Accumulated Oxygen Deficit During Arm Cranking in Hypoxia: A Bayesian Perspective and Methodological Considerations

International Journal of Exercise Science 14(3): 1090-1098, 2021. The purpose of this investigation was to observe the effects of normobaric hypoxia on accumulated oxygen deficit (AOD) with evaluation using both Bayesian and Frequentist analyses. Eighteen recreationally active men performed a graded exercise test (GXT) in normobaric normoxia (N; FiO2~20%) and normobaric hypoxia (H; FiO2~14%) to determine peak power output (PPO). Time to exhaustion trials were later conducted at 110% and 120% PPO under both N, and H. AOD and %AN (% anaerobic energy contribution) were calculated in three conditions: N, H, and H using the N regression equation (HN). Bayesian repeated measures ANOVA revealed differences in AOD and %AN between regression equations while Frequentist Repeated measures ANOVA revealed non-significant differences for AOD (p = .148) and %AN (p = .150). Using predicted oxygen consumption extrapolated from a normoxic environment during exercise in hypoxia may lead to overestimation of AOD and %AN with a Bayesian approach and contrasting results using frequentist statistics

Effecting change in primary care management of respiratory conditions : a global scoping exercise and literature review of educational interventions to inform the IPCRG's E-Quality initiative

This discussion paper describes a scoping exercise and literature review commissioned by the International Primary Care Respiratory Group (IPCRG) to inform their E-Quality programme which seeks to support small-scale educational projects to improve respiratory management in primary care. Our narrative review synthesises information from three sources: publications concerning the global context and health systems development; a literature search of Medline, CINAHL and Cochrane databases; and a series of eight interviews conducted with members of the IPCRG faculty. Educational interventions sit within complex healthcare, economic, and policy contexts. It is essential that any development project considers the local circumstances in terms of economic resources, political circumstances, organisation and administrative capacities, as well as the specific quality issue to be addressed. There is limited evidence (in terms of changed clinician behaviour and/or improved health outcomes) regarding the merits of different educational and quality improvement approaches. Features of educational interventions that were most likely to show some evidence of effectiveness included being carefully designed, multifaceted, engaged health professionals in their learning, provided ongoing support, were sensitive to local circumstances, and delivered in combination with other quality improvement strategies. To be effective, educational interventions must consider the complex healthcare systems within which they operate. The criteria for the IPCRG E-Quality awards thus require applicants not only to describe their proposed educational initiative but also to consider the practical and local barriers to successful implementation, and to propose a robust evaluation in terms of changed clinician behaviour or improved health outcomes.The IPCRG commissioned this work as part of the IPCRG e-Quality initiative. HP is supported by a Primary Care Research Career Award from the Chief Scientist's Office of the Scottish Government

Attitudinal Correlates of HPV Vaccination in College Women

This study examined associations between general attitudes toward seeking medical care, attitudes about vaccines/fear of shots, and human papillomavirus (HPV) vaccine uptake and intentions in college women. Hypothesized associations were framed by the Theory of Planned Behavior (TPB). Participants (N = 330, mean age = 18.9 years, 75% White) completed a one-time survey. The majority (61%; n = 201) had received ≥1 HPV vaccine dose. Hierarchical logistic regression examined relationships between attitudes and vaccine uptake. Pearson correlation coefficients and Kruskal-Wallis tests examined associations between attitudes and vaccine intentions. Results were partially consistent with the TPB. In the final model, perceived benefits, but not fear of shots, were associated with vaccine uptake. Among the unvaccinated, perceived benefits, but not fear of shots, were associated with vaccine intentions. Provider recommendation was the strongest predictor of vaccine uptake. Findings suggest interventions incorporating discussion of perceived benefits and provider recommendation may improve HPV vaccine receipt among college women

In vivo characterization of connective tissue remodeling using infrared photoacoustic spectra

Premature cervical remodeling is a critical precursor of spontaneous preterm birth, and the remodeling process is characterized by an increase in tissue hydration. Nevertheless, current clinical measurements of cervical remodeling are subjective and detect only late events, such as cervical effacement and dilation. Here, we present a photoacoustic endoscope that can quantify tissue hydration by measuring near-infrared cervical spectra. We quantify the water contents of tissue-mimicking hydrogel phantoms as an analog of cervical connective tissue. Applying this method to pregnant women in vivo, we observed an increase in the water content of the cervix throughout pregnancy. The application of this technique in maternal healthcare may advance our understanding of cervical remodeling and provide a sensitive method for predicting preterm birth

Spatial Awareness is Related to Moderate Intensity Running during a Collegiate Rugby Match

International Journal of Exercise Science 9(5): 599-606, 2016. The purpose of the present study was to evaluate the relationship between spatial awareness, agility, and distance covered in global positioning system (GPS) derived velocity zone classifications during a collegiate rugby match. Twelve American collegiate rugby union players (mean±SD; age: 21.2±1.4 y; weight: 85.0±16.0 kg; 7 forwards & 5 backs) on a single team volunteered to participate in this investigation. The distances travelled at low (walking/jogging; \u3c2.7m/s), moderate (cruising/striding; 2.7-5.0 m/s), and high intensities (running/sprinting; \u3e5.0 m/s) were measured for each player using GPS sensors and normalized according to playing time during an official USA Rugby match. Spatial awareness was measured as visual tracking speed from one core session of a 3-dimensional multiple-object-tracking speed (3DMOTS) test (1.35±0.59 cm·sec-1). Agility was assessed utilizing the pro agility (5.05±0.28 sec) and t drill (10.62±0.39 sec). Analysis of variance revealed that athletes travelled the greatest distance during walking/jogging (39.5±4.5 m·min-1) and least distance during running/sprinting (4.9±3.5 m·min-1). Pearson product moment correlations revealed that only distance covered while cruising/striding (20.9±6.5 m·min-1) was correlated to spatial awareness (r=0.798, p=0.002). Agility did not correlate to distance covered at any velocity zone or spatial awareness. Spatial awareness, as determined by 3DMOTS, appears to be related to the moderate intensity movement patterns of rugby union athletes

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation