Gluteal lymphoedema associated with lower extremity lymphoedema: A preliminary study with indocyanine green lymphography and magnetic resonance imaging.

INTRODUCTION: Indocyanine green (ICG) lymphography studies have identified that one in three to five patients with cancer-related lower extremity lymphoedema (LEL) demonstrated dermal backflow extending to the gluteal region. This study aimed to further characterize gluteal lymphoedema using contemporaneous magnetic resonance imaging (MRI). PATIENTS AND METHODS: Twenty-eight patients with unilateral advanced LEL who underwent both ICG lymphography and MRI prior to any surgical procedure were included in this study. The patients were divided into two groups with/without gluteal lymphoedema by the presence of dermal backflow on ICG lymphography. MRI was used to evaluate tissue changes. RESULTS: Ten patients demonstrated gluteal lymphoedema on ICG lymphography and had a higher incidence of skin hypertrophy in the gluteal region. However, no difference in excess leg volume was found between the two groups. A trend of increasing gluteal subcutaneous tissue in the affected side was identified in patients with gluteal lymphoedema with a median increase of 20% compared with an 11% increase in the non-gluteal lymphoedema group. The excess gluteal subcutaneous tissue was positively correlated to ipsilateral excess leg volume. CONCLUSION: The gluteal lymphoedema group on ICG lymphography had skin thickening in the gluteal region and was likely identified in the secondary cancer-related group. Surgical and conservative management options for gluteal lymphoedema need to be considered in advanced LEL.

The ALERT model of care for the assessment and personalized management of patients with lymphoedema.

BACKGROUND: This study documents the development and evaluation of a comprehensive multidisciplinary model for the assessment and personalized care of patients with lymphoedema. METHODS: The Australian Lymphoedema Education Research and Treatment (ALERT) programme originated as an advanced clinic for patients considering surgery for lymphoedema. The programme commenced liposuction surgery in May 2012 and then introduced lymph node transfer in 2013 and lymphovenous anastomosis (LVA) in 2016. An outpatient conservative treatment clinic was established in 2016. ALERT commenced investigations with indocyanine green (ICG) lymphography in late 2015, leading to the creation of a diagnostic assessment clinic offering ICG in 2017. RESULTS: Since 2012, 1200 new patients have been referred to ALERT for assessment of lymphoedema for a total of 5043 episodes of care. The introduction of ICG lymphography in 2015 initially allowed better screening for LVA, but is now used not only to guide surgical options, but also as a diagnostic tool and to guide manual lymphatic drainage massage. The total number of new patients who attended the surgical assessment clinic to December 2018 was 477, with 162 patients (34·0 per cent) undergoing surgery. CONCLUSION: The ALERT programme has developed a multidisciplinary model of care for personalized lymphoedema treatment options based on clinical, imaging and ICG lymphography. Patients are selected for surgery based on several individual factors.

ANTECEDENTES: Este estudio presenta el desarrollo y valoración de un modelo multidisciplinario integral para la evaluación y atención personalizada de pacientes con linfedema. MÉTODOS: El programa australiano de educación en investigación y tratamiento del linfedema (Australian Lymphoedema Education Research and Treatment, ALERT) se originó como un centro clínico avanzado para pacientes que consideran la cirugía como tratamiento para el linfedema. El programa se inició en mayo del 2012 con la cirugía de liposucción, introduciendo la cirugía de transferencia ganglionar (lymph node transfer, LNT) en 2013 y la anastomosis linfovenosa (lymphovenous anastomosis, LVA) en 2016. En 2016 se estableció una clínica de tratamiento conservador ambulatorio. ALERT comenzó las investigaciones con la linfografía con verde de indocianina (indocyanine green, ICG) a fines del 2015, lo que se siguió de la creación de una clínica de evaluación diagnóstica que ofrece ICG en 2017. RESULTADOS: Desde el 2012, 1.200 pacientes nuevos han sido referidos a ALERT para la evaluación de un linfedema, con un total de 5.043 episodios atendidos. La introducción inicialmente de linfografía con ICG en 2015 permitió un mejor cribaje para LVA, pero actualmente se utiliza no solo como guía de las opciones quirúrgicas, sino también como herramienta diagnóstica y como guía del masaje de drenaje linfático manual (manual lymphatic drainage, MLD). El número total de pacientes nuevos atendidos en la clínica de evaluación quirúrgica hasta diciembre de 2018 fue de 477, con 122 pacientes (34%) tratados quirúrgicamente. El modelo tal como se ha descrito, ha atraído a pacientes de toda Australia y Nueva Zelanda. CONCLUSIÓN: El programa ALERT ha desarrollado un modelo multidisciplinario de atención para las opciones de tratamiento personalizado del linfedema basado en la evaluación clínica, por imagen (MRI y LSG) y linfografía con ICG. Los pacientes se seleccionan cuidadosamente para el tratamiento quirúrgico en función de varios factores relacionados con el paciente, el tumor, los linfáticos y las opciones terapéuticas, y se someten a una evaluación detallada después de cualquier procedimiento.

