Slimming World in Stop Smoking Services (SWISSS): Study protocol for a randomized controlled trial

BACKGROUND: Quitting smokers gain weight. This deters some from trying to stop smoking and may explain the increased incidence of type 2 diabetes after cessation. Dieting when stopping smoking may be counterproductive. Hunger increases cravings for smoking and tackling two behaviours together may undermine quitting success. A meta-analysis of randomized controlled trials (RCTs) showed individualized dietary support may prevent weight gain, although there is insufficient evidence whether it undermines smoking cessation. Commercial weight management providers (CWMPs), such as Slimming World, provide individualized dietary support for National Health Service (NHS) patients; however, there is no evidence that they can prevent cessation-related weight gain.Our objective is to determine whether attending Slimming World from quit date, through referral from NHS Stop Smoking Services, is more effective than usual care at preventing cessation-related weight gain. METHODS: This RCT will examine the effectiveness of usual cessation support plus referral to Slimming World compared to usual cessation support alone. Healthy weight, overweight and obese adult smokers attending Stop Smoking Services will be included. The primary outcome is weight change in quitters 12 weeks post-randomization. Multivariable linear regression analysis will compare weight change between trial arms and adjust for known predictors of cessation-related weight gain.We will recruit 320 participants, with 160 participants in each arm. An alpha error rate of 5% and 90% power will detect a 2 kg (SD = 2.5) difference in weight gain at 12 weeks, assuming 20% remain abstinent by then. DISCUSSION: This trial will establish whether referral to the 12-week Slimming World programme plus usual care is an effective intervention to prevent cessation-related weight gain. If so, we will seek to establish whether weight control comes at the expense of a successful quit attempt in a further non-inferiority trial.Positive results from both these trials would provide a potential solution to cessation-related weight gain, which could be rolled out across England within Stop Smoking Services to better meet the needs of 0.75 million smokers stopping with NHS support every year. TRIAL REGISTRATION: Current Controlled Trials ISRCTN65705512

Mobile underwater sensor networks for protection and security: field experience at the UAN11 experiment

The EU-funded project UAN (Underwater Acoustic Network) was aimed at conceiving, developing, and testing at sea an innovative and operational concept for integrating underwater and above-water sensors in a unique communication system to protect offshore and coastline critical infrastructures. This work gives details on the underwater part of the project. It introduces a set of original security features and gives details on the integration of autonomous underwater vehicles (AUVs) as mobile nodes of the network and as surveillance assets, acoustically controlled by the command and control center to respond against intrusions. Field results are given of the final UAN project sea trial, UAN11, held in May 2011 in Norway. During the experimental activities, a UAN composed of four fixed nodes, two AUVs, and one mobile node mounted on the supporting research vessel was operated continuously and integrated into a global protection system. In this article, the communication performance of the network is reported in terms of round-trip time, packet loss, and average delivery ratio. The major results of the experiment can be thus summarized: the implemented network structure was successful in continuously operating over five days with nodes seamlessly entering and exiting the network; the performance of the network varied greatly with fluctuations in the acoustic channel; the addition of security features induced a minor degradation in network performance with respect to channel variation; the AUVs were successfully controlled from a remote station through acoustic signals routed by the network

Web User-session Inference by Means of Clustering Techniques

This paper focuses on the definition and identification of “Web user-sessions”, aggregations of several TCP connections generated by the same source host. The identification of a user-session is non trivial. Traditional approaches rely on threshold based mechanisms. However, these techniques are very sensitive to the value chosen for the threshold, which may be difficult to set correctly. By applying clustering techniques, we define a novel methodology to identify Web user-sessions without requiring an a priori definition of threshold values. We define a clustering based approach, we discuss pros and cons of this approach, and we apply it to real traffic traces. The proposed methodology is applied to artificially generated traces to evaluate its benefits against traditional threshold based approaches. We also analyze the characteristics of user-sessions extracted by the clustering methodology from real traces and study their statistical properties. Web user-sessions tend to be Poisson, but correlation may arise during periods of network/hosts anomalous behavior

The effects of gamelike features and test location on cognitive test performance and participant enjoyment

