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Biomedical subjects

A Nevill

Publications and source records attributed to A Nevill.

28 records · Page 2Linked to original sources

Typical error versus limits of agreement.

We have shown that the SEM (typical error) and LOA are very similar when defined at the same level of abstraction. The calculation of these sample statistics does not depend on sample size, but the precision of their estimate for the population parameter does. Only the latter concept involves the t-statistic. They do differ in the type of measurement error that is described (true score error versus test-retest error) and the coverage probability of the reference interval (0.6 versus 0.95). Bland and Altman and Atdinson and Nevill have promoted the citation of either the SEM or the LOA to help researchers in their discussion of the impact of error to real uses of the measurement tol. What is vital in this discussion is the researcher having a thorough understanding of the underlying theory behind the measurement error statistic(s) that is/are employed, especially the definition of error and the coverage probability that is selected. Such issues have been built into the title of the 95% LOA statistic, and are also an inherent part of SEM. Whilst the concept of typical error appears to be easy to understand and teach, this is only because the underlying theory and definition of what the statistic actually represents is not communicated. Only if all researchers adopt one single statistic (e.g. typical error) for measurement error is it remotely possible to push underlying theory into the background, since there would be a baseline of comparison for all. Because this scenario is highly unlikely, it is important that any measurement error statistic is well defined and understood by researchers.

Confidence Intervals↗

Maximal physiological responses to deep and shallow water running.

The maximal physiological responses to treadmill running (TMR), shallow water running (SWR) and deep water running (DWR) while wearing a buoyancy vest were compared in 15 trained male runners. Measurements included oxygen consumption (VO2 max), respiratory exchange ratio (RER) and heart rate (HR). Treadmill running elicited VO2 max and HRmax, which were higher than the peaks attained in both water tests (p < 0.01). VO2 peak averaged 83.7 and 75.3% of VO2 max for SWR and DWR respectively. Peak HR for SWR and DWR were 94.1 and 87.2% of the HRmax reached in the TMR. RER responses were similar between the three modalities. The observations suggest that the training stimulus provided by water is still adequate for supplementary training. While SWR is potentially an efficient method of maintaining cardiovascular fitness, it needs to be investigated further to establish if it is a viable technique for the injured athlete to employ.

Adult↗

Lack of evidence that feedback from lifestyle alters the amplitude of the circadian pacemaker in humans.

Two groups of healthy subjects were studied indoors, first while living normally for 8 days (control section) and then for 18 x 27 h "days" (experimental section). This schedule forces the endogenous (body clock-driven) and exogenous (lifestyle-driven) components of circadian rhythms to run independently. Rectal temperature and wrist movement were measured throughout and used as markers of the amplitude of the circadian rhythm, with the rectal temperature also "purified" by means of the activity record to give information about the endogenous oscillator. Results showed that, during the experimental days, there were changes in the amplitude of the overt temperature rhythm and in the relative amounts of out-of-bed and in-bed activity, both of which indicated an interaction between endogenous and exogenous components of the rhythm. However, the amplitude and the amount of overlap were not significantly different on the control days (when endogenous and exogenous components remained synchronized) and those experimental days when endogenous and exogenous components were only transiently synchronized; also, the amplitudes of purified temperature rhythms did not change significantly during the experimental days in spite of changes in the relationship between the endogenous and exogenous components. Neither result offers support for the view that the exogenous rhythm alters the amplitude of oscillation of the endogenous circadian oscillator in humans.

Activity Cycles↗

Modulation of whole body protein metabolism, during and after exercise, by variation of dietary protein.

The aim of this study was to investigate dietary protein-induced changes in whole body leucine turnover and oxidation and in skeletal muscle branched chain 2-oxo acid dehydrogenase (BCOADH) activity, at rest and during exercise. Postabsorptive subjects received a primed constant infusion of L-[1-13C,15N]leucine for 6 h, after previous consumption of a high- (HP; 1.8 g . kg-1 . day-1, n = 8) or a low-protein diet (LP; 0.7 g . kg-1 . day-1, n = 8) for 7 days. The subjects were studied at rest for 2 h, during 2-h exercise at 60% maximum oxygen consumption, then again for 2 h at rest. Exercise induced a doubling of both leucine oxidation from 20 micromol . kg-1 . h-1 and BCOADH percent activation from 7% in all subjects. Leucine oxidation was greater before (+46%) and during (+40%, P < 0.05) the first hour of exercise in subjects consuming the HP rather than the LP diet, but there was no additional change in muscle BCOADH activity. The results suggest that leucine oxidation was increased by previous ingestion of an HP diet, attributable to an increase in leucine availability rather than to a stimulation of the skeletal muscle BCOADH activity.

3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide)↗

An essential 'health check' for all medical devices.

In order to safeguard patient safety, all new or modified medical devices must be assessed for their safety and performance before they are used routinely in clinical practice. Most devices will carry a CE (Confirmity European) mark to demonstrate their safety, but many devices will require an alternative method of assessment. In this article, we discuss the procedures already in place, the significant gaps that exist in the system and the risk management issues. We consider the impact on research and clinical practice, and describe our comprehensive risk management system for objectively assessing the safety of any medical device.

Equipment Safety↗