Randomised controlled trial of homoeopathy versus placebo in perennial allergic rhinitis with overview of four trial series

OBJECTIVE: To test the hypothesis that homoeopathy is a placebo by examining its effect in patients with allergic rhinitis and so contest the evidence from three previous trials in this series. Design: Randomised, double blind, placebo controlled, parallel group, multicentre study. SETTING: Four general practices and a hospital ear, nose, and throat outpatient department. PARTICIPANTS: 51 patients with perennial allergic rhinitis. Intervention: Random assignment to an oral 30c homoeopathic preparation of principal inhalant allergen or to placebo. MAIN OUTCOME MEASURES: Changes from baseline in nasal inspiratory peak flow and symptom visual analogue scale score over third and fourth weeks after randomisation. RESULTS: Fifty patients completed the study. The homoeopathy group had a significant objective improvement in nasal airflow compared with the placebo group (mean difference 19.8 l/min, 95% confidence interval 10.4 to 29.1, P=0.0001). Both groups reported improvement in symptoms, with patients taking homoeopathy reporting more improvement in all but one of the centres, which had more patients with aggravations. On average no significant difference between the groups was seen on visual analogue scale scores. Initial aggravations of rhinitis symptoms were more common with homoeopathy than placebo (7 (30%) v 2 (7%), P=0.04). Addition of these results to those of three previous trials (n=253) showed a mean symptom reduction on visual analogue scores of 28% (10.9 mm) for homoeopathy compared with 3% (1.1 mm) for placebo (95% confidence interval 4.2 to 15.4, P=0.0007). CONCLUSION: The objective results reinforce earlier evidence that homoeopathic dilutions differ from placebo

Sexual healthcare professionals’ views on HPV vaccination for men in the UK

Background: Human Papillomavirus (HPV) vaccination for men could prevent anal cancers amongst men who have sex with men (MSM). Methods: An e-survey of attitudes towards vaccination for men in the UK was conducted in July–August 2014. Results: Among 325 sexual health professionals, 14% were already vaccinating men against HPV, 83% recommended genderneutral HPV vaccination and 65% recommended targeting MSM. Over 50% reported having poor knowledge about the use of HPV vaccine for MSM and the skills to identify MSM likely to benefit from HPV vaccination. Conclusions: Clear advice and guidelines on HPV vaccine use for men at sexual health clinics are required to ensure equitable opportunities for vaccination

Longevity and mortality in Kennel Club registered dog breeds in the UK in 2014

Abstract Background The domestic dog is one of the most diverse mammalian species, exhibiting wide variations in morphology, behaviour and morbidity across breeds. Therefore, it is not unexpected that breeds should also exhibit variation in mortality and longevity. While shorter longevity per se may not necessarily be a welfare issue, a generally foreshortened lifespan in a breed that is accompanied by a high prevalence of a particular cause of death may reveal potentially serious welfare concerns and highlight scope to improve breed welfare. Survey data gathered directly from owners offer useful insights into canine longevity and mortality that can support the overall evidence base for welfare reforms within breeds. Results Mortality data on 5663 deceased dogs registered with the UK Kennel Club were collected from an owner-based survey. The most commonly reported causes of death were old age (13.8%), unspecified cancer (8.7%) and heart failure (4.9%); with 5.1% of deaths reported as unknown cause. Overall median age at death was 10.33 years (interquartile range: 7.17–12.83 years). Breeds varied widely in median longevity overall from the West Highland Terrier (12.71 years) to the Dobermann Pinscher (7.67 years). There was also wide variation in the prevalence of some common causes of death among breeds, and in median longevity across the causes of death. Conclusion Substantial variation in the median lifespan and the prominent causes of death exists across breeds. This study has identified some breeds with both a low median lifespan and also a high proportional mortality for one or more specific causes of death that should be considered as both potential welfare concerns as well as opportunities for improvement

Large-scale survey to estimate the prevalence of disorders for 192 Kennel Club registered breeds

