Metabolic cost for isometric force scales nonlinearly and predicts how humans distribute forces across limbs.

Muscles consume metabolic energy for force production and movement. A mathematical model of metabolic energy cost will be useful in predicting instantaneous costs during human exercise and in computing effort-minimizing movements via simulations. Previous in vivo data-derived models usually assumed either zero or linearly increasing cost with force, but a nonlinear relation could have significant metabolic or behavioural implications. Here, we show that metabolic cost scales nonlinearly with joint torque with an exponent of about 1.64, using calorimetric measurements of isometric squats. We then demonstrate that this metabolic nonlinearity is reflected in human behaviour: minimizing this nonlinear cost predicts how humans share forces between limbs in additional experiments involving arms and legs. This shows the utility of the nonlinear energy cost in predictive models and its generalizability across limbs. Finally, we show mathematical evidence that the same nonlinear metabolic objective may underlie force sharing at the muscle level.

Renal Ganglioneuroma Presenting as an Apparent Renal Artery Aneurysm.

We present a case of a 30-year-old woman with a suspected contained rupture of a renal artery aneurysm which was managed with staged embolization and nephrectomy. Pathology demonstrated that the collection around the presumed aneurysmal rupture was an associated ganglioneuroma.