Study protocol for a randomised controlled trial of electronic cigarettes versus nicotine patch for smoking cessation

PMCID: PMC3602285This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Hymns of the Church of Jesus Christ of Latter-day Saints.

Thesis (M.A.)--Boston Universit

Involvement of young people in a qualitative study that seeks to explore experiences of renal replacement therapy choice selection

Introduction: Patient and Public involvement (PPI) has become one of the drivers in health care and seen as an integral part of the research process. PPI promotes research questions that reflect the priorities and concerns of the relevant population and develops outcomes that are important to patients (INVOLVE, 2012; Evans et al, 2014; Hickey et al, 2018). Young adults with end-stage kidney disease are supported by clinicians and their families to make decisions about their preferred renal replacement therapy (NICE, 2018). However, they can become overwhelmed with the burden of long-term chronic illness and often struggle to accept diagnosis and prognosis and cope with the complex management of their condition (Coulter and Collins, 2011; Ritchie et al., 2012). They can consequently become disengaged with the service and less involved in their care (Ritchie et al, 2012; Robinski et al, 2014). The current study explores young people’s experiences of renal replacement therapy choice selection. The study team has involved young people in the study’s development. Aims and objectives: The aim of the involvement group in this study is to involve the young people in all stages of the research process: ensuring that the research question has the correct focus, that the participant information sheet is clear and that the recruitment strategy is appropriate. In due course, the young people’s group will be involved in qualitative data analysis and in dissemination of findings. Method: The involvement group comprised three people with experiences of dialysis and kidney transplant treatment as children and young adults. They were recruited via existing networks in the research team. A role description on what was to be expected of the group members was discussed, alongside what was expected from the research team (training and travel expenses for example). Communication is via face-to face meetings and also by email. This first face-to-face meeting discussed and shaped the research question, and the possible recruitment process. Further email discussions have explored the participant information sheet, consent forms plus the development of the video and poster advert to aid recruitment. Results: The impact of PPI on the research process is already providing valuable insights into how the research design should be conducted. The first face-to-face meeting with the group highlighted the difficulties that young people face when making choice of renal replacement therapy, especially psychosocial impact and mental well-being, so the impact the choice makes on well-being was added as a secondary research question. The acceptability of the recruitment method (via social media) was discussed and a video advert was developed for the recruitment process. Members also contributed to the review of some of the research documents; participant information sheet, consent forms, posters, research proposal and piloted a validation questionnaire for suitability. Impact: Involvement of patients helped situate the study to meet the current needs of young adults diagnosed with end stage renal disease who are faced with choosing dialysis or kidney transplantation

Earthquake networks based on similar activity patterns

Earthquakes are a complex spatiotemporal phenomenon, the underlying mechanism for which is still not fully understood despite decades of research and analysis. We propose and develop a network approach to earthquake events. In this network, a node represents a spatial location while a link between two nodes represents similar activity patterns in the two different locations. The strength of a link is proportional to the strength of the cross-correlation in activities of two nodes joined by the link. We apply our network approach to a Japanese earthquake catalog spanning the 14-year period 1985-1998. We find strong links representing large correlations between patterns in locations separated by more than 1000 km, corroborating prior observations that earthquake interactions have no characteristic length scale. We find network characteristics not attributable to chance alone, including a large number of network links, high node assortativity, and strong stability over time.Comment: 8 pages text, 9 figures. Updated from previous versio

Biomarkers of potential harm in people switching from smoking tobacco to exclusive e-cigarette use, dual use or abstinence: secondary analysis of Cochrane systematic review of trials of e-cigarettes for smoking cessation

Aims This study aims to compare biomarkers of potential harm between people switching from smoking combustible cigarettes (CC) completely to electronic cigarettes (EC), continuing to smoke CC, using both EC and CC (dual users) and using neither (abstainers), based on behaviour during EC intervention studies. Design Secondary analysis following systematic review, incorporating inverse variance random-effects meta-analysis and effect direction plots. Setting This study was conducted in Greece, Italy, Poland, the United Kingdom and the United States. Participants A total of 1299 adults smoking CC (nine studies) and provided EC. Measurements Measurements were conducted using carbon monoxide (CO) and 26 other biomarkers. Findings In pooled analyses, exhaled CO (eCO) was lower in EC versus EC + CC [mean difference (MD) = −4.40 parts per million (p.p.m.), 95% confidence interval (CI) = −12.04 to 3.24, two studies] and CC (MD = −9.57 p.p.m., 95% CI = −17.30 to −1.83, three studies). eCO was lower in dual users versus CC only (MD = −1.91 p.p.m., 95% CI = −3.38 to −0.45, two studies). Magnitude rather than direction of effect drove substantial statistical heterogeneity. Effect direction plots were used for other biomarkers. Comparing EC with CC, 12 of 13 biomarkers were significantly lower in EC users, with no difference for the 13th. Comparing EC with dual users, 12 of the 25 biomarkers were lower for EC, and five were lower for dual use. For the remaining eight measures, single studies did not detect statistically significant differences, or the multiple studies contributing to the outcome had inconsistent results. Only one study provided data comparing dual use with CC; of the 13 biomarkers measured, 12 were significantly lower in the dual use group, with no statistically significant difference detected for the 13th. Only one study provided data on abstainers. Conclusions Switching from smoking to vaping or dual use appears to reduce levels of biomarkers of potential harm significantly

Absence of plastin 1 causes abnormal maintenance of hair cell stereocilia and a moderate form of hearing loss in mice