ArticleComputerised cognitive assessments are a vital tool in the behavioural sciences, but participants often view them as effortful and unengaging. One potential solution is to add gamelike elements to these tasks in order to make them more intrinsically enjoyable, and some researchers have posited that a more engaging task might produce higher quality data. This assumption, however, remains largely untested. We investigated the effects of gamelike features and test location on the data and enjoyment ratings from a simple cognitive task. We tested three gamified variants of the Go-No-Go task, delivered both in the laboratory and online. In the first version of the task participants were rewarded with points for performing optimally. The second version of the task was framed as a cowboy shootout. The third version was a standard Go-No-Go task, used as a control condition. We compared reaction time, accuracy and subjective measures of enjoyment and engagement between task variants and study location. We found points to be a highly suitable game mechanic for gamified cognitive testing because they did not disrupt the validity of the data collected but increased participant enjoyment. However, we found no evidence that gamelike features could increase engagement to the point where participant performance improved. We also found that while participants enjoyed the cowboy themed task, the difficulty of categorising the gamelike stimuli adversely affected participant performance, increasing No-Go error rates by 28% compared to the non-game control. Responses collected online vs. in the laboratory had slightly longer reaction times but were otherwise very similar, supporting other findings that online crowdsourcing is an acceptable method of data collection for this type of research.The authors are members of the United Kingdom Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excellence which receives funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration. This work was supported by the Medical Research Council (MC_UU_12013/6) and a PhD studentship to JL funded by the Economic and Social Research Council and Cambridge Cognition Limited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Systematic review and meta-analysis of serotonin transporter genotype and discontinuation from antidepressant treatment

AbstractThere is evidence that 5-HTTLPR is associated with response following treatment from selective serotonin reuptake inhibitors (SSRIs). The short (S) allele has reduced serotonin transporter expression, compared to the long (L) allele, and has been reported to be associated with poorer response in Europeans, with the effect in other populations unclear. However the published literature is inconsistent. A systematic review and meta-analysis was performed to investigate the effect of 5-HTTLPR on discontinuation from antidepressant treatment. Data were obtained from 17 studies including 4309 participants. The principal outcome measure was the allelic odds ratio (OR) for the 5-HTTLPR S allele and discontinuation status. A random effects meta-analysis provided no evidence that the S allele was associated with increased odds of discontinuation from SSRIs in Europeans (OR 1.09, 95% CI 0.83–1.42, p=0.53; 10 studies, n=2504) but in East Asians there was evidence of a reduced odds of discontinuation (OR 0.28, 95% CI 0.12–0.64, p=0.002; 2 studies, n=136). There was a suggestion of small study bias (p=0.05). This meta-analysis provides no evidence of an association between 5-HTTLPR and discontinuation from antidepressant treatment in Europeans. The low number of studies in East Asian samples using SSRIs reduces confidence in our evidence that the S allele decreases the odds of discontinuation in this population. At present, there is no evidence of an association between 5-HTTLPR and discontinuation from SSRI treatment in a European population with further studies required to investigate its effects in different populations

Effects of emotion recognition training on mood among individuals with high levels of depressive symptoms: study protocol for a randomised controlled trial.

BACKGROUND: We have developed a new paradigm that targets the recognition of facial expression of emotions. Here we report the protocol of a randomised controlled trial of the effects of emotion recognition training on mood in a sample of individuals with depressive symptoms over a 6-week follow-up period. METHODS/DESIGN: We will recruit 190 adults from the general population who report high levels of depressive symptoms (defined as a score ≥ 14 on the Beck Depression Inventory-II). Participants will attend a screening session and will be randomised to intervention or control procedures, repeated five times over consecutive days (Monday to Friday). A follow-up session will take place at end-of -treatment, 2-weeks and 6-weeks after training. Our primary study outcome will be depressive symptoms, Beck Depression Inventory- II (rated over the past two weeks). Our secondary outcomes are: depressive symptoms, Hamilton Rating Scale for Depression; anxiety symptoms, Beck Anxiety Inventory (rated over the past month); positive affect, Positive and Negative Affect Schedule (rated as 'how you feel right now'); negative affect, Positive and Negative Affect Schedule (rated as 'how you feel right now'); emotion sensitivity, Emotion Recognition Task (test phase); approach motivation and persistence, the Fishing Game; and depressive interpretation bias, Scrambled Sentences Test. DISCUSSION: This study is of a novel cognitive bias modification technique that targets biases in emotional processing characteristic of depression, and can be delivered automatically via computer, Internet or Smartphone. It therefore has potential to be a valuable cost-effective adjunctive treatment for depression which may be used together with more traditional psychotherapy, cognitive-behavioural therapy and pharmacotherapy. TRIAL REGISTRATION: Current Controlled Trials: ISRCTN17767674.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

