Tag: statistics

J Complement Integr Med. 2021 May 10. doi: 10.1515/jcim-2020-0276. Online ahead of print.

ABSTRACT

OBJECTIVES: Stress responses vary throughout pregnancy and impact of late gestational variable stress (LGVS) with vitamin C supplementation on uterine contractility is barely explored. This study investigates fetal weight outcome and in-vitro uterine contractile responses to pharmacological agents during LGVS exposure.

METHODS: Twenty four nulliparous pregnant rats were divided into four groups of six. During gestation days 10-19, groups 1 & 2 received normal saline and vitamin C (10 mg/kg) respectively. Groups 3 and 4 were exposed to stress (sleep deprivation, predator exposure, immobility, rapid cage changes, noise, and foreign object) with group 4 concurrently supplemented with vitamin C (10 mg/kg). Serum cortisol, oxidative bio-markers, fetal weights and in-vitro contractile responses of excised uterine tissue to acetylcholine (Ach), oxytocin, calcium chloride (CaCl₂), potassium chloride (KCl), diclofenac, and magnesium ions were determined.

RESULTS: Malondialdehyde activity and cortisol were significantly increased in variable stress only exposed group when compared with control and vitamin C supplemented groups. Fetal body weights, superoxide dismutase and catalase activity were significantly reduced in variable stress only exposed group. Significantly impaired contractile responses to Ach, CaCl₂ & KCl in variable stress only exposed group were modulated in vitamin C supplemented groups. Impaired contractile response to oxytocin was however not reversed. Relaxation responses to diclofenac and magnesium ions were statistically unaltered across groups.

CONCLUSIONS: Impaired fetal weights and uterine contractile activity to Ach, CaCl₂ and KCl during LGVS was modulated by vitamin C supplementation. Impaired oxytocin contractile activity was however unreversed.

PMID:33964203 | DOI:10.1515/jcim-2020-0276

Scand J Pain. 2021 May 10. doi: 10.1515/sjpain-2020-0176. Online ahead of print.

ABSTRACT

OBJECTIVES: Labour is one of the most painful experiences in a woman’s life. Epidural analgesia using low-concentration local anaesthetics and lipophilic opioids is the gold standard for pain relief during labour. Pregnancy in general, particularly labour, is associated with changes in maternal haemodynamic variables, such as cardiac output and heart rate, which increase and peak during uterine contractions. Adrenaline is added to labour epidural solutions to enhance efficacy by stimulating the α2-adrenoreceptor. The minimal effective concentration of adrenaline was found to be 2 μg mL^-1 for postoperative analgesia. The addition of adrenaline may also produce vasoconstriction, limiting the absorption of fentanyl into the systemic circulation, thereby reducing foetal exposure. However, adrenaline may influence the haemodynamic fluctuations, possibly adding to the strain on the circulatory system. The aim of this study was to compare the haemodynamic changes after application of labour epidural analgesia with or without adrenaline 2 μg mL^-1.

METHODS: This was a secondary analysis of a single-centre, randomised double-blind trial. Forty-one nulliparous women in labour requesting epidural analgesia were randomised to receive epidural solution of bupivacaine 1 mg mL^-1, fentanyl 2 μg mL^-1 with or without adrenaline 2 μg mL^-1. The participants were monitored using a Nexfin CC continuous non-invasive blood pressure and cardiac output monitor. The primary outcomes were changes in peak systolic blood pressure and cardiac output during uterine contraction within 30 min after epidural activation. The effect of adrenaline was tested statistically using a linear mixed-effects model of the outcome variables’ dependency on time, adrenaline, and their interaction.

RESULTS: After excluding three patients due to poor data quality and two due to a malfunctioning epidural catheter, 36 patients (18 in each group) were analysed. The addition of adrenaline to the solution had no significant effect on the temporal changes in peak systolic blood pressure (p=0.26), peak cardiac output (0.84), or heart rate (p=0.91). Furthermore, no significant temporal changes in maternal haemodynamics (peak systolic blood pressure, p=0.54, peak cardiac output, p=0.59, or heart rate p=0.55) were associated with epidural analgesia during 30 min after epidural activation in both groups despite good analgesia.