Therapeutic glucocorticoids prevent bone loss but drive muscle wasting when administered in chronic polyarthritis.

BACKGROUND: Patients with rheumatoid arthritis (RA) experience extra-articular manifestations including osteoporosis and muscle wasting, which closely associate with severity of disease. Whilst therapeutic glucocorticoids (GCs) reduce inflammation in RA, their actions on muscle and bone metabolism in the context of chronic inflammation remain unclear. We utilised the TNF-tg model of chronic polyarthritis to ascertain the impact of therapeutic GCs on bone and muscle homeostasis in the context of systemic inflammation. METHODS: TNF-tg and wild-type (WT) animals received either vehicle or the GC corticosterone (100 µg/ml) in drinking water at onset of arthritis. Arthritis severity and clinical parameters were measured, serum collected for ELISA and muscle and bone biopsies collected for µCT, histology and mRNA analysis. In vivo findings were examined in primary cultures of osteoblasts, osteoclasts and myotubes. RESULTS: TNF-tg mice receiving GCs showed protection from inflammatory bone loss, characterised by a reduction in serum markers of bone resorption, osteoclast numbers and osteoclast activity. In contrast, muscle wasting was markedly increased in WT and TNF-tg animals receiving GCs, independently of inflammation. This was characterised by a reduction in muscle weight and fibre size, and an induction in anti-anabolic and catabolic signalling. CONCLUSIONS: This study demonstrates that when given in early onset chronic polyarthritis, oral GCs partially protect against inflammatory bone loss, but induce marked muscle wasting. These results suggest that in patients with inflammatory arthritis receiving GCs, the development of interventions to manage deleterious side effects in muscle should be prioritised.

Controlled before-after intervention study of suburb-wide street changes to increase walking and cycling: Te Ara Mua-Future Streets study design.

BACKGROUND: Achieving a shift from car use to walking, cycling and public transport in cities is a crucial part of healthier, more environmentally sustainable human habitats. Creating supportive active travel environments is an important precursor to this shift. The longevity of urban infrastructure necessitates retrofitting existing suburban neighbourhoods. Previous studies of the effects of street changes have generally relied on natural experiments, have included few outcomes, and have seldom attempted to understand the equity impacts of such interventions. METHODS: In this paper we describe the design of Te Ara Mua - Future Streets, a mixed-methods, controlled before-after intervention study to assess the effect of retrofitting street changes at the suburb scale on multiple health, social and environmental outcomes. The study has a particular focus on identifying factors that improve walking and cycling to local destinations in low-income neighbourhoods and on reducing social and health inequities experienced by Maori (Indigenous New Zealanders) and Pacific people. Qualitative system dynamics modelling was used to develop a causal theory for the relationships between active travel, and walking and cycling infrastructure. On this basis we selected outcomes of interest. Together with the transport funder, we triangulated best evidence from the literature, transport policy makers, urban design professionals and community knowledge to develop interventions that were contextually and culturally appropriate. Using a combination of direct observation and random sample face to face surveys, we are measuring outcomes in these domains of wellbeing: road-user behaviour, changes to travel mode for short trips, physical activity, air quality, road traffic injuries, greenhouse gas emissions, and perceptions of neighbourhood social connection, safety, and walking and cycling infrastructure . DISCUSSION: While building on previous natural experiments, Te Ara Mua - Future Streets is unique in testing an intervention designed by the research team, community and transport investors together; including a wide range of objective outcome measures; and having an equity focus. When undertaking integrated intervention studies of this kind, a careful balance is needed between epidemiological imperatives, the constraints of transport funding and implementation and community priorities, while retaining the ability to contribute new evidence for healthy, equitable transport policy. The study was retrospectively registered as a clinical trial on 21 June 2018 in the ISCRTN registry: ISRCTN89845334 http://www.isrctn.com/ISRCTN89845334.

