermagem um contínuo treinamento pautado na atualização de práticas clínicasoriundas de evidências científicas. O objetivo é apresentar um estudo de caso, descrevendo os diagnósticos deenfermagem de um paciente submetido ao transplante de células-tronco hematopoiéticas autólogo que evoluiu parauma mucosite severa. Trata-se de um estudo de caso de um paciente com Linfoma de Hodgkin submetido ao TCTH. Osdados foram coletados no período de outubro a dezembro de 2015, a partir do prontuário do paciente. Foram 51 dias dehospitalização, os principais diagnósticos de enfermagem relacionados à mucosite foram: (1) náusea; (2) risco parainfecção; (3) nutrição desequilibrada; (4) deglutição prejudicada; (5) diarreia; (6) mucosa oral prejudicada; (7) dor aguda;(8) hipertermia e (9) risco de sangramento. A mucosite é uma complicação comumente encontrada nos pacientessubmetidos ao transplante. Logo, é importante que o enfermeiro desenvolva um olhar clínico apurado, a fim de detectarna sutileza dos sinais e sintomas o risco para o agravamento desta afecção.Palavras-chave: Mucosite; Transplante de Células-Tronco Hematopoéticas; Diagnóstico de Enfermagem; Processos deEnfermagem. AbstractIt is estimated that 50% to 80% of patients undergoing hematopoietic stem cells (HSCT) transplantation developed oralmucositis with significant severity and marked morbidity. The complications and complexity of this condition require thenursing team to continue training based on the updating of clinical practices stemming from scientific evidence. The aimis to present a case study, describing the nursing diagnoses of a patient submitted to autologous hematopoietic stem celltransplantation that evolved to a severe mucositis. This is a case study of a patient with Hodgkin's lymphoma undergoingHSCT. Data were collected from October to December 2015, from the patient's medical records. There werehospitalization 51 days, the main nursing diagnoses related to mucositis were: (1) nausea; (2) risk for infection; (3)unbalanced nutrition; (4) impaired swallowing; (5) diarrhea; (6) impaired oral mucosa; (7) acute pain; (8) hyperthermiaand (9) risk of bleeding. Mucositis is a complication commonly found in patients undergoing transplantation. Therefore,it is important that the nurse develops an accurate clinical view to detect in the subtlety of the signs and symptoms therisk for the affection worsening.Keywords: Mucositis; Hematopoietic Stem Cell Transplantation; Nursing Diagnosis; Nursing Process.

Process of Change and Effectiveness of Family Constellations: A Mixed Methods Single Case Study on Depression

2019 ◽  
Vol 27 (4) ◽  
pp. 418-428
Author(s):  
Sandra Ramos ◽  
Jorge A. Ramos
Keyword(s):  
Mixed Methods ◽  
Single Case ◽  
Scientific Evidence ◽  
Severe Depression ◽  
The Body ◽  
Single Case Study ◽  
Process Data ◽  
Process Of Change ◽  
Symptoms Of Depression

Aims: To analyze the process of change and the effectiveness of five sessions of family constellations (FC) using mixed methods in mixed settings (videoconference and in person). To obtain variables associated with processes and results. Methods: Using an exploratory design with mixed methods, this single case study used a triangulation of data: quantitative ( Escala de Ansiedade, Depressão e Stresse-21) and qualitative (the notes from the consultations and the patient’s responses to the Psychotherapeutic Process Data Mining Questionnaire [PPDMQ]). Results: The patient’s symptoms of depression went from a level of severe to normal, and the posttest results persisted after a 3-month follow-up. The severe depression seems to have been mitigated through interventions that promoted contact with reality, self-determination, the psychoemotional establishment of systemic places, and through finding meaning in autobiographical events. Conclusions: This article may encourage further studies that use the PPDMQ to create a metasynthesis and to gauge whether the effectiveness of FC, as a systemic, intergenerational, and integrative psychotherapy, could plausibly contribute to enrich the body of scientific evidence–based psychotherapies and mitigate the global escalation of depression.

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