CONCLUSIONS: The addition of 2 μg mL^-1 adrenaline to the epidural solution is not likely to change maternal haemodynamics during labour.

PMID:33964196 | DOI:10.1515/sjpain-2020-0176

J Complement Integr Med. 2021 May 10. doi: 10.1515/jcim-2020-0434. Online ahead of print.

ABSTRACT

OBJECTIVES: The modified Naranjo algorithm assesses the physician assigned cause-effect relationship for homeopathic medicines. It is being adopted in homeopathy researches, but not yet validated systematically. We intended to validate the modified Naranjo algorithm by examining its psychometric properties.

METHODS: An online survey sought agreement of 25 experts on the 10 items of the tool on 5-point agreement scale. Next, 285 responses from collected prospectively from chronic cases enrolled under the clinical verification program of the council in 2018 were subjected to testing of construct validity using exploratory principal component analysis (PCA). Confirmatory factor analysis (CFA; n=150) was performed to verify the goodness-of-fit of the model. Reliability was tested using internal consistency, test-retest reliability, and inter-rater reliability by kappa statistics.

RESULTS: Experts’ responses mean values were 4 or higher (i.e. responses were relevant) and standard deviations were less than 1 (i.e. less heterogeneous). In PCA using varimax, all the items loaded above the pre-specified value of 0.4 and identified 4 components explaining 64.1% of variation. The goodness-of -fit of the 4-component CFA model was acceptable (chi-square 89.253, p<0.001). Internal consistency (Cronbach’s alpha 0.7) was borderline; test-retest reliability was acceptable. Kappa statistics was moderate to fair, but poor for few of the items.

CONCLUSIONS: Statistical evaluations indicate that the modified Naranjo algorithm is useful, but needs improvement.

PMID:33964193 | DOI:10.1515/jcim-2020-0434

J Complement Integr Med. 2021 May 10. doi: 10.1515/jcim-2020-0191. Online ahead of print.

ABSTRACT

OBJECTIVES: An acquired melanin-related hyperpigmentation that occurs in sun exposure areas is Melasma which presents as gray-brown ridges and macules with prominent margins on the skin. The aim of this assay was to assess the formulation and efficacy of topical Dorema ammoniacum among Melasma patients.

METHODS: This study was a 30 days double-blind, randomized clinical trial in Melasma with a placebo group. The study was carried out on 49 patients with Melasma attending Haji Daii Nursing Center in Kermanshah, Iran. Optimized topical formulation of D. ammoniacum gum extract was prepared by evaluating the characteristics of different topical formulations of this plant. Mean Melasma severity index (MMASI) instrument was applied to assess the product effectiveness and to determine the skin stains. Patients were pursued to receive the treatment throughout the 30 days trial. This scaling was accomplished before the intervention and 30 days after the use of the herbal product. To analyze the quantitative variables, t-test and Mann-Whitney test were evaluated by SPSS 21 software, and p-value <0.05 was considered as the statistically significant.

RESULTS: The survey was performed on 40 female subjects (81.6%) and nine male subjects (18.4%) with the mean age of 32.18 ± 8.69. According to the results, the mean MSI in the drug group was significantly lower than before treatment and decreased from 86.98 ± 69.48 to 31.03 ± 32.62 (p-value <0.05).

CONCLUSIONS: In compliance with findings this survey revealed a positive effect of the cream formulation of D. ammoniacum extract on Melasma. As it was represented no side effects, this formulation is appropriate for the treatment of Melasma.

PMID:33964194 | DOI:10.1515/jcim-2020-0191

J Complement Integr Med. 2021 May 10. doi: 10.1515/jcim-2020-0368. Online ahead of print.

ABSTRACT

OBJECTIVES: In Ontario, Canada, MTs are regulated and have a common scope of practice. However, diverse practice settings and approaches to care create a need for MTs to articulate their professional identity. This study sought to answer, “what common features are foundational to the professional identity of MTs in Ontario?”