Lower gastrointestinal bleeding: an unusual manifestation of inguinal hernia.

Inguinal hernia is a common condition that usually presents with swelling and mild groin discomfort. Complications include bowel obstruction and strangulation. We report a case of a 50 year-old man who developed lower gastrointestinal bleeding secondary to an indirect inguinal hernia. Colonoscopy showed an ileocecal valve polyp, florid inflammation of cecum and ascending colon and ulcerations of the terminal ileum. Histology showed nonspecific colitis and angiodysplasia of the polyp. Surgical correction of the hernia led to the resolution of the endoscopic changes. The trauma associated with intermittent herniation of small bowel probably led to ischemia, resulting in the observed changes.

Postural and subjective responses to realistic schoolbag carriage.

The objective of this study was to determine school student's postural and self-reported responses to realistic daily schoolbag carriage and to provide support for an upper schoolbag weight limit. Sixteen boys carried unloaded, 5%, 10%, 12.5% and 15% of body weight (BW) schoolbag loads, each for a simulated school day. The 10% BW condition was repeated with tightened shoulder straps. Participants' posture was quantified and a questionnaire asked them about a number of areas relating to the physical strain caused by each schoolbag. Posture, rating of perceived exertion (RPE) and muscular strain and ability to walk and balance were significantly affected when student's schoolbag load reached 10% BW. It is suggested that 15% BW may be excessive, which supports a schoolbag weight limit of 10% BW for a typical school day. Posture, RPE and muscular strain and ability to walk and balance were not significantly affected by the duration of carriage or by shoulder strap tightness.

Measurement of the temporal patterns of school bag carriage using activity monitoring and structured interview.

The primary objective of the current study was to quantify the temporal patterns of school bag carriage over an actual school day using activity monitoring and structured interviews, in order to better understand the physical demands of school bag carriage. The temporal patterns of 40 students' school bag carriage over a 24-h period were defined by total school bag carrying time, mean event school bag carrying time, the number of school bag carrying events, total carrying time travelling to and from school and the number of students who walked or used transport to travel to and from school. There were significant correlations between activity monitor [mean(SD) 119(48) min] and structured interview [100(39) min] determined total school bag carrying time (r = 0.59), activity monitor [8(4) min] and structured interview [9(4) min] determined mean event school bag carriage time (r = 0.65), and activity monitor [15(4) events] and structured interview [11(2) events] determined number of school bag carrying events (r = 0.52). However, the number of school bag carrying events, and for students who used transport, the total amount of time spent travelling to school was significantly different using the two measures. The durations of school bag carriage and the relationship between activity monitor and structured interview were similar to those reported in previous studies.

How close to a pendulum is human upper limb movement during walking?

The aim of this work was to investigate how close to pendulum-like behaviour the periodic motion of the human upper limb (or upper extremity) is, during normal walking at a comfortable speed of locomotion. Twenty-five healthy young persons (males and females) participated in the experiment. Biomechanical testing was undertaken (mass and centre of mass of each segment of the total upper extremity). Participants were walking on a treadmill with a standardised velocity of 1.1 ms(-1) (comfortable speed for all of them). A video analysis system with Silicon software was used to measure the different angles of the arm and forearm. The theoretical period of motion and maximal angular velocity were computed for the centre of mass of the total upper limb from the measured phases of the arm swing and associated positional potential energies. Actual measured periods of motion, in comparison, represented a level of similarity to a lightly damped simple pendulum. Using this assumption, the "damping factor" was calculated from the ratio between theoretical and measured values. A vast majority of people exhibited an actual angular velocity exceeding the expected theoretical angular velocity calculated for a virtual pendulum of similar mass and length characteristics. This may be due to muscle forces that are contributing to the motion of the upper limb during walking rather than simple gravity force acting alone. The observed positional potential energy of the dominant limb was greater than that of the non-dominant limb for the vast majority of participants.

