A Tale of Three Spectra: Basic Symptoms in Clinical-High-Risk of Psychosis Vary Across Autism Spectrum Disorder, Schizotypal Personality Disorder, and Borderline Personality Disorder.

Background And Hypothesis: The clinical-high-risk (CHR) approach was developed to prevent psychosis through the detection of psychosis risk. CHR services are transdiagnostic in nature, therefore the appropriate management of comorbidity is a central part of care. Differential diagnosis is particularly challenging across 3 common comorbidities, schizotypal personality disorder (SPD), autism spectrum disorder (ASD), and borderline personality disorder (BPD).

Measuring Clinical Preparedness After Residency Training: Development of a New Instrument.

Background And Objectives: Research on preparedness for independent clinical practice typically uses surveys of residents and program directors near graduation, which can be affected by several biases. We developed a novel approach to assess new graduates more objectively using physician and staff member assessors 3 months after graduates started their first job.

Methods: We conducted a literature review and key informant interviews with physicians from varying practice types and geographic regions in the United States to identify features that indicate a lack of preparedness for independent clinical practice.

Towards a Neurophenomenological Understanding of Self-Disorder in Schizophrenia Spectrum Disorders: A Systematic Review and Synthesis of Anatomical, Physiological, and Neurocognitive Findings.

The concept of anomalous self-experience, also termed Self-Disorder, has attracted both clinical and research interest, as empirical studies suggest such experiences specifically aggregate in and are a core feature of schizophrenia spectrum disorders. A comprehensive neurophenomenological understanding of Self-Disorder may improve diagnostic and therapeutic practice. This systematic review aims to evaluate anatomical, physiological, and neurocognitive correlates of Self-Disorder (SD), considered a core feature of Schizophrenia Spectrum Disorders (SSDs), towards developing a neurophenomenological understanding.

Optimizing Survey Response Rates in Graduate Medical Education Research Studies.

Background And Objective: Survey response rates of 70% or higher are needed if findings are to be considered generalizable. Unfortunately, survey studies of health professionals have declining response rates. We have conducted survey research with residents and residency directors for over 13 years.

Single-leg cycling to maintain and improve function in healthy and clinical populations.

Exercise with reduced muscle mass facilitates greater muscle-specific adaptations than training with larger muscle mass. The smaller active muscle mass can demand a greater portion of cardiac output which allows muscle(s) to perform greater work and subsequently elicit robust physiological adaptations that improve health and fitness. One reduced active muscle mass exercise that can promote greater positive physiological adaptations is single-leg cycling (SLC).

Resident Visit Productivity and Attitudes About Continuity According to 3 Versus 4 Years of Training in Family Medicine: A Length of Training Study.

Background And Objectives: Training models in the Length of Training Pilot (LOTP) vary. How innovations in training length affect patient visits and resident perceptions of continuity is unknown.

Methods: We analyzed resident in-person patient encounters (2013-2014 through 2018-2019) for each postgraduate year (PGY) and total visits at graduation derived from the Accreditation Council for Graduate Medical Education reports for each LOTP program.

The Association Between Length of Training and Family Medicine Residents' Clinical Knowledge: A Report From the Length of Training Pilot Study.

Background And Objective: The associations between training length and clinical knowledge are unknown. We compared family medicine in-training examination (ITE) scores among residents who trained in 3- versus 4-year programs and to national averages over time.

Methods: In this prospective case-control study, we compared the ITE scores of 318 consenting residents in 3-year programs to 243 who completed 4 years of training between 2013 through 2019.

Noncircular Chainrings Do Not Influence Physiological Responses During Submaximal Cycling.

Unlabelled: Pedal speed and mechanical power output account for 99% of metabolic cost during submaximal cycling. Noncircular chainrings can alter instantaneous crank angular velocity and thereby pedal speed. Reducing pedal speed during the portion of the cycle in which most power is produced could reduce metabolic cost and increase metabolic efficiency.

Great power comes at a high (locomotor) cost: the role of muscle fascicle length in the power versus economy performance trade-off.

Muscle design constraints preclude simultaneous specialization of the vertebrate locomotor system for explosive and economical force generation. The resulting performance trade-off between power and economy has been attributed primarily to individual differences in muscle fiber type composition. While certainly crucial for performance specialization, fiber type likely interacts with muscle architectural parameters, such as fascicle length, to produce this trade-off.

Maximal muscular power: lessons from sprint cycling.

Maximal muscular power production is of fundamental importance to human functional capacity and feats of performance. Here, we present a synthesis of literature pertaining to physiological systems that limit maximal muscular power during cyclic actions characteristic of locomotor behaviours, and how they adapt to training. Maximal, cyclic muscular power is known to be the main determinant of sprint cycling performance, and therefore we present this synthesis in the context of sprint cycling.

Financial Considerations Associated With a Fourth Year of Residency Training in Family Medicine: Findings From the Length of Training Pilot Study.

