Tag: statistics

PLoS One. 2021 Jul 29;16(7):e0255010. doi: 10.1371/journal.pone.0255010. eCollection 2021.

ABSTRACT

BACKGROUND: An ethnobotanical expedition was conducted to document the traditional ethnobotanical (TEB) uses of wild flora of Dawarian and Ratti Gali villages of District Neelam, Azad Jammu and Kashmir (AJK) Pakistan. District Neelam has rich plant diversity and is hub of many endemic plant species while the study areas are not yet explored. The research area: Dawarian and Rati Gali (DRG) area is mountaineous terrain and villages are located on far and farther distances. DRG area has rich biocultural and plant diversity comprising of different ethnic groups of Kashmir state. The current research was aimed to explore and document traditional medicines (TEMs) and other domestic and commercial uses of wild plants. This study will assist to evaluate conservation and commercial worth of wild flora which can be potential candidate for drug discovery through ethnopharmacological analysis.

METHODS: The current quantitative ethnobotanical research was carried out in 2018 by interviewing 150 indigenous informants (90 male and 60 female) of DRG area using questionnaire applying structured and semi structured interview methodology. Data analysis was analyzed by using quantitative ethnobotanical statistical tools such as fidelity level (FL), informant consensus factor (ICF), Spearman’s rank correlation (SRC) and data matrix ranking (DMR).

RESULTS: The indigenous people of DRG area use wild plants in their daily life to cope life necessities i.e. food, vegetables, fodder, fuel, shelter, timber and herbal medicines. TEMs are primarily used to cure different infirmities like diabetics, asthma, dysentery, constipation, cold, fever, joint pain, wound healing, cancer, cardiovascular disorders, epilepsy, kidney infections and many types of skin diseases. Current study revealed the data of 103 wild plants species belonging to 46 plant families from selected areas of District Neelum, AJK. Results depicted that Asteraceae ranked 1st (12 plants spp). Among plant parts used leaf ranked 1st (18%), followed by seed (17%) and root (13%). While prevalent form recipe mode was decoction (20%), followed by powder (17%) and extract (14%) and fodder was highest (37%) EB use-form fodder, followed by food (32%) and fuel (17%). Quantitative ethnobotanical analysis (QEA) was carried to find the reliability and novelty of the study. Five plant species including Berberis lyceum (FL = 97.78%), Isodon rugosus (FL = 95.71%), Saussurea lappa (FL = 94.74%), Aconitum heterophyllum (FL = 92.71%) and Taxus baccata (91.58%) had shown high fidelity level which confirmed that these plants have high medicinal worth in study area. The highest value (0.94) of ICF was for diseases group “tuberculosis and leucorrhea”, followed by stomachache and flatulence (0.93), diabetics and blood pressure (0.92) and asthma and chest infections (0.88). For other uses fuel with ICF (0.83) ranked first and second was hedging and thatching (ICF = 0.82) where people use plants or their parts for construction. Spearman’s rank correlation (SRC) test indicated that number of TEB uses increases if number of species is increased. Jaccard index (JI) analysis depicted that 56.31% plants are being used as TEMs which are first time explored from the study area. While 26.21% plants are being used in different TEB uses which are different from past cited literature. These novel findings of research indicate that wild flora of the study area has great potential for novel drug discovery and provision of materialist services for the indigenous communities.

CONCLUSION: The present research revealed that TEMs uses of 58 plants are novel being first time reported from the study area (DRG) of District Neelam of AJK. The results showed that plants like Acer cappadocicum, Ajuga bracteosa and Swertia paniculata are used to cure diabetes, Viscum album, Viola canescens, Taxus baccata are used for cure of cancer, Isodon rugosus, Polygala chinensis are used in TEMs for treating cardiovascular disorders and Anaphalis triplinervis is used for epilepsy. Berberis lyceum, Ajuga bracteosa, Aconitum heterophyllum, Bistorta amplexicaule, Saussurea lapa and Jurinea dolomiaea are severely threatened and there is urgent need to do conservation measures for available of valuable MPs to the indigenous communities for life necessities and for future research. The current study will also be useful addition in ethnobotanical database, preservation of traditional culture and drug discovery and drug development through future ethnopharmacological research.

PMID:34324561 | DOI:10.1371/journal.pone.0255010

Nutr Cancer. 2021 Jul 29:1-12. doi: 10.1080/01635581.2021.1957486. Online ahead of print.

ABSTRACT

We aimed to investigate the association of fruits and vegetables (FVs) and their all subgroups intakes with breast cancer (BC) risk in Iranian women.