Comparison of four different backpacks intended for school use.

Four backpacks were evaluated for their desireability for use as school bags. Three of the four backpacks were specifically designed for school use based on previous research and ergonomic principles while the fourth (standard) backpack was chosen from two backpacks that their manufacturer considered to be the most likely to be used as a school bag. Twelve school students evaluated each of the backpacks firstly by examining them, again after donning them and again after walking with them on a treadmill by completing a questionnaire asking about the appearance, function and comfort of each backpack. On initial examination, the standard backpack was the most favoured but as functionality became increasingly important during the treadmill walk, the backpack which was designed specifically for school use and had two major compartments, substantial back padding and side compression straps became the most favoured. This particular design of backpack was reported as having the greatest practicality, being the least physically demanding and allowing the greatest balance and ease of walking. The results of this study suggest that school student's preference of backpack may change from when they first examine a prospective backpack to when they have used it. The study also shows that school students' preferred attributes in a backpack may shift over this time from 'style and image' to 'function and fit'.

Evaluation of a prototype multi-posture office chair.

Office chairs have often been designed to promote a single 'correct' rather rigid and upright posture, yet it is acknowledged that allowing changes in posture is good ergonomics practice. The present study investigated office worker's preferences for a standard shaped typist's chair (ST) and a prototype multi-posture (PMP) office chair designed to allow its users a variety of sitting positions. Forty-two (22 male and 20 female) telesales personnel (12), clerical staff (12) and researchers (18) used ST or PMP in their workplace for the first week of a 2-week study (with an even number in each work area). The PMP chair was introduced to participants with a brief lecture on how to use it and with an information booklet. Following this, each participant completed a chair comfort questionnaire. In the second week, participants swapped chairs and again completed the chair comfort questionnaire. At the end of the second week participants were also asked to complete a separate questionnaire about the usability of the information booklet that accompanied the PMP chair. Statistically significant differences in subject's rating of the two chairs were observed in 7 out of 19 questions. On a 100 mm scale, the ST chair was rated as having a greater mean overall acceptability, desirability and suitability for body build than the PMP chair. Participants also claimed to achieve better posture in the ST chair, that they tipped forward less and were more satisfied with its width. Although the participants generally preferred the ST chair, the PMP chair received more favourable ratings among the researchers who were quite mobile in their work, and in whom there was a trend for less neck, shoulder and upper back discomfort. More participants reported an overall preference for the PMP chair. The findings suggest that a more aesthetically acceptable PMP chair should be developed, peoples' reasons for preferring a more traditionally designed chair should be explored, and that the effect of postural stability education on personal preconceptions should be examined to obtain an optimal combination of healthy sitting habits, comfort and aesthetic qualities in an office chair.

Lateral difference in reaction times to lateralized auditory stimuli.

Evidence suggests that Reaction time (RT) is affected by human behaviour in that stimuli are processed and conducted faster and more accurately when they are presented directly to the specialised hemisphere and responded to more quickly when stimulus and response are mediated by the same hemisphere. The purpose of the current study was to investigate the effect of laterality using one parameter-reaction time (RT) on ipsilateral reactions to monuaural latralized stimuli. Twenty-four undergraduate polytechnic students and 10 representative level Rugby players participated in the study by reacting unilaterally to single and choice RT using simple and complicated sensor motor reactions (SMR). Results Shorter reaction times by the dominant hand while testing simple and complicated audio SMR, without reference to sex and sport skills results have been explained in terms of specialisation of left hemisphere in different aspects of information processes mechanisms, geared towards programming of the movement.

Change in knowledge and reported use of sport science by elite New Zealand olympic class sailors.

