XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

The American Society for Testing and Materials (ASTM) is an independent organization devoted to the development of standards.

American Society for Testing and Materials

Charge, Sophie B. P., and Michael A. Rudnicki. Cellular and Molecular Regulation of Muscle Regeneration. Physiol Rev 84: 209–238, 2004; 10.1152/physrev.00019.2003.—Under normal circumstances, mamma...

Cellular and Molecular Regulation of Muscle Regeneration

Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs? Issues: Selection, maturation, history, mortality, testing, regression towrd the mean, selection by maturation, treatment by mortality, treatment by testing, measured treatment variables Increase: Eliminate the threats, above all do experimental manipulations, random assignment, and counterbalancing.

Reliability and validity

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Biomechanics And Motor Control Of Human Movement

HOLMBERG, H.-C., S. LINDINGER, T. STOGGL, E. EITZLMAIR, and E. MULLER. Biomechanical Analysis of Double Poling in Elite Cross-Country Skiers. Med. Sci. Sports Exerc., Vol. 37, No. 5, pp. 807- 818, 2005. Purpose: To further the understanding of double poling (DP) through biomechanical analysis of upper and lower body movements during DP in cross-country (XC) skiing at racing speed. Methods: Eleven elite XC skiers performed DP at 85% of their maximal DP velocity (V85%) during roller skiing at 1° inclination on a treadmill. Pole and plantar ground reaction forces, joint angles (elbow, hip, knee, and ankle), cycle characteristics, and electromyography (EMG) of upper and lower body muscles were analyzed. Results: 1) Pole force pattern with initial impact force peak and the following active force peak (PPF) correlated to V85%, (r 0.66, P 0.05); 2) active flexion- extension pattern in elbow, hip, knee, and ankle joints with angle minima occurring around PPF, correlated to hip angle at pole plant (r 0.89, P 0.01), minimum elbow angle (r 0.71), and relative poling time (r 0.72, P 0.05); 3) two different DP strategies (A and B), where strategy A (best skiers) was characterized by higher angular elbow- and hip-flexion velocities, smaller minimum elbow (P 0.01) and hip angles (P 0.05), and higher PPF (P 0.05); 4) EMG activity in trunk and hip flexors, shoulder, and elbow extensors, and several lower body muscles followed a specific sequential pattern with changing activation levels; and 5) EMG activity in lower body muscles showed DP requires more than upper body work. Conclusions: DP was found to be a complex movement involving both the upper and lower body showing different strategies concerning several biomechanical aspects. Future research should further investigate the relationship between biomechanical and physiological variables and elaborate training models to improve DP performance. Key Words: EMG, FORCE, KINEMATICS, SKIING, TECHNIQUE

Biomechanical analysis of double poling in elite cross-country skiers

Accurate 3D human pose estimation from single images is possible with sophisticated deep-net architectures that have been trained on very large datasets. However, this still leaves open the problem of capturing motions for which no such database exists. Manual annotation is tedious, slow, and error-prone. In this paper, we propose to replace most of the annotations by the use of multiple views, at training time only. Specifically, we train the system to predict the same pose in all views. Such a consistency constraint is necessary but not sufficient to predict accurate poses. We therefore complement it with a supervised loss aiming to predict the correct pose in a small set of labeled images, and with a regularization term that penalizes drift from initial predictions. Furthermore, we propose a method to estimate camera pose jointly with human pose, which lets us utilize multiview footage where calibration is difficult, e.g., for pan-tilt or moving handheld cameras. We demonstrate the effectiveness of our approach on established benchmarks, as well as on a new Ski dataset with rotating cameras and expert ski motion, for which annotations are truly hard to obtain.

/pdf/learning-monocular-3d-human-pose-estimation-from-multi-view-hdynbjqjj6.pdf

Learning Monocular 3D Human Pose Estimation from Multi-view Images

Background: There is limited insight into the mechanisms of anterior cruciate ligament injuries in alpine skiing, particularly among professional ski racers.Purpose: This study was undertaken to qualitatively describe the mechanisms of anterior cruciate ligament injury in World Cup alpine skiing.Study Design: Case series; Level of evidence, 4.Methods: Twenty cases of anterior cruciate ligament injuries reported through the International Ski Federation Injury Surveillance System for 3 consecutive World Cup seasons (2006-2009) were obtained on video. Seven international experts in the field of skiing biomechanics and sports medicine related to alpine skiing performed visual analyses of each case to describe the injury mechanisms in detail (skiing situation, skier behavior, biomechanical characteristics).Results: Three main categories of injury mechanisms were identified: slip-catch, landing back-weighted, and dynamic snowplow. The slip-catch mechanism accounted for half of the cases (n = 10), and all these ...

Mechanisms of Anterior Cruciate Ligament Injury in World Cup Alpine Skiing A Systematic Video Analysis of 20 Cases

Clinica Chimica Acta

There have been considerable changes in equipment design and movement patterns in the past few years both in alpine skiing and ski-jumping These developments have been matched by methods of analysing movements in field conditions They have yielded new insights into the skills of these specific winter sports Analytical techniques have included electromyography, kinetic and kinematic methods and computer simulations Our aim here is to review biomechanical research in alpine skiing and ski-jumping We present in detail the techniques currently used in alpine skiing (carving technique) and ski-jumping (V-technique), primarily using data from the authors' own research Finally, we present a summary of the most important results in biomechanical research both in alpine skiing and ski-jumping This includes an analysis of specific conditions in alpine skiing (type of turn, terrain, snow, speed, etc) and the effects of equipment, materials and individual-specific abilities on performance, safety and joint loading in ski-jumping

http://sdcontent.skidome.org/JSS%20Biomechanics%20skiing%20and%20ski%20jumping.pdf

Erich Müller

Papers

Biomechanical analysis of double poling in elite cross-country skiers

Learning Monocular 3D Human Pose Estimation from Multi-view Images

Mechanisms of Anterior Cruciate Ligament Injury in World Cup Alpine Skiing A Systematic Video Analysis of 20 Cases

Clinica Chimica Acta

Biomechanical aspects of new techniques in alpine skiing and ski-jumping.