METHODS: This quantitative research study was a part of a larger exploratory sequential mixed methods study. An online questionnaire-based cross-sectional study was conducted based on previous qualitative findings. MTs in Ontario, who held an active certificate, were invited to participate. Data were analyzed using descriptive statistics.

RESULTS: The analysis revealed 17 common features that were endorsed by most respondents. Participants also reported thinking of themselves as healthcare professionals, rather than service providers, a feeling that was held across practice settings. Interesting and unexpected differences were noted in statements regarding the perception of MTs, areas of profession-specific knowledge, and the establishment of the therapeutic relationship.

CONCLUSIONS: This study furthers an understanding of MTs’ identity. Specifically, MTs consider themselves to be HCPs who are confident in their knowledge and abilities, especially their communication skills. They believe in providing individualized care and empowering their patients to take charge of their own health. Despite areas of overwhelming agreement, disagreement in endorsement was seen in areas such as MTs perception of their external image, use of evidence in practice, and the establishment of professional boundaries. These areas provide an opportunity for future research to continue to develop a body of knowledge regarding MTs professionalism and identity.

PMID:33964195 | DOI:10.1515/jcim-2020-0368

Bioinformatics. 2021 May 8:btab261. doi: 10.1093/bioinformatics/btab261. Online ahead of print.

ABSTRACT

MOTIVATION: Simulation-based inference can bypass the limitations of statistical methods based on analytical approximations, but software allowing simulation of structured population genetic data without the classical n-coalescent approximations (such as those following from assuming large population size) are scarce or slow.

RESULTS: We present GSpace, a simulator for genomic data, based on a generation-by-generation coalescence algorithm taking into account small population size, recombination, and isolation by distance.

AVAILABILITY: Freely available at site web INRAe (http://www1.montpellier.inra.fr/CBGP/software/gspace/download.html).

PMID:33964130 | DOI:10.1093/bioinformatics/btab261

J Gerontol B Psychol Sci Soc Sci. 2021 May 8:gbab085. doi: 10.1093/geronb/gbab085. Online ahead of print.

ABSTRACT

OBJECTIVES: During the COVID-19 pandemic, stigmatization of older persons has increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health.

METHOD: To address these gaps, we designed age-stereotype interventions based on actual news stories that appeared during the pandemic, and divided them into negative and positive versions of what we term personified (i.e., person-based) and enumerative (i.e., number-based) age-stereotype messaging. The negative versions of the two types of messaging reflected the age stereotype of decline whereas the positive versions of the two types of messaging reflected the age stereotype of resilience.

RESULTS: As expected, the exposure of older individuals to the negative-age-stereotype-messaging interventions led to significantly worse mental health (more anxiety and less peacefulness), compared to a neutral condition; in contrast, the positive-age-stereotype-messaging interventions led to significantly better mental health (less anxiety and more peacefulness), compared to a neutral condition. The findings were equally strong for the personified and enumerative conditions. Also as expected, the interventions, which were self-irrelevant to the younger participants, did not significantly impact their mental health.

DISCUSSION: This is the first-known study to experimentally demonstrate that institutional ageism, and statistics that reflect stereotypes about older individuals, can impact mental health. The results demonstrate the need for media messaging aimed at empowering older individuals during the pandemic and beyond.

PMID:33964154 | DOI:10.1093/geronb/gbab085

Int J Dent Hyg. 2021 May 8. doi: 10.1111/idh.12509. Online ahead of print.

ABSTRACT

OBJECTIVES: The use of local probiotics in the therapy of periodontitis is reflected in their ability to antagonize periodontopathogens and modulate the immune response of the host to the presence of pathogenic microorganisms. The aim of this study was to investigated the use of local probiotics in the treatment of periodontitis as an adjunctive therapy to scaling and root planning (SRP).

METHODS: The study involved 80 patients diagnosed with periodontitis. All participants underwent SRP therapy. Semi-solid probiotic was then locally applied to the periodontal pocket in randomly selected patients for the test group (40 of them). The other 40 patients were in the control group. Clinical parameters including periodontal pocket depth (PPD), bleeding on probing (BOP) and plaque index (PI) were measured at baseline, and at 7 and 30 days after treatment.