The objective of this study was to examine the change in knowledge and use of sport science in 46 elite New Zealand Olympic class dinghy sailors' one year after the adoption of a sport science support (SSS) programme by Yachting New Zealand. Twenty eight (22 males, six females) sailors responded to a questionnaire which was administered during a training camp in April 1994 and 28 (also 22 males and six females) responded to the same questionnaire at a training camp in April 1995. Ten of the sailors responded in both 1994 and 1995. The questionnaire asked whether or not the sailors used a training race diary and inquired about their knowledge and use of sport science in the areas of nutrition, psychology and physical conditioning. In 1995, additional questions enquired about sailors' perception of sport science and its affect on their racing performance. In the intervening year, six of the sailors received sport science support (SSS) in nutrition; eleven received SSS in sport psychology; eleven received SSS in physical conditioning. In 1995, the sailors reported a greater amount of fluid taken and drunk on a four-hour sail and a greater proportion of sailors ate a high carbohydrate meal after a race. They also reported feeling less anxiety before a race. Increases were also observed in the sailors' volume and intensity of physical training and in their chosen type of aerobic training. Most sailors believed that their knowledge and use of sport science had increased and that this had led to improvements in racing performance. It is concluded that elite New Zealand sailors' reported use of sport science improved in the areas of physical conditioning and nutrition between 1994 and 1995. Improvement in the use of sports psychology was less clear and the eleven sailors who received psychology SSS reported feeling more anxious before a race. There was little evidence to suggest that the sport science programme was responsible for the improvements. This study indicates that sailors are beginning to understand the importance of sport science support, but there is still much room for improvement in their use of sport science.

The oxidative DNA lesion 8,5'-(S)-cyclo-2'-deoxyadenosine is repaired by the nucleotide excision repair pathway and blocks gene expression in mammalian cells.

Xeroderma pigmentosum (XP) patients with inherited defects in nucleotide excision repair (NER) are unable to excise from their DNA bulky photoproducts induced by UV radiation and therefore develop accelerated actinic damage, including cancer, on sun-exposed tissue. Some XP patients also develop a characteristic neurodegeneration believed to result from their inability to repair neuronal DNA damaged by endogenous metabolites since the harmful UV radiation in sunlight does not reach neurons. Free radicals, which are abundant in neurons, induce DNA lesions that, if unrepaired, might cause the XP neurodegeneration. Searching for such a lesion, we developed a synthesis for 8,5'-(S)-cyclo-2'-deoxyadenosine (cyclo-dA), a free radical-induced bulky lesion, and incorporated it into DNA to test its repair in mammalian cell extracts and living cells. Using extracts of normal and mutant Chinese hamster ovary (CHO) cells to test for NER and adult rat brain extracts to test for base excision repair, we found that cyclo-dA is repaired by NER and not by base excision repair. We measured host cell reactivation, which reflects a cell's capacity for NER, by transfecting CHO and XP cells with DNA constructs containing a single cyclo-dA or a cyclobutane thymine dimer at a specific site on the transcribed strand of a luciferase reporter gene. We found that, like the cyclobutane thymine dimer, cyclo-dA is a strong block to gene expression in CHO and human cells. Cyclo-dA was repaired extremely poorly in NER-deficient CHO cells and in cells from patients in XP complementation group A with neurodegeneration. Based on these findings, we propose that cyclo-dA is a candidate for an endogenous DNA lesion that might contribute to neurodegeneration in XP.

Development of knowledge and reported use of sport science by elite New Zealand Olympic class sailors.

