Whitmore, J.M.

https://dh.howard.edu/prom_corres/1158/thumbnail.jp

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

AIMS: To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. DESIGN: Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. SETTING: Sixteen antenatal clinics in England. PARTICIPANTS: Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. INTERVENTION: All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). OUTCOME MEASUREMENTS: Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. FINDINGS: Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). CONCLUSIONS: There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care

‘Opt-out’ referrals after identifying pregnant smokers using exhaled air carbon monoxide: impact on engagement with smoking cessation support

Background. In the UK, free smoking cessation support is available to pregnant women; only a minority access this. ‘Opt-out’ referrals to stop smoking services (SSS) are recommended by UK guidelines. These involve identifying pregnant smokers using exhaled carbon monoxide (CO) and referring them for support unless they object. Methods. To assess impact of ‘opt-out’ referrals for pregnant smokers on SSS uptake and effectiveness, we conducted a ‘before-after’ service development evaluation. In a six-month ‘before’ period there was a routine ‘opt-in’ referral system for self-reported smokers at antenatal ‘booking’ appointments. In a six-month ‘after’ period, additional ‘opt-out’ referrals were introduced at 12 weeks ultrasound appointments; women with CO≥4ppm were referred to, and outcome data were collected from, local SSS. Results. Approximately 2300 women attended antenatal care in each period. Before the implementation 536 (23.4%) women reported smoking at ‘booking’ and 290 (12.7%) were referred to SSS. After the implementation 524 (22.9%) women reported smoking at ‘booking’, an additional 156 smokers (6.8%) were identified via the ‘opt-out’ referrals and, in total, 421 (18.4%) were referred to SSS. Over twice as many women set a quit date with the SSS after ‘opt-out’ referrals were implemented (121 (5.3%, 95%CI: 4.4%-6.3%) compared to 57 (2.5%, 95%CI: 1.9%-3.2%) before implementation) and reported being abstinent four weeks later (93 (4.1%, 95%CI: 3.3%-4.9%) compared to 46 (2.0%, 1.5%-2.7%) before implementation). Conclusions. In a hospital with an ‘opt-in’ referral system, adding CO screening with ‘opt-out’ referrals as women attended ultrasound examinations doubled numbers of pregnant smokers setting quit dates and reporting smoking cessation

Soil chemistry aspects of predicting future phosphorus requirements in Sub-Saharan Africa

Phosphorus (P) is a finite resource and critical to plant growth and therefore food security. Regional‐ and continental‐scale studies propose how much P would be required to feed the world by 2050. These indicate that sub‐Saharan Africa soils have the highest soil P deficit globally. However, the spatial heterogeneity of the P deficit caused by heterogeneous soil chemistry in the continental scale has never been addressed. We provide a combination of a broadly adopted P‐sorption model that is integrated into a highly influential, large‐scale soil phosphorus cycling model. As a result, we show significant differences between the model outputs in both the soil‐P concentrations and total P required to produce future crops for the same predicted scenarios. These results indicate the importance of soil chemistry for soil‐nutrient modelling and highlight that previous influential studies may have overestimated P required. This is particularly the case in Somalia where conventional modelling predicts twice as much P required to 2050 as our new proposed model. Plain language summary Improving food security in Sub‐Saharan Africa over the coming decades requires a dramatic increase in agricultural yields. Global yield increase has been driven by, amongst other factors, the widespread use of fertilisers including phosphorus. The use of fertilisers in Sub‐Saharan Africa is often prohibitively expensive and thus the most efficient use of phosphorus should be targeted. Soil chemistry largely controls phosphorus efficiency in agriculture, for example iron and aluminium which exist naturally in soil reduce the availability of phosphate to plants. Yet soil chemistry has not been included in several influential large‐scale modelling studies which estimate phosphorus requirements in Sub‐Saharan Africa to 2050. In this study we show that predictions of phosphorus requirement to feed the population of Sub‐Saharan Africa to 2050 can significantly change if soil chemistry is included (e.g. Somalia with up to 50% difference). Our findings are a new step towards making predictive decision‐making tool for phosphorus fertiliser management in Sub‐Saharan Africa considering the variability of soil chemistry

Evaluation of Candidate Stromal Epithelial Cross-Talk Genes Identifies Association between Risk of Serous Ovarian Cancer and TERT, a Cancer Susceptibility “Hot-Spot”

We hypothesized that variants in genes expressed as a consequence of interactions between ovarian cancer cells and the host micro-environment could contribute to cancer susceptibility. We therefore used a two-stage approach to evaluate common single nucleotide polymorphisms (SNPs) in 173 genes involved in stromal epithelial interactions in the Ovarian Cancer Association Consortium (OCAC). In the discovery stage, cases with epithelial ovarian cancer (n = 675) and controls (n = 1,162) were genotyped at 1,536 SNPs using an Illumina GoldenGate assay. Based on Positive Predictive Value estimates, three SNPs—PODXL rs1013368, ITGA6 rs13027811, and MMP3 rs522616—were selected for replication using TaqMan genotyping in up to 3,059 serous invasive cases and 8,905 controls from 16 OCAC case-control studies. An additional 18 SNPs with Pper-allele<0.05 in the discovery stage were selected for replication in a subset of five OCAC studies (n = 1,233 serous invasive cases; n = 3,364 controls). The discovery stage associations in PODXL, ITGA6, and MMP3 were attenuated in the larger replication set (adj. Pper-allele≥0.5). However genotypes at TERT rs7726159 were associated with ovarian cancer risk in the smaller, five-study replication study (Pper-allele = 0.03). Combined analysis of the discovery and replication sets for this TERT SNP showed an increased risk of serous ovarian cancer among non-Hispanic whites [adj. ORper-allele 1.14 (1.04–1.24) p = 0.003]. Our study adds to the growing evidence that, like the 8q24 locus, the telomerase reverse transcriptase locus at 5p15.33, is a general cancer susceptibility locus

Habitat Preferences of Butterflies in the Bumbuna Forest, Northern Sierra Leone

The habitat preferences of the butterfly fauna were studied in the Bumbuna Forest Reserve in northern Sierra Leone. The intact forest reserve and a secondary forest regrowth, disturbed as a result of slash-and-burn agriculture, were compared to savanna habitats. Of the 290 specimens collected, 195 butterfly species were included, of which significant proportion were Nymphalidae. Of the 147 forest species, 111 (75.5%) showed preferences for the forest habitats, while 70 (47.6%) and 34 (23.1%) preferred disturbed and savannah habitats, respectively. Numerically, a comparable proportion of savannah species were recorded in the 18 disturbed (73.9%) and 16 savannah habitats (63.2%). Accumulated species richness and diversity indices were lower in the disturbed habitats compared to the forest reserve, but lowest in the savanna habitats. However, a large proportion of forest species, especially those with either a more restricted geographic range or species for which no information on geographic distribution was available, were exclusively captured in the forest patches. The survey indicated the presence of a rich butterfly fauna, which should be systematically collected for further research and study in order to build a good taxonomic database for Sierra Leone