Abstract Background Pedigree or purebred dogs are often stated to have high prevalence of disorders which are commonly assumed to be a consequence of inbreeding and selection for exaggerated features. However, few studies empirically report and rank the prevalence of disorders across breeds although such data are of critical importance in the prioritisation of multiple health concerns, and to provide a baseline against which to explore changes over time. This paper reports an owner survey that gathered disorder information on Kennel Club registered pedigree dogs, regardless of whether these disorders received veterinary care. This study aimed to determine the prevalence of disorders among pedigree dogs overall and, where possible, determine any variation among breeds. Results This study included morbidity data on 43,005 live dogs registered with the Kennel Club. Just under two thirds of live dogs had no reported diseases/conditions. The most prevalent diseases/conditions overall were lipoma (4.3%; 95% confidence interval 4.13-4.52%), skin (cutaneous) cyst (3.1%; 2.94-3.27%) and hypersensitivity (allergic) skin disorder (2.7%; 2.52-2.82%). For the most common disorders in the most represented breeds, 90 significant differences between the within breed prevalence and the overall prevalence are reported. Conclusion The results from this study have added vital epidemiological data on disorders in UK dogs. It is anticipated that these results will contribute to the forthcoming Breed Health & Conservation Plans, a Kennel Club initiative aiming to assist in the identification and prioritisation of breeding selection objectives for health and provide advice to breeders/owners regarding steps that may be taken to minimise the risk of the disease/disorders. Future breed-specific studies are recommended to report more precise prevalence estimates within more breeds

Men who have sex with men who do not access sexual health clinics nor disclose sexual orientation are unlikely to receive the HPV vaccine in the UK

Background: Men who have sex with men (MSM) are recommended the Human Papillomavirus (HPV) vaccination due to their higher risk of genital warts and anal cancer. Purpose: To examine HPV vaccine acceptability amongst MSM in the UK. Methods: Using advertisements via Facebook, MSM were recruited to an online survey measuring motivations for HPV vaccination. Logistic regression was performed to identify predictors of HPV vaccine acceptability. Results: Out of 1508 MSM (median age = 22, range: 14–63 years) only 19% had good knowledge of HPV. Overall, 55% of MSM were willing to ask for the HPV vaccine and 89% would accept it if offered by a healthcare professional (HCP). Access to sexual health clinics (SHCs) [OR = 1.82, 95% CI 1.29–2.89], the disclosure of sexual orientation to a HCP [OR = 2.02, CI 1.39–3.14] and HIV-positive status [OR = 1.96, CI 1.09–3.53] positively predicted HPV vaccine acceptability. After receiving information about HPV, perceptions of HPV risk [OR = 1.31, CI 1.05–1.63], HPV infection severity [OR = 1.89, CI 1.16–3.01), HPV vaccination benefits [OR = 1.61, CI 1.14–3.01], HPV vaccine effectiveness [OR = 1.54, CI 1.14–2.08], and the lack of perceived barriers to HPV vaccination [OR = 4.46, CI 2.95–6.73] were also associated with acceptability. Conclusions: Although nearly half of MSM would not actively pursue HPV vaccination, the vast majority would accept the vaccine if recommended by HCPs. In order to achieve optimal uptake, vaccine promotion campaigns should focus on MSM who do not access SHCs and those unwilling to disclose their sexual orientation

Plasma Physics

Contains research objectives and reports on three research projects.United States Atomic Energy Commission (Contract AT(30-1)-1842

Secure Proximity-Based Identity Pairing using an Untrusted Signalling Service

New protocols such as WebRTC promise seamless in-browser peer-to-peer communications that in theory remove the need for third-party services. In practice, widespread use of Firewalls, NATS and dynamic IP addresses mean that overlay addressing or use of some fixed rendezvous point is still needed. In this paper we describe a proximity-based pairing scheme that uses a signalling service to minimise the trust requirements on the third party, achieving anonymity and avoiding the need for PKI, while still requiring only a simple asymmetric pairing protocol

A Dilatometric Study of Graphite Electrodes during Cycling with X-ray Computed Tomography

Graphite is the most commonly used anode material in commercial lithium-ion batteries (LiBs). Understanding the mechanisms driving the dimensional changes of graphite can pave the way to methods for inhibiting degradation pathways and possibly predict electrochemical performance loss. In this study, correlative microscopy tools were used alongside electrochemical dilatometry (ECD) to provide new insights into the dimensional changes during galvanostatic cycling. X-ray computed tomography (CT) provided a morphological perspective of the cycled electrode so that the effects of dilation and contraction on effective diffusivity and electrode pore phase volume fraction could be examined. During the first cycle, the graphite electrode underwent thickness changes close to 9% after lithiation and, moreover, it did not return to its initial thickness after subsequent delithiation. The irreversible dilation increased over subsequent cycles. It is suggested the primary reason for this dilation is electrode delamination. This is supported by the finding that the electrode porosity remained mostly unchanged during cycling, as revealed by X-ray CT

Cut Vertices and Semi-Inclusive Deep Inelastic Processes

Cut vertices, a generalization of matrix elements of local operators, are revisited, and an expansion in terms of minimally subtracted cut vertices is formulated. An extension of the formalism to deal with semi-inclusive deep inelastic processes in the target fragmentation region is explicitly constructed. The problem of factorization is discussed in detail.Comment: LaTex2e, 24 pages including 17 postscript figure