The objective of this study was to determine the change in elite dinghy sailor's knowledge and use of sport science, three years after the adoption of a sport science support (SSS) programme by Yachting New Zealand for its elite dinghy sailors. A questionnaire was administered to 28 (22 male, six female) elite sailors in April 1994 and to 33 (24 male and nine female) in March 1997 during a training camp for elite sailors. 15 of the sailors participated in 1994 and 1997. The questionnaire asked whether or not the sailors used a training race diary and inquired about their knowledge and use of sport science in the areas of nutrition, psychology and physical conditioning. In 1997, additional questions enquired about sailor's perception of sport science and its affect on their racing performance. Between April 1994 and March 1997, sailors received sport science support in nutrition, psychology and physical conditioning. Sailors reported a greater amount of fluid drunk on a four-hour sail in 1997 than in 1994 and a greater proportion of sailors ate a high carbohydrate meal after a race in 1997 than in 1994. In 1997, sailors reported feeling less anxiety before a race, and the sailors common to 1994 and 1997 reported feeling less sick before a race in 1997 than in 1994. Increases were observed in volume and intensity of physical training, and improvements were noticed in the chosen type of aerobic training in 1997. Most sailors believed that their knowledge and use of sport science has increased and that their increased use of sport science has led to improvements in racing performance. The results suggest that elite New Zealand sailors' use of sport science improved in the areas of nutrition, sports psychology and physical conditioning between 1994 and 1997. However, when the results were compared with those of Legg and Mackie (1999), it was evident that greater physical conditioning improvements had occurred between 1994 and 1995 than had been sustained since, while the majority of sailor's sport psychology improvements occurred between 1995 and 1997. Sailors reported fluid intake between 1994 and 1997 had steadily improved. The reason for sailor's change in emphasis on different areas of sport science over time may be a result of their adopting ideas with which they were most familiar (physical conditioning and nutrition) first, and then adopting the less widely understood discipline of sport psychology once they felt that they had mastered their use of physical conditioning and nutrition. This study indicates that sailors are beginning to understand the importance of personal preparation using sport science principles.

Preliminary assessment of force demands in laser racing.

The aim of this study was to measure forces acting on a laser sailor in order to obtain an indication of the physical demands in the major muscle groups used during dinghy racing. Force data were collected in the mainsheet and the hiking strap of a club level (body weight 94 kg) and an elite sailor (body weight 80 kg) in a range of wind conditions. The highest average and peak hiking strap forces were 647 N (59% of MVC) and 843 N (77% of MVC) respectively, recorded for the club level sailor. The highest average and peak mainsheet forces of 111 N (35% of MVC) and 289 N (90% of MVC) respectively were also recorded for the club sailor. The elite and the club sailors' results were similar in most cases. Differences were attributed to differing body weights and technique. The results provide a preliminary indication of the intensity of muscular forces required in a physical training programme for laser racing.

Temporal patterns of physical activity in Olympic dinghy racing.

BACKGROUND: The objective of the present study was to determine the temporal patterns of physical activity in four classes of Olympic racing dinghy. EXPERIMENTAL DESIGN: Descriptive. SETTING: A field (on-water) study. PARTICIPANTS: Nineteen elite New Zealand sailors (fifteen male and four female). INTERVENTION: Not applicable. MEASURES: The temporal pattern (duration and frequency) and nature of the physical activities of each sailor during each leg of simulated races were recorded on video tape and subsequently systematically quantified and categorised using notational analysis. The accumulated percentage of total leg time spent sitting (upright or leaning backwards), hiking (upright or fully extended) whilst trimming and whilst pumping the mainsheet and for the time spent on rig adjustments, tacking and gybing were calculated for both up-wind and off-wind sailing. RESULTS: When sailing up-wind, the most time was spent hiking upright (average 29-66% of total leg time) while trimming the mainsheet. During off-wind sailing, sailors spent the most time sitting upright while trimming the mainsheet (average 29-55% total leg time). Hiking upright while trimming the mainsheet was executed the greatest number of times (average 15.8-23.9) when sailing up-wind and sitting upright while trimming was executed the most times (average 3.5-7.4) when sailing off-wind. The most lengthy continuous activity was hiking upright while trimming the mainsheet when sailing up-wind (9-18 seconds) and sitting upright while trimming the mainsheet when sailing off-wind (17-34 seconds). CONCLUSIONS: The most physically demanding aspect of Olympic yacht racing is hiking. It occurs for the majority of up-wind legs when the wind starts to exceed approximately 8 knots. The only respite that the sailor gets from hiking is during tacking, rig adjustments or sitting in-board for brief periods when the wind is low. Sustained hiking tends to last for no more than approximately 20 seconds before the sailor changes to either a more extended or more upright hiking posture. The physical demands during off-wind sailing are generally less, except for a greater requirement for power in the arms and shoulders to pump the mainsheet in order to assist the dinghy in accelerating down waves. The findings of the present study are directly applicable to the design of sailing specific physical conditioning programmes for Olympic class sailors.

