Spirometry as a motivational tool to improve smoking cessation rates: a systematic review of the literature.

Obtaining spirometric testing and providing those results to individuals who smoke has been advocated as a motivational tool to improve smoking cessation. However, its effectiveness is not known. We conducted a systematic review to determine if this approach improves rates of smoking cessation. Data sources included MEDLINE (1966 to October 2005), the Cochrane Library, and experts in the field. Eligible randomized controlled trials (RCTs) enrolled at least 25 smokers per arm, evaluated spirometry with associated counseling or in combination with other treatments, followed subjects at least 6 months, and provided smoking abstinence rates. Results from nonrandomized studies also were summarized. The primary outcome was patient-reported long-term (at least 6 months) sustained abstinence with biological validation. Additional outcomes included self-reported abstinence and point-prevalence abstinence. Seven RCTs (N = 6,052 subjects) met eligibility criteria. Follow-up duration ranged from 9 to 36 months. In six trials, the intervention group received concomitant treatments previously demonstrated to increase cessation independently. The range of abstinence was 3%-14% for control subjects and 7%-39% among intervention groups, statistically significantly in favor of intervention in four studies. The only RCT that assessed the independent contribution of spirometry in combination with counseling demonstrated a nonsignificant 1% improvement in patient-reported point-prevalence abstinence at 12 months in the group that received spirometry plus counseling versus counseling alone (6.5% versus 5.5%). Findings from observational studies were mixed, and the lack of controls makes interpretation problematic. Available evidence is insufficient to determine whether obtaining spirometric values and providing that information to patients improves smoking cessation compared with other smoking cessation methods. Spirometric values are of limited benefit as a predictor of smoking cessation or as a tool to "customize" smoking cessation strategies.     

Choosing a multivariate model: Noncentrality and goodness of fit.

Anumber of goodness-of-fit indices for the evaluation of multivariate structural models are expressed as functions of the noncentrality parameter in order to elucidate their mathematical properties and, in particular, to explain previous numerical findings. Most of the indices considered are shown to vary systematically with sample size. It is suggested that H. Akaike's (1974; see record 1989-17660-001) information criterion cannot be used for model selection in real applications and that there are problems attending the definition of parsimonious fit indices. A normed function of the noncentrality parameter is recommended as an unbiased absolute goodness-of-fit index, and the Tucker–Lewis (see record 1973-30255-001) index and a new unbiased counterpart of the Bentler–Bonett (see record 1981-06898-001) index are recommended for those investigators who might wish to evaluate fit relative to a null model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nanostructured, molecularly imprinted, and template-patterned polythiophenes for chiral sensing and differentiation

An innovation to thin-film molecular imprinting is presented for the sensitive detection and effective discrimination of chiral compounds using a portable quartz crystal microbalance transduction technique. The facile approach involves i) colloidal sphere layering of latex particles onto the surface via a Langmuir-Blodgett-like technique followed by ii) template molecular imprinting using electrodeposition of a single functional and cross-linking monomer.     

Similarity considerations in the physical modelling of steel making tundish systems

To assess and quantify the relative importance of Reynolds and Froude numbers in reduced scale model studies (these cannot be simultaneously respected when the scale factor is less than unity), aqueous model investigations were carried out on three different laboratory scale tundish models. The experimental tundish systems included two strand, five strand skewed delta shaped and six strand rectangular shaped vessels. Experimental observations show that the depth of liquid in the model would only correspond to that in the full scale system, provided the model flow rate is scaled in accordance with the relationship: Q_m = λ^5/2 Q_f.S, in which, A is the geometrical scaling factor. Furthermore, on the basis of residence time distribution measurements in two different configurations of the five strand tundish, it was demonstrated explicitly that flow phenomena in tundish systems are largely dominated by inertial forces and are therefore, essentially Froude dominated.     

Activation and cell cycle antigens in CD4+ and CD8+ T cells correlate with plasma human immunodeficiency virus (HIV-1) RNA level in HIV-1 infection

gamma-Sarcoglycan is a transmembrane, dystrophin-associated protein expressed in skeletal and cardiac muscle. The murine gamma-sarcoglycan gene was disrupted using homologous recombination. Mice lacking gamma-sarcoglycan showed pronounced dystrophic muscle changes in early life. By 20 wk of age, these mice developed cardiomyopathy and died prematurely. The loss of gamma-sarcoglycan produced secondary reduction of beta- and delta-sarcoglycan with partial retention of alpha- and epsilon-sarcoglycan, suggesting that beta-, gamma-, and delta-sarcoglycan function as a unit. Importantly, mice lacking gamma-sarco- glycan showed normal dystrophin content and local- ization, demonstrating that myofiber degeneration occurred independently of dystrophin alteration. Furthermore, beta-dystroglycan and laminin were left intact, implying that the dystrophin-dystroglycan-laminin mechanical link was unaffected by sarcoglycan deficiency. Apoptotic myonuclei were abundant in skeletal muscle lacking gamma-sarcoglycan, suggesting that programmed cell death contributes to myofiber degeneration. Vital staining with Evans blue dye revealed that muscle lacking gamma-sarcoglycan developed membrane disruptions like those seen in dystrophin-deficient muscle. Our data demonstrate that sarcoglycan loss was sufficient, and that dystrophin loss was not necessary to cause membrane defects and apoptosis. As a common molecular feature in a variety of muscular dystrophies, sarcoglycan loss is a likely mediator of pathology.     

An epidemiological needs assessment of carotid endarterectomy in an English health region. Is the need being met?

