Is the E-Liquid Industry Regulating Itself? A Look at E-Liquid Internet Vendors in the United States

INTRODUCTION: The objective of this study was to assess whether the nascent, but rapidly growing e-liquid industry prohibits Internet sales to minors and employs safety measures to prevent accidental poisonings. METHODS: A stratified simple random sample (n = 120) was selected from the target population (N = 1107) of US online vendors of e-liquid in July 2015. The vendors were stratified and subsequently oversampled by trade association membership and vendor popularity. Three minors aged 16 to 17, who were supervised by adult research staff, attempted to purchase e-liquid from the 120 online vendors using debit cards issued in their names. Measures included vendors' use of age verification, warning labels on e-liquid bottles, and child-resistant packaging. RESULTS: Statistically significant differences were observed by vendor popularity, but not by membership in a trade association. The differences by vendor popularity, however, occurred for measures that were limited to an age warning and list of ingredients. The most striking finding was the scant vendors (n = 4) who successfully prevented the sale of e-liquid to the minors. In contrast, 87.5% and 53.9% of the bottles contained child-resistant packaging and a health warning label, respectively. CONCLUSIONS: Irrespective of trade association membership or vendor popularity, online vendors of e-liquids are not taking the proper precautions in preventing sales to minors. The FDA's upcoming deeming rules on e-cigarette products should include explicit requirements for offline and online e-liquid vendors, particularly the use of effective age verification, warning labels, and child-resistant packaging. IMPLICATIONS: This study demonstrates that, in the absence of any current FDA regulation of e-liquid products, self-regulation among vendors is not effective in preventing product acquisition by minors. Lax oversight of the e-liquid industry may draw consumers to bypass current tobacco control restrictions implemented in face-to-face sales settings. As a consequence, there may be an increase in online sales to minors. Further regulation of the industry may increase the already prevalent use of child-resistant packaging, leading to fewer cases of accidental nicotine poisoning

VapeCons: E-cigarette user conventions

E-cigarette ‘vaping conventions’ provide a venue for user social networking, parties, and ‘try before you buy’ access to a wide range of e-cigarette products. This study identifies and describes vaping conventions, raising awareness of this potentially problematic practice

Internet cigarette vendors make tax-free claims and sell cigarettes cheaper than retail outlets: Table 1

This paper aims to (1) assess whether promotion of tax-free sales among Internet cigarette vendors (ICVs) changed between 2009 and 2011, (2) determine which types of ICVs are most likely to promote tax-free sales (e.g., US-based, international, or mixed location ICVs), and (3) compare the price of cigarettes advertised in ICVs to prices at brick-and-mortar retail outlets

Near-infrared electroluminescence beyond 940 nm in Pt(N^C^N)X complexes: influencing aggregation with the ancillary ligand X

We present a study of aggregate excited states formed by complexes of the type Pt(N^C^N)X, where N^C^N represents a tridentate cyclometallating ligand, and X = SCN or I. These materials display near-infrared (NIR) photoluminescence in film and electroluminescence in NIR OLEDs with λmaxEL = 720–944 nm. We demonstrate that the use of X = SCN or I modulates aggregate formation compared to the parent complexes where X = Cl. While the identity of the monodentate ligand affects the energy of Pt–Pt excimers in solution in only a subtle way, it strongly influences aggregation in film. Detailed calculations on aggregates of different sizes support the experimental conclusions from steady-state and time-resolved luminescence studies at variable temperatures. The use of X = I appears to limit aggregation to the formation of dimers, while X = SCN promotes the formation of larger aggregates, such as tetramers and pentamers, leading in turn to NIR photo- and electroluminescence > 850 nm. A possible explanation for the contrasting influence of the monodentate ligands is the lesser steric hindrance associated with the SCN group compared to the bulkier I ligand. By exploiting the propensity of the SCN complexes to form extended aggregates, we have prepared an NIR-emitting OLED that shows very long wavelength electroluminescence, with λmaxEL = 944 nm and a maximum EQE = 0.3 ± 0.1%. Such data appear to be unprecedented for a device relying on a Pt(II) complex aggregate as the emitter

Mutation of the co-chaperone Tsc1 in bladder cancer diminishes Hsp90 acetylation and reduces drug sensitivity and selectivity

The molecular chaperone Heat shock protein 90 (Hsp90) is essential for the folding, stability, and activity of several drivers of oncogenesis. Hsp90 inhibitors are currently under clinical evaluation for cancer treatment, however their efficacy is limited by lack of biomarkers to optimize patient selection. We have recently identified the tumor suppressor tuberous sclerosis complex 1 (Tsc1) as a new co-chaperone of Hsp90 that affects Hsp90 binding to its inhibitors. Highly variable mutations of TSC1 have been previously identified in bladder cancer and correlate with sensitivity to the Hsp90 inhibitors. Here we showed loss of TSC1 leads to hypoacetylation of Hsp90-K407/K419 and subsequent decreased binding to the Hsp90 inhibitor ganetespib. Pharmacologic inhibition of histone deacetylases (HDACs) restores acetylation of Hsp90 and sensitizes Tsc1-mutant bladder cancer cells to ganetespib, resulting in apoptosis. Our findings suggest that TSC1 status may predict response to Hsp90 inhibitors in patients with bladder cancer, and co-targeting HDACs can sensitize tumors with Tsc1 mutations to Hsp90 inhibitors