Hearing relies on the mechanosensory inner and outer hair cells (OHCs) of the organ of Corti, which convert mechanical deflections of their actin-rich stereociliary bundles into electrochemical signals. Several actin-associated proteins are essential for stereocilia formation and maintenance, and their absence leads to deafness. One of the most abundant actin-bundling proteins of stereocilia is plastin 1, but its function has never been directly assessed. Here, we found that plastin 1 knock-out (Pls1 KO) mice have a moderate and progressive form of hearing loss across all frequencies. Auditory hair cells developed normally in Pls1 KO, but in young adult animals, the stereocilia of inner hair cells were reduced in width and length. The stereocilia of OHCs were comparatively less affected; however, they also showed signs of degeneration in ageing mice. The hair bundle stiffness and the acquisition of the electrophysiological properties of hair cells were unaffected by the absence of plastin 1, except for a significant change in the adaptation properties, but not the size of the mechanoelectrical transducer currents. These results show that in contrast to other actin-bundling proteins such as espin, harmonin or Eps8, plastin 1 is dispensable for the initial formation of stereocilia. However, the progressive hearing loss and morphological defects of hair cells in adult Pls1 KO mice point at a specific role for plastin 1 in the preservation of adult stereocilia and optimal hearing. Hence, mutations in the human PLS1 gene may be associated with relatively mild and progressive forms of hearing loss

Cytisine versus varenicline for smoking cessation for Māori (the indigenous people of New Zealand) and their extended family:Protocol for a randomized non‐inferiority trial

Background and aims Cytisine, a nicotinic acetylcholine receptor partial agonist (like varenicline) found in some plants, is a low-cost, effective smoking cessation medication that may appeal to Māori [the indigenous people of New Zealand (NZ)]. The RAUORA trial aims to determine the effectiveness, safety and cost-effectiveness of cytisine (Tabex®) versus varenicline (Champix®) for smoking cessation in Māori and the whānau (extended family) of Māori. Design Pragmatic, community-based, open-label randomized non-inferiority trial. Setting Lakes District Health Board region, NZ. Participants Daily smokers (n = 2140) who self-identify as Māori or whānau of Māori, and are: aged ≥ 18 years, motivated to quit smoking in the next 2 weeks, eligible for subsidized varenicline, able to provide verbal consent and have daily access to a mobile phone/internet. Recruitment uses multi-media advertising. Intervention and comparator Participants are randomized (1 : 1 ratio) to receive a prescription for 12 weeks of cytisine tablets [following the manufacturer’s dosing regimen for 25 days, then one 1.5-mg tablet every 6 hours (two per day) until 12 weeks] or varenicline tablets (following the manufacturer’s dosing regimen). Both groups receive brief stop-smoking advice from the prescribing doctor and withdrawal-orientated behavioural support via community-based stop-smoking counselling services (frequency, duration and mode of delivery tailored for participants) or a research assistant (six weekly 10–15- minute calls). Participants are advised to reduce their smoking over the first 4 days of treatment, with day 5 as their designated quit-date. Measurements The primary outcome is carbon monoxide-verified continuous abstinence at 6 months post-quit date. Secondary outcomes at 1, 3, 6 and 12 months post-quit date include: self-reported continuous abstinence, 7-day point prevalence abstinence, cigarettes per day, time to (re)lapse, adverse events, treatment adherence/compliance, treatment acceptability, nicotine withdrawal/urge to smoke and health-care utilization/health- related quality of life. Comments This trial compares cytisine and varenicline when used by the indigenous people of NZ and their extended family for smoking cessation

Xanthogranuloma of the lacrimal sac as a manifestation of Wegener's granulomatosis

McGill Univ, Ctr Hlth, Dept Ophthalmol & Pathol, Montreal, PQ H3A 2B4, CanadaHenry C Witelson Ocular Pathol Lab, Montreal, PQ, CanadaUniversidade Federal de São Paulo, Dept Ophthalmol, UNIFESP, EPM, São Paulo, BrazilMcGill Univ, Ctr Hlth, Dept Ophthalmol, Montreal, PQ H3A 2B4, CanadaUniversidade Federal de São Paulo, Dept Ophthalmol, UNIFESP, EPM, São Paulo, BrazilWeb of Scienc

Geoantineutrino Spectrum, 3He/4He-ratio Distribution in the Earth's Interior and Slow Nuclear Burning on the Boundary of the Liquid and Solid Phases of the Earth's Core

The description problem of geoantineutrino spectrum and reactor antineutrino experimental spectrum in KamLAND, which takes place for antineutrino energy \~2.8 MeV, and also the experimental results of the interaction of uranium dioxide and carbide with iron-nickel and silicaalumina melts at high pressure (5-10 GP?) and temperature (1600-2200C) have motivated us to consider the possible consequences of the assumption made by V.Anisichkin and coauthors that there is an actinid shell on boundary of liquid and solid phases of the Earth's core. We have shown that the activation of a natural nuclear reactor operating as the solitary waves of nuclear burning in 238U- and/or 232Th-medium (in particular, the neutron- fission progressive wave of Feoktistov and/or Teller-Ishikawa-Wood) can be such a physical consequence. The simplified model of the kinetics of accumulation and burnup in U-Pu fuel cycle of Feoktistov is developed. The results of the numerical simulation of neutron-fission wave in two-phase UO2/Fe medium on a surface of the Earth's solid core are presented. The georeactor model of 3He origin and the 3He/4He-ratio distribution in the Earth's interior is offered. It is shown that the 3He/4He ratio distribution can be the natural quantitative criterion of georeactor thermal power. On the basis of O'Nions-Evensen-Hamilton geochemical model of mantle differentiation and the crust growth supplied by actinid shell on the boundary of liquid and solid phases of the Earth's core as a nuclear energy source (georeactor with power of 30 TW), the tentative estimation of geoantineutrino intensity and geoantineutrino spectrum on the Earth surface are given.Comment: 28 pages, 12 figures. Added text, formulas, figures and references. Corrected equations. Changed content of some section