Herbal Medicine Use in Costa Rica: A Case Study Examining Herbal Medicine’s Utilization and Cultural Significance

Introduction: Herbal medicine has been widely used in the past and present, as it is deeply rooted in many cultures\u27 histories. Literature Review: Herbal medicines are used for health maintenance and treatment in Costa Rica. The country\u27s rich natural environment, accessibility, and tradition led to prominent herbal medicine use. Annona muricata (Soursop), Uncaria tomentosa (Cat\u27s Claw), Mikania species (Guaco), and Neurolaena lobata (Gavilana) have commonly been used in Central American medications and have diverse indications based on their plant parts. Case Study: A discussion with an herbalist, founder, and citizen of Longo Mai, a community in southern Costa Rica, was had about practicing herbal medicine. Herbal medicine was prominent in their lives due to its proximity and freshness. At the same time, while only some people in Costa Rica have practiced herbal medicine, knowledge of some herbal remedies has existed for generations in all families. Annona muricata, Mikania species, and Neurolaena lobata have been commonly used in Longo Mai, while Uncaria tomentosa is present but rarely used. Discussion: Herbal medicines have been essential for Costa Ricans\u27 health and culture due to the environment’s robust and immense biodiversity and the medicines’ accessibility, affordability, and strong cultural traditions. The research showed overlap, but slight variations, in how herbal medicines were prepared, strategically prescribed to reduce side effects, and their utilization. Annona muricata was the most discussed herbal medicine in Longo Mai, while Uncaria tomentosa was rarely used. The differences could be due to Longo Mai representing a small portion of Costa Rica. Therefore, these variations between the literature review and case study could be less in other areas of the country. Conclusion: These findings demonstrate the significance of providers understanding herbal medicines’ physical and cultural benefits, especially since it is widely practiced. This knowledge will allow providers to ensure that herbal medicines are used safely and improve shared decision- making by helping them support a patient’s cultural and health beliefs. Ultimately, this could improve the quality and outcomes of patient care

Estimating the cost-effectiveness of detecting cases of chronic hepatitis C infection on reception into prison

Background In England and Wales where less than 1% of the population are Injecting drug users (IDUs), 97% of HCV reports are attributed to injecting drug use. As over 60% of the IDU population will have been imprisoned by the age of 30 years, prison may provide a good location in which to offer HCV screening and treatment. The aim of this work is to examine the cost effectiveness of a number of alternative HCV case-finding strategies on prison reception Methods A decision analysis model embedded in a model of the flow of IDUs through prison was used to estimate the cost effectiveness of a number of alternative case-finding strategies. The model estimates the average cost of identifying a new case of HCV from the perspective of the health care provider and how these estimates may evolve over time. Results The results suggest that administering verbal screening for a past positive HCV test and for ever having engaged in illicit drug use prior to the administering of ELISA and PCR tests can have a significant impact on the cost effectiveness of HCV case-finding strategies on prison reception; the discounted cost in 2017 being £2,102 per new HCV case detected compared to £3,107 when no verbal screening is employed. Conclusion The work here demonstrates the importance of targeting those individuals that have ever engaged in illicit drug use for HCV testing in prisons, these individuals can then be targeted for future intervention measures such as treatment or monitored to prevent future transmission

Planet Migration and Disk Destruction due to Magneto-Centrifugal Stellar Winds

This paper investigates the influence of magneto-centrifugally driven or simply magnetic winds of rapidly-rotating, strongly-magnetized T Tauri stars in causing the inward or outward migration of close-in giant planets. The azimuthal ram pressure of the magnetized wind acting on the planet tends to increase the planet's angular momentum and cause outward migration if the star's rotation period $P_*$ is less than the planet's orbital period $P_p$. In the opposite case, $P_* > P_p$, the planet migrates inward. Thus, planets orbiting at distances larger (smaller) than $0.06 {\rm AU}(P_*/5{\rm d})^{2/3}$ tend to be pushed outward (inward), where $P_*$ is the rotation period of the star assumed to have the mass of the sun. The magnetic winds are likely to occur in T Tauri stars where the thermal speed of the gas close to the star is small, where the star's magnetic field is strong, and where the star rotates rapidly. The time-scale for appreciable radial motion of the planet is estimated as $\sim 2 - 20$ Myr. A sufficiently massive close-in planet may cause tidal locking and once this happens the radial migration due to the magnetic wind ceases. The magnetic winds are expected to be important for planet migration for the case of a multipolar magnetic field rather than a dipole field where the wind is directed away from the equatorial plane and where a magnetospheric cavity forms. The influence of the magnetic wind in eroding and eventually destroying the accretion disk is analyzed. A momentum integral is derived for the turbulent wind/disk boundary layer and this is used to estimate the disk erosion time-scale as $\sim 1-10^2$ Myr, with the lower value favored.Comment: 8 pages, 6 figure

A General Framework for Formal Tests of Interaction after Exhaustive Search Methods with Applications to MDR and MDR-PDT

The initial presentation of multifactor dimensionality reduction (MDR) featured cross-validation to mitigate over-fitting, computationally efficient searches of the epistatic model space, and variable construction with constructive induction to alleviate the curse of dimensionality. However, the method was unable to differentiate association signals arising from true interactions from those due to independent main effects at individual loci. This issue leads to problems in inference and interpretability for the results from MDR and the family-based compliment the MDR-pedigree disequilibrium test (PDT). A suggestion from previous work was to fit regression models post hoc to specifically evaluate the null hypothesis of no interaction for MDR or MDR-PDT models. We demonstrate with simulation that fitting a regression model on the same data as that analyzed by MDR or MDR-PDT is not a valid test of interaction. This is likely to be true for any other procedure that searches for models, and then performs an uncorrected test for interaction. We also show with simulation that when strong main effects are present and the null hypothesis of no interaction is true, that MDR and MDR-PDT reject at far greater than the nominal rate. We also provide a valid regression-based permutation test procedure that specifically tests the null hypothesis of no interaction, and does not reject the null when only main effects are present. The regression-based permutation test implemented here conducts a valid test of interaction after a search for multilocus models, and can be applied to any method that conducts a search to find a multilocus model representing an interaction