A six-year monitoring case study of a top-10 cycling Grand Tour finisher.

This study analysed the evolution of the physical potential of a twice top-10 Grand Tour cycling finisher (Tour de France and Vuelta a España) whose training was monitored between the ages of 18 and 23 years. The world-class cyclist's power output (PO) data and training indices were analysed over six years to determine the evolution of his record power profile and training load (TL), which were estimated by using the session rating of perceived exertion (RPE) method. The total annual duration and TL increased through six seasons by 79% and 83%, respectively. The record POs in all exercise intensity zones improved over the six years. The increases in TL, monotony (+34%) and strain (+162%) from the junior category to the world-class level significantly correlated with an improvement in his aerobic potential, which was characterised by an increase in the record POs between 5 min and 4 h. This case study of the performance level and training parameters of a world-class cyclist provides comprehensive insight into the evolution of a cyclist to the top level. Furthermore, determining the record power profile of this athlete over six competitive seasons illuminates the maturation of the physical potential of a top-10 Grand Tour finisher.

Olaparib as maintenance therapy in non resectable pancreatic adenocarcinoma associated with homologous recombination deficiency profile: A French retrospective multicentric AGEO real-world study.

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis. The POLO trial showed that olaparib (PARP inhibitor) improved progression-free survival (PFS) but not overall survival (OS), when used as maintenance therapy after ≥ 16 weeks of disease control with first-line platinum-based chemotherapy in patients with germline (g) BRCA 1 or 2 pathogenic variants (PV) metastatic PDAC. However, real-world data on the effectiveness of olaparib are missing. METHODS: Patients with unresectable PDAC associated with somatic (s) or (g)BRCA1/2 and (g)non-BRCA-HRD PV (i.e. other homologous recombination deficiency/HRD genes) who were treated with olaparib between 2020-2023 were included. The primary objective was to describe treatment patterns. Secondary exploratory objectives included OS and PFS in patients treated with olaparib according to the POLO trial or not, OS and PFS in patients with (g)HRD PV-associated PDAC versus (s)PVs, olaparib safety profile and factors associated with olaparib poor outcomes. RESULTS: Among 85 patients, 45.9 % received olaparib as defined by the POLO trial. No difference in OS and PFS was observed between patients who received olaparib according to the POLO trial versus not. Patients with (g)HRD PV-associated PDAC had better OS compared to others (22.3 versus 10.5 months, p = 0.038). Factors associated with olaparib poor outcomes included a high neutrophil-to-lymphocyte ratio and the use of olaparib outside the recommendations of the POLO trial. Few grade ≥ 3 adverse events were reported (9.4 %). CONCLUSION: Patients with (g)HRD PV-associated PDAC had longer OS than those with (s)HRD PV. Olaparib use beyond the scope of the POLO trial was associated with poor outcomes.

Influence of standing position on mechanical and energy costs in uphill cycling.

This study was designed to examine the influence of standing position (vs. seated) during uphill cycling on both mechanical cost (MC) and energy cost (EC) in elite cyclists. For the study, thirteen elite cyclists (VO2max: 71.4 ±â€¯8.0 ml·min-1·kg-1) performed, in a randomised order, three sets of exercises. Each set comprised 2 min of exercise, alternating every 30 s between seated and standing postures, using different slopes and intensity levels on a motorised treadmill. MC was calculated from the measurement of power output and speed, whereas EC was calculated from the measurement of oxygen consumption and speed. MC was significantly higher (+4.3%, p < 0.001) in standing position compared to seated position when all slopes and intensities were considered. However, EC was not significantly affected by the change in position. The standing position also induced a significant increase in rolling resistance power (p < 0.001), rolling resistance coefficient (p < 0.001) and lateral sways (p < 0.001). The significant increase in MC observed in standing position was due to a higher rolling resistance induced by bicycle sways and a shift forward of the centre of mass compared to seated position. This result should lead bicycle tire manufacturers to reduce the increase in rolling resistance between the two positions. Considering the relationship observed between the MC and bicycle sways, cyclists would be well advised to decrease the bicycle sways in order to reduce the MC of locomotion.

Dependence of the Nature of the Pedaling Activity on Maximal Aerobic Power in Cycling.

