Bioharness? Multivariable Monitoring Device: Part. II: Reliability

The Bioharness^™ monitoring system may provide physiological information on human performance but the reliability of this data is fundamental for confidence in the equipment being used. The objective of this study was to assess the reliability of each of the 5 Bioharness^™ variables using a treadmill based protocol. 10 healthy males participated. A between and within subject design to assess the reliability of Heart rate (HR), Breathing Frequency (BF), Accelerometry (ACC) and Infra-red skin temperature (ST) was completed via a repeated, discontinuous, incremental treadmill protocol. Posture (P) was assessed by a tilt table, moved through 160°. Between subject data reported low Coefficient of Variation (CV) and strong correlations(r) for ACC and P (CV< 7.6; r = 0.99, p < 0.01). In contrast, HR and BF (CV~19.4; r~0.70, p < 0.01) and ST (CV 3.7; r = 0.61, p < 0.01), present more variable data. Intra and inter device data presented strong relationships (r > 0.89, p < 0.01) and low CV (<10.1) for HR, ACC, P and ST. BF produced weaker relationships (r < 0.72) and higher CV (<17.4). In comparison to the other variables BF variable consistently presents less reliability. Global results suggest that the Bioharness^™ is a reliable multivariable monitoring device during laboratory testing within the limits presented.

Key points

• Heart rate and breathing frequency data increased in variance at higher velocities (i.e. ≥ 10 km.h^-1)
• In comparison to the between subject testing, the intra and inter reliability presented good reliability in data suggesting placement or position of device relative to performer could be important for data collection
• Understanding a devices variability in measurement is important before it can be used within an exercise testing or monitoring setting

Key words: Physiological technology, reproducibility of measurement, exercise     

The effects of inhibitory control training on alcohol consumption,implicit alcohol-related cognitions and brain electrical activity

This study aimed to replicate findings that alcohol consumption and positive implicit beer-related cognitions can be reduced using inhibitory control (IC) training, with the addition of an active training control. Frontal EEG asymmetry, an objective psychophysiological index of approach motivation, was used as a dependent measure to examine training outcomes. Participants were randomly assigned to one of two IC training conditions (Beer NoGo or Beer Go) or a Brief Alcohol Intervention (BAI) (i.e. the active training control). The IC training tasks consistently paired a stimulus that required a response with images of water (Beer NoGo) or images of beer (Beer Go). Alcohol consumption and implicit beer-related cognitions were measured at pre-training, post-training and at one week follow-up. Frontal EEG asymmetry was recorded during a passive image viewing task that presented neutral, healthy, and beer stimuli — at pre-training, post-training and follow-up. Participants in the Beer NoGo and BAI conditions consumed less beer in a taste test immediately after training than Beer Go participants, suggesting that IC training may be as effective as the already established BAI. The taste test findings were in line with the frontal EEG asymmetry data, which indicated that approach motivation for beer stimuli was altered in the expected directions. However, the positive correlation between post-training frontal EEG asymmetry data and taste test consumption was not significant. While there were no significant changes in implicit beer-related cognitions following training, a trending positive relationship between implicit beer-related cognitions at post-training and taste test consumption was reported. Further exploration addressing the limitations of the current study is required in order to clarify the implications of these findings.     

Bordetella holmesii,an Emerging Cause of Septic Arthritis

Bordetella holmesii is a well-described pathogen in asplenic and immunocompromised patients. Here we report the first two published cases of septic arthritis caused by B. holmesii documented in apparently immunocompetent patients and unaccompanied by bacteremia.     

Is poor access to dental care why people outside capital cities have poor oral health?