What defines mindfulness-based programs?:The warp and the weft

There has been an explosion of interest in mindfulness-based programs (MBPs) such as Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy. This is demonstrated in increased research, implementation of MBPs in healthcare, educational, criminal justice and workplace settings, and in mainstream interest. For the sustainable development of the field there is a need to articulate a definition of what an MBP is and what it is not. This paper provides a framework to define the essential characteristics of the family of MBPs originating from the parent program MBSR, and the processes which inform adaptations of MBPs for different populations or contexts. The framework addresses the essential characteristics of the program and of teacher. MBPs: are informed by theories and practices that draw from a confluence of contemplative traditions, science, and the major disciplines of medicine, psychology and education; underpinned by a model of human experience which addresses the causes of human distress and the pathways to relieving it; develop a new relationship with experience characterized by present moment focus, decentering and an approach orientation; catalyze the development of qualities such as joy, compassion, wisdom, equanimity and greater attentional, emotional and behavioral self-regulation, and engage participants in a sustained intensive training in mindfulness meditation practice, in an experiential inquiry-based learning process and in exercises to develop understanding. The paper's aim is to support clarity, which will in turn support the systematic development of MBP research, and the integrity of the field during the process of implementation in the mainstream

Platinum(II) Complexes of Nonsymmetrical NCN-Coordinating Ligands: Unimolecular and Excimeric Luminescence Properties and Comparison with Symmetrical Analogues

A series of seven new platinum(II) complexes PtLnCl have been prepared, where Ln is an NCN-coordinating ligand comprising a benzene ring 1,3-disubstituted with two different azaheterocycles. In PtL1–5Cl, one heterocycle is a simple pyridine ring, while the other is an isoquinoline, a quinoline, a pyrimidine (L1, L2, L3), or a p-CF3- or p-OMe-substituted pyridine (L4 and L5). PtL6Cl incorporates both a p-CF3 and a p-OMe-substituted pyridine. The synthesis of the requisite proligands HLn is achieved using Pd-catalyzed cross-coupling methodology. The molecular structures of six of the Pt(II) complexes have been determined by X-ray diffraction. All the complexes are brightly luminescent in deoxygenated solution at room temperature. The absorption and emission properties are compared with those of the corresponding symmetrical complexes featuring two identical heterocycles, PtLnsymCl, and of the parent Pt(dpyb)Cl containing two unsubstituted pyridines [dpybH = 1,3-di(2-pyridyl)benzene]. While the absorption spectra of the nonsymmetrical complexes show features of both PtLnsymCl and Pt(dpyb)Cl, the emission generally resembles that of whichever of the corresponding symmetrical complexes has the lower-energy emission. PtL1Cl differs in that─at room temperature but not at 77 K─it displays emission bands that can be attributed to excited states involving both the pyridine and the isoquinoline rings, despite the latter being unequivocally lower in energy. This unusual behavior is attributed to thermally activated repopulation of the former excited state from the latter, facilitated by the very long-lived nature of the isoquinoline-based excited state. At elevated concentrations, all the complexes show an additional red-shifted emission band attributable to excimers. For PtL1Cl, the excimer strikingly dominates the emission spectra at all but the lowest concentrations (<10–5 M). Trends in the energies of the excimers and their propensity to form are compared with those of the symmetrical analogues

Electronic Cigarette Sales to Minors via the Internet

Electronic cigarettes (e-cigarettes) entered the US market in 2007 and, with little regulatory oversight, grew into a $2-billion-a-year industry by 2013. The Centers for Disease Control and Prevention has reported a trend of increasing e-cigarette use among teens, with use rates doubling from 2011 to 2012. While several studies have documented that teens can and do buy cigarettes online, to our knowledge, no studies have yet examined age verification among Internet tobacco vendors selling e-cigarettes

Revisiting the Rise of Electronic Nicotine Delivery Systems Using Search Query Surveillance

Public perceptions of electronic nicotine delivery systems (ENDS) remain poorly understood because surveys are too costly to regularly implement and when implemented there are large delays between data collection and dissemination. Search query surveillance has bridged some of these gaps. Herein, ENDS’ popularity in the U.S. is reassessed using Google searches

Interactive Voice Response-An Innovative Approach to Post-Stroke Depression Self-Management Support

Automated interactive voice response (IVR) call systems can provide systematic monitoring and self-management support to depressed patients, but it is unknown if stroke patients are able and willing to engage in IVR interactions. We sought to assess the feasibility and acceptability of IVR as an adjunct to post-stroke depression follow-up care. The CarePartner program is a mobile health program designed to optimize depression self-management, facilitate social support from a caregiver, and strengthen connections between stroke survivors and primary care providers (PCPs). Ischemic stroke patients and an informal caregiver, if available, were recruited during the patient's acute stroke hospitalization or follow-up appointment. The CarePartner program was activated in patients with depressive symptoms during their stroke hospitalization or follow-up. The 3-month intervention consisted of weekly IVR calls monitoring both depressive symptoms and medication adherence along with tailored suggestions for depressive symptom self-management. After each completed IVR call, informal caregivers were automatically updated, and, if needed, the subject's PCP was notified. Of the 56 stroke patients who enrolled, depressive symptoms were identified in 13 (23 %) subjects. Subjects completed 74 % of the weekly IVR assessments. A total of six subjects did not complete the outcome assessment, including two non-study-related deaths. PCPs were notified five times, including two times for suicidal ideation and three times for medication non-adherence. Stroke patients with depressive symptoms were able to engage in an IVR call system. Future studies are needed to explore the efficacy of an IVR approach for post-stroke self-management and monitoring of stroke-related outcomes