OBJECTIVE: To compare the level of provision of carotid endarterectomy (an intervention of proved efficacy for prevention of stroke in patients with symptomatic high grade carotid artery stenosis) with estimates of need. DESIGN: Comparison of regional, district, and age-sex specific operation rates derived from hospital episode statistics with estimates of need based on demographic and epidemiological data; interviews with regional vascular surgeons and a joint provider-purchaser workshop to discuss implications. SETTING: Former Wessex Regional Health Authority, 1991-2 to 1995-6. SUBJECTS: All residents covered by Wessex region treated for carotid artery reconstruction. MAIN OUTCOME MEASURES: Regional, district, and age-sex operation rates as three year average 1993-6 (use) compared with respective estimates of need for carotid endarterectomy among those who presented with symptomatic carotid disease-transient ischaemic attack or minor stroke. RESULTS: The operation rate more than doubled between 1991-2 and 1995-6, from 35 to 89 per million population, compared with an estimated level of need in the region's general population of 153 per million population (transient ischaemic attack 77, minor stroke 76). The ratio of use to need was 0.47 (95% confidence interval 0.4 to 0.54); district ratios were 0.28 (0.19-0.38) to 0.81 (0.62 to 1.06). The annual use:need ratio rose over the three years 1993-6 from 0.38 to 0.59. Use:need ratios were lower in elderly and female patients. Providers were keen to develop guidelines for referral and to increase access to diagnostic facilities; purchasers were more reluctant, given the limited impact of this intervention on the incidence of stroke and the relatively high cost of the operation. CONCLUSION: Although treatment rates increased in Wessex there is still unmet need. Further research is needed to determine the referral pathways of patients with symptomatic carotid disease for diagnosis and operation and to evaluate strategies to improve access to diagnostic facilities.     

Invasion genetics of the Mediterranean fruit fly: variation in multiple nuclear introns

Biological invasions generally start from low initial population sizes, leading to reduced genetic variation in nuclear and especially mitochondrial DNA. Consequently, genetic approaches for the study of invasion history and population structure are difficult. An extreme example is the Mediterranean fruit fly, Ceratitis capitata (Medfly), for which successive invasions during this century have resulted in a loss of 60% of ancestral genetic variation in isozymes and 75% of variation in mitochondrial DNA. Using Medflies as an example, we present a new approach to invasion genetics that measures DNA sequence variation within introns from multiple nuclear loci. These loci are so variable that even relatively recently founded Medfly populations within California and Hawaii retain ample genetic diversity. Invading populations have only lost 35% of the ancestral genetic variation. Intron variation will allow high-resolution genetic characterization of invading populations in both natural and managed systems, although non-equilibrium methods of analysis may be necessary if the genetic diversity represents sorting ancestral polymorphism.     

The effect of thermal mismatch on Z-pinned laminated composite structures

Z-pinning is a method of improving the through-thickness properties of composite laminates by inserting a solid pin through the laminate prior to curing. The thermal expansion mismatch between the Z-pin and base laminate produces large residual stresses during the cure cycle. Finite element modelling has shown that these stresses are greater than the failure stress of standard resin systems indicating the resin around the Z-pin should fail. This was confirmed through microscopy, which showed cracking around the perimeter of the Z-pin. Changing the material properties and dimension of the model to represent different Z-pinning situations could not significantly reduce the residual stresses, indicating cracking should occur in all Z-pinned laminates. These results show that probably all published Z-pinning properties have been obtained from laminates that would have exhibited cracking, indicating that the improved through-thickness properties are due more to mechanical interlocking than bonding. Questions are raised about the suitability of using Z-pinned laminates in specific applications, and the effects of increased moisture ingress and long term durability.     

Reappraisal of the role of vegetables in the vitamin A status of mothers in Central Java, Indonesia

Food-based approaches for controlling vitamin A deficiency and its consequences, such as increased mortality, more severe morbidity, and anemia, have become increasingly important, thus prompting a reassessment of the relation between vitamin A intake and status. A nutrition surveillance system in Central Java, Indonesia, assessed the vitamin A intake and serum retinol concentration of women with a child < or =24 mo old with a semiquantitative 24-h recall method that categorized vitamin A-containing foods into 3 categories of plant foods and into 2 categories of animal foods and identified portions as small, medium, or large. Median vitamin A intake was 335 retinol equivalents (RE)/d (n = 600) and vitamin A intake from plant foods was 8 times higher than from animal foods. Serum retinol concentration was related to vitamin A intake in a dose-response manner. The multiple logistic regression model for predicting the chance for a serum retinol concentration greater than the observed median (> or = 1.37 micromol/L) included physiologic factors, vitamin A intake from plant [odds ratio (95% CI) per quartile: 1st, 1.00: 2nd, 1.23 (0.75, 2.02); 3rd, 1.60 (0.97, 2.63); and 4th, 2.06 (1.25, 3.40)] and animal [1st and 2nd, 1.00; 3rd, 1.31 (0.86, 2.02); and 4th, 2.18 (1.40. 3.42)] foods, home gardening [(no, 1.00; yes, 1.71 (1.12, 2.60)], and woman's education level [< or =primary school, 1.00; > or =secondary school, 1.51 (1.02, 2.22)]. Despite the fact that plant foods contributed 8 times as much vitamin A as did animal foods, serum retinol concentrations did not reflect this large difference. Home gardening and woman's education level seemed to reflect longer-term consumption of vitamin A-rich plant and animal foods, respectively.