The physical demands of Olympic yacht racing.

The primary purpose of this study was to quantify the up wards forces of the feet on the hiking strap and the forces in the mainsheet of four Olympic classes of racing dinghies (Europe, Laser. Finn and 470) during realistic on-water sailing in varying wind conditions. The secondary aim of the study was to measure the joint angles adopted by the sailors and boat heel angles. The tertiary aim was to identify events and sailing conditions associated with large or patterned force production. Forces in the hiking strap and mainsheet of four classes of Olympic sailing dinghies were measured on eleven New Zealand sailors during simulated on-water racing in a range of wind conditions. Up-wind hiking strap forces reached an average of 73-87% of predicted maximal voluntary contraction (pred MVC), with peak forces exceeding 100% pred MVC. Mainsheet forces reached 25-35% pred MVC, with peak forces reaching 40-50% pred MVC. Off-wind hiking strap and mainsheet forces were considerably lower than up-wind forces. Ankle and hip joint angles increased and knee joint angles decreased with increasing wind speed during up-wind sailing. Large forces occurred in the hiking strap and mainsheet when boats reached the tops of wave during up-wind sailing in high wind speeds and when a gust of wind hit the boat. During off-wind sailing large forces were observed in the mainsheet when surfing down waves. It is recommended that the intensities and joint angles found in this study be used as a basis for the development of class specific off-water physical conditioning programmes.

Changes in physical characteristics and performance of elite sailors following introduction of a sport science programme prior to the 1996 olympic games.

The objective of this study was to examine changes in sailors' physical characteristics during three different time periods immediately before the 1996 New Zealand Olympic trials, as a result of a newly introduced sport science programme. Twenty five (19 male and 6 female) Olympic development squad members volunteered as subjects and completed fitness tests at different times between April 1995 and March 1996 after being administered with individualised physical training programmes. Statistically significant improvements were observed in body weight, sum of skinfolds, flexibility (assessed using a sit-reach test), aerobic endurance (assessed using a maximal effort 2500 m rowing test) and strength (assessed as the maximum number of push-ups, pull-ups, and sit-ups that could be completed in 2 minutes) over the three time periods. Thus, physical training was effective in improving many aspects of sailors' fitness, especially early in the sailing season as a result of pre-season training. Physical performance correlated poorly with both light and heavy wind racing performance. The results suggest that individually tailored training programmes will increase sailing specific fitness. However, it is impossible to know what proportions of racing performance can be attributed to physical fitness, skill, talent, and technology, therefore the effect of physical training on racing performance is difficult to determine.

Combination of DMT-mononucleotide and Fmoc-trinucleotide phosphoramidites in oligonucleotide synthesis affords an automatable codon-level mutagenesis method.

BACKGROUND: Synthetic DNA has been used to introduce variability into protein-coding regions. In protocols that produce a few mutations per gene, the sampling of amino-acid sequence space is limited by the bias imposed by the genetic code. It has long been apparent that the incorporation of trinucleotides in the synthetic regime would circumvent this problem and significantly enhance the usefulness of the technique. RESULTS: A new method is described for the creation of codon-level degenerate oligodeoxyribonucleotides that combines conventional dimethoxytrityl (DMT) mononucleoside phosphoramidite chemistry with 9-fluorenylmethoxycarbonyl (Fmoc) trinucleotide phosphoramidites (whose synthesis is reported in the paper). The substoichiometric use of these Fmoc-trinucleotides in an automatable, solid-phase synthesis procedure afforded DNA fragments comprising the wild-type sequence and a controllable distribution of mutants within two- and three-codon stretches of DNA, within the multiple cloning site of the conventional cloning vector pUC19. CONCLUSIONS: DMT and Fmoc are compatible protecting groups in conventional oligonucleotide synthesis methods, resulting in controllable levels of codon-based mutagenesis.