Background : Why oral health status outside capital cities is poorer than that in capital cities has not been satisfactorily explained. The aim of this study was to determine if the reason was poorer access to dental care. Methods : Data were obtained from the Australian National Survey of Adult Oral Health (2004–06). Oral health status was measured by DMFT Index, and numbers of decayed, missing and filled teeth. A two‐step analysis was undertaken: comparing the dependent variables by location, socio‐demographic confounders and preventive dental behaviours, and then including six access to dental care variables. Results : Of the 14 123 people interviewed, 5505 were examined, and 4170 completed the questionnaire. With socio‐economic parameters in the first regression model, non‐capital city people had higher DMFT (regression coefficient = 1.15, p < 0.01), more decayed (0.42, p < 0.01) and missing teeth (0.85, p < 0.01), but not filled teeth (?0.11, p = 0.71), than capital city based people. In the second step analysis, non‐capital city people still had a greater DMFT (1.01, p < 0.01), more decayed (0.27, p = 0.03) and missing teeth (0.74, p < 0.01), but not filled teeth (0.00, p = 0.99) than capital city based people. Conclusions : Access to dental care was not the only reason why people outside capital cities have poorer oral health than people living in capital cities.     

E6AP ubiquitin ligase regulates PML-induced senescence in Myc-driven lymphomagenesis

Neoplastic transformation requires the elimination of key tumor suppressors, which may result from E3 ligase-mediated proteasomal degradation. We previously demonstrated a key role for the E3 ubiquitin ligase E6AP in the regulation of promyelocytic leukemia protein (PML) stability and formation of PML nuclear bodies. Here, we report the involvement of the E6AP-PML axis in B-cell lymphoma development. A partial loss of E6AP attenuated Myc-induced B-cell lymphomagenesis. This tumor suppressive action was achieved by the induction of cellular senescence. B-cell lymphomas deficient for E6AP expressed elevated levels of PML and PML-nuclear bodies with a concomitant increase in markers of cellular senescence, including p21, H3K9me3, and p16. Consistently, PML deficiency accelerated the rate of Myc-induced B-cell lymphomagenesis. Importantly, E6AP expression was elevated in ～ 60% of human Burkitt lymphomas, and down-regulation of E6AP in B-lymphoma cells restored PML expression with a concurrent induction of cellular senescence in these cells. Our findings demonstrate that E6AP-mediated down-regulation of PML-induced senescence is essential for B-cell lymphoma progression. This provides a molecular explanation for the down-regulation of PML observed in non-Hodgkin lymphomas, thereby suggesting a novel therapeutic approach for restoration of tumor suppression in B-cell lymphoma.     

Disinvestment and reinvestment in respiratory care: use of programme budgeting and marginal analysis in north Wales,UK

BackgroundRespiratory care is a large cost driver for Betsi Cadwaladr University Health Board, the largest health board in Wales. Since health boards face increasing pressure to deliver services that are value for money, a programme budgeting marginal analysis (PBMA) of respiratory care was commissioned.MethodsA research group with health economics, clinical, National Health Service (NHS) finance, and pharmacy prescribing expertise was established to gather evidence on the current respiratory care pathway in north Wales and to recommend where expenditure within the service should be focussed using PBMA. A PBMA panel was established consisting of managers and directors of medicines' management, therapies, finance, planning, and health-care professionals. The review identified a budget of £86·9 million spent on respiratory care in 2012–13 for a population of 700 000. With an agreed list of criteria developed by the research team and the panel, electronic voting was used to establish criteria for decision making and vote on candidates to disinvest and reinvest in. The panel was also asked to make a set of recommendations about the allocation of funding within the respiratory service. Evidence was provided in a booklet of the potential for cost savings (from NHS finance staff) and health benefits (from a rapid review of the evidence) of the proposed recommendations to equip the panel with the notion of opportunity cost when making their investment and disinvestment decisions.Findings13 candidates were discussed; they were individual proposals for resource reallocation, ranging from specific interventions to cross agency partnership. After extensive discussion facilitated by a chairperson, four candidates received recommendations to disinvest, seven to invest, and two to maintain current activity. The panel were also able to rank the candidates in order of highest priority for the health board to lowest priority.InterpretationThis exercise demonstrates the potential for health boards to use evidence-based approaches to reach potentially controversial disinvestment and reinvestment decisions. This exercise, though in its early stages, could offer further support for changes in respiratory care implementation in north Wales, if recommendations were to be implemented. PBMA also has wider implications across health agencies in the UK for resource allocation decisions, such as diabetes care.FundingNone.