Background And Objectives: The feasibility of funding an additional year of residency training is unknown, as are perspectives of residents regarding related financial considerations. We examined these issues in the Family Medicine Length of Training Pilot.

Methods: Between 2013 and 2019, we collected data on matched 3-year and 4-year programs using annual surveys, focus groups, and in-person and telephone interviews.

Metabolic power and efficiency for an amputee cyclist: implications for cycling technique.

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.

Emphasizing one leg facilitates single-leg training using standard cycling equipment.

Purpose: Single-leg cycling exercise is one of the most potent, but underutilized, stimuli for promoting peripheral muscle respiratory capacity. Special ergometers used to facilitate single-leg cycling, while maintaining biomechanics similar to double-leg cycling, are not widely available. This lack of availability of specialized ergometers may explain why single-leg cycling has not been widely implemented as standard clinical practice.

Sexual dimorphism in human arm power and force: implications for sexual selection on fighting ability.

Sexual dimorphism often arises from selection on specific musculoskeletal traits that improve male fighting performance. In humans, one common form of fighting includes using the fists as weapons. Here, we tested the hypothesis that selection on male fighting performance has led to the evolution of sexual dimorphism in the musculoskeletal system that powers striking with a fist.

Heavy and Explosive Training Differentially Affect Modeled Cyclic Muscle Power.

Introduction/purpose: Muscular power is important in applications ranging from elite sport to activities of daily living. Results for improvements in power after resistance training have been mixed, possibly because of changes in muscle activation and deactivation rates. Our purpose was to determine the effects of heavy and explosive training programs on maximal power across a range of frequencies during cyclical contractions using a mathematical model.

Simulated work loops predict maximal human cycling power.

Fish, birds and lizards sometimes perform locomotor activities with maximized muscle power. Whether humans maximize muscle power is unknown because current experimental techniques cannot be applied non-invasively. This study leveraged simulated muscle work loops to examine whether voluntary maximal cycling is characterized by maximized muscle power.

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling.

Noncircular Chainrings Do Not Influence Maximum Cycling Power.

Noncircular chainrings could increase cycling power by prolonging the powerful leg extension/flexion phases, and curtailing the low-power transition phases. We compared maximal cycling power-pedaling rate relationships, and joint-specific kinematics and powers across 3 chainring eccentricities (CON = 1.0; LOW = 1.

The Importance of and the Complexities Associated With Measuring Continuity of Care During Resident Training: Possible Solutions Do Exist.

Background And Objectives: Evolutions in care delivery toward the patient-centered medical home have influenced important aspects of care continuity. Primary responsibility for a panel of continuity patients is a foundational requirement in family medicine residencies. In this paper we characterize challenges in measuring continuity of care in residency training in this new era of primary care.

Increase in Maximal Cycling Power With Acute Dietary Nitrate Supplementation.

Unlabelled: Muscle-shortening velocity and hence power have been shown to increase in the presence of nitric oxide (NO). NO availability increases after consuming nitrate (NO). Ingestion of NOrich beetroot juice (BRJ) has increased muscle power in untrained adults.

Effects of Pedal Speed and Crank Length on Pedaling Mechanics during Submaximal Cycling.

Unlabelled: During submaximal cycling, the neuromuscular system has the freedom to select different intermuscular coordination strategies. From both a basic science and an applied perspective, it is important to understand how the central nervous system adjusts pedaling mechanics in response to changes in pedaling conditions.

Purpose: To determine the effect of changes in pedal speed (a marker of muscle shortening velocity) and crank length (a marker of muscle length) on pedaling mechanics during submaximal cycling.

Biomechanics of Counterweighted One-Legged Cycling.

One-legged cycling has served as a valuable research tool and as a training and rehabilitation modality. Biomechanics of one-legged cycling are unnatural because the individual must actively lift the leg during flexion, which can be difficult to coordinate and cause premature fatigue. We compared ankle, knee, and hip biomechanics between two-legged, one-legged, and counterweighted (11.

Response to Letter to the Editor: a counterweight is not necessary to implement simple, natural and comfortable single-leg cycle training.

Dr. Dolmage and colleagues commented on a recent publication titled, "Cardiovascular responses to counterweighted single-leg cycling: implications for rehabilitation." They assert that a counterweight is not required to facilitate natural single-leg cycling, rather a fixed gear ergometer can also accomplish the same goal.

A cycling workstation to facilitate physical activity in office settings.

Facilitating physical activity during the workday may help desk-bound workers reduce risks associated with sedentary behavior. We 1) evaluated the efficacy of a cycling workstation to increase energy expenditure while performing a typing task and 2) fabricated a power measurement system to determine the accuracy and reliability of an exercise cycle. Ten individuals performed 10 min trials of sitting while typing (SIT type) and pedaling while typing (PED type).