RESULTS: Seven days after the applied therapy in the test and control group, there was a significant decrease in the values or BOP (p<0.001), while the values of other parameters did not show a statistically significant difference (p<0.05). One month after the therapy in both groups, there was a statistically significant difference in the values of all clinical parameters (p<0.001).

CONCLUSIONS: Based on the results of this pilot study, it can be said that, during periodontal treatment, topical application of probiotics in combination with SRP increases the effectiveness of conventional non-surgical therapy of periodontitis.

PMID:33964104 | DOI:10.1111/idh.12509

Mol Ecol Resour. 2021 May 8. doi: 10.1111/1755-0998.13415. Online ahead of print.

ABSTRACT

Adaptive genetic variation is a function of both selective and neutral forces. To accurately identify adaptive loci, it is thus critical to account for demographic history. Theory suggests that signatures of selection can be inferred using the coalescent, following the premise that genealogies of selected loci deviate from neutral expectations. Here, we build on this theory to develop an analytical framework to identify Loci under Selection via explicit Demographic models (LSD). Under this framework, signatures of selection are inferred through deviations in demographic parameters, rather than through summary statistics directly, and demographic history is accounted for explicitly. Leveraging on the property of demographic models to incorporate directionality, we show that LSD can provide information on the environment in which selection acts on a population. This can prove useful in elucidating the selective processes underlying local adaptation, by characterising genetic trade-offs and extending the concepts of antagonistic pleiotropy and conditional neutrality from ecological theory to practical application in genomic data. We implement LSD via Approximate Bayesian Computation and demonstrate, via simulations, that LSD has i) high power to identify selected loci across a large range of demographic-selection regimes, ii) outperforms commonly applied genome-scan methods under complex demographies, and iii) accurately infers the directionality of selection for identified candidates. Using the same simulations, we further characterise the behaviour of isolation-with-migration models conducive to the study of local adaptation under regimes of selection. Finally, we demonstrate an application of LSD by detecting loci and characterising genetic trade-offs underlying flower colour in Antirrhinum majus.

PMID:33964107 | DOI:10.1111/1755-0998.13415

BJU Int. 2021 May 8. doi: 10.1111/bju.15443. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate if a risk score for prostate cancer (PC) lifetime risk can be used to optimize triaging of patients with a negative prostate biopsy, but under sustained suspicion of PC.

METHODS AND PATIENTS: In this prospective clinical study, we included, and risk scored patients who had a cancer-negative transrectal ultrasound guided (TRUS) prostate biopsy, but elevated prostate specific antigen (PSA), a suspicious prostate digital rectal examination and/or a positive family history (FH) of PC. The risk score estimated individual lifetime risk of PC, based on a polygenic risk score (33 single nucleotide polymorphisms), age, and FH of PC. Patients were followed, under urologic supervision, for up to 4 years with annual controls, always including PSA measurements. Multiparametric magnetic resonance imaging (mpMRI) and/or prostate biopsy was performed at selected annual controls depending on risk score and at the urologist’s/patient’s discretion, which means that the follow-up differed based on the risk score.

RESULTS: We included 429 patients. After risk scoring, 376/429 (88%) patients were allocated to a normal-risk group (<30% PC lifetime risk) and 53/429 (12%) to a high-risk group (≥30% PC lifetime risk). The high-risk group had significantly different follow-up, with more biopsy and mpMRI sessions compared to the normal-risk group. PC was detected in 89/429 (21%) patients, with 67/376 (18%) patients diagnosed in the normal-risk group and 22/53 (42%) in the high-risk group. There was no statistically significant difference in the cumulative incidence of PC between the normal-risk group and the high-risk group after 4 years of follow-up. Currently, 67/429 (16%) patients are still being followed in this ongoing study.

CONCLUSION: In a 4-year perspective our PC lifetime risk score did not demonstrate significant prognostic value for triaging patients, with a negative TRUS-biopsy and sustained suspicion of PC.

PMID:33964113 | DOI:10.1111/bju.15443