What is the most effective nicotine replacement therapy?

No single nicotine replacement therapy is most effective for all smokers. All forms of nicotine replacement therapy (gum, transdermal patch, spray, inhaler, and lozenge) are equally effective, increasing smoking cessation rates by about 150% to 200%. A Cochrane Review found that 17% of smokers who had used nicotine replacement therapy successfully quit at follow-up vs 10% of smokers in the control group. Except in special circumstances (medical contraindications, smoking 21 mg) may benefit heavy smokers or those relapsing due to nicotine withdrawal (SOR: B). For relapsed smokers, combination therapy improves long-term abstinence rates (estimated abstinence 28.6% vs 17.4% for monotherapy) (SOR: B)

Antidepressants for the Treatment of Insomnia in Patients with Depression

There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep physiology, but does not seem to improve subjective ratings of sleep quality. (Strength of Recommendation: B, based on one qualitative study and one meta-analysis.

Contact Relationships of the Late Paleozoic Narragansett Pier Granite and Country Rock

Guidebook to geologic field studies in Rhode Island and adjacent areas: The 73rd annual meeting of the New England Intercollegiate Geological Conference, October 16-18, 1981: Trip B-

Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity

Pediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants' (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated

Psychosocial Interventions Delivered by Primary Care Physicians to Patients with Depression

Few high-quality studies have been conducted examining the effectiveness of psychosocial interventions performed by primary care physicians for patients with major depression. Two randomized controlled clinical trials (RCTs) found that a psychosocial intervention, specifically problem-solving therapy, is as effective as pharmacotherapy for symptoms of major depression. (Strength of recommendation: B) However, these results should be interpreted with some degree of caution because of the limited number of studies and their small sample size

How much does smoking cessation cut CHD risk?

Patients with coronary heart disease (CHD) who refrain from smoking over a 2-year follow-up period decrease their relative risk (RR) for morbidity and mortality by about one third (strength of recommendation [SOR]: A, meta-analysis of 20 cohort studies). People who maintain abstinence after coronary artery bypass surgery are more likely to avoid angina, repeat revascularization, significant physical impairment, and CHD-related hospital admissions than patients who continue to smoke (SOR: A, 4 cohort studies with 1- to 20-year follow-up)

The Radial Structure of SNR N103B

We report on the results from a Chandra ACIS observation of the young, compact, supernova remnant N103B. The unprecedented spatial resolution of Chandra reveals sub-arcsecond structure, both in the brightness and in spectral variations. Underlying these small-scale variations is a surprisingly simple radial structure in the equivalent widths of the strong Si and S emission lines. We investigate these radial variations through spatially resolved spectroscopy using a plane-parallel, non-equilibrium ionization model with multiple components. The majority of the emission arises from components with a temperature of 1 keV: a fully ionized hydrogen component; a high ionization timescale (n_e*t > 10^12 s cm^-3) component containing Si, S, Ar, Ca, and Fe; and a low ionization timescale (n_e*t ~ 10^{11} s cm^-3) O, Ne, and Mg component. To reproduce the strong Fe Kalpha line, it is necessary to include additional Fe in a hot (> 2 keV), low ionization (n_e*t ~ 10^10.8 s cm^-3) component. This hot Fe may be in the form of hot Fe bubbles, formed in the radioactive decay of clumps of 56Ni. We find no radial variation in the ionization timescales or temperatures of the various components. Rather, the Si and S equivalent widths increase at large radii because these lines, as well as those of Ar and Ca, are formed in a shell occupying the outer half of the remnant. A shell of hot Fe is located interior to this, but there is a large region of overlap between these two shells. In the inner 30% of the remnant, there is a core of cooler, 1 keV Fe. We find that the distribution of the ejecta and the yields of the intermediate mass species are consistent with model prediction for Type Ia events.Comment: 34 pages, including 7 tables and 7 figures, Accepted by Ap

New Evidence for Efficient Collisionless Heating of Electrons at the Reverse Shock of a Young Supernova Remnant

Although collisionless shocks are ubiquitous in astrophysics, certain key aspects of them are not well understood. In particular, the process known as collisionless electron heating, whereby electrons are rapidly energized at the shock front, is one of the main open issues in shock physics. Here we present the first clear evidence for efficient collisionless electron heating at the reverse shock of Tycho's supernova remnant (SNR), revealed by Fe-K diagnostics using high-quality X-ray data obtained by the Suzaku satellite. We detect K-beta (3p->1s) fluorescence emission from low-ionization Fe ejecta excited by energetic thermal electrons at the reverse shock front, which peaks at a smaller radius than Fe K-alpha (2p->1s) emission dominated by a relatively highly-ionized component. Comparison with our hydrodynamical simulations implies instantaneous electron heating to a temperature 1000 times higher than expected from Coulomb collisions alone. The unique environment of the reverse shock, which is propagating with a high Mach number into rarefied ejecta with a low magnetic field strength, puts strong constraints on the physical mechanism responsible for this heating, and favors a cross-shock potential created by charge deflection at the shock front. Our sensitive observation also reveals that the reverse shock radius of this SNR is about 10% smaller than the previous measurement using the Fe K-alpha morphology from the Chandra observations. Since strong Fe K-beta fluorescence is expected only from low-ionization plasma where Fe ions still have many 3p electrons, this feature is key to diagnosing the plasma state and distribution of the immediate postshock ejecta in a young SNR.Comment: 7 pages, 9 figures, resubmitted to ApJ with minor changes following the referee repor