The present case-control study conducted on 150 age-matched women with newly diagnosed BC and apparently healthy controls. Anthropometric measures were collected and eventually, the mean intakes of total FVs and each subgroup were obtained from a validated 147-item food frequency questionnaire. Multivariate regression analysis was used to estimate odds ratios (OR) with 95% confidence intervals (CI).

Our findings revealed that the intake of only dark yellow vegetable was significantly higher in BC patients (P = 0.03) after controlling for covariates. OR of BC across tertiles of FVs intake, showed that there was not any statistical association of total FVs (OR: 1.83, CI: 0.54-6.24, P-trend = 0.3) and their subgroups intakes with BC risk. Except for berry fruits intake which was adversely associated with BC risk (OR: 0.36, CI: 0.09-1.37, P-trend = 0.02).

Our findings did not support the hypothesis that higher total FVs and their subgroups intakes reduce BC risk and suggested that only higher berry fruits intake may have an association with lower BC risk.

PMID:34323618 | DOI:10.1080/01635581.2021.1957486

J Plast Surg Hand Surg. 2021 Jul 29:1-6. doi: 10.1080/2000656X.2021.1952211. Online ahead of print.

ABSTRACT

BACKGROUND: Near-infrared spectroscopy (NIRS) is widely used to assess flap perfusions by measuring tissue oxygen saturation (StO₂). However, the StO₂ level for the onset of perfusion failure is still a controversial issue.

AIM: This study proposes a new threshold of StO₂ level for detecting the onset of perfusion failure as early as possible to increase flap salvage rates.

METHODS: Twenty patients undergoing flap surgery were included in this study – 13 flaps were implemented to cover defects that occurred due to trauma and 7 flaps to hide imperfections that occurred after cancer treatment. Thirteen flaps were in the lower extremity, six in the mandible, and one in the breast. NIRS was used to measure StO₂ in 240 flap regions of the 20 patients to determine flap viability using descriptive statistics.

RESULTS: The mean StO₂ values from healthy flap and control regions were obtained as 81.6% ± 0.36 and 82% ± 0.18, respectively. The lowest StO₂ value of 77.2% was defined as the onset of a vascular complication at a probability of 99.74% by subtracting three times the standard deviation from the mean StO₂ of healthy flaps. Vascular complications were observed from 21 regions in the four flaps with StO₂ values lower than 77.2%, but only one was lost.

CONCLUSION: The threshold value for the onset of perfusion failure was a 5% decrease from the expected value, much lower than previously described thresholds that may facilitate the detection of perfusion failure in the early stage and increase salvage rates in flap revisions.

PMID:34323644 | DOI:10.1080/2000656X.2021.1952211

J Pain Palliat Care Pharmacother. 2021 Jul 29:1-5. doi: 10.1080/15360288.2021.1943597. Online ahead of print.

ABSTRACT

Effective strategies that are evidence-based and non-addictive are needed to manage chronic pain and combat the opioid crisis. One potential strategy is to utilize a shared medical appointment (SMA), which is a model of providing clinical care in a group setting with multiple healthcare team members for comprehensive pain management. The purpose of this retrospective chart review is to evaluate the impact of a pain management SMA at the William S. Middleton Veterans Affairs (VA) West Clinic on opioid use and behaviors. Quantitative and qualitative data was obtained from the electronic medical record of 16 Veterans who participated in the pain SMA and analyzed using descriptive statistics. In addition to a reduction in opioid doses six months post SMA, participants gained non-pharmacological referrals, addition of non-opioid pain medications, and a mix of didactic and experiential education on pharmacologic and non-pharmacologic treatment modalities to help manage their chronic pain. This SMA allowed for greater access to healthcare professionals with a sole focus on pain management and provided Veterans with a holistic approach to their pain management.

PMID:34323646 | DOI:10.1080/15360288.2021.1943597

J Exp Psychol Learn Mem Cogn. 2021 Jul 29. doi: 10.1037/xlm0000894. Online ahead of print.

ABSTRACT

Theories of memory consolidation suggest that initially rich, vivid memories become more gist-like over time. However, it is unclear whether gist-like representations reflect a loss of detail through degradation or the blending of experiences into statistical averages, and whether the strength of these representations increases, decreases, or remains stable over time. We report three behavioral experiments that address these questions by examining distributional learning during spatial navigation. In Experiment 1, human subjects navigated a virtual maze to find hidden objects with locations varying according to spatial distributions. After 15 minutes, 1 day, 7 days, or 28 days, we tested their navigation performance and explicit memory. In Experiment 2, we created spatial distributions with no object at their mean locations, thereby disentangling learned object exemplars from statistical averages. In Experiment 3, we created only a single, bimodal distribution to avoid possible confusion between distributions and administered tests after 15 minutes or 28 days. Across all experiments, and for both navigation and explicit tests, representations of the spatial distributions were present soon after exposure, but then receded over time. These findings suggest gist-like representations do not improve over time, helping to clarify the temporal dynamics of consolidation in human learning and memory. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34323577 | DOI:10.1037/xlm0000894

Psychol Methods. 2021 Jul 29. doi: 10.1037/met0000314. Online ahead of print.

