HubMed - Alternative Health
Model Uncertainty and Bayesian Model Averaged Benchmark Dose Estimation for Continuous Data.
Risk Anal. 2013 Jun 11;
Shao K, Gift JS
The benchmark dose (BMD) approach has gained acceptance as a valuable risk assessment tool, but risk assessors still face significant challenges associated with selecting an appropriate BMD/BMDL estimate from the results of a set of acceptable dose-response models. Current approaches do not explicitly address model uncertainty, and there is an existing need to more fully inform health risk assessors in this regard. In this study, a Bayesian model averaging (BMA) BMD estimation method taking model uncertainty into account is proposed as an alternative to current BMD estimation approaches for continuous data. Using the "hybrid" method proposed by Crump, two strategies of BMA, including both "maximum likelihood estimation based" and "Markov Chain Monte Carlo based" methods, are first applied as a demonstration to calculate model averaged BMD estimates from real continuous dose-response data. The outcomes from the example data sets examined suggest that the BMA BMD estimates have higher reliability than the estimates from the individual models with highest posterior weight in terms of higher BMDL and smaller 90th percentile intervals. In addition, a simulation study is performed to evaluate the accuracy of the BMA BMD estimator. The results from the simulation study recommend that the BMA BMD estimates have smaller bias than the BMDs selected using other criteria. To further validate the BMA method, some technical issues, including the selection of models and the use of bootstrap methods for BMDL derivation, need further investigation over a more extensive, representative set of dose-response data.
HubMed - Laser Acupuncture
Is acupuncture "stimulation" a misnomer? A case for using the term "blockade".
BMC Complement Altern Med. 2013; 13: 68
Silberstein M
The term used most frequently in the literature to describe acupuncture's effects is "stimulation" which may be used to describe either (or both) the direct stimulus applied to a needle as well as putative stimulation of the nervous system, despite little published evidence describing what is actually being stimulated. In contrast, recent published work has suggested that acupuncture may, in fact be inhibitory at a peripheral level, acting by blocking neural transmission.The suggestion that acupuncture exerts its effects through peripheral neural blockade is supported by recent evidence explaining related techniques including low level laser and capsaicin at acupoints. It also explains acupuncture's effect on painful and non-painful conditions and both Eastern and Western concepts of acupuncture. There is a need for additional work to elucidate acupuncture's mechanism of action, and the suggestion that it acts through neural blockade should prompt further research in this direction.If the term "blockade" were applied to acupuncture, this would, likely, be expected to promote this minimally invasive technique, and, potentially, bring it into mainstream clinical practice for pain management as well as other therapeutic applications.
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