PURPOSE: To analyze the effect of the pedaling activity in different 4-min time trials (TT4s) (laboratory and field conditions) and compare TT4 and maximal aerobic power (MAP) determined from the classical incremental exercise test in laboratory. It was hypothesized that the exercises performed on the field would determine higher physical (power output [PO]) and mental involvements due to different environmental conditions. METHODS: Sixteen male cyclists underwent an incremental test to exhaustion and 3 TT4s under different conditions: cycle ergometer (CE), level ground (LG), and uphill (UP). RESULTS: Correlation was observed for PO with a trivial effect size and narrow limits of agreement between MAP and CE TT4 (r = .96, P < .001). The comparison between the CE, LG, and UP tests indicates that PO was significantly higher in UP than in CE (+8.0%, P < .001) and LG (+11.0%, P < .001). CONCLUSIONS: The results suggest that PO depends on the nature of the pedaling activity. Moreover, PO under CE TT4 is a relevant predictor of MAP. It seems important to measure MAP by taking into account the cycling conditions, considering that coaches and scientists use this parameter to assess the aerobic potential of athletes and determine the exercise intensities useful for monitoring adaptation to training.

Validity, Sensitivity, Reproducibility, and Robustness of the PowerTap, Stages, and Garmin Vector Power Meters in Comparison With the SRM Device.

A large number of power meters have been produced on the market for nearly 20 y according to user requirements. PURPOSE: To determine the validity, sensitivity, reproducibility, and robustness of the PowerTap (PWT), Stages (STG), and Garmin Vector (VCT) power meters in comparison with the SRM device. METHODS: A national-level male competitive cyclist completed 3 laboratory cycling tests: a submaximal incremental test, a submaximal 30-min continuous test, and a sprint test. Two additional tests were performed, the first on vibration exposures in the laboratory and the second in the field. RESULTS: The VCT provided a significantly lower 5-s power output (PO) during the sprint test with a low gear ratio than the SRM did (-36.9%). The STG PO was significantly lower than the SRM PO in the heavy-exercise-intensity zone (zone 2, -5.1%) and the low part of the severe-intensity zone (zone 3, -4.9%). The VCT PO was significantly lower than the SRM PO only in zone 2 (-4.5%). The STG PO was significantly lower in standing position than in the seated position (-4.4%). The reproducibility of the PWT, STG, and VCT was similar to that of the SRM system. The STG and VCT PO were significantly decreased from a vibration frequency of 48 Hz and 52 Hz, respectively. CONCLUSIONS: The PWT, STG, and VCT systems appear to be reproducible, but the validity, sensitivity, and robustness of the STG and VCT systems should be treated with some caution according to the conditions of measurement.

Risk of Sprint Fidelis defibrillator lead failure is highly dependent on age.

BACKGROUND: In 2007, Medtronic Sprint Fidelis defibrillator leads were taken off the market due to a high rate of lead failure. Current data do not allow for risk stratification of patients with regard to lead failure. AIMS: We sought to determine predictors of Sprint Fidelis lead failure. METHODS: Between 2004 and 2007, 269 Sprint Fidelis leads were implanted in 258 patients in our centre. Variables associated with lead failure were assessed by the Kaplan-Meier method and a Cox survival model. RESULTS: During a median follow-up of 2.80 years (maximum 5.32), we observed 33 (12.3%) Sprint Fidelis lead failures (5-year survival, 65.6% ± 7.5%). In univariate analysis, age was the only predictor of lead failure (hazard ratio [HR] for 1-year increase 0.97; 95% confidence interval [CI] 0.95-0.99; p=0.009). Patients aged<62.5 years (median) had a significantly increased risk of lead failure compared with patients aged>62.5 years (HR 2.80; CI 1.30-6.02; p=0.009). Survival without Sprint Fidelis lead failure was 55.6% ± 10.4%) in patients aged<62.5 years (24/134 leads) vs 78.6% ± 8.8% in patients aged>62.5 years (9/135 leads). The annual incidence of lead failure in patients aged<62.5 years was 11.6% ± 4.9% during the fourth year after implantation and 22.9% ± 13.2% during the fifth year. CONCLUSION: Overall, we found a higher rate of Sprint Fidelis lead dysfunction than previously described. Lead failure was much more frequent in younger patients. Our results emphasize the need for close follow-up of younger patients with Sprint Fidelis leads and suggest that, in these patients, the implantation of a new implantable cardioverter defibrillator lead at the time of generator replacement might be reasonable.