ABSTRACT

hen multiple mediators exist on the causal pathway from treatment to outcome, path analysis prevails for disentangling indirect effects along paths linking possibly several mediators. However, separately evaluating each indirect effect along different posited paths demands stringent assumptions, such as correctly specifying the mediators’ causal structure, and no unobserved confounding among the mediators. These assumptions may be unfalsifiable in practice and, when they fail to hold, can result in misleading conclusions about the mediators. Nevertheless, these assumptions are avoidable when substantive interest is in inference about the indirect effects specific to each distinct mediator. In this article, we introduce a new definition of indirect effects called interventional indirect effects from the causal inference and epidemiology literature. Interventional indirect effects can be unbiasedly estimated without the assumptions above while retaining scientifically meaningful interpretations. We show that under a typical class of linear and additive mean models, estimators of interventional indirect effects adopt the same analytical form as prevalent product-of-coefficient estimators assuming a parallel mediator model. Prevalent estimators are therefore unbiased when estimating interventional indirect effects-even when there are unknown causal effects among the mediators-but require a different causal interpretation. When other mediators moderate the effect of each mediator on the outcome, and the mediators’ covariance is affected by treatment, such an indirect effect due to the mediators’ mutual dependence (on one another) cannot be attributed to any mediator alone. We exploit the proposed definitions of interventional indirect effects to develop novel estimators under such settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34323583 | DOI:10.1037/met0000314

Psychol Assess. 2021 Jul 29. doi: 10.1037/pas0001048. Online ahead of print.

ABSTRACT

It is often important to study people’s thoughts, feelings, and behaviors over time. To this end, researchers have relied on repeated cross-sectional (RCS) studies, in which different people from the same population participate on different measurement occasions. Also, researchers have relied on panel studies, in which the same group of people participate on different measurement occasions. However, few studies have directly tested whether participants’ responses in RCS studies were similar to those found in panel studies. To address this gap, we compared the responses to 33 items, 28 of which were further grouped into four aggregates (Affections, Worries, States, Health concerns), over 8 weeks during the first COVID-19 lockdown in Denmark in a RCS study (overall N = 5,993, per measurement occasion 616 ≤ n ≤ 964) with the responses in a largely equivalent panel study (993 ≤ n ≤ 2,546 across measurement occasions). The study participants were randomly drawn from the same quota-representative participant pool and responded to the same items on the same measurement occasions. Results indicated a few differences between the study samples on the first measurement occasion (i.e., selection effects between studies). Further, we found statistical support for different trajectories in 21 aggregates/items. However, visual inspection of the trajectories suggested subtle differences between the studies at large. The results thus raise awareness that the trajectories of people’s thoughts, feelings, and behaviors can differ between survey methods, especially when only a few measurement occasions are considered. Nevertheless, such differences might not be substantial over time. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34323551 | DOI:10.1037/pas0001048

Health Psychol. 2021 Jul 29. doi: 10.1037/hea0001071. Online ahead of print.

ABSTRACT

Objective: Interventions to promote evidence-based practices are particularly needed for paraprofessional staff working with minority youth with HIV who have higher rates of HIV infection but lower rates of linkage and retention in care compared to older adults. Utilizing the ORBIT model for behavioral intervention development, we defined and refined a behavioral intervention for providers, Tailored Motivational Interviewing (TMI), to improve provider competence in previous studies (Phase 1a and 1b). The current study focuses on ORBIT Phase 2a-proof of concept. We hypothesized that TMI would be acceptable and feasible and would show a signal of efficacy of improving and maintaining community health worker (CHW) MI competence scores using an innovative statistical method for small N proof-of-concept studies. Method: Longitudinal data were collected from 19 CHWs at 16 youth HIV agencies. CHWs from 8 sites were assigned to the TMI group per the cofunders request. The remaining 8 sites were randomly assigned to TMI or services as usual. MI competence was assessed at baseline and up to 15 times over 2 years. Random coefficient models were utilized to examine time trajectories of competence scores and the impact of the intervention on competence trajectories. Semistructured interviews were conducted to determine barriers and facilitators of TMI. Results: Competence scores in the TMI group significantly increased while the scores of the control group significantly decreased. Further analysis of the intervention group demonstrated that scores significantly increased during the first 3 months after initial workshop and was sustained through the end of the study. Qualitative findings revealed insufficient time and competing priorities as perceived barriers whereas integrating MI into routine agency practices and ongoing training might facilitate implementation. Conclusions: Following a successful proof-of-concept, the next step is a fully randomized pilot study of TMI relative to a control condition in preparation for a stepped-wedge cluster randomized full scale trial. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34323574 | DOI:10.1037/hea0001071