The 2012 Ferrara seismic sequence: Regional crustal structure, earthquake sources, and seismic hazard

Inadequate seismic design codes can be dangerous, particularly when they underestimate the true hazard. In this study we use data from a sequence of moderate-sized earthquakes in northeast Italy to validate and test a regional wave propagation model which, in turn, is used to under- stand some weaknesses of the current design spectra. Our velocity model, while regionalized and somewhat ad hoc, is consistent with geophysical observations and the local geology. In the 0.02–0.1 Hz band, this model is validated by using it to calculate moment tensor solutions of 20 earth- quakes (5.6 MW 3.2) in the 2012 Ferrara, Italy, seismic sequence. The seismic spectra observed for the relatively small main shock significantly exceeded the design spectra to be used in the area for critical structures. Observations and synthetics reveal that the ground motions are dominated by long-duration surface waves, which, apparently, the design codes do not adequately anticipate. In light of our results, the present seismic hazard assessment in the entire Pianura Padana, including the city of Milan, needs to be re-evaluated. Citation: Malagnini, L., R. B. Herrmann, I. Munafò, M. Buttinelli, M. Anselmi, A. Akinci, and E. Boschi (2012), The 2012 Ferrara seismic sequence: Regional crustal structure, earthquake sources, and seismic hazard, Geophys. Res. Lett., 39, L19302, doi:10.1029/ 2012GL053214

Evaluating the role of a galanin enhancer genotype on a range of metabolic, depressive and addictive phenotypes

Funded by •ERC. Grant Number: 284167 •NIH. Grant Number: 1RO1DK0921127-01 •NWO. Grant Numbers: 463-06-001, 451-04-034Peer reviewedPublisher PD

Statistical power in clinical trials of interventions for mood, anxiety, and psychotic disorders

BACKGROUND: Previous research has suggested that statistical power is suboptimal in many biomedical disciplines, but it is unclear whether power is better in trials for particular interventions, disorders, or outcome types. We therefore performed a detailed examination of power in trials of psychotherapy, pharmacotherapy, and complementary and alternative medicine (CAM) for mood, anxiety, and psychotic disorders.METHODS: We extracted data from the Cochrane Database of Systematic Reviews (Mental Health). We focused on continuous efficacy outcomes and estimated power to detect predetermined effect sizes (standardized mean difference [SMD] = 0.20-0.80, primary SMD = 0.40) and meta-analytic effect sizes (ESMA). We performed meta-regression to estimate the influence of including underpowered studies in meta-analyses.RESULTS: We included 256 reviews with 10 686 meta-analyses and 47 384 studies. Statistical power for continuous efficacy outcomes was very low across intervention and disorder types (overall median [IQR] power for SMD = 0.40: 0.32 [0.19-0.54]; for ESMA: 0.23 [0.09-0.58]), only reaching conventionally acceptable levels (80%) for SMD = 0.80. Median power to detect the ESMA was higher in treatment-as-usual (TAU)/waitlist-controlled (0.49-0.63) or placebo-controlled (0.12-0.38) trials than in trials comparing active treatments (0.07-0.13). Adequately-powered studies produced smaller effect sizes than underpowered studies (B = -0.06, p ⩽ 0.001).CONCLUSIONS: Power to detect both predetermined and meta-analytic effect sizes in psychiatric trials was low across all interventions and disorders examined. Consistent with the presence of reporting bias, underpowered studies produced larger effect sizes than adequately-powered studies. These results emphasize the need to increase sample sizes and to reduce reporting bias against studies reporting null results to improve the reliability of the published literature.</p