Health Psychol. 2021 Jun;40(6):408-417. doi: 10.1037/hea0001080.

ABSTRACT

OBJECTIVE: Uveal melanoma, a rare eye cancer, presents potential vision loss and life threat. This prospective, longitudinal study interrogated the predictive utility of visual impairment, as moderated by optimism/pessimism, on depressive symptoms in 299 adults undergoing diagnostic evaluation.

METHOD: Depressive symptoms (Center for Epidemiologic Studies Depression Scale), subjective (Measure of Outcome in Ocular Disease vision subscale) and objective (logarithm of the minimum angle of resolution) visual impairment, and optimism/pessimism (Life Orientation Test-Revised) were assessed before diagnostic evaluation and 1 week, 3 months, and 12 months after diagnosis. Multilevel modeling, with repeated measures (Level 1) nested within individuals (Level 2) and imputation of missing data (Blimp software), was performed.

RESULTS: Depressive symptoms were significantly more elevated 1 week after diagnosis in cancer patients (n = 107) versus patients not diagnosed with cancer (n = 192). Higher subjective (but not objective) visual impairment predicted greater depressive symptoms (p < .001). Across the entire sample, the two-way (Optimism/Pessimism × Subjective Visual Impairment) interactions were statistically significant (ps < .05), but not the three-way interaction (with diagnosis). The positive association between subjective visual impairment and depressive symptoms was significant at low and moderate levels of optimism (ps < .001), but not at high optimism (p > .05). The association was significant at high and moderate levels (ps < .001), but not low (p > .05) levels of pessimism.

CONCLUSIONS: Elevated depressive symptoms are evident in adults who do (vs. do not) receive a diagnosis of uveal melanoma but appear to remit within 3 months. Perceived impaired vision, especially coupled with low optimism or high pessimism, predicts depressive symptoms over time, with implications for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PMID:34323543 | DOI:10.1037/hea0001080

Pain Physician. 2021 Aug;24(5):E649-E660.

ABSTRACT

BACKGROUND: Plasma rich in growth factors (PRGF) is a leukocyte-free platelet-rich plasma (PRP) that is an effective biological approach to tissue repair and has been demonstrated to significantly improve multiple conditions, including low back pain and degenerative disc pathology.

OBJECTIVES: The objective of this retrospective study was to analyze the effectiveness of treating both cervical and lumbar spine pain with minimally invasive infiltrations of PRGF-Endoret.

STUDY DESIGN: Retrospective study design.

SETTING: Outpatient private practice facility.

METHODS: The effectiveness of PRGF has been assessed by patient-reported outcomes (PRO) through validated questionnaires, namely Numeric Rating Scale (NRS) for back pain, Spine Tango Core Outcome Measure Index (COMI) Questionnaire for lumbar and cervical pain, and OSWESTRY Disability Index questionnaire for lumbar pain cases. Score differences between pre- and post-treatment have also been assessed stratified for multiple sub-groups of patients based on the sector of the column treated, gender, and age.

RESULTS: This study includes 65 patients (18 with cervical pain and 47 with lumbar back pain). The average time of back pain evolution was 10 years. Patients received at least 2 PRGF infiltration series about one month apart. Each patient received intervertebral disc and epidural infiltrations, root infiltrations, in case of radicular injury, and intraarticular infiltrations, in case of osteoarthritis of the facet joints. Results show statistically significant (P < 0.05) improvements on all analyzed scores. Regarding the stratified analyses, 249 (99%) sub-groups showed an improvement in all tests (252 cases overall). From the 249 improving cases, 154 (62%) showed a statistically significant difference between the pre- and the post- treatment periods.

LIMITATIONS: This research is a retrospective study with a relatively small sample cohort. Only PRO have been assessed.

CONCLUSIONS: According to the results obtained in this study, and taking into account their limitations, PRGF infiltrations are an effective and minimally invasive biological strategy in the treatment of both cervical and lumbar pain, evaluated according to PRO.

PMID:34323453